Redesigning Children’s Rehabilitative Services (CRS) to Improve Care for Arizona’s Children with Special Health Care Need

Background

Arizona’s Children’s Rehabilitative Services (CRS) was started in 1929 to serve children with complex health care needs who require specialized services. A list of specific conditions determines whether a child is eligible for CRS. Although CRS is part of the Arizona Medicaid program, CRS services have not been managed within the AHCCCS health plans. As a result, a child with complex health care needs was enrolled in a minimum of two separate systems of care. One for well-child and primary care, and the other for specialty care through CRS. Children with other conditions, including developmental disabilities or behavioral health needs, are sometimes enrolled in several systems of care.

This can be confusing for both families and providers. Coordinating care for CRS children became a challenge for AHCCCS, and clearly the burden placed on families has also been significant. Effective in January of 2011, a process was begun to integrate CRS into AHCCCS. This offers a way to ensure access to specialty care and the opportunity to consider more efficient coordination of health care services. AHCCCS is working to create a specialty health plan that would manage care not only for CRS conditions but also for other medical and potentially behavioral health conditions as well. See the memo at the links below for additional background on this initiative.

Stakeholder Engagement

Stakeholder involvement and input is critical to this process. St. Luke's Health Initiative is assisting AHCCCS in the stakeholder engagement process to ensure that consumers and their family members, providers, and other interested parties have the opportunity to be part of shaping this new model for CRS.

Stakeholder Summary

AHCCCS has worked with various stakeholders, including consumers, in developing ideas for the new CRS model. Information about that process is included in the link below.

Engagement of CRS Families

The first step is to reach out to CRS families who are currently using the CRS system and obtain input on how to design the best type of plan to deliver and pay for services for CRS conditions, as well as services related to primary care, behavioral health, and other needs. AHCCCS appreciates the unique and valuable perspective of CRS families in developing a system of quality care and cost-effective services for children with special health care needs.

St. Luke's Health Initiatives (SLHI) is working with Raising Special Kids, an organization dedicated to assisting families of children with special health care needs, to interview families identified by CRS clinics. These interviews are being held with parents throughout Arizona. A copy of the interview questions can be found at the link below. They are also conducting focus groups with families and providers and both are encouraged to complete the following online survey as part of the public input process. SLHI will compile and analyze all of the input received from families and providers through this process. Additional interviews or focus groups may be conducted as needed.

Provider Engagement Process

The health care providers serving CRS members are critical to this process. SLHI will conduct separate interviews or focus groups with the provider community. More information will be provided as that process is developed.

Public Comment

AHCCCS welcomes input in designing services for the CRS program from other stakeholders serving children with special health care needs and their families. The link below provides you with a direct link to send AHCCCS your feedback. All comments will be considered.

CRS Community Forum

On February 8, 2012, APIPA (the CRS contractor) and AHCCCS hosted a Community Forum to answer questions from families about the change in location of the Phoenix-MSIC (multi-specialty interdisciplinary clinic) that will occur in late 2012. For additional details about the meeting, please click on the links below.