Children with Medical Complexity
Promoting Relationship Building and Collaboration between Delaware Nursing Schools and Delaware Home Health Agencies
Date: June 28, 2024
On June 28, 2024, The Division of Medicaid & Medical Assistance (DMMA) hosted an event titled, Promoting Relationship Building and Collaboration between Delaware Nursing Schools and Delaware Home Health Agencies. This event was held at the Del-One Conference Center, Terry Campus, Delaware Technical Community College, Dover.
Background
Under the Department of Health and Social Services, DMMA supports programs for children with medical complexity. DMMA also supports the ongoing operation of the Children with Medical Complexity Advisory Committee (CMCAC), an advisory group supporting CMC and their families. Children in this group often have several major medical conditions occurring at the same time which makes them eligible to receive private duty nursing in their homes. Since the pandemic, there has been a significant reduction in the availability of PDNs to meet the needs of these children. In September 2021, the University of Delaware’s Center for Research in Education and Social Policy completed the PDN Workforce Capacity Study. DMMA has used the findings from this study to increase the availability of PDN.
DMMA organized this event to support the Children with Medical Complexity (CMC) group and their families, as the availability of Private Duty Nurses (PDN) for CMC children has decreased since the pandemic. The goal of this event was to create an environment where nursing schools, home health agencies and others can collaborate to address this issue.
CMC PDN Nursing School and HHA Collaboration Event Flyer 06 28 2024
Self-Directed Attendant Care for Children and Medicaid Pediatric Respite Services – VIRTUAL TOWN HALL MEETING –
On March 6, 2024, Delaware Health and Social Services, Division of Medicaid and Medical Assistance (DMMA) hosted a Virtual Town Hall meeting to discuss the Medicaid self-directed attendant care (SDAC) benefit for children and the Medicaid respite service for children.
Effective January 1, 2023, the Delaware Health and Social Services (DHSS), through the Medicaid program, began providing coverage of a self-directed option for parents on behalf of children receiving personal care services as well as respite services for children. The self-directed option gives families the flexibility to hire, for example, a neighbor, friend, or family member, including a legally responsible family member as the service provider.
Please click the link below for registration information:
Virtual Town Hall Meeting – March 2024
See the links below for more information:
- May 2023 Medicaid Respite for Children Presentation
- 2023 Respite Family Stakeholder Q&A
- 2023 Respite Provider Stakeholder Q&A
- DMMA SDAC Respite Town Hall March 2024
| In compliance with Budget Epilogue Section 141 of the State of Delaware’s Legislature, 149th Generally Assembly’s act making appropriations for the expense of the State Government for the fiscal year ending June 30, 2018; specifying certain procedures, conditions and limitations for the expenditure of such funds; and amending certain pertinent statutory requirements [House Substitute No. 1 (HS1) for House Bill No. 275 (HB275)], Delaware Health and Social Services (DHSS) / Division of Medicaid and Medical Assistance (DMMA) has published a comprehensive plan for children with Medical Complexity. | CLICK HERE TO ACCESS RESOURCES FOR FAMILIES, PROVIDERS, AND OTHERS INVOLVED IN THE CARE OF CHILDREN WITH MEDICAL COMPLEXITIY |
Identifying Children with Medical Complexity – A Working Definition
Children with medical complexity are a subset of children and youth with special health care needs because of their extensive health care utilization. For the purpose of this work, a child is considered medically complex if she/he falls into two or more of the following categories:
- Having one or more chronic health condition(s) associated with significant morbidity or mortality;
- High risk or vulnerable populations with functional limitations impacting their ability to perform Activities of Daily Living (ADLs);
- Having high health care needs or utilization patterns, including requiring multiple (3 or more) subspecialties, therapists, and/or surgeries;
- A continuous dependence on technology to overcome functional limitations and maintain a basic quality of life.
The Children with Medical Complexity Steering Committee developed this broad definition of children with medical complexity to aid in the development of a Delaware’s Plan for Managing the Health Care Needs of Children with Medical Complexity, as well as to assist in the work this group is continuing to embark on. This definition is not intended to serve as the basis for denying or authorizing care and/or payment for care for children served through the Delaware Medicaid Program.
Children with Medical Complexity Advisory Committee (CMCAC)
During development of Delaware’s Plan for Managing the Health Care Needs of Children with Medical Complexity (the Plan), it became evident early in the planning process that there would not be enough time to perform an in-depth analysis of the full continuum of care for children with medical complexity. The data needed to perform a quantitative analysis is very detailed and complex. Therefore, the first recommendation made as a result of the Plan development, was for DMMA to continue working with stakeholders to address the needs of this vulnerable population. As a result, the Children with Medical Complexity Advisory Committee (CMCAC) was developed. This group meets quarterly to strengthen the system of care, increase collaboration across agencies, encourage community involvement, and ultimately ensure that every child with medical complexity has the opportunity to receive the adequate and appropriate health care services they need and deserve. These meetings are open to the public; all meeting dates, times, and locations will be posted on the State’s public meeting calendar at https://publicmeetings.delaware.gov.
CMCAC Charter and Guiding Principles
- Children with Medical Complexity Advisory Committee Charter
- Children with Medical Complexity Advisory Committee Guiding Principles
CMCAC Priorities
- Children with Medical Complexity Advisory Committee Short Term Priorities
- CMCAC 2023 – Update – February 2023
- CMCAC 2021 – Update for 2022
CMCAC Annual Reports
CMCAC Ad-Hoc Reports
- Delaware’s Children with Medical Complexity – Family Satisfaction Report
- Delaware’s Private Duty Nursing (PDN) Capacity Study (2021) – Private Duty Nurse Results
- Delaware’s Private Duty Nursing (PDN) Capacity Study (2021) – General Nurse Results
- Delaware’s Private Duty Nursing (PDN) Capacity Study (2021) – PDN Agency Representative Results
- Delaware’s Private Duty Nursing (PDN) Capacity Study (2021) – COVID Telehealth Results
CMCAC Meeting Agendas and Minutes
January 14, 2025
- CMCAC Agenda 1/14/25
- CMCAC Notes 1/14/25
- CMC Advisory Committee Workgroup SHHN 2024 Quarter 4 Report
- CMCAC 2024 Year End Report Presentation
- CMCAC 2024 Year End Summary
- SDAC FAQ 12/2024
- Steps to Access Home Health Aid Services 12/2024
October 8, 2024
- CMCAC Agenda 10/8/24
- CMCAC Notes 10/8/24
- CMC Advisory Committee Workgroup SHHN 2024 Quarter 3 Report
July 9, 2024
- CMCAC Agenda 7/9/24
- CMCAC Notes 7/9/24
- CMC Advisory Committee Workgroup SHHN 2024 Quarter 2 Report
- MAC BAC Final Rules 7/9/2024
- CMCAC Agenda 04/09/24
- CMCAC Notes 04/09/24
- CMC Advisory Committee Workgroup SHHN 2024 Quarter 1 Report
- Description of Change to Enfit
January 9, 2024
- CMCAC Agenda 01/09/24
- CMCAC Notes 01/09/24
- CMC Advisory Committee Workgroup SHHN 2023 Quarter 4 Report
- CMC Advisory Committee Workgroup DME Supplies 2023 Quarter 4 Report
October 10, 2023
- CMCAC Agenda 10/10/23
- CMCAC Notes 10/10/23
- CMC Advisory Committee Workgroup SHHN 2023 Quarter 3 Report
- CMC Advisory Committee Workgroup DME Supplies 2023 Quarter 3 Report
July 11, 2023
- CMCAC Agenda 07/11/23
- CMCAC Notes 07/11/23
- CMC Advisory Committee Workgroup SHHN 2023 Quarter 2 Report
- CMC Advisory Committee Workgroup DME Supplies 2023 Quarter 2 Report
April 11, 2023
- CMCAC Agenda 4-11-23
- CMCAC Notes – 4-11-23
- CMC Advisory Committee Workgroup SHHN 2023 Quarter 1 Report
- CMC Advisory Committee Workgroup DME Supplies 2023 Quarter 1 Report
- Bayada Home Care Nursing – Onboarding Education Presentation 04-11-23
- University of Delaware PDN Workforce Study 2021 – Summary
February 14, 2023
- CMCAC Agenda 2-14-23
- CMCAC Notes 2-14-23
- CMC Advisory Committee Workgroup SHHN 2022 Quarter 4 Report
- CMC Advisory Committee Workgroup DME Supplies 2022 Quarter 4 Report
- Delaware First Health CMCAC Presentation 2-14-23
- COVID Update 2-14-23 Meeting
October 11, 2022
- CMCAC Agenda 10-11-22
- CMCAC Notes 10-11-22
- CMC Advisory Committee Workgroup SHNN Quarterly Report
- CMC Advisory Committee Workgroup DME Supplies Quarterly Report
April 12, 2022
- CMCAC Agenda 4-12-22
- CMCAC Notes 4-12-22
- CMC Advisory Committee DME Supplies Work Group Quarterly Reports
- CMC Advisory Committee Work Group Quarterly Report SHHN Workgroup
- University of Delaware – PDN Workforce Capacity Study – Implementing Recommendations
January 25, 2022
- CMCAC Agenda 1-25-22
- CMCAC Notes 1-25-22
- CMC Advisory Committee DME Supplies Work Group Quarterly Reports
- CMC Advisory Committee Work Group Quarterly Report SHHN Workgroup
- University of Delaware – PDN Workforce Study Findings Presentation
October 12, 2021
- CMCAC Agenda 10-12-21
- CMCAC Notes 10-12-21
- CMC Advisory Committee Work Group Quarterly Report SHHN Workgroup
- CMCAC Care Coordination Standards of Care Discussion 10-12-21
- What Parents of Children With Complex Medical Conditions Want Their Child’s Physicians to Understand
July 13, 2021
- CMCAC Agenda 7-13-21
- CMCAC Notes 7-13-21
- CMC Advisory Committee DME Supplies Work Group Quarterly Reports
- CMC Advisory Committee Work Group Quarterly Report SHHN Workgroup
- PDN Quarterly Update UD
April 13, 2021
January 12, 2021
November 2, 2020
- CMCAC Agenda 11-2-20
- CMCAC Notes 11-2-20
- CMC Advisory Committee Workgroup Quarterly Reports
- Family Satisfaction Survey Outreach Flyer
July 15, 2020
April 15, 2020
January 15, 2020
- CMCAC Agenda 1-15-20
- CMCAC Notes 1-15-20
- CMC Advisory Committee Presentation and Work Group Updates
- CMC Private Duty Nursing Gaps in Care Results
October 16, 2019
- CMCAC Agenda 10-16-19
- CMCAC Notes 10-16-19
- CMC Advisory Committee and Work Group Updates
- CMC Data Analysis Update
- CMC Private Duty Nursing Gaps in Care Analysis Update
July 17, 2019
- CMCAC Agenda 7-17-19
- CMCAC Notes 7-17-19
- CMC Work Group Updates
- Children with Medical Complexity Utilization Data
- Private Duty Nursing Gaps in Care Preliminary Findings
April 17, 2019
- CMCAC Agenda 4-17-19
- CMCAC Notes 4-17-19
- CMC Advisory Committee and Work Group Updates
- CMC Data Work Group Initial Population Report
- Highmark Health Options Private Duty Nursing Authorization Process
- AmeriHealth Caritas Delaware Home Health Services for Children with Medical Complexity
January 16, 2019
October 4, 2018
Strengthening Health Care Delivery Systems for Children with
Special Health Care Needs and the Role of Quality Measurement
As more states serve Children and Youth with Special Health Care Needs (CYSHCN) in Medicaid managed care, it is important to understand the unique needs of CYSHCN and how program and policy changes impact their access to high quality care. Delaware participated in a National Academy for State Health Policy (NASHP) learning collaborative focused on improving Medicaid managed care for CYSHCN. The link below will lead you to a webinar with presenters from Delaware, Rhode Island, and Massachusetts, who recently participated in this learning collaborative.
Improving Care for Children with Complex Medical Needs
DMMA Director Stephen Groff participated in an Alliance for Health Policy public briefing with other panelists to discuss factors that influence the quality, affordability, and accessibility of care for children with complex medical needs. http://www.allhealthpolicy.org/1052018-publicbriefing/