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Health People 2010 Goals

Purpose

The promotion of medical homes for children and youth with special health care needs in Washington State is happening within the context of specific national goals for children and youth with special health care needs. 

The purpose of this page is to give Medical Home Leadership Network teams and other interested groups information on the broader national movement to improve the health and wellbeing of children and youth with special health care needs and their families.  A key national goal is that every child with special health care needs will have access to a medical home by the year 2010.

Broad Public Health Goals for CYSHCN

Six Critical Indicators of Progress for CYSHCN

Critical Indicators for Measuring Success in Achieving the National Agenda

Core Outcomes to be Achieved

Broad Public Health Goals for CYSHCN

In Healthy People 2010, the U.S. Department of Health and Human Services, in partnership with States, communities, and many organizations in the public and private sectors, has set out a series of objectives to “bring better health to all people in this country.”

The goals set forth in Healthy People 2010 for children and youth with special health care needs (CYSHCN) are to:

1. Increase the proportion of CYSHCN who have access to a medical home and
   
2. Increase the proportion of Territories and States that have service systems for children with or at risk for chronic and disabling conditions as required by Public Law 101-239.

www.healthypeople.gov

Since 1989 the service system agenda has been the foundation for the Washington State Title V Department of Health program for Children with Special Health Care Needs (CSHCN) and all other state Title V programs. Endorsed by more than 70 professional and voluntary organizations, the agenda calls for the development of systems of care for CSHCN that are family-centered, community-based, coordinated and culturally competent.  Documenting and measuring systemic changes in terms of meaningful indicators, however, has been challenging.

The long-term outcome of systems development is that all families are able to access health and related services along the continuum of care in a manner that is both affordable and meets their needs; policies and programs are in place to guarantee that children have access to quality health care; providers are adequately trained; financing issues are equitably addressed; and families play a pivotal role in how services are provided to their children.

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Six Critical Indicators of Progress for CYSHCN

Medical Home

Once identified, children with special health care needs require a medical home: a source of ongoing routine health care in their community where providers and families work as partners to meet the needs of children and families. The medical home assists in the early identification of special health care needs; provides ongoing primary care; and coordinates with a broad range of other specialty, ancillary, and related services.

Insurance Coverage

Families must have a way to pay for services. The Childrens Health Insurance Program (CHIP) has begun to address the issues of children who are uninsured,
but the problem of under insurance remains a major concern for CSHCN and their families. In addition the range of wrap-around services needed by families requires the availability of private and/or public health insurance that covers a full range of needed services.

Screening

Infants and children with high risk health conditions must be identified early in order to help assure that they and their families receive the care and assistance to prevent future morbidity and promote optimal development. Advances in brain research, the Human Genome Project, and increased effectiveness of early intervention have expanded our capacity to identify children with special health care needs and offer an opportunity for early intervention.

Organization of Services

In order for services to be of value to CSHCN and their families, the system has to be organized in such a way that needs can be identified, and services provided in accessible and appropriate contexts, and that there is a family-friendly mechanism to pay for them. Thus, effective organization of services is a key indicator of systems development.

Families Roles

Families are the constants in the child's life and are pivotal in making any system work. Family members, including those representative of the culturally diverse communities served, must have a meaningful, enduring, and leading role in the development of systems at all levels of policy, programs, and practice. Family voices must be heard and families should be at each table in which decision making occurs. Thus, the involvement of families is a key indicator of systems development.

Transition to Adulthood

Youth with special health care needs, as adults, must be able to expect good health care, employment with benefits, and independence. Appropriate adult health care options must be available in the community and provided within developmentally appropriate settings. Health care services must not only be delivered in a family-centered manner, but must prepare individuals to take charge of their own health care and to lead a productive life as they choose. The broad definition of children with special health care needs includes those who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions who require health and related services of a type or amount beyond that required by children generally.

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Critical Indicators for Measuring Success in Achieving the National Agenda

The National Agenda for Children with Special Health Care Needs builds on past experiences and success to assure that policies and programs are in place to guarantee that:

• children have access to quality health care services are coordinated
• providers are adequately trained
• financing issues are equitably addressed
• families play a pivotal role in how services are provided to their children and
• children grow up healthy and ready to work.

These changes must occur in ways that will provide optimal outcomes for children with special heath care need and their families. As the next step in the implementation of this agenda, six national outcomes have been selected as critical to guide efforts within the Division of Services for Children with Special Health Care Needs.

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Core Outcomes to be Achieved

1. All children with special health care needs will receive coordinated ongoing comprehensive care within a medical home.
   
2. All families of children with special health care needs will have adequate private and/or public insurance to pay for the services they need.
   
3. All children will be screened early and continuously for special health care needs.
   
4. Services for children with special health care needs and their families will be organized in ways that families can use them easily.
   
5. Families of children with special health care needs will partner in decision making at all levels, and will be satisfied with the services they receive.
   
6. All youth with special health care needs will receive the services necessary to make appropriate transitions to adult health care, work, and independence.
   

Information From the US Maternal and Child Health Bureau's

Achieving and Measuring Success: A National Agenda for Children with Special Health Care Needs

www.mchb.hrsa.gov/programs/specialneeds/achievingsuccess.html

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