Children With Special Health Care Needs in West Virginia

West Virginia

The demographics of a state influence the health needs and outcomes of its population. Understanding the demographic breakdown can help state health officials determine priorities for health promotion and disease prevention. For this measure, children were defined as having special health care needs if they either had at least one functional difficulty and one health condition and/or met the criteria outlined in the Children with Special Health Care Needs (CSHCN) Screener©, which characterizes special health care needs based on the health challenges a child experiences due to an ongoing health condition, regardless of diagnosis. The screener has five criteria: 

1. Needing or using prescription medications. 
2. Needing or using medical, mental health or educational services more than average. 
3. Having functional limitations compared with children of the same age.
4. Using or needing specialized therapies, such as speech therapy or occupational therapy.
5. Receiving treatment or counseling for emotional, behavioral or developmental problems. 

Children with special health care needs have, or are at high risk for, chronic physical, developmental or behavioral conditions and require more health services than most children. These children are a diverse group with varying degrees of health care needs. 

During the 2017-2018 school year, 21.4% of children with special health care needs missed seven or more days of school due to illness or injury, compared with 6.4% of children without special health care needs.

According to America’s Health Rankings analysis, the prevalence of children with special health care needs is higher among:

• Boys compared with girls. 
• American Indian/Alaska Native, Black, Hispanic, multiracial and white children compared with Hawaiian/Pacific Islander and Asian children.
• Children with a caregiver who graduated from high school or has some post-high school education compared with children whose caregivers have less than a high school education or graduated from college.

For effective care, children with complex medical needs should have access to a medical home. The medical home approach involves comprehensive planning, patient- and family-centered care and management of medical care among patients, families and health care providers. The purpose of a medical home is for families and health care teams to work together to improve the health of children with special health care needs. Only about 40% of children with special health care needs received care in a medical home.

A 2020 review of the evidence found positive long-term results from a pilot program that identified medically complex families struggling with economic hardship and provided “housing prescriptions,” or supportive housing interventions. Alleviating the stress and financial burden of housing instability led to measurable improvements in children’s physical health and their parents’ mental health.

Healthy People 2030 has an objective to increase the proportion of children and adolescents with special health care needs who have a system of care.

Bovell-Ammon, Allison, Cristina Mansilla, Ana Poblacion, Lindsey Rateau, Timothy Heeren, John T. Cook, Tina Zhang, Stephanie Ettinger De Cuba, and Megan T. Sandel. “Housing Intervention For Medically Complex Families Associated With Improved Family Health: Pilot Randomized Trial: Findings an Intervention Which Seeks to Improve Child Health and Parental Mental Health for Medically Complex Families That Experienced Homelessness and Housing Instability.” Health Affairs 39, no. 4 (April 1, 2020): 613–21. https://doi.org/10.1377/hlthaff.2019.01569.

Maternal and Child Health Bureau. Children with Special Health Care Needs, 2017-2018. NSCH Data Brief. Rockville, MD: Health Resources and Services Administration, July 2020. https://mchb.hrsa.gov/sites/default/files/mchb/programs-impact/nsch-cshcn-data-brief.pdf.

Minnaert, Jessica J., Ashley H. Hirai, Julia F. Donney, Reem M. Ghandour, Cristina Novoa, and Jeffrey P. Brosco. National Survey of Children’s Health Children and Youth With Special Health Care Needs, 2022 – 2023. Data Brief. Health Resources and Services Administration, December 2025. https://mchb.hrsa.gov/sites/default/files/mchb/programs-impact/nsch-data-brief-children-youth-special-health-care-needs.pdf.