HRSA/MCHB 2005 FEDERAL/STATE PARTNERSHIP MEETING

PUBLIC HEALTH ACROSS THE LIFESPAN

Cross-Cutting Issues in Transition

TONI WALL: Well, another good morning to you all. Ten minutes isn't very long to give you an overview of what Maine is doing with transition, but in the short time that I have, I'd really like to present you with our current status of our transition project.

So let's begin by talking about youth. Maine's Youth Advisory Committee, YEAME, or how I always say ‑‑ I say, "Yay‑me," and I'm always corrected, it's "yah‑me" ‑‑ represents seven regions of the state. We hold six meetings per year, always on a Saturday, being respectful that youth need to be in school, and that they really need to concentrate on their education just like all other youth.

They get paid $10 an hour. I'm look at increasing that up to $12 an hour for next year. They get reimbursed for mileage whether their parents drive or whether they drive. We also cover PAC costs. Patty asked me about how much it cost per year. In trying to average that out, it's about $3,500 per year, give or take if we have a special meeting towards the end of the year where it may cost a little bit more money. But it's actually relatively inexpensive to do. I didn't mention, we have actually eight youth ranging in age from, as I look at this picture, probably about 17 to 25.

YEAME has been active since about 1998, '99, but was really formally established in 2001. We went away for a couple days and developed a mission statement and bylaws and sort of a strategic plan of really where they wanted to head in the next couple years. They have been extremely active in many things throughout this state.

Many of the MCH directors and CHSN directors here may have received our "Youth Speak" CD. They use that for presentations across Maine. There's a healthcare, and if I can name them all, there's peer, there's a health ‑‑ what our healthcare providers should know, what our peers should know, what policy makers should know, school folks, and I'm going to forget the last one. But if you have that CD, please look at it. It's really exciting. We've trained, worked with the youth. They do all the presentations for that, and it's just really gone over quite well.

They also participated and actually planned three youth conferences. They held and did the workshops on going on to college, what healthcare means to me, and getting a job. We had, oh, I think about 30 or 40 youth from across the state participate in each one of those, and those have really been great.

They were involved in our medical home training that we did, called "Stepping Stones," last year. We made sure that youth and families participated on every single one of our panels.

They also helped us with the service tapestry that the University of Maine Center on Community Inclusion houses to make sure that it's kid friendly. All too often we seem to develop or create things that just, we think they're kid friendly, but, let's face it, folks, many of us haven't been youth for 30‑plus years. And as I was telling Brianne, I find it really hard to remember what I was like when I was 20, let alone 16.

One exciting thing is that they review a lot of our policy documents. We had them review our MCH block grant a couple years ago. Actually, not this past one but last July. They attended our review in Boston. And Elijah actually came up with some interesting things that he really didn't know, what was also going on in the greater part of maternal and child health.

They've partnered with the FAC, that's our Family Advisory Council, and actually were part of the block grant needs assessment review this year, both our family and youth.

They've advised me on many things. They noticed that our application, when ‑‑ we serve kids up to the age of 21, and one of the questions was, "Well, when I'm 18 and I'm independent, who is supposed to fill out the application? My mother?" And I said, "The way it stands now, yes, your mother." So they said, "That's not right. I'm independent. I'm by myself. Let's fix this application." So we did.

They are also part of the governor's summit called "Realize," and that was regarding out‑migration of youth in Maine. And they've been really prominent on doing national presentations such as TASH.

Let's see. This is just a picture of us working together. And they really appreciate having me be part of their group. I make sure that I'm there for all of their meetings. And the one time I did come in late, and perhaps some of you have heard this story, but Elijah, who is not pictured here, looked at me and said, "Well, it's really nice that you showed up for our meeting." And I said ‑‑ and it just made me very aware, because I was probably two hours late, that when I said I needed to be somewhere, I really need to be there for them and make sure that they recognize that I really am committed to what they are doing.

This is Mallory. This is one of things that we're currently working on. Mallory is 22 and, oh gosh, I can't believe ‑‑ I think she's in her third year of college. I think it's her third year of college. Maine, like most states, is very rural. Our transportation exists in the cities. There is no transportation outside of that. And any kid, what is it they think about when they're 14 and they start high school? I can hardly wait to drive. I can hardly wait to get my license and become independent and not have to rely on mom and dad.

And it's no different for kids with special health needs. The big difference is that Mallory, she's about four feet, and she was able to access and do the written part of the driver's license, but when it came to obtaining the actual driving stuff, they didn't know what to do with her. They didn't know how to accommodate her, they didn't know where to send her, they didn't know anything.

So Mallory brought that forward to the advisory committee and, lo and behold, there were other kids on our group that experienced the same thing. So we wondered what we could do. And Maine has started a youth legislative committee made up of youth from different high schools to actually inform the legislature on different things around youth.

So we brought it in front of them, and they were amazed that something so simple for them, that they just go take their driver's test, take their test and are able to get a license, that it was so difficult for kids with special health needs. And they wanted to make a law right away that this would change.

And that's not what the YEAME wanted. What they wanted was resources. We want the mom‑and‑pop driving schools to know where to send us, where the resources are, how they can accommodate us. We don't need another law, because we knew that wouldn't work. So we're still sort of working on that process right now.

Patty asked me to talk about how this all works, so I said, well, in the beginning, what did we do? We've had Healthy and Ready to Work since 1997, so we really have eight, almost nine years of experience. And one of the things that we do really well in Maine is we collaborate and build partnerships. And right from the very beginning we decided that we're going to get all of the agencies and folks involved and have them sit at the table.

So we made sure that we had Center for Community Inclusion, DOT, the committee on transition, disability centers, education, labor, Medicaid, disability rights centers, families, and youth sat at the table at the same time to look at Healthy and Ready to Work.

And our project ‑‑ both of our projects are really, as it says, were to create systematic change at the CHS and program level and throughout the state in support successful transition for youth with special health needs and disabilities.

So we've actually ‑‑ transition has really become a growing movement in Maine. And what I've really been surprised about is all of the different people who have really come together to look at trainings. I think one of the most exciting things is the Maine Children's Cabinet, which is chaired by the First Lady, one of their priorities over the next couple years is transition. The Maine Children's Cabinet houses the commissioners of ‑‑ and if my Maine friends can clue me in on all of them because I always forget one of them ‑‑ labor, education, health and human services, corrections, and I always forget the fifth one. But they're all interested in transition, and they're really looking at foster care children right now, and we're involved with that process.

The Maine chapter of AAP recognizes that transition to adult healthcare is a huge issue. I met with them about a week ago before I came down here, and they're so leery of transitioning those kids to adult healthcare docs just because they recognize that they don't have, or I should say they think they don't have the skills in order to take care of those kids. And we need to change that perception. So we're working with AAP to fix that. The Hood Center are partners in chronic care and the medical home learning collaborative, which we're participating in now. Both are looking at transition within the pediatric care.

Our Maine Advisory Counsel on Education of Children, they've been interested in transition for eons, and that's one of the things they work on. However, they've never included health, which we found very interesting that that wasn't part of their plan. So we've really ‑‑ we're part of that advisory council, and we've brought health into that, recognizing that in order to be educated, you really need to be healthy to attend school.

The Chicago team, we sent a team to Iowa back in December to look at change and transition, and actually what they've come up with for their statement, and we also have youth involved on this Chicago team, is that all Maine high school graduates are prepared for and pursue post‑secondary education and/or employment, including self‑employment, that leads to meaningful and comfortable lives with the self‑directed supports they require to be successful.

That team is actually working ‑‑ that team helped apply for the National Governor's Association Youth in Transition, which Maine applied for but did not receive, and we're continuing to work on that even though we didn't get the application.

And I think that you need celebrate. That's one of the things that my advisory committee, the youth and I, we celebrate all our successes. In this particular slide we're holding a photo, was our last meeting of this year back in June, and they presented me with an award that, I have to tell you, that's the best award that I ever got just for helping them out and being able to do things. And this is a collage that I keep over my desk at work of the five or six years of things that we've been doing.

And why involve youth in doing transition? Because, let's face it, it's the right thing to do. They know more about what they need than we do. They need to be involved in everything, the policy‑making and all the stuff that ‑‑ all the things that we do. They need to be at the table. And just like Brianne, they need to be there and help in the policy decisions that affect their lives.

And, again, you can contact me. My web address is up there, and please feel free and I'll answer all your questions. Thank you.