ࡱ> o 3bjbj;; 88QvfQvf+     !!!!4!%9^r4H$$$$$$$$ ')$ drrdd$  $d:  $d$:",l#0["# $$0%#RQ*(Q*l#l#&Q* #ddddddd$$4ddd%ddddQ*ddddddddd : REFUGEE HEALTH Competency Skills Checklist Competencies and nursing skills are to be confirmed/assessed by the supervisor during the initial evaluation and at the time of the annual evaluation. PROGRAM COMPETENCY SUBJECTSDATE REVIEWEDREVIEWERS INITIALSI.NC Refugee Health Program PurposeA.Identify / Treat any threat to public health  B.Identify / Treat health problems that could interfere with independence and self-sufficiencyC.Connect newly arrived refugees to healthcareD.State program sends notification of arrivals to LHDE.State program coordinates refugee health assessments statewideII.Overview of Refugee Immigration ProcessA.Overseas exam, flight to US port of entry, quarantine review at port of entry and send notification to state, flight to NC on same day, assisted by NC refugee resettlement agency & local sponsorsIII.Payor A.Medicaid if meets categorical (children and adults pregnant or with dependent children) and income requirements - may have limitations B.If not eligible for Medicaid, then likely eligible for Refugee Medical Assistance (RMA) for 8 months from date arrived or date asylum granted  HYPERLINK "https://policies.ncdhhs.gov/divisional/social-services/refugee-assistance/policy-manuals/refugee-cash-assistance-program/refugee-cash-assistance-program" https://policies.ncdhhs.gov/divisional/social-services/refugee-assistance/policy-manuals/refugee-cash-assistance-program/refugee-cash-assistance-programC.If the LHD receives funding through AA activity 583 and Medicaid/RMA is pending, refugee health assessment must begin within 90 days of beginning of eligibility to guarantee reimbursementIV.Refugee Health AssessmentA.Schedule within 30 days of arrival and refer to private provider if cannot complete physical exam portion  B.Required within 90 days to guarantee reimbursementC.Need to offer appropriate language interpretation, so must know how to access and use language interpretation servicesD.Follow-up, treatment or referral in 14 days of public health concernsE.Follow-up or referral, as appropriate, on Class A or B conditions noted on clients overseas examV.Components of Refugee Health AssessmentA. HYPERLINK "http://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/domestic-guidelines.html" http://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/domestic-guidelines.html Medical history / review of health documents      B.Evaluate / treat / refer for Class A / B conditionsC.Communicable disease screeningD.Immunizations assessment and update for school requirements and for immigration requirementsE.Physical exam with gross dental, vision, hearing, and mental healthF.Treatment / referral of conditions identifiedG.Education - health services available and linkage - primary care servicesH.Complete Refugee Data Collection form and submit to state / notify if not contacted by refugee or agency and any attempts to locate  VI.Communicable DiseaseDATE REVIEWEDREVIEWERS INITIALSA.Tuberculosis screening - see Tuberculosis Competency Skills Checklist  B.Immunization assessment and update for school requirements and for immigration requirements see Immunization Competency Skills ChecklistC.STD-based on signs/symptoms, medical hx, age, risk factor, country of origin (syphilis, gonorrhea, hep B / C, HIV, Chlamydia) also see STD Competency Skills ChecklistsD.Other potential tests per signs and symptoms, hx, risk factors, age, race, ethnicity, country of origin, or behaviors intestinal and tissue invasive parasite testing and treatment, pregnancy testing, varicella titer, blood lead level testing, malaria testing and/or presumptive treatment - see other PHN Competency Skills checklists as appropriate (Family Planning, Communicable Disease, STD, Immunization, etc.)VII.Physical Exam- only for nurses who are able to perform physical exams A.A physical exam should be completed for all newly arrived refugeesB.If the LHD cannot provide the physical, a referral and communications should be made with the clients selected medical homeVIII.Overseas Medical ExaminationsA.To identify individuals with medical conditions that legally exclude them from being able to come to the U.S.  B.Does not screen for all health conditionsC.Valid for one year prior to departure - could have contracted infectious diseases after examD.See  HYPERLINK "http://www.cdc.gov/immigrantrefugeehealth/exams/medical-examination.html" http://www.cdc.gov/immigrantrefugeehealth/exams/medical-examination.html for information on Overseas Medical Examinations - components and Class A / B conditionsIX.Refugee Assistance ManualA. HYPERLINK "https://policies.ncdhhs.gov/divisional/social-services/refugee-assistance/policy-manuals" https://policies.ncdhhs.gov/divisional/social-services/refugee-assistance/policy-manuals X.LHD Refugee Health Assessment Medicaids Clinical Coverage PolicyA. HYPERLINK "https://medicaid.ncdhhs.gov/providers/clinical-coverage-policies/rural-health-clinics-fqhcs-and-health-departments" https://medicaid.ncdhhs.gov/providers/clinical-coverage-policies/rural-health-clinics-fqhcs-and-health-departments XI.Refugee DataA.NC Refugee Health Assessment Data Collection Form - refugees, asylees, certain Amerasians, Cuban/Haitian parolees/entrants, Iraqi and Afghan Special Immigrant Visa holders, and certain trafficking victimsB.Report dates: monthly reports within 30 days of screening and receiving laboratory resultsC.Refugee Health Coordinator (919) 755-3181 call with questions about screening or for problems submitting data on time Comments / Training Needs: _______________________________________________________________________ _____________________________________________________________________________________________________ __________________________ successfully demonstrates the above criteria in the work setting. (Employee Name) ____________________________ _________________________________ Employee Signature & Date Reviewers Initials& Date ____________________________ __________________________________ Employee Signature & Date Reviewers Initials& Date ____________________________ __________________________________ Employee Signature & Date Reviewers Initials& Date Skills Observer/Preceptor: __________________________________Date: ________________ Nursing Skills Observed: Communication History Taking Health Counseling / Education Physical Assessment Case Management Documentation NURSING SKILLRATINGCommunicationAchievedNeeds ImprovementNot AchievedNot Applicable1. Employee introduces self and explains purpose of visit.2. Employee establishes rapport with caregiver/client.3. Employee communicates with client/caregiver in a professional, culturally, and age appropriate manner.4. Employee communicates with staff in a professional manner.5. Employee provided services confidentially.History TakingAchievedNeeds ImprovementNot AchievedNot Applicable6. Employee conducts history in accordance with programmatic guidelines.7. Employee allows client/caregiver time to explain responses.8. Employee allows client/caregiver time to ask questions.9. Employee uses leading questions to elicit client information. Health Counseling / EducationAchievedNeeds ImprovementNot AchievedNot Applicable10. Employee provides education and counseling in accordance with programmatic guidelines.11. Employee provides age-appropriate and program-specific counseling in a clear, precise and professional manner.12. Client verbalized an understanding of information/counseling provided.13. Employee allows client time to ask questions and answers clients questions appropriately.Physical AssessmentAchievedNeeds ImprovementNot AchievedNot Applicable14. Employee explains procedures to client/caregiver.15. Employee provides client privacy.16. Employee attempts to establish rapport and make client comfortable.17. Employee performs components of physical assessment in accordance with programmatic guidelines.18. Employee discusses finding with client/caregiver.19. Employee makes appropriate referrals based on findings.Case ManagementAchievedNeeds ImprovementNot AchievedNot Applicable20. Employee has a system of documenting and follow-up of referrals.21. Employee maintains a Tickler File of client and follow-up Tickler system.22. Employee documentation supports all client contacts and referral / follow-up information.23. Follow-up is conducted in accordance with agency / programmatic guidelines.24. Records are maintained in accordance with HIPAA guidelines.25. Employee documents assessments, counseling and clients information in approved format in accordance with programmatic guidelines.DocumentationAchievedNeeds ImprovementNot AchievedNot Applicable26. Documentation is precise and clear.27. 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