General Comments

Abstract

As the year 2000 approaches, we as a nation face unique challenges in facilitating the development of systems of services for children and their families which support and nurture our next generation in healthy, productive lives. Title V of the Social Security Act has a proud history of leadership in response to needs of children and families and has worked to improve the health of underserved women, infants, children, and youth, including children with special health care needs. In 1989, amendments were enacted to the Title V Maternal and Child Health Grant (MCH block grant). These amendments redefine the mission of the state Children With Special Health Care Needs programs (CSHCN programs). The MCH block grant mandates the state CSHCN programs to assume a leadership role in developing community-based systems of services for children with special health care needs and their families. The mandate in the MCH block grant to the CSHCN programs to assume a leadership role with respect to systems development reflects the national goal of building systems of services for children with special health care needs and their families that are family-centered, community-based, and coordinated. This goal was first enunciated in 1987 by the US Surgeon General's office and the federal Bureau of Maternal and Child Health. In accordance with this national goal, the recently issued Year 2000 National Health Promotion and Disease Prevention Objectives includes objective 17.20, which specifically calls for the building of family-centered, community-based, coordinated systems of services for this population. The national initiative to develop systems of services for children with special health care needs and their families can and should be seen as part of a larger national movement to develop community-based systems of services.