CHDP Director/Deputy Director Training Section VII

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

2. History

3. 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.

4. History 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).

5. Program Legislation

6. Program Legislation 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. Program Legislation 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).

8. Program Letter 8 8

9. 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).

10. 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 administrativecapacity, linking the child to vital community resources

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

12. 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)

13. MOU 13 13

14. CHDP provides programoversightof activities of PHN working with Social Services and Probation Social Services provides work-space for PHN Probation works collaboratively withCHDP/Social Services within MOU Probation CHDP Social Services MOU 14

15. PHN Responsibilities 15 15

16. 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

17. Responsibility of PHN in MOU/SOW 17 Training/Orientation • Provide in-services for Social Services/Probation staff & foster care community Policy/ProcedureDevelopment • 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

18. 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

19. PM 160 Process 19 19

20. PM 160 Process 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

21. References 21 21

22. References • Code Blue • http://www.dhcs.ca.gov/formsandpubs/publications/Documents/CMS/CodeBlue.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

23. 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/Events.aspx • Web Resources and Publications • http://www.dhcs.ca.gov/services/HCPCFC/Pages/WebResources.aspx

24. 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