Systems of Care for Children with Special Health Care Needs

Information and resources from the Bureau for Family Centered Services for families and children with special needs

The Bureau for Family Centered Services provides leadership in building and promoting a community-based system of services for children and youth with special health care needs and their families that is family centered, comprehensive, coordinated and culturally competent.

 

Health Care Transition

According to Got Transition™ the federally funded national resource center on health care transition (HCT), “Health Care Transition is the process of moving from a child/family-centered model of healthcare to adult/patient-centered model of healthcare.” Throughout this process, BFCS coordinators help youth ages 14 to 21 with special health care needs identify the knowledge and skills they need to manage their chronic health condition and educates & supports them to become as independent as possible. Transition is a period of preparation for youth (and their families) before assuming adult health care responsibilities. 

The Bureau for Family Centered Services (BFCS) promotes a seamless move from the pediatric to adult health care system through its health care transition activities including education for youth, families and health care providers. With expertise from NH Family Voices, BFCS maximizes access to care coordination, enhances access to care relative to Medicaid Managed Care contracts, and facilitates the incorporation of the six core elements of transition into health care practices, in accordance with Got Transition™ recommendations.

BFCS also supports the work of the NH Transition Community of Practice whose mission is to make a difference in the lives of New Hampshire youth and to support successful transitions to life after high school by fostering cooperation, collaboration, and the development of best practices among cross stakeholder communities.

 

The YEAH Council: Youth Education Advocacy and Healthcare

YEAH Council is a youth driven and directed group of individuals with disabilities and/or special health care needs who are focused on developing and strengthening the skills and resources needed to achieve the unique independent life that each person desires. YEAH does this by empowering, educating and supporting individuals and professionals in the areas of education, advocacy and health care.

 

Council on Thriving Children and Early Childhood Integration Team

BFCS leadership actively participates in New Hampshire’s Early Childhood Care and Education (ECCE) B-8 System’s governance structure. The Governor Appointed State Advisory Council: Council on Thriving Children is co-led by DHHS and Department of Education and meets the federal Improving Head Start for School Readiness Act of 2007, Public Law 110-134, which requires establishment of a state advisory council on early childhood. Council membership comes from across the B-8 ECCE system, including the Governor, leadership from an array of state agencies, parents and caregivers, professionals, legislators, business, philanthropy, and representatives from educational agencies. 

As members of the DHHS Early Childhood Integration Team (ECIT), BFCS supports data driven policy and program coordination, integration, and development, while increasing performance and resource accountability across the ECCE system. This charted team works towards the vision of New Hampshire’s families and young children having access to quality resources and supports within their communities to learn, grow, and thrive.

Led by Parent Information Center (PIC), the B-8 ECCE Advisors serve in an advisory role to the Council by sharing emerging trends for children, families, communities, workforce, and business, while generating learning and capacity across ECCE system. This parent-led organization is supported through a contract with BFCS and the Bureau for Child Development and Head Start Collaboration. 

 

Watch Me Grow NH

Watch Me Grow (WMG) helps New Hampshire families ensure their child’s brightest future by tracking his or her growth and development. It is the state’s developmental screening, referral and information system for families with a child ages birth to six years.

Well-child visits allow health care providers to have regular contact with children and keep track of their health and development. During these visits, a provider may ask a family to complete a set questions on how their child plays, learns, speaks, behaves, and moves. This is developmental screening and is used to tell if a child is growing and learning as she should, or if there are delays. Like a yardstick for measuring height, developmental screening is a tool that helps families measure important areas of their child’s development through the early years. It tells if a child’s development is on track. The American Academy of Pediatrics recommends that children be screened for general development at 9, 18, and 24 and 30 months, or whenever a parent or provider has a concern.  A family can access developmental screening through community resources, child care,  and school as well as their child's primary care provider.

Watch Me Grow NH brings together organizations with the shared interest of increasing access to developmental screening and a family’s meaningful connection to services, if needed. Partners do this by working together to ensure any child, in all areas of the state, has access to screening by supporting organizations who conduct screenings with materials, training, and technology to make completing developmental screening easier, and by helping families find resources and information.  

 

Charting the Life Course

Charting the Life Course is a national framework out of the University of Kansas City and is a person centered planning approach for direct service providers and family members. NH has been implementing CTLC across services statewide with the help of the Institute on Disability (IOD) . This framework is rooted with the understanding that families know their needs best and should be driving the services that they receive. BFCS is part of the statewide system participating in a community of practice to share ideas and develop a vision for a good life across the lifespan. 

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