| Policy |
The
“Report of Health Care Visit” (DCF-742) shall be completed by the health care
provider and utilized to document the child’s ongoing health care. |
| Delivery of Five Copies |
The placing Social Worker shall include at
least five (5) blank copies of the DCF-742 with the first two lines completed in the
Placement Portfolio which is given to the caretaker at the time of placement.
When additional
forms are needed, the Social Worker shall supply them to the caretaker with the first two
lines completed. |
| Who Takes the DCF-742 to the
Health Provider? |
When
a child is taken to a health care provider, the person who takes the child, whether it be
the caretaker or the Social Worker, shall bring the Placement Portfolio, including the
DCF-742, to the provider. |
| Responsibility for Completion |
At the time of placement, the DCF Social
Worker or unit clerk shall complete the top two lines of the DCF-742 with identifying
information for the child and region, leaving the
name of the DCF Social Worker blank if the child’s Protective Service Worker has yet
to be named.
At the time the child is taken to a
health care provider, the provider is responsible for filling out the rest of the form at
the visit, if possible, and returning it to the caretaker or Social Worker.
If the child
will have a series of sessions, such as for individual or group counseling, the health
care provider may note the frequency of contact on the initial DCF-742 and only fill out a
new form for updates, as needed. |
| Provider Communication with
Social Worker |
The caretaker shall contact the Social
Worker or his/her supervisor immediately if the health care provider has indicated on the
DCF-742 that he/she needs to speak to the Social Worker.
The health care provider shall also be
encouraged to call the Social Worker with any questions or concerns. |
| Documentation |
The caretaker shall place one copy of the
DCF-742 completed by the health care provider in the Placement Portfolio for the child,
and give the other copy to the Social Worker.
The Social Worker shall
·
file the DCF-742 in the
medical section of the Uniform Case Record
·
note the occurrence of
the health visit in the LINK narrative
·
if necessary, update the
Medical Profile in LINK.
If the Social
Worker receives the completed DCF-742 directly from the provider, he/she shall give one
copy to the caretaker for inclusion in the Placement Portfolio and file the other copy in
the Uniform Case Record. |
| Review of DCF-742 |
The Social Worker shall
·
review the completed copy
of the DCF-742 for any critical information
·
discuss the information
with the caretaker to assure the scheduling of needed follow-up visits and continuity of
ongoing care.
If there are any questions, the Social
Worker shall consult with the RRG nurse to assist in clarifying and utilizing the
information reported on the form. |
| Substitute Documentation |
Substitute documentation for the DCF-742 may
be submitted by health care providers or by residential treatment facilities on their
forms, if the essential information is included.
The substitute
documentation should be attached to a copy of the DCF-742 with the child’s name on it
and inserted in the Placement Portfolio with a copy filed in the medical section of the
Uniform Case Record. |
