An Intersectoral Response to Children with Complex Health Care Needs

Abstract

The purpose of this paper is to stimulate debate on how to define and enact public responsibility to children with complex health care needs and their families. National and provincial policies define accountability at a macro level and are not intended to be prescriptive at the micro level. Indeed, principals, teachers and service providers would be critical of the involvement of policy makers in micro-management. Yet, decision-makers focus on the shortcomings of existing policy and not on the shortcomings of management. For example, the Children and Youth Home Care Network has called for "governments at all levels to assign higher priority to developing coherent policies for children with special needs and families, particularly in the home and community". Spalding and colleagues reported that service integration and coordination would not improve until there are "fundamental changes at the broader system level…. . There is no urgent need for policy to ‘catch up' with reality. Rather there is a need for principals, teachers and service providers to develop programs that support policies.

This paper details a case study of an evidence-based program that provides the critical link between the policy and good practice. This program involves Community Care Access Centres, schools and Saint Elizabeth Health Care, a complex-care nursing provider. The case study illustrates how public responsibility has been successfully enacted at a local level within existing policies for children with complex health care needs.