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Blueprint for Adolescent and Young Adult Health Care BLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE December 2016 MSAHC Blueprint Guide_v12-Print_RELEASE.indd 1 1/30/17 12:10 PM ACKNOWLEDGMENTS We would like to thank the New York State Health Foundation, especially James R. Knickman (former president and chief executive officer), Jacqueline Martinez Garcel (former vice president), and Lourdes Rodriguez (former program officer) for their vision, intellectual contribution, critique and feedback, and financial support of this Blueprint for Adolescent and Young Adult Health Care. The Foundation has been a strong supporter and advocate of policies, programs, and initiatives, like the Mount Sinai Adolescent Health Center, to improve the health and well-being of adolescents and young adults in New York State and beyond. This Blueprint was developed by Dr. Angela Diaz,the faculty and staff of the Mount Sinai Adolescent Health Center, and ICF under the advisement of a group of esteemed partners and collaborators. An advisory board was convened to provide guidance on the development of the Blueprint. Advisory board members volunteered their time to participate in meetings, review drafts, and provide thoughtful feedback and commentary during the development of the Blueprint, and we would like to acknowledge their hard work. The Blueprint advisory board members have diverse backgrounds and expertise, and a commitment to the health of young people. A list of members follows. Commissioned by Mount Sinai Adolescent Health Center with funding provided by New York State Health Foundation. i BLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CAREBLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE i MSAHC Blueprint Guide_v12-Print_RELEASE.indd 1 1/30/17 12:10 PM ACKNOWLEDGMENTS . Katherine DeFoyd – Founding Partner, Growth for Good . Jacqueline Martinez Garcel, MPH – CEO, Latino . Angela Diaz, M.D., Ph.D., MPH – Director, Mount Sinai Community Foundation, formerly Vice President, Adolescent Health Center New York State Health Foundation . Licy Do Canto – Founder and President, . Kristine Mesler – Associate Bureau Director, The Do Canto Group Child and Adolescent Health, New York State Department of Health . Lorraine Gonzalez-Camastra, LCSW – Director of Health Policy, Children’s Defense Fund-NY . Faith Mitchell – President and CEO, . David Gould – Senior Vice President for Program, Grantmakers in Health United Hospital Fund . Wendi Paster – Chief of Staff, New York State Assembly . Richard Gottfried – Assembly Member, Member Richard Gottfried New York State Assembly . Ken Peake, DSW – Chief Operating Officer and . Vincent Guilamo-Ramos, Ph.D, MS, MPH, LCSW, RN – Assistant Director, Mount Sinai Adolescent Associate Professor, Silver School of Social Work, Health Center New York University . Lourdes Rodriguez, DPH, MPH – former Program . Judith Hannan – Advisory Board President, Mount Sinai Officer, New York State Health Foundation Adolescent Health Center . Eileen Salinsky, M.B.A. – Program Advisor, Grantmakers in Health . Melanie Hartzog – Executive Director, Children’s Defense Fund . Anthony Shih, M.D., MPH – Executive Vice President, New York Academy of Medicine . Evelyn M. Kappeler – Director, Office of Adolescent Health, United States Department of Health and . Laura Sloate - Managing Director, Human Services Neuberger Bergman L.L.C., Mount Sinai Adolescent Health Center Advisory Board . Virginia Knox – Director, Family Wellbeing and Children’s Development Policy Area, Manpower Demonstration . Terri Tanielian, M.A. – Senior Research analyst, Research Corporation (MDRC) RAND Corporation . Ronda Kotelchuck – Former CEO, Primary Care . Bruce VIadeck, Ph.D. – Senior Advisor, Development Corporation Nexera, Inc. Jane Isaacs Lowe – Former Senior Program . Christine Walrath, Ph.D. – Senior Vice President, Advisor for Program Development, Robert Wood ICF Johnson Foundation BLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE ii MSAHC Blueprint Guide_v12-Print_RELEASE.indd 2 1/30/17 12:10 PM CONTENTS Chapter 1. Making the Case for Adolescent 1 and Young Adult Health Care Chapter 2. Introducing the Mount Sinai 5 Adolescent Health Center Chapter 3. Developing Adolescent and 11 Young Adult-Centered Health Care Chapter 4. Creating an Adolescent and 27 Young Adult-Centered Culture Chapter 5. Providing Adolescent and 41 Young Adult-Centered Health Care Chapter 6. Strengthening Adolescent 67 and Young Adult Care with Evaluation and Research Chapter 7. Implementing the Adolescent 75 and Young Adult-Centered Care Model: Next Steps References 87 iii BLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CAREBLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE iii MSAHC Blueprint Guide_v12-Print_RELEASE.indd 3 1/30/17 12:10 PM CONTENTS Tools for Getting Started Appendix A: Chronology of the MSAHC’s Development Appendix B: MSAHC’s Operating Budget Appendix C: List of MSAHC’s Sexual and Reproductive Health Services Appendix D: Detailed Descriptions of Therapeutic Approaches Appendix E: Links to Mental Health Intervention Descriptions Appendix F: Template of MSAHC’s Model BLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE iv MSAHC Blueprint Guide_v12-Print_RELEASE.indd 4 1/30/17 12:10 PM MSAHC Blueprint Guide_v12-Print_RELEASE.indd 5 1/30/17 12:10 PM CHAPTER 1. MAKING THE CASE FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE Why Adolescent and One of the most Young Adult–Centered important commitments Health Care? “ a country can make for Adolescents (aged 10 to 19 years) and future economic, social, young adults (aged 20 to 24 years) comprise approximately 21% of the population of the and political progress and United States1—a significant segment of our stability is to address the society with immense promise to contribute to our communities. These young people health and development are at an age of transition when they are needs of its adolescents. 3 developing and adopting healthy or unhealthy ” behaviors based on their life situations young people, their unique health care thus far.2 Despite their limitless potential needs have not yet been incorporated into to contribute to our society if given the transformation activities.5 To date, they have opportunity for a healthy future, frequently, been viewed as a subset of the pediatric their unique needs are not addressed by the population6 and discussed largely in terms of traditional, adult-focused health care model. the family medical home. The unique factors The passage of the Affordable Care Act (ACA) that relate to the needs of young people and of 2010 has stimulated increased interest in their concerns when seeking care have not medical homes that can comprehensively been specifically considered. One aim of this address health care. For young people, blueprint is to help catalyze and inform the establishment of a medical home can this discussion. increase the likelihood of building a trusting The Mount Sinai Adolescent Health Center relationship with a health care provider and (MSAHC or the Center), with nearly 50 years provide valuable insight into how all aspects of experience working with this age group, of health are connected. The importance has long recognized that it is imperative to of consistent, comprehensive care is prioritize the health of young people and underscored by evidence that nearly half of ensure access to care that is specific to young people do not have a medical home their developmental needs. In establishing and that the resulting lack of coordinated this program, MSAHC has built a model care is linked to failure to diagnose mental that responds to the need for a health home disorders at an early age.4 However, while specifically for young people, has created the transformation of primary care via the best practices in adolescent and young adult medical home model could greatly benefit health services, and is currently developing BLUEPRINT FOR ADOLESCENT AND YOUNG ADULT HEALTH CARE 1 MSAHC Blueprint Guide_v12-Print_RELEASE.indd 1 1/30/17 12:10 PM the evidence of what works in providing requires experimentation—and is when health services to young people. many adult behaviors are established. The health of young people impacts The behavioral patterns that evolve during their health and well-being throughout this developmental period help determine their lifespan. young people’s immediate health status and influence their long-term health, including During adolescence, the responsibility to be their risk for developing chronic diseases in healthy begins to shift from caregivers to adulthood.2 young people, making it critical to ensure that they have access to health care, education, Due to this developmental transition, and the opportunity to develop the skills they adolescent behavior can be highly influenced need to be productive and make valuable by individual, environmental, organizational, societal contributions.7 Health care providers and community contexts, illustrated in can play a unique role in providing appropriate Exhibit 1. Interpersonal interactions with interventions that encourage young people individuals and groups, including family to become great health care consumers and members, peers, teachers, health care adopt healthy behaviors. These interventions providers, and school personnel, can impact can be reinforced by educators, advocates, young people’s health and well-being in and family to empower young people to thrive positive and negative ways. Cultural factors physically and emotionally. shape interactions and have an impact on the young person and his or her environment. Young people experience unique challenges.
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