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Department of Children and Families
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Policy Manual
FOSTER AND ADOPTION SERVICES
Children with Complex Medical Needs

41-7-2
Certification of a Child's Complex Medical Needs

Definition

A child with complex medical needs is one who has one or more of the following:  

          a diagnosable, enduring, life-threatening condition

          a medical condition that has resulted in substantial physical impairments

          medically caused impediments to the performance of daily, age-appropriate activities at home, school or community

          a need for medically prescribed services as identified on the Certification of Child’s Complex Medical Needs form, DCF-2101.

 Those children with behavioral disorders, mental health needs, or mental retardation who do not have one or more of the conditions listed above are not included in the category of children with complex medical needs.

Initial Certification of Complex Medical Needs

Prior to requesting a placement for a child with complex medical needs, the child’s Social Worker shall obtain a signed DCF-2101 from the child’s primary health care provider that identifies and certifies the child’s complex medical status.

(The DCF-2101 is a template with a hyperlink to the DCF Intranet where descriptions of the medical terms used on the form may be accessed.)

The Social Worker shall

          first consult with the Area Resource Group (ARG) nurse to make a preliminary determination that the child has complex medical needs

          complete Section I of DCF-2101

          forward the DCF-2101 to the child’s primary health care provider for identification and certification of the child’s specific medical needs

          upon receipt of the signed DCF-2101, submit the form to the (ARG) nurse, Social Work Supervisor, and Program Supervisor for review and signatures

          document the child’s complex medical needs status in the LINK medical profile, and document any consults and the completion of the DCF-2101 in the LINK medical narrative

          notify the ARG Nurse of all hospital discharge planning meetings

          file the original DCF-2101 in the child’s record, and

       send a copy of DCF-2101 to the ARG nurse.

Recertification of Complex Medical Needs

The child’s medical status must be reviewed and re-certified by the child’s primary health care provider every six (6) months.

To obtain re-certification, the worker shall follow the same procedures as for initial certification, submitting a new DCF-2101 for signatures.

To remove a child from medically complex status the Social Worker must submit the DCF-2101 to the child’s primary health provider for identification that the child currently requires none of the care listed on the form.
Role of the Area Resource Group (ARG) Nurse

The Area Resource Group (ARG) Nurse shall

review all Certification of  a Child’s Complex Medical Needs, Form DCF-2101, for appropriateness of medically complex certification and compliance with policy

assist the Social Worker in the completion of the Discharge Plan for a Child with Complex Medical Needs, Form DCF-2102 and with the accuracy and completeness of medical information; and review of all DCF-2102 forms for accuracy and completeness of medical information and compliance with policy

review all Medical Alerts, Form DCF-741 for accuracy and completeness

participate in hospital discharge planning meetings for medically complex children

participate with FASU, the area office social worker,  and the social work supervisor in providing medical consultation during the placement of medically complex children

maintain a log or database of all medically complex children known to the ARG and update regularly with current medical information

review results of any medical information provided by the social workers on medically complex children and assist in ensuring medical follow up as needed, and

document consults, assessments, treatment services and recommendations in the  LINK medical narrative.

Review of the DCF-2101 The most recent DCF-2101 shall be reviewed at each six-month Administrative Case Review (ACR).
Administrative Case Review

The ARG nurse shall attend the Administrative Case Review (ACR) in the following situations:   

the child’s Social Worker or Social Work Supervisor has determined that the child’s unique needs require the ARG nurse’s special expertise, or

the ARG nurse has provided assessment services to the child or family within the six (6) months prior to the ACR.

Connecticut Department of Children and Families                   Effective Date: August 1, 2005 (Revised)