Planning for a Healthy Transition Health Care Concepts for Youth
February 17, 2017 Tamara Bakewell, Family Involvement Coordinator, Oregon Center for Children and Youth with Special Health Needs
Conflict of Interest Statement • I have had no relevant financial relationships with commercial interests over the last 12 months. • I will present a balanced view of diagnostic or therapeutic options. • This presentation does not contain trade names or promotes specific companies or products. • This presentation does not contain advertising.
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Today’s Objectives: • Explore concepts in health care transition as they relate to vocation or continuing education •
Learn what a Medical Home is for youth with
special health care needs • Learn resources to promote health and wellness in
young adults who experience special needs
Part 1: Setting the stage: new thinking about health care transition
What families say: “Not looking forward to my child turning 18.”
“How am I supposed to find a doctor who understands my child as well as his pediatrician did?” “It’s easier to keep her going to the pediatrician.”
Turning 18: •
Eighteen year olds are recognized as competent adults by law, and remain so unless found incapacitated by a court of law.
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Without the court's determination that an individual is incapacitated, the individual retains all his or her constitutional rights and is responsible for making his or her own decisions. These rights include the rights to decide residence, consent to or reject medical care, sign a contract, marry, and make lifestyle choices. (1)
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Guardianship orders should be tailored to meet the actual mental and physical limitations so that the scope of guardianship is the least restrictive possible. (2)
1)
http://www.thearcoregon.org/what-we-do/gaps/about-guardianship
2)
Disability Rights Oregon; Guardianship Handbook, Third Edition
What transitions do we prepare kids for? Babies Diapers to Potty Chair High Chair to Big Table Crib to Bed
Teen Years Bicycle to Car Piggy Bank to Debit Card High school to Work or college
School Age Home to School Walking to Bicycle
Why not prepare them for… • Having an insurance card? • Finding a doctor or dentist? • Getting a counselor? • Advocating for themselves within health care? • Understanding how to pay for a doctor’s appointment? • What to do in an emergency?
Think about…
Think about when you went to the doctor for the first time by yourself without your parents. What brought you there? How did you know where to go? How did you pay for it?
If it ain’t broke, why fix it? Families often report that they are planning to have their child continue to receive care from their pediatrician. What are your thoughts about this? Pros • • • • • •
Cons • • • • • •
Part 2 The business of the health care transition: Who does what?
Transition is a four-way collaboration • Share Voice • Plan • Take Responsibility
• Collaborate • Learn • Prep • Communicate
• Search • Plan • Gather Resources
Young Adult
Family
Adult Provider
Pediatrician • Assist • Plan • Handoff
Family Check for readiness- yours and theirs! Launch search for a new provider Develop transfer plan with pediatrician Gather resources for new provider Make a one-page profile for the Medical Home if your child cannot communicate on his own behalf
Pediatrician/current provider Bring up the subject of transition with you and youth Assist with readiness checklists Assist in selection of adult provider Create a “Transfer package” Health Care Transition Action Plan Portable Medical Summary Emergency Plan Referral Letter for Transfer of Care
Make the “warm handoff” with letter of introduction. Consult with new provider for a defined period of time
New Provider Work with parent and pediatrician during transition planning Learn about the youth as well as his condition
Prepare office and medical staff, if necessary, about accommodations, if needed. Work with parent to establish communication pathways that meet the needs of young adult, provider, and parent. Ensure office staff use them
Most important: Be the “Medical Home”
Coordinated: Help me navigate to get all I need
Every youth deserves a Medical Home that is:
Continuous: Work with me over time
Compassionate: Care about me as a person
Culturally Effective: Speak so I can understand you Accountable: Give me quality care
Comprehensive: I can get all I need when I need it
Accessible Be there when I need you
In Oregon, we call these
www.oregon.gov/oha/pcpch/Pages/recognized-clinics.aspx
And - the Young Adult has a role, too Begin to take, or continue to build, reasonable responsibility for own health care, no matter how small.
Think of a young person you work with. (Don’t name them.) What kinds of things can he or she do right now to promote his or her own health?
Part 3 Health and Vocation: What’s the connection? 1) Read scenario in your group. 2) In what ways could a relationship with a Medical Home impact these employment issues? 3) What, if anything, is the employer’s role?
Some transition basics Carry current insurance card Know the name of doctor or clinic and what town Know names of medications and/or diagnoses Employer has current emergency contact Carry emergency information (Blood type, allergies, etc) Know what to do if not feeling well at work or school Name of someone (Human Resources?) to help with
understanding insurance plan Your ideas?
And last…
Some Resources
Please note: These resources are not all-inclusive. They are a starting place for families and providers. Inclusion in this presentation does not imply endorsement by the OR F2F HIC, OCCYSHN, OHSU, or our project’s funder, the United States Government.
After the PPACA, these items and more are paid for by insurance policies:
Screenings*
Treatments/Services*
Tobacco, Alcohol Depression Sexually Transmitted Infections Cholesterol Diabetes Type 2
Well-woman visits Diet counseling Obesity screening and counseling Contraception Tobacco Cessation
Why are annual visits to the Medical Home be important for a healthy youth?
*Partial List. Older policies may not provide these protections. Call your health plan for confirmation.
Youth can always find care at: Federally Qualified Health Centers
School Based Health Centers
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Available to all residents, regardless of ability to pay
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Staffed like local pediatric or family practice clinics
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Sliding scale with discounts based on family size, etc.
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Preventive services, treatment, dental
Provide prevention and health education such as obesity and tobacco prevention
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Mental health services and referrals, including help with bullying and suicide prevention
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More than 60 clinics located all over Oregon
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30 clinics, over 100 locations in Oregon
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Sometimes called Community Health Centers www.findahealthcenter.hrsa.gov
www.osbha.org
Funding Sources Brochure Collection of special needs-related foundations; all with different requirements
855-323-6744 www.oregonfamilytofamily.org
• Webinars/print materials for patients and provider
• Patient assistance programs • Condition Specific Resources – Searchable data base Spend 30 minutes with this site. Lots to bookmark!
– Camps – Family support – Medication information
• Drug Discount Cards • Scholarship information
PLAIN LANGUAGE Visual Cues and Storyboards
http://www.oregon.gov/oha/pcpch/Pages/recog nized-clinics.aspx
Free to download.
Chapters: • “What’s that smell?” • “Bras, Tampons, Pads” • “Boxers or Briefs” • “Nocturnal Emissions” • “Oh please, not here!” • more
Thank You Need more resources? Tamara Bakewell Family Involvement Coordinator
[email protected]