Adult Setting: None Yes Title V 0 A policy describing the adult (IF YES) How effective are those State Medicaid 1 Weak medical home approach to policies and procedures? CHIP 2 Moderate accepting and partnering with 1 Not effective Health Plan/Insurer 3 Strong new YSHCN, including legal 2 Somewhat effective Provider (please specify) changes at age 18, is in place. 3 Very effective Family/Consumer Other (please specify) OPTIONAL: Why? No for score, above ) (Select “0” Not applicable to my organization Enter Score: Enter Score: An individual flow sheet or Yes Title V 0 None registry for identifying (IF YES) How effective are those State Medicaid 1 Weak transitioning YSHCN through 26 policies and procedures? CHIP 2 Moderate Not effective Strong years of age is maintained by 1 Health Plan/Insurer 3 the health plan and medical 2 Somewhat effective Provider (please specify) home to track completion of the 3 Very effective Family/Consumer transition process. Other (please specify) OPTIONAL: Why? No (Select for score, above ) “0” Not applicable to my organization Enter Score: Enter Score:
Adult Setting: A policy describing the adult medical home approach to accepting and partnering with new YSHCN, including legal changes at age 18, is in place. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No (Select “0” for score, above ) 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: An individual flow sheet or registry for identifying transitioning YSHCN through 26 years of age is maintained by the health plan and medical home to track completion of the transition process. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No (Select “0” for score, above ) 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:
7_Transition%20to%20Adulthood_In%20DepthFINAL.docx