Service coordination for children with complex healthcare needs in an early intervention program

The number of children with complex healthcare needs (CHCN) is growing at an unprecedented rate. Multiple systems of care are in place to address the relevant needs of these children. Ambulatory healthcare has become an accepted method for delivering therapeutic interventions through home- and community-based systems of care such as early intervention (EI). This study examined reports of EI service coordinators regarding the expected type and amount of service provided for children with CHCN, collaboration and communication between providers of medical care and EI services, and adequacy of the service coordinators' training to work effectively with this population. Despite the overall rate of growth of the population of children with CHCN, our results indicated that the relative number of children with CHCN (reported by service coordinators in our sample) remains small. Although children with CHCN reportedly required more time for care coordination, respondents indicated that these children would not be higher users of EI resources compared to children with uncomplicated developmental delays. In terms of level of comfort for working with children with CHCN, training was found to be a better predictor of comfort than experience. Furthermore, primary care physicians were reported to have a low level of involvement in development of outcomes on Individualized Family Service Plans for all children within this EI system of care.