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Special Edition: Title V Technical Assistance MeetingExpand Special Edition: Title V Technical Assistance Meeting
Title V Technical Assistance Meeting

 Member to Member

State Title CYSHCN Program Highlights: Youth Transition to Adulthood


Donna Harris.pngBy Donna Harris
Director, Office for Genetics & CYSHCN; Maryland Department of Health and Mental Hygiene

The Maryland Office of Genetics and People with Special Health Care Needs is planning on conducting a brief inventory of its programs and state disability organizations to identify the types of transition assistance offered and the populations served – youth and young adults with and/or without special needs, families, pediatric and adult clinicians. The inventory will ask respondents about whether they have a written transition policy, a method for tracking transitioning youth, a plan of care that incorporates health care transition, a portable medical summary and emergency care plan, referral assistance for supported decision making, a transfer checklist, a mechanisms to confirm transfer completion to adult providers, a process to obtain youth and family feedback on transition, and opportunities for youth to actively participate in transition improvements. In addition, the inventory will ask about respondent interest in learning more about health care transition quality improvements and, if interested, how respondents would prefer receiving assistance. Maryland also has formed a transition leadership team involving a pediatrician, adolescent health physician, internal medicine physician, local health department representative, insurance official, parent and teen experts, member of Governor's Youth Council, individualized education program coordinator, and a Social Security Administration health policy expert.


Manda_Hall.jpgBy Manda Hall, MD
Director, CYSHCN, Texas Department of State Health Services; Purchased Health Services Unit

The Children with Special Health Care Needs (CSHCN) Services Program in Texas has identified multiple opportunities to integrate the Six Core Elements of Healthcare Transition into initiatives of the Texas Title V Transition and Medical Home Workgroups. This includes piloting the Six Core Elements with workgroup members and integration of these elements into strategic plans. The Six Core Elements will be featured as part of the 3rd Annual Texas Primary Care and Health Home Summit as a keynote and breakout session. This will provide pediatric, adult, and family medicine providers with tools for integrating transition into their practice.


By Sharon Fleischfresser, MD, MPH, FAAP
Sharon F.pngMedical Director, Wisconsin Children and Youth with Special Health Care Needs Program, Wisconsin Department of Health Services, Division of Public Health

Wisconsin Children with Special Needs, with the Waisman Center at the University of Wisconsin, is supporting transition quality improvement pilot projects involving pediatric and adult practices/health systems using the Six Core Elements of Health Care Transition. Two types of grants are available – planning grants ($2,000) and implementation grants ($20,000). Planning grants are for practices just beginning to focus on transition or for practices wanting to try small projects. Implementation grants are aimed at practices/systems that have already demonstrated transition work and are seeking to spread transition efforts throughout their practice/system. Senior leadership buy-in and in-kind match are required for implementation grants. Both types of grants call for teams that include personnel from pediatric and adult care, nursing, and youth and families. Grantees are required to complete pre and post assessments using the measurement tools in the Six Core Elements package. Technical assistance is provided by the Title V Youth Health Transition team and the Waisman Center, with periodic coaching support from Got Transition.