Find State ESMs

Displaying records 1 through 3 (3 total).

ESM 15.1 The number of community organizations who help families understand what services are available and covered by insurance for all children including those with special health care needs (Connecticut)

Measure Status: Active

Evidence Level: There is limited research in the evidence base for this NPM to support this strategy.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 4. Support and mobilize partners

Service Recipient: Activities directed to professionals

Goal: To increase the number of community organizations who help families understand what services are available and covered by insurance for all children including those with special health care needs.

Numerator: The number of community organizations who help families understand what services are available and covered by insurance for all children including those with special health care needs.

Denominator: Count

Significance:

Data Sources and Data Issues: American Academy of Pediatrics highlighted the importance of continuous and adequate insurance with a policy statement. The major problems cited were cost-sharing requirements were too high, benefit limitations, and inadequate coverage of needed services. Inadequately insured children are more likely to have delayed or forgone care, lack a medical home, be less likely to receive needed referrals and care coordination, and receive family-centered care. Reference: https://www.mchevidence.org/tools/npm/15-adequate-insurance-coverage.php

Year: 2021

Unit Type: 1000, Unit Number: United Way 2-1-1 database, the statewide toll-free information line, provides a description of services and contact information for community organizations including those that help families understand services that are available and covered by insurance for all children including those with special health care needs.

ESM 15.1 Number of Managed Care Organizations (MCO) and Care Connection for Children (CCC) Care Coordinators that attend statewide meeting (Virginia)

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "On-Site Medical Practice Care Coordination Services". Find other NPM 15 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 4. Support and mobilize partners

Service Recipient: Activities related to systems-building

Goal: Increase the adequacy of insurance for children and youth with special health care needs (CYSHCN).

Numerator: Number MCO and CCC Care Coordinators that attend statewide meeting

Denominator: Count

Significance:

Data Sources and Data Issues: The VDH Title V MCH needs assessment identified that health insurance for health care services for CYSHCN is both an asset and a frustration for families. The assessment also demonstrated that parents struggle to understand their insurance and what it provides. Examples of barriers mentioned included: filling out required paperwork; understanding information about insurance/confusion; being able to access certain medications; language issues; not having insurance at all; and MCO/benefit changes mid-year that at times may disrupt services provided.

Year: 2021

Unit Type: 1000, Unit Number: VDH CYSHCN Program Documents

ESM 15.1 Establishment of Cross-Agency Coordination Committee between DPH and Medicaid (Delaware)

Measure Status: Active

Evidence Level: There is limited research in the evidence base for this NPM to support this strategy.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 4. Support and mobilize partners

Service Recipient: Activities related to systems-building

Goal: Work with Medicaid partners to develop the structure, process, and policy that will support the creation of the Cross-Agency Coordination Committee (CACC).

Numerator: Structure and schedule for CACC

Denominator: Text

Significance:

Data Sources and Data Issues: As described in our recently signed MOU, the CACC will work to establish a multi-disciplinary coordination committee who will be responsible for working together on training, messaging, case management, and procedures. The overarching goals of this committee is to ensure that the mothers and families in Delaware who are eligible for services are given a clear understanding of where and how they can obtain those services. This group will address any redundant services and activities between agencies as well as filling any gaps in services that exist.

Year: 2021

Unit Type: Yes/No, Unit Number: CACC meeting minutes.