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The practice has attested to treat children, youth, and young adults formerly enrolled in the Michigan Department of Health & Human Services Children’s Special Healthcare Services program.

A recent update for performance year 2024 MDHHS requires that health plans survey adult provider networks to assess availability for special populations of transition-aged youth and young adults, CSHCS Enrollees and those with chronic conditions.

Please take a couple of minutes to fill out this survey.

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* 1. Practice Group NPI

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* 2. Practice Name

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* 3. Practice Address

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* 4. Practice Phone Number

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* 5. Name of Person Completing Survey

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* 6. Does the practice have documented policy and procedures on health care transitioning youth to adult?

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* 7. Does the practice offer transition planning preparation, and training for patients starting at the age of twelve (12)?

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* 8. Does the practice use a transition registry to identify track and monitor youth throughout the pediatric-to-adult health care transition process?

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* 9. Does the practice use a Transition Readiness Assessment Questionnaire (TRAQ)?

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* 10. Does the practice have patient/caregiver educational material to assist them in transition, including sensitive services and special needs?

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* 11. Do providers allocate time alone with patient (Adult Model of Care)?

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* 12. Does the practice regularly update transition care plan, including readiness assessment findings?

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* 13. Does the practice ensure transfer of care, including the sharing of youth/youth adult care readiness assessment and other pertinent medical information?

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* 14. Does the practice confirm first adult clinician appointment was held/completed?

Thank you for taking the time to complete the Molina Healthcare of Michigan Practice Health Care Transition Survey. More information on Health Care Transition can be found on the MDHHS website https://www.michigan.gov/mdhhs/assistance-programs/cshcs/transition-to-adulthood/health-care-teams.

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