Identification of the Foster Care Population in the Pediatric Practice

1. Identification of the Foster Care Population in the Pediatric Practice Based on the Wilmington Health – Pediatrics experience

2. Disclaimer No source is 100% accurate. This is a “weeding out” process

3. Determine your practice parametersDoes your practice want to: • Follow patients in county of practice • Follow patients in surrounding counties • Follow patients in traditional foster placement • Follow patients in non-traditional foster placements (trial home placement, relative/kinship placement, non relative placement)

4. At the beginning of project, Wilmington Health – Pediatrics chose to follow patients in New Hanover County DSS custody in both traditional and non-traditional foster placements. Due to great demand, we’re currently establishing a protocol for Pender and Brunswick County DSS.

5. Identification of Current Patients – Getting started • Utilize Medicaid Portal Informatics Center to filter your practice data to reflect patients receiving HSF or IAS Medicaid. You can also filter per set practice parameters. (Be aware: This will also pull adoption subsidy patients. Also, this may not capture patients in DSS custody in non-foster/relative placement and receiving other forms of Medicaid) • Work is in process so IC will provide more accurate information

6. Identification of Current Patients • Obtain list from your DSS contact of children in foster care linked to your practice • Cross reference lists – this will aid in removing children who have been adopted and receiving IAS Medicaid as adoption assistance

7. Create a means to identify Foster Care Population in your practice • How will you know a child is in DSS custody? • Who is responsible for this task? • What will it look like in practice EMR?

8. Pop ups created in scheduling database to alert scheduling staff • High Priority Reminder created in EMR – with AAP Foster Care Standard of Care Schedule • V61.06 or V61.05 indicated in Problem List

9. Receiving New Foster Care Patients • Establish a referral protocol with DSS for children coming into DSS custody who are not linked with another provider or being transferred from another provider • Develop forms for the referral process as well as forms within practice appropriate to the foster care population

10. DSS Social Worker forwards DSS-5243 – Child Health Status Component, Foster Care PHI Authorization, and all available medical records • Chart created (updated for current patients), pop ups/reminders added • Appointment scheduled Current protocol for receiving new referrals

11. Patients seen per AAP’s Foster Care Standards of Care • Screening tools applied (PEDS, MCHAT, PSC) • Referrals made for specialty care/behavioral health • Physical form/Health Summary form generated to DSS social worker. Ongoing

12. 85 Foster Children served • Reduced Well Child Check delinquency rate from 21% (traditional) to 1 ½ % (foster care standards) • 74 Foster Care Well Child Checks completed • 21 Specialty referrals • Reduced ER visits – 5 ER visits in 3 months prior to program inception; 1 since Foster Care Coordination program highlights from 10/1/12 – 1/31/13

13. Questions?