21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Family and Morale, Welfare, and Recreation Command FMWRC) Family and Morale, Welfare, and Recreation Command FMWRC) Redesigned Special Needs Accommodation Process (SNAP) Judy Eoff Redesigned Special Needs Accommodation Process (SNAP) Judy Eoff

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff SNAP Inter-Agency Process Team Team Members LTC Donna Upshaw-Combs, Army Public Health Nurse, Fort Riley MAJ Kathi Hill, Army Public Health Nurse, Fort Campbell Shirley Brown, FMWRC-Family Programs Judy Eoff, Exceptional Family Member Program Manager, Fort Lee Marcina George, FMWRC-CY Joann Hollandsworth, FMWRC-CY Dorene Jenkins, Outreach Services Director, CYS, Fort Bragg Beth McMillan, Community Health Nurse, Fort Huachuca Ann Schulte, Exceptional Family Member/FAP Manager, IMCOM NE Chris Welde, RCYET Team Chief, IMCOM-W Shirley Young, FMWRC-CY

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff GOAL: Streamline the SNAP Process Mission / Charge OUTCOMES: Standardized policies and procedures User friendly process Decrease barriers to care Timely access to care

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Defined Roles Installation EFMP Manager CER / Outreach Services Director CYS Coordinator / Designee Army Public Health Nurse Parent Augmentees

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Installation EFMP Manager Establish the SNAP Team as subcommittee of installation EFMP Committee Serve as SNAP chairperson and core member Schedule SNAP meetings and case reviews in a two-week period Notify all SNAP Team members about meeting agenda Ensure SNAP minutes are prepared, disseminated and filed Ensure all annual case reviews are tracked and completed Review and update annually the installation annex of the HQDA SNAP SOP in coordination with core members Make recommendations for special needs training for direct staff/providers, SNAP Team members, and parents Provide training resources/materials Refer parents/guardians to appropriate installation and/or community services Establish an installation SNAP Review Team; serve as member Keep command informed about difficult cases or complex issues

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff CER / Outreach Services Director Ensure Tool 1 is completed – initial screening; provide parent with the appropriate Medical Action Plan Explain SNAP process - Inform parent about the SNAP process Collect forms/Tools and forward to appropriate person Refer to specialist - CER Staff can talk the basics but once the parent discusses intimate details, then the parent could speak to the Outreach Services Director/Special Needs Director Identify to parent documents needed for SNAP review CER serves as the central repository for SNAP documentation –CER = one stop shop Documentation – input into CYMS and forwarded to relevant info and paperwork to assigned program Attend SNAP Recapture medical update and child information at re-registration or changes are indicated Parent that has not followed thru on documentation – pass can be expired in CYMS Transfer child data from losing Garrison to receiving Garrison Keep Chain of Command advised of any special needs cases as warranted

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Child & Youth Services Coordinator / Designee Adhere to the recommendation of the SNAP Ensure CYS Staff are trained related to Special Needs Quality Control for CYS SNAP administration responsibilities Keep Chain of Command advised of any special needs cases as warranted Ensures procedures are established for ensuring emergency intervention child care is established. Attend SNAP or appoint a designee Establishes an Installation annex for CYS to the Special Needs SOP Attend SNAP Cases for placement for complex cases

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Army Public Health Nurse Attend SNAP Review and validate medical documents – Pre-SNAP and on going Make referrals as appropriate for medical care; documents – follow up if clarification is needed Access medical records Documentation recommended in electronics medical records Special Needs training for direct care staff/parents Translate medical documents Approve and provide exceptions to policies on medication if indicated Serve as Health Consultant/ Quality control (assurance) for the entire SNAP Process – e.g. during inspections looking to see the process is working Forward appropriate forms to EFMP / CER Review Medical Action Plans for efficiency Case Management of EFMP/Special Needs/SNAP Children Keep Chain of Command advised of any special needs cases as warranted

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Parent Complete the forms/provide required docs. Attend SNAP and follow up meetings Follow-up with SNAP care plans/recommendations Liaison between the medical provider and the SNAP Team Communicate concerns to SNAP Provide authorized release of information to get services for child (HIPPA, Privacy Act, etc.) Advise SNAP team, direct care staff and program where child is attending of any changes to child’s condition/status Want parent to be a partner in the SNAP process Attend Training if applicable

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff AUGMENTEES Child &Youth Services Nurse Case Management Special needs training (meds, care) Administer medication – recue meds *(Not allowed at this time) Perform medical procedures within the scope of practice Attend the SNAP Review documentation in CYMS Maintain actions/documentation/Institute action plans and ensure action plans can function on a day-to-day basis Validate Medical Action Plan/Revalidate Plan – ongoing - to ensure child’s needs are met / monitor change in conditions Observations of children – re: Child behavior issues Quality control/Assurance (under the direction of the APHN and CYS Coordinator Keep Chain of Command advised of any special needs cases as warranted **

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Augmentees JAG Rep. SJA –(Advisor to the Commander on all legal issues) –Serve on the Review Team –Adjunct member on call to SNAP – on call Subject Matter Expert (SME) –Legal Advise related to DA Policy on Special Needs School Liaison Officer –Liaison to schools and other educational resources –Serve as a Resource to parent on school related to Special Needs issues –Partner with EFMP

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Forms Original Forms have gone from 8 pages to 3 Developed 4 Medical Action Plans (MAP) Benefits –Process of registration is streamlined –Increased ease of SNAP process –Standardized MAP staffed though OTSG for approval

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Forms Enrollment and Assessment Forms –Tool 1 (replaces & 7625 – 2) –Tool 2 (replaces 7625 – 3) Medical Action Plans –Asthma –Diabetes –Allergies –Seizures –Special Diet Plan

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Health Screening Tool 1

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Health Screening Tool 2

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Asthma Medical Action Plan

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Seizure Medical Action Plan

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Patron Completes CYS Army CYS Screening Tool 1 in CER Patron CYS Screening Tool Responses/Answers No Yes Register Enroll Place in CYS program Medical Action Plan Required Patron Takes Medical Action Plan To Provider and Returns To CER SNAP Required Register Enroll Place in CYS program YesNo Forward Tool 1 To APHN Reviews Tool 1, medical records, contacts patron, etc. Returns Tool to CER and EFMP No Yes Schedule for SNAP Conduct SNAP Meeting Complete Tool 2 Accommodation YesNo Place in CYS Program Send SNAP Tools to CER Forward SNAP Tool 2 and Medical Action Plan to Program Service site Provide Resource and Referral Services Maintain SNAP Tools in CER Provide Patron copy Tool 2 EFMP Manager CER APHN SNAP Flow Chart

21 July 2008Delores Johnson/IMWR-FP/(703) (DSN 761) / M.-A. Lucas/IMWR-CY/(703) (DSN 761) Judy Eoff Questions????