Hipaa Release Form Illinois - Excel

					       Category    Subcategory        Topic Category                                    Resource Title
Care Management
                  Scope of Services

                                                       40 Development Assets-Middle School
                                                       40 Developmental Assets
                                                       40 Developmental Assets Elementary Age
                                                       An Assets Checklist
                                                       Annual Preventive Service Visit North Carolina
                                                       Asset Building Overview
                                                       Assets Checklist Sample
                                                       Bright Futures Guidelines 3rd Edition and SBHCs NASBHC Webinar Presentation
                                                       NASBHC
                                                       Bright Futures Principles and Guidelines
                                                       Child Health Resources Put Prevention into Practice
                                                       Cultural Competency Health Practitioner Self Assessment
                                                       Early Childhood Framework Developmental Assets
                                                       Guidelines for Adolescent Preventive Service
                                                       Health, Mental Health, and Safety Guidelines for Schools
                                                       Materials Guide Choosing and Adapting Culturally and Linguistically Competent Health Promotion Materi
                                                       Mental Health Services MI Policy Recommendations
                                                       Periodicity Chart AAP Bright Futures
                                                       Providing Culturally and Linguistically Sensitive Services to LGBTQI2-S
                                                       Rights and Responsibilities for Teens in the SBHC
                                                       Role of Community in Defining Scope of Services NASBHC
                                                       SBHC Behavioral Health Overview NASBHC
                                                       SBHC Chronic SHCN Overview NASBHC
                                                       SBHC Family and School Personnel Overview NASBHC
                                                       SBHC Improving Health Equity and Reducing Health Disparities Position
                                                       Statement NASBHC
                                                       SBHC Primary Care Overview NASBHC
                                SBHC Risk Assessment Overview NASBHC

                                SBHC Support Services for Families and School Personnel Overview NASBHC
                                SBHC Wellness Overview NASBHC
                                Screening Algorithm Preventive and Health Guidance GAPS
                                Sentinel Condition Overview UNDER CONSTRUCTION




Interventions
                Primary Care
                Interventions
                for Acute and
                Chronic
                                Assessment, Prevention and Treatment of Child and Adolescent Overweight and
                                Obesity
                                Cholesterol Screening Guidelines American Academy of Pediatrics
                                Health Assessment for Overweight Children in School Presentation Under
                                Construction
                                Health Care for Special Populations: Examining the Role of SBHCs Presentation
                                NASBHC

                                Healthy Care for Healthy Kids Toolkit Assessment and Diagnosis
                                Managing Asthma through the Chronic Care Model of Improvement Part 1
                                Presentation Under Construction
                                Managing Asthma through the Chronic Care Model of Improvement Part 2
                                Presentation Under Construction

                                Mental Health Interventions for Obesity Presentation Under Construction
                                Motivational Interviewing Presentation Under Construction

                                National Guidelines for the Diagnosis and Management of Asthma NHLBI
                Obesity Model Programs and Evaluating Quality Programs Presentation Under
                Construction

                Pediatric Asthma Guidelines


General
Interventions
                1 Overview of Risk and Protective Factors Presentation NASBHC
                2 Assessment of Risk and Protective Factors Presentation NASBHC
                3 Modifying Risk and Protective Factors Presentation NASBHC
                Annual Preventive Service Visit North Carolina
                Annual Wellness Exam-EPSDT Envision NMX Nov 07
                Health Education Toolkit NASBHC Under construction
                Immunization Guidelines Oregon
                Social Learning Theory
                Vaccination of Adolescents: New Frontier Presentation
                Vaccination of Adolescents Presentation
                Vision Screening AAP guidance
                Vision Screening Policy Sample
                Visit Sheet NRHA WVA

Mental Health
Interventions   Bright Futures Principles and Guidelines

                Bright Futures Promoting Mental Health
                Child and Adolescent Mental Health
                Child Health Resources Put Prevention into Practice
                Clinical Assessment Tool Risk and Stress Factors
                Cognitive Behavioral Intervention for Trauma in Schools Fact Sheet

                Cognitive Behavioral Intervention for Trauma in Schools Presentation NASBHC

                Cognitive Behavioral Therapy Training in Core Skills Presentation NASBHC
Complete Depression Guidelines New Mexico
Comprehensive Risk Assessment Review Tool Mental Health Education and
Training Initiative NASBHC
Depression Screening Review

Five Axis Cheat Sheet Mental Health Education and Training Initiative NASBHC

Friends for Youth an Group Intervention for Anxiety Presentation NASBHC
Guidelines for Adolescent Preventive Services
Illinois Center Mental Health Partnerships Guidelines
Introduction to Manualized Interventions Presentation NASBHC
Mental Health Assessment Free Tools CSMH
Mental Health Conditions Fact Sheets for Classrooms Minnesota
Mental Health Diagnostic Training Presentation NASBHC
Mental Health Diagnostic and Procedural Coding Presentation NASBHC
Mental Health Protocol Manual Baton Rouge
Mental Health References - Bright Futures
Motivational Interviewing
Promoting Mental Health-Bright Futures
Risk and Protective Factors by Disorder
Risk and Protective Factors Overview Mental Health Perspective

Running Effective Groups with Children and Adolescents Presentation NASBHC
SBHC Behavioral Health Overview NASBHC
Skillstreatming a Group and Individual Intervention for Problem Solving
Presentation NASBHC
Student Traumatic Experience Recovery Toolkit
Teen Violence and Safety Web Resources
Types of Traumatic Stress
What Can SBHC Providers Do To Address ADHD Presentation NASBHC Under
Construction
Poor School
Performance       America's Promise Alliance
                  Bright Futures Principles and Guidelines
                  No Child Left Behind


Oral Health       American Dental Association
                  Bright Futures Tool Box Oral Health Resource Center
                  Catalyzing Improvements in Oral Health
                  CHCS Report Oral Health Best Practices
                  Dental Need and School-Based Services Fact Sheet
                  Dental Health Web Sites
                  Dental Safety Net Resource Guide
                  Models for Delivering School-Based Dental Care Article
                  Oral Health Poster Convention NASBHC




Substance Abuse
                  Alcohol Drug Screening - Riverside SBHC WVA
                  Alcohol Use Disorders Identification Test
                  CAGE 4 Question Assessment for Problem Drinking
                  Drug and Alcohol Use American Academy of Pediatrics
                  Evidence-Based Practices for Substance Use Disorders
                  Substance Abuse Info for Clinicians MSMHA
                  Substance Abuse Services Sample Policy Michigan
                  Tobacco Evidence Based Practices and Outcomes
                  Tobacco Prevention for Clinicians MSMHA
                  Understanding the Link Between Adolescent Trauma and Substance Abuse
                  Toolkit for Providers


Reproductive
Health Care       Chlamydia Facts and Resources
              Screening for Chlamydia Infection




Information   Acronym Abbreviation List
              Client Responsibilities Summary
              Confidentiality Agreement Form Employees
              Confidentiality Sign
              Dear Parent Letter
              Health Education Presentation Form
              Health Education Presentation Form Sample 1
              Health Education Presentation Form Sample 2
              HIPAA and Schools UNC Article
              HIPAA FERPA IDEA and SBHCs-NASBHC
              Immunization Letter to Parents
              Parent Letter - Clay SBHC WVA
              Parent Letter - Rainelle Medical Center
              Parent Letter Abdominal Pain
              Parent Letter BMI
              Parent Letter Ear Infection
              Parent Letter Follow Up
              Parent Letter GI Virus
              Parent Letter Pink Eye
              Parent Letter Sinus Problem
              Parent Letter Sore Throat
              Parent Letter Student Seen
              Parent Letter URI
              Sports Physical Letter

Medical
Records       Adolescent Physical Exam Charting Sheet Michigan
              Adolescent Review of Systems Charting Sample Michigan
              Care Review Form
              Chart Audit Form Mental Health and Training Initiative NASBHC
Chart Order Example
Chart Order-New River Health Center

Chart Review Guide Mental Health Education and Training Initiative NASBHC
Consent Annual Update Summersville SBHC WVA
Consent Cover Letter English Wisconsin
Consent Cover Letter for Collins SBHC WVA
Consent Dental Mt. Hope SBHC WVA
Consent for Care Policy - Riverside SBHC WVA
Consent Hepatitis B - Oak Hill SBHC WVA
Consent HPV Oak Hill SBHC WVA
Consent Insurance form - New River Health Association WVA
Consent Mt. Hope SBHC WVA
Consent Sample
Consent Mental Health - New River Health Association WVA
Consultation Form Sample
Control Log - Rainelle Medical Center, WVA
Encounter Form Mental Health Maryland
Encounter Form- New Mexico
Encounter Form Well Child NRHA WVA
Health History English Elementary School
Health History English High School
Health History English Middle School
Health History Spanish Elementary School
Health History Spanish High School
Health History Spanish Middle School
Integrating EMR into SBHC Settings Presentation NASBHC
Media Contact Consent Form Student
Medical Assistant Triage Progress Note Michigan
Medical Record Request - Riverside SBHC WVA
Medical Records Complete and Accurate - Riverside SBHC WVA
Medical Records Format - Riverside SBHC WVA
Medical Records Retention - Riverside SBHC WVA
Medical-Dental Encounter Form-Maryland
         Medication Dispense Log Charts - RMC WVA
         Medication List -Chart
         Mental Health Contact Note Mental Health Education and Training Initiative
         NASBHC
         New Client Encounter and Chart Order - Riverside SBHC WVA
         Notice of Privacy-Rainelle Medical Center
         Part 1 - Consent General - Rainelle Medical Center
         Part 2 - Consent Insurance Info - Rainelle Medical Center
         Part 3 - Consent Counseling - Rainelle Medical Center
         Physical Activity and Nutrition Group Charting Michigan
         Physician Referral Form Sample
         Problem List Chart
         Progress Notes Chart
         Referral Consent Basic
         Registration Sample
         Release of Medical Record - RMC WVA
         Sports Physical Examination Form Michigan
         Telephone Triage - Riverside WVA
         Tracking Referrals RWC Louisiana SBHC
         Triage Visit Record
         Visit Sheet - NRHA WVA




System   Clinical Laboratory CLIA WVA
         Emergency Box Checklist
         Emergency Kit Log - Rainelle Medical Center WVA
         Formulary Draft Guidelines
         Immunization Guidelines-Oregon
         Inactive Charts - Clay WVA
         Infection Control Policy and Procedure North Carolina
         Lab Housekeeping-Personal Protective Equipment Protocol Checklist and
         Guidelines
         Laboratory Tickler - Riverside WVA
            Medication Inventory Expiration Disposal Chart - RMC WVA
            Referral Resource Summary Information Sheet
            Sample Drugs Policy and Procedure North Carolina
            Temperature Record and Log - Riverside WVA
            Wellness Center Drug Inventory - NRHA WVA

Measuring
Outcomes    Children with Special Health Care Needs
            Coding 101 Web Conference NASBHC
            Coding Compliance Cheat Sheet Blank
            Coding Compliance Cheat Sheet Sample
            Coding Compliance Expanded Version
            Coding Handout 1 - Blank Coding Audit Cheat Sheet
            Coding Handout 10 - Completed Encounter Form - case 10a
            Coding Handout 11 Completed Audit Cheat Sheet - 10a
            Coding Handout 2 - Blank Coding Audit Cheat Sheet
            Coding Handout 3 - Blank Chart Note
            Coding Handout 4 - Blank Encounter Form
            Coding Handout 5 - Completed Chart Note - case 10
            Coding Handout 6 - Completed Encounter Form - case 10
            Coding Handout 7 - Completed Coding Audit Cheat Sheet - case 10

            Coding Handout 8 - Completed Coding Audit Cheat Sheet - back - case 10
            Coding Handout 9 - Completed Chart Note - case 10a
            Electronic Medical Records McKesson Presentation NASBHC
            Maryland QI Focus Group Questions
            Mental Health Counselor Activity Report Sample Seattle

            Promoting Healthy Development Survey-Parents
            The Child and Adolescent Health Measurement Initiative
            Young Adult Health Care Survey
Special Topics
                 Adolescent Best Practice Resource NAHIC
                 Adolescent Health Care in SBHC Position Statement NASBHC
                 Advocates for Youth Adolescent Access to Confidential Health Services
                 CDC Review of School Laws and Policies Concerning Child and Adolescent Health
                 ASHA
                 Covered Services Chart

                 Crisis Management for Clinicians Maryland School Mental Health Alliance
                 Crisis Planning Guide for Schools and Community
                 Family Centered Care Integrated Medical and Dental JSPN
                 Family Engagement Quiz NASBHC
                 HIPAA and Schools UNC Article
                 Ideas for Parent Involvement in School-Based Health Care
                 It's A Family Affair: Families and Healthcare Presentation NASBHC
                 It's A Family Affair Resources for Family Engagement NASBHC
                 Minor Consent Law Categories

                 OSHA- Blood Born Pathogens Exposure Control Guidelines Policies RMC WVA
                 Patient Confidentiality AMA 2007
                 Social Learning Theory
                 SAM Position Paper Confidential Health Care for Adolescents
                 SSRIs and SBHCs Position Paper King County WA
                 State Policies and Confidential Care for Adolescents NAAAH

Practice
Management
Improvement      SCORE Model-Care Management
                                                                                  Resource           Resource Type Key
                                            FTP Hyperlink                         Type*      *       Description
                                                                                                 O   Overview
                                                                                                 P   Presentations
                                                                                                 N   Policies +Procedures
                                                                                  S              S   Samples
                                                                                  R              L   Links
                                                                                  S              T   Tools
                                                                                  S              R   References
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          http://brightfutures.aap.org/index.html                                 L
          http://www.ahrq.gov/ppip/childguide/                                    L
          https://www4.georgetown.edu/uis/keybridge/keyform/form.cfm?formID=277   L
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          http://www.ama-assn.org/ama/pub/category/1980.html                      L
          http://www.nationalguidelines.org/                                      L
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http://www.aap.org/new/july08lipidscreening.htm                                    L

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http://www.nichq.org/NICHQ/Topics/PreventiveCare/Obesity/Tools/HCHKAssesmentanddia
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http://www.nhlbi.nih.gov/guidelines/current.htm                                    L
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http://www.aaaai.org/members/resources/practice_guidelines/default.asp           L




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http://brightfutures.aap.org/index.html                                          L

http://brightfutures.aap.org/pdfs/Guidelines_PDF/4-Promoting_Mental_Health.pdf   L
http://mentalhealth.samhsa.gov/child/childhealth.asp                             L
http://www.ahrq.gov/ppip/childguide/                                             L
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http://www.rand.org/rgspi/projects/school_trauma.html   L
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http://www.nctsnet.org/nccts/nav.do?pid=typ_main        L

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http://americaspromise.org                                                     L
http://brightfutures.aap.org/index.html                                        L
http://www.ed.gov/nclb/landing.jhtml                                           L


http://www.ada.org/public/index.asp                                            L
http://www.mchoralhealth.org/Toolbox/professionals.html                        L
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http://odphp.osophs.dhhs.gov/pubs/guidecps                                     L
http://odphp.osophs.dhhs.gov/pubs/guidecps                                     L
http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b101/1/125   L
http://adai.washington.edu/ebp/ebpresources.htm                                L
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http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm                         L
http://www.ahrq.gov/clinic/uspstf/uspschlm.htm   L




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DOCUMENT INFO
Description: Hipaa Release Form Illinois document sample