technology to an individual’s independence and participation in community life, including work. Policy makers should also investigate new approaches for supplying covered technologies and providing timely and appropriate repairs to equipment that is damaged or not working.

Promote models of coordinated chronic care and other strategies for improving the transition of young people from pediatric to adult health care.

For many young people with disabilities, the transition from pediatric to adult health care brings many challenges. These challenges include the fragmented organization and financing of health care, dysfunctional provider reimbursement methods, and the limited adoption of sophisticated information technology to support information exchange among the generalists and the specialists who care for young people with complex health conditions.

The convergence of the medical home model of care for children with special health care needs and the chronic care model designed primarily with adults in mind offers great promise. If the principles and practices underlying these models were widely adopted, young people would be much more likely to receive the comprehensive assessments, guidance, and services that correspond to the recommendations of professional societies for managing the transition from pediatric to adult health care. Among other steps needed to support the successful movement of young people from pediatric to adult care, the U.S. Congress should extend Medicaid and State Children’s Health Insurance Program coverage through age 21 for all beneficiaries with chronic conditions or disabilities and should specify that program benefits cover appropriate transition assessment, coordination, and management services for these young people.


Develop educational programs, evidence-based reviews, practice guidelines, and other materials to support health professionals in caring for people with disabilities.

Health care professionals are not necessarily well informed about the primary health care needs of people with disabilities, the prevention and management of secondary health conditions, the challenges that adults face in aging with disabilities, and the transition of young people with disabilities from pediatric to adult services. Among other actions, this report recommends strengthening education in chronic illness and disability man-

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