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data collection and retention of records for immunizations with the Department for Public Health. No long-term solutions have been identified, and there is no statewide registry. Administrative data are used for tracking, but using this data source is problematic. Currently, Kentucky ranks third in the nation on the percentage of children ages 19 to 35 months (88.6%) who have been immunized. This is based on the National Immunization Survey implemented by CDC in 1994, which began tracking immunizations in Kentucky in 1995.

Quality improvement strategies for the primary care case management program, KenPAC, will include methods and tools such as: CAHPS; access and utilization data on birth outcomes, EPSDT, immunizations and other selected performance measures; and selected quality studies. Quality study designs will be based on methods developed by NCQA.

The Department for Medicaid Services (DMS) has established two advisory groups to provide input to the Divisions responsible for quality improvement in Medicaid and KCHIP. The two groups are; the Quality Improvement Advisory Council (QIAC) and the KCHIP Advisory Council. Also, there is an interagency quality improvement team to promote coordination, communication and implementation within the DMS.

The managed care entities must have a Consumer Advisory Committee who report to The Quality Improvement Advisory Council. They review member handbooks and educational materials, issues related to quality and access to covered services, and complaints. The Quality Improvement Council also reviews and advises on quality standards, grievances and appeals, and makes recommendations on incentives and policies that affect managed care entities. Authority for the Quality Improvement Council is 907 KAR 1:705. The KCHIP Advisory Council also reviews and advises on quality standards and improvement strategies.

The KCHIP Branch in coordination with the Division of Quality participates on the Quality Improvement Interagency Team. This team reviews and provides input on clinical studies, benchmarks and outcome measures, annual member and provider satisfaction surveys, and the design, implementation and analysis of studies conducted by research entities.

7.2. Describe the methods used, including monitoring, to assure: (2102(a)(7)(B)) (42CFR 457.495)

7.2.1 Access to well-baby care, well-child care, well-adolescent care and childhood and adolescent immunizations. (Section 2102(a)(7)) (42CFR 457.495(a))

Under the KenPAC (PCCM) program, the recipients' primary care providers manage access to well-baby care, well-child care, and well-adolescent care. In addition, the Department for Medicaid Services assesses access to care, evaluates the member and provider complaints, grievances, appeals and denials of care for KenPAC. They review member education materials, provider credentials and practice issues, suspected cases of potential fraud and abuse, and monitor primary care provider assignments. The KenPAC program of PCCM will remain until the program is bid out to a managed care