Transition Planning for Youth With Special Health Care Needs (YSHCN) in Illinois Schools.

"Transition Planning for Youth with Special Health Care Needs (YSHCN)" chronicles the research and work completed by agencies in Illinois to provide examples of best practice in transition planning. Increasing numbers of YSHCN survive into adulthood creating a need for focus on the transition to adult life for these young people, including meeting health care needs. As a part of the Transitions project, the Illinois Chapter of the American Academy of Pediatrics and the University of Illinois at Chicago Division of Specialized Care for Children surveyed Illinois public high schools to identify transition planning efforts, staff training needs and used those results to develop and implement training. A natural way to organize health services is by integration with school transition services. The credentialed school nurse would be the ideal person to contribute to the development of the health care transition plans based on the student's heath care provider's medical management plan.

The capacity of primary care pediatricians to care for children with special health care needs.

OBJECTIVE: To measure the willingness and ability of primary care pediatricians (PCPs) to accept children and youth with special health care needs (CYSHCN) into their practices. METHODS: Surveys were mailed to 1441 members of the Illinois Chapter of the American Academy of Pediatrics practicing primary care. RESULTS: In all, 376 physicians were eligible for analyses. When asked if they would accept additional CYSHCN, 6% selected "yes," 34% selected "yes, with supports," and 60% selected "no." PCPs closer to residency or with intermediate numbers of CYSHCN in their practices were more willing to add additional CYSHCN. PCPs preparedness to care for various conditions ranged from 96% for asthma to 53% for spina bifida. Familiarity with programs ranged from 89% for Early Intervention to 4% to 22% for the state's waiver programs. CONCLUSIONS: Most PCPs did not want additional CYSHCN in their practices. Variation exists in PCP preparation to care for varying conditions and in familiarity with supportive programs.

Barriers to care for children and youth with special health care needs: perceptions of Illinois pediatricians.

OBJECTIVE. To assess primary care pediatricians' (PCPs') perceptions of caring for children and youth with special health care needs (CYSHCN). METHODS. Cross-sectional survey of Illinois pediatricians. RESULTS. Thirty-five percent of surveys were returned and 26% were analyzed. The top 3 perceived barriers were insufficient time (72%), insufficient reimbursement (68%), and lack of support services (59%). Insufficient interest was the least cited barrier (19%). Preparedness to perform tasks related to care of CYSHCN ranged from 89% for accessing early intervention services to 24% for billing and coding. The percentage of PCPs somewhat or very comfortable providing primary care to patients with technology dependence ranged from 75% for blood glucose monitoring to 12% for dialysis. CONCLUSIONS. The issues of time, reimbursement, billing, and coding are perceived as significant barriers to the care CYSHCN. There is substantial variation in PCPs' comfort in the care of CYSHCN who require the assistance of medical technologies.