you & me affirm ah ha! squirm disagree who you are? experts in the room about me!
TRANSCRIPT
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You & Me
•Affirm
• Ah ha!
•Squirm
•Disagree
Who You Are?
Experts in the Room
About me!
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Transition to Adulthood
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Growing Up Ready to LIVE!
Health & Wellness + Humor
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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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What would you think
a group of “successful”
adults with disabilities
would say is the most
important factor
that assisted them
in being successful?
6 Choices
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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
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Family
Aspirations &
Expectations
• Aspirations Youth (Opportunity to Try)
• ExpectationsAdults (Raising the bar)
• HEALTHY - How to stay well for longer periods
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Youth With Disabilities Stated Needs for Success in Adulthood
PRIORITIES:
1 Career development (develop skills for a job and how to find
out about jobs they would enjoy)
2 Independent living skills
3 Finding quality medical care (paying for it; USA)
4 Legal rights
5 Protect themselves from crime (USA)
6 Obtain financing for school (USA)SOURCE: Point of Departure, a PACER Center publication Fall, 1996
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Survey - 1300 YOUTH with SHCN / disabilities
Main concerns for health:
• What to do in an emergency,
• Learning to stay healthy*
• How to get health insurance*,
• What could happen if condition
gets worse.
SOURCE: Joint survey - Minnesota Title V CSHCN Program and the PACER Center, 1995
*SOURCE: National Youth Leadership Network Survey-2001300 youth leaders disabilities
Youth are Talking: Are we listening?
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Why Do People Work?
Money
Self-Esteem
Friends
Why do people with disabilities work?
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Outcome Realities
• Nearly 40% of youth with SHCN cannot identify a primary care physician
• 20% consider their specialist to be their ‘regular’ physician
• Primary health concerns are not being met
• Fewer work opportunities, lower high school grad rates and increased drop out from college
• YSHCN are 3 X more likely to live on income < $15,000
CHOICES Survey, 1997; NOD/Harris Poll, 2000; KY TEACH, 2002
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Hmmmm…….
Reactions?
Discussion
First thoughts?
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Health & Transition
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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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CORE National Performance Measures
Transition & ………
1. Family
2. Screening
3. Medical Home
4. Health Insurance
5. Community
6. Transition
1.Youth Involvement
2.Secondary Disabilities
3.Peds to Adult
4.Extend Dependent Coverage
5.Entitlement to Eligibility
6. Inclusion in Community
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Screening
SECONDARY DISABILITIES
- Prevention/Monitor
- Mental Health - High Risk Behaviors
AGING & DETERIORATION - Info long-term effects (wear & tear; Rx, health cx)
- New disability issues & adjustments
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Screen for Life Areas
How does health affect:
• Employment
• Leisure, Recreation
• Community: transportation, housing,
activities
• Higher Education or Training
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Screen for All Health Needs
• Hygiene (look good, feel good, smell good)
• Nutrition (Stamina, Bowel Management, obesity, etc.)
• Exercise (fitness and stamina)
• Sexuality Issues (masturbation, STIs, GLBT)
• OB-GYN (Routine care, Birth Control, Rape)
• Mental Health (genetic, situational)
• Routine (Immunizations, Blood-work, Vision, etc.)
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Health Insurance
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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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TICKET TO WORK http://www.socialsecurity.gov/work/aboutticket.html
Employment Network (EN) of their choice to obtain employment services, vocational rehabilitation services, or other support services to help the beneficiary find and maintain employment
MEDICARE (SSDI) Premium-free coverage for 4.5 years beyond the
current limit for disability beneficiaries who work.
Medicaid (SSI) Most States have the option of providing Medicaid
coverage to more people between the ages of 16-64 with disabilities who work.
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This bottle of Natural Spring Water
is provided as a service for our guest.
If consumed, $5.25 will be billed to your room.
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Case Study
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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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Tools
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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 refills 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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Little Miss-Matched
5M
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What would
you do,
if you thought
you could not fail?
