CHILDREN WITH SPECIAL HEALTH CARE NEEDS (CSHCN) PROGRAM 2011-2012 QUARTERLY NARRATIVE REPORT CSHCN Program: Quarter(s): Oct 2011 – December 2011 Report Completed By: Jan 2012 – March 2012 E-mail address: April 2012 – June 2012 Telephone Number: July 2012 – September 2012 Instructions: The quarterly narrative is a standardized document that should be used throughout the entire contract year. The format of the forms should not be changed. The narrative and data report should be submitted electronically to the contract manager via secure file transfer of the Health Commerce System no later than 45 days from the end of the quarter for which reimbursement is being claimed. For each quarter, describe in the narrative section, where applicable, steps taken in that period to accomplish planned work plan requirements. If planned activities shift based on unanticipated circumstances, the quarterly report should indicate change and/or modifications. The Summary Page should discuss any changes that occur during the contract period. EXAMPLE Work Pan Requirements Q-1 10/1/11-12/31/11 Q-2 1/1/12-3/31/12 Q-3 4/1/12-6/30/12 Q-4 7/1/12-9/30/12 LHD shall provide information via print or electronic form about the services of the CSHCN Program, gap-filling programs, insurance, and state and local programs to health care providers and health care facilities. Mailed out CSHCN brochures to local school districts, libraries and social workers at three area hospitals. Disseminated brochures on CSHCNs at two health fairs and one community event. Distributed at two area hospitals Mom” informational bags that included CSHCN Resource Directory, CHP, FHP and medical home brochures. Attended five outreach events this quarter. See attached list of details. NOTE: If a requirement has a checkbox in a column(s) labeled as Q-1, Q-2, Q-3 or Q-4, a narrative response is not required. Indicate the requirement is met by checking the box in the appropriate column. A narrative response is needed for all other requirements.
Goal 1. Program Administration: Local Health Departments (LHD) will effectively administer a Children with Special Health Care Needs (CSHCN) Program. Objective – LHD has all appropriate staff responsible for carrying out activities for a comprehensive CSHCN Program. Requirements ( box indicating requirement met) Q-1 10/1/11-12/31/11 Q-2 1/1/12-3/31/12 Q-3 4/1/12-6/30/12 Q-4 7/1/12-9/30/12 Develop and maintain an updated organizational of all personnel, including any vacant positions. The chart should include all personnel who perform CSHCN activities and the location of the CSHCN Program within the organization. Submit with the first quarterly report each year. Objective – LHD has appropriate and up-to-date policies and procedures in place to guide staff activities. Requirements ( box indicating requirement met) Q-1 10/1/11-12/31/11 Q-2 1/1/12-3/31/12 Q-3 4/1/12-6/30/12 Q-4 7/1/12-9/30/12 Develop and update as needed CSHCN Program (including Physically Handicapped Children’s Program when applicable) policies and procedures for daily use, orientation of new staff and education. Manuals are centrally located and available for use by LHD staff and for review by NYSDOH staff during the site visit review process or upon request.
Goal 2. Program Services: Families of CSHCN and your and young adults with special health care needs (YAYASHCN) who contact the CSHCN Program will receive timely and appropriate information and referrals to insurance, health services, and community resources to address their identified needs. Objective – 100% of families of CSHCN and YAYASHCN who are uninsured or underinsured will be provided with information regarding health and dental insurance and gap-filling programs. Requirements ( box indicating requirement met) Q-1 10/1/11-12/31/11 Q-2 1/1/12-3/31/12 Q-3 4/1/12-6/30/12 Q-4 7/1/12-9/30/12 Determine if each CSHCN served by the program has insurance. Determine if each CSHCN served by the program has a primary care provider. Describe specific activities: Objective – 100% of families of CSHCN and YAYASCHN with health related needs will be assisted in accessing appropriate community resources. Work Pan Requirements Q-1 10/1/11-12/31/11 Q-2 1/1/12-3/31/12 Q-3 4/1/12-6/30/12 Q-4 7/1/12-9/30/12 Describe specific activities: Provide families with information, guidance, and referrals about available community resources; refer to resources and follow up on outcomes of referrals; and document outcomes.
Goal 3. Outreach and Education: Empower families of CSHCN and YAYASHCN to navigate community systems of care. Objective – Increase awareness and knowledge of the public, health care providers and other professionals about information, tools and resouces to empower families of CSHCN and YAYASHCN to navigate community systems of care. Work Pan Requirements Q-1 10/1/11-12/31/11 Q-2 1/1/12-3/31/12 Q-3 4/1/12-6/30/12 Q-4 7/1/12-9/30/12 Describe specific activities: LHD shall provide information via print or electronic form about the services of the CSHCN Program, gap-filling programs, insurance, and state and local programs to health care providers and health care facilities. LHD shall provide information via print or electronic form about the services of the CSHCN Program, gap-filling programs, insurance, and state and local programs and community resources to families (including culturally diverse populations) of CSHCN, YAYASHCN, and family serving organizations and providers (i.e. Parent to Parent, respite). LHD shall inform and/or provide opportunities for families about support meetings and training workshops on CSHCN related topics including medical home, education advocacy, and transition.