26.2 Continuum of Care Extends Beyond the Hospital: School-Based Supports for Children with Chronic, Complex Inpatient and Outpatient Care

Children and youth with special healthcare needs (CYSHCN) face chronic and systemic stress while managing complicated treatment regimens and schedules. Hospital-based school programs (HBSP) have evolved to meet the educational needs of inpatient (IP) CYSHCN; however, nationally, programs vary greatly. This session describes the work of the Riley Hospital for Children (RHC) HBSP IP and outpatient (OP) educational liaison service, sharing our program structure and impact across the state of Indiana as a possible model for other HBSP school-related services. Data comprise the education needs of IP and OP RHC HBSP patients (eg, patient characteristics, services) from 2021 to 2022. Data were collected initially forgrantreporting purposes. The session focuses on education needs, including direct instruction and providing re-entry services across IP and OP settings. RHC HBSP served 875 and 390 children on the IP (4-22 years old [M = 11.74, SD = 3.95]) and OP (4-20 years old [M = 11.07, SD = 4.15] units, respectively with hematology/oncology (19.1%), hospitalist (13.7%), neurosurgery (10.1%), general surgery (8.6%), and gastroenterology (8.2%) the top most-served IP units. One-hundred seventy-five (20%) IP patients had an individualized education program (IEP), whereas 78 (8.9%) patients had a 504 Plan at the time of admission. Eleven patients were recommended to obtain an IEP and 171 patients were recommended to obtain a 504 Plan during their admission or by the time of discharge.OP clinics included cystic fibrosis (24.9%), dialysis (8.7%), hematology/oncology (54.3%), pulmonary (2.6%), and rheumatology (9.4%). Ninety-five (24.4%) OP patients had an IEP, whereas 82 (21.0%) patients had a 504 Plan at the time of admission. Twelve patients were recommended to obtain an IEP and 159 patients were recommended to obtain a 504 Plan during their OP services. Additional information on diagnosis and other school-based services will also be provided at the presentation. CYSHCN require unique needs across inpatient and outpatient hospital settings. While a large portion of CYSHCN previously had IEPs, many more patients were assisted in obtaining 504 Plans with the help of the RHC HBSP. Patients also required continued consultation with schools postdischarge, more so than while receiving care. HBSP are an important resource to expand the continuum of care beyond the hospital setting for CYSHCN.