CHDP Director/Deputy Director Training Section VII 7/1/2010 Health Care Program for Children in Foster Care (HCPCFC)

History 7/1/2010

History The trauma of family separation and frequent moves for foster children compound serious health conditions. Given this fact, foster children require more health services than other children, which they often fail to receive due to inadequate medical records and limited access to care. 7/1/2010

History Code Blue: Health Services for Children in Foster Care (1998) 4 Code Blue: Health Services for Children in Foster Care (1998) Report by the California Foster Care (FC) Children’s Task Force: foster care children typically suffer serious health, emotional, and developmental problems and the causes of these conditions are multiple. Recommendations of the Task Force included: develop a system of health care for children in FC, improve coordination and delivery of services in counties, and hire FC Public Health Nurses (PHNs). 7/1/2010

Program Legislation 7/1/2010

Program Legislation State Budget Act of 1999 6 State Budget Act of 1999 Appropriated State General Funds (GF) to the California Department of Social Services (CDSS) for the purpose of increasing the use of PHNs in meeting the health care needs of children in foster care. 7/1/2010

Program Legislation Assembly Bill 1111 (1999) 7 Assembly Bill 1111 (1999) Enabling legislation for the Health Care Program for Children in Foster Care (HCPCFC). It defined the components of the program and added to the Welfare and Institutions (W&I) Code, Section 16501.3(a) through (e). 7/1/2010

Program Letter 8 8 7/1/2010

Child Health and Disability Prevention (CHDP) Program Letter 9 CHDP Program Letter (PL) No. 99-6 (10/21/99) Describes the HCPCFC (as provided for by the State Budget Act of 1999 and the W&I Code sec. 16501.3). It states that funds to CDSS will be transferred to the Department of Health Services (DHS), CMS Branch, and will be distributed through the CHDP program in the form of an augmentation to the local CHDP program allocation. CDSS and DHS developed a Memorandum of Understanding (MOU) to ensure the availability of federal matching funds, which are available only to DHS as the single agency (for Medicaid). 7/1/2010

Program Description 10 HCPCFC is administered through the local public health department CHDP programs to provide public health nursing expertise in meeting the medical, dental, mental and developmental health needs of children and youth in court-ordered out-of-home placement, or foster care. FC PHN’s worksite should be in the Social Services office. The PHN works in tandem with the child’s social worker or probation officer to ensure the needed health care resources are provided. Documentation in the Health and Education Passport (HEP) Participation in interdisciplinary team conferences Serves in an administrative capacity, linking the child to vital community resources 7/1/2010

Program Implementation Tools 11 Legislation Memorandum of Understanding (MOU) Health Services Social Services Probation Scope of Work (SOW) PHN Duty Statement HCPCFC Resource Guide 7/1/2010

Legislative Mandates 12 FC Nurses must be PHNs and must be housed within Social Services Purpose: enhance physical, mental, dental, & developmental well being of foster children Serves as liaison with health care professionals Collaborates with Social Services/Probation workers to coordinate health care services Services provided must be limited to Title XIX mandates (NO Direct Care) 7/1/2010

MOU 13 13 7/1/2010

MOU 14 Probation Social Services CHDP CHDP provides program oversight of activities of PHN working with Social Services and Probation Social Services provides work-space for PHN Probation works collaboratively with CHDP/Social Services within MOU 7/1/2010

PHN Responsibilities 15 15 7/1/2010

Responsibility of PHN in MOU/SOW 16 Accessing Resources Identify & liaise with health care providers in the community Serve as resource & facilitate referrals Assist in out-of-county placement referrals Health Care Planning & Coordination Collaborate with the Social Worker (SW)/Probation Officer (PO) to develop a health plan for each child expected to remain in out of home placement Interpret health care reports Obtain & provide medical input for the HEP 7/1/2010

Responsibility of PHN in MOU/SOW 17 Training/Orientation Provide in-services for Social Services/Probation staff & foster care community Policy/Procedure Development Participate in multi-disciplinary meetings for review of health-related issues Transition from Foster Care Assist foster child & SW with community health care resources & final HEP update Quality Assurance Participate in joint reviews, evaluation process & data development 7/1/2010

HCPCFC PHN vs. Social Services - funded PHN 18 HCPCFC PHN limited to perform duties as specified within the MOU “No Direct Care” Social Services PHN may perform duties as specified by their funding source 7/1/2010

PM 160 Process 19 19 7/1/2010

PM 160 Process PM 160 comes to CHDP from the provider’s office 20 PM 160 comes to CHDP from the provider’s office PM 160 Goes To Foster Care PHN Assure all documentation is in the child’s HEP PHN reviews PM 160 and collaborates with SW, Medical Provider, Substitute Care Provider, utilizing resources; makes appropriate referral 7/1/2010

References 21 21 7/1/2010

References Code Blue HCPCFC CHDP CMS http://www.dhcs.ca.gov/formsandpubs/publications/Documents/CMS/C odeBlue.pdf HCPCFC http://www.dhcs.ca.gov/services/ hcpcfc/Pages/ResourceGuide.aspx/ CHDP http://www.dhcs.ca.gov/services/chdp/Pages/default.aspx CMS http://www.dhcs.ca.gov/services/Pages/CMS.aspx 7/1/2010

Public Health Nurse Resources PHN Directory http://www.dhcs.ca.gov/services/HCPCFC/Documents/ HCPCFCDirectory.pdf Regional Meeting Calendar http://www.dhcs.ca.gov/services/HCPCFC/Pages/Event s.aspx Web Resources and Publications http://www.dhcs.ca.gov/services/HCPCFC/Pages/WebR esources.aspx 7/1/2010

Contact Information 24 Nurse Consultant III CDHCS/Children's Medical Services Health Care Program for Children in Foster Care 1515 K Street, Suite 400 P. O. Box 997413, MS 8100 Sacramento, CA 95899-7413 (916) 327-1400 7/1/2010