Integrating Service Needs for Homeless Children in a Medical Home

Christine Achre, MA, LCPC

Key objectives of presentation

Describe service needs of homeless children Provide an Overview of the Medical Home for

Homeless Kids Project Describe preliminary outcomes of the project Discuss lessons learned from coordinating

this project

Beacon Therapeutic Diagnostic and Treatment Center Brief agency overview History of delivering services to homeless

families Day School Services Broader Shelter Outreach Services Specialized TOTS program

Needs of homeless children Demographics of homeless children

20% of children ages 3-5 have diagnosable mental health disorders

Sicker than housed children Social and emotional delays at

higher rates than housed children Developmental delays at higher

rates than housed children with a higher socioeconomic level

Exposed to multiple transitions Despite the high needs for services,

less than 50% of children will get the help they need

Source: National Center on Family Homelessness

Needs of homeless childrenNeeds of homeless children

Seminal study by the National Center on Family Homelessness (formerly known as the Better Homes Fund) identified four key areas of a child’s life affected by homelessness Emotional development Physical Illness Family Stability Education

Needs of homeless children

Emotional needs Mental health

characteristics and needs Higher rate of emotional and

behavioral problems Less likely to receive

necessary professional care.

Needs of homeless children

Physical Illness Physical health characteristics

and needs Higher rate of acute/chronic illness Lack of access to services

Needs of homeless children Family stability

Most, but not all homeless families are headed by a single mother

Reasons for becoming homeless represent economic, emotional and environmental hardships

Homeless mothers often represent with significant challenges

Involvement in foster care Homeless as children Mental health concerns including post-traumatic stress,

depressive and anxiety disordersSource: National Center on Family Homelessness

Needs of homeless children Education

Characteristic needs of young homeless children Increased rate of developmental delay and

learning disability System issues that inadvertently

contribute to the needs Lack of access for routine immunizations,

dental care

Needs of homeless children

Despite the enormous needs of homeless children, the system had been fragmented and disconnected

Medical Home for Homeless Kids Project Background of the Medical Home Model Partnership between Beacon Therapeutic

and University of Chicago Comer Children’s Hospital About University of Chicago Comer Children’s

Hospital

What is a Medical Home?

Key components Accessible Family Centered Coordinated Comprehensive Continuous Compassionate Culturally Competent

Source: AAP Policy Statement: The Medical Home

Medical Home for Homeless Kids Project

Goals of the project

Identify and fill an access need to ensure that physical health needs of homeless children are met

Identify and provide specialized developmental services to ensure that homeless children can succeed in their kindergarten placement

Medical Home for Homeless Kids Project Key Service Components

Specialized developmental screening Well-child physical health care Access to dental care Psychiatric and psychological support on-site as well

as in the shelter setting Recreational therapist focusing on children’s motor

skills Educational linkage and advocacy

Medical Home for Homeless Kids Project Project receives funding support from

Illinois Department of Human Services In-kind services from University of Chicago United Way Pilot Funding United Way Partner Agency funding Housing and Urban Development (HUD)

Medical Home for Homeless Kids Project Initial Outcome

Children and their parents are made aware of the resources offered by the Medical Home program Indicator:

100% of parents will consent to participation in TOTS/Medical Home Program

Initial outcomes revealed – 100% consented to participation in the program

Medical Home for Homeless Kids Project Initial Outcome

Kids enhance their positive life-skills Indicator

100% of children referred will follow up on development and/or physical health screenings

Initial outcomes revealed100% consented to one or both areas of screenings

Medical Home for Homeless Kids Project Intermediate Outcomes

90% of children will exhibit improvement in their overall functioning including physical, emotional, behavioral and developmental Initial outcomes revealed 89% of children exhibited

improvement

Medical Home for Homeless Kids Project Long-Term Outcome: Children will

successfully transition to their kindergarten placement having stabilized all identified need areas Indicator: 90% of children who complete

treatment will successfully transition to kindergarten

Initial outcomes revealed – 100% of children who left the program were transitioned to their kindergarten placement

Medical Home for Homeless Kids Project Strategies and Clinical Tools Used

Behavior Monitoring Form Child Behavior Checklist Kindergarten Readiness Form Children’s Global Assessment Scale Parent Stress Index (PSI) Trauma Symptoms Checklist for

Young Children (TSCYC)

Medical Home for Homeless Kids Project Lessons Learned

Parents must be partners Transient nature of this population Transportation logistics Health Information and follow-up for parents Time and coordination among partners

Medical Home for Homeless Kids Project Conclusion

We believe that the medical home program reflects an integrated, multi-disciplinary service delivery model