The CART model: Organized systems of care for transition age youth and adults with developmental disabilities (pp. 473-477)
Authors: Clarissa Kripke, Mary Giammona, Alan Fox, and Jim Shorter
Abstract: In 2006 a group of stakeholders in the Bay Area of Northern California from academic, clinical, community, social service and public insurance sectors came together with the goal to develop a proposal for a pilot model system of care. The vision was to ensure that all transition age youth and adults with DD have access to the health care services they need to maximize their wellness and function. Health care for people with DD was defined as interdisciplinary, team-based care, with patients and caregivers at the center of the team. Through an iterative process including stakeholder interviews and literature review, the group identified the key components of a comprehensive, sustainable system of care. The components are encapsulated in the pneumonic, CART, which stands for: Clinical services for both primary care and assessment and consultation, Advocacy for patients who need support to access care, Research programs in health surveillance and health services and Technical assistance for clinicians at the point-of-care and Training to ensure an adequate workforce. The CART model is being proposed in the context of both national and statewide health care reform. Components of the model have been established such as the Office of Developmental Primary Care in the University of California, San Francisco, Department of Family and Community Medicine, the Wellness Health Advocacy Program at the Arc of San Francisco, a pilot Health Advocacy Program at the Family Health Center at the main Family Medicine residency training site in the area and a multidisciplinary clinic. An advocacy effort is underway to develop the resources to integrate these components into a comprehensive CART model program and to study the effectiveness of the pilot.
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