Integrated Systems of Services

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Illinois Medical Home Project

About Medical HomeFor ProvidersFor Youth & Families

A medical home is an approach to providing primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective.  In a medical home, the primary care team develops a trusting relationship with the family and works as a partner to assure that all of the child’s needs are met.

Through its medical home initiatives, ICAAP works with individual physicians, primary care practices, and community and state agencies to support the dissemination and implementation of the medical home model, with a focus on improving services for children with special health care needs.

Integrated Systems of Services for Illinois Children and Youth with Special Health Care Needs: About the Project

The Illinois Chapter of the American Academy of Pediatrics (ICAAP) and the Division of Specialized Care for Children (DSCC) have received a 3-year grant from the US Maternal and Child Health Bureau to improve access to quality, comprehensive, coordinated, community-based services for children and youth with special health care needs and their families by providing resources and training to build medical homes and transition youth with special needs into adult health care.  The goals of the project are to:

Goal 1:  Improve the ability of primary care providers to incorporate the principles of the medical home model into their practices and better link families with community-based services.

Goal 2:  Create inclusive community-based systems of services for children and youth with special health care needs through a collaboration of statewide stakeholders.

Goal 3:  Provide training and support to assist youth with special needs to successfully transition into the adult healthcare system and maximize their potential in adulthood.

Goal 4:  Develop and implement a strategy to sustain and support medical home advances across the state.

Goal 5: Plan, develop, and implement the project and evaluation.

A major focus of this grant is to develop trainings to assist Youth with Special Health Care Needs (YSHCN) to transition successfully into the adult health care system.  Trainings will be developed over a one-year period (Sept 2010 to October 2011) along three tracks: (1) training curriculum and resources to assist pediatricians, family physicians, and their staff in transitioning YSHCN to adult health care (pediatric training); (2) training curriculum and resources to assist adult-oriented health care providers in delivering coordinated, ongoing, comprehensive care for youth and young adults with special health care needs (adult training); and (3) resources to assess transition readiness and prepare youth and families for transition to adult care (youth and family resources).

Each training track/resources will be developed by a workgroup made up of experts in the field.  Trainings and resources will then be tested with pilot site practices prior to widespread dissemination.  The feedback received and lessons learned from the pilot sites will help refine the training curricula and resources prior to applying for CME and American Board of Pediatrics quality improvement (QI) Part IV Maintenance of Certification credit.   The three training tracks will be offered as in-office presentations as well as by webinar.  Dr. Miriam Kalichman is also available to provide free consultation services and conduct joint patient visits with providers who request training in how to conduct physical exams and assessments of medically complex patients or those with developmental disabilities.

This grant also supports ICAAP’s and DSCC’s activities to promote and sustain the medical home model around the state.


For more information about ICAAP’s medical home initiatives, please contact:

Kathy Sanabria, MBA, PMP
Associate Executive Director, Programs
Illinois Chapter, American Academy of Pediatrics
1400 W Hubbard, Suite 100
Chicago, IL 60642
Phone: 312/733-1026 ext 208
Fax: 312/733-1791