Section G: Minnesota Children with Special Health Needs
2004 Minnesota County Health Tables
Introduction
Minnesota Children with Special Health Needs Data
This section of the Minnesota County Health Tables consists of supplemental information related to
two programs targeted to improving the health of mothers and children. These data were provided by
the Minnesota Department of Health, Family Health Division.
The Children with Special Health Needs component contains five tables. These tables reflect the
anticipated number of children with special health needs and the number of these children receiving
services from various programs.
Public Health Significance
The presence of a childhood chronic illness or disability has significant physical, emotional and
financial impact on the child, family and community. While this population is diverse in age, diagnoses,
functional limitations, unmet needs, health status, use of resources, health care coverage and eligibility
for public programs, the challenges they face are similar in nature. Public health has a significant role in
assuring that :
1. The needs of this population are assessed.
2. Services are provided based on family choices and are flexible, available, and accessible
3. Local and state public policy supports the development of systems to support comprehensive,
coordinated, community based, culturally competent and family centered care.
4. Prevention strategies reduce or prevent family stress, out-of-home placement, family disruptions, and
secondary complications of the chronic illness or disability.
Source: Minnesota Children With Special Health Needs
HOW TO CONTACT US
Minnesota Children with Special Health Needs
Minnesota Department of Health
85 East Seventh Place / PO Box 64882
St. Paul, MN 55164-0882
Phone: 651-215-8956 OR 1-800-728-5420
E-mail: [email protected]
FAX: 651-215-9988
http://www.health.state.mn.us/mcshn
2004 Minnesota County Health Tables
Children with Special Health Care Needs [CSHCN] Data
A major challenge in planning and implementing programs and services for children with special health care needs is
defining the population. Numerous approaches have been used to define the population based on the purpose of a
particular program or service. The population includes children to age 21 with physical, developmental, or mental
health conditions which are virtually certain to last for at least one year which cause either 1) limitation in function,
activity or social role or 2) dependency on medication, special diet, medical technology, assistive device or personal
assistance, to compensate for or minimize limitation of function or 3) the need for medical care or related services
over and above the usual for child’s age.
Importance of the Problem
Children with special needs and their families are uniquely dependent upon the success of the health and community
systems to prevent premature death, prevent long-term complications and achieve optimal functioning, thus
decreasing the economic burden to the community.
Number of children with special health needs
The National Survey of Children with Special Health Needs conducted by the National Center for Health Statistics,
used the operationalized the Maternal and Child Health Bureau definition (above).
Children with Special Health Care Needs Table 1: Minnesota Children with Special Health
Care Needs by State and County, 2004
CYSHCN (0 to 18) Need Medications
State of Minnesota
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
Carver
Cass
Chippewa
Chisago
Clay
Clearwater
Cook
Cottonwood
Crow Wing
Dakota
Dodge
Douglas
Faribault
Fillmore
Freeborn
Goodhue
Grant
Hennepin
Houston
2004 Minnesota County Health Tables
154,153
385
10,604
951
1,368
1,128
165
1,385
771
954
2,807
812
372
1,560
1,490
256
127
359
1,676
12,718
643
926
453
647
884
1,368
174
31,914
635
117,384
284
8,071
703
1,030
869
117
1,066
561
709
2,153
593
273
1,176
1,095
191
92
268
1,266
9,690
486
690
329
475
659
1,015
125
24,945
460
Need for Services
78,673
190
5,409
471
690
582
78
714
376
475
1,443
398
183
788
734
128
62
180
849
6,495
325
463
220
318
442
680
84
16,719
308
Development, Behavioral
or Emotional Needs
44,946
109
3,091
269
394
333
45
408
215
271
824
227
105
450
419
73
35
103
485
3,711
186
264
126
182
252
389
48
9,553
176
G-2
Hubbard
Isanti
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Koochiching
Lac Qui Parle
Lake
Lake of the Woods
Le Sueur
Lincoln
Lyon
McLeod
Mahnomen
Marshall
Martin
Meeker
Mille Lacs
Morrison
Mower
Murray
Nicollet
Nobles
Norman
Olmsted
Otter Tail
Pennington
Pine
Pipestone
Polk
Pope
Ramsey
Red Lake
Redwood
Renville
Rice
Rock
Roseau
St. Louis
Scott
Sherburne
Sibley
Stearns
Steele
Stevens
Swift
Todd
Traverse
Wabasha
Wadena
Waseca
Washington
Watonwan
Wilkin
Winona
Wright
2004 Minnesota County Health Tables
527
1,134
1,246
315
495
1,264
150
388
224
289
130
835
170
740
1,158
172
288
611
714
748
1,051
1,145
259
869
628
215
4,095
1,702
377
821
288
910
319
15,404
121
492
526
1,737
287
570
5,138
3,789
2,563
492
4,016
1,122
235
288
761
113
696
411
578
7,247
373
225
1,277
3,567
387
836
912
229
367
944
111
287
160
211
92
621
125
563
875
131
210
454
536
549
785
875
189
656
485
156
3,144
1,241
287
600
214
664
230
11,934
90
364
387
1,305
214
422
3,823
2,969
1,970
366
3,048
847
177
214
558
81
511
306
438
5,476
286
165
963
2,719
259
560
612
154
246
633
74
192
107
141
61
416
84
378
586
88
141
304
360
368
526
586
126
440
325
104
2,107
832
192
402
143
445
154
7,998
60
244
259
875
144
283
2,562
1,990
1,320
246
2,043
567
119
143
374
54
342
205
294
3,670
191
110
646
1,822
148
320
349
88
140
362
42
110
61
81
35
238
48
216
335
50
80
174
205
210
301
335
72
251
186
60
1,204
475
110
230
82
254
88
4,570
34
139
148
500
82
162
1,464
1,137
755
140
1,167
324
68
82
214
31
196
117
168
2,097
109
63
369
1,041
G-3
Yellow Medicine
317
234
157
90
Source: Minnesota Department of Health, Minnesota Children with Special Health Needs
CSHCN (0-18)
Children with Special Health Care Needs (CSHCN) is a sythetic estimate based on the findings of the Minnesota sample
of the National Survey of Children with Special Health Care Needs. That survey identified the percentage children in
Minnesota have a special health need by age grouping (6.6%-17.4%). The percentages were then applied to the 2003
estimated number of children birth to 18 years of age in each of the age groupings in each county.
Need Medications
Children are found to have a special health care need because they need prescription medications for a health or related
condition that has lasted or is expected to last more than one year.
Need for Services
Children who are found to have a special health care need because they need medical care, mental health or educational
services for a medical, behavioral or mental health condition that has lasted or is expected to last more than one year.
Developmental, Behavioral or Emotional Needs
Children who have a special health care need because they have an emotional, behavioral or development problem for
which they need treatment or counseling.
2004 Minnesota County Health Tables
G-4
Children and Youth with Special Health Care Needs By Age Grouping
The National Survey of Children and Youth with Special Health Care Needs Surveyed more than 3,000 Minnesota families
to determine the prevalence of special health care needs among children birth to 18 years old in our state. The prevalence of
special health care needs varies by age grouping. The overall prevalence of special health care needs was found to be
12.4% of the population. Among children birth to age 6, the prevalence is 6.4%. Among children 6 years of age to age 12,
the prevalence is 12.5%. Among youth age 12 to age 18, the prevalence of special health care needs is 17.4%.
Children with Special Health Care Needs Table 2: Prevalence of special health care needs among
children and youth in Minnesota by county (estimated).
State of Minnesota
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
Carver
Cass
Chippewa
Chisago
Clay
Clearwater
Cook
Cottonwood
Crow Wing
Dakota
Dodge
Douglas
Faribault
Fillmore
Freeborn
Goodhue
Grant
Hennepin
Houston
Hubbard
Isanti
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Koochiching
Lac Qui Parle
Lake
Lake of the Woods
Le Sueur
Lincoln
Number of children with
Number of children with
Number of youth with special
special health care needs birth special health care needs age 6 health care needs age 12 to 18
to age 6 years
to 12 years
years
25,034
51,292
77,827
53
126
207
1,691
3,647
5,266
139
288
525
216
424
728
196
367
565
19
49
96
242
437
706
102
234
435
140
301
513
457
999
1,351
111
245
456
49
127
197
240
521
800
199
499
792
39
80
137
16
40
71
54
115
191
266
540
870
2,041
4,369
6,309
99
218
326
138
292
497
58
140
255
89
203
355
131
282
472
197
438
733
21
55
99
5,841
10,771
15,302
80
204
351
73
165
289
159
359
616
170
385
691
41
99
175
69
165
261
190
400
673
21
48
82
54
128
207
26
71
128
38
91
161
14
40
76
123
265
447
22
57
91
2004 Minnesota County Health Tables
G-5
Lyon
121
242
McLeod
184
373
Mahnomen
28
59
Marshall
38
90
Martin
90
190
Meeker
110
228
Mille Lacs
104
229
Morrison
159
329
Mower
190
374
Murray
34
82
Nicollet
138
277
Nobles
109
208
Norman
27
70
Olmsted
697
1,345
Otter Tail
225
532
Pennington
62
119
Pine
113
247
Pipestone
41
93
Polk
118
296
Pope
41
92
Ramsey
2,696
5,235
Red Lake
18
34
Redwood
70
157
Renville
73
164
Rice
267
562
Rock
43
92
Roseau
80
187
St. Louis
753
1,645
Scott
684
1,357
Sherburne
431
877
Sibley
72
159
Stearns
648
1,309
Steele
175
368
Stevens
38
72
Swift
41
96
Todd
103
241
Traverse
14
36
Wabasha
94
224
Wadena
62
128
Waseca
93
185
Washington
1,109
2,508
Watonwan
62
126
Wilkin
30
71
Winona
200
411
Wright
579
1,201
Yellow Medicine
46
96
Source: Minnesota Department of Health, Minnesota Children with Special Health Needs
2004 Minnesota County Health Tables
377
601
85
160
331
375
415
563
581
143
453
312
118
2,053
945
196
461
153
495
186
7,473
69
266
289
908
152
303
2,740
1,748
1,255
261
2,059
580
125
151
417
63
378
221
299
3,630
184
124
666
1,788
175
G-6
Early Intervention
Early intervention Services are services provided in conformity with an individualized Family Service Plan (IFSP) that is designed to
meet the special developmental needs of a child eligible under Part C of the Individuals with Disabilities Education Act (IDEA); and
the needs of the child’s family related to enhancing the child’s development and that are selected in collaboration with the parent. The
US Department of Education has established a benchmark of 2% of the birth to three population should be eligible for and receiving
early intervention services
Children with Special Health Care Needs Table 3: Number of Minnesota Children (birth to 3) with
Special Health Care Needs, Number of Minnesota Children (birth to 3) Receiving Early Intervention
Services as of December 1, 2003 by State and County
State of Minnesota
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
Carver
Cass
Chippewa
Chisago
Clay
Clearwater
Cook
Cottonwood
Crow Wing
Dakota
Dodge
Douglas
Faribault
Fillmore
Freeborn
Goodhue
Grant
Hennepin
Houston
Hubbard
Isanti
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Koochiching
Lac Qui Parle
Lake
Estimated Number of
children birth to three with a
special health care need1
11,813
26
776
63
102
94
9
115
45
64
209
55
20
114
77
20
7
26
128
920
45
63
27
42
58
91
10
2908
38
33
74
76
18
34
91
8
24
12
16
Lake of the Woods
Le Sueur
Lincoln
2004 Minnesota County Health Tables
6
60
10
Number in Early
Percentage of the Total Birth to Three
Population Served By Early Intervention
Intervention2
3,523
1.79
5
1.16
299
2.31
23
2.18
30
1.76
35
2.23
5
3.23
71
3.69
21
2.77
19
1.78
66
1.90
15
1.63
5
1.47
17
0.90
46
3.59
3
0.90
0
0.00
13
2.97
44
2.07
295
1.92
20
2.64
24
2.30
13
2.90
7
1.01
21
2.16
27
1.78
2
1.19
702
1.45
21
3.35
15
2.76
21
1.71
28
2.22
6
1.95
10
1.78
18
1.18
2
1.45
5
1.27
7
3.57
5
1.91
2
1.89
26
2.59
4
2.40
G-7
Lyon
57
McLeod
90
Mahnomen
14
Marshall
17
Martin
43
Meeker
53
Mille Lacs
46
Morrison
76
Mower
93
Murray
16
Nicollet
67
Nobles
53
Norman
10
Olmsted
333
Otter Tail
101
Pennington
29
Pine
52
Pipestone
20
Polk
49
Pope
19
Ramsey
1314
Red Lake
9
Redwood
31
Renville
34
Rice
124
Rock
20
Roseau
35
St. Louis
341
Scott
314
Sherburne
201
Sibley
32
Stearns
305
Steele
82
Stevens
17
Swift
18
Todd
47
Traverse
5
Wabasha
47
Wadena
27
Waseca
42
Washington
495
Watonwan
30
Wilkin
13
Winona
91
Wright
266
Yellow Medicine
21
Source: 1National Survey of Children with Special Health Care Needs. (estimated)
Education Policy Division
2004 Minnesota County Health Tables
19
2.01
27
1.80
4
1.71
5
1.79
13
1.80
19
2.14
24
3.16
23
1.82
26
1.68
3
1.13
29
2.59
11
1.24
3
1.74
75
1.35
30
1.78
12
2.47
7
0.80
9
2.66
22
2.71
5
1.56
362
1.65
2
1.38
4
0.77
7
1.25
45
2.18
3
0.91
11
1.88
70
1.23
91
1.74
80
2.38
14
2.61
93
1.83
27
1.97
2
0.72
3
1.03
19
2.43
1
1.14
10
1.27
11
2.44
21
2.97
142
1.72
12
2.42
2
0.95
26
1.72
93
2.10
8
2.27
2
Minnesota Department of Education, Special
G-8
Follow-Along Program
The Follow-Along Program (FAP) provides a means for counties to track children who may be "At-Risk" for developmental
delay due to a number of physical, sociological and environmental factors.
Children with Special Health Care Needs Table 4: Number of Minnesota Children (Birth to
Three) Tracked by Follow Along Program through the Minnesota Department of Health on June
30, 2004
State of Minnesota
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
Carver
Cass
Chippewa
Chisago
Clay
Clearwater
Cook
Cottonwood
Crow Wing
Dakota
Dodge
Douglas
Faribault
Fillmore
Freeborn
Goodhue
Grant
Hennepin
Houston
Hubbard
Isanti
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Koochiching
Lac Qui Parle
Lake
Total birth to three population
196,886
432
12,929
1,053
1,707
1,566
155
1,924
757
1,069
3,479
919
339
1,894
1,282
333
116
437
2,125
15,339
758
1,044
448
696
973
1,518
168
48,469
626
543
1,230
1,264
308
562
1,522
138
393
196
262
Lake of the Woods
Le Sueur
Lincoln
Lyon
2004 Minnesota County Health Tables
106
1,002
167
943
Number
16,622
235
404
no data available
63
234
Included With Chippewa
655
634
281
169
59
131
215
251
81
not particiapting
137
355
575
67
261
not particiapting
99
69
286
115
827
183
105
207
399
Included With Cottonwood
342
130
10
6
Included With Chippewa
17
80
137
234
366
Percent
8.4
54.4
3.1
no data available
3.7
14.9
Included With Chippewa
34.0
83.8
26.3
4.9
6.4
9.8
11.4
19.6
24.3
0.0
18.4
16.7
3.7
8.8
25.0
0.0
14.2
7.1
18.8
68.5
1.7
29.2
19.3
16.8
31.6
Included With Cottonwood
60.9
8.5
7.2
1.5
Included With Chippewa
6.5
75.5
13.7
30.4
38.8
G-9
McLeod
1,501
371
Mahnomen
234
no data available
Marshall
279
202
Martin
723
not particiapting
Meeker
886
283
Mille Lacs
760
192
Morrison
1,267
433
Mower
1,550
no data available
Murray
265
Included with Lincoln
Nicollet
1,120
562
Nobles
889
264
Norman
172
no data available
Olmsted
5,552
251
Otter Tail
1,681
627
Pennington
486
124
Pine
871
162
Pipestone
338
Included with Lincoln
Polk
812
71
Pope
321
118
Ramsey
21,893
no data available
Red Lake
145
no data available
Redwood
519
159
Renville
559
23
Rice
2,065
505
Rock
331
Included with Nobles
Roseau
585
33
St. Louis
5,687
207
Scott
5,232
82
Sherburne
3,357
331
Sibley
536
390
Stearns
5,082
not particiapting
Steele
1,373
344
Stevens
279
188
Swift
292
Included With Chippewa
Todd
782
279
Traverse
88
71
Wabasha
786
303
Wadena
451
31
Waseca
706
71
Washington
8,242
679
Watonwan
495
265
Wilkin
210
106
Winona
1,516
145
Wright
4,425
178
Yellow Medicine
352
Included With Chippewa
Source: Minnesota Department of Health, Minnesota Children with Special Health Needs
24.7
no data available
72.4
0.0
31.9
25.3
34.2
no data available
Included with Lincoln
50.2
21.6
no data available
4.5
37.3
25.5
18.6
Included with Lincoln
8.7
36.8
no data available
no data available
30.6
4.1
24.5
Included with Nobles
5.6
3.6
1.6
9.9
72.8
0.0
25.1
67.4
Included With Chippewa
35.7
80.7
38.5
6.9
10.1
8.2
53.5
50.5
9.6
4.0
Included With Chippewa
Children Tracked by Follow-Along Programs: A number of procedures (Ages and Stages Questionnaire, phone calls and
letters) for maintaining contact with a family with “at-risk” children for monitoring the child’s development and needs of the
child and/or family. State total includes Fond Du Lac Human Services Division (n=153)
2004 Minnesota County Health Tables
G-10
Maternal and Child Health Tables
Supplemental Security Income (SSI) or Tax Equity and Fiscal Responsibility Act (TEFRA)
SSI and TEFRA require the same level of disability for medical eligibility. In addition to meeting
medical eligibility criteria, there is financial eligibility criteria which must be met to receive SSI.
Changes in the SSI implemented in 1997 decreased the number of children eligible for the program.
Revisions in TEFRA eligibility now require that children meet a “level of care” criteria and this has also
reduced the number of children eligible for the program
Children with Special Health Care Needs Table 5: Number of Minnesota Children
Eligible or on Supplemental Security Income (SSI) or Tax Equity and Fiscal
Responsibility Act (TEFRA) by State and County
State of Minnesota
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
Carver
Cass
Chippewa
Chisago
Clay
Clearwater
Cook
Cottonwood
Crow Wing
Dakota
Dodge
Douglas
Faribault
Fillmore
Freeborn
Goodhue
Grant
Hennepin
Houston
Hubbard
Isanti
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Children under 18 with a
functional limitation as of
December, 2003
31,219
76
2,147
187
274
231
31
283
149
189
573
158
73
313
291
51
24
71
337
2,577
129
184
87
126
175
270
33
6,634
122
103
222
243
61
97
251
29
2004 Minnesota County Health Tables
Children under 18 Children under 19 Years
on TEFRA as June 30,
Years on SSI as of
2004
December, 2003
9,593
2,478
26
3
321
186
73
13
173
8
42
34
14
1
121
30
32
19
69
12
30
42
82
4
18
5
52
20
131
26
28
2
4
1
29
1
103
25
302
331
25
4
58
16
25
11
32
10
59
4
56
17
6
2
2,951
411
21
6
45
5
32
12
93
10
16
1
22
5
62
23
5
0
G-11
Maternal and Child Health Tables
Koochiching
Lac Qui Parle
Lake
76
25
43
14
56
9
Lake of the Woods
24
4
Le Sueur
165
36
Lincoln
33
5
Lyon
150
48
McLeod
233
34
Mahnomen
35
8
Marshall
56
14
Martin
121
65
Meeker
143
17
Mille Lacs
146
38
Morrison
209
40
Mower
233
100
Murray
50
13
Nicollet
175
47
Nobles
129
46
Norman
41
12
Olmsted
836
214
Otter Tail
330
93
Pennington
76
25
Pine
160
44
Pipestone
57
16
Polk
177
52
Pope
61
14
Ramsey
3,174
1,789
Red Lake
24
3
Redwood
97
28
Renville
103
26
Rice
347
72
Rock
57
10
Roseau
112
18
St. Louis
1,017
479
Scott
790
52
Sherburne
524
64
Sibley
97
18
Stearns
811
274
Steele
225
51
Stevens
47
14
Swift
57
19
Todd
148
45
Traverse
22
4
Wabasha
136
22
Wadena
82
34
Waseca
116
29
Washington
1,456
103
Watonwan
76
17
Wilkin
44
13
Winona
256
90
Wright
723
96
Yellow Medicine
62
22
Source: Minnesota Department of Health, Minnesota Children with Special Health Needs
2004 Minnesota County Health Tables
4
4
7
2
21
0
9
17
3
0
7
12
15
21
18
2
20
15
5
58
32
5
4
4
10
2
180
3
12
8
33
3
4
73
112
55
9
124
30
2
6
11
1
7
1
10
111
3
2
17
53
4
G-12
Maternal and Child Health Tables
Estimated Number of Children with Functional Limitations: Number of children under the age of 18, based
upon the Slaits CSHCN survey Minnesota survey results who are limited or prevented from doing things other
children do because of a condition that has lasted or is expected to last more than one year
Children on SSI: Actual number of children under the age of 18 who met both the medical and financial criteria
for SSI in December, 2003. Total includes children whose county of residence is not known.
Children on TEFRA: Actual number of children under the age of 19 who were participating in the TEFRA
program on June 30, 2004. State total include 7 children out-of-state.
*Includes children whose county of residence is not known.
2004 Minnesota County Health Tables
G-13