Medical Home – CYSHCN

What is a Medical Home? 

• A medical home is a family-centered approach to providing comprehensive, high quality primary care.
• The family works with their primary health care team to get needed medical and non-medical services for their child. 
• A medical home extends beyond the four walls of a clinical practice. It includes specialty care, educational services, family support, and more.
• Receiving care through a medical home can improve a child’s health and make life easier for the child’s family. A medical home care team can include: 
  • Doctors and nurses; 
  • Therapists; 
  • Dentists; 
  • Pharmacists; 
  • Community Health Workers; 
  • School staff; 
  • Friends; 
  • Neighbors; and 
  • Anyone who cares for your child. 
• Care in a medical home is:

• Accessible – services are in the child’s and family’s community. Someone can help the child 24 hours a day, 7 days a week. 
• Family-Centered – providers see the family as the expert in their child’s care. Family members are valued care team members and contribute to decision making. 
• Continuous – the child sees the same pediatric health care team over time. The team supports the child’s transition to adulthood. 
• Comprehensive – the child’s care includes: 
  • Check-ups; 
  • Preventative care; 
  • Primary care; and 
  • Specialty care.

The child and family are connected to support and education opportunities. 

• Compassionate – the medical home team is genuinely concerned about the overall well-being of the child and family. 
• Culturally Effective – services are delivered in the child’s and family’s preferred language. The care team respects the family’s cultural and religious beliefs.

The medical home facilitates partnerships between patients, physicians, and families. CYSHCN who receive care in a medical home are more likely to meet other Core Outcomes designed to measure and improve quality of life .  

According to the 2021-22 NSCH, 35.9% of CYSHCN in Texas received care in a medical home (compared to 40.7% nationally).

Care coordination supports the medical home model. We fund community-based organizations that provide case management services in some areas of the state to help families find resources. You can find out more HERE. We also fund public health case management staff in all areas of the state. You can find out more HERE. 

Brochures

We publish family and provider brochures to explain the importance of the medical home model. Order our brochures directly through the HHSC Warehouse or call them at 512-250-7162 for assistance with your order. You can also download electronic versions below.  

• Every Child Deserves a Medical Home: A Guide for Families (English).
• Todos Los Niños Merecen Un Hogar Médico: Una Guía Para Las Familias (Spanish).

Additional Medical Home Resources

Free Continuing Education (CE) Courses

The Texas Health Steps online program offers free CE courses for primary care providers and other health professionals. These courses offer updated clinical, regulatory, and best practice guidelines for: 

• Preventative health:  
• Oral health; 
• Mental health; and  
• Case management topics. 

Here are several Texas Health Steps courses related to medical home:

• Building a Comprehensive and Effective Medical Home;
• Culturally Effective Health Care; and
• Developmental Surveillance and Screening: Birth through 6 Years.

• The National Resource Center for Patient/Family-Centered Medical Home works to improve the health and well-being of, and strengthening the system of services for, CYSHCN and their families by enhancing the medical home.
• Texas Parent to Parent Medical Home Toolkit explains what a medical home is and how to get one.
• The Navigate Life Texas website, created by parents for parents, includes tips for families on how to work with your child’s doctor to create a medical home.
• The Mountain State Regional Genetics Network Texas team helps families connect to genetic services and resources. The network also helps providers understand available services so they can make referrals.
• The Texas Primary Care Consortium is a nonprofit, practitioner-led organization. The Consortium’s mission is to promote the Patient-Centered Medical Home Model of care in Texas.

The Texas Department of State Health Services does not endorse external links to other websites or documents created by other agencies. These links and documents are informational and may not be accessible to persons with disabilities.