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Medically Fragile Young Adult Care

Experience the seamless transition from pedatric care to adult care

We bridge the critical gap between pediatric and adult care systems, ensuring that turning 18 is a milestone of growth rather than a disruption in service, by keeping your trusted nursing and caregiver team in place.

What is the Young Adult Transition Program?

In Wisconsin, turning 18 marks a significant shift in how care is funded and authorized, often moving from the Children’s Long-Term Support (CLTS) Waiver to Adult Long-Term Care programs like IRIS or Family Care. B&Y Health Care specializes in navigating this “transition cliff.” We ensure that your young adult maintains their established Private Duty Nursing (PDN) team while helping your family maximize the new self-directed opportunities available to adult caregivers.

Key Points for Wisconsin Families:

Continuity of Skilled Nursing:
Turning 18 does not mean you have to find new nurses. We work to transition your child’s current Private Duty Nursing (PDN) authorization from pediatric to adult codes, allowing your existing B&Y nursing team to continue providing 8+ hours of daily skilled care without interruption.
The “IRIS” Opportunity: Many young adults transition to the IRIS (Include, Respect, I Self-Direct) program. As an agency, B&Y Health Care supports this model, which often gives young adults and their families more freedom to hire parents and trusted relatives as paid workers with fewer restrictions than the pediatric waivers.
Adult Family Caregiving: Unlike the strict “extraordinary care” rules for minors, parents of adults (ages 18+) can often be employed as caregivers for a broader range of support tasks. We handle the specialized training and “Participant-Hired Worker” paperwork required to set this up correctly.
Guardianship & Decision Making: At age 18, legal adulthood begins. To continue directing your child’s care as a parent, you may need to establish Legal Guardianship or Power of Attorney. We assist families in understanding how these legal designations impact your ability to be a paid provider under Wisconsin Medicaid rules..
Bridge to Independence: For young adults capable of more independence, our care plans shift focus toward “Daily Living Skills” training—empowering them to manage their own cares, medications, and community integration to the best of their ability.

The Critical Transition Timeline

Don’t Wait Until 18. Here is Your Roadmap:

Age 17 ½: The “Golden Window.” This is when the formal transition process begins. You must contact your county’s Aging and Disability Resource Center (ADRC) to schedule an Options Counseling meeting. We recommend calling B&Y Health Care before this meeting so we can prepare your current nursing data to ensure the adult functional screen accurately reflects your child’s needs.

Age 17 (9 Months): Guardianship Filing. If your child will need a Legal Guardian as an adult, the application process should start now to be finalized by their 18th birthday. Alternatively, families should explore Supported Decision-Making agreements if guardianship isn’t the right fit.

Age 18: Adult Program Enrollment. Your child officially transitions to adult long-term care (IRIS or Family Care). At this time, you must also re-apply for SSI (Supplemental Security Income) as an adult. We assist families in ensuring there is no gap in nursing hours during this switch

Age 19: The “Katie Beckett” End Date. Wisconsin’s Katie Beckett Medicaid eligibility strictly ends at age 19. If your child is not yet enrolled in an adult waiver (IRIS/Family Care) by this date, they risk losing Medicaid coverage. We help ensure your waiver enrollment is locked in before this deadline.

Age 21: School Services End. While medical adulthood starts at 18, many young adults remain in High School Transition programs until age 21. B&Y Health Care coordinates with your school district to ensure nursing cares can be provided during the school day or during transportation.

“Did You Know?”

Did You Know? Your Pediatric Nurse Can Stay. Wisconsin allows a “Transition Period” for nurses. Even if your nurse is currently certified for pediatric care, they can often continue serving your child into young adulthood (ages 18–19) while they complete their adult certifications. You do not have to lose the nurse your child trusts just because of a birthday.

Approaching Age 17? Let’s Plan the Handoff

Transitioning to adult waivers is complex, but you don’t have to do it alone. Contact B&Y Health Care today for a Pre-Transition Nursing Review. We’ll review your current hours and help you prepare for your ADRC Options Counseling meeting.