1. 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

2. 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

3. 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

4. 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

5. Age and Sex distribution: n=600
Percent

6. Race distribution:

7. 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

8. 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%

9. 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)

10. 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

11. Contact Information:
-- Project Director
-- Youth Clinic Coordinator
-- Public Health Epidemiologist
– 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