Preventive Health Care Services Must Be Up to Date

State regulations require documentation that the child has received vaccines and screening tests according to the recommendations of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Any document (including an electronic printout from the child's medical record) that provides this information is acceptable. The Office of Child Development and Early Learning (OCDEL) offers a form that allows health care providers to say whether the child is up to date, the CD 51. This Child Health Report form was last revised in 2008. It does not require the dates and results of the recommended screening tests. It has a check box to indicate "yes" or "no" that the child has received all the recommended screenings. The only screening information it requests is the results of any abnormal vision, hearing or lead screening. These are important, but not all the screenings that assess whether a child is healthy and ready to learn. 

In addition to vaccines, children need age-appropriate screening for vision, hearing, lead, anemia, oral health, growth and development. In many busy pediatric offices, someone other than a doctor or nurse practitioner fills out routine health forms. Then they stamp the physician's signature or pass the form to the health professional to sign. Few people who fill out the forms check the child's office record with the nationally recommended schedule of services. Independent audits of medical office records find too many children do not receive all of their screenings and vaccines.

Increasingly, health care providers are using electronic medical records (EMRs). The EMR can produce a computer printout that contains vaccine dates and the results of screenings. Doctors want the EMR to check whether the child is up to date status. At this point, not all do. Best practice in early education and child care is for early educators to check a record of the dates and results of all recommended screenings and the dates for vaccines to be sure there are no gaps in what the child should have received. To help early educators do this more easily, ECELS offers internet accessible software to programs that enroll at least 25 children. This software is called WellCareTracker™ and is found at www.wellcaretracker.org. This software tests the dates of preventive services and gives reports that early educators can use to be sure every child is up to date when the child starts coming to the program and stays up to date while enrolled.

Early educators can partner with parents and health professionals to be sure children receive needed services. Look at children's health records to see if any child missed a routine service or has a special need. Ask the families to arrange for needed catch-up services. For children with special needs, neither the CD 51 nor the EMR printout alone is sufficient to plan daily care. ECELS has a form to help caregivers get information to support their care of children with special needs. These may be medical, behavioral or developmental concerns. Download this form and the explanation of each item on the form. Use these tools to be sure children are healthy and benefit as much as possible from your program Reviewed and reaffirmed 5-2019