The Impact of COVID-19 on Systems of Care for Children and Youth with Special Health Care Needs

The Impact of COVID-19 on Systems of Care for Children and Youth with Special Health Care Needs

The COVID-19 pandemic uniquely impacted and brought unprecedented challenges for children and youth with special health care needs (CYSHCN) and their families. It is common for CYSHCN and their families to find support through different avenues such as health care, education, family and community systems. The COVID-19 pandemic highlighted existing gaps in these systems when providing and coordinating care for children who have or are at increased risk for chronic physical, developmental, behavioral or emotional conditions and revealed new opportunities for change and improved care.

CYSHCN tend to be high pediatric health care service users which became difficult during the COVID-19 pandemic. Compared to other children, CYSHCN often have more requirements for in-person and direct care and coordination from their care systems. The closing of schools and health care offices, as well as the halting of activities during the pandemic, greatly impacted the health, development and well-being of this group. Such closures caused increased visits by CYSHCN to specialty care settings in order to make up for the lack of in-school and in-home services that were available at the time.

“Families of CYSHCN play a pivotal role in the care of their children, which became more glaringly clear during the COVID-19 pandemic as they navigated health care and therapy facility closures,” said Valerie Boebel Toly, PhD, RN, CPNP-PC, FAAN, coauthor of the article. “The COVID-19 pandemic also highlighted the need for and family’s acceptance of care delivery options for their CYSHCN, such as telehealth video chat visits, however, it exposed a digital divide that further widened care inequities.”

Additionally, the pandemic exacerbated the existing school health personnel crisis, which led to a lack of optimal health services for many children, especially CYSHCN, who rely on schools for many of their health and social service needs. In the United States, only 39% of schools have full-time school nurses, and 80% of children with mental and behavioral health needs receive services in schools. With staffing shortages impacting these school-based services, the COVID-19 pandemic amplified the hurdles that CYSHCN and their support systems go through to ensure that they receive an education that enables them to develop to their utmost potential.

This article provides “critically important frameworks inclusive of health, education, and family well-being that pediatric nurse practitioners and other child health clinicians can use to optimize the medical management and coordination of care for children with complex chronic illnesses,” said Stacee M. Lerret, PhD, RN, CPNP-AC/PC, CCTC, FAAN, coauthor of the article.

The full article, titled “The Impact of COVID-19 on Systems of Care for Children and Youth with Special Health Care Needs” was published in the March/April special edition of the Journal of Pediatric Health Care and can be accessed here.

Apr. 12, 2023

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