Coordination of Care and Services Wednesday, September 6 ...
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1 Coordination of Care and Services Agreement (CCSA) Form Wednesday, September 6, 2017
Transcript of Coordination of Care and Services Wednesday, September 6 ...
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Coordination of Care and Services Agreement (CCSA) Form
Wednesday, September 6, 2017
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"Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery of health care services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities and is often managed by the exchange of information among participants responsible for different aspects of care."
-Agency for Healthcare Research and Quality, 2007
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The CCSA Form
DDP created the CCSA form to allow the client and the agency that provides linkage services to identify and select available medical and community resourcesthat align with the client’s needs and preferences.
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• Gives the client the opportunity to consent to allow confidential information to be shared among services providers to help:
•Coordinate services•Assist with closing the referral loop •Allow for easier linkages to care
The CCSA Form
• VDH’s Goal: to have a CCSA form for any person who is newly diagnosed with HIV and needs to be linked to HIV care OR for persons who need active linkage to clinical or support services.
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When Should the CCSA Form be Used?
New HIV diagnoses• Part of the
active referral process for DIS
Clients who are OOC and need to be reengaged • Data to Care
Persons who are already in
care but would like
coordination of other services
Service navigation for HIV negative and positive
clients*service
navigation*navigation to PrEP or nPEP
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Type of Client CCSA Form Use
Newly diagnosed with HIV
Proof of consent to follow-up Verification of 1st HIV care appointment
attendance Record of active referral to any services
Previous HIV positive re-engaging in care
Proof of consent to follow-up Verification of 1st HIV care appointment
attendance Record of active referral to any services
HIV negative Proof of consent to follow-up Record of active referral to any services
other than HIV medical care
Previous HIV positive already in care
Proof of consent to follow-up Record of active referral to any services
other than HIV medical care
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Section A: Acceptance
FAX TO VDH IF CLIENT DECLINES- ATTN: TANGYE HARRISDO NOT COMPLETE FORM FOR PrEP CLIENTS WHO DECLINE CCSA
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Section B: Consent
• Information can be shared among agencies client approves
• Can be followed up on for 2 years (24 months)• Client can withdraw consent at any time
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Section C: Client Information (page 1)
• HIV Negative Testing Information—For PrEP Clients ONLY
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Section C: Client Information (page 2)
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Section D: Linkage
• FAX THE ENTIRE FORM TO LINKAGE PERSONNEL• Both pages 1 and 2 or there will be
information missing
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Section E: Referrals and Confirmation of Linkage
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Form is completed
Form is completed
Linkage personnel faxes
ENTIRE form back to
originator
Linkage personnel faxes
ENTIRE form back to
originator
Originator faxes ENTIREform to VDH
Originator faxes ENTIREform to VDH
Referral Loop is Closed!
Referral Loop is Closed!
If agency does NOToriginate the CCSA form:
Form is completed
Form is completed
Linkage Personnel faxes ENTIRE form to
VDH
Linkage Personnel faxes ENTIRE form to
VDH
Referral Loop is Closed!
Referral Loop is Closed!
If agency originates the CCSA form and is providing linkage services internally:
FAX FORMS TO SECURE FAX NUMBER: 804-864-7970
CCSA Form Flow
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Storage Reminder• Store all forms with client
information behind THREE LOCKS
• File with associated client records
• Organize so that documents can be easily retrieved if needed
• Monitor access to secure file locations
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CCSA form is online!
http://www.vdh.virginia.gov/disease-prevention/disease-prevention/std/resources-forms/
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CCSA Form Quick Facts• 1,330 forms received since 2014• Forms from 75 agencies and health departments• Non-LHD sites = CBOs, Health Centers, etc.,
2014 2015 2016 2017 Total
Local Health Department(LHD)Sites
198 293 374 213 1,078
Non- LHD Sites 38 42 90 82 252
Combined 236 335 464 295 1,330
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Most Common Errors
• No client signature when consent is given
• Not specifying why client refused care
• Missing required Medical Referral info
• Not including Date Attendance Verified for medical appointments
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Fatima ElaminHIV Prevention Data Manager804-864-7903 or [email protected]
Chelsea CaumontHIV Testing Analyst804-864-7903 or [email protected] Testing Analyst
Amanda SaiaHIV Surveillance Epidemiologist804-864-7862 or [email protected]• Data to Care Program Questions
