Appendix B

ACTION PLAN

Title V / Maternal and Child Health (MCH) – Children’s Special Health Services (CSHS)

North Dakota Title V / MCH – CSHS Priority Area
Medical Home Quality Improvement/Demonstration Project
Definitions:
Objective
An objective is a statement of intention with which actual achievements and results can be measured and compared.
Objective(s) must be written “SMART” – specific, measurable, achievable, relevant and time-phased. / Strategies and Activities
Strategies and Activities must be linked to evidence-based, evidence-informed and/or promising practices.
Strategies are the general approaches taken to achieve the objectives.
Activities are specific actions to implement the strategies.
Note: Activities should occur betweenJanuary 1, 2018– June 30,2019. / Measurement methodand references used for evidence-based, evidence-informed and/or promising practices
Applicants can choose to implement one of the two options listed below. Depending upon which option is chosen, the mandatory activities have been completed for you. It is anticipated that each applicant will also have additional activities.
Objective
Option 1: Achieve the National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMH) recognition by June 30, 2019.
Option 2:Implement a quality improvement initiative to advance medical home for children with special health care needs (CSHCN) by June 30, 2019. / Strategies and Activities
Mandatory strategy and activities for Option 1:
Demonstrate compliance with NCQA PCMH transformation concepts, competencies, and criteria throughthe following activities:
  • Participate in external PCMH-orientated collaborative activities including but not limited to annual meetings of the ND Medical Home Coalition.
  • Involve patient/family/caregiver in quality improvement activities focusing on children, youth, and young adults with special health care needs.
  • Incorporatebest practice medical home/care coordination toolsto improve care.
Mandatory strategy and activities for Option 2:
Demonstrate utilization of quality improvement strategies to address one or more of the following: care coordination, family engagement, or cultural competency. Required activities include:
  • Conducting an assessment and implementingactivities identified in a quality improvement plan.
  • Participating in external PCMH-orientated collaborative activities including but not limited to annual meetings of the ND Medical Home Coalition.
/ Option 1 measurements:
  • If PCMH recognition has been achieved, provide documentation to CSHS. If recognition has not been achieved,provide detailed status reports to CSHS on progress in the transformation process.
  • A MedicalHome state plan is available which has been developed by Medical Home Coalition partners.
Option 1 - List of references for evidenced-based strategies:
(Refer to the Application Guidance for a list of best practice medical home/care coordination/family engagement links).
Option 2 measurements:
  • Provide detailed reportsto CSHS on the quality improvement initiative that include but are not limited toa summary of the assessment (with baseline data where possible), completed plan activities, and outcomes achieved through the initiative to advance medical home for CSHCN in the identified focus areas.
  • A Medical Home state plan is available which has been developed by Medical Home Coalition partners.
Option 2 List of references for evidenced-based strategies:
(Refer to the Application Guidance for a list of best practice medical home/care coordination/family engagement links).
Additional action plan(s) for medical home quality improvement or demonstration project.