This document includes NC InCK Alternative Payment Model Performance Measure reporting templates, calculation instructions, and data flow for health care providers.
Template
Shared Action Plan Completed Example
The Shared Action Plan (SAP) is a brief, shareable, living document created in
collaboration between the Family Navigator, family, and the NC InCK member’s integrated care team. Please use this Shared Action Plan completed example to guide you.
Shared Action Plan (Spanish)
The Shared Action Plan (SAP) is a brief, shareable, living document created in
collaboration between the Family Navigator, family, and the NC InCK member’s integrated care team.
The SAP encourages coordination and communication among all integrated care team members and
trusted, natural supports. Key components of the SAP include preferences and strengths, a list of
integrated care team members and their contact information, and the family’s personal goals. The SAP
serves as a valuable tool in building partnerships with families, and it promotes communication and
integrated care coordination among families and integrated care team members.
Shared Action Plan Template (English)
The Shared Action Plan (SAP) is a brief, shareable, living document created in
collaboration between the Family Navigator, family, and the NC InCK member’s integrated care team.
The SAP encourages coordination and communication among all integrated care team members and
trusted, natural supports. Key components of the SAP include preferences and strengths, a list of
integrated care team members and their contact information, and the family’s personal goals. The SAP
serves as a valuable tool in building partnerships with families, and it promotes communication and
integrated care coordination among families and integrated care team members.