CHF Model
The CHF transition clinic is a significantly different transition service model compared to those reported in the health care literature to date. CHF is a nurse-managed transition clinic staffed by a family nurse practitioner who serves as the transition coordinator and works in close consultation with an interagency team of child and adult service providers. The adult providers are from community-based education, job preparation, housing and community agencies, and organizations who meet monthly with the FNP to provide input on the development of a comprehensive transition service plan that addresses the individualized needs of youth with special health care needs for these services. Based upon the team recommendations, the FNP works with the youth/young adult to implement the plan, which involves coordinating access and referrals to community resources and programs. The primary mission of the CHF clinic is to assist adolescents with special health care needs in meeting their goals for adulthood.