The conceptual model for reporting in children and youth projects.

Abstract

IN 1965, the 89th Congress passed a set of amendments to the Social Security Act of 1935. President Johnson signed those amendments into law. One small and hardly noticed title among the many present in that law was Title II. It resulted in what has since become known as the Children and Youth Comprehensive Health Care Service Delivery Program. Title II was unique and pleasantly different from other care service acts in general, and particularly different from Titles XVIII and XIX in the same law and which are known better as Medicare and Medicaid. The major conceptual difference is that Medicare and Medicaid are merely monetary reimbursement mechanisms and have nothing to do with organizing and structuring a care delivery system as is provided in the Children and Youth legislation. Title II, which established the Children and Youth Projects, was intended to create new means of service delivery, or to substantially modify existing ones. There was no intent to accept what was extant. The service delivery projects were to be tailor-made to fit each local area geographically defined. The projects were required to include collaboratively, and cooperatively, all purveyors of services in their projects, be they in health or education or welfare. The major objective was to make possible programs which would provide comprehensive services for children of low-income families, through promotion of health, including casefinding, preventive services, diagnosis, treatment, correction of defects, and aftercare, both medical and dental.* In addition, the regulations prepared to implement Title II (better known as the Blue Book) proposed services in nursing, social service, nutrition, speech and hearing, psychology, physical therapy, and occupational therapyt Such C and Y projects were to increase availability and improve the quality of care services but not to replace or reduce prior services or state or local funds. In addition, the law stated that any treatment, correction of defects or aftercare . . . is available only to children who would not otherwise receive it because they are from low-income families or for other reasons beyond their control. Those eligible to