HRSA’s MCHB uses six critical indicators to measure the quality of a system of care for CSHCN:
- Families of children and youth with special health care needs partner in decision making at all levels and are satisfied with the services they receive;
- Children and youth with special health care needs receive coordinated ongoing comprehensive care within a medical home;
- Families of CSHCN have adequate private and/or public insurance to pay for the services they need;
- Children are screened early and continuously for special health care needs;
- Community-based services for children and youth with special health care needs are organized so families can use them easily;
- Youth with special health care needs receive the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence.
Together, these six Core Outcomes can be used to measure progress toward the Healthy People 2010 objective to increase the proportion of States and territories that have service systems for children with or at risk for chronic and disabling conditions. In this analysis, a child was considered to be served by a “service system,” as described in the Healthy People objective, if his or her care met all relevant criteria for his or her age. For children from birth through age 11 years, the first five outcomes were included, and all six outcomes were counted for children from age 12 through 17 years.
Among children aged 11 years and under, 20.4 percent were served by a system of care according to these standards. For children aged 12–17 years, 13.7 percent had care that met all six criteria.
