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Youth and Transition to Work A Health Perspective

Youth and Transition to Work A Health Perspective. Merle McPherson, MD, MPH Disability Research Institute Symposium April 2005. History. Surgeon General’s Conferences, 1982 & 1988 Title V’s Revised Legislative Mandate – OBRA 1989 Facilitate the development of community-based systems

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Youth and Transition to Work A Health Perspective

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  1. Youth and Transition to Work A Health Perspective Merle McPherson, MD, MPH Disability Research Institute Symposium April 2005

  2. History • Surgeon General’s Conferences, 1982 & 1988 • Title V’s Revised Legislative Mandate – OBRA 1989 Facilitate the development of community-based systems of services. • Healthy People 2000 & 2010 • Broad Definition of Children with Special Health Care Needs (CSHCN) Published in Pediatrics (1998)

  3. History (cont.) • Supreme Court Decision – Olmstead v. L. C. (1999) Challenges governments to develop more opportunities for individuals with disabilities through more accessible system of cost-effective community-based services. • The President’s New Freedom Initiative (2001) • Delivering on the Promise, Report to the President (2002) “HRSA’s MCHB will take the lead in developing & implementing a plan to achieve appropriate community- based services systems for children & youth with special health care needs (CYSHCN) & their families” (pg III-39).

  4. MCHB 6 Core Outcomes • Families of CYSHCN will partner in decision making & will be satisfied with the services that they receive. • CYSHCN will receive coordinated, ongoing, comprehensive care within a medical home. • Families of CYSHCN will have adequate private and/or public insurance to pay for the services that they need.

  5. MCHB 6 Core Outcomes (cont.) • Children and youth will be screened early & continuously for SHCN. • Community-based service systems will be organized so that families can use them easily. • YSHCN will receive the services necessary to make transitions to adult life, including adult health care, work, & independence.

  6. Consensus StatementAAP/AAFP/ACP 2002 • The optimal goal of health care transition is to provide health care that is family-centered, continuous, comprehensive, coordinated, compassionate, & culturally competent in a health care system that is as developmentally appropriate as it is technically sophisticated. Source: “A Consensus Statement on Health Care Transitions for Young Adults with Special Health Care Needs” Pediatrics. 2002 Dec; 110 (6 Pt 2): 1304-6.

  7. Healthy & Ready To Work (HRTW) Initiative WHY? • 90% of CYSHCN are now living to adulthood. • Employment rate for adults with disabilities hovers around 30%. • SSI disability programs continue to grow in number of recipients. • Access to health insurance, health care, & utilization of services are cited as barriers. • The transition to adulthood, including employment & independence, is a natural progression in a lifespan approach to systems of care for CYSHCN.

  8. HRTW Initiative (cont.) • MCHB Launches HRTW Initiative Phase I: 9 Demonstration Sites & 1 National Center (1996-2001) Phase II: 6 State Implementation Projects (2001-2005) & HRTW National Center (2002 – 2006) From July 2001 to September 2004, the 6 Phase II Projects reported 12,182 youth & young adults served.

  9. HRTW Initiative (cont.) • The importance of maintaining one’s health & wellness, & its role in allowing personal goals to be reached should not be understated. • Health impacts all aspects of life. • To stay healthy, people need an understanding of their health & to participate in their health care decisions. • HRTW Initiative endeavors to help develop family-centered, culturally competent systems of care.

  10. National Status By 2010 • Wellness Federal, State & community-based services are organized, financed & delivered in ways that promote & sustain the well-being of YSHCN & their integration into community activities & the workforce. • Community-Based Effective community-based systems of care for all CYSHCN through private-public partnerships are in place.

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