title: Identifying Social Determinants of Health and Legal Needs for Children With Special Health Care Needs.
abstract: Children with special health care needs (CSHCN) require comprehensive care with high levels of community and government assistance. Medical-legal partnerships may be particularly suited to address needs for this population. To explore this, we conducted in-depth telephone interviews of families of CSHCN cared for in the primary care practice of our tertiary care children's hospital. The majority of the sample (N = 46) had been late on housing payments and 17% of homeowners had been threatened with foreclosure. Families frequently reported denial of public benefits. Approximately 10% had executed advance planning documents such as guardianship plans for the children or wills for the parents. A minority of families had sought help from community agencies or lawyers. Less than one third had ever discussed any of the issues with health care providers, but two thirds were likely or very likely to in the future. CSHCN may especially benefit from the social support of a medical-legal partnership.
authors.affiliation: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA dejong@email.unc.edu.
authors.forename: Neal A
authors.initials: NA
authors.lastname: DeJong
authors.affiliation: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors.forename: Charles T
authors.initials: CT
authors.lastname: Wood
authors.affiliation: Legal Aid of North Carolina, Inc, Durham, NC, USA.
authors.forename: Madlyn C
authors.initials: MC
authors.lastname: Morreale
authors.affiliation: Legal Aid of North Carolina, Inc, Durham, NC, USA.
authors.forename: Cameron
authors.initials: C
authors.lastname: Ellis
authors.affiliation: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors.forename: Darragh
authors.initials: D
authors.lastname: Davis
authors.affiliation: Legal Aid of North Carolina, Inc, Durham, NC, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Fernandez
authors.affiliation: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Steiner
mesh_terms: D002648:Child; D002662:Child Health Services / Q000639:trends; D003430:Cross-Sectional Studies; D019988:Children with Disabilities; D000067571:Financial Statements; D005102:Health Expenditures; D006801:Humans; D007407:Interviews as Topic; D000067408:Legal Services; D009657:North Carolina; D011632:Public Assistance; D064890:Social Determinants of Health; D012944:Social Support
keywords: children with special healthcare needs; medical–legal partnership; social determinants of health