Got Healthcare?
Self-Management
Skills for Health Care
Antoinette W. Coward, M.S., M.C.H.E.S.
Health Care Transition Coordinator
Office for Genetics and People with Special
Health Care Needs
Maryland Department of Health and Mental
Hygiene
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 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 helping young people with
special health care needs plan their move from the
child-centered health care system to the adultcentered 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…
• 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 selfmanagement skills and knowledge
78.8
78.0
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 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.
Medicaid
• 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
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
Health 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
with 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 . . .
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 . . .
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 Resources
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 Transitions
http://healthytransitionsny.org/skills_media/tool_show
• My Med Schedule
http://www.mymedschedule.com/
Teen Care Notebook
http://cshcn.org/planning-record-keeping/teen-carenotebook
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
Families
•
My Health Care Notebook
http://fha.dhmh.maryland.gov/genetics/SitePages/care_notebo
ok.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 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
• National Health Care Transition Center: Got Transition
http://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/HCTClini
calReporteversion27June2011.pdf“
http://www.gottransition.org/provider-information OR google “Got Transition?”
Sample Health Care Transition
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
Transition
• 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
Transition
• 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
Transition
• 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 Resources
• Who helps you?
– New responsibilities
– Practicing Independence
– Taking Charge
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?
For questions or additional information,
contact:
Antoinette W. Coward
Office for Genetics and Children with Special Health Care
Needs at antoinette.coward@maryland.gov or
410-767-5602