Population-Specific Service
Delivery Issues
Adolescents. Historically adolescents have been hard to reach, yet they will be
the largest group of children covered under SCHIP. Special needs of this group include
confidential care, and services in the areas of reproductive health, mental health, and
substance abuse treatment. School-based centers will be a valuable resource in reaching
this population.
Native Americans are generally undercounted in estimates of the uninsured due to
coverage by the Indian Health Service (IHS). Historically there have been serious problems
in conducting successful outreach in the Native American community as well.
Immigrants. With changes resulting from welfare reform, concerns have arisen
about where immigrants will obtain health care. In light of changes in the law and who is
eligible for services, outreach to eligible children of immigrants will be increasingly
important.
Children with Special Health Care Needs (CSHCN). This population may be
ill-suited to managed care due to their diverse health care needs. CSHCN may be better
served through more specialized service delivery systems designed to meet a wider range of
healthcare needs.
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