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

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Limits * This approach identifies a very narrow population of children, primarily
those with mental retardation and certain neurological and mental health
diagnoses.
Eligibility determination using the SSI approach is expensive.
Source National Commission on Childhood Disability: Supplemental Security Income
for Children with Disabilities. Washington, DC: National Commission on
Childhood Disability, 1995.
Content Children with chronic conditions lasting or expected to last 12 months are
identified using a parent questionnaire that addresses: I) functional limitations -
- unable to play with other children, restricted in activities, difficulty feeding,
dressing, washing, toileting, walking, and difficulty hearing, seeing or
communicating; 2) reliance on compensatory modalities -- medication use,
special diet, special equipment, and personal assistance, and 3) service use/need
beyond routine care - hospitalizations, doctor visits, nursing care or treatment,
physical, occupational or speech therapy, psychological services, special
arrangements at school, special instruction or other educational services, and
need for unobtainable services.
Purpose Epidemiology
Approach Function and service-based
Testing 1994 Disability Supplement to the National Health Interview Survey, national
and Use telephone survey, and New York inner-city sample. Currently in use only for
epidemiologic purposes.
Strengths * This assessment tool was designed specifically for children with special
health care needs.
* It is focused on the child rather than the condition. Therefore, it can
capture children who have functional problems but no diagnosis.
* It has been well tested for survey purposes and it will be available in the
form of a survey instrument very soon.
Limits * Since the tool was designed for survey purposes, it may not be
applicable for assessing individual children with special health care
needs in plans.
* The instrument was not designed to provide information on types,
numbers, or severity of conditions, nor was it designed to identify
children at risk of chronic conditions.
* The measure is subjective in that it relies on parent responses and could
be subject to gaming by plans.
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