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HomeMy WebLinkAboutMINUTES - 02231988 - 2.7 POSITION ADJUSTMENT REQUEST No. Date.: .. lit 8�7r Dept. No. SEE See Copers Department Health Services Budget Unit No. Attached Org. No. Attached Agency No. 54 Action Requested: Classify positions per- attached listing: # Proposed Effective Date: 1/6/818 Explain why adjustment is needed: To implerment the Merrithew Health Start Perinatal Program pursuant to AB 3021 Margolin legislation. Classification Questionnaire attached: Yes [] No Description of Duties' Estimated cost of adjustment: 3 ' ; Cost is within department's budget: Yes © No �] If not within budget, use reverse side to explain how costs are to be funded. i Department must initiate necessary appropriation adjustment. Web Beadle, Use additional sheets for further explanations or comments. Dept. Personnel Officer or Department ea- Personnel Department Recommendation Date: 1, X30 -3 7 _ 4 Cl.assify one 32/40 Public Health Nurse, two 24/40 Public Health Nurses and two 40/40 Public Health Nurses, Salary Level T9 1760 (2844-3640) ; three Dietitian P..I. positions and one 40/40 Dietitian position, Salary Level C5 1500 (2036-2474) ; two Clerk - B Level 20/40 positions, Salary Level C5 1141 (1422-1728) . i r� Amend Resolution 71/17 establishing positions and resolutions allocating classes toAthe Basic/Exempt Salary Schedule, as described above. / v Effective: 0 day following Board action. d Date or Director o s nne County Administrator Recommendation Date: fA-3,o - t3? rove Recommendation of Director of Personnel D Disapprove Recommendation of Director of Personnel } 0 Other: - t f fo o my Administra or Board of Supervisors Action V Adjustment APPROVED/ on FEB 2 3 g Phil Batcheor, Clerk of the Board of , Supervisors and County Administratof FEB 2 3 1988 Date: BY: ; APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT. DESCRIPTION OF DUTIES I Merrithew- Healthy Start Program PUBLIC HEALTH NURSE - - 1. Health Education In the 'role of Perinatal Health Educator, the public health nurse -, is a member of the Merrithew Healthy Start Program Care team. The team includes the physician, nurse practitioner, dietitian, medical social services . worker, case coordinator/health educator, - clinic nursing RN's and and _LVN's and perinatal clerk. The Public Health -Nurse: - organizes and carries out all elements of the perinatal health education. process including client orientation, health education assessments, health education care plan development, individual health teaching, group teaching, health education referrals, and followup on all health education recommendations. Specifically, a) Conduct individual client orientation, following written protocol of issues to be covered, for each new prenatal patient at initial contact. b) Review- patient health education self-assessment form and complete initial health education assessment on each new prenatal patient. Carry out reassessments- each trimester . c) Based on information collected, complete individual health education care plan for each new prenatal patient. Care plan to include definition of needs, recommended interventions and timeline, as well as patient reaction to plan. d) Monitor patient's compliance with health education plan through reassessing needs and progress once each trimester. Revise care plan as indicated. e) Carry out individual health education teaching, according to each patient' s plan; teaching to be accomplished at regularly scheduled prenatal medical visits. f) Maintain tickler file on each patient to facilitate followup action,. g) Organize group teaching activities (to be carried out by self or others as assigned) for prenatal patients; making use of pamphlets , videos, and other teaching aids, as appropriate. h) Make referrals for health education services not -provided at prenatal clinic sites (eg. , smoking cessation, drug or alcohol recovery, childbirth education) and followup with patients to assure compliance. i) Carry out postpartum health education assessment upon client' s return to clinic after delivery. j) Document health education assessments and all services provided (both 'individual and group) on appropriate forms and maintain in prenatal medical record, k) Complete billing forms for all followup and intervention services. ' 1) Participate in quality assurance activities with PHN Pg 2 special attention to reviewing perinatal health education activities (assessments, individual and group teaching, referrals) and identifying needed improvements. m) Other perinatal health education responsibilities as assigned. 2. Case Coordination In the role of Case Coordinator, the public health nurse is a member of the Merrithew Healthy Start Program care team. The -PLJBLI-C-:F{€�T. =NUPSF==. coordinates all aspects of the patients' perinatal care with particular emphasis on developing and monitoring implementation of the individual interdisciplinary care plan for each patient. Specifically, the Case Coordinator role has the following responsibilities: a) Oversees completion of initial support services assessments within four weeks of patient beginning care. Complete billing form for all initial assessments and case coordination. b) Coordinates (define frequency) team meetings to review care plans and charts of patients being followed. Ensures charts are available for review at team meeting time. Facilitates discussion of .patients' -problems/ needs during team meeting. Ensures appropriate followup of identified actions. c) Ensures ongoing communication between team members via individual or team case conferences to evaluate and re-evaluate the patient's progress and the quality of care given. d) Coordinates procedure with medical social service worker and dietitian to identify followup and reassessment needs for each patient at her return medical visits. e) Coordinates procedure to keep track of client' s attendance at appointments, including identifying the reasons for any missed appointments, and helping the client obtain a replacement appointment at the appropriate time. f) Oversees the client's entire care pian schedule, assisting the client to fulfill the recommendations for her plan of care (e.g. , referrals, tests, special appointments) . g) Oversees the completion of all recommendations made' on the care plan, ensuring that results of referrals and tests are made known to appropriate team members and recorded in the client chart and on the care plan. h) Ensures that client receives assistance with any necessary practical arrangements for meeting her care plan, including the provision and explanation of special instructions, transportation arrangements, assistance with translation needs, etc. i) Oversees the maintenance of the client's chart for completeness of documentation of medical, nursing, nutrition, health education, and psycho=social interactions with the client. PHN Pg 3 j) Assist Dietitian and Medical Social Services Worker with followup activities when. necessary. k) Ensures provision of appropriate copies of the prenatal record at the hospital during the intrapartum period. 1) Ensures completion of all data elements, then forwards copy of care plan form to MCAH for data tracking and State reporting, once care for current pregnancy is complete -- either after case closure or after delivery and postpartum services have been provided. DESCRIPTION OF DUTIES Merrithew Healthy Start Program Perinatal Clerk (B-level) The Perinatal Clerk is reponsible for assisting the Case Coordinator/Health Educator in a variety of patient tracking and chart documentation responsibilities. In addition the Perinatal Clerk assists in routing patients and charts during prenatal clinic times. Specific responsibilities include the following activities: a) On instruction from Case Coordinator, and in coordination with appointment clerk carry out followup procedure for patients who failed to keep their prenatal appointment. b) Identify prenatal patients one day prior to visit in order to compile a list of patients which will be reviewed by the health care team for followup needs. c) Provide "clinic flow sheets" for each chart before each clinic session and collect all flow sheets at the end of clinic for appropriate followup according to instructions from Case Coordinator: d) During prenatal appointment times assist in routing patients and charts according to the flow sheets on each chart and the wait times for each practitioner. e) Arrange translation services when necessary and as available. f) Under the direction of the Case Coordinator, assist patients to make appointments for special tests or other recommended followup and to make any special arrangements necessary to comply with care plan. g) Assist Case Coordinator in insuring that all appropriate documentation is maintained in patient' s chart including results of referrals and tests, special appointments, and billing forms etc; that chart is available at hospital at time of delivery; and that all care plan forms are completed and forwarded to MCAH for analysis and State reporting. h) All other B-level clerk responsibilities, as outlined in specification. r DESCRIPTION OF DUTIES Merrithew Healthy Start Program Perinatal Dietitian The Perinatal Dietitian is a member of the Merrithew Healthy Start Program care team. The team includes the physician, nurse practitioner , dietitian, medical social services worker, case coordinator/health educator, perinatal clerk and clinic nursing staff. The Perinatal Dietitian organizes and carries out all aspects of the direct patient care perinatal nutrition services, including, nutrition assessments, nutrition care plan development, individual patient teaching/counseling, participating in team meeting, maintaining. knowledge of food and nutrition resources and assisting in nutritional aspects of group teaching activities. Specifically, the Perinatal Dietitian has the following responsibilities: a) Complete initial nutrition assessments on all prenatal patients within four weeks of their entry into care, generally at the first medical visit. Carry out reassessments each trimester. b) Based on information collected develop nutrition care plan for each patient. Care plan .to include definition of needs, recommended interventions and timeline, as well as patient reaction to the plan. c) Refer all prenatal patients to WIC for enrollment and provide documentation of nutrition assessment at time of referral and as appropriate thereafter . d) Maintain tickler file on each patient to enable monitoring of followup interventions to be provided at subsequent medical visits. In coordination with case coordinator , review charts (or tickler system) prior to each prenatal. clinic in order to flag patients for nutrition followup. e) Monitor patient' s compliance with nutrition plan, including WIC referral and voucher pick up, through reassessing needs and progress once each trimester . Revise care plan as indicated. f) Carry out individual nutrition interventions, (counseling & teaching) , according to each patient' s plan; teaching to be accomplished at regularly scheduled prenatal medical visits. g) Assist case coordinator/health educator with planning, - coordinating and carrying out nutrition related group teaching activities including review and selection of appropriate perinatal nutrition education materials. h) Make referrals for food and nutrition services' not provided at prenatal clinic sites (e.g. emergency food, food preparation, etc. ) and followup with patient to assure compliance. i) In cooperation with medical social services worker , maintain up-to-date list of food and nutrition resources for all care team members to use in making client referrals. j) Carry out postpartum nutrition assessment and teaching upon client's return to clinic after delivery. k) Document nutrition assessments and all services provided (both individual and group) on appropriate forms and maintain in prenatal medical record. 1) Participate in team meetings to review interdisciplinary care plans and 'charts of patients being followed. m) Participate in quality assurance activities with special attention to reviewing perinatal nutrition services (assessments, individual and group teaching, referrals, etc) and identifying needed improvements. n) Complete billing form for all followup and intervention (excludes initial assessment which is completed by Case Coordinator) . o) Assist Case Coordinator/Health Educator and Medical Social Services Worker with followup activities when necessary. p) Other perinatal nutrition responsibilities as assigned.