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Children's Care Coordination

Care coordination is part of the patient and family support services provided by St. Luke's Children's. It's a family-driven, patient-focused, and physician-led program that promotes community-based, coordinated care for children with special and medically complex health care needs.

Our team is made up of inpatient and outpatient care coordinators who work with primary care providers and specialists. We link families to community resources and act as patient advocates within the school system. We pay attention to inpatient-outpatient transitions and adult transitions, as well as coordinating multiple surgical procedures.

What to Expect From Your Care Coordinator

Your care coordinator will:

  • Serve as an expert on community resources.
  • Facilitate referrals, wrap-around meetings and care conferences.
  • Act as a contact point between your family, your care team and community providers.
  • Guide you through the health care system.
  • Coordinate multiple specialty appointments in a single day at the Idaho Elks Children's Pavilion.
  • Coordinate multiple procedures under a single sedation, when appropriate.
  • Track interventions and outcomes through care plans.
  • Support primary care providers and specialists.
  • Attend care conferences.
  • Provide support and advocacy in the school, home, and community.
  • Assist with any medical or therapeutic concerns or challenges your family might face.

Educational Support

Children with special health care needs often require accommodations and individualized support when entering the educational system. An outpatient care coordinator can assist with requesting services for your child through your local school district. 

Your care coordinator can attend school meetings, coordinate communication between the school and your medical team, as well as assist with writing health care plans to ensure your child’s health care needs are being met.

Inpatient/Outpatient Transitions of Care

We want to be sure that your child’s transition from the hospital to your primary care provider or specialist is as smooth as possible. Building a pattern of clear communication plays a major role in the success of this transition. 

If your child has been connected with an outpatient care coordinator, the inpatient care coordinators will work with you while your child is in the hospital to assist with any new needs, such as equipment or nutrition. They will also ensure your outpatient care team has the current medical plan.

If your child experiences a significant change in his or her health and qualifies for outpatient care coordination while you are in the hospital, the inpatient care coordinator will help make a connection between you and your assigned care coordinator to provide support to you and your child. 

Food Insecurity

Food insecurity isn't the same as being hungry. Food insecurity is when you're having trouble consistently feeding every member of your family to support active and healthy lifestyles at every age. 

If you've had to juggle the responsibilities of paying your bills and buying food, you may be food insecure. For children in particular, food insecurity can have an enormous impact. Their physical and emotional growth may suffer, and their ability to learn and do well in school can be affected, all of which can have consequences lasting into adulthood. 

The Idaho Foodbank maintains a database of food sources in Idaho, from places to get a meal to food pantries and emergency shelters. If you need help putting food on the table or even just a place to go, this is a good place to start.

Community Resources

Resources exist throughout Idaho that can help fulfill basic necessities like clothing, physical and mental health care, finding work, and even help with legal problems and taxes.

The Idaho Department of Health and Welfare is always a good resource regardless of where in Idaho you live.

To access care coordination, your primary care provider or specialist will need to initiate a referral to the program.