Child Health Team Coordinator Packet COORDINATOR TRAINING PACKET

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Gertrude Terry
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1 COORDINATOR TRAINING PACKET CCN Child Health Team Revised August

2 Contents SECTION ONE The Role of the Coordinator... 3 SECTION TWO Before, During, and After Meetings... 4 SECTION THREE Forms and Documents: A Reference List... 5 SECTION FOUR Submitting Forms to OCCYSHN... 9 SECTION FIVE Tips for the Coordinator

3 The Role of the Coordinator For your reference, the standards specific to the coordinator s role are as follows: The CCN Child Health Team Coordinator will provide administrative support to the team. He or she will: a. Coordinate Child Health Team meetings, including administrative tasks related to team operations, pre-meeting day logistics, meeting day activities, and post-visit follow up. b. Communicate with families of children referred to the Child Health Team to coordinate and implement child/family visits. c. Create comprehensive files for children referred to the Child Health Team in line with Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA) requirements. Files include records from medicine, education and community-based services. d. Disseminate reports and shared care plans appropriately and communicate with community partners as needed to ensure effective team meetings and coordination of care. e. Find referrals to the Child Health Team through marketing and networking. f. Coordinate shared care plan tracking with the Parent Partner. g. Submit program data forms to OCCYSHN and facilitate data collection, as requested by OCCYSHN, e.g. program evaluations, etc. h. Participate in CCN Child Health Team learning opportunities provided by OCCYSHN. The complete CCN Child Health Team Standards can be found here. 3

4 Before, During, and After Meetings Remember, there are two types of meetings, the Child/Family Visit and the Team Meeting. These are most commonly held back-to-back. BEFORE o When a referral is received and a child or their family will be seen, or will be the subject of a meeting, contact family to check on interest and availability to attend a Child/Family Visit meeting o If there is interest, add the child s name to the CCN Roster o Identify and reserve meeting space o Send notice of meeting to CCN Child Health Team members o Obtain a parent-signed CCN Release of Information (ROI) form; add providers to form if needed based on information obtained from the referral packet o Fax ROI to primary care provider to request medical records o Fax ROI to school and other organizations to request records o Create a chart or file for each child s medical, school, and other records o Provide the chart to CCN team physician or team medical provider one week prior to child visit/meeting o Contact family to confirm date, time and location of child visit/meeting o Provide family contact information to Parent Partner at least one week prior to meeting o The Pre-Meeting Checklist provides a helpful one-page document of the needed steps DURING o Ask meeting participants to sign Confidentiality Attendance Roster o Complete Shared Care Plan during the Child/Family Visit o Give copies of the Shared Care Plan to the family (at end of meeting) o Make notes regarding the process, dates, and team decisions AFTER o Complete the Shared Care Plan Tracking Tool and give copy to Parent Partner o Fax completed Child Visit Data Form(s) to OCCYSHN within 1 week of meetings o Fax completed Team Activity Data Form to OCCYSHN within 1 week of meetings o Distribute Child s Shared Care Plan to family (if they have not already received it), Primary Care Provider, and other meeting participants 4

5 Forms and Documents: A Reference List There are many documents and forms designed to support the CCN Child Health Team. The list below is designed as a brief reference for the coordinator. All forms can be accessed in the Toolbox or directly at this link. Help with specific forms can be found in the Help with Forms section in the Toolbox. BEFORE MEETINGS: 1. The Parent Referral Packet. This packet will be sent to families. It needs to be filled out and returned. Please see the last section for a list of included items. 2. CCN Child Roster: An on-going Excel document used to track children seen by the team and the status of the Shared Care Plan. No names are ever removed from this list. This form is a template that can be saved as a document on your hard drive and filled out during the meeting. 3. Appointment Confirmation Letter This reminder can be used to confirm with parents along with a phone call. 4. Pre-Meeting Checklist This is a handy form to keep track of referral packet information and other needed steps prior to a Child/Family Visit. 5. Label to Affix to CCN Records This checklist can be attached to the child s file to organize and track documents. 6. Physician Sample Letter and Summary Form A cover letter introducing CCN Child Health Teams to a child s physician and asking for the attached form to be returned. 7. Teacher Sample Letter and Summary Form 5

6 A cover letter introducing CCN Child Health Teams to a child s teacher and asking for the attached form to be returned. DURING MEETINGS: 1. CCN Shared Care Plan Used to coordinate care and responsibilities and filled out with input from the team and family during a Child/Family Visit. This form is a template that can be saved as a document on your hard drive and filled out during the meeting. 2. Confidentiality Attendance Roster All participants must sign at each meeting. AFTER THE MEETING: 1. CCN Data Codes This reference list contains the codes needed to complete the CCN Care Plan Tracking Tool WTR# column and the Child Visit Data form. 2. CCN Care Plan Tracking Tool This form is used by the Parent Partner to track the recommendations on the Shared Care Plan. It is also updated as each recommendation is completed. This form is a template that can be saved as a document on your hard drive and filled out during the meeting. 3. CCN Child Visit Data Form The form must be filled out for each child for whom a Shared Care Plan is created (or if the child is scheduled and the family is absent) and sent to OCCYSHN within a week of the meeting. 4. CCN Team Activity Data Form This important form is used by OCCSYHN to document the overall activities of the team. It is also used to initiate reimbursement for the team physician. It must be sent to OCCYSHN within a week of the meeting. 5. CCN Child/Family Visit Facilitation Guide: 6

7 The coordinator can use this reference guide to ensure important conversations occur while leading and facilitating a Child/Family Visit. 6. CCN Team Meeting Facilitation Guide: This one-page reference can help the coordinator include all the important steps needed for a successful team meeting. YEARLY DOCUMENTS: 1. Annual Confidentiality Statement: This needs to be read and signed by each team member in September of each year. The forms should be filed and stored by the coordinator on site. REFERRAL PACKET: Below you will find a list of the forms typically included in the referral packet given to families. The CCN Release of Information (ROI) is required and should not be altered. When returned, the forms should be placed in a confidential file and stored at your site. Sample Letter to Parents A letter of introduction to the family. Please update with your team s information CCN Release of Information Form Authorization for Release and Exchange of Information or ROI). This must be used. List of Providers A form used by families to list health or medical providers used in the last year. Health Questionnaire To help the family consider other needs the child may have. 7

8 Patient Contact Information Form Basic patient information. Parent Summary Form To help the family express any areas of concern and describe the strengths of their child. Letter to Parents (Sample Template) Please update with your team s information. Referral Packet Cover May be stapled on the packet when sent to parents. OHSU Release of Information (Authorization to use Protected Information) This is ONLY USED if records are requested from OHSU clinics or doctors. 8

9 Submitting Forms to OCCYSHN The Coordinator is responsible for faxing or otherwise securely sending the following forms to OCCYSHN: Child Visit Data Form submit one week after meetings Team Activity Data Form submit one week after meetings Child Roster submit entire history in January and June Shared Care Plan Tracking Tool as soon as it is closed 9

10 Tips for the Coordinator Here are some thoughts and suggestions to help streamline the process. Many of these ideas have been gathered from other coordinators. The Confidentiality Attendance Roster During the Child/Family Visit, an extra step can be avoided by using the last page of the Shared Care Plan as a confidentiality and attendance roster. In this case, each person should initial and print their name. The WTR # column on the Shared Care Plan It is not necessary to complete the WTR # column during the meeting. The codes can be looked up and added after the meeting. The Data Codes The document listing codes is two pages. Page 1 is for the Child/Visit Data form. Page 2 lists the WTR # codes. (WTR = Why This Referral) Consider speaking with your Professional Adjunct or other team members about the most appropriate codes to select. The CCN Child Roster Your predecessor will have begun the CCN Child Roster. Save the document in a location you can access and continue to add names. No names are ever removed from this document. Enter the child s name on CCN Child Roster after you receive the release of information. If you cannot access your team s roster, contact your consultant. The Shared Care Plan Tracking Tool Instead of re-typing the information into the tracking tool, save some time and complete the first three columns of this form by cutting and pasting information from the completed CCN Shared Care Plan. Please copy the language from the Shared Care Plan to the Tracking Tool exactly as it appears. The Tracking Tool should be saved and a copy given to the Parent Partner. The Parent Partner is responsible for following up with the family on progress towards the recommendations. 10

11 When the team agrees that the child s Shared Care Plan is closed, record the date of closure on the Tracking Tool and fax it to OCCYSHN. Typing and Filling Out Forms The Professional Adjunct or another responsible team member may type the Shared Care Plan while the coordinator leads the meeting. Sometimes the Professional Adjunct may be more familiar with medical terminology. CCN Child Health Team Contact Information If you would like to contact other CCN Child Health Team Coordinators, a list of contact information can be found on the website and at this link. 11

Coordinator s Introduction to Community Connections Network (CCN): Child Health Team

Coordinator s Introduction to Community Connections Network (CCN): Child Health Team Oregon Center for Children and Youth with Special Health Needs, 2015 Instructions 1. Please watch the first PowerPoint