Meeting the Needs of Children in a Home-Based Setting

GAO discussed efforts related to meeting the needs of children that have a severe chronic health condition in a home-based setting. GAO found that: (1) families with chronically ill children at home needed both medical and support services; (2) although most of the families needing medical services had no difficulty obtaining them, about half had difficulty finding one or more support services such as babysitting, counseling, or transportation; (3) parents attributed their difficulties in obtaining both types of services to high out-of-pocket expenses, lack of information about service availability, and lack of a focal point to contact when they needed help; (4) home visiting, a service delivery program that provided preventive health, social, or educational services, was a cost-effective way to improve health and decrease the risk of child abuse and developmental delay; (5) the three characteristics of successful home visiting included clearly defined objectives, providers' skills matched with service delivery objectives, and a stable funding program; and (6) while federal support of research projects has helped to develop new approaches in home visiting, short-term funding has hampered institutionalizing successful approaches. GAO believes that more guidance is needed to: (1) consolidate and publicize sources of information on services available; (2) provide this information to parents at the time of hospital discharge or when they return to their community; and (3) ensure that a focal point is available when needed.