"Children and Youth with Special Health Care (CYSHCN) Needs Acuity Project", Mary Hooshmand, PhD, PI

The purpose of this project was to develop, test and implement an acuity tool for CYSHCN incorporating three domains (medical, behavioral, and psychosocial) with the potential to introduce a new service delivery model for systems of care incorporating risk-stratified caseloads for care coordination across caseloads.


This project was approved as a QI project through the Florida Department of Health IRB and Children’s Medical Services (CMS). The pilot began on July 1, 2013 in Miami-Dade and Monroe Counties across six caseloads and was completed in December 2013 with adjustments made to the acuity tool based on inter-rater reliability and feedback from teams across Miami-Dade and Monroe Counties. Acuity training was completed in May 2014 in the North and Central Florida Regions (Orlando, Viero/Rockledge, Daytona, Jacksonville, Ocala and Gainesville CMS offices). At the request of the Florida Department of Health, Dr. Hooshmand provided further training across all Title V CMS program offices in Florida completing this project in December 2014. Subsequently, the acuity tool was implemented in coordination with an electronic health records (EHR) component across the state of Florida. An evaluation component has been proposed to include assessment of the relationship between illness severity (CRGs, medical and behavioral diagnoses), family psychosocial factors, and healthcare utilization. A manuscript is in preparation.