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HomeMy WebLinkAboutMINUTES - 01181994 - 1.4 (3) TO: BOARD OF S-,:! EE"RVISORS `) ( � Mark Finucane Health Services Director �(�� Contra FROM:. r V- By: Elizabeth--A. :,Spooner, Contracts Administrator (-`oS♦a Co l DATE: January 10, 1994 Courcy SUBJECT: Approval of County's Child Health and Disability Prevention Program Annual Plan Update and Budget for FY 1993-94 i SPECIFIC REQUEST(S) OR RECO�MMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: A. Approve the Child Health and Disability Prevention Program (CHDP) Annual Plan Update and Budget for FY 1993-94 (County #29-338-6) for submission to the State Department of Health Services; and B. Authorize the Chair, Board of Supervisors, to execute on behalf of the County, the certification page which certifies the County's compliance with certain State requirements. II. FINANCIAL IMPACT: This funding is included in the current Health Services Department/Public Health Division Budget. The funding source breakdown of theiFY 1993-94 Budget is as follows: Early, Periodic Screening, Diagnosis and Treatment (EPSDT) : Federal . . . . . . . . $ 44, 916 State ! . . . . . 855, 519 County In-Kind. . . . . 444, 041 $ 1,344,476 Child Health and Disability Prevention (CHDP) : Federal . . . . . . . . $157, 834 Prop 99 200% Program State (100%) . . . . . . 109 , 026 $ 266,860 TOTAL $ 1, 611,336 The total funding for these programs in Fiscal Year 1992-93 was $1, 467, 013 . CONTINUED ON ATTACHMENT: X YES SIGNATURE: ! / RECOMMENDATION OF COUNTY ADMINISTRATORRECOMMEN TIO OF BOARD CO MITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Wendel Brunner, M.D. (313-6712) CC: Health Services (Contracts) ATTESTED Auditor-Controller (Claims) it Batchelor, C of the Board of State Department of Health Services Supen►imand CountyAdmin'IsU tgt M982/7-e3 BY --2. ��i e a 0 0'. 4 DEPUTY t #29-338-6 Board Order Page 2 III. REASONS FOR RECOMMENDATIONSIBACKGROUND: The County's Child Health and Disability Prevention (CHDP) Program is mandated by California Health and Safety Code Section 320. 5 and complies with the Child Health and Disability Prevention Act which implements the Early, Periodic Screening, Diagnosis and Treatment (EPSDT) Program required by Title XIX of the Social Security Act. The screening, diagnosis and treatment requirements are, under the State CHDP regulations the obligation of the local CHDP Program of the County Health Services Department. The CHDP Program! is also responsible for working closely with the County to assure compliance with Prop 99/AB 75 Access to Health Services including outreach, tracking, provider recruitment and case management for certain health problems. The Board Chair should sign seven copies of the certification page. Six copies of the certification page and four sealed copies of this Board Order should be returned to the Contracts and Grants Unit for submission to the State. i i i I i l CONTRA COSTA COUNTY/CITY (FISCAL YEAR 1994-95) 2 9 6 H. CERTIFICATION STATEMENT The undersigned certify that: (1) The statements herein are true and complete to the best of their knowledge; (2) this community's CHDP and CCS programs will comply with all federal and state policies and legal requirements pertaining to the CHDP and CCS programs; (3) the undersigned agree to provide the Department of Health Services the required program reports, reports of budgets, program and personnel changes, and access -to all fiscal and program records for purposes of audit and review by state and federal staff and; (4) this plan and justification become a public document as prescribed by the California Public Records Act of 1968. Signature of CHDP Director Date "Signature of CCS Administrator Date Axe -6Z g gnatute f Director Health Officer Date nat e f Sig ature & Title of Other Date 11"'S f n i_i� 11 (Optional) certify that this plan is approved by the Local Governing Body. Local Governing Body Chairperson Date 6 I , Ll 29 08- FY 93-94 PIAN UPDATE • APPLICATION • AGENCY DESCRIPTION • CERTIFICATION • PLAN ABSTRACT 0 CIDP/DSS IA - - r APPLICATION z.L.LiL.Lz kit t_Aiaru"LA 1)h.F.JLK1'_N1E1N-T OF HEALTH SERVICES PRIMARY CARE AND FAIAMY HEALTH DIVISION C=DRENL 'S MEDICAL SERVICES JOINT CHDP/CCS PLAN AND BUDGET JUSTIFICATION FOR FY 1994 THROUGH 1995 I. AGENCY LNIFOWMATION A. Official Agency Name and Address NAME: Contra Costa County Health Department TELEPHONE: 313-6150 ADDRESS: 595 center Avenue #310 — Martinez, CA 94553 NAME AND=E OF DIRECTOR: Wendel Brunner, M.D. Pub] ic Health DF rector B. CHDP DIRECTOR NAME: Bob Isom, PHN, MPH TELEPHONE: 313-6150 ADDRESS: 595 Center Avenue 7310 Martinez, CA 94553 C. CCS ADMINISTRATOR NAME: Rob i n Thomas, PHN, MBA TELEPHONE: 313-6100 ADDRESS: 50.5 Center Ave, #110__ Martinez, CA 94553 D. Check all other state programs for which the local health department is receiving funding for FY 1993-94. Farmworkers; x Immunization Assistance Indian Health Primary Care Grant (AB 1317) Rural Health (AB 2450) Adult Day Health Care (AB 1611) x Office of Family Planning x Dental Health (SB 111) x WIC Supplemental Food x Maternal and Child Health x Comprehensive Perinatal x Anti-Tobacco (AB 75) Services Program Other x Office of AIDS CONTRA COSTA COUNTY MATERNAL AND CHILD HEALTH AGENCY DESCRIPTION ( Contra Costa County's MCH Program is directed by Wendel Brunner, MD, who is also the Assistant Health Services Director for Public Health. Within the Public Health Division, there are five managers with responsibility for MCH Programs. The MCH Program is responsible for the deliver of perinatal services, resource development and case management, data collection, analysis and general planning for omprovement in the health status of mothers and children. The agency is arranged in the following fashion: CHDP and EPSDT provide wellness care and assistance with making and keeping appointments for MediCal eligible children to age 21 and low income children to age 19. These programs also provide nutritional, dental and health education resources for medical providers, assistance for Foster Care families, a dental referral program and coordination with Headstart and State Preschools. The 200% Program provides follow-up treatment services for low income children. The BIH Project is a subcontract with the East Bay Perinatal Council to outreach to Black women in West County for prenatal care, follow-up for infants to age 3 and drug treatment counseling. The High Risk Infant Project provides family support, education and monitoring of infant health and development for infants 0-3 who meet State MCH criteria. The High Risk Infant Program is co-supervised by the Director of CHDP and the Developmental Disabilities Director. CCS provides case management and payment for care for children 0-21 with eligible conditions who meet financial criteria. The program provides diagnosis and treatment, which includes physical and occupational therapy for eligible children and school sites. There is also a Children's HIV program for testing and coordination of medical, support services and data management. Clinical Services includes School Bases Services - SB111 Dental Program and TeenAge Program (TAP) and Public Health Clinics - Family Planning, STD/TB, Well Child and Teen Clinic. The SB11 Dental Program provides dental health education for pre-school and elementary school children. S81 includes a classroom program and screening and referral for care and sealant clinics. TAP provides peer education and counseling programs in high schools, juvenile detention facilities and community day schools, as well as, providing Scoliosis screening for 7th and 8th graders. The Family Planning Program offers clinic services for health screening, distribution of family planning methods, counseling, treatment and referral for STDs and HIV risk behavior. The Well Child Clinics provide health screening exams in accordance with CHDP requirements, including immunizations and health education. The clinics also provide referral for follow-up to CCS and Merrithew Memorial Hospital and clinics. The Women, Infants and Children (WIC) Program provides supplemental food, (vouchers), nutritional education and counseling for pregnant, lactating, postpartum women, infants and medically eligible low income children to age 3. LH2lagncydes.mch CERTIFICATION PLAN ABSTRACT PLAN ABSTRACT Recently the CHOP Program held it's Annual Mid-Year Program Plan Review. The review is an opportunity for all staff to gather and assess the extent to which goals and objectives contained in the CHOP Plan have been achieved. More importantly, it allows the opportunity to seek input from collective staff on strategies to reduce barriers to those non-achieved objectives. The process includes looking at trends, program stats and unmet needs. As a result, some objectives are sometimes modified and priorities shifted. We are sharing a summary of the results of the review with other Public Health Programs of the Health Services Decartment so that the issues and objectives whic: CH15P will be working on this fiscal year will be familiar to you. These objectives wiil be included in the 1993-94. CHOP Annual Plan to the State. As you peruse the attached summary we hope you'll find "windows of opportunities" where collaboraticn with CHOP would be mutually beneficial. We also welcome your comments and succesticns - 313-6150. PRIORITY HEALTH ISSUES FOR CHDP FOR FY 93-94 STATE=NIDE 1. 80% participation for Medi-Cal 2. Manaced care 3. Immunizations for under 2 years 4. Anti-tobacco education COUNTYWIDE 0 Provider maintenance and recruitment 0 Quality assurance OTHER ISSUES OF IMPORTANCE 0 Dental care access 0 Lead poisoning prevention and education 0 Unintentional injury prevention and education CHDP COMPONENTS EARLY PERIODIC SCREENING DIAGNOSIS AND TREATMENT 1. Provider maintenance and recruitment. 2. Increase accessibility, availability and provision of services for target population. 3. Universal method of tracking immunizations. 4. Explore feasibility of resuming the Baby Track Project. PROP 99 - NON MEDI-CAL POPULATION 1. Recruitment and maintenance of specialty care providers. 2. Encourage proper utilization of services provided via the non Medi-Cal prcjec: (in collaboration with CCHP). 3. Explore alternative strategies for reaching this target population. 4. Increase number of 200% children with up-to-date immunizations. 5. Investigate funding opportunities for migrant children. DENTAL 1. Provider maintenance and recruitment, particularly for 2 year olds on Medi-CGI. 2. Increase availability and accessibility of dental care services. 3. Expand dental sealant project for foster care children and increase their access to dental care. 4. Community education on importance of early and regular dental care. NUTRITION 1. Nutrition surveillance using the PM 160 (CHDP billing form). 2. Training of health professionals in appropriate method for taking measurement. 2 f 3. Resource development an childhood eating disorders for foster care parents. 4. Community education of methods for stretching food dollars. FOSTER CARE 1. Encourage proper utilization of health care services, particularly to avoid duplication of services. 2. Integration of a health education component within the SSD/CHDP Inter-Agency Agreement (foster care section). 3. Quality assurance related to services provided in group homes. 4. Increase awareness and use of the 'Foster Care Passport'. ANTI-TOBACCO EDUCATION 1. Increase membership, diversity and productivity of the MCAH Advisors Scard. 2. Statewide outreach project to increase number of clients served. 3. Quality Assurance as it related to anti-tobacco education. 4. Integrate anti-tobacco education in the training of on-line-staff. HEALTH EDUCATION 1. Provider recruitment and technical assistance. 2. Increase visibility and credibility within community and the media. 3. Increase the number of school entrance examinations among children within selected cities. 4. Develop a comprehensive annual CHDP training plan to also include staff development. 5. Quality assurance as it relates to managed care for wellness. EMH:jr/dmd e101midyrpin.rev 3 FISCAL YEAR UPDATE 1993 - 1994 CONTRA COSTA COUNTY CHILD HEALTH & DISABILITY PREVENTION PROGRAM SOCIAL SERVICE DEPARTMENT INTERDEPARTMENT SERVICES AGREEMENT 1993 - 1994 0 DEPUTY DIRECTOR BOB ISOM, PHN, MPH CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT PUBLIC HEALTH DIVISION CHILD HEALTH & DISABILITY PREVENTION PROGRAM 595 CENTER AVENUE, SUITE 310 MARTINEZ, CA 94553 (510) 313-6150 CONTRA COSTA COUNTY CHILD HEALTH AND DISABILITY PREVENTION PROGRAM INTERDEPARTMENTAL SERVICES AGREEMENT 1993 - 1994 TABLE OF CONTENTS I. Statement of Agreement II. Statement of Need III. Organizational & Functional Relationships A. Organizational Charts B. Flow Charts IV. Social Services Department Responsibilities & Activities A. Basic Informing of AFDC-FG/U MediCal Only B. Documentation of Informing by Eligibility Worker C. Basic Informing of AFDC-FG/U Referrals D. Documentation of Informing by Social Worker E. Referral to EPSDT/CHDP F. Documentation of Referral by Social Worker and Eligibility Worker G. Case Management for AFDC-FC Recipient o V. EPSDT Unit Responsibilities & Activities A. Administrative Location B. Duty Statement C. Medical Supervision D. Action on Referrals E. Notices for Health Assessments F. Documentation on PM 357 G. Documentation of Responses to Notice H. Quarterly Report VI. CHDP Program Responsibilities and Activities A. Medical Providers B. Dental Provider C. Resources & Materials for Social Services Department D. Process for Maintenance of Care for Out of County Clients E. Process for Maintenance of Records of Services Rendered to Foster Care Children F. Title V Services G. (Referrals for Public Health Nursing Services. not required) VII. Joint Social Services/CHDP Program Responsibilities VIII. Staff Education A. Eligibility Workers Orientation B. Social Workers Orientation C. Out of Home Care Facility Staff Orientation D. Health Department Orientation and Annual Update E. Eligibility and Social Worker Annual Update F. Evaluation of Additional Staff In-Service Education Needs IX. Management,Information & Program Evaluation A. Description of Information Compiled and Shared B. Program Evaluation X. Compliance Certification A. Enabling Legislation B. Program Regulations C. Regulations for Reimbursement of EPSDT Services D. Regulations Defining Social Services Department Responsibilities E. Releases by State Health Services and Social Services Department CONTRA COSTA COUNTY CHILD HEALTH AND DISABILITY PREVENTION PROGRAM INTERDEPARTMENTAL SERVICES AGREEMENT 1993 - 1994 SERVICES PLAN I. STATEMENT OF AGREEMENT By this inter-departmental services agreement, the Contra Costa County Health Services Department and the Contra Costa County Social Services Department clarify their plan of cooperation regarding the responsibilities of each in assuring compliance with the provisions of the Child Health and Disability Act which implement the Early, Periodic, Screening, Diagnosis and Treatment Program required by Title XIX of the Social Security Act. The Early, Periodic, Screening, Diagnosis and Treatment Program shall herein after be referred to as the EPSDT Program. The Child Health and Disability Prevention Program shall herein after be referred to as the CHDP Program. II. STATEMENT OF NEED Specific needs in Contra Costa County are: A. Increase the number of persons applying for AFDC MediCal who request CHDP services by 10%. Presently, approximately 70% of the persons applying for AFDC/MediCal request services. The average target population screened in 1991-1992 was 28,500. B. Develop a strong linkage with probation. C. Implement additional training for Foster Care workers and relative care takers and foster parents. D. Secure additional staff to meet needs of CHDP's Foster Care Component. During the last three years the number of foster care children entering the system has grown by approximately 35%. Mental health services for this special target group is extremely limited. During the last three years, we have noticed an increase in the number of mental health referrals for foster children. 1 Our pool of public and private mental health practitioners is limited. In order to address this program gap in service, we have developed an Interagency Agreement with the County Children's Mental Health Unit as a basis for improving mental health access service for EPSDT eligibles. We have developed an EPSDT Mental Health Specialist position and will hire the person in FY 93-94. (Mental Health Agreement previously submitted and approved) E. Formalize arrangement with community college district to become part of the education team which provides and/or coordinates training to foster parents. F. Increase outreach to teens. During the last two years several projects were planned and carried out to increase the number of teens served. Projects with Community Based Organizations (CSOs) and CHDP medical providers need to be ongoing to have some positive impact. Coordination of activities with Contra Costa County's Teen Age Program to enhance outreach capabilities will continue. G. Need to work more closely with Department of Social Services in order to assess the reporting system and to identify the source(s) of discrepancy in monthly reports. Several of our monthly reports from Social Services reflect counts of cases different from the actual number of cases we receive in our program. H. Need to increase provider network (medical and dental) to accommodate client growth and needs, especially the CHDP population. III. ORGANIZATIONAL AND FUNCTIONAL RELATIONSHIPS A. "see attached organizational charts (6)" 1. Relationship between administrative staff of the CHDP Program and the Social Services Department. 2. Health system interrelationships. 3. Social Services system interrelationships. 2 4. Social Services system relationship to Probation Departments. 5. Relation of EPSDT Unit(s) to both departments. 6. Reporting channel of EPSDT Unit to CHDP Director. B. "see attached flow charts (3) to depict CHDP process from informing through diagnosis and treatment" 1. AFDC families; 2. MediCal only families; and, 3. AFDC/FC children. IV. SOCIAL SERVICES DEPARTMENT RESPONSIBILITIES AND ACTIVITIES A. Basic Informing of AFDC-FG/U & MediCal Only Applicants/Recipients: 1. Social Services shall provide information to the appropriate responsible adult of all MediCal Only and AFDC/MediCal applicants under 21 years of age. At the time of their face-to-face intake or redetermination interview, the eligibility worker will provide information about the resources and services (medical and dental) available to the client. This information will include: transportation and scheduling assistance to obtain early, periodic screening, diagnosis and treatment services available under the Child Health and Disability Prevention Program. Social Services will refer information only clients to the EPSDT Program for follow up as appropriate; follow department procedures for obtaining interpreters so they may carry out informing requirements to the responsible adult who is blind, deaf, illiterate, or does not understand or speak the English language. a. Brochure Distribution: The State-approved CHDP brochure will be provided to, and discussed with, all applicants and recipients 3 during the eligibility intake interview and annually thereafter, at the time of the redetermination interview. (For documentation, see Item G in this section.) b. Give an oral explanation about CHDP, the value of preventive health services, availability of health assessments and dental services. The need for prompt diagnosis and treatment and the scope and benefits of the CHDP Program. C. Refer all persons to the EPSDT Unit who respond positively to questions asked about CHDP services. Refer all persons 1) if more information about CHDP Program services is wanted 2) if CHDP Program services - medical and/or dental are wanted, and 3) if transportation assistance is needed to obtain CHDP services. 2. Annual informing at the redetermination interview will be provided in the same manner as the initial informing for 100% of MediCal eligible persons under the age of 21. 3. Social services will make available resources to inform EPSDT eligibles who are blind/deaf or have special communication needs, example - sign language. B. Documentation of informing by Eligibility Worker A copy of the CHDP-6 (the informing documentation form) and CA-2 will be kept in case folder and consist of "Dates of Client Referrals to Services (CHDP) via Income Maintenance," (CDS-357), the response to the offer of scheduling and transportation, the receipt of a brochure and request for additional information. 4 C. Basic informing for AFDC-Foster Care (FC) Recipients: Basic informing for AFDC foster care children is carried out by the foster care eligibility and/or social worker at the time of placement. A copy of the CDS-357 is forwarded to CHDP for foster care nurse follow up. 1. The payee will be given a state approved.brochure about CHDP services for clients in foster care and information about the recipient's need of prevention health care, and . 2. The payee will be given an oral explanation about CHDP services and offer the services in accordance with IV A.1,b and c, as indicated herein. 3. "Payee" is defined as the foster parent(s) in a foster home or the officially designated representative of the payee, when the AFDC-FC or MediCal eligible child resides in a group home, residential treatment center or other out of home care facility. 4. Social Service (including the Adoption Unit) and CHDP have a contractual agreement whereby CHDP will provide Foster Care recipients with CHDP service information, referral to CHDP providers, and follow-up to diagnosis and treatment. All services will be re-offered annually and re-documented in the case record. Social Services will inform the Foster Care payee of need for CHDP services. 5. Informing requirements described in CA through C.4 shall apply for AFDC-FC placements controlled by the probation department and/or licensed adoption agency. 6. When a child is placed with a relative and the relative applies for AFDC, informing will be done per standard procedure, using the CHDP informing documentation form, CHDP-6. 7. When an out of county CDS 357 form is received from Social Service, CHDP will forward the referral to the CHDP Program of the new county of residence. This is a reciprocal arrangement among local programs. 5 D. Documentation of Informing by Social Worker: The following information will be documented on a CHDP-6 and included in the services/family reunification record: 1. Date of explanation 2. Client's responses to offer of: additional CHDP Program information medical and/or dental services, and transportation and or appointment scheduling assistance when CHDP medical/dental services are requested. E. Referral to the EPSDT Unit or CHDP Program: 1. All "Yes" responses to basic informing will be referred to the CHDP via a CDS 357. This is required to ensure that all necessary diagnostic and treatment services are initiated within 120 days of the date of eligibility determination. The recipients who receive their care via a prepaid health plan will be informed and referred in the same manner. 2. When a child from Contra Costa County is placed in another county, a referral (CDS 357) is generated to the CHDP Program. The CHDP Program in turn refers it to the appropriate county of residence. 3.1A CDS 357. referral will be generated by Social Service (including the Adoption Unit) for all County Board and Care children (CBCC cases). F. Documentation of Referral by Social Worker: The Social Service Department has entered into an interagency agreement which has been previously submitted and approved by State CHDP as part of this agreement. 6 The basic content of this agreement is as follows: 1. Delegate to CHDP staff, the Social Worker responsibility for informing Foster Parents, relative caretakers, and group home providers of CHDP requirements. 2. Provide a Public Health Nurse for consultation and follow up for CHDP foster care children, 3. Documentation of referral outcome. The following will be documented when any "Yes" response is given, written or verbal, to the offer of services: 1. Case Name and MediCal Identification Number. 2. Type of services requested: a. Additional information. b. Medical services C. Dental services. d. Transportation assistance. e. Appointment scheduling assistance. 3. Source of referral; new application, redetermination or self-referral. 4. Case type - AFDC, AFDC Foster Care, MediCal Only, Share-of-Cost. 5. Complete listing of members in case with birthdates, including unborns with expected date of confinement (EDC). 6. Foster parent/payee and child are listed in AFDC-FC cases. 7. Residence address and telephone.numbers. 8. Worker signature. 7 i 9. Date of eligibility determination for AFDC FG/U and MediCal only cases or date of request for AFDC-FC cases and self-referrals. G. Case Management for AFDC-FC Recipients: 1. The Social Worker shall ensure that the child receives medical and dental care which places attention on preventive health services through the CHDP Program, or equivalent preventive health services in accordance with the CHDP Program's schedule for periodic health assessments. 2. The Social Worker shall ensure that arrangements are made for necessary diagnosis and treatment of health conditions suspected or identified. 3. Medical and dental records including but not limited to copies of the CHDP Confidential Screening/Referral Reports (PM160) or results of equivalent preventive health services must be maintained in the family reunification/services case record to verify health status of the child. V. EPSDT UNIT RESPONSIBILITIES AND ACTIVITIES A. The Central CHDP Office Unit is located at 595 Center Avenue, Suite 310, Martinez. The Administrative Unit is located within the Health Services Department. B. Duty Statements of Unit Personnel were previously submitted and approved. C. Supervision of Unit: 1. Professional medical supervision is provided by the CHDP Medical Director who is also the Maternal, Child and Adolescent Health Director. 2. The Deputy Director is responsible for the day to day supervision and administrative direction of the CHDP/EPSDT Unit. 8 D. The EPSDT Unit will accept and take appropriate action on all referrals of MediCal eligible persons under 21 years of age as required by Federal EPSDT regulations. The Unit will follow up on all referrals generated out of the Income Maintenance Unit in Social Services. 1. Self referrals will be offered, provided or assisted with scheduling and transportation when requesting CHDP services, which includes medical and dental services as desired. 2. Persons requesting scheduling and transportation assistance and desiring initial health and/or dental services or due for such services as outlined in the State's periodicity schedules will be referred, to a provider of their choice. These services will be completed and all necessary diagnosis and treatment will be initiated within 120 days of request or eligibility determination. Confirmation that appointments were kept will be via receipt of PM160 in the CHDP office and/or by phone confirmation with the doctor/dentist. These services will be provided to all referred recipients unless one of the following occurs: a. eligibility is lost b. recipient is lost to contact. "Good Faith" efforts will include phone calls, letters and checking the Social Service microfiche for new location, or C. recipient failed to follow-up with services. 3. Persons requesting health assessment components not given by their provider will be referred for the components requested in order that all indicated CHDP services are received within 120 days of request. 4. A follow-up effort will be made for those who requested scheduling and/or transportation assistance to ensure that appointments (both screening appointments and any needed diagnostic/treatment 9 appointments) were kept; to re-offer assistance in scheduling and transportation to those whose failure to keep appointments was not due to action by or decision of the family/recipient; and to offer, provide and document this same assistance as requested to those for whom further diagnosis and treatment is indicated. A good faith effort will be made to locate those lost to contact. Confirmation that follow-up care was received will include date of appointment and name of provider. As time and budgetary resources permit, follow-up will also be carried out for high-risk cases who did not request support services. Dates, types of assistance offered, names of persons accepting or declining offer, names of providers, and dates of appointments will be documented on the CDS 357 parts B & C. E. Notices for Health Assessments, with the.offer of scheduling and transportation assistance, will be sent monthly to children with labels received from the State. These children will be twenty-seven months of age or younger who have a PM160 on file but have not had another PM160 submitted for services given in the past five months and who are still Medical eligible. F. Documentation on the CDS 357 will include the following information: 1. Date and type of transportation assistance offered. 2. Date and type of scheduling assistance given. 3. Date of appointment and name of provider. 4. Confirmation that services were received, by: a. a PM160 on file, or b. verbal confirmation with provider - if medical; parent - if dental- that appointments have been kept. 5. In addition, if the child has an identified problem as a result of the health screen and needs follow-up to diagnosis and treatment the CDS 357 will 10 ( also include the following information documented on Part C: a. response to offer of scheduling and transportation assistance, b. type and date of scheduling/transportation assistance given, C. dates) of appointment and name(s) of provider(s), and d. confirmation of care by verification from provider. (NOTE: No coding system will be used to document these activities.) 6. The date appointment scheduling and/or transportation assistance was declined and by whom will be recorded on CDS 357. 7. Disposition of case will be documented to include appointment status, eligibility lost, refusal of services or loss to contact and Good Faith Effort was made to locate the person as defined in Section VII. G. Dates periodic notices sent and any response received will be documented on State printout and kept in the CHDP Administrative Office. H. A quarterly report will be submitted at the end of each quarter to the State Department of Health Services showing the number of AFDC and MediCal Only persons requesting CHDP services. VI. CHDP PROGRAM RESPONSIBILITIES AND ACTIVITIES A. An adequate number of medical providers will be recruited, maintained and available to meet county needs and federal regulations in regard to allowable time frames. B. An adequate number of dental providers will be recruited, maintained and available to meet county needs and federal regulations in regard to allowable time frames. Health assessment services will also include referral for follow-up to diagnosis and treatment. 11 /111. STAFF EDUCATION A. Within 90 days of employment adequate training will be provided to all health and welfare personnel involved in the CHDP Program including the Prenatal Component. Inservice conducted by appropriate CHDP staff utilizing audio visual aides, lecture, packet of materials and question and answer period will be used as the training format. B. Within 90 days of employment by the Social Service Department (including the Adoption Unit), Social Workers and Eligibility Workers will have completed orientation regarding the CHDP Program and their role and responsibility for informing clients about CHDP and referring clients for services. Appropriate CHDP Program staff will conduct this training. C. Within 90 days of employment by the Probation Department, appropriate probation staff will receive CHDP training. The CHDP Social Service Department liaison will work with the Probation Department to facilitate the training. Appropriate CHDP Program staff will conduct this training. D. Upon licensure and at renewal, foster parents and group care homes, residential treatment center and out of home care facility staff will complete orientation regarding nature, scope, benefits, and availability of CHDP Program. Appropriate CHDP Program staff will implement this training. E. Orientation and an annual update regarding the CHDP Program will be provided to all appropriate health department staff. F. All Social Workers and Eligibility Workers will receive adequate training and annual update regarding the CHDP Program. G. Additional staff inservice education needs will be identified as follows: 1. The Social Services Department liaison (Program Analyst) will work closely with CHDP to help identify training needs. Training needs will be determined and discussed during routine, ongoing CHDP/SSD coordinating meetings. Training to fill these needs will be coordinated and carried out jointly by CHDP staff and Social Service Training staff. 13 ' C. Provide information to the Social Service Department about the availability of certified CHDP providers by making provider lists available as often as the lists are updated and upon request. Provide outreach and informing brochures with the address and phone number of the local CHDP Program. To better reach the MediCal eligible population, these materials and brochures will be made available to all Social Services offices and locations. These materials will be provided as needed and requested. D. When a CHDP eligible recipient is found to have moved to a new county of residence, the original CDS 357 will be sent to the new county CHDP program so that continuity of services will be assured. A copy of the CDS 357 will be retained in the CHDP Administrative Office along with the date the original CDS 357 was sent. E. When a child is in foster care, a copy of the PM160 will be sent to the Social Worker of record. Follow-up to diagnosis and treatment information will also be included. F. Title V Services The Unit will assure that any recipients eligible for Title V services are informed of available services and referred, if they desire, to Title V grantees that offer services appropriate to the recipients' needs. G. No supplemental EPSDT funds are requested for Public Health Nursing Services. VII. JOINT SOCIAL SERVICES/CHDP PROGRAM RESPONSIBILITIES A Good Faith Effort will be made to locate all persons lost to contact. The EPSDT Unit/CHDP Program will query the Social Services Department for current addresses, phone numbers, and MediCal status of these persons. Upon request, the Social Services Department will share this information. 12 �l The CHDP Deputy Director will take lead responsibility for ensuring that training needs are met. 2. The CHDP Deputy Director works with all appropriate program personnel (Social Services, Health Services and Probation) to identify CHDP/EPSDT training needs, to plan and arrange this training as needed based on regulatory changes, program evaluation, coordination meeting discussions and needs assessment. All Health, Income Maintenance and Children's Services Staff, will participate in periodic CHDP training sessions. Outcome of training will be assessed by use of a post training evaluation tool. IX. MANAGEMENT INFORMATION AND PROGRAM EVALUATION A. The following information will be compiled and shared between departments. 1. Numbers of a. eligibles - intake/redetermination. Children in foster care placement separate, b. requests for CHDP services, C. requests for more information, d. requests for scheduling and/or transportation assistance, e. medical assessment services requested and received, f. dental services requested and received, g. referrals to diagnosis and treatment, 2. Examples of children helped will be noted in our CHDP Program newsletter called "CHDP Update" and distributed to Social Service Department staff. 14 B. The following program evaluation methods will be carried out to assure compliance with State and Federal Regulations: 1. Periodic formal and informal chart review in conjunction with the Social Services and Health Services Departments are organized and carried out by the CHOP Program Staff to assure quality. 2. Data on initial numbers of CHOP "Yes" responses and subsequent number of referrals for CHOP appointments are monitored and tallied monthly by the CHOP Office. Joint SSD/CHDP procedures are reviewed and updated annually. 3. Follow-up to diagnosis and treatment appointments, and required periodicity notification systems activities are integrated and monitored by CHDP/EPSDT staff. Modifications to the procedures are made on as needed basis. 4. Periodic coordination meetings (every other month) with CHOP and Social Service are held to determine whether CHOP informing requirements are being met. 5. The CHOP Office maintains a case review monitoring system to assure that required documentation regarding penalty-liable cases is in place. The EPSDT Staff conducts peer reviews of cases. 6. Review status of CHDP/SSD plan and interagency agreement objectives on a quarterly basis. X. COMPLIANCE CERTIFICATION In signing this agreement, we hereby certify that the CHOP program in our community will meet the compliance requirements and standards pertaining to our respective departments contained in the following: 15 A. Enabling legislation of the CHOP Program. Reference: Health and Safety Code Sections 320 through 324.5 and Section 2444165.3. B. CHOP Program regulations that implement, interpret, or make specific the enabling legislation. Reference: California Administrative Code, Title 17, Sections 6800 through 6874. C. MediCal regulations pertaining to the availability and reimbursement of EPSDT services through the CHDP Program. Reference: California Administrative Code, Title 22, Sections 51304(c), 51340 and 51532. D. Regulations defining county Social Services Department responsibilities for meeting CHDP/EPSDT Program requirements. 1. Social Service Regulations Reference: (a) Staff Development and Training Standards --- Manual of Policies and Procedures (MPP) Sections: 14-530, 14-610. (b) Civil Rights -- MPP Sections: 21-101, 21-107, 21-107.212, 21.115. (c) Eligibility and Assistance Standards -- MPP Sections: 40-107.61, 40-107.611, 40-107.612, 40-131.3, 40-131.3(k), 40-181.21, 40-181.211, 45-201.5. (d) Child Welfare Services Program Standards -- MPP Sections: 31-075.3(h), 31-075.3(h)(1), 31-075.3(h)(2), 31-205.46, 31-205.461, 31-205.462, 31-205.18, 31-330.1, 31-330.11, 31-401.4, 31-401.41, 31-405.1(f), 31-405.1(g), 31-405.1(g)(1). 16 2. MediCal Regulations Reference: California Code of Regulations, Title 22, Sections: 50031; 50157(a), (d), (e), (f); and 50184 (b). E. Current interpretive releases by State Health Services and Social Services Departments. 1. Children's Medical Services (CMS)/CHDP Program Letters and Information Notices -- Health Services. 2. All County Letters -- Social Services. 3. Joint Letters -- Health Services and Social Services. 4. CMS/CCS Numbered Letters pertaining to the CHDP Program -- Health Services. This interdepartmental agreement is in effect from July 1, 1993 through June 30, 1994 unless revised by mutual consent. 17 Child Health & Disability Prevention County Social Services Department Program Director Director Date Date Attachments: Organization Charts Flow Chart(s) Duty Statement(s) if appropriate 18 O N o+ o+ z ' N+ +J >1 L d > d A y pl L G C L A r 7 O A C O.N� C y A 7 y N OI L.7 C 07 y p O L M W OO u 7 u O(nd N t O.D. 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Make Contact HV TV OV ML Document all activities on 357 form (Part B) . If P.L. and no response to contact within 30 days Check Social Service fiche for address chance If address change, resume contact attempts - If no change, close Files PE:cm 10/89 rev 2/93 epsdt2lcpsdtman.I f Contra Costa County Flow Chart for PM160 Case Management CHDP PROVIDERS -]CHDP CLERK • Date stamped in PM-160s withoutPM-160s with codes/comments codes/comments Files Reviewed by CHDP Coordinator (PHN) I Public Health Aides Public Health Nurses • Makes contact with client HV TV Letter OV • Assures that parent understands/is compliant to diagnosis treatment plan • Documents all activities on Part C of 357 Files * Note: if no contact from parent/guardian after a minimum of 3 attempts, case is closed. PE:cm 10/89 rev.2/93 cpsdt2\EPSDTMAN.6 CgNTRA COSTA COUNTY 1 March 1,135 Annual Time Reoortino Plan ° Chart 1.0 2000 Perfecto Villarreal -. Welfare Director f GAfrCE1GENJ7 1.0 ZOOA Sheiba Burke Executive Secretary dA.MTciGENR Z111,M2 Z333,Z444 ZAAA,2555,2666 Yvonne Bullock Robert Hofmann Don Cruze Z00B Asst.Director Asst.Director Asst Director Shirley Kalinawskl Children's/Adult Svcs. income Maintenance Administration GA/GAIN/WP Div Mgr Mtz/Antioch 3 Pmm Chart 2 Chart 3 I Chart 4 Z11A A300 ( Z55A W400,H400 =1.,c,,,. Jerry Madden Dale Caton JudAFOCtFC Div Mgr SecretaryGAICAIN7tCAR Div Mgt s Martinez Administration Richmond('Heber) l Chart 5 ' A,00 Clog z500 Unda Waddington John Lee Ralph McGee Z7C0 CWS Division Mgr AFOCtFC Div Mgt Fiscal Div Mgt Judy Campcml Martinez Antioch Martinez-Douglas Or. 1Personnel Officer 2 Personnel Analysts III Personnel C:ks A200.C200 E300 2600 dao;udaNn Charles Underwood Stephanie Guynn Jim Takanashi APStIHSS Div Mgr AFDC,*MCIFS Div Mgt Fiscal Div Mgr Central/East County El Sobrante Martinez-Douglas Dr. C100 H300 Z800 Linda Canan Bill Reid Pat Boyle CWS Division Fdgr APOC/MC/FS Div Mgr Systems Manager Antioch Richmond(1305 Mac) Martinez-Douglas Or. G100 Z3G0 ZA00 Connie Rinne Frank Gallagher Ken Adams CWS Division Mgr Eligibility Unit Supv. Fraud/Appeals Mgr Richmond Sp Pdts/QA/MCJORC Martinez-Douglas Or. 5200,H200 ZVo Bob Sesaler Chris Moore AAA Director Eligibility Unit Supv. Martinez Quality Cont/Tran.Ch.Care Non Wal(ata(ICRP) .. 9Protuvpi]t 23.op.it FTE count Ne P9.6.6 SERVICES BUREAU March 1,19^- late a zrfw) Chart 1.0 Z111,Z222,ZBSS Yvonne Buttock Servkas Asst Director IaIlrCraLO„aYc„aa1M { _ 1.0 Z11A Elaine Balyd ChlldlAduU Svcs Secretary FSAr7QSVC,ZL"MP1? 1.0 A100 1.0 A200,C2,Z2 1,0 0100 1.0 G1C0 0 Linda Waddington Charles Underwood Linda Canan Connie Rinne 1'4 2800 CWS Div Mqr APS/tHSStCWS Div Mgr CWS Div Mgt CWS Div Mgr Bob Seadier Martinez(Muir Rd.) Central!&aserwest Co, Andoch Richmond (Research Dr.) Diredor Area.agency an Aging FSA/TC9LO,sVC.EMpn FSA/TCJSVC7 FSARC3VC.1LO,EMP/7 FSA/7CSVC AMPff Men w o.n{{CR) IM53 6200 CNS CiMO ER lion.. GiAO Vewr..••+Prgm M2C0 EA Infix—Coud A,Ao Norm MickeyBob Smayda VACANT }sOCPI w«ksupenAgr Susan Lawrence 4L Steve Peavler I Sao CCn'SSYCAa Sup CCTSSVC46 2'+d.Prgm Cowonsnn I Sup CerrS5voAs I C:k Fsvrcmvw Court Row—no. i elk FSCITG'SVCA? 2 elk FSC/rC+sVG7 7 FN CCTS3VC46 FSWC/SVC 7 8.6 SW.CC/TSISVC/A6 GAA/rG'GcNR 5 Swat CC A'S 0116 a SYS CCrrS1SVCt46 CNS 0101 Patty Molina PISS M2AQ,G2001 1 Sr.Lead Clerk ER Ccun Glao AAA ER lnn.pcoun A180 Kagey Dorosz ehldree'a sm suap. Chaneen Raines Sr aron Johnscn Mary Jensen 1 SUP CC/TS+SVC744 pyVyrjyV� I Sao CWS M46 i AstL OkaaTor I Sup CC/TSSVG'46 2 CA FsCrrC1SYCJ7 2 elk FSCMGSVW rnN+CL Dk.Mcrsf I CIS FSC/rC1SVC7 1.2 Ewe Cen:sal 7 Sws CWSSVC446 9 SW.CWSSvC•6 7.6 SWI CC/TySVG4d ER Imsa+ GIRO 4e:an wenn pCR) 5 SW CC/SISVC/46(020A) Cheryl Sublea I I Sup CCTS/SVC4b IM58 Z2A0 I n C:k FSCTC1SvCG'NS/FM GiCO St-Ems.,=7nartt FM AICD Saien Mulahed r swt C=SiSYC146 Penny James Jack Bartlett Peter Harris SUP CC/rSSVC46 I Sup CWSISVCA6 SR E-a uguAat oc.ry Cxn I Suo CC/TSSvC.6 i elk FSCTGSVCn 1 elk FSCrrG'SYC•J7 I Cik FSCiCSVC7 1 EW CC?SSVC146 t AAA Sett A4K I 5.6 SW.CC+TSSIK'/4d ER Court lntGiCO yor•Nertarf(ICA? 95Wat CC/TSSVG'ad 55Wf CGRSSYC++b Carolrol Walsh fAkra G:/TSrSVC/4a I Sao=313 C:44 CQnS--APS 2280 telt FSCnVSVW CNS FRIPP Gloo FR/PP A= 7 SW.CCTSSVC46 Sr.1 d� � Peter Koster Syng Park :uCy Weitrner � Corsh Devoe t Suo CCrSISVC46 i Sup CWSMVC+46 •AAA Start Asst,i I Sao CCrrwsvcJ46 /C:k FSC/TCSVCn 2 elk FSCrTCSVW ZS .nnr Prgm Aida 2 CIS PSCRGsvw 7 SN4 CCRSSVC/46 5 SWs CC,TSSVC46 9 SWs CGTy5VC46 eWSiFM C70p .yon Nedare(ICR) Pat McDonald 1 Sao C4/TSSVC/46 IMSS P.ym. A2X0 1 elk FSWCJ3VC+7 CNS FR/PP oleo 1 CIar S-. Ap.P—s AtEO Roz C'evincerizi 7 swat CCTs/SVC46 Ann Campbell Iso«uhf Casey Dixon I Sup C=SIM46 t A-=uunc C:fn•Ex.. 1 SUP CCrTSSVG46 6Account Clerks Ielk FSCTCSVGT 1s«nnryl 2 Ck FSCRCSVCn7 swillCCTSSvC46 FSUG'SVC7 CWSFM CtEO M+.n—W.pCRi 6 Swat CC/TSsvCa6 Grace Underwood I supCC/rS1Sm a IMSSIAPS 2200 1C1k F9C G/SZ7 CWS FP/PP OtFO MKaa lkensai9 AiFO Lee Hunter A Sva crlrslave/A6 Joan BurgerLern`.s Lyon Kathy Robinson i PROGRAM ANALYST 1 SUP CCTSSVC46 MiC.XP Manager Sao CGTSSYC.d Dough.Or.,MM. 1 elk FSCTCJSVC/7 1 AAA Staff Agri 1 I elk FSCrTCSVC// FSNtCSVC7 CNS FR/PP CIFO 6 SIMS CCRSr'VC46 ,yon r+edare(iCRj 5 SWt CCTSSvC46 Darla Johnson 1 Sup CCT3/8vC4a IHSS OC 220E i elk FSCRGSVW Court Rtp1ER MOP ER Prgm AiGO j Ken O'Day a SWe GC/Te/SYc/46 Edward Mann 011e NICt10(SOn 1 SxPI wonw I Sup crlrs/svv4e I Sup CCTSIM46 Douglas Dr.,Mrs 1.5 sws CCrrSrSVC46 7 Sws CCJTS/SVC46 F&WC;SVGnCWSFR/PP CiGO (G1AA.G1AE) s Cif SP«CWSfSvC4a (1 Mus,2 Antioch,2 Res—cm) Ginny Wyatt .. t Sup CC17S+SVC4a CWS PRPP Z20C Ick FSCyCSVC17 CWS Clef Sp« A1G0,01 ER sc...nv,9 AIGO Sheri Ferguson 7$We OWSISMA6 Otis Nicholson Sharon Bacon I PROGRAM ANALYST Sup(See A100 at Muir) I Sup C=SISVC/46 OoU9las or.,Mia CSCSo c-(G/F6,6146) 2 Cat FSG/TC/SVC/7 FSNTG'SVC7 SPP/CRpu` Z180 FSCrTGSVCn 4.8 SWs CC/TSSVC/Aa Myra Emanuel i Sup CCTSMVC/46 CWS FR/PP ZZOG I elk FSC c1SYC7 Cier Sapp GIXo O6,ce SUPpon AtA0 : 95 SWs CWSISVC46 Meda Reda Dorothy Russell Roz Devincenzi i PROGRAM ANALYST (8130 law.M2Yo,Chart 2) I Sup FsA/TCELO,SVC.EMPr7 oovgus Or.,Mea, I elk FSArrC/SVO,EMP17 I elk FSC/rC/ELO,SVC,EMP/T FSA(TCSVCJ7 AOM Supp C1X0 4 Cka F5ARCSYC,EMP17 2Cns FSA/TCELG.SvC.EMPi7 Diane Tomiins I Sup FUMVELO.M'EMP/7 CNs Z208 2 Oki FSCRCRLG,SVC,EMPn Gwen Easter(LOA) a elk$11werELGAVICAMPn I PROGRAM ANALYST Douglas Oct Will. FSA/TVSVC7 wr9plUsuup251 FTE MY pg•272.7 XOVR23.ops 19 (Nen warier.-126) INCCsnE UMAt Nay F BUREAU `f,?- March 1,199_: (aa a12MA13) Chart 1.0 C300 Bob Hofmann Income Maintenance Asst.Director .. FWTGLLgaVC,aMM r 1.0 A300 1.0 C300 1.0 E300,Z300 1.0 H300 Jerry Madden John Lee Stephanie Guynn Bill Rel AFDCIMCIFS Div Mgr AFDCIMCIFS Div Mgt AFDC/MCIP3 Div Mgr AFDC/MCIFS Div Mgt MsrVnez Antfoch EfSobrante Rfcrtmond F3A/TC7EtG,3VC,EMpn F3AITC/ELO.SMEMPI7 F4UT4cELG,EMPr7 F3A/rC1EL4,EMPt7 GGTCC i3F:� AFDC Mt. A3e0 AFDCInuiu DUO AFDG'MCYluke E3A0 AFDC!�hako H3AO Chris Moore I Christeen Orozc� Dorothy Arco Pam Morgan Susan Gahan 1 Sup CCnsELV43 j 3 Sup CCJTSIELW43 (� I Suo CCrr51ELW43 t Sup CCRarE1.G143 1 Sua CCIrS+EL0r4a 1px FSCIYG'ELGn I GY FSC?G'ELGn I C'k fSClTCJEL0I7 1 CA PSCAVELOn I Cit FSCnC/ELOn 3 EWS CVrSIEL0/43 ,. d ews CCRSELW43 I EN.CGT3/ELC/43 x EWS CCJrWRoM3 7 EWS eenS/ELW43 Sx P;y/O/vORC .3"J; AFDC n!axsrntm A3^D0 acct 1w�lntm Ciao AFGG'MC mMMa E3aG AFx Intxka M)CO Frank Gallagher v i Donna Jacoby Alana Hq an Niki Peterson Pat Ventimi ilo 'svp Cars/ELc;u 9 C t CIS FSCITC'ELG/7 I Suo CC/TSIELG%43 1 Suo CC/TSELWA3 ISuo CC IrSELO/43 1 Suo CGTS/ELW43 7'cvv.CGTC'ELG143 C:X FSG7GE1.017 1 C:k FSC(TCJELdn I Gk FSC/1rCJELCr7 I C:k FSWCJELW I 8 SEWS CClTS/EL0143 7 ENS CC/TSIELGt43 9 EWS CCrrSIELG/43 a EWS CCMS/EL0143 'NAF,9+MC A3GJ ( FFSI,Cix / Au<e GC0 ECoAFDC'FC M.0 HSJO Eleanor Mork I ;.r.n McGrath Naomi Martinez Lois RcbertsontSupCCnSELO/43 I i I Sup CGTS+EL^a/AS ]MQFrWCrM1YSpC 1 Suo C:1T3/EtW4a t Sup CGT&ELG;41 I CIk FSCnC'ELGn xSCTG'ELGn 1 C;k FSCJTC/ELat?li C=k FSCJTGELGn 10 EWs CC/TSIELW43 I 7 EN.CGTSELW43 9 EW.Ccn'SIELW43 e.a eN.=SIELW43 AFDCIFC A3HO I IAFCC 1".• GE0 RV.q..Gln E3Eo CIFS F4.4 HUO Donna Harbaugh (� I Sam Machado Carol Calvert Marva Simmons 1 Sup CWS/ELG/43 ` t Sup CVTVEtG/43 1 Sua CCZMELW43 1 Sup CC;-MG/43 I CA FSCIfC;El.W H � I C:k FSC,CiELGn t Ck FSC(TC1ELGn I C4 PSC/TG'ELGr7 7 ENS CG'TSELG/43 I I 6 EN.CWSIELGM3 S EWa C=WELO/43 a EWS CGTS(EL0143 mrasp Cu. A3+0 II I MC/FS F-a C3GG Af00:nfF10 E3FO AF DO F'r14 M3P0 Luci Flynn i E!arne Grothman 1 Fran Tress Clarie Keenan I Sup CCRSELG/43 j 1 Sup CGTSE'w^/43 ! 1 Sup CCRSELWU 1 Sup CGTS£LO143 I C;x FSCrrG'ELCn i 1 C:k FSWCWELG/7 I C:k FSC/TC/EtW Glx FSGTG'Eton 9 Ewa C:JTS/ELG/43 I 7 EW.CCITSIELG/43 !EW.CWMW43 S EWs CGTWELO/43 I l AFDC AJMO., 'MVFS InvF a. C3Ko AFCC 1414 E300 AFDC Fwta Mico Kathy Robinson ' Mica Rcsario Pat Avalos Vlctona Scott 1 Sup CC/TSELG/43 I 1 Sua C:;-S/ELC143 Is o CC/TSMLGN3 I Sup CGTSELW43 I CIS FSCRCn'ELG1 I i Ci, 45GTG'ELGn C:S FSCnGELGr7 CIk FSC/TG'ElGn 51ENs CCrt$/ELGt43 i(i 6 Vis C4Z.TSELG143 a ENs CCrrSfELW43 a ews CC,-S'ELW43 I AFDC;Rel AWI0 t MGFS F.- CJL G AFDC Fwta E3M0 AFDC F4 WICT M3RG Judy CICOtt Tom'ngley Maggie Arcaya Penny Morton I Sup CCrrS/ELG413 i Suo CC:7SE1.0443 I Suo CCrTSJELGIA3 I Suo CGTS/ELG/43 I CA FSG'TCrEtOn I Clk FSGTCIELW I CIS FSCrrClELG/7 CIN PSWC1£1.017 7 EWs CCRSELG/43 10 ENs,.C.TS/ELG/43 SEWS CCrTSELW43 7Ewa CGTSELW43 CMSFJCO Mosp M3EO 1 AFDC GPO C:xr,Supo E34 AFx Fina M350 Richard Cabral Linda C^ppin Barbara McCoy Kathl Katy I Sua CWS/ELW43 1 U.CGTSELGr43 I Sup FSA/TC/ELGn I Sup CWS1ELCJ43 S Cfk FSCrtCrELGn I CIk FSG7G'ELG/7 S Clks FSCnC/ELGn I CR FSGTG'ELGn 7 EWS CC/TS/ELCJ43 9 EWS GG'TSElW S 3 CIks FSAfreaw a Ewa CCMSrEL0143 i Rmorc.Suop A3XO AFDC Fwia GOO pas C-14. E4Yo,MAYO CI.r/R.C.pL M3X0 Mary Majalca Sharon Pettet Miriam McMoy Bonnie Albers 1 Sup FSA/TGELG.SVC,EMPn i Sup CG'TSIELW43 .S Sup FSC1TCISVC,ELO,EMPn 1 Suo FSC/TMG.EMP/7 $Clk.FSGTCIELG,SVC,EMPn ICIS FSCrTGELG/7 t CIS FSGTG'SVC,ELG.EMPn a CIks FSC/TCJELG,EMPn 3C:xf FSAITG'ELG.SVC,EMPn 10EN.CGTSEL0143 tSupv.(000"S to WlOp an Ch.s3i CGV.MiCMons A3YO,C3Yo AFDC Fw1a CSTo AFDC 23A0 CW Supp M3Y0 Irena Gonzales Jamie Putido Mary Barrow Dorothy Russell .S Sup FSA cjeLG,SVC,EMPn 1 Sup CGTS/E1.OI43 t Program Ana" 1 Sup FSA/TG'ELd.3YC,EMPn 3 CNS FSC/TC/ELO,SVC,EMP/7 1 Cfk FSGTG'L°LGn Douglas or.,WE I Oka FW4TC/MO,EMPn 2 CA*FS/rC ELG,SVC,EMPr7 9 Ewa CC1TST1G/43 FS4rTCM.On S C:kS FSA(TCJELO,EMPr7 (AiSO S.W.GIRO,Cna4s2) AFDGFC mVFW GVO FS/FSEBT/CA 2390 : Data Coors. M4YO,E4YO Chris Gallagher Terry Salter Miriam McMDy I Suo CGTSEI,W+1 (Program MStyrt SGx FSCITCISVC,ELG.EMPn 1 CIk FSCJrG'EtW D*.91ss Or.,M12 2 Cik FSCrrCJSVC,ELO,EMPn 10 ews C,^,.^.&VLW43 FSMTC.SLG,EMP17 13.p..!.porta to W400 on Ca,95) c:.icauR.<pt Cuo7s:ndy 2306 Deanna Blythe Baldwin 1 Suo FS4rrC;RG,SVC,EMPnProgmm Analyst 11 CIks FSC/rC:ELG.SVC,EMPR Douglas Or.,Mti I C1xs FSAnGELG,SVC.EM1S/7 FSAnGELGn i SWSIMG30 OCva14-0-t GYO,A3YO Irene Gonzales S Sup FSA/TGeLo,SVC,EMPn ' i Cts FSCrrC/eto.SVC,EMPII 2CISS FSA/TG'ELG,SVC,EMPn wtgplulwttplll FTE count 2w pg. ' .bu43.apw ig •4q.t ADMINISTRATION BUREAU ? March 1,155'; ip at zfus) " Chart 1.0 Z555,ZB,Z8 Don Cruze Administration Ass4 Director OAAAMCMAW7 1.0 Z55A Dale Caton Secretary Administration oAArtOGEW7 1.0 Z!500 1.0 Z600 1.0 ZA00 1.0 2800 Ralph McGee Jim Takahashi Ken Adams Patrick Boyle Fiscal Div Mgr Fiscal Div Mgr Fraud/Appeals Mgt Systems Officer FlscailStatslStaffDev 3udgerlFaclflContmers cGnslELGAFRD/grsss SystemsDevlMatnt 0AAinCIGEN10 GAA/nGGEW17 113AYtC7FRW($Pik}unci) EDPfTWFUNII. GAAITS/GEW7 Fival ZOO Wa Frd NAFO Dov/Moa{ ZL-A' Phil Simonds Ralph Alvarado 5 system,Anaym 1 Fiscal Analyst 15.0 CGTaiFROrass 2 systema Spwilam F,eaalaWAAA audga 2 Oka FSCRCrfROY7 1 PC Coordinator { GAAYTGGEW7 7 WFIa=S1FRO1656 EDPITSIFUN148 I I( FucauStau A0 APPeals ZAW Sys Cake 5rta Zlz: Leslie Gutierrez F"tis' Z6E0 t suaeMaor Charles Couch Appeals7fair Hearings 1 A. T-WSuW 7 Cl.—1 Wkra " 1 Account Clarks t}lois}Malys SCWSI GiRcen purcneaa;lCnma10ov9en CCJTS/EtGrii GAAfTGGENn j GAAYTGGENn ( GAA"TGOEW7 EFDPP Cowrie sutvMnm Act 2:a4 Early fraud Prgm Jim Morphy 26Et 10%FSGTWRW(Douglas) 1 Focal Maly,t I a,.L.4 Cis a WFu CGTS1FRO166a Douglas Oa.Mot 1 Sr.t.eW Cis GAARGGEW7 I Purcn»ap/SupPy coots G.TCIGENn Sled Dw Z509,Z:OE j Stall Development Camncu Zacg 2 Pmgram Mayou Carol Mathis Dougra,Dr.,MTS t Conuan Program Maya 33,TSir EN l FUW:A I Cara -. l GM+T�,vEW7 4rtca Suao Z6z0 Pauli Wampler t C:anc,i suaemsor Adm1SD/Aoa,alflCloHd Fans GAAnCGEN d FUNn(Proratw), Aamn suop 26% Douglas Dr..Mai A C:ks APaa,n FSCITGELGn 7 Cha Adm GAAITC,JGEW7 2 Oka S=CjGENn @o,w f,es 2701 Sutured Or.,Cmd 5 Cat GAArTCYGEW7 argp�uauup271 FTE count 7.a pg. DM1N27 opw ig -640 'i , GAIN/GA/Work Programs BUREAMarch 1,195: (sa of 2n,93) 'I Chan 2000 Perfecta Villarreal GAIN/GA Bureau Director FS/VTClaaw?(see p9.11.F'r£Count) 1.0 A3OO,C30O 1.0 G4OO,H400,W4O0 Shirley Kalinowski Judy Simmons GAI?VGAIWP Div Mgr GAIN/GAfWP Div Mgr UWAntlochlftm�P'ollcy Richmond FSAITC3MOLGAMPn FSA/TCSVC.ELG,EMPn GNFS Fr}a MAO GAIN Mae GNN GZAe GNN Simone St.Germain Vacant John Randle Pat Allen I Sup CG'TS/EL0I43 Sup CCITSrEMPIS2 t Sup CC(r31EMP152 1 Sup CCn S/EMP152 2 C:k FSUTUELGn 1 Clk FSC4TCIEMPn 2 Clk FSUTCtEMP/7 1.5 Clks FSUTCIEMP/7 T ewt CC,TS/ELG/43 a Swe CC/T&EMPIS2 3 SSPA.FSCRC4)AP/7 2 VCs CC TS/EMPIS2 S.As84u sup+.b".11,93 6 SWI CCJTVEMP/52 S SWs CUTS/EMP/52 GNFSAnom a AIC3 GNN C4AO IGAR CABO GA/FS lntake eOerah Polk Shirley Carpenter Evie Cartock Leone Kelly }Uo CCRSIELGI43 1 Sup CUTSIEMPM2 1 Sup CWSISVC/4s Is CGTSI£LG/a3 }C;k FSG'rCJEMPn t Clks FSVT=AJPn I Clks FSWCJSVC/T t Clk FSG`TG'ELGn 9 EWt Crn'S/ELGI43 1 SSPA FSCrTGEL4Pr7 t SSPA FSCIrC/SVU46 13 EWs CC/TS/ELG/43 ' a S1Mt CC1rSIEMpIS2 2 Sw CC/rSISVC/46 I GMF sm'A.e C4O0 GNFS/FMIO C4Fg IGAR M4ae Pat Hammon Arlyce Siino t cl"FSWCrSVGn I Sup cc TWELG/43 i Sup CUTSIELG/43 2 SSPA.Crn'S1SVG46 2 C;k FSCITC/EtAPn t ak FSCnCIEMPn 1.9 SW CC/TS/SVC/46 E eNs CGTS/ELGI43 6 Ews CWWELG/41 GNFS FMM W4/0 GNFS mMke Wanda Wong Beverly Wright I Wort Prgms 580 Emp Prgm Cara Z.'el iSup CWSIELGI43 I Sup CC/TS/ELG/43 ' Janis McGregor Kareen Morgan 1 Clk FscrrUELGn ICA FSUTCIELOn 1 U.CGTS/E.14P152 1 Program"A"t 9 EVts CClrS/ELGI43 6 EMCUTS/ELGI43 i }C;k FSCIrG"EMPn gOYq}se Or„Mit S SSP" EMP/52 FSARCIEMPn� j 15`Nt C01STGTSlEMp/52 GNFSFM}o W4Ne Galea Support W44A; Lee Weikert Judy Kuflin 'NP RKh N4a0 t Sup CCITS/ELG/43 1 SUP4Mt0r 2 C;ks FSWC/EMPn 1 C;k FSC/TC1ELGn t0 Clerks}Wkno 3 SSP"C"-SIE-P,52 9EWs CCITS/ELG/43 FSGTC/ELG,EMP/7 IVC CCIMEMP/S2 I t SW CCITS/EMP/52 GaWP-- 7.2C0 OC Coortl E4Y0 "WChkd Cars ULA. Ret". Miriam McCoyJanet Tom kins . jewel Mansap}t (2 CKs at 1305 Richmond) i program Analyst I Program M."t (I Clk at Reseerch) OougMs Or.,Mtt j Cougias Or,Mit sop ws.,-thee.are counted FSA(TCISVC.EMPn FSA/TCa$S C,ELG,EMPn there,but E4Vg rspart6 to W400 .brgP}usWtp23t FTE taunt?e 1. NNGA23.0p+10 +t55} FOSTER CARE CDS357 FLOW SHEET CDS 357 (FC) initiated from Department of Social Services CHDP 1.11 EPSDT FC Worker Contacts Foster Parent TV - HV - Letter Response I No RESPONSE - EPSDT Informing Done - Packet of Information Social Service Fiche c-ecked: sent to Foster Parent- - Correct Social Worker - Status of Case open/closed Oven � Closed .� CDS357 filed ;n New PlacementSame Placement closed FC files CDS357 filed in Documentation done open FC files on CDS357 Part B Documentation done on CDS357 Part C if follow up indicated at time of informing CDS357 both sides sent to Social Worker Completed case isfiled in open FC case files Mcm 9/8/93 N57ffow Poster Care PM160, Plow, sheet PM160 received from provide= Social. 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2A Children With Waiver 10 .6% 10 .6% 10 .6% Children With Neither 60 4% 48 3% 53 3% TOTAL CHILDREN ENROLLED _ Total Number First Graders 12,569 ' 113,822 15,204 I Total With Certificates 11 ,080 88% 12,664 92% 13,931 92% Total With Waiver 118 1% 254 2% 279 2 Total With Neither 1 ,371 11% go4 6% 994 6% IF STATE DATA ARE NOT USED, PLEASE L TDICATE SOURCE OF YOUR DATA 32 COUNTY/CITY CONTRA COSTA 1993-94 Plan Update CHILD HEALTH AND DISABILTIY PREVENTION PROGRAM NUMBER AND PERCENT OF TARGET POPULATION ASSESSED AND REPORTED ON PM 160s FY (a) FY (b) FY (c) Eligible/Target Population 92-93 93-94 94-95 MediCal Children 0-20 (1) 62,698 62,698 67,000 State-Funded Non-Medi-Cal (2) 75,194 75,194 80,000 Children 0-18 TOTAL TARGET POPULATION 137,892 137,892 147,000 (1) Sze Estimated Target Population Table: Column 2 (a) See Program Letter #92-12 (2) See Estimated Target Population Table: Column 3 (b) See CMS Information Notice #93-2 (3) See Estimated Target Population Table: Column 1 (c) Project based on previous years and local knowledge (a) * (b) (c) 92-93 93-94 94-95 Number of Assessments PM 160s % PM 160s % PM 160s % Reported on PM 160s Actual Estimated Projected Medi-Cal Assessments (1) 29,233 47 34,000 54 39,000 58 State-Funded Non-Medi-Cal (2) 5,387 7 5,800 8 7,200 9 Assessments TOTAL ASSESSMENTS (3) 34,620 54 39,800 62 46,200 67 (1) Use CIB Report Columns 11, 12 & 32 (a) Total CIBs for 12 months of FY 92-93 (2) Use CIB Report Columns 21 & 22 (b) Total CIBs available and estimate for rest of year (3) Total (1) & (2) (c) Project based on past years and local knowledge * Percent is calculated by dividing #of assessments by # of children in target population, e.g., dividing (1)(a) below by (1)(a) above. While not an actual percent of population served, this number provides a rate of service for evaluation and planning. If specified state data are not used, attach explanation. If you wish to submit additional data on assessments performed for the eligible population in your community program area, please attach it to. your plan along with the source(s) of data. COUNTY/CITY: CONTRA COSTA 1994-95 CHDP Plan CHDP PROGRAM CASE MANAGEMENT DATA Complete the form using all data currently available. Where data is not available, please attach explanation. Fiscal Year Totals 1992-93 A. Total number of AFDC/Medi-Cal cases informed by Department of Social 8858 Services' workers. B. Total number of cases in A requesting CHDP services (include newborns). 7485 1. Number of AFDC cases. 6252 2. Number of Medi-Cal only cases. 1233 3. Total number of EPSDT eligibleerp sons referred by Department of Social Services' workers who requested: 15857 (a) medical and/or dental services 4263 (b) medical and/or dental services with scheduling and/or transportation 9662 (c) information only (optional) 1932 C. 1. Number of persons who were contacted by telephone, home visit, face-to-face, office visit, or written response to outreach letter. 10,000 (est) 2. Total number of persons actually provided scheduling and/or transportation assistance by program staff. 2088 3. Total number of persons in C.2 (those provided scheduling and/or transportation assistance) who actually received medical and/or dental 1312 services. Medi-Cal Non-Medi-Cal D. 1. Total number of referrals on CHDP health assessments for further diagnosis and treatment. (Codes 4 or.5 entered on the PM 160.) 1263 704 2. Total number of referrals in D.1 where the follow-up appointments 1338* 1037* were kept. * Discrepancy due to ongoing problem follow-up. If your program collects any other data regarding the numbers and types of contacts made or attempted or other measures of your workload atul related outcome data,please feel free to attach this information in whatever format you currently collect it. PEz- p6\949SF.Ip a 1 r CHDP PHN ACTIVITY REPORT SUMMARY FISCAL YEAR 1992-93 ****•�"'�-jJuty €Au4. (Sept.lOct. lNov. IDec. [Jan. 93{Feb. IMarch€April! May jJune jjYTD Totatl I. INTENSIVE INFORMING € ( € ( € € ( ( € ( ( € I€ 9 of 357s received I 1 l 132 l 222 ( 90 ( 151 i 130 j 113 ( 160 ( 125 1111 1 147 Il 1381 HV € € € 61 ( 98 l 78 ; 186 1 57 ( 84 j 81 1 73 l 65 { 70 {l 853 ! OV € I € 0 1 1 l l 3 1 € 3 1 ( 2 l 1 1 €€ t0 € TV I I ( 51 ( 123 ( 129 j 139 ( 98 ( 124 1 125 ( 111 ( 81 j 103 11 1084 ; TIB/OIS j ( ( 89 j 187 j 166 ( 135 ( 106 1 106 ( 92 ( 98 j 89 ( 110 (( 1178 J NHV ; 1 ( 42 ( 85 1 67 1 43 ( 50 ( 39 1 47 j 47 j 61 ( 63 I{ 544 1 Letters € I I 32 I 86 j 82 ( 92 l 61 1 56 ( 82 j 80 1 65 l 84 jl 720 MID appts made ( 1 ( 79 ( 175 j 177 j 123 I 91 ( 84 j 155 € 93 ( 88 ( 78 ll 1143 MID appts kept ( ( j 43 j 72 l 93 ( 73 1 50 j 63 ; 68 1 59 j 72 ( 56 jI 649 ! MID r. Kept € € 1 54x1 41x1 53%1 59x1 55x1 75x1 44x1 63x1 82--1 72%11 577'! Case Conferences 1 ( ( 32 ( 74 1 0 1 22 1 19 j 86 1 98 1 62 ( 46 ( 6 lj 445 € 11. OUTREACH € l I I I I € I € I I I €€ ! 3575 Generated ( 1 ( 0 ( 12 ( 5 j 5 ( 4 ( 3 j 12 ( 5 j 3 ( 17 (j 66 MID appts made € € ( 0 j 11 ( 5 ( 4 l 5 ( 5 l 25 1 7 { 6 1 15 1I 83 j MID appts kept € ( ( 1 l 1 1 1 ( 4 1 1 ; 1 l 15 I 4 1 8 i 7 i1 43 MID Kept 1 € € =RR 1 9%j 20x1 100x1 20%1 20%1 60%j 57X1 133%1 47x11 5Z:! Community presentations! 1 1 6 1 t3 1 1 1 2 1 € I ( I € 11 22 1 # of Sites € l I € € I I 1 1 l 2 1 4 ; 3 l 1 €) 11 - # Served I i € € I 30 € € 7Z I I 35 ( 90 l 40 ( 10 j1 277 1 Group homes € f 1 5 ! € 4 ! € 3 ! € 4 ! € !! 12 H.S. I I I 20 I I € I I I I I l I1 20 ! F.P. Orientation ( I ( 45 j 1 47 1 30 ( ( 10 ( ; ( ( (l 132 j ! l I € l I 1 I € I l € l! 01 I € I I € ! I I I € I ! II 0 III. CASE MANAGEMENT I I l I I I I € € ( € € €€ € Total PM160s reviewed ( I l 254 ( 306 1305 ( 159 ; 272 ; 262 1 321 ( 237 j 318 j 242 1l 2676 1 PM160s with 4s/5s I I ( 95 ( 132 ( 104 j 114 ( 102 ( 107 1 168 j 101 ( 113 j 81 1j 1117 % % % 1 ERR 1 ERR 1 377.1 43%j 34%j 72%) 38x1 41%j 52:1 43X1 36%1 33%11 42%! Cases contacted w/ conal I i I I I I I I I I I II I HV I ( l 46 1 52 1 42 1 70 1 55 1 36 ( 82 1 53 1 34 1 52 I1 522 OV € 1 1 0l 01 21 21 11 10I l 11 71 Il 23I TV j ( ( 91 l 123 ( 117 l 172 l 108 j 132 j 188 ( 160 { 128 ( 128 1j 1347 l TIMIS I I l 265 1 .275 ( 178 1235 I 230 ; 199 1 271 l 236 ; 305 l 231 (l 2425 j NHV € € I 34 j 48 j 57 1 32 l 32 1 27 l 33 1 28 ( 34 1 38 1( 363 Letters ( 1 ( 40 ( 66 ( 53 ( 59 ( 56 ( 45 1 44 j 84 1 71 ( 52 jj 570 Cases - f/up appt kept l I 1 27 ( 59 l 45 I 69 l 60 l 83 1 65 ; 42 j 44 I 42 (j 536 I Cases - SIT prvded 1 j ( 35 l 28 { 40 l 48 ( 42 { 21 j 36 ( 31 l 35 1 29 ll 345 1 Referrals to 2nd provider[ I 1 33 l 44 ; 39 ; 39 l 25 l 23 l 47 ( 32 ( 31 l 25 1I 338 ; IV.- PROVIDER RELATIONS ! I I 1 I I € 1 ( I I I 1l I New Providers enrotted l € i 0 1 0 € 0 i € I € l € € 11 0 l Providers recertified I j ( 0 ; 0 I 0 1 I ( I I I I II 0 Provider contacts ( l ( 11 j 0 ( 24 j 19 ( 37 l 29 l 30 ( 48 l 41 ( 43 (i 282 ------------------------- Monthty MID % will not be accurate as prior month's "made" may be inctuded in current month's "kept". PE-cm 10/8/92 rev 3/25/93 123\9293phn.wkl SUMMARY OF EPSDT ACTIVITY FISCAL YEAR 1992 - 1993 *************July IAug. ISept.10ct. INov. IDec. (Jan. 931Feb. IMarchlAprillMay (June ((YTD Totall A. Social Service Referrals (EPSDT)1 I I I I I I I I I I 1 11 1 # of cases informed * 1 807 1 725 1 735 1 776 1 628 1 717 1 651 1 681 1 905 1764 1 672 1 797 11 3858 # of cases requesting services 1 717 617 i 634 1 676 i 567 1 628 1 586 i 599 i 801 668 1 575 1 73 11 7.41 MediCal I 93 1 100 I 88 1118 ( 100 I 98 I 93 1 94 1147 1 115 1 80 1 107 11 1233 1 AFDC 1 592 1 501 530 530 443 509 i 471 1 482 619 1 532 1 470 i 573 11 6252 of unborns 1 106 1 79 1 44 1 78 1 70 i 81 1 75 I 77 1 116 1 103 i 69 1 87 11 985 # of FC 357 1 76 1 50 1 60 88 i 51 1 69 1 60 1 59 1 51 1 65 1 51 1 66 11 746 j of individuals 11435 11336 11369 11398 11155 11284 1 1139 11259 11545 11355 111—7, 11405 11 15357 1 of PL357 individuals ** i 911 1 750 1 821 1 840 1 686 1 744 1 735 1 785 1 966 1 833 1 687 1 904 11 9662 of other 357 persons received 1 11 1 1 22 1 i 23 I 9 1 1 18 1 I 17 I 1 11 100 of resources/letters mailed `1 370 1267 1373 1 367 1 308 1 341 1 406 1 356 1 337 1 376 1 34» 1 371 11 4216 I of TV made 111690 11330 11535 11371 11024 11663 1 1632 11549 11626 11734 11151 11673 11 17978 1 of HV made `1 1 2 i 27 1 23 i 31 1 25 1 28 1 26 1 31 1 37 11 230 1 # of 016 made `1 1 25 i 17 10 1 1 47 1 72 1 32 i 61 1 82 (1 346 1 Subtotal "" +12060 11597 11935 11755 11369 12027 1 2069 11977 11726 12168 11587 12163 11 22433 1 B. Medical Appts EPSDT/CHOP I I I I I I I I I i I I II I # of Appts. Made 1 31 1 15 1 57 1 39 1 43 1 25 1 63 1 64 1 43 1 41 1 18 1 47 11 436 1 # of Appts. Kept 1 30 1 10 1 35 1 35 1 28 1 14 1 34 1 37 1 30 1 18 1 12 1 27 11 310 1 % of Kept Appts. 1 97.1 677.1 61X1 90X1 65X1 56X1 54X1 58%1 70X1 44X1 67,1 57:11 64%1 Dental Aaars EPSDT I i I I I I I I I I I I Il 1 # of Appts. Made 1 12 I 14 1 24 i 18 i 19 1 12 1 44 1 25 1 31 I 13 1 14 i 26 11 240 1 # of Appts. Kept 1 8 1 11 1 16 1 13 1 19 1 7 1 40 1 25 1 26 1 18 1 18 1 12 I1 205 1 % of Kept Appts. 1 67:.1 797.1 67X1 72:1 100X1 58X1 91%1 1007.1 84X1 138X1 129X1 46%11 85;'.I Help the Children # Made 1 10 1 6 1 7 1 8 1 7 1 1 1 7 1 9 1 6 3 1 1 1 2 11 57 1 # Kept 1 10 1 5 1 5 1 7 1 8 1 1 1 5 1 9 1 5 1 3 1 1 I 2 I 1 51 I HTC % of Kept Appts 1 1007.1 83%1 71%j 88X1 114X1 100X1 71%1 100°,1 83X1 1007.1 100X1 1007.11 89%1 County Clinic $ Made 1 6 1 8 1 5 1 8 1 8 1 7 1 4 1 11 1 3 1 8 1 8 1 9 11 79 1 # Kept 1 4 1 6 1 3 1 6 1 2 1 6 1 3 1 6 1 1 1 5 1 8 1 8 11 54 1 CC % of Kept Appts 1 67/.1 75%1 60X1 75%1 25X1 86X1 75X1 55%1 33X1 63X1 100%1 89X11 68:1 D. F/up to Diagnosis & Treatment I 1 I I 1 1 I 1 1 1 I I 11 I Total 4 of M/Cal PM 160s recd 12577 11878 12167 11865 12924 12170 1 2861 12797 12833 12339 12400 12422 11 29233 1 Total # of Non M/Cal PM 160s reed 1 355 1 428 1565 1 496 1 453 1 419 1 456 1 523 1 543 1 351 1 428 1 370 11 5387 1 Grand Total 12932 12306 12732 12361 13377 12589 1 3317 13320 13376 12690 12828 12792 11 34620 1 Total # of cases selected for f/up I I I I I I I I I I I 1 11 1 To EPSDT Unit 1 41 1 40 1 64 1 52 1 90 I 54 1 53 i 43 1 47 1 35 1 31 1 50 11 600 1 Cases Completed I I I I I I I I I I I I II I By EPSOT Unit 1 64 1 47 1 42 1 40 1 58 1 60 1 43 1 50 1 34 1 36 1 38 I 60 11 572 1 Cases where S/T provided 1 11 1 4 1 4 1 7 I 5 1 11 1 10 1 3 1 6 1 8 1 3 1 52 11 124 1 # of contacts to complete +l 192 1 141 1126 1 120 1 174 1 180 1 129 1150 1102 1 108 1 114 1 180 11 1716 1 E. Other Activities WIC +l 29 1 25 1 15 1 10 1 2 1 15 1 10 1 7 i 10 ( 5 ( 20 ( 15 11 163 1 CCS +1 61 61 51 71 31 51 81 51 71 51 111 511 731 Healthy Baby +I 5 1 4 1 4 1 4 1 4 1 2 1 4 1 4 1 2 1 3 1 2 1 2 II 40 I CHOP (200%) +1 16 1 21 1 51 1 33 1 27 1 18 1 18 1 27 1 26 1 30 1 23 1 36 11 326 1 General Public Calls +1 22 1 35 1 38 i 43 1 43 i 29 1 35 1 27 1 27 ( 24 1 29 1 43 11 395 1 Grand total of all contacts ++++12330 11829 12174 11972 11622 12276 1 2273 12197 11900 12343 11786 12444 11 25146 1 this is a new format Monthly % of kept appts will not be accurate as prior month's "made" may be included in current month's "kept" * Total 9 cases 1-9 CDS 630 ** Total # persons 4,6,3 CDS 630 cm 9293epsd.wkl 9/11/92 rev. 3/25/93 CHOP 200% Activities for.Fiscal Year 1992 - 1993 IIJuly IAug ISept IOct (Nov IDec Ilan 93IFeb IMarchlAprillMay IJune IlYear to datell A. Total PM 160s receivedlI 355 i 428 1 565 1 496 1453 ( 419 1 456 ( 523 1 543 1351 1 428 1 370 (( 5387 li S. Coded PM 160s receivedll 50 1 42 1 33 I 52 1 61 i 93 i 40 i 43 1 74 1 63 1 93 1 60 II 704 11 11 14%1 10X1 6X1 10X1 13%1 22%1 9X1 8%1 14X1 18%1 22%1 16X11 13X11 C. Cases Completed 11 I I I I I I 1 I I I 41 1101 II 142 I I -------------------------- ---- ---- ---- ---- ----- ----- 11------------i I C. DENTAL II i I I I i i I I I I I II II Appts. Made: I I I I I I I I I i I I I II I I Pedodontist 11 54 1 22 1 19 1 30 ( 43 1 33 1 34 1 39 1 33 I 30 1 18 1 1 1I 356 11 General 11 131 1 34 i 8 1 47 1 31 1 20 1 40 1 75 1 25 1 27 1 22 1 0 11 460 II County I I 17 ( 11 1 5 1 0 1 1 1 1 0 l 0 1 1 1 0 1 o f 14 i 1 49 � I Emergency 11 7 1 7 ( 3 I 12 ( 15 ( 11 1 17 I 14 I 18 1 15 ( 23 I 0 II 142 11 Orthodontist 11 0 1 `.1 1 0 ( 0 I 0 1 I I I I I I II 1 Total:* 11 209 ( 75 35 1 89 1 90 1 64 1 91 1 128 1 77 1 72 1 63 1 15 II 1008 II Appts. Kept: II I i I I I I I I i I II II Pedodontist II 15 1 16 ( 18 1 25 1 27 ( 32 ( 29 ( 23 1 23 ( 21 1 15 ( 13 II 257 11 General 27 1 19 ( 50 1 19 20 23 1 26 ( 14 i 22 17 1 6 11 287 County II 71 ..01 91 01 1 I I 01 01 01 I 81 811 33 II Emergency 11 7 I 6 2 1 12 1 15 10 1 17 1 14 1 18 1 14 1 16 1 0 11 131 Orthodontist 11 0 1 1 ( 0 1 0 1 0 1 I I I I I 1 1 0 II 2 . I Total:. *11 73 1 50 1 48 1 87 1 62 1 62 1 69 ( 63 1 55 1 57 ( 57 ( 27 11 710 Kept/Made % 11 35X1 67%1 1377.1 98X1 69X1 977.1 76X1 49X1 71%1 79%1 90X1 180X11 70%I � --------------------------1I-----I-----1 ----(-----I-----1-----1------I-----1-----1-----1-----1-----(1------------il 0. MEDICAL I I I I I I I I I I I I I I Appts. Made Vision 11 26 1 6 1 11 1 13 1 11 1 9 1 16 1 16 i 9 1 16 1 16 1 17 11 149 11 Hearing 11 Z5 I .6 I 4 1 7 1 9 1 6 1 6 1 10 ( 8 1 8 1 6 1 7 1I 102 it Orthopedic 11 7 1 0 1 3 1 7 1 4 1 7 1 5 1 5 1 2 1 3 1 2 1 1 II 46 11 Other 11 53 1 19 1 15 1 45 1 14 i 25 1 19 i 12 1 21 1 14 1 8 1 16 11 263 II Total:* 11 113 1 31 1 33 1 72 1 38 1 47 1 46 1 43 1 40 1 41 1 32 1 41 11 560 i1 Appts. Kept I I I I I I I I I I I I II I I Vision 1 14 i .4 1 3 1 8 1 6 1 8 1 11 1 11 1 8 1 8 1 15 1 19 i t 96 11 Hearing II 10 1 5 1 0 1 4 1 5 1 3 1 3 1 5 1 5 1 6 1 3 1 6 II 5= II Orthopedic 1I 7 I 3 1 1 I 5 1 3 1 6 1 3 1 3 1 2 1 2 1 1 1 0 (( 36 11 Other II 21 ( 20 ( 4 1 36 1 10 1 11 i 14 1 7 ( 7 1 5 1 14 1 22 (( 171 II Total:** 11 52 1 32 1 8 1 53 1 24 1 28 1 31 1 26 1 22 1 21 1 33 1 47 II 358 Kept/Made % 11 46X1 1031 24X1 74X1 63%1 60X1 67:1 60X1 55X1 51%1 103X1 115%11 6,4%11 (I I I 1 I I I i I I I I II it TOTALS Total M & D Appts Made *11 322 1 106 1 68 1 161 1 128 1 111 i 137 1 171 1 117 1 113 1 95 1 56 it 1568 II Total M & 0 Kept **11 125 1 82 1 56 1 140 1 861 gal 100 1 89 1 77 1 781 90 1 74 11 1068 i1 Total Apots Kept/Made X 11 39X1 77X1 82%1 87X1 67%1 81%1 73%1 52%1 66X1 69X1 95X1 132%11 68%11 --------------------------11====►==-1=—==1====1==-==I=====I=====(____=1====1=====1=====1=-=11=___________! � E. CASE MANAGEMENT I I I I I I I I I I I I I I I I I TV 111137 1781 1 96 1630 1 774 1 695 1 883 11038 1. 671 1 880 1938 1819 1I 9342 I1 TIB 11 259 1 156 1 40 1 13 1 136 1 34 1 71 1 100 1 48 1 70 i 71 1 105 11 1103 1 013 11 77 1 59 i 15 1 36 i 42 1 33 1 67 1 69 1 60 ( 90 1 108 1 110 it 766 II HV/OV 11 1 1 3 1 1 1 6 1 10 1 1 1 20 1 13 1 19 1 29 1 42 1 17 11 162 II Letters 11 123 1 69 1 14 1 51 1 67 1 45 1 79 1 60 1 36 1 45 1 63 1 70 11 722 II Other II I I 41 41 1 I I 11 01 01 1 I 21 111 1411 (Site Visits) 11 5 1 z 1 11 1 7 1 4 1 3 1 5 1 5 1 1 1 0 1 1 1 2 II II Total Case l i=====!=====1=====1====1=====1=====1======1==—=1===1=====1====1=-- Management Contacts 111602 11070 1 181 1 747 11034 1 811 1 1126 11285 1 835 11115 11225 11124 11 12109 11 --------------------------11-----1--- 1-----1-----1-----1-----1------1-----1-----1-----1-----1-----1 i------------I i Wellness Exams Scheduled II I I I I I I I I I I I II I I CHOP Providers 11 I I 1 1 I I I I I I I II II Appts. Made 11 66 1 26 1 32 1 43 I 36 1 38 1 44 1 64 1 30 ( 23 i 24 1 43 11 469 II Appts. Kept 11 22 1 23 1 10 1 25 1 29 1 25 1 37 1 30 1 11 1 18 1 5 1 32 i1 267 II Kept/Made % 11 33%1 88%1 31X1 58X1 81%1 66X1 84%1 47%1 37X1 78X1 21X1 74X11 57—.11 Monthly Kept/Made % will not be accurate as prior month's "made" may be included in current month's "kept". 123\9293200% PE:cm 7/13/92 COUNTY/CITY: CONTRA COSTA 1994-95 CHDP Plan CHDP PLAN UPDATE EXAMPLES OF CHILDREN HELPED THROUGH CHDP (MINIMUM OF FIVE) DURING FISCAL YEAR 1992-93 DIAGNOSIS TREATMENT IMPACT 1. Severe Baby Bottle Referred to pediatric Potential for abscesses Tooth Decay in 19 dentist decreased month old. Child required Child's growth and anesthesia due to age development will now • Referred to Season of be normal. Sharing to cover cost of anesthesia • Funds received by dentist • Treatment completed 2. Persistent side pain Lab and x-rays ordered Proper diagnosis and after wellness exam treatment of condition Referred back to will, hopefully, allow primary MD, who the child to lead a repeated lab work - normal, full life. White Blood Cell count elevated • Referred to Childrens Hospital - Oakland - diagnosed with Leukemia • Chemotherapy started 3. Shortness of breath with Wellness exam revealed After diagnosis made, exercise heart murmur treatment was initiated. • Referred to Childrens This alleviated child's Hospital - Oakland - symptoms for several diagnosed with Cor months. Unfortunately, Pulmonale child expired while • Treatment initiated awaiting a transplant. Referred for heart/lung transplant PE= p6\9495help COUNTY/CITY: CONTRA COSTA 1994-95 CHDP Plan CHDP PLAN UPDATE EXAMPLES OF CHILDREN HELPED THROUGH CHDP (MINIMUM OF FIVE) DURING FISCAL YEAR 1992-93 DIAGNOSIS TREATMENT IMPACT 4. Fever of unknown Referred for Xrays and Long term disability origin further testing avoided due to prompt Rule out hydronephrosis Referred to Childrens diagnosis/treatment. Hospital - Oakland - Infant able to admitted to hospital grow/develop normally. • Xrays of kidneys - normal • Chest Xray revealed mass • Lung biopsy performed • Coccidioidomycosis diagnosed - treatment started. 5. Neo-natal seizures Placed in Intensive Care Infant is receiving early Drug exposure - in for respiratory distress, intervention services, infant utero placed on phenobarbital stimulation by High Risk Esotropia for seizures Infant Public Health Nurse Premature - 34 week Referred to and occupational therapy by gestation ophthalmologist for County Selpa. Infant is Apgar scores - 3 + 4 esotropia being seen on a regular Abnormal EEG Presented to ICIS basis for his vision and Developmental delay roundtable where child neurological problems. was referred to High Risk Infant Program • Followed by neurologist at Childrens Hospital - Oakland. • Referred to County Selpa where child will receive Occupational Therapy. PE:cm p619495help COUNTY/CITY: CCC-MTZ 1994-95 CHDP Plan CHDP PLAN UPDATE EXAMPLES OF CHILDREN HELPED THROUGH CHDP (MINIMUM OF FIVE) DURING FISCAL YEAR 1992-93 DIAGNOSIS TREATMENT IMPACT o severe dental o appt. made o pain caries (BBTD) with local stabilized & & child in pedodontist resolved pain with a specializing draining oral in BBTD o antibiotics fistula (24 given for mos. old) infection & stabilized C some teeth extracted that were not salvageable (3) o some teeth capped that were salvageable (4) O family provided with extensive counciling re: BBTD O child switched from bottle to cup with success U2/plan