HHS releases framework to improve care for children with special needs


Photo: Marko Geber/Getty Images

In an effort to improve care for children with special healthcare needs, the Department of Health and Human Services has released “The Blueprint for Change: A National Framework for a System of Services for Children and Youth with Special Health Care Needs” through a special supplement in the journal Pediatrics.

Facilitated through the Health Resources and Services Administration, the national framework is targeted at the estimated one in five children in the U.S. who currently have special healthcare needs.

According to HHS data, one in four families in the U.S. has at least one child with a special healthcare need. These children have, or are at increased risk for, chronic physical, developmental, behavioral or emotional conditions. There are an estimated 14 million children nationwide who require specialized care and services.

Currently, the agency said, only about 15% of this population is accessing optimal support, including early and continuous screenings; patient-centered and ongoing care with consistent providers who communicate with each other; adequate insurance coverage; access to community-based services; and support for transitions to adult life.

According to HRSA’s National Survey of Children’s Health, special healthcare needs were most common among non-Hispanic Black children, with nearly one in for having a special healthcare need compared to about one in five non-Hispanic white children and about one in six Hispanic children. Children with such needs are more likely to be living in poverty, and fewer than two-thirds of families have adequate insurance to cover their healthcare and related costs.


The Blueprint for Change is organized around four primary areas: health equity, family and child well-being and quality of life, access to services, and financing of services. The Blueprint provides a definition, overall vision, key principles and strategies for each area.

Some of the guiding principles include ensuring that all services and supports for children and youth with special healthcare needs (CYSHCN) are designed and implemented to reduce health disparities and improve health outcomes for all CYSHCN; ensuring all services and supports for CYSHCN at the individual, family, community, and provider levels are easy for families and professionals to navigate; making sure service sectors increase the ability of CYSHCN and their families to access services by addressing administrative and other processes that hinder access; and ensuring healthcare and other related services for CYSHCN and families are financed and paid for in ways that best support their needs.


While the blueprint is focused primarily on children’s physical health, HHS has made a push to address their mental health as well, announcing in March it would provide close to $35 million in funding toward strengthening and expanding mental health services and suicide prevention programs for children and young adults. Of the total, $9.2 million comes from the American Rescue Plan.

The funding will be spread out across seven grant programs, with areas of focus including school-based mental health programs and services, suicide prevention and early intervention, mental health services for college students and support for Black youth.

The announcement comes on the heels of HHS Secretary Xavier Becerra’s recent National Tour to Strengthen Mental Health in which he sought to hear from Americans about their mental health struggles. The tour was part of a broader administration effort to engage with local leaders to bolster community mental health and crisis care systems.


“Every child deserves the care and support they need to stay healthy and thrive,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration is committed to promoting health and the well-being of our nation’s children and their families, including children with special healthcare needs. With this Blueprint for Change, we’re providing guidelines to improve systems of care so that children with special healthcare needs can thrive physically, emotionally, and socially.”

Twitter: @JELagasse
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