Whats Health Got to Do with Transition Everything

1
AMCHP 2004
Whats Health Got to Do with Transition?
Everything!
2
Who Are the Children Youth?

• CYSHCN Children and youth with special
  health care needs are those who have or are at
  increased risk for a chronic physical,
  developmental, behavioral, or emotional condition
  and who also require health and related services
  of a type or amount beyond that required by
  children generally.

3
How many CYSHCN

• Title V CYSHCN 970,044 (0-18)
• (Title V Block Grant FY 2000
  Annual Report / FY 2002 Application
• Most State Title V CSHCN
  Programs end at age 18)
• SSI Recipients 959,379 ( 0-17)
• 
  321,114 (13-17)
• 
  243,689 (18-21)
• 
  460,019 (22-29)
• SOURCE SSA, Children
  Receiving SSI, December 2002, 2003

4
Mandates for the System

• Amended Legislation for Title V of the Social
  Security Act (1989)
• Facilitate the development of community-based
  systems
• of services
• Healthy People 2010 Objective 16-23
• Increase the proportion of States and
  territories that have
• service systems for CSHCN.
• The Presidents New Freedom Initiative (2001)
• Responsibility given to HRSA for developing and
• implementing a community-based service system

5
Delivering on the Promise (1)

• The New Freedom Initiative report
• Delivering on the Promise (March 2002)
• Reviewed barriers to community living for people
  with disabilities.
• Compiled reports from nine Federal agencies,
  including HHS.
• Charges HRSA with developing and implementing
  plan to achieve appropriate community-based
  systems for children and youth with special
  health care needs and their families.

6
Delivering on the Promise (2)

• Identified access barriers to
• Comprehensive, family-centered care
• Affordable insurance
• Early continuous screening (special health care
  needs)
• Transition services to adulthood
• Also addressed issues for families
• Complexity and organization of services resulting
  from fragmentation and multiple funding streams
• Need for family satisfaction

7
6 Core Components of Service System

• 1. Family Participation and Satisfaction
• 2. Access to Medical Home
• 3. Access to Affordable Insurance
• 4. Early and Continuous Screening
• 5. Easy-to-Access Community-Based Service
  Systems
• 6. Services Necessary to Transition to Adulthood

8
Transition Health 1980s, 1990s Now

• Surgeon General Koop - 1989 conference was
  dedicated to the transition of health care for
  YSHCN.
• MCHB - demonstration grants 1989-92
• MCHB launched Healthy Ready to Work initiative
  Because Everyone Deserves a Future.
• 1996-2001gt Phase 1 9
  Demonstration Sites
• 2001-2005gt Phase 2 6 State
  Implementation

9
HRSA/MCHB funded HRTW Projects

10
HRTW Team Experienced, Creative Can Do!
MCHB/DSCSHN- Monique Fountain, MD
PACER,MN - Ceci Shapland
AED-DC - Carol Valdivieso Cythnia Glimpse AED-FL
- Patti Hackett
info_at_hrtw.org
Comm for CSHCN, KY- Kathy Blomquist Shriners
Hospitals for Children - Betty Presler
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HRSA/MCHB Performance Measure 6 Transition

• TRANSITION TO ADULTHOOD
• All youth with special health care needs
  (YSHCN) will receive the services necessary to
  make transitions to all aspects of adult life,
  including adult health care, work, and
  independence. (2002)

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Outcomes Performance Measure 6 Transition to
Adulthood

• HRTW Systems Development
• Youth Participation in Decision Making
• Accessible Affordable Health Insurance
• Medical Home / Adult Health Care
• Education, Employment, Independent Living
• and Recreation