Integrating service needs for homeless children in a medical home
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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

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Integrating service needs for homeless children in a medical home

Integrating Service Needs for Homeless Children in a Medical Home

Christine Achre, MA, LCPC


Key objectives of presentation

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

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

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 children1

Needs 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 children2

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 children3

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 children4

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 disorders

Source: National Center on Family Homelessness


Needs of homeless children5

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 children6

Needs of homeless children

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


Medical home for homeless kids project

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

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 project1

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 project2

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 project3

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 project4

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 project5

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 project6

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 project7

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 project8

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 project9

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 project10

Medical Home for Homeless Kids Project

  • Conclusion

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


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