Improving the System of Services for CYSHCN is the primary goal of the D70 HRSA-funded state implementation grants. A recent webinar presentation and discussion of D70 grants highlighted successes of the grants in various states and their implications for the future of systems of care for CYSHCN. States have used D70 funds in a variety of ways to address systems building.
Identification of CYSHCN: North Dakota Integrated Services employs a team, including a primary care physician, care coordinator and two family partners, as the foundation for their systems of care. Other components include regular screening to identify CYSHCN, a comprehensive resource list available to families, care plans, pre-visit calls and information meetings by parent partners.
Medical Homes: Pennsylvania has supported medical home implementation and transition services as part of their systems of care for CYSHCN. Partnerships with family and youth play a key role in facilitating this implementation.
Cultural Competency: With their D70 grant, Missouri has created sustainable change to support their systems of care for CYSHCN. Their primary focus is improving family centered, coordinated, culturally competent care.
Child Health Improvement: New York has aligned CYSHCN program activities with other child health improvement strategies through coordination and quality improvement initiatives. They also have implemented best practice standards for children with autism.
Family Partnerships: Navajo Nation (Arizona, New Mexico, Utah) – Diné for our children. This program created a grassroots movement that fostered cultural expansion, cultivated partnerships, empowered teams of parents and CYSHCN to become leaders and tasked families with key project roles and responsibilities.
While numerous states have implemented successful programs, more works needs to be done to move health care for CYSHCN toward an integrated system. Strategies for systems integration that were mentioned include: building, enhancing and maximizing partnerships; engaging family and youth as partners; continuous quality improvement; using data to build capacity and measure impact; and providing technical assistance, resource and support.