Medical College of Wisconsin Pediatric Special Needs Patient Care

• Facilitating communication between providers, such as hospital staff, primary and specialty care providers, durable medical equipment companies, pharmacies, social workers, community agencies and education systems.
• Providing patients/families with the necessary information to make informed decisions about their child’s health care.
• Helping patients/families navigate the health care system.
• Creating and updating comprehensive clinical summaries.
• Advocating for a patient’s best interests.
• Providing emotional support to patients/families.
• Expediting consultations or other services.
• Organizing and facilitating care conferences.
• Assisting with managing patients during hospital stay.
• Coordinating health care appointments.

Individuals, age 21 and younger, with multiple medical needs may be referred to the program.

All Special Needs Program patients have:

• Ongoing chronic medical problems.
• Multiple specialists (average is eight per patient).
• Many clinic appointments and/or long hospitalizations.

Some patients may have:

• An unknown diagnosis.
• A long commute to the hospital.
• A life change that affects their health.
• Other barriers to care.

Anyone involved in the care of a child with multiple medical needs, including parents or health care professionals, may make a referral to the Special Needs Program. The program staff reviews each referral and will schedule a consultation to determine care coordination needs and program eligibility. Patients who are eligible will be offered enrollment in the program. For general program information, call (414) 266-6943.

To make a referral to the program, call (414) 266-6943 or toll-free (888) 249-7233.