Pediatric to Adult Healthcare

• Birth Injury
• Life Care Plan
• Pediatric to Adult Healthcare

Transitioning From Pediatric to Adult Healthcare with a Birth Injury

The transition from pediatric to adult healthcare for a child with a birth injury can be daunting. As your child grows, their health needs often change with them.

There are significant differences between pediatric and adult healthcare. Adult healthcare requires autonomous, independent skills in contrast to the family-oriented, parent-driven nature of pediatric care.

This care transition should ideally occur between 18 and 21 years of age but can differ based on the individual’s care needs. The National Survey of Children’s Health found that 81% of youth with special care needs do not receive transition preparation services. Some factors that can lead to a poor transition of care include:

• Inadequate planning,
• Poor service coordination,
• Gaps in care, and
• Lack of resources

The goal for any young person is to maximize their functioning and health throughout their lifetime as they enter adulthood. Through the delivery of high-quality, developmentally appropriate, and continuous healthcare services, this goal can be achieved.

What are the Fundamentals of Successful Healthcare Transitions?

Planning for the transition from pediatric-centered care to adult healthcare should start when the child is young. To start, families and their child’s health care team, including specialists, primary care physicians, and therapists, should collaborate in the preparation process.

As the child gets closer to the healthcare transition period, they should be educated and included in discussions about their health. Continuous and clear communication with all parties involved will foster more confidence in the transition of care.

Updating medical records throughout your child’s life is of utmost importance. The more a future health care professional can understand the unique needs of your child, the better. Identifying services in your community that can provide health screenings and education on topics like sexual health and genetic counseling is also beneficial.

How Do You Transition Your Child to Adult Healthcare?

In this context, “transition” is defined as the “purposeful, planned movement of adolescents with chronic medical conditions from child-centered to adult-oriented health care.”

The American Academy of Pediatrics (AAP) recommends that caregivers and physicians plan a child’s transition to adult healthcare as early as age 12. A proactive coordination can make the transition process smoother for both the caregiver and child.

Individuals with developmental and/or intellectual delays and those with serious chronic medical needs may require a more in-depth transition plan. These individuals may need ongoing care from specialists and/or home care which must be accounted for.

According to Got Transition, a national resource for health care transitions, the recommended transition timeline is as follows. Based on your child’s needs, some of this advice may need to be reassessed to fit their unique transition of healthcare.

• Educate your child about their own health condition, including details about any medications and/or allergies.
• Encourage your child to ask questions, if able, during doctor’s appointments and other healthcare visits.
• Ask your child’s pediatrician or primary care provider at what age they stop caring for young adults.

• If able, assess your teen’s knowledge about their health, family medical history, and health care needs.
• Ensure your teenager carries their own health insurance card and knows what to do in case of an emergency.
• Under supervision, help your teen make a doctor’s appointment and order prescription refills.
• To help your child gain independence, encourage them to see the doctor alone for part of the visit.

• At this stage, determine if your child will need help making health care decisions before they become a legal adult.
• Ask your teenager’s physician to educate them on their privacy rights once they turn 18.
• Encourage your child to visit the doctor alone and to ask any questions they have during the appointment.

Typical age to begin moving from pediatric to adult healthcare.

• Once your child is a legal adult, they are responsible for their care. Unless your young adult consents or legal forms are completed, guardians can no longer access their medical information or be in the doctor’s appointment.
• Encourage your young adult to ask their pediatric doctor for a referral to an adult doctor.
• Ensure their adult physician accepts your young adult’s health insurance and determine if there are any possible care charges.
• Confirm that your young adult has their health insurance information and medical summary with them.

• Motivate your young adult to maintain their healthcare requirements and update their medical summary into adulthood.
• Educate your young adult on possible changes to their insurance and how to make sure their doctor will accept new insurance policies or company changes.

Potential Consequences of an Unsuccessful Healthcare Transition

Over half of young people with chronic health conditions receive inadequate support and services in their care transition. While there is no universally accepted age of health care transfer, many jurisdictions use inflexible age cut-offs from services. This severance of care creates fragmentation and discontinuity in care provisions.

Inadequate planning, poor service coordination, lack of resources, and gaps in education and training can hinder a successful transition to adult care. Potential consequences of a poor transition of healthcare include:

• Patient disengagement
• Poor treatment adherence
• Increased hospitalization rates
• Overall detrimental health outcomes

Additional Barriers to Successful Healthcare Transitions

Lack of Professional Training in the transition of care

One-third of undergraduate/graduate medical education programs did not provide students with any education about transition of care.

Financial Barriers

A transition to adult healthcare can be accompanied by insurance coverage limitations. If the young adult ages out of their guardians’ insurance plan or public insurance programs, their healthcare may be too great an expense to handle on their own.

Cognitive or Emotional Impairment

Some brain injuries damage parts of the brain responsible for cognition and emotional regulation. While therapies can aid in optimized functionality, some children are unable to take on the responsibility of care after turning 18.

Lack of Preparation, Planning, and Coordination

Pediatricians and caregivers should work together to create a comprehensive plan for care transition. These plans should be drafted no later than the child’s fourteenth birthday to ensure sufficient time for preparation. If families and healthcare providers fail to prepare for the transition, the young person’s health could face the consequences.

What Steps Can Ensure a Successful Transition of Care?

The importance of supporting and facilitating the transition of adolescents with special health care needs into adulthood cannot be understated. A consensus statement created by the American Academy of Pediatrics and other organizations assess six “critical first steps” to ensure a successful transition of care:

Step One

Identify healthcare professionals who can support the unique challenges of your child with special needs during their transition. The healthcare provider should assume responsibility for care coordination, current health care, and future health care planning for your adolescent.

This step is intended to ensure that as the transition occurs, there are no gaps in care. The goal is that the young person maintains comprehensive, accessible, and uninterrupted care.

Step Two

Ensure that the medical professional possesses the knowledge and skills required to provide appropriate healthcare transition services to young people with special care needs. Primary care providers and physicians should ideally have training and certifications for care transitioning.

Step Three

Update and maintain a comprehensive medical summary that is accessible and portable. This information is crucial for a successful health care transition, as it allows future care providers to gain knowledge about medical history.

Step Four

In collaboration with your child and their medical provider, create a written healthcare transition plan, ideally by age 14. The transition plan should at least include:

• Services needed,
• Who will provide the services, and
• How the medical care will be financed

This plan should be reassessed every year up to the transition of care. This includes reviewing all information and updating it where necessary.

Step Five

All adolescents should have access to the same standards for primary and preventive care during their healthcare transition. However, individuals with special healthcare needs may require more resources and services than others to optimize their health.

Additional services and resources, if necessary, must be implemented into your child’s personalized plan for care transition. Examples of standard care guidelines include:

• American Medical Association’s Guidelines for Adolescent Preventive Services (GAPS)
• National Center for Education in Maternal and Child Health’s Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
• U.S. Public Health Service’s Guidelines to Clinical Preventive Services

Step Six

Ensure affordable, continuous health insurance coverage is accessible for your adolescents with special health care needs into adulthood. The insurance should appropriately cover compensation for:

• Health care transition planning for all young people with special health care needs
• Care coordination for those who have complex medical conditions

What Happens When Your Child Ages Out of Health Insurance?

Maintaining continuous health care coverage is crucial for good health. However, health insurance can get tricky once your child becomes a legal adult at age 18.

If the guardian’s health insurance plan is employer-sponsored or independently purchased, young adults can typically stay on the plan until age 26. So, what happens when they turn 27?

There are several options to ensure that your young adult maintains health insurance throughout their life, including:

• If the individual can be gainfully employed, many employers offer insurance to those who work full-time.
• Tax credits to help pay the cost of individual coverage. Eligibility includes individuals who:
• Earn between 133% and 400% of the federal poverty level
• Do not have an affordable source of insurance
• Are not covered by another insurance plan
• Medicaid coverage through the Supplemental Security Income (SSI) or “Buy-In” program:
• Most adults with disabilities in the U.S. who qualify for SSI disability benefits also qualify for Medicaid coverage.
• Income-based Medicaid coverage is available to all adults under 65 whose incomes are less than 138% of the federal poverty level.

It is important to do thorough research and account for the factors that influence your child’s health insurance coverage when deciding on future coverage plans.

What Questions Should I Ask My Child’s Doctor?

The initiation of a healthcare transition can be overwhelming, and you may feel you have more questions than answers. Your child’s primary care provider should not only work with you on the care transition, but they should also strive to answer all your questions.

Some examples of questions to ask in preparation for your child’s healthcare transition include:

1. At what age does my child need to change to a new doctor for adults?
2. Can you refer my child to an adult physician?
3. Can we collaborate on a comprehensive medical summary and emergency care plan for my child?
4. When can my child meet with you alone during visits to become more independent in their health care?
5. What kind of adult-oriented doctors does my child require?
6. Before my child becomes a legal adult, what information about consent and privacy do we need to know?
7. What if my child needs help making health care decisions after turning 18?

What Other Services Are Available to Your Child in Adulthood?

The process of transitioning children with birth injuries into adult healthcare can be confusing and isolating. It is important to know that you and your child are not alone in this complex transition. There are many tools and resources available to make the process more manageable.

Miller Weisbrod Olesky, Attorneys at Law

If your child’s birth injury was the result of medical negligence and malpractice, the birth injury attorneys at Miller Weisbrod Olesky are here to review the medical records through our extensive case review process.

We are a national birth injury law firm helping families who face the devastating consequences of birth injuries caused by medical malpractice and negligence.

Birth injury lawsuits are complex. But our National birth injury lawyers focus on providing experienced, skilled representation to get the best results for our clients. Our track record of successful settlements and verdicts speaks for itself.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment once you do. The sooner you reach out, the sooner we can investigate your case and gather the evidence to support your claim.

Contact us today to schedule your free consultation by calling our toll-free line at (888) 987-0005. You can also reach us by filling out our online request form.

Family Voices

Founded in 1992, Family Voices is a family-led nonprofit organization that aims to transform systems of care to work better for all youth, especially those with special care needs or disabilities. Their Family-to-Family Health Information Centers (F2F HICs) program supports families by:

• Coordinating appointments, services, and medications
• Helping families understand their health coverage
• Peer-to-peer counseling

F2F HICs can also support families in the transition from pediatric to adult health care systems. With 59 centers in the United States, over 200,000 families and 100,000 healthcare professionals are served each year.

National Resource Center for Supported Decision-Making

The National Resource Center for Supported Decision Making (NRC-SDM) connects individuals to people, organizations, and resources that help in decision making. NRC-SDM’s resources are available to anyone, but they have specific tools and information for children and adults with disabilities.

Is Your Child’s Birth Injury the Result of Medical Malpractice?

Parents whose children suffer birth injuries want and deserve answers as to whether mistakes by the doctors and nurses contributed to the injury. Our top rated birth injury attorneys have represented families all over the United States in their time of need after a birth injury.

We use our skills and expertise to obtain for you and your child a medical malpractice settlement that will help fund your child’s Life Care Plan. This includes specialized medical therapy to maximize the quality of life and independence of your child through their lifetime.

• Were there signs of birth injury or birth complications during the pregnancy, labor, and delivery process, or presence of risk factors, which were either not recognized or properly treated?
• During the labor and delivery, were there clear indications that the baby was suffering from fetal distress, but appropriate actions were not taken by the maternal fetal specialists, obstetricians or nurses?
• Was there a delay in diagnosis of a likely premature birth that led to later complications, including brain injury?
• Did the medical team fail to order a series of tests to diagnose this birth complication in a timely manner?
• Was the decision to perform a cesarean delivery delayed leading to birth trauma during vaginal delivery or labor?
• Did the neonatal resuscitation team fail to quickly begin important breathing support?
• Should brain cooling (also called “hypothermia therapy”) have been provided to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?

Our birth injury attorneys have recovered millions of dollars in settlements for families of children that have suffered a birth injury. At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do, no matter how long or tough your case is.

What is the Statute of Limitations in a Birth Injury Lawsuit?

A statute of limitations (SOL) is a law that sets a time limit on how long an injured person has to file a lawsuit after an accident. It is essential to understand that statutes of limitations vary based on the type of case and the state where it is filed.

For instance, the deadline for birth injury claims is typically different from other claims, such as injury to personal property, fraud, contract disputes, and collection of debts.

Generally, the clock starts ticking on the date the injury occurred. However, there are exceptions to this rule, and in some cases, the statute of limitations starts when a person discovers or reasonably should have discovered an injury. When dealing with government agencies, SOLs can become even more complex.

For example, if the party that injured you was:

• A federal employee
• Employed by a military hospital, Veterans Administration facility, or a federally funded medical entity

Birth Injury Claim Under Federal Tort Claims Act (FTCA)

You may need to file a birth injury claim under the Federal Tort Claims Act (FTCA). In FTCA cases, claimants must go through certain administrative procedures before filing a lawsuit. In some states, you may have less time to give notice if:

• The negligent party was a local or state government hospital.
• The doctors and medical providers are employees of a governmental entity.

If you file your case outside of the statute of limitations, the court will typically dismiss it. This means you will not be eligible to recover compensation for you or your child’s injuries.

Determining when a statute of limitations begins on your case can be tricky. If you are considering pursuing compensation, contact a birth injury attorney as soon as possible.

Contact Our Birth Injury Attorneys Today

Birth injuries are not always preventable, but medical errors are. It takes an expert review of the facts of your birth to determine whether medical professionals mismanaged your child’s delivery.

Our team of committed birth injury attorneys, nurses and paraprofessionals work to answer these questions and seek compensation. We use our detailed medical negligence case review process to assess your potential birth injury case.

Our Process

We begin learning more about your child by gathering records to determine what happened during and after your delivery. This includes a detailed review of the treatment doctors provided or failed to provide after labor. We also consider your child’s status of meeting or missing developmental milestones.

We call in skilled medical experts who review your records and provide insight into where medical professionals went wrong. If we feel medical negligence caused or worsened your child’s injuries, we meet with you to discuss further.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment once you do. The sooner you reach out, the sooner we can investigate your case and gather the evidence to support your claim.

We work on a contingency fee basis, meaning you will not pay any legal fees until we win your case. We do not pursue any medical malpractice cases unless we fully believe we can win.

Contact us today to schedule your free consultation by calling our toll-free line at (888) 987-0005. You can also reach us by filling out our online request form.