9.2.3.6: Identification of Child’s Medical Home and Parental Consent for Information Exchange

As part of the enrollment of a child, the caregiver/teacher should ask the family to identify the child’s primary care provider, his or her medical home, and other specialty health care professionals. The parent/guardian should provide written consent to enable the caregiver/teacher to establish communication with those providers. The family should always be informed prior to the use of the permission unless it is an emergency. The providers with whom the facility should exchange information (with parental consent) should include:

1. Sources of regular medical and dental care (such as the child’s primary care provider, dentist, and medical facility);
2. Special clinics the child may attend, including sessions with medical specialists and registered dietitians;
3. Special therapists for the child (e.g., occupational, physical, speech, and nutritional), along with written documentation of the services rendered provided by the special therapist;
4. Counselors, therapists, or mental health service providers for parents/guardians (e.g., social workers, psychologists, or psychiatrists);
5. Pharmacists for children who take prescription medication on a regular basis or have emergency medications for specific conditions.

RATIONALE

Primary care providers are involved not only in the medical care of the child but also involved in supporting the child’s emotional and developmental needs (1-3). A major barrier to productive working relationships between child care and health care professionals is inadequate communication (1,2).

Knowing who is treating the child and coordinating services with these sources of service is vital to the ability of the caregivers/teachers to offer appropriate care to the child. Every child should have a medical home and those with special health care needs may have additional specialists and therapists (4-7). The primary care provider and needed specialists will create the Care Plan which will be the blueprint for healthy and safe inclusion into child care for the child with special health care needs.

COMMENTS

A source of health care may be a community or specialty clinic, a public health department, specialist, or a private primary care provider. Families should also know the location of the hospital emergency room departments nearest to their home and child care facility.

The California Childcare Health Program has developed a form to help facilitate the exchange of information between the health professionals and the parents/guardians and caregivers/teachers at http://ucsfchildcarehealth.org/pdfs/forms/CForm_ExchangeofInfo.pdf. They also release an information form at http://ucsfchildcarehealth.org/pdfs/forms/CF_ReferralRel.pdf. For more information on the medical home concept, see the American Academy of Pediatrics’ (AAP) Medical Home Website at http://www.medicalhome
info.org.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

2.3.3.1 Parents’/Guardians’ Provision of Information on Their Child’s Health and Behavior
3.5.0.1 Care Plan for Children with Special Health Care Needs
9.4.1.3 Written Policy on Confidentiality of Records
9.4.1.4 Access to Facility Records
9.4.1.5 Availability of Records to Licensing Agency
9.4.1.6 Availability of Documents to Parents/Guardians
Appendix AA: Medication Administration Packet
Appendix FF: Child Health Assessment
Appendix O: Care Plan for Children with Special Health Care Needs

REFERENCES

1. American Academy of Pediatrics (AAP). 2001. The pediatrician’s role in promoting health and safety in child care. Elk Grove Village, IL: AAP.
2. Murph, J. R., S. D. Palmer, D. Glassy, eds. 2005. Health in child care: A manual for health professionals. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics.
3. Hagan, J. F., J. S. Shaw, P. M. Duncan, eds. 2008. Bright futures: Guidelines for health supervision of infants, children, and adolescents. 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics.
4. Starfield, B., L. Shi. 2004. The medical home, access to care, and insurance: A review of evidence. Pediatrics 113:1493-98.
5. Homer, C. J., K. Klatka, D. Romm, K. Kuhlthau, S. Bloom, P. Newacheck, J. Van Cleave, J. M. Perrin. 2008. A review of the evidence for the medical home for children with special health care needs. Pediatrics 122:e922–37.
6. Inkelas, M., M. Regolado, N. Halfon. 2005. Stategies for integrating developmental services and promoting medical homes. Los Angeles: National Center for Infant and Early Childhood Health Policy.
7. Nowak, A. J., P. S. Casamassimo. 2002. The dental home: A primary care concept. JADA 133:93-98.