CHDP Provider Information

CHDP Program: Provide complete health assessment for the early detection and prevention of diseases and disabilities for low-income children and youth.

Health History, Physical Exam, Developmental/ Nutritional/ Dental Assessment, Vision/ Hearing screening, Tb test, Lab tests, Immunizations (click here for VFC), Health Education and Anticipatory Guidance, and Referrals for any needed diagnostics and treatment. A health assessment consists of (AAP/Bright Futures).

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Provider Obligations: Comply with the CHDP Provider Manual, Review CHDP Provider Information Notices, provide follow up and medical case management including specialty care referrals, outreach to families, give a written summary of findings to patient or family and note in chart, provide a medical home, ensure availability of medical services after hours, participate in the VFC program, and maintain active Medi-Cal provider status.

CHDP Care Coordination Form for medical providers and Instructions: Use this form to notify the local CHDP office of any health care follow up, transportation needs, dental home needs or follow up, or referrals. 

Dental Care Coordination Form for dental providers: Use this form to inform the local CHDP office of any dental follow up, transportation needs, or referrals and fax or email securely to our office at: 831-763-8410 or HsaCHDP@santacruzcounty.us

HCPCFC (Health Care Program for Children in Foster Care) Health Contact Form (form and instructions): This form should always be filled out whenever a foster child is seen at a medical office. Fax to 831-763-8643 ATTN: Susan Irby.

CHDP Gateway Program Information for Providers.

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CHDP Training: In progress

CHDP Providers Training Materials

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Audiometry Training, Practicum and Forms

Training

• CHDP Audio Training

Practicum

• CHDP Audio Practicum

Forms

• Ages and Stages
• Ages and Stages(Spanish)
• Anatomy of the ear
• Audio Training Supply List
• California Children's Services (CCS) Eligibility for Hearing Loss
• Flow Chart Hearing Screening Conditioning
• Hearing Disorders
• Hearing Screening and Anticipatory Guidance
• Play Audiometry Sign-Off Sheet
• Screening Procedures

BMI Anthropometric Training, Practicum and Forms

Training

• CHDP BMI Training
• WIC Outreach Presentation

Practicum

• Practicum starts on slide 21 of training presentation

Forms

BMI

• BMI Charts
• BMI Resources
• BMI Training Evaluation Form
• Measuring Length - Infants
• Measuring Stature - Children
• Measuring Weight - Infants
• Measuring Weight - Children

Care Coordination

• CHDP Care Coordination/Follow-Up form instructions
• CHDP Care Coordination form
• Foster Child Health Contact form Instructions
• Foster Child Health Contact Form (HCPCFC)
• Medi-Cal Dental Care Follow-Up Request Form

Oral Health Training, Practicum and Forms

Training

• CHDP Oral Health Fluoride Varnish(FV) Training

Practicum

• Practicum starts on slide 21 (or 28) of training presentation (see link above).

Forms

Oral Health

• CHDP classification of dental treatment needs
• Dental Periodicity schedule for referral by age
• Dental Health Flyer
• Dental Health Flyer(Spanish)
• Oral Health Guideline
• Oral Health List of Training Documents & Supplies
• Medi-Cal Dental and Optometry List

Care Coordination

• CHDP Care Coordination/Follow-Up form instructions
• CHDP Care Coordination form
• Foster Child Health Contact form Instructions
• Foster Child Health Contact Form (HCPCFC)
• Medi-Cal Dental Care Follow-Up Request Form

Vision Training, Practicum and Forms

Training

• CHDP Pediatric Vision Screening
• CHDP Pediatric Vision Screening ADA

Practicum

• CHDP Vision LEA HOTV Practicum ADA

Forms

• California Children's Services (CCS) Eligibility for Diseases of the Eye
• LEA Symbols
• Medi-Cal Dentists and Optometrist List
• Vision Screening
• Vision Screening Pre-Test (Answer Key)
• Vision Screening Sign-off Sheet
• Vision Screening Training Key Points
• Vision Screening Training Scenarios for Practicum