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

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Presentation on theme: "1 WELCOME TO HEALTHWORKS TRAINING: DCFS Mandated Healthcare Services for Children in Foster Care."— Presentation transcript:

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

2 2 INTRODUCTION DCFS Presenter HealthWorks Presenter Trainees Please Interrupt anytime with Questions Share your Views, Issues and Comments

3 3 LEARNING OBJECTIVES : SOME OF THE TOPICS WELL 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 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 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

6 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 PCd; 53% in Cook are 0 to 5 years old 28 % are 6 to 12 years old 45.3% are 13 years and older

7 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 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 childs case file

8 8 TIMEFRAMES WITHIN WHICH THESE HEALTHCARE SERVICES MUST BE DONE HOURS: INITIAL HEALTH SCREENING (IHS): completed within 24 hours of custody for every NEW Custody case DAYS: COMPREHENSIVE HEALTH EVALUATION WITHIN 21 DAYS AFTER Temporary Custody DAYS: Enrollment with a HealthWorks Primary Care Physician (PCP) within 45 days of DCFS custody 4. ON-GOING : WELL CHILD EXAMS 1. Children under 2:(according to schedule based on good medical practice: 2. Children 2 and older: Annual physical, vision, hearing and dental 5. IMMUNIZATIONS (according to schedule :

9 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 10 THEN THERES 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 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 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 13 HANDOUTS sf 1. PART ONE OF THE HANDOUTS - IS THE SLIDE SHOW 1. 2 SLIDES TO A PAGE 2. SLIDE NUMBER BOTTOM RIGHT 2. PART TWO - COPIES OF HEALTHWORKS FORMS /DOCUMENTS 3. ALSO A LIST TELEPHONE NUMBERS YOU MIGHT FIND USEFUL

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

15 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 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 17 WHAT FORMS MUST BE USED FOR AN INITIAL HEALTH SCREENING EXAM - sf 1. Encounter Form (sections NB. Check Arrival/Departure time 2. 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 18 THE HEALTHLINE : 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 HWs 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 childs prior PCP if known

19 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 63 rd St and Lake Michigan ERC Maryville Clinic: 810 West Montrose St. Anthonys Hospital: 2875 West 19 th Street 8 other Sites for IHS in Cook County Cook County Childrens Hospital: 700 S Wood Street Mt. Sinai Hospital: 1500 S California Loretto Hospital: 645 South Central Avenue Michael Reese Hospital: 2929 S Ellis Ave Provident Hospital : 500 E 51 st Street Roseland Hospital: 45 W 111 th Street Bethany Hospital: 3435 West Van Buren Street St. Alexius Medical Center: 1555 N Barrington Road

20 20 DOCUMENTING THE IHS (IF ITS NOT DOCUMENTED, IT DIDNT 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. Dont Wait…more difficult when documents are sent to Medical Records Fax it to HealthWorks for their central file

21 21 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 childs case is opened or RE-OPENED. (Closed and reopened regardless of shortness of time in between it is a NEW custody cases)

22 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, childs 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:

23 23 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 24 MODULE 3 MODULE 3 IS ALL ABOUT INTEGRATED ASSESSMENT: THE ILLINOIS MODEL

25 25 INTEGRATED ASSESSMENT (IA) sf There are Three (3) phases of the Integrated Assessment Process (Illinois Model): 1. 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 2. 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. 3. 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: 3 rd 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.

26 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) WHATS NEEDED FOR CHE: CHILDS 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 27 THE PURPOSE OF THE COMPREHENSIVE HEALTH EVALUATION ? Every worker involved with any case must have the best understanding possible of all the childs needs/strengths: physical, mental, developmental, behavioral, (must take into account the childs and familys 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 28 THE EXPECTATIONS OF HEALTHWORKS CARE COORDINATORS (CC) (Lets 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 childs foster parent from the worker placing the child, in order to schedule the CHE. Health Information: a) ALL IHS Records with the CFS 655 from Investigator b) The CFS 656 From Caseworker c) All Known prior Medical Records from a Data Search (IDPA/ Cornerstone/ Birth Hospital/School) d) CC then Compiles these Records in the 7 page Comprehensive Health Profile for the CHE Provider e) The completed CHE package is then sent to CHE provider for review and completion

29 29 THE CHE & OUR EXPECTATIONS OF DCFS/POS WORKER WHAT DOES DCFS & HEALTHWORKS EXPECT FROM THE CASEWORKER? CANT STRESS ENOUGH THAT HealthWorks DEPENDS ON DCFS/POS WORKER for current information on childs 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 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 childs 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 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 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 Childrens 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 33 AND THESE ARE THE CHE SITES IN SUBURBAN COOK COUNTY SUBURBAN CHICAGO NORTHWEST: Lutheran General Childrens Hospital WEST: McNeil Family Practice SOUTH: Family Christian Health Center (Harvey), Aunt Marthas Community Health Center (Harvey), FAR SOUTH: Aunt Marthas Health Center (ChIcago Heights)

34 34 THE CHE & EXPECTATIONS OF HEALTHWORKS CARE COORDINATORS AFTER THE CHE : (Slide 44 ) HealthWorks Care Coordinators Role: Continues Case Management of each new child case for the first 45 days Continues collecting childs Health Documentation SENDS CHE DOCUMENTATION 1. TO THE CHILDS PRIMARY CARE PHYSICIAN: Copies of all CHE documentation 2. TO FOSTER PARENT: Copies of all CHE documentation, PLUS the Childs Health Passport 3. TO CASEWORKER: Copies of all CHE documentation, PLUS Childs 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 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 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 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 ) KID-4345

38 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 childs 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 & Childs 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 childs PCPs, CWs, SCGs

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

40 40 CHILDS 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 childs and familys health history; who tracks the childs 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 41 THE CHILDS HEALTH PASSPORT (HP) VERY IMPORTANT TOPIC: MOST SCG GET THE HP BUT DONT 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, childs 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 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 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 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 childs 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 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 45 MODULE 5 OTHER HEALTH ISSUES

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

47 47 SCHOOL HEALTH REQUIREMENTS n Illinois schools have their own health requirements – and children can be excluded from school if they are not current with shots and health exams n 1. IMMUNIZATION, PHYSICAL, & DENTAL. IL law requires children entering K, 5 th and 9 th 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, 2 nd, 6 th grades to have dental exam by a licensed dentist prior to May 15 th. DCFS Health Services reminds POS and DCFS workers each year of this SCHOOL requirement so our DCFS children are not excluded from school

48 48 DCFS SCHEDULE FOR ALL ON-GOING WELL CHILD EXAMS: n (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 n < 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 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)

50 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

51 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 childs 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 childs growth and development. Detect and address health problems before they become serious. Keep child healthy

52 52 TRANSPORTATION : ACCESS TO HEALTHCARE SERVICES: sf POS/DCFS CW Can Call Regional Medical Liaisons for Transportation to Doctors 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 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 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 54 WE HAVE SAID THIS BEFORE : FOSTER PARENT ARE HEALTHWORKS CRITICAL PARTNER HealthWorks needs childs current placement information: Foster Parents 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 55 BLANK

56 56 IDPA HEALTH BENEFITS HOTLINE (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 57 HIPAA: HEALTH RECORDS & FEDERAL LAW sf The Health Insurance Portability and Accountability Act of 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 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 59 SUMMARY (a) sf DCFS/POS Workers MUST comply with ALL DCFS Health Policies and Mandated Healthcare Services in a timely manner 1. IHS Within 24 Hrs for ALL New Custody Cases 2. ALWAYS call HealthWorks with current placement information when you place a child. 3. ALWAYS call the Healthline to arrange for and IHS ( KID-4345 for New Custody Cases 4. Gather health info on CFS 655 (DCP) and CFS 656 (CW) & fax to HealthWorks

60 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. 7. Documentation – HealthWorks keeps a CENTRAL HEALTH FILE for each Child, needs to get copies of ALL Health Records.

61 61 SUMMARY (c) 8. 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. 9. 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 62 IMPORTANT TELEPHONE NUMBERS E R C (Shelter 810 W Montrose) HEALTHLINE (COOK) 800-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 63 THE END THANK YOU ! Revised


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