Conduct activities to support Yes Title V 0 None CYSHCN and their families in 1 Weak (IF YES) How effective are those State Medicaid self-management of the policies and procedures? CHIP 2 Moderate child’s health and health care. 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: Promote quality of life, healthy Yes Title V 0 None development, and healthy (IF YES) How effective are those State Medicaid 1 Weak behaviors across all life stages. 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:
Conduct activities to support CYSHCN and their families in self-management of the child’s health and health care. 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: Promote quality of life, healthy development, and healthy behaviors across all life stages. 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