Introduction
6. What Are the M&M Indicators?
Recognizing that the Six Core CSHCN Outcomes represent various components, the M&M Project developed indicators to guide the measurement of state achievement. A list of these indicators follows.
Outcome #1: Families of children with special health care needs will partner in decision-making at all levels and will be satisfied with the services they receive.
1.1 % of families of CSHCN reporting satisfaction with the quality of regular source of primary care, getting referrals and appointments for needed services, and coordination between primary and specialty care overall services.
1.2 % of parents of CSHCN who report satisfaction with their level of involvement/input in setting concerns and priorities to make decisions about their child's care plan.
1.3 % of parents of CSHCN who report knowing what to do when they are not satisfied with the services their child/family receives.
1.4 % of parents of CSHCN who are supported financially for their involvement in state and local activities, including transportation, provision of stipends, employment of families, and child care.
1.5 % of parents of CSHCN who report that they are effective partners in policymaking at the state and local levels.
Outcome #2: Children with special health care needs will receive coordinated, ongoing, comprehensive care within a medical home.
2.1 % of CSHCN with a regular source of primary medical care through a primary care provider.
2.2 % of CSHCN whose regular source of care communicates in a way that is clear and understandable to the family.
2.3 % of parents whose regular source of primary medical care identifies, discusses, and addresses the comprehensive needs of their child and family.
2.4 % of CSHCN whose regular source of primary medical care ensures age-appropriate well-child checks, including: vision, hearing, developmental, behavioral/mental health, oral health, newborn screening, immunizations.
2.5 % of parents of CSHCN who receive referrals and assistance from their regular source of primary medical care in accessing needed/desired services.
Outcome #3: Families of children with special health care needs will have adequate private and/or public insurance to pay for the services they need.
3.1 % of CSHCN with insurance that covers costs of needed services, including: mental health, dental care, age-appropriate well-child checks, durable medical equipment, ancillary services, non-durable medical supplies, care coordination, prescriptions, specialty care, related therapies (e.g., PT, OT, speech/language, audiology), in-home nursing.
3.2 Amount of out-of-pocket costs paid by families of CSHCN, including costs of: mental health, dental care, age-appropriate well-child checks, durable medical equipment, ancillary services, non-durable medical supplies, respite care, transportation, care coordination, prescriptions, specialty care, related therapies (e.g., PT, OT, speech/language, audiology), in-home nursing, home modifications, car/van modifications.
3.3 % of CSHCN who can choose providers of their choice.
3.4 % of CSHCN whose insurance provides timely approval for needed care, clear information to parents and providers about coverage, resources, and complaint procedures, and overall parent satisfaction.
Outcome #4: Children will be screened early and continuously for special health care needs.
4.1 % of infants whose mothers began prenatal screening in the first trimester of pregnancy for: Smoking, Alcohol, Drugs, Tests for birth defects, HIV, Physical abuse.
4.2 % of at-risk infants and children being tracked for special health care needs and developmental delays.
4.3 % of children receiving age-appropriate well-child checks including: vision, hearing, developmental, behavioral, mental health, oral health, metabolic, EPSDT (if implemented in state).
4.4 % of children receiving needed follow-up due to failed screening or risk factors: vision, hearing, developmental, behavioral, mental health, oral health, metabolic.
Outcome #5: Community-based service systems will be organized so families can use them easily.
5.1 % of parents of CSHCN who have a single coordinated service plan that involves all providers and a lead service coordinator who communicates with the family.
5.2 % of parents of CSHCN who report that they are able to access comprehensive services for their child and family.
5.3 % of parents of CSHCN who have specialty care available in their region of the state.
5.4 The degree to which the state service system has an enrollment/eligibility process that links families of CSHCN (and their medical home) with a wide variety of public and private services and resources.
5.5 Number of private/public partnerships to provide community-based, comprehensive medical services for CSHCN (e.g., data sharing, contracts, MOAs).
Outcome #6: Youth with special health care needs will receive the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence.
6.1 % of youth with SHCN who by age 14 have a transition plan that addresses employment, transportation, housing, independent living, physical and mental health, and necessary accommodations; and % of youth with SHCN who by age 16 have a transition plan that includes appropriate agencies as part of the transition planning team.
6.2 % of youth with SHCN whose regular source of primary medical care facilitates the transition from pediatric to adult providers.
6.3 % of adult health care providers who are prepared to serve youth with SHCN.
6.4 % of youth who report satisfaction with the information and training they received to make informed decisions about their health care and other services.
6.5 % of youth with SHCN who received necessary services/supports by age 21: Health insurance, post-secondary education, Employment, Health Insurance, Transportation, Housing, Personal care attendant, SSI, SSA-related work incentives (e.g., PASS, 1619 a & b).