A process for identifying Yes Title V 0 None providers who are interested in 1 Weak (IF YES) How effective are those State Medicaid caring for YSHCN exists at the policies and procedures? CHIP 2 Moderate adult medical home and health 1 Not effective Health Plan/Insurer 3 Strong plan levels. 2 Somewhat effective Provider (please specify) 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: A process for welcoming and Yes Title V 0 None orienting young adults exists (IF YES) How effective are those State Medicaid 1 Weak within the adult medical home. 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 for score, above ) (Select “0” Not applicable to my organization Enter Score: Enter Score:
A process for identifying providers who are interested in caring for YSHCN exists at the adult medical home and health plan levels. 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: A process for welcoming and orienting young adults exists within the adult medical home. 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