California Ranks Lowest in The Nation on Health Care for Children with Special Needs


cahealthcarespneedsCalifornia is ranked lowest in the nation on health care for children with special health care needs (CSHCN) according to a report released November 17, 2010 by the Lucile Packard Foundation for Children’s Health.

One in seven children in California has a special health care need. The report defined CSHCN as those with a physical, mental, developmental or other type of ongoing health condition that requires an above routine need for or use of health and related services of a type or amount than required by children generally. This may include diagnosis such as autism, Cerebral palsy, asthma or heart disease.

It also found that nearly 60% of children in California with special health care needs have two or more conditions. The most common conditions include allergies, asthma, attention deficit hyperactivity disorder (ADHD) and emotional problems.

In California, about 107,000 children with special needs are uninsured, placing the state 40th in the country for health coverage. But even among the insured, more than one-third do not have adequate insurance to meet their special needs.

The report also called out other areas of special health care needs in California that were lacking:

  • Less than 55% of California children with special medical needs receive routine preventive care vs. 69% of children with special needs nationwide.
  • Only 37.1% of children with special needs received necessary transition to adult services vs. 41.7% nationwide.
  • More than 26% of parents of children with special needs reported experiencing stress vs. 19.3% nationwide.
  • An estimated 3,780,000 hours per week are spent by CSHCN families on coordinating their child’s care, which is equiva­lent to 94,500 full-time employees.

“The national dialogue on improving the health care delivery system largely overlooks children,” stated Lucile Packard Foundation president and CEO, Dr. David Alexander. “When people talk about the system, they’re creating changes that are primarily organized around the needs of seniors and adults…Unless the system is fundamentally changed, California and the nation – currently ‘a C-minus kind of performance’ at best – will continue to perform poorly in meeting the special health care needs of children. Because their needs are more acute, reworking the health care system for children with special needs could offer a roadmap for the rest of the population. If you can make a system that works for them, it’s going to work for everybody.”

Christina Bethell, OHSU associate professor and lead author of the study, said California’s low ranking might stem partially from the complex local and state government bureaucracies that parents must navigate to obtain care for their children. Since 60% of CSHCN have more than one type of health condition, current policies and programs that focus on specific health issues do not adequately address the needs of the majority of these children. An emphasis on cross-agency and cross-sector collaborations, especially for medical, mental and developmental health related services, are vital towards addressing the future needs of this growing and important segment in California’s population.

To review the full study click here.


“Calif. Ranks Last in Caring for Children With Special Needs”. California Healthline. 18 November 2010.

Lin, Joanna. “Health Care System Fails Kids”. California Watch. 18 November 2010.


AP Tips:  What You Can Do to Care for Child’s Special Health Care Needs
This is an important time to educate yourself about your child’s health and development, and to find resources available to promote your child’s well-being. Click here for AP tips on how to navigate the system and receive the services and programs your child needs.
Click Here to join or start a group where you can connect with other parents who are establishing services in your area. Parents are often the best resource for navigating the system.
Click Here for AP Expert Kristin Reinsberg MS, LMFT blog on budget cuts in California affecting the cutting of services and programs for AP Families.