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PI: Janet E. Farmer, Ph.D.
Funded by the Missouri Foundation for Health 2003-2006

Project Summary
Children with special health care needs (CSHCN) are those who have a chronic physical, developmental, behavioral, or emotional condition who also require more health and related services than children generally (McPherson et al., 1998). Their families report significant difficulty navigating the complex system of care to obtain needed medical, educational, therapeutic and social services. The purpose of this project is to improve the system of care for rural and underserved children with special health care needs by expanding an existing program, the Missouri Partnership for Enhanced Delivery of Services (MO-PEDS; funded by the Robert Wood Johnson Foundation and the Missouri Department of Health, 1998-2002). During the past four years, this demonstration project introduced strategies for family-centered, comprehensive, and coordinated care of children with special health care needs in 3 primary care practices in central Missouri. The MO-PEDS program evaluation showed that 95% of enrolled families found it to be helpful, and it significantly reduced unmet needs and family burden.

Because of the positive impact of the MO-PEDS project, we propose to expand this intervention to serve more CSHCN and their families. The proposed MO-PEDS expansion has three broad aims:

1. To improve the quality of care for rural and underserved CSHCN by increasing the availability of comprehensive care coordination services.

2. To evaluate the impact of these services on CSHCN enrolled in a Medicaid managed care organization (Missouri Care).

3. To sustain the MO-PEDS intervention by developing a training program on comprehensive care coordination for state agency personnel, in collaboration with the Bureau of Special Health Care Needs in the Missouri Department of Health and Senior Services.

This expansion will be conducted in 16 counties in central Missouri, where 200 families will be served over the next 3 years. In addition to providing direct service, the impact of this project will be enhanced through activities designed to extend its use to managed care organizations and state agency personnel. Our partners in the development of this project will be the University of Missouri Department of Child Health, Missouri Care (a Medicaid managed care organization), and the Bureau of Special Health Care Needs in the Missouri Department of Health and Senior Services. Expected benefits of these activities include improved health and quality of life for CSHCN and their families, enhanced provider satisfaction with care, and more cost-effective health care.

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