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Family and Children's
Resource Program

Vol. 23, No. 1
May 2018

Preparing Transitioning Youth to Look After Their Own Medical Needs

In our efforts to support youth in foster care in their transition to independent adulthood, their health and health care deserve special attention. Experience and research tell us that many of these youth have a hard time accessing and managing their medical care (Courtney, et al., 2001, 2016a; Reilly, 2003; Rosenbach, 2001).

This is a problem, because foster youth are three to seven times more likely than their peers to have chronic health conditions such as diabetes or asthma (Jaudes, 2012). In fact, in 2014, nearly 72% of youth in foster care age 18-21 had at least one chronic condition (NC Pediatric Society, 2016). Transitioning youth need our support to meet their medical needs.

How You Can Help
The following suggestions for preparing youth to assume care of their medical needs come from a review of the research and a conversation with Kern Eason, Pediatric Program Manager at Community Care of North Carolina (CCNC), and Christy Street, Project Director of the NC Pediatric Society's Fostering Health project.

Highlight health care's importance. Youth this age tend to feel invincible, so they may not see the need to focus on their health (Jaudes, 2012). Outline the importance of preventive medical care, regular check-ups, dental and vision care, healthy eating, and exercise.

Emphasize mental health, too. Youth in foster care have higher levels of emotional distress that can have a significant impact on their mental and physical health (Felitti et al., 1998; Jaudes, 2012). Unfortunately, many youth do not continue mental health services once they exit care. Underscore the importance of continuing counseling and medication management (Courtney, et al., 2001; Reilly, 2003).

Make sure they know their rights. Youth aging out of care can qualify for Child and Family Medicaid until age 26, regardless of their income. This gives them higher levels of coverage than others their age typically have. Youth adopted before age 18 may qualify for Health Choice benefits, or they can be on their parents' medical coverage until age 26.

Teach them about the difference between pediatric and adult care. For example, adults must decide who will be on their medical team (e.g., parents/caregivers) and they must advocate for themselves with health professionals. In addition, adults' appointments with physicians are often shorter. Young adults with chronic conditions (e.g., sickle cell anemia) may have to manage relationships and appointments with both specialists and their primary care doctor.

Help them navigate logistics. The application and enrollment process for Medicaid is complicated and must begin before youth leave care. Connect youth with an eligibility worker and inform the worker of the youth's foster care status, so they get the right type of coverage. Help youth complete the application and obtain the necessary documentation.

Youth also need to know when their pediatrician will stop treating them, so they can find an adult provider well in advance. Link youth to a CCNC care coordinator so they will have more support overcoming barriers to care (NC Pediatric Society, 2016; Jaudes, 2012; Rosenbach, 2001).

Start preparing youth for the transition at age 14 or 15. Give youth increasing levels of responsibility for scheduling appointments, obtaining prescription refills, researching their conditions/medications, etc.

Share information with youth about their family's medical history. Knowing their family medical history and being able to accurately report this to medical providers is a key part of preventive care.

Resources for Workers and Youth

Fostering Health NC. This NC Pediatric Society project features an online resource library with tools for maximizing partnerships between DSS, primary care providers, and CCNC.

Transition Quickguide. This guide seeks to help youth and young adults gain self-care and decision-making skills to take charge of planning and managing their own health and career goals.

American Academy of Pediatrics Transition Guide. This accessible 5-page guide clearly outlines steps youth must take to assume responsibility for their health as they transition to independence.

Pen & Paper Self-Assessment. Created by Got Transition (, this is a tool youth can use to determine their readiness to manage their health needs.

Online Quiz. This is similar to the tool above, but in online quiz format.

TeensHealth. This website offers health-related information for youth and their caregivers.

Fostering Connections I and II. These 30-minute, self-paced online courses provide knowledge and tools for collaborating successfully with medical homes and CCNC to improve outcomes for children. Available to NC county child welfare professionals via


References for this and other articles in this issue