Authors Define a Community-Based System of Service for CYSHCN and their Families

October 19, 2007

"The definition of a system of service[s] presented here is intended to provide a basis for discussion among policy makers, practitioners, state programs, researchers, and families as they move toward operationalizing a definition of the 'community-based systems of services' contained in Title V of the Social Security Act," state the authors of an article published in the October 2007 issue of Pediatrics Electronic Pages.
Numerous demonstrations have examined the feasibility, financing, and effects of various ways of organizing services for children and youth with special health care needs (CYSHCN). Although these efforts have strengthened the knowledge base regarding the organization of services, they have not led to a systematic effort to put into place a universal, equitable, and sustainable system that adequately meets the needs of CYSHCN. The article presents and discusses efforts to develop consensus on defining a system of services that will foster progress toward this goal.

Using MEDLINE, the researchers conducted a search for articles on systems of services for children with chronic health and mental health conditions published in key journals in child health, maternal and child health, child mental health, and education within the past 10 years. A draft definition was developed, and a consensus conference was convened to involve parent group representatives, health economists, state and federal program managers, public health experts, and pediatric clinicians in reviewing and revising the definition.

A system of services for CYSHCN was defined as "a family-centered coordinated network of community-based services designed to promote the healthy development and well-being of children and their families."

"Building on the efforts of MCHB [the Maternal and Child Health Bureau] to develop measures of elements of services needed by CYSHCN, this new definition of a system of services provides opportunities to broaden measurement and accountability across the system of services," the authors conclude.

Additional information on underlying principles, some implementation issues, and topics relating to measuring or assessing the system of services is provided.

Perrin JM, Romm D, Bloom SR, et al. 2007. A family-centered, community-based system of services for children and youth with special health care needs. Archives of Pediatrics and Adolescent Medicine 161(10):933-936. View a copy of the Abstract.

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