1

WELCOME

TO HEALTHWORKS TRAINING: DCFS Mandated Healthcare

Services for Children in Foster Care

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INTRODUCTION DCFS Presenter HealthWorks Presenter Trainees

Please Interrupt anytime with Questions

Share your Views, Issues and Comments

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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

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MODULE 1 sf

GIVES AN OVERVIEW OF THE HEALTHCARE SERVICES THAT ARE

MANDATED BY DCFS SPECIFIC TIMEFRAMES FOR THESE

SERVICES TO BE COMPLETED

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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

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 (51,000-1997)

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

8

TIMEFRAMES WITHIN WHICH THESE HEALTHCARE SERVICES MUST BE

DONE

1. 24 HOURS: INITIAL HEALTH SCREENING (IHS): completed within 24 hours of custody for every “NEW” Custody case

2. 21 DAYS: COMPREHENSIVE HEALTH EVALUATION WITHIN 21 DAYS AFTER Temporary Custody

3. 45 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 :

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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

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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

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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

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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

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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

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MODULE 2 sf

This section is all about

Initial HealthScreening (IHS)

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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.

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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)

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WHAT FORMS MUST BE USED FOR AN INITIAL HEALTH

SCREENING EXAM - sf1. Encounter Form (sections 1-4

1. 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.

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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

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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: 2875 West 19th Street

8 other Sites for IHS in Cook County Cook County Children’s 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 51st Street Roseland Hospital: 45 W 111th Street Bethany Hospital: 3435 West Van Buren Street St. Alexius Medical Center: 1555 N Barrington Road

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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 (708-841-9738)

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

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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)

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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 800-228-6533 (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) 773-989-3450

NEEDED: Order for Temporary Custody or Guardianship from Court

Note(1): “Permanent” monthly Medical Card – not in the mail call Medical Card Hotline 800-228-6533

Note (2) Medical Card for children placed out-of-state. Contact Interstate Compact: 217-785-2680

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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

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MODULE 3

MODULE 3 IS ALL ABOUT

INTEGRATED ASSESSMENT: THE ILLINOIS MODEL

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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: 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.

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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

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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

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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:

a) ALL IHS Records with the CFS 655 from Investigatorb) The CFS 656 From Caseworkerc) 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

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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)

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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.

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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)

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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

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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)

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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

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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

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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

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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 800-25ABUSE )

1-800-KID-4345

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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

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EXPECTATIONS OF HEALTHWORKS’ CARE COORDINATORS

Repeat Slide 28

BEFORE THE CHE:  SLIDE 28

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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 BEIf 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

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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

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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, 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:

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 thisn < 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, 217-557-5796 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)

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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

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)

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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.

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BLANK

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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 800-226-

0768 (call for any healthcare provider) Call Doral Dental for closest dentist

888-286-2447 Call Vision Care for eye exams 800-

226-0768 Medical Card Hotline 800-228-6533

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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.

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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)

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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 (1-800-KID-4345 for New Custody Cases

4. Gather health info on CFS 655 (DCP) and CFS 656 (CW) & fax to HealthWorks

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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.

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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.

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IMPORTANT TELEPHONE NUMBERS

E R C (Shelter 810 W Montrose) 773-989-3450 HEALTHLINE (COOK) 800-KID-4345 HEALTHWORKS (phone) 708-841-5926 HEALTHWORKS (fax) 708-841-9738 MEDICAL CARD HOTLINE + 800-228-6533 OUT-OF-STATE MEDICAL CARD ^ 217-785-2680 DCFS CONSENT HOTLINE 800-828-2179 DORAL DENTAL 888-286-2447 IDPA HEALTH BENEFITS HOTLINE * 800-226- 0768 HEALTH SERVICES (SPRNGFLD) 217-557-2689 TEL HEALTH SERVICES (SPRNGFLD) 217-557-5796 FAX HEALTH SERVICES (CHICAGO) 312-814-5516/ 6976 DCFS NURSES 312-814-5693 DCFS AIDS PROJECT 312-328-2284-85 MEDICAL TRANSPORTATION LIAISONS NORTH REGION 773-866-5687 CENTRAL REGION: 773-584-2323 SOUTH REGION : 773-371-6139 ^ 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

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THE END

THANK YOU !

Revised 9-30-2005