Public Health Nursing
Assessments include ASQ and ASQ:SE, initial family intakes, evaluation of healthand immunization status, and review of any medical records. In addition, postpartum assessments will be conducted for women who have recently delivered, including screening for postpartum depression. Referrals are made to KidConnections to inform the Level I screenings, as appropriate.
Once families are referred and assigned to a home visitor/therapeutic service provider, PHNs will work in collaboration with the home visitor provider to follow up nursing assessments, ASQ and ASQ:SE follow-ups at 6 month intervals, or as needed, and then again within the last 30 days of services prior to closing. PHNs assist the home visitor with linkage and follow-up through Early Start, VMC IND Clinic and other medical issues.
In addition FIRST 5 funds a PHN who partners with the County of Santa Clara Social Services Agency Dept of Children and Family Services (DFCS) to serve children birth through age 5 in the foster care system. This PHN provides services to those children involved in Informal Supervision, Family Maintenance, Family Reunification, children involved in Department 70 of Dependency Court and Emancipated Foster Youth. The services provided include the following:
- Assess children in their home environment
- Conduct developmental screening using the ASQ and ASQ-SE when appropriate
- Refer to the FIRST 5 System of Care for further assessments and intervention when appropriate
- Implement a plan of care to assist clients to access appropriate health and community based services, including the FIRST 5 Family Resource Centers
- Teach children and caregivers about diagnosed health problems, self-care and treatment needs
- Case management and conferences with child’s physician in a multidisciplinary team approach.
- Early assessment, intervention and referral to special needs resources
- Communication link between parent/caregiver, medical provider and social worker.
- Referrals to long term home visitation if qualify for Nurse Family Partnership (pregnant under 28 weeks gestation, first time mother and low income)
