Durable medical equipment and Yes Title V 0 None home health services are 1 Weak (IF YES) How effective are those State Medicaid customized for CYSHCN. policies and procedures? CHIP 2 Moderate 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: A of services Yes Title V 0 None “full continuum” for health (IF YES) How effective are those State Medicaid 1 Weak children’s behavioral needs, including acute services policies and procedures? CHIP 2 Moderate in a 24-hour hour clinical setting, 1 Not effective Health Plan/Insurer 3 Strong intermediate services, and 2 Somewhat effective Provider (please specify) outpatient services and 3 Very effective Family/Consumer community support services are Other (please specify) provided. OPTIONAL: Why? No Not applicable to my organization Enter Score: Enter Score:
Durable medical equipment and home health services are customized for CYSHCN. 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: A “full continuum” of services for children’s behavioral health needs, including acute services in a 24-hour hour clinical setting, intermediate services, and outpatient services and community support services 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