Transcript Healthy and Ready to Work

Partnering for Successful and
Healthy Transitions:
Racing to Work!
Kathy Blomquist, Debbie Gilmer, Theresa Glore
HRTW National Resource Center
APSE National Meeting
Louisville, KY, July 10, 2008
www.hrtw.org
Objectives of Session
• Experience the power of Celebratory
Learning
• Enhance understanding of transition
resources and current research
• Identify best practices in transition and
health care transition planning
• Practice strategies for supporting youth with
special health care needs in transition
• Be re-newed, re-energized, and re-vitalized
from sharing a learning experience with
your professional peers
• Have fun with us!
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Agenda
• Welcome!
• Entering Charts
• Bingo!
• State of the State of the Research
Kentucky’s Racing Form
• Racing to Work! Transition Planning
• Reflection and Evaluation
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Breeding…
Horses lend us the wings we lack.
~Author Unknown
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Everyone can work!
Achieving all A’s!
Aspirations
Access
Accommodations
Assistive Technology
www.hrtw.org
Data: Children & Youth with Disabilities and Health Needs
Nationwide
10.2 million (13.9%) <18
Title V CYSHCN
1,418,445 ( 0-18*)
SSI Recipients
1,132,000
( 0-17)
Sources:
1.
2.
3.
www.hrtw.org
2006 NS-CSHCN www.cshcndata.org,
Title V Block Grant FY 2008, www.mchb.hrsa.gov
* Most State Title V CSHCN Programs end at age 18
SSA, Children Receiving SSI, April 2008, www.ssa.gov
SSI Recipients Who Work: 18-29 (SSA 2008)
Youth & Young Adults
• 304,948 All blind & disabled SSI recipients ages 18-21
- 33,863 (11.7 %) recipients work
- 1619(b) participants: 1.2% of 18-21
• 539,439 All blind & disabled SSI recipients ages 22-29
- 85,238 (15.8%) recipients work
- 1619(b) participants: 4.2% of 22-29
• Employment Among Persons 16-20 With and
Without Employment Disability (2006 Census)
- With employment disability: Employed:16.8%
- Without employment disability: Employed: 41.2%
http://www.socialsecurity.gov/policy/docs/statcomps/ssi_workers/2006/sect01.html#chart1
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Transition & …No Insurance
•13.7 million young adults ages 19-29
without health insurance
•19 is critical age –
Uninsured rate jumps from 12% (18 and under)
to 30% (for ages 19-29)
SOURCE: Commonwealth Fund 2008
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NOD/Harris Survey of
Americans with Disabilities
Variable
(2004)
People with
Disabilities
People without
Disabilities
Not getting needed
health care
18%
7%
Health insurance not
paying for service
28%
7%
Income less than
$15,000 per year
26%
9%
Education:
HS dropouts
21%
10%
Employment
35 %
78%
needed
www.hrtw.org
What do
Young People Want?
• To have opportunities just like all youth fun, jobs, friends
• To be included and accepted
• To be independent
• To be educated
• To experience health and wellness
• To hear applause for their performance
www.hrtw.org
Reflection …
• What I want to remember
• Ways I’ll use this information
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Training…
No horse gets anywhere until he is harnessed.
No stream or gas drives anything until it is confined.
No Niagara is ever turned into light and power until it is tunneled.
No life ever grows great until it is focused, dedicated, disciplined.
Harry Emerson Fosdick
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Health Impacts Performance &
Productivity
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 or identify the
appropriate supports.
www.hrtw.org
Partner with Youth and Families
•
Talk about health in relation to
learning and employment
•
Promote participation in health care
and decisions
•
Include the school nurse more
actively in the IEP
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Partner with Health
Professionals
• Everyone has the same goal: promoting
optimal potential
• Think health!
• Transition is about community partners:
Partner with primary physician, school nurse,
etc.
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Adolescent Employment Readiness
Center (AERC) Research
(Dr. Patience White):
Youth are less interested
in any transition
organized around medical
issues and
more interested in a
transition to financial and
social independence.
www.hrtw.org
Measuring what youth
should know and do
•
•
•
•
•
•
•
•
•
Health condition
Providers
Insurance
Family and friends
Independent living
Postsecondary education and training
Employment
Recreation and leisure
Other general skills
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Reflection …
• What I want to remember
• Ways I will use this info
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Racing Form:
Kentucky Data!
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HRTW-KY Survey & Followup
• Mail Surveys
– KY Commission for CSHCN 18+
– SHC, Lexington
• Initial Survey: 1999-2001 N=650
(see Blomquist, 2006, Orthopaedic Nursing)
• Followup Survey 2001-2003
(see Blomquist, 2007, Orthopaedic Nursing)
N=300
–
–
–
–
85% from KY
94% white
64% female
28% independent in ADLs
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HRTW-KY Survey & Followup
N=300
DEMOGRAPHICS
Comparison: Census, BRFSS, Childtrends Databank
Variable
Initial
2-years
later
18-23
(21.1)
20-25
(23.1)
Live with parents
58%
43%
56% men
43% women
ages 18-24
Live with spouse/
significant other
22%
30%
53%
in mid 20s
Age
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Comparison
HRTW-KY Survey & Followup
N=300
(2)
DEMOGRAPHICS
Variable
Initial
2-years
later
Comparison
Single/
never married
Children
85%
73%
77%
20-24 yr olds
17%
25%
(49%
unwed)
(33%
unwed)
48% women
32% men
by mid 20s
30%
23%
Got help with survey
www.hrtw.org
HRTW-KY Survey & Followup
(3)
N=300 HEALTH
Variable
Perception of health
Initial
12%
32%
35%
18%
3%
Ex
VG
G
F
P
2-years
later
13%
30%
31%
21%
4%
Ex
VG
G
F
P
Comparison
20%
39%
33%
7%
1%
Ex
VG
G
F
P
Have doctor
85%
83%
73%
18-24 yr olds
Have been to ER in
past year
37%
39%
25%
www.hrtw.org
HRTW-KY Survey & Followup
(4)
N=300 INSURANCE
Variable
Initial
2-years
later
Comparison
Have no insurance
24%
25%
39% of KY
18-24 yr olds
Type of Insurance
*41%
medicaid
*9% own
job
*27%
family
*10% other
*42%
medicaid
*18% own
job
*19%
family
*13% other
43%
54%
57% took
73% took
Offered health
insurance with work
www.hrtw.org
*9% medicaid
*53%
employment
based
HRTW-KY Survey & Followup
N=300
Variable
Working
Receive SSI
(5)
WORK AND SCHOOL
Initial
2-years
later
Comparison
45%
51%
21% FT
26% FT
By age 25, 92%
men and 81%
women work
36%
36%
*21%
working
*58% use
computers
*19% drive
Completed HS or
higher
66%
72%
Idle – not working, not
23%
29%
in school, no children
www.hrtw.org
86% of
20-24 yr olds
Issues!
Planning for YSHCN becoming adults:
• Sending System: Preparing families, youth
and professionals - envisioning adulthood
• Receiving System: Different expectations,
programs, rules and regulations
• ONE Plan for Collaboration across
systems in the community: health, education,
work, housing, transportation, technology, play
www.hrtw.org
Reflection….
• What do we do to promote work for
youth with special health care needs
and disabilities?
• To promote health?
• To promote access to health
insurance?
www.hrtw.org
Starting Gate!
I have seen things so beautiful, that they have
brought tears to my eyes. Yet, none of them
can match the gracefulness and beauty of a
horse running free.
Unknown
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Successful
health care transition!
Youth are able to do independently
or direct others:
•
•
•
•
•
Access health services
See the doctor alone
Discuss their health conditions
Communicate their health care needs
Self-manage their care, and support is
available
www.hrtw.org
Youth are able to (con’t.)
• Make health care decisions (or support is in place)
• Understand when their pediatric practice
expects transition, and what to expect from adult
health care providers
Young adults
• Have insurance and know how to use it
responsibly
• Have adult health care – primary, specialty,
therapies, assistive technology
• Are prepared for and have jobs and careers
www.hrtw.org
Racing to Work…Transition
Planning
A horse is the projection of peoples' dreams about
themselves - strong, powerful, beautiful - and it has the
capability of giving us escape from our mundane
existence.
Pam Brown
www.hrtw.org
HRTW TEAM
Medical Home &
Transition
Title V Leadership
Richard Antonelli, MD,
MS, FAAP
Toni Wall, MPA
Kathy Blomquist, RN, PhD
Patience H. White, MD,
MA, FAAP
Theresa Glore, MS
Betty Presler, ARNP,
PhD
Family, Youth &
Cultural Competence
Federal Policy
Mallory Cyr
Ceci Shapland, MSN
Trish Thomas
HRSA/MCHB Project Officers
Elizabeth McGuire/Lynda Honberg
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Patti Hackett, M.Ed
Interagency
Partnerships
Debbie Gilmer, M.Ed
www.hrtw.org
www.hrtw.org
Contact Us
• Kathy Blomquist:
[email protected]
• Debbie Gilmer: [email protected]
• Theresa Glore: [email protected]
Healthy & Ready to Work National
Resource Center
www.hrtw.org
www.hrtw.org