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  DFCS Online Policies & Procedures

  DFCS Online Policies & Procedures

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Handbook 19: How To..
19-4.3 How to Refer to Public Health Nursing Services

 

How To..
19-4.3  How to Refer to Public Health Nursing Services
Reference Points
Overview
Medical Concerns for PHN Referral
Making a Referral for PHN Services
Role of the Public Health Nurse


Reference Points
Effective Date: 8/1/10
Last Updated: 4/09/2013
 Non CWS/CMS Forms:
MS Word Referral to Public Health Nursing (1650c)
 CWS/CMS Forms:
bullet Client Management Section: Case Plan
bullet Services Management Section: Contact Notebook


Overview   The Santa Clara County Public Health Department provides Regional Public Health Nurses (PHNs) to work with parents, caregivers, and children who are receiving services through the Department of Family and Children's Services (DFCS).  A Home Visitation Program is offered to children ages 0 through 5 who receive voluntary  and Court-ordered services through DFCS.  Limited PHN services are also extended to children ages 6 and older, including non-minor dependents and non-minor former foster youth who are under 21 years of age.
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Medical Concerns for PHN Services  

Children ages 6 and older who have the following concerns may be referred to Public Health Nursing Services

  • Growth/development concerns
  • Premature infants
  • Infants drug exposed in utero
  • Unmet medical needs
  • Pregnant teen
  • Obesity
  • Asthma
  • Diabetes
  • Other medical concerns
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Making a Referral for PHN Services  

For children 0 through 5 years:

For children 6 years and older will be considered on a case by case basis:

  • Please contact AnneMarie Santos, Lead PHN at the Regional Public Health Nursing Referral Center at (408)494-1521 to discuss the child's specific medicall/health needs.
  • If directed, the social worker faxes a completed Referral to Public Health Nursing (SCZ 1650c) to the Public Health Department Referral Center at (408) 494-1557.  Services can be provided in Spanish and Vietnamese.  Services for this age group are limited and referrals are accepted on a case-by-case basis.
Note that referrals for Public Health Nursing services for children involved in Family Wellness Court utilize a different referral process.
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Role of the Public Health Nurse  

The Public Health Nurse:

  • Prioritizes referrals according to presenting concerns
  • Assesses children in their home environment
  • Implements a plan of care to assist clients to access appropriate health and community based services
  • Teaches children and caregivers about diagnosed health problems, self-care, and treatment needs
  • Provides:
    • Case management and conferences with the child’s physician in a multidisciplinary team approach
    • Early assessment, intervention, and referrals to special needs resources
    • A communication link between parent/caregiver, medical provider, and social worker
    • Referrals to long term home visitation, if the client qualifies for Nurse Family Partnership (pregnant under 28 weeks gestation, first time mother, and low income)
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Other References  
bullet2 OPP Chapter 4-8: Public Health Nursing Home Visitation Program
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