Medicaid Managed Care - U.S. Senate Special Committee on Aging
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Medicaid Managed Care - U.S. Senate Special Committee on Aging

Medicaid Managed Care - U.S. Senate Special Committee on Aging Medicaid Managed Care - U.S. Senate Special Committee on Aging

aging.senate.gov
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2. Child Health Questionnaire (CHQ) 652 Content Children with health and functional impairments are identified using parent and child questionnaires that address 14 concepts: physical functioning, bodily pain, role/social limitations-physical, general health perceptions, change in health, role/social limitations-emotional/behavioral, mental health, general behavior, self-esteem, emotional impact on the parent, impact on parent's personal time, limitations on family activities, and family cohesion. Purpose Health and functional status assessment Approach Function based Testing National and international sites. Currently in use only for epidemiologic and Use purposes. Strengths * The approach captures multi-dimensional aspects of health and function and can be used to assess the impact of children's illness on other family members. * The approach is well tested for children, though not specifically for children with special health care needs. * A set of assessment tools for school-aged children are complete and available, including scales of three different lengths. * Multiple translations are available. Limits * This is a generic assessment tool that was not designed with identification of children with special health care needs in mind. * There are no shorter versions for infants/pre-schoolers at this time (only a 100 item scale is available). * There are no specific questions on learning problems and disabilities. * Because of its subjective nature, the approach may be subject to gaming by health plans. Source: Landgraf JM, Abetz L, Ware JE: Child Health Questionnaire: A U1ser's Manual. Boston: The Health Institute, New England Medical Center (forthcoming in December 1996). 3. Maternal and Child Health Bureau's Definition (MCHB)l Content Children with special health care needs are those who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by children generally. Purpose Planning and systems development for federal and state Title V Programs for Children with ong>Specialong> Health ong>Careong> Needs 3

Approach Service based 653 Testing 1994 Disability Supplement to the National Health Interview Survey for and Use epidemiologic estimates Strengths * This approach is inclusive of those with a chronic condition as well as those at risk. Diagnosis or functional status information does not necessarily have to be collected. * Using a service-based approach allows for looking more broadly across conditions and functional levels. Limits * This approach would likely take into account in excess of 20 percent of all children. * The term "increased risk" is not defined. * Except for national testing, this definition has not yet been applied at a managed care plan level. Source McPherson M: New Definition of Children with ong>Specialong> Health ong>Careong> Needs. Rockville, MD: Maternal and Child Health Bureau, 1995. Content Children who are SSI eligible must have a medically determinable physical or mental impairment that has lasted or is expected to last at least 12 months or result in death. The condition list of impairments includes over 100 conditions. Under The Personal Responsibility and Work Opportunities Reconciliation Act, children are no longer eligible solely on the basis of a functional impairment that is comparable to one that would prevent an adult from working or one that would substantially reduce a child's ability to function in age-appropriate manner. Purpose Eligibility determination for cash payments, ong>Medicaidong> eligibility in most states, and referral to Title Vs CSHCN program Approach Diagnostic and function based Testing Used in state Disability Determination Service Agencies and Use Strengths This is the only operational model that integrates diagnostic and functional status information. It is used by many state ong>Medicaidong> agencies for setting risk-adjusted capitation rates. 4

2. Child Health Questi<strong>on</strong>naire (CHQ)<br />

652<br />

C<strong>on</strong>tent Children with health and functi<strong>on</strong>al impairments are identified using parent and<br />

child questi<strong>on</strong>naires that address 14 c<strong>on</strong>cepts: physical functi<strong>on</strong>ing, bodily pain,<br />

role/social limitati<strong>on</strong>s-physical, general health percepti<strong>on</strong>s, change in health,<br />

role/social limitati<strong>on</strong>s-emoti<strong>on</strong>al/behavioral, mental health, general behavior,<br />

self-esteem, emoti<strong>on</strong>al impact <strong>on</strong> the parent, impact <strong>on</strong> parent's pers<strong>on</strong>al time,<br />

limitati<strong>on</strong>s <strong>on</strong> family activities, and family cohesi<strong>on</strong>.<br />

Purpose Health and functi<strong>on</strong>al status assessment<br />

Approach Functi<strong>on</strong> based<br />

Testing Nati<strong>on</strong>al and internati<strong>on</strong>al sites. Currently in use <strong>on</strong>ly for epidemiologic<br />

and Use purposes.<br />

Strengths * The approach captures multi-dimensi<strong>on</strong>al aspects of health and functi<strong>on</strong><br />

and can be used to assess the impact of children's illness <strong>on</strong> other family<br />

members.<br />

* The approach is well tested for children, though not specifically for<br />

children with special health care needs.<br />

* A set of assessment tools for school-aged children are complete and<br />

available, including scales of three different lengths.<br />

* Multiple translati<strong>on</strong>s are available.<br />

Limits * This is a generic assessment tool that was not designed with<br />

identificati<strong>on</strong> of children with special health care needs in mind.<br />

* There are no shorter versi<strong>on</strong>s for infants/pre-schoolers at this time (<strong>on</strong>ly<br />

a 100 item scale is available).<br />

* There are no specific questi<strong>on</strong>s <strong>on</strong> learning problems and disabilities.<br />

* Because of its subjective nature, the approach may be subject to gaming<br />

by health plans.<br />

Source: Landgraf JM, Abetz L, Ware JE: Child Health Questi<strong>on</strong>naire: A U1ser's<br />

Manual. Bost<strong>on</strong>: The Health Institute, New England Medical Center<br />

(forthcoming in December 1996).<br />

3. Maternal and Child Health Bureau's Definiti<strong>on</strong> (MCHB)l<br />

C<strong>on</strong>tent Children with special health care needs are those who have or are at increased<br />

risk for chr<strong>on</strong>ic physical, developmental, behavioral, or emoti<strong>on</strong>al c<strong>on</strong>diti<strong>on</strong>s<br />

and who require health and related services of a type or amount bey<strong>on</strong>d that<br />

required by children generally.<br />

Purpose Planning and systems development for federal and state Title V Programs for<br />

Children with <str<strong>on</strong>g>Special</str<strong>on</strong>g> Health <str<strong>on</strong>g>Care</str<strong>on</strong>g> Needs<br />

3

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