CSHCN Systems Development Group

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Maternal and Child Health – Children with Special Health Care Needs  

The Children with Special Health Care Needs (CSHCN) Systems Development Group (Systems Development) works to strengthen community-based services to improve systems of care for children and youth with special health care needs (CYSHCN), including clients receiving health care benefits through the State’s CSHCN Services Program, which is administered by the Health and Human Services Commission. 

Our work is driven by Title V Performance Measures that are selected based on priorities identified through a comprehensive needs assessment process. Progress achieved on Performance Measures is reported annually to the federal government in collaboration with all Title V Maternal and Child Health programs in Texas.  

Specific Performance Measures within the CSHCN domain of the Texas Title V Block Grant include:

  • Percent of adolescents with and without special health care needs who received the services necessary to make transitions to adult health care
  • Percent of children with and without special health care needs having a medical home
  • Percent of children and youth with special health care needs and their families who received supports and services necessary to be integrated into their communities

Staff work closely with other state and national programs, agencies and community organizations to make progress on Title V Maternal and Child Health Block Grant state-selected National and State Performance Measures for CYSHCN. Programmatic activities related to these performance measures are planned and implemented in partnership with stakeholders including families, community organizations, universities, national technical assistance centers, and other state agencies and programs.  

CSHCN Systems Development Group Areas of Focus: 


Due to advances in health care, CYSHCN are living longer, healthier lives. Most are surviving into adulthood, highlighting the need for services and support to transition into adult care[1]. Transition is a dynamic, lifelong process that seeks to meet a youth and family’s individual needs as the youth moves from childhood to adulthood[2].  In Texas 18.6% of CYSHCN received services necessary to transition to adult health care (compared to 22.9% nationally)[3].  

Medical Home

CYSHCN who receive care within a medical home are more likely to meet other Core Systems Outcomes[4]. A medical home is an approach to providing comprehensive primary care that facilitates partnership between patients, physicians, and families. Care within a medical home should be comprehensive, coordinated, continuous, accessible, family-centered, culturally competent and compassionate.[5] In Texas, 45% of CYSHCN received care in a medical home (42.3% nationally).[6].    

Community Inclusion

CYSHCN have the same needs as typically developing children, in addition to other types of supports based on their disability and individual family needs. All families contribute to and are impacted by their communities. The extent to which communities are accessible and welcoming can minimize the sense of isolation experienced by many CYSHCN and their families. In Texas, 55% of CYSHCN caregivers report feeling isolated because of their child's disability, and over a third do not feel a sense of belonging to their community.      

External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services.  For more information about Children with Special Health Care Needs, Maternal and Child Health, or information regarding maternal and child health in Texas, please email TitleV@dshs.texas.gov or call (512) 776-7373

Last updated June 11, 2021