Department for Community Based Services

Standards of Practice Online Manual

12.18.3 Medically Complex Home

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 12-Resource Family Recruitment, Certification and Reimbursement
Effective:
11/18/2015
Section:
12.18.3 Medically Complex Home
Version:
5

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Legal Authority/Introduction

LEGAL AUTHORITY:

INTRODUCTION:

Medically complex foster/adoptive homes provide specialized care for children with complex medical needs who are in the custody of the cabinet. Foster/adoptive homes expressing a desire to care for children designated as medically complex must demonstrate their ability and aptitude to provide specialized medical care. Additional training and certification in infant, adult and child CPR and First Aid are required beyond the pre-service training.

     

Procedure

The R&C Worker:

  1. Follows the procedures outlined in SOP 12.18 Specialized Foster Care Services, as well as, the procedures listed below;
  2. Determines whether the applicant home has the aptitude and desire to provide medically complex  foster care services1 and is able to care for a child in the custody of the cabinet who is determined to be medically complex by designated cabinet staff due to:
    1. Significant medically oriented care needs related to a serious illness or condition diagnosed by a health professional that may become unstable or change abruptly, resulting in a life-threatening event;
    2. A chronic condition that is expected to be life-long and progressive and to require extensive services;
    3. An acute, time-limited condition requiring additional oversight; or
    4. A severe disability that requires the routine use of medical devices or assistive technology to compensate for the loss of a vital body function needed to participate in activities of daily living and significant and sustained care to avert death or further disability.
  3. Ensures that the primary caretaker in the applicant medically complex foster or adoptive fragile resource home is not employed outside the home unless it is determined that the child’s needs will continue to be met;
  4. Obtains permission (through supervisory channels) from the Director of the Division of Protection and Permanency for an exception to this requirement, and this must occur at the time of placement;
  5. Helps arrange for the applicant medically complex foster or adoptive fragile resource home to:
    1. Complete the initial medically complex Join Hands Together training (12 hours of training) offered by the Cabinet which covers the following topic areas and specific to children with medical complexity:  and
      1. Growth and development;
      2. An overview of procedures and techniques which may be utilized to provide care;
      3. Observation and assessment;
      4. Management and diet and environment;
      5. Documentation of provided care;
      6. Parenting skills; and
      7. Permanency planning
    2. Obtain certification in infant, child and adult CPR and first aid; 2
  6. Documents completion of the training and certification in the resource family’s case file;
  7. Documents when professional experience related to the care of a child with medical complexity substitutes for the initial and annual medically complex training requirements if approved by DPP Director and the foster or adoptive parent:
    1. Is health professional;
    2. Is certified in infant, child and adult CPR and First Aid; and
    3. Has completed twelve (12) hours of continuing education focusing on pediatrics within the past year that will assist the parent in the care of a child with medical complexity;
  8. Documents that the applicant medically complex foster or adoptive home receives training from a health professional in how to care for the specific medically complex child and maintains current certification in CPR and first aid;
  9. Ensures that the applicant medically complex foster or adoptive home is located within one (1) hour of a medical hospital with an emergency room and thirty (30) minutes of a local medical facility; 
  10. Submits documentation for an approved medically complex foster or adoptive home to receive re-approval by the Cabinet as a medically complex home if the parent:
    1. Annually completes prior to the anniversary date of the original approval as a foster or adoptive home:
        1. Twelve (12) hours of ongoing Cabinet-sponsored training related to the care of children with medical complexity that is offered two times per year in a conference setting; and
        2. Ten (10) additional hours of Cabinet-sponsored training and;
        3. Maintains current certification in infant, child and adult CPR and first aid; and
    2. Continues to meet the requirements as a medically complex foster or adoptive home;
  11. Authorizes:
    1. The basic medically complex foster or adoptive rate to a foster or adoptive home approved to care for a child who is determined to be medically complex by the Medical Support Section in the Division for Protection and Permanency;
    2. The advanced medically complex foster or adoptive rate to a foster or adoptive home parent who has been approved for two (2) years and is approved to care for a child who is determined to be medically complex by the Medical Support Section in the Division of Protection and Permanency; or
    3. The specialized medically complex foster or adoptive rate to a foster or adoptive home with a parent, who provides for the care of a child with medical complexity determined by designated cabinet staff to meet specialized medically complex criteria due to a required higher level of medical care or oversight, which may also include behavioral or emotional needs related to the medical condition;
    4. The degreed specialized medically complex rate to a foster or adoptive parent who maintains a current license as a health professional, and provides for the care of a child with medical complexity determined by designated cabinet staff to meet specialized medically complex criteria due to a required higher level of medical care or oversight, which may also include behavioral or emotional needs related to the medical condition.
  12. Documents in TWIST the approval (if approval is granted) by the addition of a new resource recommendation.

Practice Guidance

  • The medically complex foster or adoptive home demonstrates access to available supportive services for the approved number of children in the home, unless an exception is granted by the SRA as described in SOP 12.11.1 Placement Exception Requests.
  • If a child who has diabetes is placed in a residential facility, the SSW should refer to SOP 4.26 Meeting Basic Health Care Needs regarding instruction on how to handle medication administration for that child.

  • An approved medically complex foster or adoptive home cooperates in carrying out the child’s health plan.
  • The specialized medically complex per diem rate is based on the severity of the child’s health condition and is assigned by the Medical Support Section.  
 

Footnotes

  1. Such services would be provided to a child who meets medically complex criteria, as determined by the Medical Support Section in the Division for Protection and Permanency.
  2. The preferred method of obtaining this training is in a group setting; however, if the foster parents cannot locate or attend group training, online certification through American Red Cross or American Heart Association in first aid and CPR for infants, children and adults will be accepted.

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