title: A medical home center: specializing in the care of children with special health care needs of high intensity.
abstract: OBJECTIVE
  Children with special health care needs (CSHCN) benefit from a medical home, however, a subset, those children with high intensity needs, have medical and social service issues beyond the capacity of most primary care practices. We describe a novel medical home center that is designed to meet the needs of children with special health care needs of high intensity (CSHCN-HI).
  The medical home center, U Special Kids (USK) is located at the University of Minnesota and affiliated with a tertiary medical center. USK serves CSHCN-HI throughout the state of Minnesota and, because of state supported funding for the program, children have access to the program regardless of their health insurance coverage. The team is expert at gathering an overall perspective of the child's needs, identifying gaps, accessing services and weaving together the plethora of disparate services, agencies and providers. A major goal of this model is to transition care from USK to a primary care medical home within the child's community. Transition is more likely to occur optimally once the child's complex needs are organized, the family is trained, adequate management resources are in place, and the intensity of care coordination needs are reduced.
  
  
  CONCLUSIONS
  We propose that, in addition to a primary care medical home, CSHCN-HI benefit from a unique medical home center that can provide sufficient resources and expertise to organize their complex care coordination needs. Medical home centers, designed specifically to manage the care of children with complex high intensity medical and care coordination needs, have the potential to reduce excess health care utilization and improve patient outcomes by providing this group of children with customized, accessible and integrated services.
authors: Division of General Pediatrics, University of Minnesota, McNamara Alumni Building, 200 Oak Street SE, Suite 160, Minneapolis, MN 55455, USA.
authors: Anne
authors: A
authors: Kelly
authors: Allison
authors: A
authors: Golnik
authors: Rhonda
authors: R
authors: Cady
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D002908:Chronic Disease; D003191:Comprehensive Health Care / Q000458:organization & administration*; D019988:Children with Disabilities; D006297:Health Services Accessibility; D006801:Humans; D008910:Minnesota; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration
references: Pediatrics. 2004 Jul;114(1):79-85
references: 15231911
references: Pediatrics. 2002 Jul;110(1 Pt 1):184-6
references: 12093969
references: Curr Opin Pediatr. 2004 Dec;16(6):700-5
references: 15548935
references: Pediatrics. 2004 May;113(5 Suppl):1517-21
references: 15121920
references: Curr Opin Pediatr. 2004 Dec;16(6):689-92
references: 15548933
references: Pediatrics. 2004 May;113(5 Suppl):1507-16
references: 15121919
references: Pediatrics. 2005 Jun;115(6):e637-42
references: 15930189
references: Pediatrics. 1997 Aug;100(2 Pt 1):197-204
references: 9240799
references: Pediatrics. 2004 May;113(5 Suppl):1522-8
references: 15121921
references: Ment Retard. 1995 Dec;33(6):364-73
references: 8569486
references: Pediatrics. 1998 Jul;102(1 Pt 1):137-40
references: 9714637
references: Pediatrics. 2005 Nov;116(5):1238-44
references: 16264016
references: Pediatrics. 2004 May;113(5 Suppl):1485-92
references: 15121916
references: Arch Pediatr Adolesc Med. 1998 Oct;152(10):1003-8
references: 9790611
references: Pediatrics. 2004 May;113(5 Suppl):1529-37
references: 15121922