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 2012 Federal Poverty Level Guidelines (Effective 7/1/2012 - 6/30/2013)

C-1 2013 Federal Poverty Level Guidelines (Effective 7/1/2013 - 6/30/2014)

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)

     14. Orthognatic Surgery

F-1 Evaluation Forms

G-1 Transitioning to Adulthood