1. www.hrtw.org The Ultimate Outcome: Transitions to Living! Ready, Set, Keep that Job! Understanding Physical and Mental Health Needs...It's More than Work Skills Patti Hackett, Med Co-Director, HRTW National Resource Center Bangor, ME

2. www.hrtw.org Create new contact Space or Underscore ____ (this bumps listing to the top) Type “ICE – 01” – ADD Name of Person - include all ph #s - Note your allergies You can have up to 3 ICE contacts (per EMS) Do you have “ICE” in your cell phone contact list? To Program……….

3. www.hrtw.org What would you think a group of “successful” adults with disabilities would say is the most important factor that assisted them in being successful?

4. www.hrtw.org FACTORS ASSOCIATED WITH RESILIENCE for youth with disabilities: Which is MOST important?  Self-perception as not “handicapped”  Involvement with household chores  Having a network of friends  Having non-disabled and disabled friends  Family and peer support  Parental support w/out over protectiveness Source: Weiner, 1992

5. www.hrtw.org FACTORS ASSOCIATED WITH RESILIENCE for youth with disabilities: Which is MOST important?  Self-perception as not “handicapped”  Involvement with household chores  Having a network of friends  Having non-disabled and disabled friends  Family and peer support  Parental support w/out over protectiveness Source: Weiner, 1992

6. www.hrtw.org Definitions Health & Transition Prep for the Difference Health Insurance Tool Case Study

7. www.hrtw.org Disability is …… a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society.

8. www.hrtw.org Disabled?? Special Health Care Needs? HEALTH SERVICES Children & Youth with Special Health Care Needs (CYSHCN) - Genetic - Chronic Health Issues - Acquired EDUCATION SERVICES - Youth with Disability - Youth with Health Impairment ADA & 504 - Disability and/or Health Impairment

9. www.hrtw.org

10. Health Impacts All Aspects of Life Success in the classroom, within the community, and on the job requires that young people are healthy. To stay healthy, young people need an understanding of their health and to participate in their health care decisions.

11. www.hrtw.org CORE National Performance Measures Transition & ……… 1. Screening 2. Family 3. Medical Home 4. Health Insurance 5. Community Services 6. Transition SOURCE: BLOCK GRANT GUIDANCE New Performance Measures See p.43 ftp://ftp.hrsa.gov/mchb/blockgrant/bgguideforms.pdf

12. www.hrtw.org Definitions Health & Transition Prep for the Difference Health Insurance Tools Case Study

13. www.hrtw.org PediatricAdult Age-related Growth& development, future focussed Maintenance/decline: Optimize the present FocusFamilyIndividual Approach Paternalistic Proactive Collaborative, Reactive Shared decision-makingWith parentWith patient ServicesEntitlementQualify/eligibility Non-adherence>Assistance> tolerance Procedural PainLower threshold of active input Higher threshold for active input Tolerance of immaturityHigherLower Coordination with federal systems Greater interface with education Greater interface with employment Care provisionInterdisciplinaryMultidisciplinary # of patientsFewerGreater

14. www.hrtw.org Shared Decision Making ProviderParentYoung Person Major responsibility Provides careReceives care Support to parent and child ManagesParticipates ConsultantSupervisorManager ResourceConsultantSupervisor

15. www.hrtw.org Levels of Support Family RoleYoung Person IndependentCoach Can do or can direct others Interdependent Consultant Coordinates Can do or can direct others May need support in some areas DependentManages Coordinates expand circle of support Needs support full-time -all areas expand circle of support

16. www.hrtw.org FAMILIES: Prepare for Changing Roles Temporary spokesperson on behalf of minor child (until age 18, or declared by the court) - 2 voices to be heard: families and CY - Circle of Support - Assent to Consent handout: Changing Roles

17. www.hrtw.org Definitions Health & Transition Prep for the Difference Health Insurance Tools Case Study

18. www.hrtw.org Transition & ……Insurance NO HEALTH INSURANCE 40% college graduates (first year after grad) 50% HS grads who don’t go to college 40% age 19–29, uninsured during the year 2x rate for adults ages 30-64 Source: Commonwealth, 2003, 2005

19. www.hrtw.org Extended Coverage – Family Plan 1. Adult Disabled Dependent Care (40 states) Incapable of self-sustaining employment by reason of mental or physical handicap, as certified by the child's physician on a form provided by the insurer, hospital or medical service corporation or health care center 2. Adult, childless continued on Family Plan Increasing age limit to 25-30 CO, CT, DE, ID, IN, IL, ME, MD, MA, MI, MT, NH, NJ, NM, OR, PA, RI, SD, TX, VT, VA, WA, WV

20. www.hrtw.org Definitions Health & Transition Prep for the Difference Health Insurance Tools Case Study

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22. Handout: Portable Medical Summary Carry in your wallet Good Days - Cheat Sheet: Use as a reference tool - Accurate medical history - Correct contact #s - Document disability Health Crisis - Expedite EMS transport & ER/ED care - Paper talks when you can not

23. www.hrtw.org Know Your Health & Wellness Baseline How does your body feel on a good day? What is your typical - body temperature - respiration count - elimination habits? - quality of skin (front and back)

24. www.hrtw.org Skills Before 10 Before 18 Carry and present insurance card X Know wellness baseline, Dx, Meds XX Make own Doctor appts X Call in Rx X Learning Choice X Decision making (assent to consent) X Prepare for Doc visit: 5 Qs XX Present Co-pay XX Assess: Insurance, SSI, VR X Gather disability documentation X

25. www.hrtw.org Definitions Health & Transition Prep for the Difference Health Insurance Tools Case Study

26. www.hrtw.org Screen for Life Areas How does health affect: Employment Leisure, Recreation Community: transportation, housing, activities Higher Education or Training

27. www.hrtw.org Health Affects Everything! Joe’s Story Great job Excellent training Own apartment Good social life Then what…………………….???

28. www.hrtw.org Assessing Health in Transition: Employment Does Joe’s health condition dictate certain work conditions? Will Joe’s medication affect his job duties? Should he disclose his health condition to the employer? Does his health dictate hours of work?

29. www.hrtw.org Post Secondary Education Does Joe need to take his medication while in class or at work? How will it affect his performance? Will Joe need accommodations in his schedule for medical treatments and/or appointments?

30. www.hrtw.org Home Living Does Joe ……. understand his seizure disorder? carry his own emergency medical information? understand the side effects of his medication? have an emergency plan? have health insurance?

31. www.hrtw.org Community Life Does Joe …….. have an adult health care practitioner? know how to communicate his health care needs? know when, how and where to fill a prescription? know how to travel to the doctor or drugstore? Does he have transportation?

32. www.hrtw.org Leisure-Recreation Does Joe understand the effects of recreational drugs or alcohol on his health and seizure disorder? Will his medication or health condition affect his choice of activities?

33. www.hrtw.org Using the IEP for Health Transition Goal: I will learn about my seizure disorder and my health needs to live more safely in the community. Objective: I will write a report for social studies on seizure disorders. I will learn three side effects of my medication

34. www.hrtw.org Using the IEP for Health Transition Objective: I will develop an emergency plan with my physician and present it to my case manager. I will identify and interview two adult physicians and choose a new adult doctor by June, 2008.

35. www.hrtw.org What would you do, if you thought you could not fail?

36. www.hrtw.org Patti Hackett, MEd Co-Director, HRTW Center Bangor, ME pattihackett@hrtw.org

37. www.hrtw.org