PEDIATRICS Vol. 102 No. 1 July 1998, pp. 137-139
COMMENTARY:
A New Definition of Children With Special Health Care Needs
| The first 300 words of the full text of this article appear below. |
Developing community systems of services for children with special health care needs represents a significant challenge for pediatricians, families, managed care organizations, and public and private agencies providing services to this population. At the state level, Maternal and Child Health (MCH) and Children With Special Health Care Needs (CSHCN) programs are vested with the responsibility for planning and developing systems of care for all children with special health care needs. Historically, these programs have been supported through Title V of the Social Security Act, with state-matching funds, to provide health services to selected groups of children with special needs, typically those with complex physical conditions. However, during the last half-century, service systems have become increasingly complex as a result of health, education, and social policy changes, as well as changes in the epidemiology of child health, including increases in the number and proportion of children with chronic conditions and disabilities and changes in their case-mix.1-4 These changes have resulted in gaps in some service areas and duplication in other areas, as well as fragmentation in the way service systems are organized.5
Recognizing these difficulties, health policy leaders at the state and federal levels, with broad input from public and private agencies, providers, and families, effected legislative changes in the federal Omnibus Budget Reconciliation Act of 1989, which expanded the mission of CSHCN programs to facilitate the development of community-based systems of services for children with special health care needs and their families. Since then, the explosive growth of managed care has presented new challenges and opportunities as well as a heightened urgency for the development of systems of care that integrate health and related services for this population.6,7
Developing systems to serve children with special health care needs
requires a clear definition of the population to be served. State CSHCN
programs
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W. E. Weller, C. S. Minkovitz, and G. F. Anderson Utilization of Medical and Health-Related Services Among School-Age Children and Adolescents With Special Health Care Needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data) Pediatrics, September 1, 2003; 112(3): 593 - 603. [Abstract] [Full Text] [PDF]
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P. C. van Dyck A History of Child Health Equity Legislation in the United States Pediatrics, September 1, 2003; 112(3): 727 - 730. [Abstract] [Full Text] [PDF]
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H. Sanders, M. F. Davis, B. Duncan, F. J. Meaney, J. Haynes, and L. L. Barton Use of Complementary and Alternative Medical Therapies Among Children With Special Health Care Needs in Southern Arizona Pediatrics, March 1, 2003; 111(3): 584 - 587. [Abstract] [Full Text] [PDF]
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C. Houghton A Mentoring Program for New School Nurses The Journal of School Nursing, February 1, 2003; 19(1): 24 - 29. [Abstract] [Full Text] [PDF]
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J. Reiss and R. Gibson Health Care Transition: Destinations Unknown Pediatrics, December 1, 2002; 110(6): 1307 - 1314. [Abstract] [Full Text] [PDF]
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P. Scal Transition for Youth With Chronic Conditions: Primary Care Physicians' Approaches Pediatrics, December 1, 2002; 110(6): 1315 - 1321. [Abstract] [Full Text] [PDF]
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J. M. Neff, J. Valentine, A. Park, J. Hicks-Thomson, D. A. Christakis, J. Muldoon, and S. Churchill Trends in Pediatric Hospitalizations of Children in Washington State by Insurance and Chronic Condition Status, 1991-1998 Arch Pediatr Adolesc Med, July 1, 2002; 156(7): 703 - 709. [Abstract] [Full Text] [PDF]
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R. N. Roberts Stating the Obvious: Why Do We Care About Access to Health Care? Journal of Early Intervention, January 1, 2002; 25(1): 12 - 14. [PDF]
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J. C. Barrett Teaching Teachers About School Health Emergencies The Journal of School Nursing, December 1, 2001; 17(6): 316 - 322. [Abstract] [Full Text] [PDF]
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