Building Systems of Care for Children With Chronic Health Conditions.

Abstract

Objective: To describe the leadership role that rehabilitation psychologists can play in improving the health care delivery system for children with special health care needs (CSHCN). Setting: Midwest academic health center and surrounding communities. Participants: Children with chronic health conditions and disabilities and their families. Intervention: A model research demonstration project designed to promote family-centered, comprehensive, coordinated, and community-based care for CSHCN. The project aims to enhance environmental supports for CSHCN and their families in 2 ways: (a) by improving the ability of primary care providers to deliver effective chronic care management and (b) by integrating this improved clinical practice into an enhanced Medicaid managed care service delivery system for persons with chronic illness and disabilities. Conclusions: Psychologists have the potential to improve the quality of life of CSHCN and their families by intervening not only through direct services but also by promoting positive changes in the larger health care environment.

The school‐based health center as a resource for prevention and health promotion

“…Approximately one in five children in the United States experiences the symptoms of a diagnosable mental disorder in any given year (U.S. Public Health Service, 1999). Nearly 18% of school-age children have one or more chronic health conditions, and 7% of those have significant functional limitations as a result (Farmer, Clark, & Marien, 2003). Minority children are at greater risk of poor health and are less likely to have a regular source of health care.…”

Comprehensive Primary Care for Children With Special Health Care Needs in Rural Areas

“…15,22 To our knowledge, this is the first study to evaluate the feasibility and impact of a medical home intervention for CSHCN in this geographic area. We examined program outcomes in 3 broad areas: access to and satisfaction with health care and related services, family functioning, and child functioning.…”

Effectiveness of a children’s home and community-based services waiver program

“…In fact, the results of these studies contributed to the enactment of the Virginia Community Services Act for At Risk Youth and Families, which mandates a collaborated system of services that is child centered, family focused, and community-based. A recent study by Farmer, Clark and Marien [21] similarly suggests a Medicaid managed, family-centered, and community-based system of care for children with mental illness. Our study, conducted in a real-world environment to optimize ecological validity, supports an interagency collaborative model as part of a comprehensive system of care for children.…”

“…Indeed, families of children with special health care needs describe the system of care as fragmented, inconsistent, and unresponsive [21]. Although the Medicaid waiver program has grown nationwide since its inception, the program still remains small in relation to those offering institutional placement [8].…”