4517. Health Care Services for Children In Out-Of-Home Care

Purpose 

Ensure children in out-of-home placement have an Initial Health Screen (IHS) to identify and address any emergent medical concerns at the time of placement. Children in out-of-home care must also have initial as well as on-going Early and Periodic Screening, Diagnosis and Treatment (EPSDT) and dental examinations to ensure their continued health and well-being.

Policy

  1. Children (birth to 18 years of age) entering out-of-home care must have an IHS within five calendar days by a qualified medical provider as quickly as possible to identify and address any medical concerns.
  2. Children (birth to 18 years of age) must receive an EPSDT examination within 30 days of entering out of home placement.
  3. Children in out of home placement (birth to age 3) must receive an EPSDT examination according to the published schedule for their age group. Children (age 3 to age 20) must receive at least an annual EPSDT examination.
  4. Children in out of home care must have an initial dental examination scheduled within the first 30 days of placement.Note: This does not apply to infants/toddlers without their first tooth eruption.
  5. Children in out of home placement must receive at least one dental examination every 6 months.

Procedures

Initial Health Screens (IHS):

  1. Ensure children who enter out-of-home placement receive an IHS by a qualified medical provider as soon as possible but no later than 5 calendar days.Note: Qualified medical providers include: Medical Doctor (MD), Advanced Registered Nurse Practitioner (ARNP), and Physicians Assistant (PA).
    Note: Medicaid provider availability in the regions may fluctuate and affect timeframes. Regional efforts to identify providers who complete the IHS should continue in order to maintain and build capacity.
  2. Ensure children see their last known medical provider whenever possible.Exceptions to requirement for IHS:
    1. Children released from a hospital (in-patient or Emergency) directly into out-of-home care.
    2. Children receiving services through a Pediatric Interim Care center (PIC).
    3. Children receiving services or scheduled to receive services through a Child Advocacy Center (CAC) or sexual assault clinic.
  3. Provide all known health information about the child to the caregiver(s) prior to the IHS.
  4. Share all known health information about the child with the medical provider who completes the IHS.
  5. Provide all information and recommendations from the IHS to the child's current caregiver(s) as per 4413 Placement Servicespolicy.
  6. Document the initial health screen information in the FamLink Health/Mental Health Pages under the "Health" tab and insert a new "Medical/Dental/Exam" within the required placement documentation timeframes as per Initial Placement and Moves 15400.
  7. Document the reason for an exception to a child receiving an IHS in a case note.

EPSDT Examinations:

  1. Ensure children in out-of-home placement receive EPSDT examinations according to the periodicity schedule below:
    1. Within 30 days of out-of-home placement
    2. Five examinations during a child's first year
    3. Three examinations for children between 1 and 2 years of age
    4. Annual examinations for children between 3 and 20 years of age
  2. Children entering out-of-home placement that received an EPSDT examination within 30 days before placement, do not need another EPSDT unless:
    1. Medically indicated, or
    2. There are allegations of abuse or maltreatment that require medical attention.
  3. Obtain a copy of the EPSDT results and determine if recommended treatments or follow-ups have occurred for the child.
  4. Provide the child's caregiver all EPSDT results and assist them with obtaining any recommended services for the child.
  5. Document child's health condition(s), the dates, and results of all EPSDT examinations including those that occur after the initial 30 day EPSDT. Document exams and health conditions in the FamLink Health/Mental Health Pages under the "Health" tab within the required placement documentation timeframes as per Initial Placement and Moves 15400.Note: CHET screeners will document the initial EPSDT examination date and results on the Health and Mental Health Pages in the electronic case file.
  6. Review and record the child's EPSDT information at Shared Planning Meetings and the report to the court.

Dental Examinations:

  1. Schedule the child's dental examination within 30 days of out-of-home placement.
  2. Children in out-of-home placement that received an initial dental assessment within 6 months before placement do not need another dental examination unless medically indicated.
  3. Obtain a copy of the dental exam and determine if recommended treatments and follow-ups have occurred for the child.
  4. Provide the child's caregiver all dental examination results and assist them in obtaining any recommended services for the child.
  5. Document the dates and results of all dental examinations in the FamLink Health/Mental Health Pages under the "Health" tab and insert a new "Medical/Dental/Exam" within the required placement documentation timeframes as per Initial Placement and Moves 15400.
  6. Review and record the child's dental information at Shared Planning Meetings and the report to the court.

Forms and Tools

Resources

  • Access to Baby and Child Dentistry (ABCDental) website (for children up to age six) - http://abcd-dental.org/
  • HRSA Fostering Well-Being Care Coordination Unit - 1-800-562-3022, ext. 59594 or dhsfwbccu@dshs.wa.gov
  • Well Child/Health Services Consent Card - DSHS 03-338 (5/2006)