Public Health

1
Public Health Youth Transition Core Functions
and Practices

• John Reiss, Ph. D.
• Director of Policy and Program Affairs
• Institute for Child Health Policy
• jgr_at_ichp.edu

2
USA Demographics - Youth

• 25.1 million youth, age 15-21 years
• 3 million (12) have a disability (94-95 Census)
• 15.3 million youth, age 15 - 17
• 3.2 M (21) have a special health need (NHIS on
  Disability, 1994)

3
Survival

• 90
• CYSHCN
• Reach
• Age 21

4
Health Employment
5
Transition to Adult Providers
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6
Health Care Medical Home for YouthAssessment

• Medical home addresses youths comprehensive
  needs in age/developmentally appropriate
  settings
• Child-centered (pediatric) adult-oriented
  providers, programs systems are organized,
  financed and receive training to provide a
  medical home
• Transition to adult primary and specialty
  providers is planned and occurs as a matter of
  routine.

7
Health Care Medical Home Assessment

• Provider Interest
• Knowledge and Skills
• Training and Experience
• Infrastructure and Support
• Opportunities for Peds-Adult Interaction
• Transition and Continuity of Care Models

8
Health Care Medical Home Assessment

• Are Facilities and Programs Barrier Free?
• Physical and Environmental Setting
• Communications Methods
• Cultural Relevance
• Attitudes
• Expectations

9
Policy Development Assurance
10
Health Care Medical Home Policy Development
Assurance

• Collaborate with youth family leaders
  withPeds, FP, IM other adult providers
• Enforce ADA access accommodation mandates
• Raise awareness
• Provide training and TA
• Transition Information Referral
• CME and licensure requirements

11
Health Insurance Assessment of Access
Coverage

• Personal health services and supports
• Youth family education
• Psychosocial supports
• Prevention of secondary conditions
• Coordination of services
• Supports well-being quality of life
• Facilitates participation in education, work and
  community

12
Health Insurance Assessment of Access Coverage

• Network capacity for children, youth adults
• Providers, facilities and programs Coordination
  across plans
• Pro-active transfer between plans
• Funding of transfer to adult health care
• Consultation with adult primary care
• Co-management
• Documentation Transition plan development

13
Health Insurance Assessment of Access Coverage

• Life-time benefits caps
• Co-payment requirements
• Limits on benefits - amount, duration scope
• Rehab - Yes Habilitation - No
• Changing eligibility status
• Family coverage
• Residence
• Work and Income

14
Health Insurance Policy Development Assurance

• Guidance reimbursement billing codes
• Guidelines for transition process
• Medicaid, Title V, FEHBP, State Employees
• Participate in TWWIIA Medicaid buy-in
• Title V MCH Block Grant Activities
• Documentation of costs and benefits

15
Health Care TransitionPolicy Development
Assurance

• Health Care Transition for Youth
• E-mail Special Interest Group
• To join
• Join-Transition_at_list.ichp.edu