Health care needs and services for technology-dependent children in developmental centers

In an attempt to document the trend toward a more seriously ill and medically needy population of children in California state developmental centers, we studied the medical status and health care needs of the pediatric and young adult population (birth to 22 years of age) residing in all acute care and skilled nursing care units in developmental centers in 1988. All children in California's state developmental centers are severely to profoundly mentally retarded and chronically disabled, and many have serious health problems. Of the 865 children in 5 developmental centers, 441 (51%) resided in acute and skilled nursing care units and were technology dependent (Office of Technology Assessment classification). We suspect that our findings (ethical and quality-of-care issues, staffing, licensing mandates, cost-of-care considerations) reflect the rapidly expanding population of children with special health care needs and may be important in planning for services in other states as well as in California.