Child_Abuse_Medical_Services_-_Scope_of_Work.pdf

ATTACHMENT A

SCOPE OF WORK

FOR THE PROVISION OF CHILD ABUSE MEDICAL SERVICES

1. POPULATION TO BE SERVED

1.1 Provide Child Abuse Medical Services to individuals for suspicions of child maltreatment, at the discretion of Contractor’s medical expertise. Individuals shall hereinafter be referred to as “PATIENTS.” PATIENTS include, but are not limited to, the following:

1.1.1 Children ages birth to seventeen (0-17) years, who have been referred by

Social Services Agency (SSA) Children and Family Services (CFS), medical providers, law enforcement, or Juvenile Court; and

1.1.2 Developmentally delayed and/or disabled adults ages eighteen (18) years and older, who cannot be adequately served by adult programs due to their special needs and have been referred by law enforcement or Adult

Protective Services (APS).

2. DEFINITIONS

2.1 Child Abuse Services Team (CAST): A multidisciplinary program established in

1989 that enables social services, law enforcement, deputy district attorneys, medical providers, victim advocates, volunteer advocates, and therapists to collaborate on child abuse investigations.

2.2 CAST Case Review Meeting: A meeting comprised of CAST partners, who meet a minimum of one (1) time per month to review CAST services cases received.

2.3 CAST Medical Services: The medical component of CAST which includes medical evaluations and forensic medical exams conducted when investigations involve suspected child abuse or neglect and are intended specifically to support child sexual abuse evaluations.

2.4 CAST Policy Board Meeting: A meeting comprised of County of Orange Agency

Directors and CAST representatives to address policy issues that impact upon the

CAST program.

2.5 Orange County Suspected Child Abuse and Neglect (OC SCAN) Meeting: A meeting consisting of representatives from SSA, Pediatric Services, the District

Attorney’s Office, law enforcement agencies, behavioral health personnel, and community agencies to review and coordinate critical cases.

2.6 Orange County Child Death Review Team: A team established to provide a forum for multi-disciplinary review of child deaths reported to the Coroner with a focus on ensuring the quality of the multi-agency response to child deaths through increased communication, collaboration, and education.

2.7 Suspected Child Abuse and Neglect Team: A multidisciplinary team that works to identify and educate community partners on best practices for child abuse assessment, diagnosis, and referral.

2.8 Consultation Services: Consultation and medical evaluation services provided primarily telephonically to SSA’s social workers and CAST. These services may also be provided in person or via email.

2.9 Working to End Child Abuse and Neglect (WE CAN) Coalition: A collaboration of more than one hundred (100) programs and departments, both public and private, that work together to collectively address the intersecting needs of children, families, and communities touched by child abuse and/or neglect.

3. OUTCOME OBJECTIVES

3.1 Goals of Child Abuse Medical Services include to:

3.1.1 Promote collaboration among professionals including, but not limited to, medical professionals, child welfare, law enforcement, therapists, district attorney, victim advocates and volunteers to streamline the process of assisting patients, provide comprehensive services and to minimize the trauma experienced by victims by coordinating services and investigations.

3.1.2 Ensure Social Workers have access to ongoing medical consultation regarding potential/suspected child abuse and/ or neglect during designated consultation hours.

3.2 Outcomes for Child Abuse Medical Services include:

3.2.1 Provide an average of twenty (20) hours of Consultation Services per week.

3.2.2 Provide a minimum of two (2) trainings per year on child abuse and neglect issues to nurses, social workers, and/or other SSA staff.

3.2.3 Administer a survey upon completion of each training provided, resulting in a minimum of ninety (90) percent of responding attendees indicating that the training was useful and beneficial.

3.2.4 Medical Physician shall conduct consultations with a minimum of eighty-five percent (85%) of consultations within forty-eight (48) hours of request.

4. WORKLOAD STANDARDS

4.1 CAST Medical Services

4.1.1 Medical Physician, Licensed Vocational Nurse (LVN) and Office

Manager shall each provide services at CAST Medical Facility an average of forty (40) hours per week; and

4.1.2 Medical Physician shall provide administrative oversight and medical services an average of twelve (12) hours per week.

Consultation Services

4.1.3 Medical Physician shall provide services an average of twenty (20) hours per week, Monday through Friday afternoons, with a maximum of one thousand forty (1,040) annual hours during the term of this agreement.

4.1.4 Medical Physician shall provide on-call consultation services an average of ten (10) hours per week, Monday through Friday, Saturdays, and

Sundays, including evening hours, with a maximum of five hundred twenty (520) annual hours.

5. HOURS OF OPERATION

5.1 Provide services during hours that are responsive to the needs of the population(s) to be served as determined by ADMINISTRATOR, except COUNTY holidays as established by the Orange County Board of Supervisors. Services shall be provided on holidays, whenever possible. CAST Medical and Consultation services shall be provided during the weekday hours of 9AM-5PM, unless hours of operation are adjusted upon agreement.

5.2 COUNTY’s holiday schedule is as follows: New Year’s Day, Martin Luther King

Jr. Day, President Lincoln’s Birthday, Presidents’ Day, Memorial Day, Independence Day, Labor Day, Native American Day, Veterans Day, Thanksgiving

Day, Friday after Thanksgiving Day and Christmas Day. Written approval from

ADMINISTRATOR for any closure outside of COUNTY’s holiday schedule and the hours listed in Subparagraph 5.1 of this Attachment A is required.

6. GENERAL REQUIREMENTS

6.1 Participate in, and support the establishment of, a group to guide enhancement efforts related to services that may include, but are not limited to, development of protocols, peer review processes, OC SCAN team meeting structures, training, and educational materials.

6.2 Participate in countywide child abuse prevention efforts, including the Suspected

Child Abuse and Neglect Teams, Orange County Child Death Review Team, and

Working to End Child Abuse and Neglect Coalition.

6.3 Deliver culturally responsive and linguistically appropriate services to meet the primary language needs of PATIENTS.

7. SERVICE REQUIREMENTS

7.1 CAST Medical Evaluations – Clinical and Forensic Services

7.1.1 Coordinate all clinical medical encounters and examinations required at the CAST Medical Facility and other mutually agreed upon facilities.

7.1.2 Perform onsite physical abuse or neglect and/or forensic sexual assault medical examinations, and as appropriate, follow-up examinations.

7.1.3 Provide physician oversight, supervision, and training of medical staff.

7.1.4 Document services and activities in a manner that allows information to be effectively and accurately retrieved and presented to the Courts, CAST collaborators, or the community.

7.1.5 Ensure CAST medical records of child maltreatment/abuse/neglect cases produced by CAST Medical Facility are made available to

ADMINISTRATOR, as needed or requested, in compliance with federal

Health Insurance Portability and Accountability Act (HIPAA) regulations.

7.1.6 Ensure a secure chain-of-custody for case records and potential evidence.

7.1.7 Provide expert testimony in juvenile court proceedings.

7.1.8 Be responsible for the Medical Evaluation services component at the

CAST Medical Facility.

7.1.9 Participate in peer review activities, CAST Policy Board, and operational meetings.

7.2 Consultation Services

7.2.1 Provide Consultation services to SSA, District Attorney’s Office, Sheriff-

Coroner, law enforcement agencies, and County Counsel on reported abuse or neglect cases. In addition to providing services by telephone, services shall also be provided in-person or by email and may include, but not be limited to, the following:

Review of medical records and/or photographs;

Evaluation of diagnostic tests;

Conferring with social workers, caregivers, CAST, CFS staff, and/or other medical child protective team professionals (e.g., District Attorney’s Office staff, law enforcement agency staff, etc.) regarding child abuse and neglect;

Recommending follow up; and

Rendering medical opinion.

7.2.2 Provide consultations to medical staff in support of the accurate diagnosis of abuse or neglect including, but not limited to, discussion of cases with collateral personnel (i.e., anyone involved in the case in a professional capacity including social worker and witness, District Attorney’s Office staff, law enforcement agency staff, etc.) and review of PATIENTS’ medical records at the CAST Medical Facility or other mutually agreed upon medical facilities.

7.2.3 Participate in pre- and post-interview debriefings with interview observers comprised of law enforcement, medical providers, SSA staff, deputy district attorneys, volunteer advocates, and mental health providers.

7.2.4 Refer PATIENTS to services such as therapy, dental, subspecialties, and/or other programs or providers deemed necessary.

7.2.5 Provide expert testimony which may include, but is not limited to, testifying in juvenile court proceedings as mandated by subpoena.

7.2.6 Provide on-call consultations up to ten (10) hours per week, Monday through Friday, Saturdays, and Sundays, including evening hours. Provide a monthly schedule and submit to ADMINISTRATOR for approval. If services are required, respond within forty-eight (48) hours.

7.3 Medical Billing

7.3.1 Invoice law enforcement agencies (e.g., police departments) for forensic sexual exams authorized by said law enforcement agencies and invoice other entities (e.g., health insurance) for non-forensic services, when applicable. Seek reimbursements from applicable alternative resources for all reimbursable services prior to invoicing ADMINISTRATOR.

7.4 Additional Responsibilities

7.4.1 Notify ADMINISTRATOR, in writing, within seventy-two (72) hours, if physician position becomes vacant for any reason.

8. FACILITIES

8.1 Administrative services shall be provided at:

CAST Medical Facility/Orangewood Children and Family Center

401 The City Drive South

Orange, CA 92868

8.2 Services may also be provided at other locations, as necessary and/or as mutually agreed upon.

8.3 Laundry facilities at Orangewood Children and Family Center may be used as needed for clinical operations.

9. REPORTING REQUIREMENTS

Prepare and submit to ADMINISTRATOR, by the tenth (10th) calendar day of each month and in a format approved by ADMINISTRATOR, complete and accurate statistical reports for the prior month of service that include, but are not limited to, the following:

9.1 CAST Medical Services Monthly Activity Report

9.1.1 Total number of PATIENTS served;

9.1.2 Data on PATIENTS served (e.g., age and sex);

9.1.3 Type of encounter or exam (e.g., acute, follow-up exam, follow-up labs, physical abuse exam, etc.);

9.1.4 Date exam is offered and date exam is performed; and

9.1.5 Reason for not performing an exam (e.g., no disclosure was provided, PATIENT was a no-show, etc.).

9.2 Consultation Services Monthly Activity Report

9.2.1 Total number of consultations provided;

9.2.2 Data on subject of consulted case (e.g., child’s age, sex, type of abuse, etc.);

9.2.3 Type of consultation (e.g., telephone, in-person, or review of medical records, etc.);

9.2.4 Turnaround timeframe of consultation (e.g. consultation was provided within forty-eight [48] hours of request);

9.2.5 Total number of consultations provided to social worker(s) which could not be finalized and referred out;

9.2.6 Total number of on-call hours provided per week; and

9.2.7 Total number of training(s) provided to healthcare workers, including

PHN, first responders, social workers, and/or SSA staff, CAST participants such as law enforcement officers, volunteer advocates, deputy district attorneys, victim witness staff and therapists.

9.3 Provide additional reports as mutually agreed upon, regarding services and activities performed hereunder.

10. MEETINGS

10.1 Participate in OC SCAN meetings to review and coordinate critical cases.

10.2 Participate in CAST Case Review Meetings and monthly staff meetings.

10.3 Participate in CAST Policy Board Meetings, to address policy issues that impact the CAST Program.

11. STAFFING REQUIREMENTS

11.1 Providing training and maintaining a competent, stable, and experienced workforce to fulfill service requirements. Staff shall be able to read, write, speak, and understand English. If Client/Family contact is required to obtain the required documentation or provide services, provide translation services for languages needed so that all Client(s)/Families are provided services in their primary language.

11.2 Use a formal recruitment plan which complies with federal and State employment and labor regulations. Recruit and maintain trained personnel who are responsive to, and who understand, the diversity of cultures which can be found among the client population. Employ staff with the background, training, and experience to provide Child Abuse Medical Services.

12. TRAINING

12.1 Provide trainings and presentations on the risks and signs of abuse or neglect to various groups including, but not limited to, the following.

12.1.1 Social workers, CAST participants such as law enforcement officers, volunteer advocates, deputy district attorneys, victim witness staff; and therapists; and

12.1.2 Healthcare workers, including medical students and residents, Public

Health Nurses (PHN), first responders, and the medical community.

12.1.3 Mandated reporters, civic organizations, and the general public; and

12.1.4 Educational institutions, colleges, universities; and at workshops, and conferences.

9.3 Provide additional reports as mutually agreed upon, regarding services and activities performed hereunder.