Altman Stephanie, O'Connor Sarah, Anapolsky Ellyce, Sexton Laura
Sargent Shriver National Center on Poverty Law, Chicago, IL, USA.
Chicago Medical-Legal Partnership for Children, Legal Council of Chicago, Chicago, IL, USA.
J Pediatr Rehabil Med. 2014;7(1):71-7. doi: 10.3233/PRM-140270.
While all children face challenges as they become adults, children with chronic medical conditions or disabilities face unique barriers in their transition to adulthood. Children, especially those who are low income and have special needs, are eligible for a range of supports including income supports, health care coverage, vocational and educational supports. These supports are critical to sound health because they ensure access to necessary medical services, while also offsetting the social determinants that negatively affect health. Unfortunately, as children transition into adulthood, eligibility for these benefits can change abruptly or even end entirely. If medical providers have a better understanding of five transition key dates, they can positively impact their patients' health by ensuring continuous coverage through the transition to adulthood. The key dates are as follows: (1) transition services for students with an Individualized Education Program (IEP) must begin by age 16 (in some states such as Illinois, these services must be in place by age 14 1/2); (2) at age 18, eligibility for income supports may change; (3) at age 19, eligibility for Medicaid may change; (4) at graduation, eligibility for educational supports will end unless steps are taken to extend those benefits until age 22; and (5) when individuals prepare to enter the workforce, they will become eligible for vocational rehabilitation services. With an understanding of these key transition dates and how to partner with social services and advocacy organizations on behalf of their patients, medical providers can help to ensure that transition-age patients retain the holistic social services and supports they need to protect their health.
虽然所有儿童在长大成人的过程中都会面临挑战，但患有慢性疾病或残疾的儿童在向成年过渡时面临着独特的障碍。儿童，尤其是低收入且有特殊需求的儿童，有资格获得一系列支持，包括收入支持、医疗保险、职业和教育支持。这些支持对健康状况良好至关重要，因为它们确保了获得必要医疗服务的机会，同时也抵消了对健康产生负面影响的社会决定因素。不幸的是，随着儿童步入成年，这些福利的资格可能会突然改变，甚至完全终止。如果医疗服务提供者能更好地了解五个过渡关键日期，他们就可以通过确保在向成年过渡期间持续提供保险来对患者的健康产生积极影响。关键日期如下：（1）针对有个性化教育计划（IEP）的学生的过渡服务必须在16岁时开始（在伊利诺伊州等一些州，这些服务必须在14岁半时到位）；（2）18岁时，收入支持的资格可能会改变；（3）19岁时，医疗补助的资格可能会改变；（4）毕业时，教育支持的资格将终止，除非采取措施将这些福利延长至22岁；（5）当个人准备进入劳动力市场时，他们将有资格获得职业康复服务。了解这些关键过渡日期以及如何代表患者与社会服务和倡导组织合作，医疗服务提供者可以帮助确保处于过渡年龄的患者保留保护其健康所需的全面社会服务和支持。
