Ky.gov
Effective: 4/22/2025

C7.22 Meeting Basic Health Care Needs

Legal Authority

Introduction

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Practice Guidance

  • File all documentation once completed in the case file. 
  • The child’s behavioral health screening refers to a basic behavioral health assessment, rather than a full behavioral health diagnostic examination. 
  • Children under age three (3) involved in a substantiated case of child abuse or neglect are to be referred within seven (7) calendar days of identification to Kentucky Early Intervention Services (KEIS) for developmental screening (CAPTA 106(b)(2)(B) and 34 CFR 303.303).
  • Children under five (5) who do not qualify for referral to KEIS should receive an Early Periodic Screening, Diagnosis, and Treatment Services (EPSDT) screening from the local health department. 
  • Developmental screenings for children under five (5) may be in place of or in addition to a behavioral health assessment, dependent upon the outcome of the behavioral health screeners required by SOP C7.22.3 Standardized Screening and Assessment for Children in Out of Home Care.​
  • The SSW should be aware that a child who is eligible for Medicaid is also eligible for EPSDT services from the local health department. 
  • The documentation provided by the medical or mental health professional is an appropriate substitute for the following forms: 
    • DPP-106C Child Medical History and Annual Physical Exam; 
    • DPP-106D Medical Appointment; 
    • DPP-106E Dental Care; 
    • DPP-106F Visual Screening; and 
    • DPP-106G Mental Health Services. 
  • The foster/adoptive parent of a child with diabetes may administer or assist with the self-administration of medication if the foster/adoptive parent has been trained to administer insulin and glucagon, recognize the signs and symptoms of hypoglycemia and hyperglycemia, and take appropriate steps to respond to these symptoms by: 
    • A physician who is licensed under the provisions of KRS Chapter 311; 
    • An advanced practice registered nurse, registered nurse, or licensed practical nurse who is licensed under the provisions of KRS Chapter 314; or 
    • Any other health care professional with diabetes treatment within his or her scope of practice. 
  • The foster/adoptive parent must receive written authorization from the health care practitioner which contains the following information, to administer or assist with the ​administration of diabetes medication: 
    • Youth's name; 
    • Name and purpose of the medication; 
    • Prescribed dosage; 
    • Route of administration; 
    • The frequency with which the medication may be administered; and 
    • Circumstances under which the medication may be administered.

Procedure

The SSW:

  1. Completes the following forms upon entry of a child into OOHC: 
    1. DPP-106A Authorization for Routine Health Care and Authorization for Non-Routine Health Care; 
    2. DPP-106B Initial Physical and Behavioral Health History to obtain an outline of the child's medical history from the family; and 
    3. Screener. 
  2. Ensures that the child receives a physical health screening within forty-eight (48) hours of an order in which a child enters the custody of the Cabinet for Health and Family Services (Cabinet/CHFS), and treatment for any injury/illness that may be the result of maltreatment within twenty-four (24) hours of the order; 
  3.  Notifies the child’s assigned managed care organization (MCO) within five (5) working days of a child’s entry into out -of-home care (OOHC); 
  4. Shares the child’s medical and behavioral health care needs with the MCO to assure all needs are addressed;
  5. Submits the DPP-106B Initial Physical and Behavioral Health History to the MCO within ten (10) working days of the child’s entry into OOHC. Staff submits the DPP-106B for MCO signature, but it is not required for Department for Community Based Services (DCBS) records;
  6. Foster parent/caretaker, or parent completes section I of the DPP-106C-Child Medical History and Annual Physical Exam (section II is completed by the medical provider during the physical exam); 
  7. Makes arrangements for the child to attend the following appointments within two (2) weeks of an order in which a child enters the custody of the Cabinet, either via a temporary order of custody or commitment: 1 
    1. Medical exam (documented on the DPP-106D-Medical Appointment); 
    2. Dental examinations (documented on the DPP-106E-Dental Appointment); and 
    3. Visual exam (documented on the DPP-106F-Visual Screening); 
  8. Facilitates completion of the child’s behavioral health screening performed by a qualified mental health professional (QMHP) (documented on the DPP-106G-Mental Health Services) within thirty (30) calendar days of a child’s entry into OOHC; 
  9. Makes arrangements and documents service provision when the screening indicates that further assessment or treatment is necessary;2
  10. Refers children under age three (3) involved in a substantiated case of child abuse or neglect or affected by illegal substance use to Kentucky Early Intervention Services (KEIS) for developmental screening within seven (7) calendar days of identification [CAPTA 106(b)(2)(B) and 34 CFR 303.303].
  11. Arranges for a child to have a complete medical, dental, and visual examination no less than once per year; 3 
  12.  Uses the medical passport guidelines to document the physical and mental health care services for a child in OOHC;
  13. Follows guidelines for authorization for medical services for a child in OOHC; 
  14. Follows guidelines for medical care for a medically complex child; 
  15. Provides the child of an appropriate age a written summary of information about his health, and (when there is a signed DCBS-1 Informed Consent and Release of Information and Records) the health of his birth parents, and includes a copy in the child’s record to include the following information regarding the family’s known health history: 
    1. Immunizations; 
    2. Operations; 
    3. Childhood illnesses; and 
    4. Mental illness. 
  16. Maintains a written summary of the birth parents’ known health history in the case record based on information obtained through interviews, observation, or health records received to include the following information: 
    1. The status of the birth parents’ past and current physical and mental health; 
    2. Physical and mental health services that have been or are being provided to them; 
    3. Their history of substance use or misuse; and 
    4. Physical or developmental disabilities.


Footnotes

  1. The MCO should assist the worker in locating providers and arranging these appointments. 
  2. Arrangements are made for initial service provision within two (2) working days of the receipt of the information. 
  3. More frequent examinations are arranged as necessary, based on the child’s age and physical condition.​
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Documents

Revisions

4/22/2025

  • The child’s behavioral mental health screening refers to a basic behavioral mental health assessment, rather than a full behavioral mental health diagnostic examination. 
  • Children under age three (3) involved in a substantiated case of child abuse or neglect are to be referred within seven (7) calendar days of identification to Kentucky Early Intervention Services (KEIS) for developmental screening (CAPTA 106(b)(2)(B) and 34 CFR 303.303).​
  • Children under five (5) who do not qualify for referral to KEIS should are to receive an Early Periodic Screening, Diagnosis, and Treatment Services (EPSDT) screening from the local health department. or, if eligible, a First Steps screening (federal zero to three program) as a substitute for a mental health screening. ​
  • Developmental screenings for children under five (5) may be in place of or in addition to a behavioral health assessment, dependent upon the outcome of the behavioral health screeners required by SOP C7.22.3 Standardized Screening and Assessment for Children in Out of Home Care.​
​8.  Facilitates completion of the child’s behavioral mental health screening performed by a qualified mental health professional (QMHP) (documented on the DPP-106G-Mental Health Services) within thirty (30) calendar days of a child’s entry into OOHC; ​
10.  Refers children under age three (3) involved in a substantiated case of child abuse or neglect or affected by illegal substance use to Kentucky Early Intervention Services (KEIS) for developmental screening within seven (7) calendar days of identification [CAPTA 106(b)(2)(B) and 34 CFR 303.303].​