he Child Health Clinics provide primary health care services to 78,000 New York City children every year, care that in many cases is otherwise not available, because most of these children are uninsured. Citizens’ Committee for Children of New York, Inc. (CCC) convened a Task Force of members of its Board of Directors and its Advocacy Council to conduct a study of Child Health Clinic staffing, services, policies and proce- dures throughout the City in January and February 1999. The purpose of the study was to examine whether the New York City Health and Hospitals Corporation (HHC) is fulfilling the clinics’ dual public health and primary care missions while maintaining high quality and open access for low-income and immigrant children, regardless of their insurance status. The study was undertaken in the context of a number of significant shifts in the health care field, including: the development and expansion of eligibility for publicly funded health insurance to children that has given low-income families more options in choosing health care providers; the growth in use of medical-home primary care models in providing health care to children; and, the impact of the advent of managed care in public sector programs, both on service delivery systems and on payment for services. The clinics have undergone significant administrative restruc- turing as well in their transfer from the City Department of Health (DOH) to HHC in 1994, and their integration into HHC’s geographic networks in 1997 and 1998. CCC’s study surveyed nineteen Child Health Clinics and five pediatric divisions of 1 Communicare HHC networks. Findings from the study showed that overall administrative support for the clinics from the HHC network offices is, with some excep- tions, strong, and that the clinics provide a range of primary care services on a day-to-day basis. However, it was also clear that there are a number of areas in which the clinics would benefit from operational improvements, and in which HHC’s ability to plan child health services must be strengthened to ensure that the clinics continue to provide high quality services to children in need of a primary care provider. Selected findings from CCC’s study, along with accompanying recommendations, are summarized below:

• CLINICS PROVIDE A FULL RANGE OF PREVENTIVE AND PRIMARY CARE SERVICES AND MEET AMERICAN ACADEMY OF PEDIATRICS AND MEDICAID EARLY, PERIODIC, SCREENING, DIAGNOSIS AND TREATMENT (EPSDT) STAND ARDS.
• MANY CLINICS NOW SERVE ADOLESCENTS.
• MOST CLINICS PROVIDE SOME ASSISTANCE IN SECURING INSURANCE COVERAGE.
• CLINICS COULD BEA SOURCE OF HEALTH CARE FOR MORE CHILDREN IN FOSTER CARE.
• MANY CLINICS RUN OUT OF SUPPLIES AND MEDICATIONS.
• MANY CLINICS DO NOT MAKE HOME VISITS.
• CLINICS MAY BE UNDERUTILIZED.
• PHYSICAL PLANTS VARIED GREATLY; SOME CLINICS HAD SIGNIFICANT EQUIPMENT AND STRUCTURAL PROBLEMS.
• SYSTEM OVERSIGHT AND PLANNING NEEDS STRENGTHENING.