241414 Caring for our most vulnerable children: How is California doing?

Wednesday, November 2, 2011

Jennifer Rienks, PhD , Family Health Outcomes Project, Dept. of Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Katherine Gillespie, MA, MPH , Family Health Outcomes Project, Dept. of Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Geraldine Oliva, MD, MPH , Family Health Outcomes Project, University of California San Francisco Dept. Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Kathy Chance, MD , Children's Medical Services Branch, California Department of Health Care Services, Sacramento, CA
Background: The California Children's Services Program (CCS) provides diagnostic and treatment services, medical case management, and physical and occupational therapy services to children and youth with specified special health care needs (CSHCN) who meet financial eligibility criteria. CCS covers many complex medical conditions, including cancer, cystic fibrosis, hemophilia, cerebral palsy, traumatic injuries, and infectious diseases. In 2010, surveys were completed by families with children covered by CCS and by physicians paneled by CCS to care for these children to identify strengths and weaknesses of CCS and the challenges facing those involved with CCS. Methods: Web-based surveys were developed and links to the surveys were distributed to CCS families and physicians via local county CCS programs, family advocacy organizations, the state CCS program, and professional organizations. Results: 417 family surveys and 142 physician surveys were completed. The majority of families are very satisfied (45%) or somewhat satisfied (39%) with the CCS program. 17% of families report problems accessing primary care; 28% report problems accessing specialty care, with delays getting appointments with specialists being the most common problem; and 40% of families needing mobility aids or devices for their children experience delays in getting this equipment. For physicians, time consuming paper work (78%), delays receiving payments (66%), and low reimbursement rates (60%) are the most important barriers to participation in CCS. Conclusions: While families are generally satisfied with CCS, the program remains challenged by shortages of specialty physicians and medical equipment providers, complex paper work and low reimbursement rates.

Learning Areas:
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
At the conclusion of this session, attendees will be able to describe the strengthens and weaknesses of the California Children's Service (CCS) Program and identify the key challenges facing the CCS, children with special health care needs, and physicians participating in CCS.

Keywords: Children With Special Needs, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have have my MPH and a MA in anthropology and am currently a research associate at a University where we conduct research and provide training and technical assistance to local public health programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.