1. 3 in 30 Committee for Advancing Residential Practice January 11, 2018
Liz Kromrei, CPS Director of Services

3. New: 3-Day Medical Exam
All youth entering foster care will receive the 3-day medical exam (unless they have to receive emergency/urgent medical care) because it is in the best interest of children and youth entering DFPS conservatorship.

4. What is the 3-Day Exam?
The 3-day medical exam is an additional exam.
It DOES NOT replace the Texas Health Steps (THSteps) medical checkup or the Child and Adolescent Needs and Strengths (CANS) Assessment.

5. What is the 3-Day Exam?
It is a medical screening for each child within 3 business days of the removal.
Children and youth MAY NOT receive vaccinations at the 3-day exam unless the medical professional determines that a tetanus vaccination is necessary or parental consent is obtained.

6. Implementation Schedule for 3-Day Exam
Time Period
Percentage of removals (FY2017)
Regions
1 - April 1, 2018
26%
1, 9, 10, 7 (note: Lubbock County is already implemented)
2 – June 1, 2018
23.9%
2, 3E, 3W
3 – August 1, 2018
25.3%
4, 5, 6A, 6B
4 – October 1, 2018
24.7%
8, 11

7. Step 3: Removal caseworker assures transportation to appointment.
Caseworker Protocol
Step 1: Removal worker (INV/CPS) determines which level of medical care needed. (If emergency care is needed, that is obtained instead of the 3-Day Medical Exam.
Step 2: Removal worker (INV/CPS) arranges for 3 day medical exam appointment by scheduling or ensuring an appointment.
Step 3: Removal caseworker assures transportation to appointment.

8. Step 4: Clinic provides medical care.
Caseworker Protocol
Step 4: Clinic provides medical care.
Step 5: Upon completion of the medical exam, recommended follow up is done (including scheduling CANS and THSteps).
Step 6: DFPS assigned worker documents the medical exam in IMPACT (Child’s SUB stage) and ensures required follow up is scheduled.

9. Timing of Components Requirement Timeline 3-Day Initial Medical Exam
Within 3 business days of removal
Texas Health Steps Medical Check-Up
Within 30 days of removal and then based on periodicity schedule
Child and Adolescent Strengths and Needs Assessment (CANS)
Within 30 days of removal and then annually thereafter.

10. Who conducts the 3-Day Exam?
A Physician (MD or DO) or other Health Care Provider (HCP) may complete the initial 3-day medical exam.
To locate a provider, See STAR Health:
or Call STAR Health Member Services
for assistance finding a provider:

11. Required Paperwork for 3-Day Exam
The removal worker should provide the adult who will be attending and transporting for the 3-day exam with:
A fully signed and authorized
Medical Consent Form 2085-B, and
2. A copy of the removal affidavit, if filed. If not yet filed, the removal worker should provide information about reasons for the child’s removal directly to the medical professional.

12. Medicaid Eligibility Questions
With few exceptions, children in CPS conservatorship are covered by STAR Health Medicaid as soon as they come into care.
The fully signed and authorized
Medical Consent Form 2085-B provides proof that the child is covered by Medicaid due to the removal and must be accepted by STAR Health contractors (medical providers, pharmacists, etc.)

13. Medicaid Eligibility Questions
For assistance with any eligibility issues
Call STAR Health Member Services
AND/OR
Contact your regional Well-Being Specialist.
See CPS Medical Services:

14. How does 3 in 30 help with service planning?
3 in 30 promotes communication between CPS, STAR Health, caregivers, medical and behavioral health providers
Using Health Passport, caseworkers use 3 in 30 information for informing the court, service planning, permanency conferences, and placement changes.
Health Passport is accessible by medical consenters, foster parents, CASAs, medical and behavioral health providers

15. Questions? Feedback?
What do you need from us to implement the 3-Day Medical Exam?
Liz with input, further questions:
THANK YOU!!!