The Medical Home model is designed around patient needs and aims to improve access to care (e.g. through stretched office hours and improved communication between providers and patients via email and telephone), increase care coordination and enhance overall quality, while simultaneously reducing costs.
The medical home relies on a team of providers—such as physicians, nurses, nutritionists, pharmacists, and social workers—to meet a patient’s health care needs. Studies have revealed that the medical home model’s attention to the whole-person and integration of all aspects of health care offer can help improve physical health, behavioral health, access to community-based social services and management of chronic conditions.
The Sampson County Health Department has joined efforts to improve the relationships with Medical Homes and their patients through the Care Coordination for Children Program (CC4C). This case management program functions with the goal to improve the care of children in the county by linking families with Medical Homes that will meet their specific needs, arming families with education and resources, and safeguarding to ensure needs are met with timely follow-up and evaluation.
The Care Coordination for Children (CC4C) Program is comprised of nurses and social workers that work as case managers under the direction of Community Care of North Carolina and NC Division of Medical Assistance. It is offered at no charge for children birth to 5 years of age who: have long term medical conditions; are dealing with challenges within their environment that may increase their stress levels; and/or referred by a medical provider or other community agencies.
The Sampson County Health Department is working in collaboration with Department of Social Services in the development of Plan of Safe Care (POSC) Referrals. This initiative is a state-wide plan involving multiple agencies and community partners. This POSC will ensure the safety and well-being of infants born with and identified as being affected by substance abuse withdrawal symptoms resulting from prenatal substance exposure. The POSC will address the health and substance use disorder treatment needs of both the infant and the affected family member or caregiver.
The Care Coordination for Children (CC4C) Program utilizes screening tools to identify risk concerns on children from birth to five years of age. The CC4C Program assess the basic skills needed to live and parent well through completion of the Life Skills Progression Checklist with parents of children identified at risk. The CC4C Program utilizes the Survey of Well-Being in Young Children (SWYC) that focuses on the importance of early identification by screening infants and children up to five years of age at risk for developmental-behavioral disorders along with family and social concerns.
Once a referral is received, a CC4C care manager is assigned to the family to assess the needs of child and family. A plan of care and goals are developed by the family with the assistance of CC4C staff. CC4C staff work with families through home visits, phone calls, provider visits, and other types of contact to assist them with meeting their needs.
The Sampson County Health Department works tirelessly to be an active participant in caring for the county’s youth by implementing best practice recommended services to meet the needs of our youth. Other services provided by the Sampson County Health Department are Well Child Check through our Child Health Clinic.
The Child Health Clinic Well Child Check involves performing assessments on children 0-20 years old as recommended by Medicaid in partnership with the child’s Medical Home. Through this program, the Sampson County Health Department is skilled to assist children to comply with the Department North Carolina Public Instruction’s requirements for entry into North Carolina Schools. Sampson County and Clinton City Schools require specific paperwork to be completed to show that physical examination/immunizations requirements have been met by no later than 30 days after entering school. If exams and immunizations are not updated by the 30th day of enrollment, the child is usually required to stay at home until the requirements are met.
Well Child Checks provided through the Health Department meet the requirements for children entering into Daycare, Preschool, Head Start, More at Four and school grades Kindergarten through 12th grade. This assists with achieving our community goal of ensuring the health and well-being of the children of Sampson County. Bright Futures, a best practice program, is used by the Sampson County Health Department. The Bright Futures principles acknowledge the value of each child, the importance of family, the connection to community, and that children and youth with special health care needs are children first. These principles are used with each Well Child Check visit to assist in delivering and supporting the highest quality health care for children and their families.
For child health clinic well child checks, you can call to schedule an appointment at the Sampson County Health Department at 910-592-1131, ext. 4001.
For more information on the Care Coordination for Children – CC4C – Program or to make a referral, you can call 910-592-1131, ext. 4230, 4973, 4238, 4237 or 4241. Referrals may also be faxed to 910-592-4724, Attn: Patricia Canady.