www.hrtw.org the ultimate outcome: transitions to living! ready, set, keep that job! understanding...
TRANSCRIPT
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, MedCo-Director, HRTW
National Resource CenterBangor, ME
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……….
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What would you think
a group of “successful”
adults with disabilities
would say is the most
important factor
that assisted them
in being successful?
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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
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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
www.hrtw.org
Definitions
Health & Transition
Prep for the Difference
Health Insurance
Tool
Case Study
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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.
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Disabled?? Special Health Care Needs?
HEALTH SERVICESChildren & 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
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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.
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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
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Definitions
Health & Transition
Prep for the Difference
Health Insurance
Tools
Case Study
www.hrtw.org
Pediatric Adult
Age-relatedGrowth& development, future focussed
Maintenance/decline:Optimize the present
Focus Family Individual
ApproachPaternalisticProactive
Collaborative,Reactive
Shared decision-making With parent With patient
Services Entitlement Qualify/eligibility
Non-adherence >Assistance > tolerance
Procedural Pain Lower threshold of active input
Higher threshold for active input
Tolerance of immaturity Higher Lower
Coordination with federal systems
Greater interface with education
Greater interface with employment
Care provision Interdisciplinary Multidisciplinary
# of patients Fewer Greater
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Shared Decision Making
Provider Parent Young Person
Major responsibility
Provides care Receives care
Support to parent and child
Manages Participates
Consultant Supervisor Manager
Resource Consultant Supervisor
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Levels of Support
Levels of Support Family Role Young Person
Independent Coach
Can do or can direct others
Interdependent ConsultantCoordinates
Can do or can direct others
May need support in some areas
Dependent ManagesCoordinates
expand circle of support
Needs support full-time -all areasexpand circle of support
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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
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Definitions
Health & Transition
Prep for the Difference
Health Insurance
Tools
Case Study
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
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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
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Definitions
Health & Transition
Prep for the Difference
Health Insurance
Tools
Case Study
www.hrtw.org
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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
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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)
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Skills Before10
Before 18
• Carry and present insurance card X
• Know wellness baseline, Dx, Meds X X
• Make own Doctor appts X
• Call in Rx X
• Learning Choice X
• Decision making (assent to consent) X
• Prepare for Doc visit: 5 Qs X X
• Present Co-pay X X
• Assess: Insurance, SSI, VR X
• Gather disability documentation X
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Definitions
Health & Transition
Prep for the Difference
Health Insurance
Tools
Case Study
www.hrtw.org
Screen for Life Areas
How does health affect:
• Employment
• Leisure, Recreation
• Community: transportation, housing,
activities
• Higher Education or Training
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Health Affects Everything!
Joe’s Story
• Great job
• Excellent training
• Own apartment
• Good social life
Then what…………………….???
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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?
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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?
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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?
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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?
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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?
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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
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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.
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What would
you do,
if you thought
you could not fail?
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