From Pediatric to Adult Care
TRANSITION TIPS
Are you the parent of a teen with special needs on the verge of adulthood? Now is the time to begin the process of moving from a child/family-centered model of health care to an adult/patient-centered model of health care. For parents and caregivers, this can be a bittersweet, but also very stressful time. That’s why it’s important that you prepare – and prepare early – for this transition.
When should my child begin the transition process?
Community First Health Plans, a locally owned and operated non-profit health plan offering health coverage for all individuals of all ages and abilities, begins preparing Members with special needs and their caregivers for a transition of care beginning at age 10. Qualifying Members are also assigned a personal Transition Specialist who will assist them throughout the process.
Why so early?
Because during this period of time, youth can be at risk of losing access to therapies, medical equipment, and other services that were covered by insurance or provided in schools. It’s important to be prepared.
Here a few helpful tips to ensure that you and your child are prepared for a transition in healthcare.
Let your child play an active role in their health care. Explain your child’s disability or illness to them and make sure they can explain it to others. Encourage them to ask questions at their health care appointments and advocate for themselves whenever possible. A Transition Assessment can be a great tool to help assess your child’s readiness to transition to an adult health care provider. Community First Health Plans Transition Specialists use age appropriate assessments to ensure continuity of care.
Prepare a transfer package with your child’s pediatric provider. If your child will be changing providers, ask your child’s current pediatric provider to (1) recommend adult provider(s), and (2) prepare and send a transfer package to your child’s new provider(s). This package should include a plan of care, medical summary, and emergency care plan. Discuss the need for decision-making supports if your child has intellectual disabilities, and the best time to transfer their care.
Contact your health insurance company. Ask questions to get the most out of your health care benefits. Is there a Transition Specialist who can help prepare you and your child for transition of care? When will your child age out of their current health plan? Is there another plan they are eligible for? Will they lose access to certain services or therapies once they enter adulthood? Are there community resources available to help or fill in any gaps in care?
Ask to meet your child’s new provider(s) before the transfer process. Get to know your child’s new provider(s) to ensure a good fit. After meeting, circle back with your child’s current pediatric provider(s) and ask them to follow-up with you to confirm transfer of care. Pediatric and adult primary and specialty care providers should continue to work together for the benefit of your child.
Community First Health Plans offers children and adults of all ages and abilities specialized health plans which provide access to high quality health care in our community. This includes children with physical, intellectual, and developmental disabilities who are transitioning into adulthood. Our Transition Specialists can help manage your child’s transition of care, ensuring necessary services and supports don’t fall through the cracks.
If you’re interested in learning more or would like to see if your child qualifies for one of our health plans, please visit us at CommunityFirstHealthPlans.com or call 1-800-434-2347.
For more tools to help with health care transition readiness for special populations, visit https://www.gottransition.org/resources-and-research/special-populations.cfm.