Profile of Children with Special Health Care Needs in Ohio Anthony Goudie, Ph.D.

Acknowledgements Project Collaborators oGerry Fairbrother, Ph.D. oLisa Simpson, MB, BCh., MPH, FAAP oKeith Mandel, M.D.

Acknowledgements OFHS Reviewers oDr. James Bryant, ODH oHarvey Doremus, ODJFS oKaren Hughes, ODH oDr. Lisa Raiz, OSU

Agenda CSHCN in Ohio - Who Are They? Level of Complexity Unmet Needs / Health Care Access Problems or Barriers Policy Implications

CSHCN in Ohio - Who Are They?

How are CSHCN identified? Prescription Medications Mental Health or Educational Services Functional or Activity Limitations Specialized Therapies Emotional, Developmental, Or Behavioral Problems

570,913 CSHCN in 2008

CSHCN in Ohio - Demographics

CSHCN in Ohio – Health Status

CSHCN in Ohio – Insurance Status Note: Uninsured are those without insurance for all or part of the 12 months prior to the survey.

Level of Complexity

Level of Complexity Among CSHCN

CSHCN by Level of Complexity

Health Status by Level of Complexity

Insurance Status by Level of Complexity

Unmet Needs / Health Care Access Problems or Barriers

CSHCN Experience a Higher % of Unmet Needs / Health Care Access Problems or Barriers

Families of CSHCN who incur major medical costs are: Twice as likely to be covered by private than public insurance Almost 3 times as likely to have poor, fair, or good than very good or excellent health status

CSHCN who delay or avoid getting needed health care are: 10 times more likely to be uninsured than privately insured Twice as likely to be older (ages 13-17) than younger Twice as likely to have poor, fair, or good than very good or excellent health status 4 times as likely to live in a rural (non-Appalachian) region compared to Hamilton county

CSHCN who do not get needed prescription medications due to cost are: Greater than 10 times more likely to be uninsured than privately insured Twice as likely to be under 6 than between years of age Twice as likely to have poor, fair, or good than very good or excellent health status 4 times as likely to live in a rural (non-Appalachian) region compared to Hamilton county

Families of CSHCN who have an unmet need for health care of any kind are: Greater than 6 times as likely to be uninsured than covered by private insurance Almost twice as likely to have poor, fair, or good than very good or excellent health status

CSHCN Transitioning to Young Adults Have More Unmet Needs 28.1 % of young adults with SHCN are uninsured

Policy Implications

Stable and adequate health care insurance is vital for this vulnerable pediatric population Early screening for diagnoses of chronic conditions if they manifest at an early age Focus on CSHCN transitioning to adulthood to avoid high levels of unmet needs Policy Implications

Entire families are impacted by caring for a child with SHCN The health care system is but one of many that CSHCN interact with, and coordination between all is important for quality of life and well-being (e.g. behavior in school may be due to poor adherence taking medications) Policy Implications

Thank You