Children and Youth with Special Health Care Needs (CYSHCN)

Child with special needs finger painting

In California, nearly one in seven children are estimated to have special health care needs.¹ Children and youth with special health care needs (CYSHCN) include infants, children, and youth from birth to age 21 who have one or more chronic physical, developmental, behavioral, or emotional conditions, and require special health and support services. The Maternal, Child, and Adolescent Health (MCAH) Division of the California Department of Public Health (CDPH) collaborates with the California Department of Health Care Services (DHCS) and other partners to improve systems that serve CYSHCN at the state and local levels. MCAH also promotes family engagement and resilience, funds programs that provide screening and links to services, and applies a public health approach to support this population.

Program Profile

Print Version (PDF)

About Us

NATIONAL VISION: Ensure optimal health and quality of life for all children and youth with special health needs and their families.²

OUR WORK: Through the Title V Block Grant, California works to expand public health systems and services for CYSHCN and their families. This includes support for local programs that work with this population and local systems to refer and link children to a broad range of services such as early intervention or public health nursing. Two current projects include local innovation grants and an oversample of the National Survey of Children’s Health.

WE SERVE: Infants, children, and youth, birth-21 years, who have one or more chronic physical, developmental, behavioral, or emotional conditions, and require health and support services beyond those needed by children generally. Services are provided through local agencies with state-level support. If you are a parent or family member of a child looking for services, we highly recommend reaching out to your locallocal Early Start Family Resource Center .

FUNDING: CYSHCN efforts are supported by CDPH using federal funds from the Title V Maternal and Child Health Block Grant.

How Do We Know How Many Children Have Special Health Care Needs?

This number comes from the National Survey of Children’s Health, which covers children and youth from birth through age 17. Qualifying criteria to be considered a child with special health care needs in this survey include:

Prescription medication
Specialized service need/use
Elevated service need/use
Functional limitations
Ongoing emotional, behavioral, or developmental condition

Association of Maternal & Child Health Programs. National Title V Children and Youth with Special Health Care Needs Program Profile (PDF) . April 2017.

Then and Now: History of Title V and CYSHCN

Title V is a federal funding source designed to provide family-centered, community-based health care infrastructure and services to maternal and child populations in all U.S. states and territories. Services for CYSHCN have been an integral part of the Title V mission since its inception in 1935. In fact, at least 30% of Title V funding must be used to support CYSHCN.

Title V CYSHCN programs started with a focus on direct services for children with physical disabilities, due in large part to the polio epidemic during the 20th century. In 1981, Title V and other programs were combined into a block grant allocated to the states. As types and prevalence of special health care needs have changed over time, services have evolved and vary greatly from state to state.³

Partnership with Department of Health Care Services

A portion of the Title V funding that MCAH receives for CYSHCN is allocated to California Children’s Services (CCS), a state program designed to provide services to children and youth with the most medically complex health care needs. The CCS program is administered by the DHCS Integrated Systems of Care Division (ISCD) as a partnership between county health departments, health plans, and DHCS.