Transition of Care Planning for Students
Coming to college is an exciting prospect for new students; it is also a time when students practice new ways to independently manage their time, money, health, and stress—possibly for the first time. This can feel daunting for any student, but may be especially overwhelming for students who are managing chronic physical or mental health concerns. This guide is intended to help you and your family identify the most effective ways of managing this transition.
As students transition into adulthood, they will have new responsibilities for their health care, including:
- Making and keeping medical and/or counseling appointments
- Providing insurance information to providers and pharmacies
- Reporting their treatment history to new healthcare providers
- Signing consent for treatment and other forms
- Reporting concerns if symptoms change or side effects to medications emerge
- Filling prescriptions
- Taking medications as prescribed
It’s important to have a complete knowledge of your medical history, even if you live with your parents and continue to see the same providers. Some information that you should be aware of includes:
- Create a health summary of past and present treatments including medications and surgeries with this form. Have copies available for each new provider.
- If you have a chronic disease or condition, make sure that you know some basic information about it. Read about it on a reputable website such as WebMD or the Mayo Clinic website. Be able to give its proper name and some basic information about the disease. Ask your family how you got diagnosed with this condition.
- Learn about your family health history, including the diseases and conditions that family members have had.
- Know about any allergies that you have, including:
- Medications, food, bees, environmental allergens, or any other substances that you are allergic to
- Your body’s response to coming into contact with allergens
- Any medications that you need to take if you experience an allergic reaction
- Know the medications that you take regularly, including the dosage and when and why you take them. You can use an app like Medisafe.
- If you have a medical condition that is life-threatening or may prevent you from communicating with first responders in an emergency, consider getting a medical alert bracelet or necklace. Some of these conditions include seizure disorders, diabetes, or severe allergies that result in anaphylactic shock. Medical alert bracelets can also be helpful if you take certain medications (e.g., blood thinners), have certain medical devices (e.g., a pacemaker, cochlear implant), or have severe allergies to certain medications or items that may be used by medical providers in an emergency (e.g., penicillin, latex).
*If you have a chronic disease or condition, it is important to be able to advocate for your physical and/or mental health needs, particularly as you enter adulthood and become more independent from your family. Part of self-advocacy is being able to tell others about your condition, how your condition impacts your day-to-day functioning, what you need to help you be successful, and what treatments have been tried and been proven helpful or not helpful. Many young people find it helpful to have an easily accessible, electronic copy of a psychiatric or medical summary. A medical or mental health summary typically includes:
- Primary diagnosis
- Other medical and/or mental health conditions
- Outpatient treatment history
- Other treatments
- Allergies to medications, current medications and past medication trials
- Diagnostic studies such as lab work, EEGs, brain scans, psychological/neuropsychological testing
In addition to this summary, it might prove helpful to pull together other important documents into a transition portfolio. You can take your portfolio with you to meetings in the Office of Disability Services, as well as to initial counseling or medical appointments at the Wellness Center. A transition portfolio could include:
- Medical or mental health summary
- Educational, psychological, neuropsychological testing
- Most recent 504 Plan or IEP
- List of accommodations and services you may need in college–be sure to consult with the Office of Disability Services as soon as possible to make sure that any necessary accommodations are in place before school starts
- Medical or psychiatric advanced directive
* Adapted from: Set to Go
*Similar to many other young people headed to college, you may prefer to remain with your home-based treatment team. You may feel comfortable with your current providers, you may not want to “start over” with new providers, and it just might seem to be the simplest approach to take. However, providers will take into consideration many factors as they discuss treatment plan options with you. The goal is to develop thoughtful, practical, individualized, and safe care plans that maximize continuity of care during your transition to adult-level care and campus.
Some factors taken into consideration by your providers are:
- Patient age limit restrictions for some practices
- How stable your condition has been
- How prepared you are to manage your physical and/or mental health needs independently
- How far away you will be
Some possible treatment plan arrangements are:
- Complete transfer of care to providers on or near campus
- Treatment shared between home-based and campus-based (on or near campus) providers
- Treatment continues with home-based providers
Despite the obvious differences among the above treatment plan scenarios, there are also some important common elements:
- In most cases, providers will recommend that any major medication changes, especially trials of medications, be completed and assessed by late winter/early spring of your senior year in high school. It is often helpful to make medication changes during periods where you experience less stress and change to prevent any unforeseen adverse reactions from causing a significant impact or leading to unintended consequences. Major medication changes in the few months before your first semester of college put you at risk for problems and it makes sense to plan and make changes with the team that already knows you well.
- You will be asked to sign releases of information for new providers to speak with former providers or, in the case of shared treatment, for all providers to communicate. This is particularly important for breaks, holidays, emergencies, and complicated situations.
- You may be asked to sign a release for your providers to be able to contact your parents/guardians if you are having difficulties that put you at risk or that they may be able to help address with you. Parents are a good source of historical information and often students turn to their parents in times of distress. Please note that your parents can call your providers with their concerns at any time. The overall goal is open and transparent communication among your support team members with you as an active participant.
- You should establish a plan for when you will reach out for help and whom you will contact first and as a backup if you are not feeling well..
Ideally, your treatment plan should be discussed in detail and put in writing for all key members of your care team. This is especially important in the case of shared treatment. For example, it would make sense to consider your physical location (at school vs at home) to determine who is in charge of your care at any given moment or in the event of an emergency. Also, if you have medical providers both at home and school, they will need to establish a mutually agreed upon medication refill policy.
* Adapted from: Set to Go
Taking care of yourself in ways that promote overall good health and mental wellness is an important part of your transition to campus life. Talk with your family and support team about and make plans to:
- Develop a routine that includes adequate time for schoolwork, classes, and self-care.
- Try to eat a balanced diet. Although it can be easy to stick to chicken nuggets and pizza every day, make sure that you are incorporating fruits, vegetables, and lean protein into your meals.
- Exercise regularly, in accordance with any recommendations that your medical provider may have given you. Walk around campus, take a dip in the pool, or stop by the fitness room in Montgomery!
- Make sure to get plenty of sleep (7 to 9 hours) each night. Do your best to stick to a regular sleep schedule, and make sure that you are engaging in effective sleep hygiene to get ready for bed.
- Use the internet and social media in smart, safe ways.
- Learn about how tobacco, alcohol, and drugs may affect your health and interact with medications you are taking.
- Make healthy choices about relationships and sex.
- Manage stress effectively.
- Develop a support network. In addition to the friends you make on-campus, academic advisors, staff, faculty, and the RD and CA’s in your residence hall are all available to provide support.
If there any of these elements are difficult for you to manage, try to address them before coming to college if possible. If you are already here and are struggling with some of these self-care tasks, consider talking with friends and family members, a medical provider, or a counselor about ways to improve these skills.
Even if you don’t take medication daily, it’s important to know how to fill a prescription. It can be helpful to learn about how to fill a prescription before you need one–we may not feel up to learning new skills when we’re sick!
- Make sure you are aware of any allergies that you have.
- If you take any other medications regularly, including over-the-counter medications and supplements, be sure to know the names and dosages. (See Learn About Your Health History above.)
- If you have insurance:
- Find out about how much prescriptions will typically cost you
- Find out if you are required to use certain pharmacies or mail order services
- Find out if your contact and insurance information are already on-file with a particular pharmacy
- If you don’t have insurance, consider asking your provider about lower-cost generic medications that can help to save you money. You can also download an app like GoodRx to compare prescription drug prices and obtain coupons that you can use to save money at the pharmacy.
After you’ve received a prescription, it’s important to start taking it as soon as possible unless otherwise directed by your medical provider. Your provider may give you a paper copy of a prescription, call or fax your prescription to a pharmacy, or use e-prescribing software. When you go to the pharmacy, you should bring your prescription (if you’ve been given a paper copy), your insurance card, and a photo ID (which may be required for certain medications. Make sure to ask the pharmacist if you have questions about how to take your medicine and what side effects to watch out for.
If you are taking a medication on an ongoing basis, you will also need to manage refills. It’s important to keep track of when you need to get refills
- Keep track of when you need to get refills in order to avoid running out of your medication and missing doses. You can use a calendar, pill sorter, or an app like Medisafe.
- If your pharmacy offers auto-refill services, consider using them. Most pharmacies will call you when your prescription has been automatically refilled.
- If you need to call or go to the pharmacy to refill a prescription, it is helpful to do so several days before you run out of your medications. This allows time to resolve any unexpected problems that may come up, such as insurance authorization, physician contact, or pharmacy supply.
- Prescriptions may not have any refills, but can also have up to 11 months of refills. Be aware of when you expect to run out of your medication, and find out what to do to continue the medication if needed–for example, most physicians will need to see you before providing a new prescription or calling in additional refills, and they may need you to complete lab work or other tests to determine if your dosage needs to be adjusted. Make sure to schedule follow-up appointments well in advance.
- If you are going out of town for vacation or a school break, make sure that you have enough medication to last during this time.
The following pharmacies are in close proximity to the College:
- Disability support on campus
- Set to Go: An amazing program by the JED Foundation aimed at helping all college students develop the skills needed to successfully transition into college.
- Got Transition: This site is full of resources designed to help young adults become prepared to independently manage their health care needs