An adolescent model of care

2. What We Know About Adolescent & Young
Adult Health (AYA)
 The Upstate has no adolescent and young adult (AYA)
center
 There is no AYA model of care like UCAYA in SC.
 Health damaging behaviors begin during adolescence
 Risk behaviors Co-occur
 Adolescent barriers exist
 Provider barriers exist
(National Research Council & Institute of Medicine, 2007)

3. Who, What, Where, Why, When…
A multidisciplinary team of professionals
UCAYA: Adolescent & Young Adult Model of Care
The Upstate of South Carolina
Improve the health of adolescents & young adults
Created in 2014 over a cup of coffee.

4. UCAYA’s Mission:
To bridge the gap in adolescent and young adult services by educating,
empowering collaborating and connecting patients, families, practices and
communities with evidence based knowledge, clinical education and
support.
UCAYA’s Vision:
To streamline access to healthcare services, preventive
resources and support for adolescents and young adults
in the Upstate of South Carolina.

5. Trends in South Carolina High School Youth
Show…We have a lot of work to do!
 3 / 10 are overweight or obese
 3 / 10 felt sad or hopeless almost every day for 2 weeks
or more; 1 / 10 attempted suicide in the last 12 months
 1 / 2 high school students in SC have had sexual
intercourse
 4 / 10 have tried cigarettes
 6 / 10 tried alcohol once in their lifetime with 2 out of 10
drinking before age 13
 2 / 10 used Marijuana one or more times in the last 30
days
 2 / 10 took a prescription drug without a prescription
(Centers for Disease Control and Prevention, 2013)

6. Costs: Direct and Indirect
Fiscal Costs
 36 billion U.S. dollars direct
 700 billion U. S. dollars indirect
 14 billion U.S dollars on mental
health and substance abuse
UCAYA Predicted Outcomes
 Decreased expenditures
 Increased Return on
Investment
 Improved Quality of Life
(Park et al., 2001; Ginsburg & Foster, 2009)

7. Our current approach to adolescent risk behaviors
targets obesity, physical activity initiatives,
substance abuse programs, pregnancy prevention
programs…separately.

8. What if we embraced a holistic approach?

9. The Upstate Coalition for
Adolescents and Young Adults
Developed A Model of Care Using the Public Health Services Framework
(Teipel & Brindis, 2011)

10. UCAYA: Raising Awareness, Improving Policy,
Providing Care & Resources
 Holistic Health Model incorporating Triple Aim, Public
Health Framework and NIHCM Service Models to address:
 Mental Health - Depression/Suicide/Self-harm/Eating
Disorders/Anxiety
 Psycho-social Health - Social Media Issues - Cyber
Bulling/Teasing/Abuse
 Physical Health – Obesity – Nutritional counseling,
Physical Activity, Tobacco/Drugs/Alcohol/Substance
abuse/Reproductive Health – Confidential care/STIs,
Safety - Violence

12. The UCAYA Goal: E2C2
 To better serve our adolescents and young adults
we will EDUCATE and EMPOWER,
COLLABORATE and CONNECT providers,
communities, families and teens

13. The E2C2 UCAYA Model
The Virtual Presence:
Web/Social Media UCAYA.org, Wikispaces,
Facebook, Twitter, Instagram
 Allows UCAYA to be where AYA are
 Complements traditional communication
 Connects and empowers through interactive
dialogue
 Increases public awareness through educational
campaigns
 Reaches individuals, providers, communities
 Policy development through community and state
liaisons
 Research UCAYA Model

14. UCAYA Connections through Social Media:
Wikispaces, LinkedIn…
With more to come Facebook, Twitter, Instagram…

15. ucaya.org

16. The E2C2 UCAYA Model
The Physical Presence
 ‘Center’- hub for adolescent service organizations to
collaborate and connect 10 -25 year olds AYA with
needed services
 Provider services – confidential, consistent, friendly,
safe care, information, and testing with teen convenient
hours of operation
 Educational resources – For the public and for
Pediatric, Med-Peds, Family Medicine, OB-GYN,
Psychiatry residents and research infrastructure.
Potentially creating an environment for the development
of an Adolescent Medicine Fellowship
 Support services – counseling, support groups,
Girlology, Guyology, Greenville Family Partnership, New
Impact, The Riley Center

17. Proposed Upstate Center for
Adolescents and Young Adults Level 1
Full services AYA friendly clinic facility, extended evening and Saturday hours.
Onsite youth supportive agencies to increase access to specialty services.

18. Proposed Upstate Center for
Adolescents and Young Adults Level 2
Onsite lab services to test for STI’s and a stabilization unit for imminent mental
health needs to decrease non-essential AYA traffic in the ER.

19. The E2C2 UCAYA Model
 Referral System built from a virtual and
physical presence to meet the needs of our
community
 Self-generating and sustainable AYA
model using a multidisciplinary systems
approach based upon collaboration and
integration among stakeholders
 Adolescents, young adults
 Families
 Provider
 Community agencies

20. UCAYA Is An Innovative Model Supported by
Theory and Best Practice…
AYA models of care examples:
The Teen Wellness Center: A Model of Care, Gaston, North
Carolina (CDC Funded)
UCSF Benioff Children’s Hospital – (Oakland) Ages 11-24
Milford Regional Medical Center (Massachusetts)
Adolescent Health Services, Ages 11-29
Hasbro Children’s Hospital: (Rhode Island Hospital)
A Lifespan Partner Adolescent Healthcare Center, Ages
10-25

21. What these models have in common:
 Extended age parameters 10 - 11 to 21 – 29
 Team of physicians, psychologists, psychiatrists, social
workers, nurses, and specialists in health education and
substance abuse provide primary and specialty care for
youth, teenagers, and young adults
 Adolescent/Young Adult (AYA) focus with emphasis
on confidentiality
 Well care – physicals, immunizations, nutritional
support, counseling
 Specialty care – Chronic conditions care, Mental health
care, birth control, STI testing, LGBT support, teen
parenting programs, substance abuse, education
 ‘One stop’ shopping model

22. UCAYA Model Fulfills Needs Voiced by National
Institute for Health Care Management (NIHCM)
 Emphasizes growing need for mental health services
 Incorporates suggested NIHCM models Consultation, Co-
location and Collaboration of care
 Shares information, resources and transitions of care.
 Focuses on prevention, early identification, timely
treatment
 Integrates services, coordinates care, improves monitoring
with a collaborative approach
 Evaluation research is central to outcomes.
(Ginsburg & Foster, 2009)

23. UCAYA informed by stakeholder responses to
presentations and interviews…
 S.C. State Adolescent Coordinator DHEC: Martha
Hinson wants to partner with UCAYA
 Greenville Family Partnership: Carol Reeves, Dr. John
Sanders want to partner with UCAYA
 The Riley Center Beth Riley MSW, LISW-CP CEDS
wants to partner with UCAYA
 Pediatric stakeholders: Drs. Bob Saul, Jill Golden,
Nancy Henderson, Kerry Sease and Des Kelly, Tom
Moran, Cheryl Kimble
 Community voices: Ismael Reyna MPA, Crissy
Maynard, Anne Spence

24. UCAYA in a nutshell: A System’s Approach
to Close the Gap in AYA Health
 UCAYA E2C2 – Educate and Empower,
Collaborate and Connect!
 Comprehensive, holistic plan incorporates all
three NIHCM service models (Consultation, Co-
location and Collaboration) through virtual
presence, physical presence, referral system
 Virtual presence: Web, Social media -
convenient ‘arm’ to reach the AYA population,
families, providers and community
 Physical presence: Concrete location ‘Hub’ for
primary care visits,‘Home’ for collaborative
agencies
 Referral system to complete the ‘circle of care’
for AYA, decreasing fragmentation and episodic
care
 Replicable System’s Management Public Health
theoretical framework
(Ginsburg & Foster, 2009; Teipel & Brindis, 2011)

25. Building the UCAYA Model…...E2C2
We invite you to invest in innovation
for adolescent & young adult health in
the SC!
How?

26. Phase 1:
 Phase 1: Establishing target group and gathering
data/input from focus groups
 Duration: 1-2 years
 Method: Focus Groups and Surveys
 Surveys/Focus groups paper and electronic
surveys to distribute to teens 10-25, parents,
and providers
 Collaborative meetings to integrate UCAYA
goals with community members, providers and
agencies
 Explore grant opportunities and fundraising to
support phase 2 development
 Board creation

27. Phase 2:
Phase 2: Development and enhancement of the virtual
presence of UCAYA
Duration: 1-5 Years (Concurrent with Phase 1)
Method:
 Create/Enhance: Wiki Spaces, ucaya.org,
LinkedIn, Facebook, Instagram, Twitter:
#Adolescent Ally!
 Budget development
 Brand UCAYA Marketing
 Link AYA to interventions in the area (office at
GFP can be launch point initially if needed)
 Community integration Educational discussions
focusing on topics of interest to the target
population (mental health, substance abuse, etc)

28. Phase 3
Phase 3: Planning and building of The Upstate
Center for Adolescents and Young Adults.
Duration: 2-3 years
Method:
Site visits at other models for phase 3
Expand budget and business plan
Generate funding GHS and/or private sector
Secure practitioners that will provide care at the
center
Marketing campaign for the strengths of the
center

29. Contact Information
Emails: ucayaofsc@gmail.com
Educational Wiki:
http://UCAYA.wikispaces.com
Website: UCAYA.org

31. Models of Care
http://www.appcnc.org/spotlight-story/the-teen-
wellness-center-a-model-in-clinical-care
http://www.childrenshospitaloakland.org/main/
departments-services/adolescent-medicine-
teen-health-1.aspx
http://www.milfordregional.org/care-
treatment/adolescents/
http://www.hasbrochildrenshospital.org/adoles
cent-medicine.html