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Health Care Transition: A Health Care Provider's Guide to Helping Youth Transition from Pediatric to Adult Health Care

  • Implemented in 2010
  • Submitted by North Carolina Division of Public Health
  • Contact Irene Jurczyk
  • Topic: Transition

Briefly describe the activity and its purpose.

Carolina Health and Transition (CHAT) is a systems-based project funded by a three-year grant awarded to the North Carolina Division of Public Health (NCDPH) from the Health Resource and Services Administration (HRSA). The purpose of CHAT is to ensure that youth with special health care needs (YSHCN) receive coordinated, comprehensive care within a medical home, as well as the needed services and supports to make transitions to adult life. Children and youth with significant special health care needs, their families and caregivers, and medical providers will develop an understanding of and skills necessary to successfully transition youth with special health care needs from pediatric to adult health care.

This resource, with clinical tools provided, has been used to help educate students and staff to facilitate transition services. The information is not meant to be prescriptive. Rather it is an invitation to better understand the importance of transition care for YSHCN, and offers tools to help meet the needs of these youth.

 The adoption of transition services will contribute toward:

  • Increasing the number of YSHCN who have the skills necessary to successfully transition from pediatric to adult health care systems within a medical home
  • Increasing the number of families of YSHCN who are able to advocate for their child's successful transition, by recognizing differing transition issues and goals for each phase of development, and navigate insurance and service gaps in medical care
  • Increasing the number of medical providers in pediatric and adult care practices who have knowledge and expertise in providing high quality, culturally competent, transition-related services

The transition materials included in this submission were collected as part of a grant from the Maternal and Child Health Bureau, HRSA, grant number R40MC19925. The authors of the transition materials agreed to their inclusion in the toolbox.

What are the expected learning outcomes for trainees?

The goals of the CHAT program are:

  • To increase the availability of and access to quality, coordinated, and comprehensive health care services within a medical home
  • To facilitate the successful transition of YSHCN from pediatric to adult systems of health care.

The medical provider practicum is a component of comprehensive strategies developed to support these program goals.

Briefly describe any lessons learned or challenges associated with implementing this activity.

Given the differences in the structure and management of health care provider organizations, there are likely to be many variations in staff knowledge, expertise, and administrative systems. Therefore, in addition to providing a "user friendly" format, the CHAT program is versatile enough so that it can be adapted to fit the needs of most public health clinics or health care organizations.

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