CHF demonstrated the potential of this nurse-managed clinic as a transition service model. This model, originally designed for application in educational settings was utilized to primarily address health care concerns associated with this period of transition. It is possible that this service model could be replicated in a number of health care settings ranging from regional tertiary centers to community- and school-based clinics. CHF used a noncategorical approach for enrolling consumers; however, this model could be easily adapted for condition-specific populations. This service model differed from more commonly reported transition models in several ways. Transition services were comprehensive in scope, addressing the youth's/young adult's needs for adult health services, education and training, employment, housing, and community living, unlike more conventional programs that focused solely on medical services.
This model relied on leveraging resources currently available in the community to meet the individualized needs for transition services. This transition clinic made use of available community resources to avoid duplication of services. Numerous public service programs are funded at the local, state, and federal levels to provide the very services for training, job preparation, and community living that youth and young adults with special health care needs require to successfully make the transition to adulthood (Betz, 1999). For example, the recently passed Workforce Investment Act now provides for year round youth programs that include job training, leadership, and mentoring activities to assist all youth, including those with special health care needs, to develop job preparation skills.
Additionally, lessons were learned about the process of providing transition services beginning with the assessment of needs and continuing with ongoing monitoring of service coordination and referral (Betz & Redcay, 2002). The process of assessing the youth's/young adult's transition needs is more involved and comprehensive than previously described (Betz, 1998a). As a result, service needs were more complex, dynamic, and long-term in scope. Most of the youth and young adults referred for services required ongoing support and monitoring not only to assure adherence with the transition plan but to respond to their ever-changing needs. For example, one youth was reluctant to assume more independence for his transportation needs, as he had relied heavily upon his parent for transportation. However, his attitude and behavior changed swiftly when his parent unexpectedly died, as he was now compelled to learn to drive. As circumstances changed, the youths/young adults changed themselves during a very dynamic period of their lives. A job preference for summer employment could be the catalyst for an entirely new career or vocational choice. All of these circumstances require continual monitoring and intervention by the transition service coordinator.
Another insight gained from this experience was the need for all professionals and providers in health care and other interagency systems to adopt a lifespan approach in providing services to youth with special health care needs. That is, professionals need to make reference to and about the child's future as an adult. This perspective needs to be as pervasive and expectant as it is for healthy children. Role modeling and mentoring of youth and young adults by adults with special health care needs fosters positive expectations for the future. Encouraging peer support and leadership activities is an avenue for fostering positive attitudes and learning strategies for every day living that are essential for meeting goals for adulthood. Peer support groups such as Kids as Self-Advocates (a program of Family Voices) enable youth to network and learn from their peers.
CHF demonstrated the potential of this nurse-managed clinic as a transition service model. This model, originally designed for application in educational settings was utilized to primarily address health care concerns associated with this period of transition. It is possible that this service model could be replicated in a number of health care settings ranging from regional tertiary centers to community- and school-based clinics. CHF used a noncategorical approach for enrolling consumers; however, this model could be easily adapted for condition-specific populations. This service model differed from more commonly reported transition models in several ways. Transition services were comprehensive in scope, addressing the youth's/young adult's needs for adult health services, education and training, employment, housing, and community living, unlike more conventional programs that focused solely on medical services.
This model relied on leveraging resources currently available in the community to meet the individualized needs for transition services. This transition clinic made use of available community resources to avoid duplication of services. Numerous public service programs are funded at the local, state, and federal levels to provide the very services for training, job preparation, and community living that youth and young adults with special health care needs require to successfully make the transition to adulthood (Betz, 1999). For example, the recently passed Workforce Investment Act now provides for year round youth programs that include job training, leadership, and mentoring activities to assist all youth, including those with special health care needs, to develop job preparation skills.
Additionally, lessons were learned about the process of providing transition services beginning with the assessment of needs and continuing with ongoing monitoring of service coordination and referral (Betz & Redcay, 2002). The process of assessing the youth's/young adult's transition needs is more involved and comprehensive than previously described (Betz, 1998a). As a result, service needs were more complex, dynamic, and long-term in scope. Most of the youth and young adults referred for services required ongoing support and monitoring not only to assure adherence with the transition plan but to respond to their ever-changing needs. For example, one youth was reluctant to assume more independence for his transportation needs, as he had relied heavily upon his parent for transportation. However, his attitude and behavior changed swiftly when his parent unexpectedly died, as he was now compelled to learn to drive. As circumstances changed, the youths/young adults changed themselves during a very dynamic period of their lives. A job preference for summer employment could be the catalyst for an entirely new career or vocational choice. All of these circumstances require continual monitoring and intervention by the transition service coordinator.
Another insight gained from this experience was the need for all professionals and providers in health care and other interagency systems to adopt a lifespan approach in providing services to youth with special health care needs. That is, professionals need to make reference to and about the child's future as an adult. This perspective needs to be as pervasive and expectant as it is for healthy children. Role modeling and mentoring of youth and young adults by adults with special health care needs fosters positive expectations for the future. Encouraging peer support and leadership activities is an avenue for fostering positive attitudes and learning strategies for every day living that are essential for meeting goals for adulthood. Peer support groups such as Kids as Self-Advocates (a program of Family Voices) enable youth to network and learn from their peers.
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