Children and Youth with Special Health Care Needs A Mohave County Community Assessment
Dec 25, 2015
Prevalence of CYSHCN
www.mohavecounty.us www.snacmc.org
Children & Youth with Special Health Care Needs (CYSHCN):
• Children up to age 21• Chronic physical,
developmental, behavioral, or emotional disability
• Requires services beyond that required by children generally
241,067 CYSHCN in Arizona
www.mohavecounty.us www.snacmc.org
What we Know…
• Limited access to care• Insurance coverage• Geographic barriers & transportation
www.mohavecounty.us www.snacmc.org
Special Education
Section 504
Individualized Education
Program (IEP)
Arizona Child Find Program
Individuals with Disabilities Education
Act (IDEA)
Little is known about
the experiences
of CYSHCN in Mohave County
www.mohavecounty.us www.snacmc.org
CYSHCN Needs Assessment
Why?
• To identify health care experiences and needs
How?
• 4 surveys:• School staff (n=147), • Providers (n=71) • Parents/caregivers of CYSHCN
(n=116)• Youth with special health care
needs (n=49)
• 8 key informant interviews with parents/caregivers.
• Parent/Caregiver group feedback
www.mohavecounty.us www.snacmc.org
School Staff & Providers
64% = general education teachers
23% = special education teachers
12% = administrators, nurses, and paraprofessionals/support staff
Average time on job for
providers was 12.6 years
www.mohavecounty.us www.snacmc.org
Youth & Parents/Caregivers
Cognitive Developmental Behavioral/Emotional Physical
70% of parents/caregivers said their CYSHCN had a developmental or genetic diagnosis
Mental retardationMemory loss
ADHDAutism Spectrum Disorders
DepressionAnxiety
Hearing, speech impediments
Half the youth said their disability does not impair their functioning. Those who said they were limited, reported :
• Learning difficulties• Physical challenges (e.g. driving)• Difficulties controlling behavior
www.mohavecounty.us www.snacmc.org
Type of insurance coverage as reported by parents/caregivers
Most parents/caregivers surveyed receive public health insurance for their CYSHCN.
No Insurance Coverage
Private Insurance
Public Insurance
0 10 20 30 40 50 60 70 80 90
5
45
77
Number of Parents/Caregivers
www.mohavecounty.us www.snacmc.org
Most requested services by parents/caregivers:
1.Dental
2.Speech
3.Occupational Therapy
4.Counseling
www.mohavecounty.us www.snacmc.org
Somewhat Satisfied to Very Satisfied with Health Care Services Received
3 out of 4 Youth
4 out of 5 Parents/Caregivers
1 out of 5 Providers
Dissatisfied to Very Dissatisfied with School-Related Services
www.mohavecounty.us www.snacmc.org
Parents/Caregivers(50%)
School Staff
(92%)
IEP process can be improved
IEP process can be improved
www.mohavecounty.us www.snacmc.org
Perception of Self Perception of Others
Not Adequately Trained
Adequately Trained
Not Adequately Trained
Adequately Trained
Scho
ol S
taff
Prov
ider
s
0 10 20 30 40 50 60 70 80 90
66
82
20
46
Number of Respondents
Staff Not Adequately Trained
Staff Adequately Trained
Staff Not Adequately Trained
Staff Adequately Trained
Scho
ol S
taff
Prov
ider
s
0 10 20 30 40 50 60 70 80 90
81
61
22
39
Number of Respondents
A higher percent of school staff (44%, n=66) felt inadequately prepared/trained and perceived their co-workers to be inadequately trained (55%, n=81) to work with CYSHCN.
www.mohavecounty.us www.snacmc.org
Most Common Barriers to Accessing Health Care
1. Services not available (57%)
2. Cost (41%)
3. Health care plan limitations (37%)
As reported by Parents/Caregivers
www.mohavecounty.us www.snacmc.org
Most Reported Barriers to Providing Quality Educational Services
1. Cost is a limiting factor (54%)
2. Lack of resources (52%)
3. Specialty schools unavailable (45%)
As reported by school staff
Challenges
Access to Services • Service providers
• Specialty services• Family support programs• Socialization and physical activity• Health care coverage
Challenges
School Environment
• Special education and related services• Difficulties qualifying for services• IEP complexities• Accountability• Individualized Education Programs
Challenges
School Environment
(continued)• Communication (CYSHCN Advocate)• Resources and funding• Additional school services• Employment and transitional programs
Challenges
• Coordination & awareness of resources
• Community awareness & engagement
• Parent/caregiver education
• Educator & provider training
Respite & DaycareSpeech Therapists
Behavioral TherapistOccupational Therapists
Physical TherapistsSign Language InterpretersDevelopmental Pediatrician
Education and Training
www.mohavecounty.us www.snacmc.org
Additional Challenges in Schools
Wheelchair accommodations
Accessible doors and hallways
Handicap-friendly playgrounds
www.mohavecounty.us www.snacmc.org
Recommendations:
1. Needs Assessments
2. Coordination and Awareness of Resources
3. Access to Care
4. Special Education & Related Services
www.mohavecounty.us www.snacmc.org
Next Steps
Share with the community and providers
Highlight Community Assessment during fall public forum and press releases
Guide future efforts of SNAC’s strategic plan