Transitioning from Adolescent Care to Adult Care

According to the “A Consensus Statement on Health Care Transitions for Young Adults With Special Health Care Needs” adopted by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians –American Society of Internal Medicine, the goal of transition in health care for young adults with special health care needs is to “maximize lifelong functioning and potential through the provision of high-quality, developmentally appropriate health care services that continue uninterrupted as the individual moves from adolescence to adulthood.”
The Georgia AAP, in collaboration with the Georiga Department of Public Health through a grant via the Federal Maternal and Child Health Bureau, Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (DHHS), offers these resources herein as tools to support transitioning young adults with special health care needs to adult care.

Special Edition on Youth Health Care Transitions – The Georgia Pediatrician

Healthcare is a vast system that requires the guidance of a medical home to help families with children and especially children with special healthcare needs, to navigate. In 1998, the commentary entitled, A New Definition of Children With Special Health Care Needs was established in Pediatrics to ensure advocacy to guide public and community based programs and services to create program planning for this population. This definition was established as children with special healthcare needs are those children “who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.” This of course implies any child who requires more than the

Of special concern is the health care transition of youth and youth with special health care needs. This special edition of The Georgia Pediatrician was created through a collaboration with the Maternal and Child Health Section of the Georgia Department of Public Health with the support of primary care pediatricians, a young adult, and an adult specialty physician. It was modeled from the American Academy of Pediatrics Transition ECHO – Support transition from pediatric to adult care and is intended to serve as a summary guide of tools and resources to support youth from transitioning from the pediatric model of care to the adult model of care. Those include information on policy, assessment of readiness, and a quality improvement model to support health care transitions as well as an insight to the young adults experience in transitioning to adult oriented care. If you have any questions about youth health care transitions, please contact Fozia Khan Eskew at the Georgia Chapter of the American Academy of Pediatrics at feskew@gaaap.org.

Georgia Department of Public Health Transition Resources for Families and Adolescent

Click here for transition materials for youth and young adults transitioning from pediatric to adult care as well as for their parents/caregivers

American Academy of Pediatrics:  Transition

The following information was compiled by the AAP to support physicians in transitioning youth to adult care.  Please click here to view this resource information.

Frequently Asked Questions regarding Transitioning from Adolescent Care to Adult Care

When should adolescents transition to Adult Care? Ideally this transition occurs between the ages of 18 - 21 years.
What is the pediatrician’s role in supporting transitions for children and youth with special health care needs?  The pediatrician’s role is as follows:  1) understand the rationale for transition from child-oriented to adult-oriented health care; 2) have the knowledge and skills to facilitate that process; and 3) know if, how, and when transfer of care is indicated.
What are the first steps in supporting transitions?
1.CYSHCN need a health care professional who partners with them and their family to coordinate their current health care needs and supports future health care planning that is uninterrupted, comprehensive, and accessible care within their community.

2.Support training within healthcare systems to provide developmentally appropriate health care transitions to CYSHCN

3.Provide and maintain a portable, accessible and comprehensive medical summary to support collaboration among health care professionals.

4.Work with the adolescent and family beginning at age 14 to annually prepare a written health care transition plan by age 14 that includes identified service needs, health care professional resources, and provision of reimbursement for these services,

5. Recognize that all adolescents and young adults should be supported in this transition to adult care and that CYSHCN may require more resources and services than do other young people to optimize their health.

6.Support efforts to provide affordable, continuous health insurance coverage for all young people with special health care needs throughout adolescence and adulthood.

Current Assessment of Health Care Transition Activities

This is a qualitative self-assessment method that allows individual providers, practices, or networks to determine the level of health care transition support currently available to youth and young adults transitioning from pediatric to adult health care.  It is intended to provide a current snapshot of how far along a practice is in implementing the Six Core Elements.

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American Academy of Pediatrics Georgia Chapter