Like many adults with ID, Mr. Foster does not have a PCP. People with ID often must contact many physicians before they can find one who will provide care to them. Lack of a PCP may be the result of unsuccessful transition from a child-oriented system of care. Health transition must take place for all youth as they “age out” of child-oriented systems, but this process is particularly critical for youth with ID.
Few adult health primary care providers are trained in the health care needs of adults with ID. There is also a perception that a visit with a patient with ID will take more time. With pressures in the typical primary care practice to limit the duration of patient visits, some PCPs prefer not to take on patients with disabilities. The America College of Physicians has developed a set of tools for physicians, specific to the needs of young people with ID, to facilitate successful health transition, good communication and care coordination. The toolkit is found at https://www.acponline.org/clinical-information/high-value-care/resources-for-clinicians/pediatric-to-adult-care-transitions-initiative/condition-specific-tools ► click on “General Internal Medicine” to expand menu ► click on “Intellectual/ Developmental Disabilities” to open the PDF.
The Nisonger Center UCEDD at The Ohio State University provides on-line training for health professions trainees and health professionals to provide quality healthcare for people with ID (Healthcare Access for Persons with Disabilities). This training is available at: http://nisonger.osu.edu/education-training/ohio-disability-health-program/disability-healthcare-training/
Since implementation of the ACA, working age adults with disabilities are more likely to have health insurance and less likely to have barriers to access1. Other benefits of the ACA that are especially important for people with ID are the requirement for free coverage of preventive services, provision of essential health benefits and elimination of lifetime limits on health benefits. The Autistic Self-Advocacy Network’s (ASAN’s) page “Health Care and You: Why How We Pay for Health Care Affects Our Lives and How to Improve It” summarizes key laws and regulations impacting healthcare for people with ID and provides links to ASAN’s toolkits and resources on health care (https://autisticadvocacy.org/actioncenter/issues/healthcare/).
References:
- Kennedy, J., Wood, E. G., & Frieden, L. (2017). Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017734031.
Question 3.5
What should the social worker do to connect Mr. Foster to services and supports?