1. WELCOME HEALTHWORKS TRAINING:TO
HEALTHWORKS TRAINING:
DCFS Mandated Healthcare Services for Children in Foster Care

2. INTRODUCTION DCFS Presenter HealthWorks Presenter Trainees
Please Interrupt anytime with Questions
Share your Views, Issues and Comments
QUESTIONS: HOW MANY OF YOU ARE DCP?
HOW MANY OF YOU ARE FOLLOW UP?
HOW MANY OF YOU ARE PRIVATE AGENCY WORKERS?
HOW MANY OF YOU ARE WORKERS FROM OUTSIDE OF COOK?

3. LEARNING OBJECTIVES: SOME OF THE TOPICS WE’LL COVER
WE HOPE THAT EVERYONE WILL LEAVE WITH A BETTER UNDERSTANDING OF
1. All the Healthcare Services Mandated for Children in DCFS care and the specific Timeframes for these Services
2. How to Access these HealthCare Services
3. The crucial role that Caseworkers and Caregivers play in the healthcare process
4. HealthWorks and how (HW) can be a valuable asset to caseworkers – help is only a phone call away
5. The important role that HW CARE COORDINATORS play in DCFS Healthcare System – in the initial 45 days of a case
6. Lastly, (where the buck stops) who is ultimately responsible for insuring that children get timely and appropriate Healthcare services?. It is the caseworker of course who is ultimately responsible

4. MODULE 1 sf GIVES AN OVERVIEW OF THE HEALTHCARE SERVICES THAT ARE
MANDATED BY DCFS
SPECIFIC TIMEFRAMES FOR THESE SERVICES TO BE COMPLETED

5. HEALTHWORKS IS A PARTNERSHIP
Almost every thing that we talk about today is going to be in one way or another about “HEALTHWORKS”
(1) HealthWorks, first and foremost is a partnership.
HealthWorks Is the lead partner – in an association
With Hospitals, clinics, doctors, who serve our children
With caseworkers & With foster parents
(2) This Partnership is about insuring Access
to ALL DCFS Children
for ALL DCFS Required Healthcare Services
(3) This Partnership is also about DOCUMENTATION: A CRUCIAL RESPONSIBILITY OF HEALTHWORKS.
DCFS needs to know if children have in fact received the necessary health services to insure their well being
More about documentation later slide 38
WHAT DO YOU THINK I AM TALKING ABOUT WHEN I SAY “HEALTHWORKS” ?
Back in 1986 when I started working for DCFS, no one used the word “ HealthWorks”
Children came into DCFS care, we placed them in a foster home and gave the SCG the temporary medical card. And that was the beginning and end of HealthCare for that child unless the child got sick. There was no Initial Health Exam, there was no comprehensive Health Exam. There was no annual physical, vision, hearing, dental etc.

6. HOW CHILDREN COME INTO DCFS CARE: sf
(1) Through Protective Custody (PC)
By the police
By DCP/Investigator
By a physician
(2) Custody by means other than Protective Custody
(a) Temporary Custody or Guardianship given by a Juvenile Court judge (w/o PC being taken)
(b) Disrupted Guardianship or Adoption cases
(c) Dependency and Voluntary Placement Agreement cases
There were 17,772 Children in DCFS care 7/2505 (51, )
Monthly about 180 kids are PC’d; 53% in Cook
26.75 are 0 to 5 years old
28 % are 6 to 12 years old
45.3% are 13 years and older
Any Investigators in the class? Or on call downstate caseworkers who can take custody?
You will hear all kinds of Legal Terminology: PC = Protective Custody… Who can take Protective Custody??
TC= Temporary Custody
How does DCFS get Temporary Custody??
How long does an investigator have to obtain Temporary Custody?
TC: TR= Temporary Custody with rights to Major Medical
TC: TW= Temporary Custody without rights to Major Medical
Some Statistics:
There were 17,772 Children in DCFS care 7/2505 (51, )
Monthly about 180 kids are PC’d; 53% in Cook
26.75 are 0 to 5 years old
28 % are 6 to 12 years old
45.3% are 13 years and older

7. WHICH ARE THE HEALTHCARE SERVICES MANDATED BY DCFS? sf
1. An Initial Health Screening (IHS)
2. A Comprehensive Health Evaluation (CHE)
3. Enrollment with a HW Primary Care Physician
4. Age-appropriate Well Child Exams and Immunizations
5. Annual Health, Vision and Hearing, screen from age 3 to 21
6. Oral/Dental exam from age two (2)
7. All Referrals to Specialty & follow up services
8. Also mandated, Documentation of health services in HW central file and child’s case file
1 to 3 Some mandated Services are because of the ACLU suit and resulting Consent Decree…In 1994, as part of the Consent Decree HealthWorks was implemented to provide Health Services CONSISTENT WITH pediatric standards ser forth by Feds in EPSDT.
4 to 6 : Because many of the health Services are paid for through the Medicare Program they must comply with EPSDT Guidelines. Early and Periodic Screening, Diagnostic and Treatment = special program of preventative and comprehensive health services designed to provide early discovery and treatment of health problems of children In Illinois EPSDT = The Healthy Kids program

8. TIMEFRAMES WITHIN WHICH THESE HEALTHCARE SERVICES MUST BE DONE
24 HOURS: INITIAL HEALTH SCREENING (IHS): completed within 24 hours of custody for every “NEW” Custody case
21 DAYS: COMPREHENSIVE HEALTH EVALUATION WITHIN 21 DAYS AFTER Temporary Custody
45 DAYS: Enrollment with a HealthWorks Primary Care Physician (PCP) within 45 days of DCFS custody
ON-GOING : WELL CHILD EXAMS
Children under 2:(according to schedule based on good medical practice:
Children 2 and older: Annual physical, vision, hearing and dental
IMMUNIZATIONS
(according to schedule :
24 Hours: Consent Decree ACLU
21 Days: Consent Decree… 21 Calendar Days
45 days:
On-Going well child exams: These exams are schedule by Am Ac of Ped
Annual exams: DCFS Policy
Immunization:

9. WHY ALL THESE HEALTHCARE SERVICES FOR CHILDREN IN FOSTERCARE? sf
(FIRST REASON)
Children in foster care are uniquely disadvantaged
Are more likely to have a high rate of acute and chronic health problems
May have had prenatal exposure to drugs and alcohol and all the related medical problems
more likely to have developmental delays & behavioral problems.
DCFS as surrogate parent has the obligation to provide for the well being of children in care

10. THEN THERE’S THE BH CONSENT DECREE sf
(SECOND REASON)
Lawsuit filed by the American Civil Liberties Union (ACLU) on behalf of children in DCFS care
To raise the standard of care across-the-board (including HealthCare) for children in foster care
Consent Decree laid out certain standards of Health Care that DCFS agreed had to be met
Because of this Consent Decree, DCFS has to insure that children get adequate, timely and professional HealthCare Services

11. DCFS DIVISION OF SERVICE INTERVENTION: HEALTH SERVICES sf
HEALTH SERVICES is an office within DCFS (not to be confused with “HealthWorks”)
HW is a private organization- the partnership of hospitals/doctors we spoke about earlier:
DCFS Office of HEALTH SERVICES IS responsible
For developing health policies
For monitoring HealthWorks to make sure it meets all the expectations and responsibilities as laid out in its contract with DCFS
For providing assistance to ALL (POS/DCFS) Caseworkers in matters of HealthCare
For providing consultation through DCFS Nurses for children with complex medical conditions

12. ACCESS TO HEALTH CARE: THE PURPOSE OF HEALTHWORKS aka LEAD AGENCIES
To make Health Services a reality for DCFS children
DCFS implemented HealthWorks (HW) Program in September of 1993
HW was To address barriers that prevented DCFS children from receiving Healthcare services.
Barriers were:
Lack of Access to HealthCare Services
Lack of Access to To Qualified professional providers
Lack of Documentation of HealthCare Services that were provided.
Physicians in HW network have to meet professional standards
Board certified in Pediatrics, Family Practice, Internal Medicine, Obstetrics-Gynecology
They have also agreed to document HealthCare services by completing DCFS Health forms and returning them to HealthWorks
Repeat in slide 36

13. HANDOUTS sf PART ONE OF THE HANDOUTS - IS THE SLIDE SHOW
2 SLIDES TO A PAGE
SLIDE NUMBER BOTTOM RIGHT
PART TWO - COPIES OF HEALTHWORKS FORMS /DOCUMENTS
ALSO A LIST TELEPHONE NUMBERS YOU MIGHT FIND USEFUL

14. MODULE 2 sf
This section is all about
Initial HealthScreening (IHS)

15. WHAT IS AN IHS & WHY IS IT NEEDED?
An IHS is an Unclothed physical examination for every child coming into DCFS custody
IHS - To assess the health needs of the child requiring immediate attention
To check for any infectious disease
To look for any signs of abuse or neglect
To make an informed decision about appropriate placement.
IHS should be done preferably PRIOR to placement.

16. WHAT IS THE TIMEFRAME FOR AN INITIAL HEALTH-SCREENING EXAM (IHS) sf
IHS must be done within 24 hours whenever there is a NEW CUSTODY case 
(1) Protective Custody By DCP, By police, By a physician
(2) Custody by means other than Protective Custody:
e.g.. Temporary Custody or Guardianship (without PC being taken
Reopening a closed case without regard to the shortness of time between closing and reopening
(e.g. Child is returned home, but custody taken again the following day)

17. WHAT FORMS MUST BE USED FOR AN INITIAL HEALTH SCREENING EXAM - sf
Encounter Form (sections 1-4
NB. Check Arrival/Departure time
Consent for Ordinary and Routine Medical and Dental Care (for examination & for Release of information
LOOK AT BACK OF THIS FORM.
LIST OF 8 RISK FACTORS WHICH IF ANY PRESENT, DCFS REQUIRES THE CHILD TO BE TESTED FOR HIV.
If any child on your caseload falls within these guidelines & has not been tested for HIV; child should be tested
YOU DO NOT NEED A NY OTHER SPECIAL CONSENT FORM FOR HIV TEST. THIS FORM IS SUFFICIENT.
3. LOOK AT DIFFERENT “CONSENT FOR THE RELEASE OF INFORMATION” FORM (P 39)
4. Temporary Medical Card
5. NEW: CFS: 655 Initial Child Health History Form  
DCP is to gather as much health information as possible on taking Protective Custody of a child and take this info to IHS.

18. THE HEALTHLINE: 1-800-KID-4345
In COOK County:
In all NEW CUSTODY cases, the HealthLine must be called to arrange an Initial HealthScreening exam.
Why call The HealthLine? The Health Line operator will help
To select an IHS site
To arrange for an IHS
To inform HealthWorks of new custody case
So HW’s Care Coordinator can begin data search of prior medical records and begin Interim Case management for the first 45 days
Outside of Cook County
Caseworker usually calls the HealthCare Provider that DCFS has relationship with OR child’s prior PCP if known

19. ACCESS TO THE INITIAL HEALTHSCREENING EXAM:
INITIAL HEALTHSCREENING SHOULD BE AT ONE OF THE SITES BELOW:
Because HealthWorks has an Agreement with IHS Sites:
(1) IHS completed within one hour of arrival
(2) use of DCFS forms supplied by Healthworks
(3) copy of IHS to Case Worker & copy is sent to HealthWorks
3 Preferred Sites for IHS Cook County
LaRabida Hospital: East 63rd St and Lake Michigan
ERC Maryville Clinic: 810 West Montrose
St. Anthony’s Hospital: West 19th Street
8 other Sites for IHS in Cook County
Cook County Children’s Hospital: 700 S Wood Street
Mt. Sinai Hospital: S California
Loretto Hospital: 645 South Central Avenue
Michael Reese Hospital: S Ellis Ave
Provident Hospital : 500 E 51st Street
Roseland Hospital: 45 W 111th Street
Bethany Hospital: West Van Buren Street
St. Alexius Medical Center: 1555 N Barrington Road

20. DOCUMENTING THE IHS
(IF IT’S NOT DOCUMENTED, IT DIDN’T HAPPEN!) The documentation of health services is of critical importance.
IN COOK COUNTY: The IHS Provider & the DCFS/POS Worker FAXES ALL IHS RECORDS TO HEALTHWORKS ( )
When Police take PC; or PC is taken of a hospitalized child: The Hospital Discharge Exam IS the equivalent of an IHS.
Get at the time of Discharge. Don’t Wait…more difficult when documents are sent to Medical Records
Fax it to HealthWorks for their central file

21. WHOSE RESPONSIBILITY IS IT TO HAVE THE IHS DONE?
EXPECTATIONS OF THE DCFS/POS WORKER FOR INITIAL HEALTH SCREENING EXAM? sf
WHOSE RESPONSIBILITY IS IT TO HAVE THE IHS DONE?
DCP is responsible for IHS when they take PC
Follow-up/Permanency Worker is responsible for having the Initial Health Screening Exam done:
In an INTACT/DISRUPT Case
When Judge gives DCFS Temporary Custody or Guardianship w/o PC being taken
Each time a child’s case is opened or RE-OPENED. (Closed and reopened regardless of shortness of time in between it is a NEW custody cases)
CASE ASSIGNMENT PROTOCOL
1.     Private Agencies shall not accept HMR cases directly from DCFS employees other than CAPU staff.
2.     Private Agencies shall not accept traditional foster care cases directly from DCFS employees other than CAPU staff
3.     A placement team is not responsible for case management services until it is contacted by CAPU
4.     CASE ASSIGNMENT PAYMENT UNIT must always be sent a packet of info when a new child case is either opened when PC is taken; or when a case is to be screened for court intervention. Only CAPU cam assign a case
5.      
6.     When a new SCR report results in placement of additional children on active cases open to DCFS teams,
a.     the DCFS follow up worker is responsible for Health Screens, the placement of children and the provision of the Medicaid card.
b.    When the need for placement arises after hours and on weekends or holidays the DCP worker is responsible for these activities (p. 20)
7.     When a new SCR reports result in placement of additional children on active cases open to private agencies,
a.     the DCP worker is responsible for health screens, the placement of children and the provision of Medical cards.
b.    DCP is responsible for placing the child after working hours.
8.      
9.     Intact to Placement Cases: (without DCP involvement)
a.     The screening worker (CPS or POS) prepares the screening documents
b.    A packet is routed immediately to CAPU
c.     CAPU will offer the case to the team that served the intact family
d.    Screener is responsible for IHS etc.
10. Intact to Placement Cases: (DCP involvement) When DCP takes PC of children involved with child protection services/intact cases (CPS), DCP must inform CAPU immediately for assignment and placement. Only CAPU can assign a case. A placement team is not responsible for case management services until it is contacted by CAPU
a.     c CPS Intact Worker responsibilities (p 50)
b.    Contact the HealthLine to schedule an IHS
c.     Fill out the portions of the Encounter Form
d.    Provide the Medicaid card
e.     Complete the Family Assessment Worksheet CFS 1440
11. Placement Worker responsibilities:
a.     Among other responsibilities
b.    Instruct the SCG to call the Healthline to schedule CHE
c.     Select a PCP
12.  
New Cases - assigned only by CAPU not by other DCFS employees
a.     When PC is taken: Prior to placing a child in a foster home, DCP must have completed an IHS, have a temporary medical card to give the SCG. If a traditional agency is receiving the case at PC the agency should meet DCP at IHS exam and then transport the child to SCG

22. POS WORKERS & ACCESS TO MEDICAL CARDS sf
HOW DOES POS WORKER GET A “TEMPORARY” MEDICAL CARD?
During Business Hours:
CALL the DCFS Liaison for your agency.
Call Medical Card Hotline (9am – 4p) They will fax a letter w official letterhead, child’s name, ID, IDPA number and eligibility date.
After Hours (also weekends, emergencies):
Call ERC (Emergency Shelter)
NEEDED: Order for Temporary Custody or Guardianship from Court
Note(1): “Permanent” monthly Medical Card – not in the mail call Medical Card Hotline
Note (2) Medical Card for children placed out-of-state. Contact Interstate Compact:
To get out of state Medical Card (1) call INTERSTATE COMPACT-Carolyn Gephardt for Medical Card out of state
(2) call Payment Unit

23. WHAT DCFS EXPECTS OF EVERY WORKER WHO PLACING A CHILD IN a Foster Home
WHAT DCFS EXPECTS OF EVERY WORKER WHO PLACING A CHILD IN a Foster Home? (with SCG) sf
WE EXPECT CASEWORKERS TO -
1. GIVE SCG copies of ALL the IHS Documentation
2. Make SCG aware of any Health Issues, Medication, Medical Equipment child needs
3. Give copy of Asthma Action Plan if child is Asthmatic & Study Home environment for Asthma triggers
4. VERY IMPORTANT: CASEWORKER MUST CALL & INFORM HEALTHWORKS WHERE THE CHILD IS BEING PLACED: NAME, ADDRESS AND ESPECIALLY A CURRENT TELEPHONE NUMBER OF FOSTER PARENT
5. Inform Foster Parent to call and cooperate with HealthWorks: The bottom line is that HW needs to get in touch with SCG As Soon As Possible
To schedule the Comprehensive Health Evaluation in 21 days ( calendar days: If HW unable to contact SCG = lost time)
To assist in selection of Primary Care Physician (PCP) for the child

24. MODULE 3 INTEGRATED ASSESSMENT: THE ILLINOIS MODEL
MODULE 3 IS ALL ABOUT
INTEGRATED ASSESSMENT: THE ILLINOIS MODEL

25. INTEGRATED ASSESSMENT (IA) sf
There are Three (3) phases of the Integrated Assessment Process (Illinois Model):
FIRST PHASE: Initial Assessment of DCP - Prior to case opening, DCP collects info related to immediate safety, ongoing potential of risk and ends with transitional visit. CPSW does same for child welfare cases/ no PC cases
SECOND PHASE: A Clinical Screener and Caseworker have joint interviews with child. Parents, SCG resulting in Integrated Assessment Report (IAR) – basis for Service Plan. (w/i 45 days of placement.
THIRD PHASE: ALL the on-going assessments by CPSW: collecting, analysing info > updating IAR and >497 until the case is closed.
WHICH CASES ARE TARGETED FOR INTEGRATED ASSESSMENT?
All standard Cases –new placement cases – no addon; no disrupted intact cases
(Trigger Cases) Multiple Placement Disruption: 3rd placement in foster home or HMR after 2 placements in 18 months
So I/A Process provides CPSW with front end assistance for coordinating all info & used to identify strengths and needs of child and family systems. It is the basis for 497.
Integrated Assessment Report: drafted in 30 days by clinical screener. CW, Supervisor, Clinical Screener review report: Findings, recommendations/services best suited to address child’s needs, prognosis for permanency; begin to develop with family Comprehensive Service Plan. Family Meeting on day 40. I/A report and Client Service Plan presented to Juv. Court day 45

26. WHAT IS A COMPREHENSIVE HEALTH EVALUATION (CHE)?
CHE EXAM MUST BE “COMPREHENSIVE”: IT INCLUDES
A physical exam, A vision, and hearing screen (3 yrs and older) and oral health screening (2 yrs and older) Asthma Screen
Lab tests: TB, anemia, lead, sickle cell, urinalysis, HIV test per DCFS guidelines ( if no prior test)
Clinical screener & CW must complete a behavioral or mental health interview with child, SCG and parent
Integrated Assessment Report drafted by Clinical Screener (= Social History)
WHAT’S NEEDED FOR CHE: CHILD’S PRIOR MEDICAL HISTORY
(CFS 656) Child and Family Health History by the DCFS/ POS worker and faxed to HealthWorks 5 days prior to CHE
The 7 page Comprehensive Health Profile: a compiled by HW from all the prior health records HW found: (birth history, immunization records; school health records) for CHE provider to review and complete  at time of CHE 
The CHE MUST BE completed in 21 Calendar Days from TC

27. THE PURPOSE OF THE COMPREHENSIVE HEALTH EVALUATION ?
Every worker involved with any case must have the best understanding possible of all the child’s needs/strengths: physical, mental, developmental, behavioral, (must take into account the child’s and family’s strengths)
Those needs/strengths must then be addressed by putting in place the most appropriate services for this child and family in the Client Service Plan (497)
The hope is with a better understanding of the needs and strengths, the child/family will be better served, there will be less placement disruption, and child will be better prepared to adapt successfully after return home or after emancipation

28. THE EXPECTATIONS OF HEALTHWORKS’ CARE COORDINATORS (CC)
(Let’s talk about what DCFS expects of some key actors CC; CW; & SCG)
HW Care Coordinators (CC) work every case for the first 45 days
BEFORE THE CHE: 
To do their job HW C C NEEDS
current information about the child’s foster parent from the worker placing the child, in order to schedule the CHE.
Health Information:
ALL IHS Records with the CFS 655 from Investigator
The CFS 656 From Caseworker
All Known prior Medical Records from a Data Search (IDPA/ Cornerstone/ Birth Hospital/School)
CC then Compiles these Records in the 7 page “Comprehensive Health Profile” for the CHE Provider
The completed CHE package is then sent to CHE provider for review and completion

29. THE CHE & OUR EXPECTATIONS OF DCFS/POS WORKER
WHAT DOES DCFS & HEALTHWORKS EXPECT FROM THE CASEWORKER?
CAN’T STRESS ENOUGH THAT HealthWorks DEPENDS ON DCFS/POS WORKER for current information on child’s placement in order to schedule the CHE and assists the Foster Parent (SCG) In selecting PCP
Inform SCG to call/cooperate with Healthworks
Fill out Child and Family Health History CFS 656 and fax it to HealthWorks 5 days prior to CHE
Caseworker is to attend the CHE
Encourage SCG to and to keep scheduled appointments and be on time (if appt missed?)
Encourage Bio-parent to be present at the CHE (if there are no safety factors)
Provide transportation for SCG if necessary
(Slide 43 repeat)

30. THE CHE & OUR EXPECTATIONS OF FOSTER PARENT
WE EXPECT THE FOSTER PARENT:
To cooperate with HealthWorks
To get in touch with Healthworks ASAP
To cooperate in scheduling the Comprehensive Health Evaluation
To select Primary Care Physician (SCG id free to pick the doctor of their choice as the child’s PCP)
To be on time for the CHE
To bring the temporary medical card
By all means let HealthWorks know ASAP if they are going to miss the appointment.

31. ACCESS TO THE COMPREHENSIVE HEALTH EVALUATION
WHO CONTROLS ACCESS TO CHE EXAMS?
Only HealthWorks can schedule the CHE.
CHE must now be done only at one of 15 selected CHE sites
Who should be present at the CHE?
1. Foster Parent
2. Case worker (IS expected to participate in the CHE)
3. Bio parent is also expected to participate in the CHE (If Safety is NOT a factor)

32. THESE ARE THE CHE SITES IN THE CITY OF CHICAGO
NORTH: Ravenswood Professional Medical Group
NORTHWEST: Prime Care Community Health – Northwest (Northwest Family Health Center)
WEST: Lawndale Christian Health Center (3860 W. Ogden)
Farragut Community Academy ( 2345 S. Christiana)
Lawndale HC (Homan Square)
SOUTH: La Rabida Children’s Hospital
SOUTHEAST: Chicago Family Health Center (CFHC)
SOUTHWEST: Holy Cross
FAR SOUTH: Chicago Family Health Center (Roseland)
NORTH: Ravenswood Professional Group
NORTHWEST: Prime Care Northwest

33. AND THESE ARE THE CHE SITES IN SUBURBAN COOK COUNTY
SUBURBAN CHICAGO
NORTHWEST: Lutheran General Children’s Hospital
WEST: McNeil Family Practice
SOUTH: Family Christian Health Center (Harvey),
Aunt Martha’s Community Health Center (Harvey),
FAR SOUTH: Aunt Martha’s Health Center (ChIcago Heights)

34. THE CHE & EXPECTATIONS OF HEALTHWORKS’ CARE COORDINATORS
AFTER THE CHE: (Slide 44 )
HealthWorks Care Coordinator’s Role:
Continues Case Management of each new child case for the first 45 days
Continues collecting child’s Health Documentation
SENDS CHE DOCUMENTATION
1. TO THE CHILD’S PRIMARY CARE PHYSICIAN: Copies of all CHE documentation
2. TO FOSTER PARENT: Copies of all CHE documentation, PLUS the Child’s Health Passport
3. TO CASEWORKER: Copies of all CHE documentation, PLUS Child’s Health Passport
And In addition to all of the above
the CW also gets the Child Health Summary (Part 3 of CFS 497) for the First ACR

35. MODULE 4 (REPEAT OF SLIDE 12) HEALTHWORKS
1. Partner with HealthCare Network Providers: Doctors, Hospitals,Clinics who agree to complete DCFS forms
1993 HW designed to address
Lack of access to healthcare services
Lack of access to qualified providers
Lack of receipt of documentation of healthcare services
LEAD AGENCY:?? At the head of, the one that coordinates, runs the network
Physicians have to meet the standard of IDPA “Healthy Kids Program” aka Maternal and Child Health Primary Care Program. ( Illinois Department of Healthcare and Family Services HFS ) In addition they must be
Board certified either in Pediatrics, Family Practice, Internal Medicine, Obstetrics-Gynecology
HW is also Partner with Caseworkers and with Foster Parent

36. HEALTHWORKS: IS STATEWIDE
DCFS Developed its own network of Healthcare Services
LEAD AGENCIES: Coordinate this whole network
1.  HEALTHWORKS IN COOK COUNTY: Healthcare Consortium of Illinois (HCI ) Is the One Lead Agency Supported by:
A NETWORK OF HOSPITALS, CLINICS, DOCTORS PRIMARY CARE PHYSICIANS (PCP)
IHS SITES
COMPREHENSIVE HEALTH EVALUATION (CHE): 12 CHE Sites
2. HEALTHWORKS OUTSIDE OF COOK COUNTY:
PUBLIC HEALTH DEPARTMENTS IN 18 COUNTIES
1 PRIVATE ORGANIZATION

37. HEALTHWORKS AND THE HEALTHLINE:
(Repeat of slide 18)
24 HOUR TELEPHONE THAT CASEWORKERS TO MAKE AN APPOINTMENT FOR AN INITIAL HEALTHSCREENING EXAM
( NOT TO BE CONFUSED WITH CHILD ABUSE HOTLINE ABUSE )
1-800-KID-4345

38. THE IMPORTANCE OF DOCUMENTATION
DOCUMENTATION: A CRUCIAL RESPONSIBILITY OF HEALTHWORKS.
(1) The documentation of health services is of critical importance in determining if children have in fact received the necessary services to insure their well being
(2) HW is required to maintain a central file of every child’s health information. This will happen only with the cooperation of Healthcare providers, Caseworkers and Foster Parents.
(3) Therefore, IHS, CHE, Well child visits, ETC. MUST ALL be documented and HW must collect this documentation
(4) DCFS Health Forms & Child’s Health Passport MUST be used by PCPs
(5) Finally HW not only has to collect documentation
(2) But also has to provide Health Info for CHEs, has to share it with the child’s PCPs, CWs, SCGs

39. EXPECTATIONS OF HEALTHWORKS’ CARE COORDINATORS
Repeat Slide 28
BEFORE THE CHE:  SLIDE 28

40. CHILD’S ENROLLMENT IN HEALTHWORKS PCP sf
45 DAYS: Enrollment IN HW: means identifying or selecting a HealthWorks Primary Care Physician (PCP) for each child.
Enrollment should be within the first 45 days of DCFS custody
Benefits of PCP:
1. CONTINUITY OF SERVICE: Using the same doctor who knows the child’s and family’s health history; who tracks the child’s health services (shots, problems,meds); checks the child’ s growth and development; makes referrals.
2. PROFESSIONAl services
3. DCFS HEALTH forms ARE UTILIZED
4. COMPLETED documentation sent to Healthworks .
HealthWorks can assist in selecting A PCP in the Network.
NOTE: THE CHILD OR FOSTER PARENT HAS THE RIGHT TO CHOOSE WHO THE PCP WILL BE
If Out-of-Network Doctors is selected he/she should be encouraged to become part of the HealthWorks Network(10 days from identification – 90 days to complete)
DCFS Expectation: at least 90% enrolled. Data shows about 94.6% actually enrolled in Cook County (June 2005)

41. THE CHILD’S HEALTH PASSPORT (HP)
VERY IMPORTANT TOPIC: MOST SCG GET THE HP BUT DON’T KNOW WHAT TO DO WITH IT!
1. THE HP Is initiated by HealthWorks after the Comprehensive Health Evaluation-
HP is meant to be a Compilation of : Family Health history, child’s birth history, age appropriate exams, hospitalizations, surgeries, medications, medical problems, immunization history, IHS,CHE, PCP name/phone,
2. HP Is an up-to-date snapshot of child health information so any medical provider will have in hand a health summary of any child they have to examine
3. CW should Remind Substitute Caregiver that H P Needs to be taken to and updated at every medical exam by HW Network PCP
4. Medical Card & Health Passport GO WITH CHILD TO ANY NEW PLACEMENT 
5. Caseworker CAN get an updated copy of Health Passport for ACR from HW or SCG

42. HEALTHWORKS – A SUMMARY
1. HW To Maintain the HealthLine 24 hrs a day
2. Provide Care Coordination Services for first 45 days
3. To Schedule CHE at Selected Provider Sites
4. To assist Foster Parent in selection of PCP within 45 days
5. To Assign cases to MCM agencies for ages 0-5 & pregnant and parenting teens and their children 0-5
6. To Initiate and update Health Passport
7. COLLECT & MAINTAIN HEALTH DOCUMENTATION IN CENTRAL HEALTH FILES & ENTER HEALTH DATA IN THE DCFS HEALTHCARE INFORMATION SYSTEM (HCIS) FOR EACH CHILD IN DCFS CARE
8. PROVIDE HEALTH DOCUMENTATION: to PCP, SCG; & send all health related documents including the Child Health Summary (Pt 3 of 497) TO CASEWORKER.
9. To Enlist, credential, re-credential, and monitor network of HealthWorks’ Primary Care Physicians
10. To Provide training in DCFS mandated Healthcare Services to POS/DCFS/ personnel & HealthCare Providers

43. WHAT HEALTHWORKS EXPECTS OF DCFS/POS WORKERS sf
(Repeat of Slide 29 above- WORTH REPEATING)
HW ASKS ALL CASEWORKERS TO:
1. Inform HealthWorks where the Child is being place: Name, Address, Telephone of Foster Parent
2. Inform Foster Parent to call and cooperate with HealthWorks for CHE scheduling and PCP Selection
3. Share Health Info with Foster Parent
4. Gather ALL child’s Health Information (CFS 656).
5. Fax to HealthWorks 5 Days Prior to CHE
6. Be present at the CHE
7. Provide Transportation if needed
8. Encourage Bio Parent to attend
9. Arrive on Time

44. WHAT CASEWORKERS CAN EXPECTS FROM HEALTHWORKS
(Repeat of Slide 34 above)
1. HealthWorks sends to CASE WORKER a copy of the CHE and ALL the Health-related documents within 7 Days of CHE.
2. HealthWorks prepares a Health Summary after the CHE which helps CW in completing the Health Summary for Client Service Plan (497)
3. Keeps Central File of Health Records for each child
4. HealthWorks initiates and updates the Health Passport after CHE
5. Caseworkers can also obtain current copy of Passport and child immunization records from HealthWorks for ACR
(Slide 34 above)

45. MODULE 5
OTHER HEALTH ISSUES

46. ONGOING HEALTHCARE SERVICES
DCFS MANDATED ONGOING HEALTHCARE SERVICES
SCHOOL HEALTH REQUIREMENTS

47. SCHOOL HEALTH REQUIREMENTS
Illinois schools have their own health requirements – and children can be excluded from school if they are not current with shots and health exams
1. IMMUNIZATION, PHYSICAL, & DENTAL.
IL law requires children entering K, 5th and 9th grades be current with immunizations and have a current physical exam
The form used to document this school requirement is the CFS 600- The Certificate of Child Health Examination
The original copy of CFS 600 goes to school nurse
2. (NEW IL LAW: Starting July 1, 2005 IL law requires all children in any K, 2nd, 6th grades to have dental exam by a licensed dentist prior to May 15th.
DCFS Health Services reminds POS and DCFS workers each year of this SCHOOL requirement so our DCFS children are not excluded from school

48. DCFS SCHEDULE FOR ALL ON-GOING WELL CHILD EXAMS:
(Well child visits help to keep a child healthy, help detect and address problems before they become serious )
< AGE 1: AT 1, 2, 4, 6, 9 MTHS
AGE 1 TO 2 YRS AT 12,15, & 18 MTHS
AGES 2 TO 21 Annual Physical and Dental
AGES 3-21 Vision and Hearing Annually
HealthWorks needs all this
< AGE 1: AT 2 WKS
documentation
Remind Foster Parent to comply with schedule of immunization & well child visits
Assist SCG with transportation if necessary

49. ASTHMA MANAGEMENT sf
Asthma can be a life-threatening condition THAT AFFECTS BETWEEN 12 AND 25% OF DCFS CHILDREN
BUT WITH PROPER CARE ASTHMA CAN BE CONTROLLED
At time of PC, DCP is to ask caretaker if child has any health issues, (allergies, asthma, respiratory problems)
For child diagnosed with Asthma: CFS 690 & CFS 691 MUST BE COMPLETED
FAX CFS 691 TO HEALTH POLICY, Springfield
ASTHMA ACTION PLAN (AAP) (CFS 690)
Share Copies of AAP: with SCG, HealthWorks, case file
When placing a child with SCG: DCFS/POS Worker MUST check for Asthma triggers before placing child in foster home ( animal dander, cockroaches, cigarette smoke)
Reinforce with SCG the seriousness of Asthma
Refer serious cases of Asthma to DCFS nurse: ( serious case = 2 Emergency Room visits for Asthma in a year OR one hospitalization for Asthma in a year)
For children taking Asthma medication in school, they are permitted to carry their asthma medication with them and use it while in school; school sponsored activitity; under supervision of school personnel; after school activities.
To meet requirements of school code for self administration
Written authoriation for self administration
Written statement from child’s PCP with
Name of medication
Dosage
Times or circumstances under which it must be taken/administered

50. APORS: ADVERSE PREGNANCY OUTCOME REPORTING SYSTEM sf
1. Illinois law - Regarding children born with medically complex conditions: substance exposed infants (sei), low birth weight <3.5 lbs, blood disorders, serious congenital infections, fetal alcohol syndrome, discharge from icu
2. Birth Hospitals are required to report these cases to IDPH, Local Public Health Depts. (CDPH, and CCDPH)
3. IL law mandates Nursing Services for Medically Complex Children (0-2 Years of Age)
4. APORS children 0-2 years are cared for by Nurses from Chicago Department of Public Health or Cook County Department of Public Health (2 MCMA)
5. Nurses visit, make assessments, assist families with access to appropriate services
6. These 2 MCMA also assist Caseworkers with the Health Summary for Client Service Plan
7. DCFS/POS WORKERS MUST CALL DCFS nurses for consultation on ALL medically complex cases
8. SEI INFANTS: IL law & DCFS Policy On HIV testing for SEI infants. AIDS PROJECT REFERRAL; CONFIDENTIALITY; DOCUMENTATION
In our presentation we usually just mention APORS. This is just to make case managers aware of the Illinois Law and the other players involved with a special group of children ages 0 to 3.
APORS stands for Adverse Pregnancy Outcome Reporting System which is mandated by Illinois Law. Illinois Department of Public Health requires all hospitals to report to Chicago Department of Public Health, Cook County Department of Public Health or other local Health Departments (depending on where the child lives) all newborns with complex medical conditions. Babies with serious congenital issues, children born substance exposed or showing signs of withdrawal, with very low birth weight, with blood disorders just to name a few.
Nurses from Chicago Department of Health or Cook County Health Department follow these children until age two. They visit the homes, make assessments, help with parental instruction and assist in obtaining resources . These nurses know the needs of these children and understand what services are needed. So for children in DCFS care who belong to this group, the nurses can assist your case workers or case managers with part 3 - Health Summary section of the Client Service Plan

51. WHY DCFS REQUIRES ONGOING HEALTHCARE SERVICES?
Dental/Oral Health: Children need regular dental care starting at age 2 or earlier: to prevent problems with gums, teeth, mouth. This should be part of annual physical exam and is a DCFS requirement. .
Hearing/Vision screen: to identify children who may have a visual or hearing problem. These often go unnoticed until a child develops significant educational and/or medical problems.
Immunizations: One of the best ways to protect a child’s health is with immunizations. Not adequately immunized a child may suffer from illnesses, a lifetime of disability, or even death.
Annual Physical: Important to track child’s growth and development. Detect and address health problems before they become serious. Keep child healthy

52. TRANSPORTATION : ACCESS TO HEALTHCARE SERVICES: sf
POS/DCFS CW Can Call Regional Medical Liaisons for Transportation to Doctor’s Appointments.
RML will call First Transit to get an approval number
Approval number is given to Transportation Service (registered with First Transit)
As of April 04, you can call RML only for transportation to Medical visits, (not for therapy sessions or counseling)
RMLs need to be called about a week ahead of time.
Telephone # for Regional Medical Liaisons

53. HW IN PARTNERSHIP WITH MEDICAL CASE MANAGEMENT AGENCIES
1. Medical Case Management Agencies provide services for DCFS children age 0-5; for all APORS children (0-2) and for Pregnant or parenting Wards and their children (0-5)
2. There are seven (7) MCM Agencies including CDPH, and CCDPH
3. CDPH & CCDPH use Public Health Nurses who provide In-Home Assessments, Parental Instruction for APORS Infants until age 0-2
4. CCDPH And Five (5) MCM Agencies serve children ages 0-5:
Facilitate access to follow-up with Primary Health Care, and Specialty Services (For Wards 0-5; and children of parenting wards 0-5)
Assure that each Ward (0-5) in their care has a Health Care Plan for Inclusion in Client Service Plan.
HealthWorks sends CW the very first child Health Summary after CHE (part 3 of 497)
MCM sends caseworker subsequent Health Summary for part 3 of Client Service Plan
. MCMA Update Cornerstone database (Immunization, EPSDT Exams)

54. WE HAVE SAID THIS BEFORE : FOSTER PARENT ARE HEALTHWORKS’ CRITICAL PARTNER
HealthWorks needs child’s current placement information: Foster Parent’s current phone number and address
HealthWorks needs the COOPERATION of the Foster Parent
HW & DCFS/POS workers depends on SCG to schedule the CHE, to follow Immunization & DCFS Well Child Visit Schedules.
HealthWorks asks SCG to take Passport to every medical visit and get the Passport Updated by the Doctor
HealthWorks needs to obtain all current health documentation.

55. BLANK

56. IDPA HEALTH BENEFITS HOTLINE 800-226-0768
(different from printed copy)
Ready to assist with finding specialty medical services if needed
IDPA HEALTH BENEFITS HOTLINE (call for any healthcare provider)
Call Doral Dental for closest dentist
Call Vision Care for eye exams
Medical Card Hotline

57. HIPAA: HEALTH RECORDS & FEDERAL LAW sf
The Health Insurance Portability and Accountability Act of 1996.
A Federal Statute designed to protect confidentiality of health information; to restrict disclosure of health information to the minimum necessary.
Penalties for non-compliance
 There are new Consent Forms signed by the DCFS Guardian which are HIPAA Compliant .
Over and above Consent For the Release of Information, you might be asked to provide proof that a child is a ward of the State: Send the provider a Dispositional Order : either for Temporary Custody or for Guardianship.

58. HEALTH RECORDS NEEDED FOR ADMINISTRATIVE CASE REVIEWS sf
1. Health Passport:
Foster Parent will have the most current updated copy of HP
Healthworks can now electronically update the Health Passport. (HealthWorks depend on SCG and CW for most current health information)
2. CFS 497 Client Service Plan: Child Health Summary
3. Age Appropriate Forms CFS 652 F-T
4. CFS 600 Certificate of Child Health Examination
5. Up-to-date immunization record (Cornerstone report accepted)
6. Current annual health exam (AGE 2-21)
7. Current annual vision /hearing (AGE 3-21)
8. Current annual dental/oral exam (AGE 2-21)

59. SUMMARY (a) sf
DCFS/POS Workers MUST comply with ALL DCFS Health Policies and Mandated Healthcare Services in a timely manner
IHS Within 24 Hrs for ALL New Custody Cases
ALWAYS call HealthWorks with current placement information when you place a child.
ALWAYS call the Healthline to arrange for and IHS (1-800-KID-4345 for New Custody Cases
Gather health info on CFS 655 (DCP) and CFS 656 (CW) & fax to HealthWorks

60. SUMMARY (b)
5. Assist HW & SCG in scheduling Comprehensive Health Evaluation within 21 Days of Temporary Custody (TC)
6. CW, SCG need to participate in CHE. Bio Parent also to participate when safety is not an issue.
Documentation – HealthWorks keeps a CENTRAL HEALTH FILE for each Child, needs to get copies of ALL Health Records.

61. SUMMARY (c)
Healthworks provides Caseworker with ALL Health related documentation after the CHE. CW also gets Child Health Summary Part 3 for inclusion into your Client Service Plan.
Partnership & Cooperation: HealthWorks, Caseworker, Foster Parent, PCP form a partnership for accessing Healthcare services for DCFS Children
10. Ultimately, the Caseworker is responsible for compliance with ALL DCFS Health Services in a timely manner.

62. IMPORTANT TELEPHONE NUMBERS
E R C (Shelter 810 W Montrose)
HEALTHLINE (COOK) KID-4345
HEALTHWORKS (phone)
HEALTHWORKS (fax)
MEDICAL CARD HOTLINE
OUT-OF-STATE MEDICAL CARD ^
DCFS CONSENT HOTLINE
DORAL DENTAL
IDPA HEALTH BENEFITS HOTLINE *
HEALTH SERVICES (SPRNGFLD) TEL
HEALTH SERVICES (SPRNGFLD) FAX
HEALTH SERVICES (CHICAGO) / 6976
DCFS NURSES
DCFS AIDS PROJECT
MEDICAL TRANSPORTATION LIAISONS
NORTH REGION
CENTRAL REGION:
SOUTH REGION :
^ When children placed out-of-state need medical card of that state
* Call this number to find a medical doctor/specialist who take medical card

63. THE END
THANK YOU !
Revised