| Course | D394 Care for Individuals and Families |
|---|---|
| Task | Task 1 |
| Paper type | Family care coordination plan |
| Length | About 1,100 words, 4 pages |
| Format | APA 7 |
| School | Western Governors University (WGU) |
| Program | BS Health and Human Services |
| Updated | September 2026 |
Free sample paper for D394 Task 1
Care Coordination for a Family at the Edge of the Services Cliff: A 19-Year-Old With Autism and Epilepsy Leaving School, His Mother's Wellness and the Services That Can Replace What Ends
Student Name
Leavitt School of Health, Western Governors University
D394: Care for Individuals and Families, Task 1
Course Instructor
Month Day, Year
Care Coordination for a Family at the Edge of the Services Cliff: A 19-Year-Old With Autism and Epilepsy Leaving School, His Mother's Wellness and the Services That Can Replace What Ends
The Family
Marcus is a composite 19-year-old with autism and epilepsy who will leave his public high school's transition program in June, when he completes it with a certificate of attendance and his special education services end. He speaks in short phrases, needs prompting for daily routines and has a seizure about once a month despite two medications. He lives with his mother, Renee, 46, a certified nursing assistant who works twelve-hour shifts at a nursing home, and his sister Kayla, 15. His father lives in another state and pays irregular child support. For the past fourteen years, Marcus's school day has provided structure, therapy, a nurse who managed his seizures and seven hours of supervision that allowed his mother to work. In June all of that ends at once. Families and professionals call this moment the services cliff.
The evidence shows why it matters. In a national study of youth with autism, more than half of those who had left high school in the previous two years had no participation in either employment or postsecondary education, the lowest participation of any disability group, and youth from lower-income families were at the highest risk (Shattuck et al., 2012). Without planning, Marcus is likely to spend his days at home while his mother either leaves her job or leaves him alone.
Wellness of the Whole Family
Wellness is broader than health; it spans emotional, physical, social, financial, occupational, intellectual, environmental and spiritual dimensions, and each family member's wellness affects the others (Swarbrick, 2006).
For Marcus, physical wellness depends on seizure control and on activity to replace the physical education and walking he gets at school. Social and occupational wellness will collapse without a daytime program or supported work; his school job placement at a grocery store ends with the transition program. Emotional wellness is tied to routine, and an abrupt change in routine is likely to increase his distress.
For Renee, financial and occupational wellness are the most exposed. Without daytime supervision she cannot work her shifts, and her income supports the household. Her emotional wellness is already strained; she describes herself as "running on fumes" and has not seen her own physician in two years. For Kayla, the risk is that she becomes her brother's after-school caregiver at the expense of her own schooling and friendships, a pattern common among siblings of young adults with disabilities.
Needs Identified
The family's needs, in priority order, are: (1) a daytime program or supported employment for Marcus beginning in June; (2) adult medical care, since his pediatric neurologist and his pediatrician have asked the family to move him to adult providers within the next year; (3) income and health coverage for Marcus as an adult, since his eligibility for disability benefits and Medicaid will now be based on his own income rather than his mother's; (4) a legal plan for decision-making now that Marcus is an adult; and (5) respite and support for Renee.
Services and Resources
Each need maps to a specific service.
| Need | Service or resource | What it provides | First step |
|---|---|---|---|
| Daytime structure and work | State vocational rehabilitation agency; developmental disability services day and employment programs through a Medicaid waiver | Job coaching, supported employment, day habilitation | Referral before graduation; waiver waitlist application |
| Adult medical care | Adult primary care practice experienced with autism; adult neurologist | Ongoing care and seizure management | Transfer summary from the pediatric team |
| Income and coverage | Supplemental Security Income application at age 18 or older; Medicaid | Monthly income and adult health coverage | Social Security appointment |
| Decision-making | Legal aid clinic or disability rights organization | Advice on supported decision-making, powers of attorney or guardianship | Consultation before June |
| Caregiver support | Parent-to-parent network; respite through the waiver or a local respite program | Peer support and scheduled breaks | Contact through the school's transition coordinator |
The Care Coordination Plan
Care coordination means deliberately organizing a person's care across providers and services so that information is shared and nothing falls through the gaps. Here, the coordinator would be a case manager from the county developmental disability services agency, working with the school's transition coordinator until June.
The plan runs on a timeline. Before graduation: a joint meeting of the family, the transition coordinator, a vocational rehabilitation counselor and the county case manager to agree on a daytime plan; applications for the Medicaid waiver and Supplemental Security Income; a legal consultation on decision-making; and a request to the pediatrician for a written transfer summary. For health care, a structured transition from pediatric to adult care, beginning with a transfer summary and continuing until the young adult is settled with adult providers, is recommended practice (White et al., 2018). In the first month after graduation: Marcus starts a day program three days a week and a supported job trial two days a week; his first adult neurology visit is scheduled; Renee attends one parent network meeting. By three months: the case manager reviews attendance, seizure frequency and Renee's work schedule with the family and adjusts the plan.
Anticipated Barriers
Medicaid waiver waiting lists are long in many states, so the day program may not be funded by June. If so, the case manager would seek interim funding through the county, and vocational rehabilitation services, which do not depend on the waiver, would begin immediately. Transportation is a second barrier because Renee works shifts; paratransit eligibility should be applied for in the spring. A third barrier is Marcus's own adjustment to new routines, which a gradual introduction, including visits to the day program before he starts, can reduce.
Measuring Whether Coordination Worked
Three simple measures will show whether the plan is working: the number of weekdays Marcus spends in a program or job each week, the number of shifts Renee misses because of supervision gaps, and whether Kayla's after-school hours stay free for school and friends. The case manager will record all three at each review.
Conclusion
Marcus's family faces the loss of every school-based support at once. A coordinated plan, begun months before graduation and led by one case manager, can replace those supports with adult services, protect his mother's job and health, and keep his sister from becoming his caregiver by default.
References
Shattuck, P. T., Narendorf, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129(6), 1042-1049. https://doi.org/10.1542/peds.2011-2864
Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29(4), 311-314. https://doi.org/10.2975/29.2006.311.314
White, P. H., Cooley, W. C., Transitions Clinical Report Authoring Group, American Academy of Pediatrics, American Academy of Family Physicians, & American College of Physicians. (2018). Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics, 142(5), e20182587. https://doi.org/10.1542/peds.2018-2587
What the D394 Task 1 instructions ask
The first D394 task asks you to plan coordinated care for an individual and family. Most versions ask you to describe the family and situation, assess wellness, identify needs, match needs to services and resources, write a care coordination plan with roles and timelines, anticipate barriers and describe how success will be measured. The family may come from your course or be a realistic composite. Evaluators look for needs ranked by priority, services named specifically rather than by category, a plan with one clear lead and a timeline, and measures that would show whether coordination actually helped. A list of services without coordination, or without the caregiver's needs, will not meet the plan aspects.
How this D394 Task 1 example is built
The plan opens with the family's situation and the date that drives everything, graduation in June. Wellness is assessed for the young man and his mother separately, since caregiver strain is part of the problem. Needs are ranked, and each is matched in a table to a service with eligibility and contact. The coordination section names a case manager as lead, sets meeting intervals and describes how consent allows information to be shared across agencies. Barriers such as waiver waiting lists have interim plans. Three simple measures, program days, medical transition and the mother's reported strain, show whether the plan works. Research on outcomes for young adults with autism supports the urgency.
Where the D394 Task 1 rubric puts the marks
D394 Task 1 aspects are scored competent, approaching competence or not evident. A family aspect checks that the situation is described clearly. A wellness aspect looks for assessment of individual and family well-being. A needs aspect rewards priorities supported by the situation. A services aspect wants specific resources matched to needs. A coordination aspect asks for a lead, roles, timelines and information sharing. Barrier and evaluation aspects look for realistic obstacles and measurable outcomes. Evaluators expect research to support key claims and notice when caregivers' needs are included, since family-centered care is the course's focus. Evaluators also check that the timeline begins before the deadline that drives the plan, since coordination that starts after graduation is too late.
D394 Task 1 help: what sends it back
Coordination plans come back most often when services are listed by category, such as counseling or respite. Name the program and how the family would reach it. Second, no one leads. Assign a coordinator and explain their role. Third, the caregiver is invisible. Include her needs and supports. Fourth, barriers are ignored, especially waiting lists and eligibility gaps. Plan interim steps. Finally, measure the plan with simple indicators the family and coordinator can track, such as days in a program each week, rather than general statements that the family is better supported. Write the plan so that another case manager could pick it up on a sick day and know what happens next.
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D394 Task 1 questions, answered
Should D394 Task 1 include the family's wellness?
Yes. Assess the individual and the caregiver, since the course focuses on families. The sample shows how a mother's strain is part of the problem the plan must address.
How many services should a D394 plan include?
Enough to meet each priority need, usually four to six specific services. The sample matches each ranked need to one named service in a table with eligibility and contact.
Does D394 Task 1 need references?
Yes. Cite research that supports key claims, such as outcomes for young adults leaving school services, and sources for the programs you describe. Program descriptions can cite the agency's own materials.
Is the D394 family in the sample real?
No. Marcus and his mother were written as a teaching case. The research on transition outcomes and the service types described are real. Any resemblance to a real family is coincidental.
Where can I find a free D394 Task 1 sample paper?
The whole coordination plan, needs table included, is published above with comments. Share your D394 task and family scenario, and your first tailored plan costs nothing. Coordination plans for other family situations can be requested the same way.