Health Services Coordination Standard Work

Health Service Coordinators (HSCs) assist providers, workers, and employers in a variety of ways. Some examples include:

1. Coordination and tracking of referrals:
   • Track referrals through provider chart notes and follow up with the worker to ensure that they have engaged with referred services. 
   • Contact referred providers' offices as needed.
   • Check with workers to see if there are any barriers to completing referred services and work to resolve them.
   • Review provider chart notes to determine next steps and assist when needed.
2. Assessment of barriers to recovery:
   • Conduct Functional Recovery Questionnaire (FRQ) and report positive FRQs to attending providers.
   • Document pain and function scales to ensure that progress is being made.  Alert attending provider if pain and function scales show that progress is not being made.
   • Complete other assessments as needed (ex: HSC's barriers assessment).
3. Ongoing monitoring of recovery:
   • Review new workers, work lists, and tasks daily.
   • Assist workers in navigating L&I and health care systems.
   • Determine and follow up on HSC care coordination plan goals and next steps.
   • Coordinate case conferences, refer to COHE advisors, and suggest PGAP or other programs as applicable.
   • Assist providers and workers in completing occupational disease or opioid paperwork.
4. Refer to community services:
   • Maintain a list of community resources and share them with workers as needed.
   • Follow up with workers about community resources if it is part of their care coordination plan.
5. Assistance with medication issues:
   • Explain the new prescribing best practices to providers (L&I resources and guidelines).
   • Check with workers about their medication usage and if they're taking them as prescribed.  Report issues to providers.
   • Alert the attending provider if the patient complains of pain issues and/or shows drug-seeking behaviors.  Discuss referrals to possible interventions (ex: PGAP) with provider.
   • Remind providers about L&I opioid paperwork and requirements.
6. Coordination of return to work:
   • Ensure that employer, provider, and worker understand restrictions, capacities, return to work expectations, programs, and assistance opportunities (ex: Stay at Work).  
   • Answer questions about L&I related programs.
   • Assist employers with job descriptions; assist Vocational Rehabilitation Councilors (VRCs) working with providers to complete the job analysis review process.
   • Communicate and coordinate with VRCs.
   • Track work status and include return to work goals in the care coordination plan as needed.
7. Support during transitions of care:
   • Assist workers in finding a new attending provider when needed.
   • Assist providers in submitting transfers of care when needed.
   • Assist workers coming from emergency departments and needing ongoing care to ensure continuity of care. 
   • Assist workers transitioning to and from attending provider care.
   • Communicate with other health services coordinators when workers are transitioning to other providers.
8. Coordination of surgical care:
   • Ensure communication to workers who are surgical candidates.
   • Ensure that workers have pre-operative released to work plan.
   • Ensure that workers have post-operative recovery and released to work plan.
   • Communicate with surgeon when worker is not making progress on their post-operative recovery and released to work plan.
   • Ensure that the worker transitions to a non-surgical provider when ongoing care is needed.

Health Services Coordinator (HSC) Minimum Qualifications

1. Bachelor's or equivalent degree and three years of experience in direct patient care, return-to-work coordination, occupational health care, or equivalent experience OR Seven years experience in direct patient care, return-to-work coordination, occupational health care, or equivalent experience.
   • Direct patient care includes nurse, medical assistant, nurse navigators, and care coordinators, but does not include referral coordinators, schedulers, or clinical administrative staff.
2. Able to obtain and maintain an L&I Provider ID, and bill HSC services.  No reported issues with Labor & Industries.
3. Experience or demonstrated skills in:
   • Oral and written communication with health care professionals, patients, employers, and insurance staff and resources.
   • Data management and tracking.
   • Completing care coordination or similar documentation.
   • Analyzing and communicating provider, care coordinator, and best practice reporting data.
4. Must successfully complete L&I required training and/or testing.

Assistant Health Services Coordinator Minimum Qualifications

1. Three years experience in direct patient care, return-to-work coordination, occupational health care, or equivalent experience.
   • Direct patient care includes nurse, medical assistant, nurse navigators, and care coordinators, but does not include referral coordinators, schedulers, or clinical administrative staff.
2. Able to obtain and maintain an L&I Provider ID, and bill HSC services.  No reported issues with Labor & Industries.
3. Experience or demonstrated skills in:
   • Oral and written communication with health care professionals, patients, employers, and insurance staff and resources.
   • Data management and tracking.
   • Completing care coordination or similar documentation.
   • Analyzing and communicating provider, care coordinator, and best practice reporting data
4. Must successfully complete L&I required training and/or testing.

Please refer to your best practice program's Special Fee Schedule for more information.