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Part 1: Health Needs

Your opinion is important! Please take a few minutes to complete this survey.  The purpose of this survey is to get your opinion about your child’s needs and ways to improve them. The Department of Health will use the results of this survey and other information to identify the most pressing problems for families of children and youth with special health care needs.

The following is a list of 7 health priorities related to children and youth with special health care needs (CYSHCN):    

A.   Medical Home: To increase the percent of children who have a medical home (personal doctor or nurse, coordinated and family-centered care, referrals or care coordination if needed).    *family-centered care is a partnership between families and clinicians. It’s a collaborative relationship. It helps families set the goals for their child’s treatment and recovery.

B.   Transition: To increase the percent of adolescents who have received the services necessary to make transitions to adult health care.    

C.   Mental Health: Increase the percentage of children with a mental/behavioral condition (depression, anxiety problems, or conduct problems) who receive treatment or counseling.

D.   Adequate Insurance: To increase the percent of children who have insurance coverage with benefits that usually meets needs and allows the child to see needed providers.   

E.    Family Partnership: To increase the percent of CYSHCN and their families who report that they share in decision-making and are satisfied with the services they receive. 

F.    Early Screening: To increase the percent of children who are screened early and continuously for special health care needs.

G.   Easy access to services: Services and supports for CYSHCN and their families will be organized in ways that families can use them easily.

Question Title

* 1. In the following list, what do you think are the three most important needs for children and youth with special health care needs and their families? (These needs are explained in detail above.)

Check only three: 

Question Title

* 2. In the following list, what do you think are the three most important parts of a medical home for children and youth with special health care needs and their families?

Check only three:

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