HRTW-CA CONTACT

HRTW-CA ABSTRACT

PROBLEM:
The prevalence of chronic illness amongst this nation’s youth is a foremost public health concern. According to recent prevalence reports, it is estimated that 18% of children have special health care needs (CSHCN); this percentage increases to 21% in the adolescent age group (McManus, 1999). Since 1960, the numbers of C/ASHCN has risen 100% (Blum & Gerber, 1992). There is need for coordinated service system change to address these concerns (Woods, Haberman & Packard, 1993). The systemic changes to address the long-term needs of C/ASHCN are needed in the educational, social service, rehabilitation, and health care systems and require the coordination of effort between these service systems.

GOALS AND OBJECTIVES:
The goals of the project are:

Goal 1: To increase understanding of the holistic needs of ASHCN as they transition to adulthood having aspirations for physical and mental well being, and living independent, productive and successful lives.

Goal 2: To promote and enhance community-based collaborations and partnerships with public and private entities within service delivery systems.

Goal 3: To establish linkages and provide input to local school-to-work systems pertaining to the needs, strengths and special problems of ASHCN in making successful transitions to adult health care, career and employment opportunities, and independent living and to implement and replicate in other communities in the state.

Goal 4: To assure that ASHCN will lead healthy and productive lives and maximize their financial independence.

METHODOLOGY:
The project consist of the following components: outreach training, training infrastructure, conference, technical assistance and consultation, collaborative interagency model, mentoring program, integrated career paths in school-to-work programs, transition teams, advocacy training model and system for identification of eligible adolescents.

COORDINATION:
Project activities are coordinated with a number of agencies at the community level. Our project partner is Southern California Transition Coalition (SCTC). This coalition has been in existence since 1991. Together with SCTC Coalition, we have partnerships with the agencies and local offices representing California Children Services (Title V), private, public and nonprofit health agencies, Department of Rehabilitation, Department of Education (14 local school districts, East San Gabriel Valley Regional Occupational Program), 2 regional centers (developmental disabilities), Department of Mental Health, Workforce Investment Act agency (LA Works), Employment Development Department, Center for Independent Living, Consumer/Parent coalition, Social Security Administration, and juvenile justice.

EVALUATION:
Systemic evaluation will be conducted in a variety of forms to insure effectiveness in meeting project goals and objectives. Data gathered from evaluation efforts is evaluated formatively and summatively to monitor effectiveness and outcomes. Methods include compilation of data regarding program activities such as date, amount, recipients, geographic region; self-report on usefulness and relevancy of technical assistance, team participation; pre and post test measures of training and services, adolescent and family outcomes.

EXPERIENCE TO DATE:
During the past year, CA HRTW has provided transition training to 4,169 youth, parents, young adults, service providers and professionals. Over 60% of participants represent ethnically diverse populations. Three hundred and sixty four technical assistance contacts have been provided to assist in the provision of services and program development. Currently CA HRTW is working with 4 community-based organizations that provide services to A/CSHCN in developing outreach transition services. CA HRTW has replicated the interagency team at Childrens Hospital Los Angeles and has provided transition services to 26 adolescents and young adults with SHCN.

KEY WORDS:
Adolescents with Special Health Care Needs, Adolescents with Disabilities, Interagency Collaboration, Youth in Transition

[Summary]

HRTW – CA Summary of Project Activities

Project: California Healthy and Ready to Work
Coordinator: Cecily Betz
State: California

Year four of HRTW projects. Ytd = October 1, 2000 to January 31, 2001

1. How many adolescents with special health care needs/disabilities have received training and/or support to promote self-determination and/or leadership skills? 13

• What types of training, support, or leadership skills were provided?
• 3 participated in youth leadership group in high school setting
• 10 young women in peer support group
• What were the outcomes or effectiveness of this training?
• 3 high school students participated more fully in transition planning
• 3 consumers obtained jobs and 2 moved into independent living situations
• How are the outcomes or effectiveness measured?
• Teacher report and consumer self report
• We are tracking this information via our project records as we are keeping files on each of the youth/young adults we are serving.

2. How many families have participated in training/support to
increase their knowledge of the services and supports available to them? 48

• What types of training, support, or leadership skills were provided?
• Transition training on using systems to facilitate their son’s or daughter transition to adult services i.e. adult providers
• What were the outcomes or effectiveness of this training? We have not measured as yet.

3. How many health care professionals, teachers, vocational rehabilitation counselors and other human service professionals have received training/support related to planning and providing effective services/supports to adolescents with special health care needs and their families?

In what manner has this training/support been delivered?

• 38 meetings wherein the focus was to discuss provision of transition services.
• 115 telephone consultations wherein information and technical assistance was provided in response to call about providing transition services
• 2 onsite meetings to provide technical assistance pertaining to provision of transition services with emphasis on effecting health care transitions
• 7 outreach training programs to provide information on transition services with emphasis on health care transitions.
• 7 professional presentations on the needs of adolescents with special health care needs in transition with emphasis on health care transitions.
• 9 mini workshops (up to 3 hours in length) on transition with emphasis on health care transitions.

• No as too soon following training.
• What has been its effectiveness? Not assessed at this point in time.

• Describe the types of employment and the current satisfaction of the employed youth.
• 6 are employed as a result of HRTW, as clothing store salespersons, music studio asst.,fast food clerk, assembly line worker, and YMCA clerk. All are satisfied with their jobs.

• Describe the types of training and preparation.
• 14 are in an employment training program, ( community college programs, regional center job training, Dept. Rehab. job training, occupational center classes) 7 others are high school students

• Almost all referrals have access to a medical home but not necessarily due to HRTW.

7. How many youth with special health needs have transitioned from a pediatric to adult health care provider as a result of the project? 16

Describe.

• 10 with SHCN have transitioned to Adult Health Care based on our input ( 4 see only adult providers, 2 have transferred to adult rehab facilities, 4 see adult providers but have a 1 x a year check up at Childrens Hospital oncology clinic

• 9 have insurance as a result of us. Most youth under age 18 or 21 are covered by CCS ( CMS) or MediCal ( Medicaid ) . The 9 youth were encouraged to apply for MediCal before they reached age 21.

9. Have there been any changes in policies at the state or local levels that have occurred as a result of project activities? If yes, please describe briefly.

10. What has been accomplished (established, done) to increase the extent to which service systems are comprehensive, coordinated, family-centered, community-based, and culturally competent?

11. What has been your most significant project activity to date?

• We have been significantly involved with outreach training efforts directed to health care and interagency professionals. We have also been involved in a number of community-based coalition efforts at the local level that have resulted in systemic changes such as incorporating health concerns into the IEP transition planning in the San Gabriel/Pomona Valley area. Pilot testing innovative transition service program and getting referrals from Title V Program for Children with Special Health Care Needs as mentioned above.

12. Are there any other significant project activities or outcomes that have not been addresses?

• During this period of time we have been involved with conference planning with American Academy of Pediatrics, Southern California chapter and California Children Services for transition conference held on May 10 (that will be reported in the next progress report).