CMS-07-021/023 - Los Angeles County Department of Children and ...

0500-501.20 (Rev 12/02)
EXHIBIT G
4. Document any request for records in the Health Notebook. Include the date, name,
title, agency, address, and telephone number of the person making the request, the
information requested and the reason for the request.
5. Discuss and obtain SCSW written approval for the release of records. Document
SCSW's approval in the Case Notes. Print a hard copy of the documented written
approval and give it to the SCSW for signature. File it in the Additional Services
Documentation Folder.
6. Photocopy the records authorized for release. Review carefully, black-out any
unauthorized information and photocopy the initial copy. Release the second copy
and ensure that the initial altered copy is shredded.
C. WHEN: MEDICAL DOCTORS AND DENTISTS REQUEST CASE
RECORD INFORMATION
Medical doctors require copies of the medical history for the family and all medical
records for the child in order to provide comprehensive health care services for the
child. Selected portions of a child’s school records may be considered for release if the
child’s school performance is being monitored in order to adjust a medication regimen.
Medical doctors may not have access to any child abuse reports or the identity of the
reporting party, the child’s psychological records unless the doctor is a psychiatrist, any
educational, psychological or medical records for other family members, any attorney
client privileged information, or any information regarding siblings or other unrelated
children referenced in the case records.
A dentist providing services to the child may have copies of all available dental records.
If an invasive procedure is deemed necessary, the dentist may have access to selected
medical record information that could have an impact on the procedure being
considered.
For information regarding the release of HIV/AIDS status, see Procedural Guide 0500-
504.10, Protection and Disclosure of HIV/AIDS Information.
CSW Responsibilities
1. Discuss the child’s health care needs with the SCSW.
2. Discuss the child in non-identifying terms with a potential health service provider.
3. Obtain a signed DCFS 4389 from the potential health service provider if identifying
information is requested and from the selected health service provider before
releasing any requested information. File it in the Additional Services
Documentation Folder.
4. Document any request for records in the Health Notebook. Include the date, name,
title, agency, address, phone number of the person making the request, the
information requested, and the reason for the request.