Webcast
KMCO Archives
Healthcare Transition in the Era of Managed Care
October
25,2000
Hello
and Welcome to our webcast from the Quality Community
Managed Care project from the University of Illinois
at Chicago School of Public Health. I'm Faye Eldar,
your moderator. I'm the family coordinator at the Quality
Community Managed Care project, and I'm happy to be
with you today. We have another web cast in our ongoing
series in the Kids And Managed Care web site. Our show
today is about young adult transitions in health care.
It is a very important topic and we have two experts
to share their information with us today. One of them
is Lou Terranova. He is Program Service Manager for
the Division of Specialized Care for Children (DSCC)in
northern Illinois and Rockford. That's an Illinois Title
V Children With Special Health Care Needs agency and
he comes to the DSCC with a background in health care
administration. Our parent speaker today is Jane Gaulke.
She is the parent of a young adult who has gone through
transition, and she lives in MacHenry County in northern
Illinois. I'd like to ask each one of you to introduce
yourself and tell us a little bit about yourself and
your background and transition experience. Lou, could
you go first please?
A.Okay
thank you, Faye. As you mentioned, I'm with the Children
With Special Health Care Needs program for the state
of Illinois here in the northern Illinois regional office.
And one of our projects for this office was too look
at transition issues for children with special health
care needs as they go from pediatric center care to
adult level care or as they age from age 18 to age 21,
at which time at age 21, they are no longer eligible
for the program here in Illinois. So we have been working
on for over the past year close to two years now and
identifying transition issues that families face and
so we can assist them as we develop a plan to transition
the child you know through adolescence to adult medical
services. We've developed some informational material
and it's a learning process. Not to say that we have
the set answers or pat answers, but because it's unique
to each family and each child and whatever resources
are available in the family's home community.
Q.Well
Lou, thank you very much for explaining about transition.
We're going to be getting back to you in a few minutes
to give us some more detail about this really important
topic. Jane, could you please tell us a little bit about
your family, where you live, and about the transition
of your son. I believe he's 21 years old now is that
right?
A.
Yes he is, Faye. I'm a Mom of a disabled child and Tim
was diagnosed when he was about four years old. He has
a degenerative disease of the white matter of the brain,
which is a genetic disability and I really don't have
any definite solutions or what's going to happen to
Tim in the future. Tim just turned 21 this year. He's
been in school and then this year, this is the first
year that he'll be out of school. And our transition
went pretty well. But Tim is able to speak vocally and
he is gives input into what he wants for his future
and so it hasn't been that difficult. The difficult
part is that I haven't found a lot of programs as of
yet to get him outside of the home, because I want him
to still have a social life. So that's one of the problems
that concerns me right at the moment.
Q.
And what has he been doing since he graduated?
A.
Well fortunately, we've been pretty busy. We've had
a pretty busy summer and he helps me out in the garden
and I do have aids that come in. I have help from DORS
Department of Human Resources. They provide me with
a set amount of hours a week that I can hire people
to come in and help me. They help me feed him and dress
him and they keep him entertained and stimulated. We
do reading with him and he just got an electric chair,
so he's been busy practicing on that.
Q.
Well that's wonderful. Thank you so much for sharing
that with us. Now Lou, could you tell us about some
of the special transition concerns that are related
to health insurance for young adults who have special
needs?
A.
Depending on the child's needs you know and the type
of insurance plan or coverage available through the
plan, some concerns or some issues are requirements
that how long can the child remain on the plan? For
example, some insurance plans stipulate that the child
has to be a student, a full-time student in order to
be eligible for benefits past the age of 21 to be covered
on the families plan. Some children with special health
care needs are not able to continue you know with schooling.
So that's one issue.
Another issue is what we call the transitioning from
pediatric to adults level care and in some plans or
some providers even where that occurs or when that occurs
has been an issue. For example, when does the child
stop seeing the pediatric specialist and now see an
adult specialist? And is the adult specialist willing
to take on the case? So those are some issues that families
face in working with insurance plans.
Q.
Okay now Jane, could you tell us first of all your experience?
Was your son able to stay on your health insurance or
not?
A.
Yes he was. My husband works at the Community College
and their insurance company provides for him as a dependent
and he does not have to be in school full time. So we're
very fortunate in that because I know a lot of insurance
companies will not do that unless they are a student.
So that has not been a problem. Some of the other problems
we have faced is I was looking for special equipment
for Timothy and my insurance company was giving me a
hard time. They didn't feel that he needed some of this
equipment until I received a call one day from my insurance
advocate. And I didn't realize at the time that I even
had one. But if you look in the front of your insurance
book that tells you what your benefits are, she's a
registered nurse and she's an advocate for me to work
with my insurance company. And she read the letters
from my doctors and decided that he qualified for this
equipment. So she was a tremendous help. She took a
lot of the pressure away, a lot of the paperwork. She
took a lot of the hastle away and just it just relieved
me so much because Timothy was getting pressure point
sores when he was laying in bed. And so she arranged
for a new mattress. It just was a great great relief
to have her help me and I didn't even know she existed.
Q.
And I'm sure that most people don't. You were really
fortunate to find this kind of help. Could you tell
us if the advocate is an employee of the insurance company
or does that come from the place of work? How does that
work?
A
Well as far as I know, she works for she's hired,
the insurance company hires a company that she works
for, and they help, because the people in the office
aren't really qualified to deal with some of these children
that have you know great needs.
Q.
Well that's great. Now in terms of switching from
pediatric to adult doctors, has Timothy done that? Yes
and his Timothy was associated with Shriners for 17
years. But when they turn 21, they're considered adults
and so they don't accept them anymore. But Dr. Smith,
who was Timothy's orthopedic doctor, gave me some names
of other referrals of doctors and he also told me that
if I had a question, I could still make come in and
talk to him and have a consultation with him. So I felt
that he just wasn't abandoning us, you know he was still
willing to help us through if Timothy had any you know
orthopedic problems. So that wasanother big relief because
Shriners has been with us for so long. It's like a big
safety net. Then when you go into this 21-year-old age,
you start losing them. Now Tim's pediatrician is also
a family doctor. So Dr. Rayez has been with us since
Timothy's been born, since he's been 21. I mean he will
continue to see Timothy until he retires I presume.
And you know he's just he knows Tim and Tim's history,
so it's you know it's I don't have any problems with
him at all.
Q.
Well I'm really glad that that has worked out for
you and for your family, Jane. And just an aside to
our listeners, we're talking about young adults continuing
on parents insurance. Illinois is not a state where
that is regulated by law. In some states, that is required
by a state law that if a disabled dependent is on the
parents' insurance for employment, they're required
to continue them. But we don't have a law like that
in Illinois and each state has different laws. Now Lou,
can you tell us about your experience with young adults
staying on the parents' insurance from the families
that you've worked with from over the years at DSCC.
Is that pretty common or are there often difficulties?
A.
I wouldn't say that it is common. It can be done. But
the key is that the family has to be aware of what their
plan's provisions include and don't wait until the child
is 18 or 21 and then try to find out. A lot of things
with transition, it's never too early to start because
these issues are going to come up. So it's not at all,
it can be done. I think in Jane's case, I think that's
great that they continued the coverage for her son.
But
families, need to be aware and begin planning the process.
Jane brought up a good point and most insurance plans
will have an advocate or what they call a case manager.
In some cases, that person is not identified until a
certain of level of costs are reached or for certain
diagnoses. But most plans will have a case manager available
upon request by the family. So the family should contact
this person within the insurance plan to begin that
planning process you know for transition and to see
what benefits are available when the child turns age
21 if there is the possibility of continuation of coverage
for certain conditions or under what certain circumstances.
Q.
And at what age do you think families should start looking
into this? In the schools, the transition is planning
is required starting at age 14. But what about health
care transition?
A.
I would say by about age 16. And the reason for that
is because at about that age, the there are several
reasons. The the pediatrician who's involved with the
child's care may curtail or may begin the process for
transitioning to an adult care provider. Depending on
the child's condition, they may feel more appropriate
to be seen by an adult provider rather than than a pediatrician.
And that's the key component too is to to look at the
child the young adult. But they need to become more
involved with decision making, particularly self care
issues, and so at about that age, 14 to 16 ,you would
start as part of the transition plan to involve the
child in some decision making, in self care activities,
and then talk to the pediatrician about an appropriate
time to begin that referral process to an adult care
provider.
A.
I think that's really good advice, Lou, and I know
I did follow that with my daughter who's now 19 and
I told her as she got older, she would be losing, the
doctors that she goes to. At appointments I had
her ask the doctors until what age can I continue to
see you. And some of them said until age 18 and some
of them said until age 21 and she said she didn't want
to change all the doctors all at once.
Tell us something else about young adults with disabilities.
If they get jobs, do they usually get health insurance
and does that cover the medical care that they need?
Q.
Well studies that we've looked into as part of this
project show that a great percentage, in fact, some
studies put it at 60 percent of people with disabilities
between age 16 and 64 are either unemployed or under-employed.
Those that do are able to secure work, their average
wage is about 25 percent less than a non-impaired individual.
And so already there is that discrepancy. Again, depending
on the individual's abilities will greatly determine
the type of job that they're able to secure, including
you know previous work experience, educational preparation
and their skill level
Another factor that impacts on employability are people
with chronic illnesses may experience frequent periods
of illness. As a result, you know having unexpected
time off of work or school. So that also impacts them.
For those that do are able to find employment just like
I think with the rest of the work force, you know it
depends on what insurance plans are available through
the employer. And and I think any worker, including
those with a disability that have frequent health care
needs, need to look very carefully at the level of benefits
that are available through the the employer's health
insurance plan.
So you would say first they need to find out if the
job offers insurance. Second, find out if the insurance
covers the things that they need and third, find out
how much the insurance costs.
Q.
Okay and what happens if a young adult cannot stay
on the parents' insurance plan and they also cannot
get insurance from a job? What's available to help them?
A.Through
some state and federal type of programs, each state
has the formerly called the Public Aid or Medicaid program
that would be available. Each state's program varies,
however. There is also the SSI program that is federally
funded. That may be a resource. In Illinois, there is
also the Office of Rehabilitation Services or ORS whose
purpose is to assist individuals both educationally,
vocationally, as well as develop employment skills so
they would provide services to assist in those endeavors
as well. Again, each state may vary into the type of
program that is available.
Another fairly new program or actually it's a law, is
the Work Incentives Improvement Act in which previously
if a person received Medicaid benefits and they were
able to to get a job, then their benefits through Medicaid
would be discontinued. Now, however, as a result of
this new law that was passed in 1999, those types of
barriers have been removed so that there isn't that
penalty for a person with a disability if they were
to secure a job that that would not mean now that they
would automatically lose any Medicaid benefits.
Q.
Is the program that you're referring to the Medicaid
Buy-in program?
A.
Yes.
Q.
Okay well I know that that's new. We're all very excited
about that because this is a new opportunity for adults
with disabilities because a lot of people had to choose
between working and having health care. So this is helping
a lot of people and I believe Illinois is currently
working on a plan. Has it started yet, Lou?
A.
I don't believe it's in effect yet in this state
Q.
And where would you refer people who wanted to find
out more about it?
A.
They could contact, in Illinois, the SSI coalition.
Oh yes. And I can give you that number which is area
code 312-223-9600 for more information about this plan
in Illinois.
Q.
Well that's going to all of our listeners when this
can you can switch to the resource section of the webcast
when you're done listening and you will have more information
and a link to the website if the SSI coalition as well
as other information about new laws and programs related
to transition service for young adults with disabilities.
And Jane, have you heard about some of these new initiatives
and new programs?
A.
I have heard of a a couple of them. I haven't had
very much success in in finding placement for Tim in
work. I had ORS come out and they didn't feel that he
was qualified to be trained to go out and work in the
work force by himself. So it's been kind of a dilemma.
So I guess unless Tim and I would take the initiative
and find some kind of work at home on the computer or
something that I feel that we could do ourselves and
maybe market ourselves, I don't really see a lot of
chances out there for him to achieve employment. So
it's kind of disheartening. I don't think MacHenry County
has offered a lot.
Q.
I know transition is very difficult and very complicated
for everybody, for the family, for the young adult and
for the service providers. I understand that you he
use to be in the DSCC program and you had a case manager
who helped you find out about things like SSI. Could
you tell us a little bit about that please?
A.
My case worker manager was Lisa. And she was very helpful.
She made phone calls for me, she kept me up to date
as to what was going on, she helped us get the lift
for the van that Timothy needed. My husband and I pretty
much taken care of Tim by ourselves with his disability
for the last 17 18 years until I had a health problem
and my husband had a health problem and we decided that
we had to change and we had to go out and look for help.
And Lisa was just marvelous. I can't say enough about
this agency. They really did help us a lot. And she
also you know sent me information and so we worked together
quite closely until Tim turned 21. Because he turned
21 and became an adult, that service ended. But when
before that, it was really nice. It was really nice
that I could call her up and talk to her and she really
knew how to handle things.
Q.Well
that's great. Now Lou, can you tell us a little bit
more about how the DSCC consultants work with families
on transition?
A.
We try to work with the family in developing what vision
do they have for their child when they turn or when
they become an adult. And it is some difficult issues.
For example, we we ask the family as uncomfortable as
it is, where do you see your son or daughter when you're
no longer available to help take care of them? Where
is the child in terms of becoming independent to the
extent possible for self care and to make decisions?
Issues of guardianship in addition to the issue of securing
medical care and payment for that medical care. We talked
about the insurance issues and whether or not they can
be continued on the plan. So we try to to approach and
discuss those issues with the families. Again, there
are no common solutions because it depends on on the
family's resources, the needs of the child and the interests
of the child as well. And so each plan, what we call
a transition plan, will be unique to that particular
child.
Q.
And where do you and the members of your staff go to
get your updates and training on transition issues?
A.
Basically, we we've kind of learned as we've gone along
and when you say where have we learned from, it's from
the families themselves who have had to go through that.
When we began this project, we were in contact with
families who have become over-age for for our program
and asked them what were your experiences? You know
what work, what didn't? How do you see us helping families
before their child turns age 21? That was very insightful.
Again, I think the issue of transition while it's been
around but it is fairly new in the sense that it hasn't
really been addressed fully. And so it's still evolving.
There are a number of projects throughout the country
that are looking at transition issues. In particular,
one is out in Washington state. So it's an evolving
program or process I should say that really is a collaborative
effort between families and agencies or programs such
as DSCC.
Q.
Well I know is complicated. I'm going through that
with my daughter now who's 19 years old. I found out
about resources from other parents but it's pretty difficult
and I'm sure that Jane you would agree with that that
transition is not easy compared to the other things
you've had to do for your Timothy.
A.
You know it is it has been very difficult. I think
it just depends on the individual child and you know
what their handicap is. I think that as a parent you
have to be assertive. You have to know your doctors
and I think you have to go in and question your doctors
and make sure that you can work with this doctor and
make sure that this doctor's going to be able to work
with your child. I think that there's just it's a constant
thing that's always changing. Nothing you know really
stays the same all of the time. New problems arise.
So I think if you take one step at a time and and go
through the steps and talk to your friends and your
neighbors and other people of parents with disabled
children, it kind of takes a little bit of the burden
off your shoulders and makes you see things a little
bit clearly. So I think that that's what you have to
do. You have to approach it from that kind of standpoint
that maybe we'll learn something new today and that
type of thing.
Q.
Well I think that that's some really good advice.
Now Lou mentioned guardianship. Can you explain to us
a little bit more about what is guardianship and how
do you find out about it and determine if you're it's
necessary for your young adults?
A.
Well in Illinois, legally when a person turns age
18, they're considered an adult and to that extent are
able to make their own decisions. Now depending on the
child's medical condition, that may or may not occur.
But at some point, the the parents need to be able to
determine at what point the child is able to assume
responsibility for making decisions regarding their
medical care. Again, the natural law assumes that at
age 18, unless there are other circumstances, the family
may have to go to court and secure a legal decision
to continue to become the what's called a guardian or
the the individual that can make decisions. Another
issue is if the parents are not available through death
for example, who then you know will be responsible for
making these medical decisions on behalf of the child
or I should say the young adult. So that's a very important
issue that families need to address at some point for
their child.
Q.
And Jane, did you pursue guardianship for Timothy?
A.
Yes I did when he was 18 and I did go to my lawyer
and we went to court and I did it strictly not so much
to have control of Timothy's funds or or anything like
that. I did it because I was worried about him medically.If
Timothy became desperately ill, I did not want the doctors
to be able to tell me that this had to be done. I feel
that I know Timothy the best in this world, not that
I'm smarter than a doctor, but I felt that I wanted
to be able to sit down and talk to that doctor and I
wanted his suggestions and whether I took that suggestion
or not I wanted that to be my right as Timothy's Mother
and guardian.
Q.
And what did you tell Timothy about the guardianship?
A.
Well he went to court with us and we explained as
we went along.W e talked to a lawyer and he even talked
to a judge and it was okay with him. He knew that I
wasn't trying to take charge of his life I mean he has
his own opinion and we had even discussed him going
into a home if that's what he thought he wanted like
Miseriacordia. We thought that maybe he would like that
socially, but you know as of this point, he has decided
that you know he's just not interested in that. . But
these are options that we talked to him about and feel
that he has the right to know them and I don't suppose
that we you know explained it all that technically.
We put it in his own own terms so that he could understand
everything that was being done because I I felt that
he was this is his life. This is not my life.
Q.
Well it sounds like you did an excellent job and you've
also brought him up to be a self advocate which is an
important transition skill
A.
I think that it is. I think that I think that children
sometimes are intimidated by adults and I noticed even
when the gentleman was there working with him in his
new electric chair, Timothy was putting his input in.
Q.
Wonderful. Now Lou, could you share with us some
experiences you and your staff members have had in talking
with families and their children about self advocacy
and self determination?
A.
It is apparent that at some point you have to give up
some control as your child matures. And for children
with special health care needs, because their needs
are more so, sometimes that transitioning or giving
up may be difficult. We try to encourage the family
to work on independence which would include for example,
involving the child in decision making. And as Jane
had noted, her son was able to give input you know when
they were making modifications to the wheelchair. So
make sure that the child has an understanding of their
their condition and how it impacts on them. You know
as the child matures, they're going to have a different
understanding level of just how it impacts that condition
and how it impacts on their life. To also to encourage
the child to to be more involved in self care you know
whether that be self catherization or levels of hygiene.
Those types of things again dependent upon the child's
ability. So that's how you can start.
Another
way is to when when you go to the doctor's office, a
lot of times the physician will talk directly to the
parent, even though they have this young person young
adult in the room with them. But rather direct the provider
to ask questions directly to the young adult and elicit
their responses and establish eye to eye contact with
the child rather than with the with the parent. Those
are some things that we try to we mention to families
and try to work with them to encourage independence
for medical transitioning
And I think that applies to all areas of life. I always
say we have to teach our children to be self advocates
from an early age, and it starts when they're really
little, giving them a choice of whether they want to
drink apple juice or orange juice or whether they want
to wear denim or corderoy overalls and then it moves
on. As you know, my daughter is deaf-blind and she has
cerebral palsy and I have been teaching her to be a
self advocate, to ask her own questions in the doctor
appointments. Now I have her sit down at her braille
writer and write the questions. Then we bring them to
the doctor's office and I arrange for her to have an
interpreter so if she wants to ask questions when I'm
not there, she can have privacy and I've let her know
that as you get older, you get to have privacy and have
your own life. But it's not easy. And I do agree with
you that many doctors just expect only to talk to the
parents and it never occurs to them to talk to the child
who is the patient and you know particularly for my
daughter and other people who don't speak, it's easy
to be looked over.
A.
agree with Lou. I find that a lot that people will come
up and talk to me and an ask a question that really
should be directed to Timothy. And I'm like well you
have to ask him. And they always seem to speak louder
too. I don't know why they do that, but his pediatrician
does now ask Tim. He doesn't ask me the questions. He
asks him.
Q.
I will say I don't think that doctors get specific training
in this area and it's something that they also learn
on the job from their patients and the patient's families.
A.
You know that's probably very true. How many kids do
they have to deal with that has you know that would
have Timothy's problems. So I guess we have to give
them credit, but it is it is interesting to see how
people direct questions to me instead of Timothy and
I just turn it over to him.
Q.
Lou, could you tell us a little bit about the DSCC consultant's
role in like getting involved sometimes with doctor
visits or in training for doctors and working with young
adults with specialY needs?
A.
Yes we provide care coordination for families. We do
make ourselves available if at the family's discretion
if they want us to accompany them to an office visit
or if they've left the doctor's office and they still
have questions. We will either advocate for the family
or at the request of the family meet with physicians
to to discuss transition or any other medical questions
that the family may have about the child's condition.
As far as actual education of the provider it's basically
one on one. You know what are the needs of the child
and what are the concerns of the family and how can
we facilitate that communication between the family
and the provider?
Q.
I see and has it ever happened that a consultant got
a call from a family after a medical visit when they
had been to see one of the pediatric specialists and
they just said to them your child is too old and they
can't come back here anymore. What would happen in a
case like that?
A.
Well if they had me, we would look for a more timely
type of transition you know process. We found it both
ways in that parents aren't the only ones sometimes
who are reluctant to to give up taking care of the child,
especially if a pediatrician has had a life-long involvement
you know with with the child. They have concerns about
continuity of care and they may find it difficult to
find an appropriate time to transition to an adult care
provider, as well at some point physicians. For example,
it's been our experience that some physician specialties
will only treat children up to a certain age be that
age 14 or age 16, and then expect an adult neurologist
or cardiologist to begin you know taking over the care.
If we know who those providers are, we will warn the
families or begin working with the families.
Q.
So then there's not a hard and fast rule about whether
young adults with disabilities should stay with a pediatric
provider or at a certain age should change. You're saying
that this is a more individual decision that it is really
part of a process. Is that right?
A.Yes.
It's dependent upon the child's needs, the comfort level
of the family and as well as there are some adult providers
who even though this is a 19 or 21 year old individual,
that they're still uncomfortable only because of of
their experience hasn't been with a person with that
particular condition. It depends on a number of factors;
the child's level of impairment and needs, the providers,
both the pediatric and the adult care provider and their
level of experience and comfort level in dealing with
that type of condition. It is important, however, when
an individual goes to an adult care provider not to
cut out completely the pediatrician or the pediatric
specialist because they can be a valuable resource to
the adult provider. And so there may be like an ongoing
consult between the pediatric provider and the adult
care provider.
Q.
Jane, has your family been involved in any relationships
with that like that with a pediatric specialist and
an adult specialist for Timothy?
A.
No I can't t say that I really have had to switch my
doctors. Timothy's dentist is has been with him since
he's been three. His neurologist has been with him since
he's been four. Dr. Rayez has been with him, his pediatric
and family doctor has been with him since he's been
born. So the only one that I had to switch was with
Dr. Smith down at Shriners. He was an orthopedic specialist.
So I really haven't had to deal with that many other
doctors than the ones that I've been very familiar with.
The only thing that I can say is that I know what I
would do with Dr. Smith. I would go and I would get
a recommendation for another doctor and I would make
an appointment to go down and see this doctor before
you know anything was even wrong and I would bring Timothy
and see how he would interact with Timothy and with
myself and if he was willing to answer questions and
see how we all got along. I think that that's a key
to great health care is being able to work with your
doctor and I would like him to be able to take some
of my input and I would like to hear his input and I
would like us to be able to agree on you know what we
think is best for Timothy.I think you have to sit down
and do your homework and then I think that you know
you have to go out and search.
Q.
Well that's really good advice. I think we all need
to remember that. A question for you, if you would go
with Timothy to meet a new doctor and see if they might
be suitable, is that something that would be covered
by your insurance or would you have to pay for that
out of pocket?
A.
I don't believe a consultation would be covered, so
that would have to come out of my pocket. But that to
me would be something that would be very worthwhile
because I think what I would do is introduce Timothy
to the doctor and then I would see how they interact.
And Timothy's a very good judge of character. He knows
who he's comfortable with and he knows who he can talk
to and if it was somebody that was very abrupt or somebody
that he couldn't even understand, it would be difficult
for him. So as long as this doctor is for Timothy, I
would think and Timothy's going to be in his care, that
he has to be comfortable with it. So I guess even if
I did have to pay for it, it's something that I would
be willing to do.
Q.
It would be a good investment?.
A.
Oh yes.
Q.
We just have a few moments left so Lou, are there
any other important things about health care transitions
that you'd like to share with us?
A.
Well I think if we were to summarize the discussion,
I think a couple of guidelines and that would be it's
never too early to begin the transition process. If
you think about the future for your child, particularly
the level of medical care the child requires. I think
another point you know we've identified is that the
best advocate for the child will be the parents because
of their knowledge of the child and, of course, they
have that vested interest. There are other like their
case manager through DSCC or through the insurance plan
to get the ball rolling, you know it's the parent that
has to initiate it.
And
then too to just base all decisions on on the needs
of the child you know first and foremost as you look
at the different types of insurance plans and what they
will cover or different types of state plans or programs
that are available to assist the family and helping
either fund or access health care services.
Well
I want to thank both of you for your time and your very
helpful contributions with a lot of important transition
information. I know that this will be really useful
to lots of families and lots of providers all over the
country and thank you for sharing your expertise with
us. I'm grateful for your help and we're now concluding
our webcast in the KMCO series on managed care and children
with special health care needs. Thank you for logging
on to our webcast production. We're very interested
in your comments and questions regarding the webcast
and we invite you to contact us. our e-mail address
is kmco@uic.edu. Our telephone number is area code (312)
996-2233 and our fax number is (312) 413-0367. We hope
that you've enjoyed this broadcast and that you will
also join us for our upcoming broadcasts. They're scheduled
for the fourth Wednesday of each month at 1:30 p.m.
central time. Please take note that once we have aired
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on the same website and you can access them at any time.
Our internet address is www.uic.edu\sph\cade\qcmc2 and
it features our archived webcasts. There are extensive
lists of resources related to children and youth with
special health care needs and managed care, links to
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