Figure 1. Pennsylvania Programs and Systems Serving CSHCN:
What care and services need to be coordinated?
Who is providing care coordination?

HEALTH AND MEDICALLY RELATED CARE COORDINATION/CASE MANAGEMENT FOR
CHILDREN WITH SPECIAL HEALTH CARE NEEDS
Early Intervention Service Coordination
(0-3 yrs, all eligible)
Title V CSHCN Care Coordination
(0-21 yrs, all eligible)
Medical Home Primary Care Practices
(0-21 yrs, patients at select sites)
Medicaid Managed Care Special Needs Units
(0-21 yrs, all eligible and enrolled)
Specialty / Tertiary Care Providers
(0-21 yrs, patients at select sites)
Elks Home Services
(0-2 years, select families at select sites)

OTHER SYSTEMS WITH CASE MANAGEMENT
Mental Health / Mental Retardation
Targeted case management
(0-21, selected populations)
Education / Schools
IDEA Special Education,
504 case management
(0-19 years, all eligible)
Juvenile Justice case management
(0-19 years, all eligible)
Child Welfare Case management
(0-21 yrs, all eligible)

These public health programs serve care coordination functions for various families with different risks and needs.
Home visiting
Healthy Start
Family Partnerships