System Principles, Standards and Key Questions for Assessment of State Systems of Care for CYSHCN

Transcription

1 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl fr Cmmunity-Based Services and Supprts System Principles, Standards and Key Questins fr Assessment f State Systems f Care fr CYSHCN DOMAIN: COMMUNITY-BASED SERVICES AND SUPPORT CYSHCN and their families are prvided access t cmprehensive and cmmunity-based supprts, prvided by their health plan and/r in partnership with ther cmmunity agencies including family rganizatins, public health, educatin, Early Interventin (Part C), Special Educatin welfare, mental health, and hme health care rganizatins. State: Date: Type f Agency Cmpleting this Tl: State Medicaid Health Plan/Insurer Prvider (please specify ) Family/Cnsumer Other (please specify: ) When prviding answers in this assessment tl, please d s frm the perspective f the rganizatin r system in which yu wrk r are affiliated. Clumn A System Standards (Structure and Prcess) 1. Agreements are in place between the health systems and varius cmmunity agencies and prgrams serving CYSHCN and are structured t: prmte family supprt thrugh linking families t family rganizatins and ther services and supprts prmte shared financing establish systems fr timely cmmunicatins and apprpriate data sharing Clumn B Within my rganizatin, there are plicies and prcedures in place fr this standard: Clumn C What agencies/entities in yur state have the authrity t implement and/r ensure this standard? (Check all that apply.) Clumn D Please rate yur rganizatin s authrity t implement r imprve plicies and prcedures that supprt this standard. ensure access and crdinatin f services fr individual children and their families 1

2 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl prmte cllabratin between cmmunity-based rganizatins and agencies, prviders, health care systems, and families specify respnsibilities acrss the varius prviders, and cmmunity-based agencies serving children and their families 1 RESPITE CARE (as part f the cmmunity based services) 1. Respite services, bth planned and emergency, are available t all families and caregivers f CYSHCN. 2

3 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl fr Cmmunity-Based Services and Supprts 2. Families are infrmed abut available respite services and helped t access them. 3. When ut-f-hme respite services are needed, transprtatin is available t help a child and family access these services. 3

4 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl 4. Health prviders and plans screen families and caregivers f CYSHCN fr respite care needs, make them aware f available respite services in their cmmunity, and prvide them with apprpriate and timely referrals t prviders that are qualified t serve CYSHCN. N (Select 0 fr scre, abve) 5. Health prviders and plans have a system in place fr ensuring timely referrals fr families f CYSHCN with emergency respite needs. N (Select 0 fr scre, abve) 4

5 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl fr Cmmunity-Based Services and Supprts PALLIATIVE AND HOSPICE CARE (as part f the cmmunity based services) 1. Curative and palliative care (als knwn as cncurrent care) is available and ffered at the same time. N (Select 0 fr scre, abve) 2. Palliative and hspice care utilizes family-centered mdels f care that respect individual s preferences, value, and cultural beliefs, and prvide family access t psychscial screening and referrals t needed supprts and services. 5

6 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl 3. The child and family plays an active rle in decisin making regarding gals and plans f care. HOME-BASED SERVICES (as part f the cmmunity based services) 1. Hme health care is a cvered benefit fr CYSHCN that includes health care fr the child and supprtive care fr the family, and is prvided in the family's hme by licensed prfessinals wh have experience in pediatric care. 2 6

7 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl fr Cmmunity-Based Services and Supprts SUMMARY: COMMUNITY-BASED SERVICES AND SUPPORT Effectiveness Indicatr: Ttal f Scres frm Clumn B (Plicies and Prcedures) clumn: / 30= Organizatinal Influence Indicatr: Ttal f Scres frm Clumn D (Ability t Implement and Imprve) clumn: / 30= Additinal Ntes: 7

8 Natinal Standards fr Systems f Care fr CYSHCN: IN-DEPTH State Systems Assessment Tl ENDNOTES: 1 See framewrk presented by Richard C. Antnelli (2012). Integratin fr Children with Special Health Needs: Imprving Outcmes and Managing Csts. Presentatin fr the Natinal Gvernrs Assciatin, July 12, Unpublished. 2 Libby RC, Imaizumi SO. American Academy f Pediatrics, Cmmittee n Child Health Financing, Sectin n Hme Care. Plicy Statement: Financing f Pediatric Hme Health Care (Secnd Editin). Available at: Updated Accessed Octber