All children, including CYSHCN, Yes Title V 0 None receive recommended 1 Weak (IF YES) How effective are those State Medicaid immunizations according to the policies and procedures? CHIP 2 Moderate Advisory Committee on 1 Not effective Health Plan/Insurer 3 Strong Immunization Practices (ACIP). 2 Somewhat effective Provider (please specify) 3 Very effective Family/Consumer Other (please specify) OPTIONAL: Why? No Not applicable to my organization Enter Score: Enter Score: Reasonable access to routine, Yes Title V 0 None episodic, urgent, and emergent (IF YES) How effective are those State Medicaid 1 Weak physical, oral health and mental policies and procedures? CHIP 2 Moderate health care are provided. 1 Not effective Health Plan/Insurer 3 Strong 2 Somewhat effective Provider (please specify) 3 Very effective Family/Consumer Other (please specify) OPTIONAL: Why? No Not applicable to my organization Enter Score: Enter Score:
All children, including CYSHCN, receive recommended immunizations according to the Advisory Committee on Immunization Practices (ACIP). Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No Not applicable to my organization Enter Score: Title V State Medicaid CHIP Health Plan/Insurer Provider (please specify) Family/Consumer Other (please specify) 0 None 1 Weak 2 Moderate 3 Strong OPTIONAL: Why? Enter Score: Reasonable access to routine, episodic, urgent, and emergent physical, oral health and mental health care are provided. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No Not applicable to my organization Enter Score: Title V State Medicaid CHIP Health Plan/Insurer Provider (please specify) Family/Consumer Other (please specify) 0 None 1 Weak 2 Moderate 3 Strong OPTIONAL: Why? Enter Score:
4_Medical%20Home_In%20DepthFINAL.docx