Integrated Systems for Children and Youth with Special Health Care Needs

This database is no longer actively maintained and is here for archival purposes only

Organization Type: 
Not For Profit
Program Type: 
Standing Program
Education Level: 
Technical certificate programs or certificate training programs
Educational Elements: 
Program Description: 

Through the Statewide Parent Advocacy Network (SPAN), the Integrated Systems for Children and Youth with Special Needs(CYSHCN) works to improve six core outcomes for program participants and their families.  These outcomes include early and continuous screening, access to medical homes and community-based services that are easy to use, adequate healthcare financing to pay for needed services, effective transition to adult services, and family engagement at all levels in addition to family satisfaction with services.

The program achieves these outcomes by:

  • Working with primary care practices to help them provide more comprehensive, culturally competent, family-centered care to children with special needs and their families;
  • Providing information, resources, and parent-to-parent support to families of CYSHCN through Family Resource Specialists at county Special Child Health Services Case Management Units and Autism Clinical Enhancement Programs;
  • Developing and disseminating tools and resources on the six core outcomes;
  • Supporting parent leadership in systems change;
  • Supporting a Statewide Youth Advisory Council of youth with and without special healthcare needs;
  • Facilitating a Statewide Community of Care Consortium for CYSHCN to bring stakeholders together in order to identify gaps, develop recommended improvements, and work together to implement those recommendations
Targeted Professions
Family Medicine
Nurse Practitioners
Patient Educators
Self-Reported Competencies
PCPCC’s Education and Training Task Force identified 16 interprofessional training competencies critical for preparing health professionals for practicing in team-based, coordinated care models such as patient-centered medical homes. Listed below are the self-reported competencies that this program has achieved, which have been organized by the five core features of a medical home as defined by the Agency for Healthcare Research and Quality
Patient-Centered Care Competencies: 
Advocacy for patient-centered integrated care
Cultural sensitivity and competence in culturally appropriate practice
Development of effective, caring relationships with patients
Patient-centered care planning, including collaborative decision-making and patient self-management
Comprehensive Care Competencies: 
Population-based approaches to health care delivery
Risk identification
Coordinated Care Competencies: 
Care coordination for comprehensive care of patient & family in the community
Health information technology, including e-communications with patients & other providers
Interprofessionalism & interdisciplinary team collaboration
Quality Care & Safety Competencies: 
Assessment of patient outcomes
Evidence-based practice
Quality improvement methods, including assessment of patient-experience for use in practice-based improvement efforts
Accessible Care Competencies: 
Promotion of appropriate access to care (e.g., group appointments, open scheduling)
Last updated November 15, 2013

* Please note: Information contained in this database is self-reported by representatives from each program. It does not represent an exhaustive list of education and training programs and inclusion does not constitute an endorsement from the PCPCC.


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