SLAITS Survey on Children with Special Health Care Needs

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SLAITS Survey on Children with Special Health
Care Needs

• Bonnie Strickland, Ph.D.
• MCHCOM.COM Webcast
• December 8, 2000

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National CSHCN Survey

• Partnership between Maternal and Child Health
  Bureau (MCHB) and National Center for Health
  Statistics (NCHS)
• Using SLAITS, complete 750 CSHCN interviews per
  state.
• Data available Summer 2002

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Purpose

• Establish uniform state, regional, and national
  prevalence estimates for CSHCN under 18 with
  existing special health care needs using the MCHB
  definition,
• Provide state, regional, and national data for
  CSHCN characteristics and systems impact as
  baseline estimates for federal and state
  performance measures, Title V needs assessment
  activities and HP 2010.

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Additional Purposes

• Provide estimates of health care coverage for all
  children and
• Provide information on low income, uninsured,
  families regarding health status and
  Medicaid/SCHIP

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Prevalence Estimates Using Uniform Measure

• Living with Illness Survey (Foundation for
  Accountability)
• Questionnaire for Identifying Children with
  Chronic Conditions (QUICCC-R)

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Examples of ScreenerTopics

• Need or use medicine prescribed by a doctor
• Need or use more medical care, mental health, or
  educational services than is usual for most
  children
• Limited or prevented in ability to do things
• Need or get special therapy
• Need or get treatment or counseling for an
  emotional, developmental, or behavioral problem

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Interview Process

• Households screened for children under 18
• NIS conducted if household has a 19-35 month old
  child
• Screener to identify children with special health
  care needs
• Detailed questionnaire for children with special
  health care needs
• Target sample size 750 CSHCN per state

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Characteristics and Impact DataService Needs
and Systems Adequacy

• Demographics
• health and functional status
• access to care
• care coordination
• satisfaction with care
• health insurance coverage
• adequacy of health care coverage
• impact on family

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Health and Functional Status

• Extent to which condition limits ability to do
  things other children can do
• Overall severity and stability of condition
• IFSP or IEP
• School days missed

10
Access to Care

• Usual source of care (location and provider),
• Reasons for delay in obtaining needed health
  care,
• Difficulty in obtaining specific services

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Care Coordination

• Availability
• Source of care coordination
• Coordination within health
• Coordination with community services
• Services from Title V

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Satisfaction with care

• Time spent with child/family
• Listening and partnership
• Respect for values and customs
• Adequacy of information

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Health Insurance Coverage

• Source of insurance
• Gaps in insurance coverage
• Duration of uninsurance

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Adequacy of Health Care Coverage

• Adequacy of benefits,
• Out-of-pocket costs,
• Access to health care providers,
• Adequacy of information,
• Overall satisfaction

15
Impact on Family

• Out-of-pocket expenses,
• Health care provided by family,
• Time spent providing and coordinating care,
• Financial and employment impact.

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Objective / Performance Measure

• All CSHCN will receive regular ongoing
  comprehensive care within a medical home
• Existence of a primary care provider
• Care coordination by PCP
• Communication between PCP and other health
  providers, schools, and child care providers

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Objective /Performance Measure

• All families of CSHCN will have adequate
  insurance to pay for the services they need
• Current health insurance coverage
• No insurance and gaps in coverage over past 12
  months
• Delays or failure to get needed care due to costs
• Access problems due to health plan
• Satisfaction with health plan

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Brief Interview for Children Without Special
Needs

• Health Insurance Coverage
• Demographics

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Medicaid and SCHIP

• All low income and uninsured receive
  Medicaid/SCHIP section plus a subsection of the
  CSHCN questions
• Main reason for no health insurance
• Awareness of Medicaid/SCHIP
• Application, eligibility, and enrollment
  information,
• Reasons for not wanting to enroll.

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Schedule

• Questionnaire Finalized Nov 1999
• Pretesting Mar Sept 2000
• Conduct interviews Oct 2000 2001
• 6 month national data Sept 2001
• State-level data Summer 2002
• Repeat periodically