CITY OF CASPER

• #1 FIELD MEDICAL ASSESSMENT PROTOCOL
• #2 IMMEDIATE CARE PROTOCOL
• #3 BASELINE ASSESSMENT PROTOCOL
• #4 INITIAL FOLLOW-UP CARE PROTOCOL
• #5 LONG-TERM FOLLOW-UP CARE PROTOCOL

#4 INITIAL FOLLOW-UP CARE PROTOCOL

A visit for initial follow-up care occurs within 30 days of the baseline assessment to reevaluate the comprehensive health status of the child, identify any latent symptoms, and ensure appropriate and timely follow-up services as the child’s care plan and placement are established. If possible, the visit should be scheduled late in the 30 day time frame for more valid developmental and mental health results.

STEPS:

1. Follow-up of any baseline test results.

2. Perform a developmental examination (Using instruments such as the Denver, Gesell, and Bayley) as indicated by developmental screen in Protocol #3.

3. Conduct mental health history and examination. (Requires qualified pediatric professional)

4. If abnormal findings on any of the above, schedule intervention and follow-up as appropriate to the findings; then proceed with long-term follow-up protocol (See Protocol #5). If no abnormal findings, schedule visits per long term follow-up care protocol (Protocol #5).

5. Adequacy of child’s shelter/placement situation should be reviewed by CPS worker and modified as necessary.

Long-term follow-up care is designed to: 1) monitor physical, emotional, and developmental health, 2) identify possible late developing problems related to exposure to the methamphetamine environment, and 3) provide appropriate intervention. At minimum, a pediatric visit is required 12 months after the baseline assessment. Children considered to be Drug Endangered Children (DEC) cases should receive follow-up services a minimum of 18 months post identification.

Required Components of Follow-Up Care

1. Pediatric Care Visits. The visits should occur according to the American Academy of Pediatrics schedule.

A. Follow-up previously identified problems.

B. Perform comprehensive (EPSDT) physical exam and laboratory examination with particular attention to:

a. Liver function (repeat panel at first follow-up only).

b. Respiratory function (history of respiratory problems, asthma, recurrent pneumonia, check for clear breath sounds)

c. Neurological evaluation.

C. Perform full developmental screen.

D. Perform mental health evaluation by licensed child mental health professional.

2. Plan follow-up treatment or adjust existing treatment for any medical problems identified. Medical records should continue to accompany the child’s course of care.

3. Adequacy of child’s shelter/placement situation should be reviewed by CPS worker and modified as necessary.

4. Plan follow-up strategies for developmental, mental health or placement problems identified.

Optional Enhancements to Follow-Up Care

1. Conduct pediatric care visits including developmental screen and mental health evaluation at 6, 12, and 18 months following the baseline assessment.

2. Conduct home visits by pediatric trained RN at 3, 9, 15, and 18 months post-baseline assessment. Ensure that home visits occur between the pediatric clinic visits until the last visit at 18 months.

3. Perform drug screening of non-CPS caregiver. Recommend Mon/Wed/Fri screening protocol.

4. Perform home visits following reunification.

5. Child Development Center monitoring of age appropriate development through age 16.