A project team at Children's Hospital Corporation in Boston determined how to organize, deliver, and finance services for technology-dependent children who have made the transition from hospital to the public schools. These are children who are on long-term oxygen therapy, ventilatory assistance, intravenous feedings, and other types of highly technical care. Then they replicated the project.

Key Results: The project:

• Established a model program in the Boston public schools with a nurse coordinator responsible for the intake, planning, and monitoring of 150 technology-dependent children.
• Carried out a training program at Children's Hospital for about 30 Boston public school nurses.
• Created a resource library for school nurses.
• Conducted a study of financial issues concerning parents of children with special health care needs in Boston public schools.

Based on results of the pilot project in Boston, the model was replicated at five additional sites: Nevada/Placer County, Calif.; Lowell, Mass.; New York City; Wake County, Raleigh, N.C.; and Norfolk, Va.

• The Lowell and Wake County sites institutionalized full services based on the Boston model.
• Nevada/Placer County replicated parts of the program.
• Norfolk concentrated on developing a management information system for children with chronic illness.
• The size and complexity of the New York school system proved a challenge, and the New York project took only small steps toward replicating the Boston model.

The grantee organization produced a revised edition of a manual it had developed earlier—Children and Youth Assisted by Medical Technology in Educational Settings: Guidelines for Care—to support the replication efforts of the project.