The family can choose primary and specialty providers, including a specialist as the primary provider. The child s care plan is developed by the family and providers, and is monitored often. The health insurance plan identifies and follows children with special needs. Covered benefits include the services that children with special health care needs require. The plan of care allows and describes standing referrals, access to out of network providers, extension of benefits, exceptions to policy, and supports for a family to care for the child safely at home.
Families can easily find and use information about grievance and appeals processes.
Health systems regularly review and address gaps in coverage and services, based on family feedback. Families and providers make decisions together, with the child participating as much as possible. Administrative policies and practices support long term relationships between families and providers. Families help professionals develop and use tools that measure quality of care and family satisfaction. Families participate in in-service trainings with providers, agencies and health plans.