Complex Endocrine Disorders and Diabetes
For questions, call 860.545.9370
"Teens in Transit" is a transition program for patients with complex endocrine disorders anddiabetes. Four adult endocrinologists and one reproductive endocrinologist have signed on to see these transition patients collaboratively with the pediatric endocrinologists. During the period of co-management, brief for diabetic patients and longer for complex endocrine patients and transitioning GH-deficient patients, the "transition passport" can be developed as a team and the adolescent can begin to relate to the adult specialist. The "transition passport" lists all current diagnoses, therapies, associated disease complications/adult morbidities for which continued surveillance is required, and summarizes all baseline clinical and psychosocial evaluations. It also develops an adult care roadmap that provides guidelines for frequency of medical visits to specialists and primary care providers, the role of each adult provider in the overall care plan, and the frequency of lab studies and other clinical evaluations.

Cardiac Care
For questions, call 860.545.9400 or email fheller@ccmckids.org
Advances in surgery, medication and cardiac treatment enable many patients with congenital heart problems to survive into adulthood. The transition of these young people from pediatric cardiologists to adult cardiologists requires additional training and ongoing collaborative care to improve health outcomes for these patients. There are significant knowledge gaps in what is essentially a new area of medicine. Funding for this program is being provided by Calhoun Snack Foods.

Cystic Fibrosis
For questions, call 860.545.9440 or email gdrapea@ccmckids.org
As the survival rate of people with cystic fibrosis continues to improve, there are increasing numbers of adults with CF. As people with CF age, they often present with more "adult specific" health issues such as CF related diabetes, osteoporosis, fertility and reproductive issues, and cardiac related problems such as hypertension. Adults with CF also have different non-medical issues such as education and career planning, health insurance, relationship issues, disability, and end of life and transplant issues. It is appropriate that care of adult individuals (with or without CF) should be delivered by a physician trained in adult care. Developing an Adult CF program that cares for and assists adults with CF is a priority for the CF Foundation as well as this CF Care Center. An Adult Transition Protocol has been developed to facilitate this process.

Hemoglobin Disorders Treatment Center
For questions, call 860.545.9630
The steps to transition young adults with sickle cell disease to adult care providers:

• As a person with sickle cell disease approaches 18 years of age, the topic of transition is discussed to determine the patient's perceptions and wishes regarding transitioning to adult medicine specialists.
• The Hemoglobin Disorders Treatment Center staff holds a patient care review conference to refine the patient's problem list and determine if any specific medical evaluations or testing is required prior to transitioning the patient.
• Taking into consideration the patient's medical problems and needs and the emotional and social "readiness" of the patient, goals for transition are agreed upon, including the timing.
• The patient's primary care physician is invited to participate in the planning process for transition.
• Appropriate adult primary care and hematology providers are chosen by the patient with direction as needed from the staff and the PCP.
• Permission to release medical information to these providers is obtained and the providers are contacted.
• A formal summary of the patient's medical problems and current ongoing management is created and a copy given to both adult care providers and the patient.
• The patient has initial appointments with the providers and then has follow-up by phone or in person with the Treatment Center staff.
• The CCMC Hemoglobin Disorders Treatment Center staff make themselves available to the patient and the new providers for consultation until the patient is well established in the adult heath care setting.

Bleeding and Prothrombotic Disorders
For questions, call 860.545.9630
The comprehensive hemostasis program at CCMC cares for children and adolescents with bleeding disorders, such as hemophilia and von Willebrand disease, and prothrombotic disorders such as factor V Leiden. The program manages patients with thromboembolic disease (stroke, blood clots in the lung or leg, etc.). The program is affiliated with the University of Connecticut Comprehensive Hemophilia Treatment Center. The nurse coordinator and social worker for the Center work with patients both here at CCMC and at the UCONN Health Center. Thus, the transition to adult care is smooth and nearly seamless because of the coordination and continuity made possible by the nurse and social worker participating in the care of both children and adults with these disorders.

Spina Bifida
For questions, call 860.545.9230
The Center for Children with Special Health Care Needs will assist any family/child with transition to adult providers. We work with the family and their community to set up a local support network that meet the needs of the individual young person. We also link with various, appropriate State agencies that assist a person with special health care needs succeed as adults.