Got Healthcare? Got Healthcare? Self-Management Self-Management

Skills for Health Care Skills for Health Care

Antoinette W. Coward, M.S., M.C.H.E.S.Health Care Transition CoordinatorOffice for Genetics and People with Special Health Care NeedsMaryland Department of Health and Mental Hygiene

We’ll talk about:We’ll talk about:

• Health Care Transition: Being Healthy• Self-Management Skills for Health Care

– New responsibilities– Practicing independence– Taking charge

• Resources and Agencies to Support Transition

Ground RulesGround Rules

• LISTEN when someone else is talking

• RESPECT each other

• SHARE ONLY WHAT YOU FEEL is OK

• ASK for HELP as needed

Health Care Transition is:Health Care Transition is:• Health care transition is helping young people with

special health care needs plan their move from the child-centered health care system to the adult-centered health care system. Some ways that this is done include:– Current doctors and health care providers discussing

changing health care needs as youth become adults and eventually see adult providers

– Doctors and other health care providers encourage youth development toward self-management skills and knowledge

– Families, youth, and providers working together on a written Transition Plan(s)

Some quick facts…Some quick facts…• Many Maryland families report that their

YSHCN do not receive the services they need to successfully transition to health care, work, and independence.– In 2009-10 only 36.8 %; Maryland ranked 40th (NS-CSHCN)

YSHCN ages 12-17 whose families report that… Maryland % Nation %

Needed, but doctors and other health care providers have not discussed eventually seeing providers who treat adults

21.8 17.4

Needed, but doctors and other health care providers have discussed youth’s health care needs as he/she becomes an adult

26.1 30.9

doctors and other health care providers usually or always encourage development of self-management skills and knowledge

78.8 78.0

Transition Planning Transition Planning • Developing a transition plan for YSHCN is an

important tool in the process of moving to adulthood

• Including health care in the transition plan, or developing a separate health care transition plan with care providers, is crucial.

• Health care transition planning should be done by youth, families, and providers.

Health Care Transition and InsuranceHealth Care Transition and Insurance

• Maintaining and/or finding health insurance is an important consideration in health care transition.

• Talk with your benefits counselor, MCO Special Needs Coordinator, or membership services for specific information about insurance plans as youth become adults.

MedicaidMedicaid• Disabilities offer a pathway to Medicaid

eligibility in many states and the Children’s Health Insurance Program (CHIP) is specifically intended to cover uninsured children, including CYSHCN.

• States are required under the Affordable Care Act (ACA) to increase their income eligibility for Medicaid to individuals under age 65 by January 1, 2014.

• MCO Hotline: 1-800-284-4510

Health Care Reform and Transition Health Care Reform and Transition

Youth can remain on your parents insurance until age 26. • The parent’s plan must offer dependent

coverage and the parent must enroll in a family or dependent plan;

• Insurance company can not deny coverage for a pre-existing health condition.

Questions for Potential Adult Questions for Potential Adult Health Care ProvidersHealth Care Providers

• Do you take my (or my child’s) insurance?• At what age do you start accepting patients?• Are you familiar with my (or my child’s) condition?• Are you accepting new patients?• What is the average wait time for an appointment? • Is your office accessible for people with disabilities?

Family and Cultural Values to Help Family and Cultural Values to Help with Transitionwith Transition

• Respecting your family and cultural values• Timeframes for when young people start to

take more responsibility for their own care varies in different families and cultures

Successful transition means that . . .Successful transition means that . . . Young people are able to:• Access health services independently• Discuss their health condition • Communicate their health care needs• Self-manage their care or support is available• Feel comfortable seeing the doctor alone• Make health care decisions or support is in

place

Successful transition means that . . .Successful transition means that . . .

Young people: • Have insurance• Have health care that

is age appropriate • Have only as much

support as necessary because parents have to let go, too

AGES 12 – 14 “New Responsibilities” AGES 15 – 17 “Practicing Independence” AGES 18 & UP “Taking Charge

Health Care Transition Health Care Transition Resources for YouthResources for Youth

• Teen Care Notebook http://cshcn.org/planning-record-keeping/teen-care-notebook

• The Youthhood http://www.youthhood.org/

• Got Transition? http://www.gottransition.org/youth-information

• Healthy Transitionshttp://healthytransitionsny.org/skills_media/tool_show

• My Med Schedulehttp://www.mymedschedule.com/

Teen Care NotebookTeen Care Notebook http://cshcn.org/planning-record-keeping/teen-care-notebook

This resource is on the flash drive bracelets you received today.

It can help youth/young adults manage aspects of their own health care.

It contains pre-made, fillable forms for:

• Medications• Appointment Logs• Care Schedule• Home Care Providers• Hospital Information• Insurance/Funding

Sources form• Equipment and

Supplies List• And more!

http://www.youthhood.org/health/index.asp or google “youthhood”

http://www.youthhood.org/health/index.asp or google “youthhood”

http://www.gottransition.org/youth-resources or google “Got Transition?”

http://www.gottransition.org/youth-resources or google “Got Transition?”

http://healthytransitionsny.org/skills_media/tool_show or google “Healthy Transitions New York”

MyMedSchedule.com https://secure.medactionplan.com/mymedschedule/index.htm

Transition Resources for Parents and Transition Resources for Parents and FamiliesFamilies

• My Health Care Notebookhttp://fha.dhmh.maryland.gov/genetics/SitePages/

care_notebook.aspx

• Got Transition http://www.gottransition.org/families-information

• Transition to Adult Health Care: A Training Guide in Two Parts

http://www.waisman.wisc.edu/wrc/pdf/pubs/TAHC.pdf

My Heath Care NotebookMy Heath Care Notebook http://fha.dhmh.maryland.gov/genetics/SitePages/care_notebook.aspx

This resource is also on the flash drive bracelets you received today.

It can help parents manage aspects of their child and or youth’s health care.

It contains pre-made, fillable forms

http://www.gottransition.org/families-information OR google “Got Transition?”

Transition Resources for Providers Transition Resources for Providers

• National Health Care Transition Center: Got Transitionhttp://www.gottransition.org/providers-best-practices

• Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home

http://www.gottransition.org/UploadedFiles/Files/HCTClinicalReporteversion27June2011.pdf“

http://www.gottransition.org/provider-information OR google “Got Transition?”

Sample Health Care Transition Sample Health Care Transition Plan to Use with Your Physician Plan to Use with Your Physician http://www.gottransition.org/UploadedFiles/Files/4.1_Transition_Action_Plan.pdf - Link to document

Agencies to Support Health Care Agencies to Support Health Care TransitionTransition

• Maryland Department of Health and Mental Hygiene (DHMH) OGPSHCN: Provides services for children and youth with special health care needs. (http://fha.dhmh.maryland.gov/genetics)

• Maryland Department of Disabilities (MDoD) and Governor's Interagency Transition Council for Youth with Disabilities (IATC): Advances the rights and interests of people with disabilities so they may fully participate in their communities. (http://www.mdtransition.org/)

Agencies to Support Health Care Agencies to Support Health Care TransitionTransition

• Maryland Developmental Disability Council (DD Council): Provides leadership to ensure independence, productivity, integration, and inclusion of individuals with disabilities in the community through promotion of systems change. (http://www.md-council.org/ )

• Maryland Medical Care Programs: Provides patient care coverage and services. (http://mmcp.dhmh.maryland.gov/SitePages/Home.aspx )

Agencies to Support Health Care Agencies to Support Health Care TransitionTransition

• Maryland Center for Developmental Disabilities (MCDD): Provides programs and resources to people with disabilities and their families. (http://mcdd.kennedykrieger.org/ )

• Maryland State Department of Education (MSDE): Prepares children with disabilities to move from school to the appropriate postsecondary outcomes. (http://www.marylandpublicschools.org )

Circle of Support ResourcesCircle of Support Resources

• Who helps you?– New responsibilities– Practicing Independence– Taking Charge

Start small. Start slow. Start now!Start small. Start slow. Start now!How do you prepare teens/young adults to

meet the challenges of adult health care? By using ordinary, every day teaching opportunities and lots of practice.

“Just because a thing is inconceivable doesn’t mean it’s impossible.” – Lewis Carroll

Questions?Questions?

For questions or additional information, contact:

Antoinette W. CowardOffice for Genetics and Children with Special Health Care

Needs at antoinette.coward@maryland.gov or 410-767-5602