RESUMEN
Children and youth with special health care needs require more health care and related services and consequently incur more costs than other individuals. Implementation of the "medical home" concept has benefitted children with special needs, resulting in fewer unmet medical needs and more consistent health care delivery. As advances in health care have enabled an increasingly higher percentage of children with special needs to live far into adulthood, the transition from adolescence to adulthood poses new challenges in obtaining medical care, education, job training, and employment opportunities. A more comprehensive medical home paradigm for children with special needs is composed of three fundamental components: 1) home/community, 2) education, and 3) medical/dental care. These components should be developed equally and in parallel, emphasizing consumer advocacy, care coordination, education, life skills, and career development, to attain independent or minimally dependent living. This new model has been initiated at Hospital for Special Care in New Britain, Connecticut, in its Special Care Family Academy.