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Table of Contents

CHAPTER ONE - GENERAL INFORMATION

I. MATERNAL AND CHILD HEALTH PROGRAMS

II. DEFINITIONS

III. GENERAL INFORMATION ABOUT CHILDREN'S SPECIAL HEALTH SERVICES

CHAPTER TWO - CSH ELIGIBILITY AND COVERED SERVICES

I. BRIEF SUMMARY OF PROGRAM

II. ELIGIBILITY

III. NOTIFICATION OF ELIGIBILITY/TERMINATION

IV. PROGRAMS AND COVERED SERVICES OF CHILDREN'S SPECIAL HEALTH SERVICES

CHAPTER THREE - ELEMENTS OF CARE COORDINATION

I. ELEMENTS OF CARE COORDINATION

II. PROGRAM REPRESENTATION

III. CHILD AND FAMILY ASSESSMENT

IV. COORDINATING CARE

CHAPTER FOUR - CARE COORDINATOR

I. DEFINITION OF CARE COORDINATION

II. WHO IS ELIGIBLE FOR CARE COORDINATION

III. QUALIFICATIONS OF PHN CARE COORDINATOR

IV. MINIMUM STANDARDS OF CARE COORDINATION

CHAPTER FIVE - DOCUMENTATION, FORMS, AND REPORTS

I. DOCUMENTATION

II. FORMS

CHAPTER SIX - PROGRAM EVALUATION

I. PROGRAM EVALUATION

II. FEDERAL PERFORMANCE MEASURES

III. STATE PROGRAM STANDARDS

IV. CSH CARE COORDINATION EVALUATION/TRAINING TOOL

V. SYSTEM/DATA COLLECTION OF LOCAL PROGRAM

APPENDIX

A-1 Wyoming Department of Health Organizational Chart

A-2 Public Health Division Organizational Chart

A-3 Maternal and Family Health Organizational Chart

B-1 MFH Regional Map by Benefits and Eligibility Specialist

C-1 2016 Federal Poverty Level Guidelines (Effective 4/1/2016 - 3/31/2017)

C-1 2015 Federal Poverty Level Guidelines (Effective 4/1/2015 - 3/31/2016)

D-1 Diagnostic Evaluation Policy

D-2 CSH Guidelines for Parents

D-3 MHR/NBIC Guidelines for Parents

E. CSH Policies

Medical Conditions Eligibility Criteria

     1. Convulsive Disorders

     2. Neurofibromatosis (NF)

     3. Juvenile Idiopathis Arthritis (JIA)

     4. Cystic Fibrosis (CF)

     5. Diabetes Mellitus Type I (DM)

     6. Esotropia/Exotropia and Amblyopia

     7. Autism Spectrum Disorder/Pervasive Developmental Delay (PDD)

     8. Global Developmental Delay (GDD)

     9. Osteogenesis Imperfecta (OI)

    10. Retinopathy of Prematurity (ROP)

    11. Tympanostomy Tubes

    12. Hemophilia and Variants

    13. Cerebral Palsy (CP)

F-1 Evaluation Forms

G-1 Transitioning to Adulthood