Integrating Service Needs for
Homeless Children in a Medical
Home
Christine Achre, MA, LCPC
Key objectives of presentation
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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
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Brief agency overview
History of delivering services to homeless
families
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Day School Services
Broader Shelter Outreach Services
Specialized TOTS program
Needs of homeless children
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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 children
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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
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Emotional development
Physical Illness
Family Stability
Education
Needs of homeless children
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Emotional needs
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Mental health
characteristics and needs
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Higher rate of emotional and
behavioral problems
Less likely to receive
necessary professional care.
Needs of homeless children
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Physical Illness
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Physical health characteristics
and needs
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Higher rate of acute/chronic illness
Lack of access to services
Needs of homeless children
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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
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Needs of homeless children
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Education
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Characteristic needs of young homeless
children
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Increased rate of developmental delay and
learning disability
System issues that inadvertently
contribute to the needs
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Lack of access for routine immunizations,
dental care
Needs of homeless children
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Despite the enormous needs of homeless children,
the system had been fragmented and disconnected
Medical Home for Homeless Kids Project
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Background of the Medical Home Model
Partnership between Beacon Therapeutic
and University of Chicago Comer Children’s
Hospital
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About University of Chicago Comer Children’s
Hospital
What is a Medical Home?
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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
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Key Service Components
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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
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Project receives funding support from
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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
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Initial Outcome
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Children and their parents are made aware of the
resources offered by the Medical Home program
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Indicator:
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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
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Initial Outcome
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Kids enhance their positive life-skills
Indicator
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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
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Intermediate Outcomes
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90% of children will exhibit improvement in their
overall functioning including physical, emotional,
behavioral and developmental
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Initial outcomes revealed 89% of children exhibited
improvement
Medical Home for Homeless Kids Project
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Long-Term Outcome: Children will
successfully transition to their kindergarten
placement having stabilized all identified
need areas
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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
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Strategies and Clinical Tools Used
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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
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Lessons Learned
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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
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Conclusion
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We believe that the medical home program reflects an
integrated, multi-disciplinary service delivery model