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CHILD SERVICE COORDINATION Child Service coordination is a free service offered to ail Cabarrus County families with children age 1 day to 3 years who have a special need which puts them at risk for developmental problems regardless of family income. The birth of a child with special needs can be a shattering experience to a young couple. When special foods, special equipment, special eye doctors, special surgeons, special pediatricians, nutrition, physical therapy, and respiratory therapy services are needed, the problems become overwhelming. Financial, emotionai, as well as medical problems mount up on a family. As a service coordinator, frequently known as a case manager, the nurse or social worker becomes a resource of information to this family to decode the medical jargon, locate the appropriate type of assistance or help to apply for supplementary security income, etc. The number of families who will face special challenges at the birth of their child, or soon after, is increasing very rapidly. With a current caseload of 138 being managed by I full-time equivalent, when the Department of Environment, Health, & Natural Resources recommends 50 children as a manageable caseload, only families with severe needs can be offered this service while other are struggling without the benefit of a service coordinator. We would like to request the addition of a full-time Social Worker II for the Child Service Coordination Program. This position would not require any county funding. If hired in January, the first 3-6 months would be supported by revenues generated from visits made to Child Service Coordination clients by present nursing staff. These visits are reimbursed by Medicaid at the rate of $80 per month. At present, we have two nurses spending the equivalent of one full-time person in this program. The state provided us with $43,711 this year and we have earned $18,580 from the Medicaid reimbursement through October 31, 1993. Maintaining the same staffing, we would generate more than enough income to support the position until the social worker can make enough visits to support her own position (approximately $30,000/year). A caseload of 50 children, 83 % whom are Medicaid eligible, would generate $3,360 per month for $40,320 per year in additional revenue. Since about half the caseload comprises families with sociai problems which have a potential of adversely impacting upon the baby, we feel a social worker would be better able to work with these families freeing the nurses to work more with the families of babies with medical problems. We request that you approve the addition of this position.