APHA Annual Meeting, November 2009 “Youth Clinic – Philly Style” Comprehensive Youth Clinics in North Philadelphia Philadelphia Department of Public Health Khudsiya Khan, MD; Rachel Poles; Karen Rendulich, MD; Issy Esangbedo, MD; Victor Igbokidi, MD; Roy Hoffman, MD; Susan Robbins, MD; Jessica Robbins PhD APHA Annual Meeting, November 2009

Background: Adolescents must navigate a multitude of emotional, cognitive, and physical changes, many of which can render them at risk for mental health illness, violence, sexual abuse, and drug and alcohol abuse. State of Adolescent care in North Philadelphia: Poor access to preventive health care leading to poor health outcomes and use of emergency rooms for non-emergent care High prevalence rates of STDs, teen pregnancy, substance abuse, violent behavior, behavioral health issues 40% high school students dropout or do not complete HS in 4 years

Goals of Youth Clinics: To provide comprehensive care to youths in North Philadelphia, integrating primary health care with dental care, family planning, gynecologic care, prenatal care and behavioral health care as a “one-stop-shop” model To facilitate early detection and treatment of behavioral problems, while reducing the stigma associated with care from traditional mental health facilities To help procure health insurance (if eligible) by connecting with benefits counselors

Methods: Youth Clinics were started in 2 of 8 Philadelphia’s Public Health Centers located in North Philadelphia in September 2007 by a funding from PA Department of Health thru which a F/T position of Youth Clinic Coordinator and P/T child psychologist were procured Eligibility: Youths 13 – 18 year-old, living in North Philadelphia Care coordination: Youths seen by pediatricians needing dental, FP/Gyn/prenatal care or behavioral health care are offered care coordination by Youth Clinic Coordinator Assessment of behavioral health needs: All youths are offered PSC -17 checklist at least once annually. Youths with positive screen are connected with behavioral health care

Age and Sex distribution: n=600 Percent

Race distribution:

Data: Data was collected over 15 months from inception of Youth Clinics in October 2007 to December 2008 600 youths were seen who made 1024 visits 440 Youths were referred to Youth clinic coordinator for coordination of referrals to dental, reproductive and/or behavioral health services >50% of youths, especially at one Health Center, lacked health insurance and were referred to benefits counselors

Results of Satisfaction Survey (n=116): Patients reporting satisfaction with services 85 % Youths who would recommend the Youth Clinic to a friend 95% Youths who found it helpful to speak with Youth Clinic coordinator 86% Youths who found the “One-Stop-Shop” model for multiple services helpful 41%

Measures for Success of Youth Clinics: Number of youths enrolled: 600 youths were enrolled, which was 50% more than anticipated Satisfaction of youths assessed by anonymous surveys to different components of clinic Successful case coordination as assessed by successful referrals to needed services (85% successful connections)

Impact of Youth Clinics: Short Term Impact: Increased number of youths under medical care with access to multiple services offered on one site whose problems are successfully resolved Long Term Impact: decrease STDs and unintended pregnancies in service population decrease morbidity and mortality associated with delay in access to care increase number of youths receiving behavioral health services due to earlier identification and referral

Contact Information: khudsiya.khan@phila.gov -- Project Director Rachel.poles@phila.gov -- Youth Clinic Coordinator jessica.robbins@phila.gov -- Public Health Epidemiologist susan.robbins@phila.gov – Medical Director, Pediatrics Acknowledgement: PA Department of Health, Division of Adolescent Health Care Services for a generous grant funding the Youth Clinics from Sep 2007 – Dec 2008 Division of Ambulatory Health services of the Philadelphia Department of Public Health and All staff of Health Center #5 and Health Center #6 Division of Maternal, Child and Family Health, PDPH, for ongoing support of Youth Clinic operations