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Welcome!
Healthy Start Infant
Screening Training
Direct Services
Program Components
• Universal prenatal and infant risk screening
• Healthy Start Care Coordination and
Wr...
Risk Screening
Florida Statute 383.14 - requires the screen
(questionnaire) to be offered to all pregnant
women at their f...
Monitoring
The Healthy Start Coalition
monitors screening rates of the county
and individual providers
and offers technica...
Benefits of Infant Screening
Identifies risk factors which could increase an
infant’s risk of death
Assures early referr...
More on
Screening
• The Infant Risk Screen is initiated with each
Birth Certificate (BC)
• The person completing the BC mu...
Scoring the
Screen
• A score of 4 or more is an automatic referral to
Healthy Start because of risks which increase
the ch...
Other Risk Factors for
Eligibility and Referral
• Neonatal Abstinence Syndrome
• Currently substance misuse or abuse – tob...
Self Referral
If the infant does not score a 4 or more, or the
mother or infant do not have any of the other
risk factors ...
The Healthy
Start Program IS
A statewide, voluntary program available at no
cost to participants
Designed for prenatal w...
Healthy Start is NOT
It is Risk-Based
• Income-based
• A Medicaid program
• Based on immigration status
• Department of Ch...
Healthy Start
Care
Coordination
Three methods of referral to Healthy Start
1. Infant risk screen score of 4 or more
2. Ref...
After a Referral
is Made
• Assignment to a Care Coordinator
• Initial Contact within 5 working days to
determine risk leve...
Healthy Start Care
Coordinators
• Make contacts on a regular schedule based
on risk level (P, E, I, II, III)
• Provide edu...
Wraparound
Services
• Breastfeeding Education and Support
• Psychosocial Counseling
• Tobacco Education and Cessation
• Ch...
Length of Services
• Prenatal – up to 6-8 weeks post-partum
• Infant – up to 3 years of age
A client can be closed wheneve...
• Consent to the Healthy Start infant screen - This is
done by stating “yes” to the first statement
• Consent to be contac...
First Consent Item:
Consent to Screen
Second Consent Item:
Consent to Contact/Program
Participation
Third Consent Item:
Co...
Patient Contact Info Referral Status
Reason if referral “based
on other factors” or if
scored in but NOT
referred
Electron...
Scored Items
Electronic Birth Records (EBR)
Scored Items View:
Patient Signature
Field
Electronic Birth Records (EBR)
Patient Signature Field:
Infant Screen – Paper Version
Patient Section: First Consent Item:
Consent to Screen
Third Consent Item:
Consent to Share
...
Infant Screen – Paper Version
Patient Section:
Patient Contact
Information
Patient Signs and
Dates
Infant Screen – Paper Version
Provider Section:
Scored Items
Provider Signs
and Dates
Infant Screen – Paper Version
Provider Section:
Referral Status
Reason if referral “based on
other factors” or if scored i...
How can we increase
consent for the first
consent item?
The first consent item is now auto-populated as “YES” on the
elect...
Explain why consent to contact is important.
How can we increase
consent for the second
consent item?
• If you need help t...
How can we increase
consent for the third
consent item?
Explain why consenting to releasing information
is important.
• We...
When she says yes, you can add:
“You are making a good decision to screen your new
baby. Even if you or your baby may not ...
If the patient is reluctant
to sign:
• Reinforce that this information is absolutely
confidential.
• Healthy Start follows...
If the patient doesn’t want the screen because she
doesn’t think the baby is at risk, let her know that our
Healthy Start ...
Discussing the
results if the infant
scores 4 or more:
• Nurse, midwife, or doctor shares the score with the
mother and ex...
According to Florida State Statute, 383.14 (FAC
64-C), the health care provider shall assure that
the parent or guardian i...
Discussing the results if
the infant does not have
a score of 4 or more:
• Provide the score to the mother
• Discuss Healt...
If at any time in the first year of the baby’s life someone
feels they may need Healthy Start services, they can call
861-...
For more information…
Contact: Jamee Thumm
Education Coordinator
941.373.7070 ext. 307
jamee.thumm@healthystartsarasota.or...
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Hs infant screening training 2013 revised 7-29-13

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Education on Healthy Start Services, including infant screening and referral instructions.

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Hs infant screening training 2013 revised 7-29-13

  1. 1. Welcome! Healthy Start Infant Screening Training
  2. 2. Direct Services Program Components • Universal prenatal and infant risk screening • Healthy Start Care Coordination and Wraparound Services
  3. 3. Risk Screening Florida Statute 383.14 - requires the screen (questionnaire) to be offered to all pregnant women at their first prenatal visit and all infants before leaving the delivering facility
  4. 4. Monitoring The Healthy Start Coalition monitors screening rates of the county and individual providers and offers technical assistance as needed. Infant Screening Rate for Fiscal Year 2012-13 Sarasota County 97% Florida 93%
  5. 5. Benefits of Infant Screening Identifies risk factors which could increase an infant’s risk of death Assures early referral to Healthy Start for services Helps health care providers care for the “whole patient” Increases Healthy Start funding in the county
  6. 6. More on Screening • The Infant Risk Screen is initiated with each Birth Certificate (BC) • The person completing the BC must “offer” the screen and receive consent to conduct the screen • Consent must be obtained to send the screen answers to Healthy Start, and for Healthy Start to make contact
  7. 7. Scoring the Screen • A score of 4 or more is an automatic referral to Healthy Start because of risks which increase the chance of infant death in the 1st year. • This is why it is so important to obtain “yes” on each of the questions about screen completion, release of information to HS, and allowing HS to contact the patient. • In the hospital, scores of 4 or more should be reported to the patient’s nurse for follow-up.
  8. 8. Other Risk Factors for Eligibility and Referral • Neonatal Abstinence Syndrome • Currently substance misuse or abuse – tobacco, drugs, or alcohol • Severe depression, active mental illness, or post-partum depression • Breastfeeding problems and needs more intensive follow-up and assistance post-discharge • Current abuse or neglect in the home • Homelessness • Fetal loss after 20 weeks gestation, for interconception health education when she is ready
  9. 9. Self Referral If the infant does not score a 4 or more, or the mother or infant do not have any of the other risk factors for eligibility: The mother can call Healthy Start at 861-2905 to discuss her needs.
  10. 10. The Healthy Start Program IS A statewide, voluntary program available at no cost to participants Designed for prenatal women and infants Tailored to meet each individual’s needs and circumstances by providing referrals, information, and supportive services Confidential
  11. 11. Healthy Start is NOT It is Risk-Based • Income-based • A Medicaid program • Based on immigration status • Department of Children and Families
  12. 12. Healthy Start Care Coordination Three methods of referral to Healthy Start 1. Infant risk screen score of 4 or more 2. Referrals based on other factors 3. Self-referrals We have 9 Care Coordinators
  13. 13. After a Referral is Made • Assignment to a Care Coordinator • Initial Contact within 5 working days to determine risk level and assets • A more in-depth assessment is scheduled if necessary. • Ongoing coordination of care commences as needed.
  14. 14. Healthy Start Care Coordinators • Make contacts on a regular schedule based on risk level (P, E, I, II, III) • Provide education, support, and monitoring • Make linkages in the community • Make referrals for wraparound services if needed
  15. 15. Wraparound Services • Breastfeeding Education and Support • Psychosocial Counseling • Tobacco Education and Cessation • Childbirth Education • Nutrition Counseling • Parenting Education and Support • Interconception Education We have 8 Wraparound Service Providers
  16. 16. Length of Services • Prenatal – up to 6-8 weeks post-partum • Infant – up to 3 years of age A client can be closed whenever services are declined, transitioned elsewhere, or when risks are resolved. A client remains in care coordination as long as services are necessary and the client is actively participating.
  17. 17. • Consent to the Healthy Start infant screen - This is done by stating “yes” to the first statement • Consent to be contacted/program participation - This is done by stating “yes” to the second statement • Consent to release of information - This is done by stating “yes” to the third statement* * If the patient states “no” to any of the above statements, she may not be able to access program services Recap: How can a patient begin to access services?
  18. 18. First Consent Item: Consent to Screen Second Consent Item: Consent to Contact/Program Participation Third Consent Item: Consent to Share Information Electronic Birth Records (EBR) Consent Items:
  19. 19. Patient Contact Info Referral Status Reason if referral “based on other factors” or if scored in but NOT referred Electronic Birth Records (EBR) Patient Contact and Referral:
  20. 20. Scored Items Electronic Birth Records (EBR) Scored Items View:
  21. 21. Patient Signature Field Electronic Birth Records (EBR) Patient Signature Field:
  22. 22. Infant Screen – Paper Version Patient Section: First Consent Item: Consent to Screen Third Consent Item: Consent to Share Information Second Consent Item: Consent to Contact/Program Participation
  23. 23. Infant Screen – Paper Version Patient Section: Patient Contact Information Patient Signs and Dates
  24. 24. Infant Screen – Paper Version Provider Section: Scored Items Provider Signs and Dates
  25. 25. Infant Screen – Paper Version Provider Section: Referral Status Reason if referral “based on other factors” or if scored in but NOT referred
  26. 26. How can we increase consent for the first consent item? The first consent item is now auto-populated as “YES” on the electronic screen. However, consent still needs to be requested from the mother. Explain why the screen is important and how it is used. • Help identify infants and moms that might need help. • It is so important that we are required by Florida Law to offer this screen to all new moms.
  27. 27. Explain why consent to contact is important. How can we increase consent for the second consent item? • If you need help this allows Healthy Start to contact you. • Sometimes mom’s needs change, saying “yes” means Healthy Start can contact you if you need help later.
  28. 28. How can we increase consent for the third consent item? Explain why consenting to releasing information is important. • We need permission to share this screening info with Healthy Start. • All information is kept private and confidential. • Healthy Start only shares information that is needed for your or your baby’s care.
  29. 29. When she says yes, you can add: “You are making a good decision to screen your new baby. Even if you or your baby may not need services now, if you do in the future this helps getting you in Healthy Start more quickly.”
  30. 30. If the patient is reluctant to sign: • Reinforce that this information is absolutely confidential. • Healthy Start follows state laws and HIPAA guidelines. • The mother’s social security number is entered into the state data system regardless of consent to share the Healthy Start Screening Information.
  31. 31. If the patient doesn’t want the screen because she doesn’t think the baby is at risk, let her know that our Healthy Start Program gets additional funding from the state the greater the number of screens that are completed and consents to participate in Healthy Start. Altruism sometimes enhances consent. If the patient still refuses any aspect of screening, the demographic information and provider’s signature must be entered and the form is attached to the birth certificate.
  32. 32. Discussing the results if the infant scores 4 or more: • Nurse, midwife, or doctor shares the score with the mother and explains what the risks mean. • Tell about Healthy Start and the free services offered. • Let the patient know that a Care Coordinator will be contacting her soon to learn more about what services are needed. • Make sure the patient has authorized consent to contact and share information! • Please make sure the patient has brochures about the Healthy Start and the Infant Screen.
  33. 33. According to Florida State Statute, 383.14 (FAC 64-C), the health care provider shall assure that the parent or guardian is informed of the baby’s risk status as determined by the infant risk screening instrument. Remember!
  34. 34. Discussing the results if the infant does not have a score of 4 or more: • Provide the score to the mother • Discuss Healthy Start and free services offered • If the patient meets any of the eligibility criteria and needs referred in “based on other factors” consent must still be provided by the patient and the same information is needed as if the infant scored in. • Please make sure the patient has brochures about the Healthy Start and the Infant Screen.
  35. 35. If at any time in the first year of the baby’s life someone feels they may need Healthy Start services, they can call 861-2905 to talk to a Care Coordinator. Patients can always call Healthy Start for more information about any of the services offered. If the patient wants more information:
  36. 36. For more information… Contact: Jamee Thumm Education Coordinator 941.373.7070 ext. 307 jamee.thumm@healthystartsarasota.org Visit the local Healthy Start Coalition website: healthystartsarasota.org Visit the Florida Dept. of Health info. website: www.healthystartbaby.com

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