According to Contemporary Pediatrics1, a medical home is a “community-based primary care setting that integrates quality and evidence-based standards in providing and coordinating family-centered health promotion in wellness, and in acute and chronic condition management.” For primary pediatric care providers such as Pediatricians, family Physicians and Nurse Practitioners, being part of a medical home means forming a partnership with families and caregivers of children and youth with special health care needs. Within this partnership, the pediatric care provider helps families and caregivers coordinate services offered by providers outside of the medical home, such as educational services, out-of-home care and community services, with the medical services offered within the medical home by the pediatric care providers. The pediatric care provider can also evaluate and offer advice to caregivers about the their child's system of care. This collaboration ensures that both the medical and non-medical needs of these children are met within a supportive, family-centered, and compassionate environment that allows the children to meet their full potential.
Based on guidelines supported by both the American Academy of Pediatrics and the American Academy of Family Physicians, the medical home model enables pediatric care providers to offer more personalized and higher quality care to their patients with special needs. It also allows caregivers to take a more central role in decisions regarding their child's system of care.
A recent article2 in the journal Contemporary Pediatrics dicusses the role of the pediatric care provider in medical homes. Besides providing an in-depth description of the medical home, it also presents information on how your practice can benefit from implementing such a system. The article also offers tips for improving the quality and cost effectivenness of your medical home.
1 Onufer, C.N., Marks, J., Gibson, C.(2006).New momentum on building a medical home for the child with a chronic health problem. Contemporary Pediatrics, 23(10), 65-73. Retrieved December 1, 2006 from http://www.contemporarypediatrics.com.
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The United States Maternal and Child Health Bureau defines children with special health care needs (CSHCN) as those who have (or are at increased risk for):
1) Chronic physical, developmental, behavioral or emotional conditions (expected to last at least a year) and
2) Who require health and related services of a type or amount beyond that required by children generally; 18% of children in the United States are included in their definition.
A proposed expanded definition of children and youth with special health care needs was published in Pediatrics, the official Journal of the American Academy of Pediatrics1. It available for viewing at the Pediatrics website.
1McPherson, M., Arango, P. Fox, M, et al.(1998) A New Definition of Children With Special Health Care Needs. Pediatrics 102(1),137-139. Retrieved on December 1, 2006 from http://pediatrics.aappublications.org/Back to the top
Paperwork must be filled out in order for a child or youth with special health care needs to be a part of a Medical Home. Although a parent or caregiver fills out most of the forms, the pediatric care provider is also responsible for some paperwork as well. This page explains the two forms that pediatric care providers will come in contact with most frequently.Both forms must be completed for every child that is member of your medical home.
The first form, the Screener form, is a short survey of the health needs and conditions of a child or youth with special health care needs. Health conditions of a child or youth with special health care needs may be physical, mental or behavioral. Although it is the parent who fills out this form, pediatric care providers uses the completed form to begin their relationship with the child or youth.
The second form, the complexity index is filled out by the pediatric care provider. The purpose of this index is to identify the level of complexity/intensity involved in supporting children and youth with special health care needs in our practice.Back to the top