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Lucile Packard Children’s Hospital’s Teen Van celebrates its 10th anniversary

Lucile Packard Children?s Hospital

From the van, Seth Ammerman cares for troubled adolescents and helps them to turn their lives around.

BY KRISTA CONGER

Managing the health care of hundreds of adolescents from one 38-foot vehicle may sound challenging. But Lucile Packard Children's Hospital's Mobile Adolescent Health Services Program, better known as the Teen Van, is celebrating its 10th anniversary of doing just that. It's a lifeline for local homeless and uninsured youths and young adults, going beyond comprehensive exams and free medications to deliver something more intangible: a sense of purpose that helps many of these youths turn their lives around.

"We've helped thousands of kids in the Bay Area," said the van's medical director and adolescent medicine specialist Seth Ammerman, MD. "By providing a medical home—where we get to know individuals well—and focusing on prevention and early intervention, we can help kids get off the streets and into housing, school and jobs." He estimates that about two-thirds of its homeless patients eventually find someplace to live.

The benefits extend beyond individuals. Studies have shown that every dollar spent on the kind of services provided by the Teen Van saves $4 in future health-care costs. The program has served as a national model of cost-effective health care for at-risk adolescents since its inception in 1996. The van, which is entirely supported by donations, rotates through six sites in San Francisco, Santa Clara and San Mateo counties.

Teens making it to the van receive a comprehensive physical and mental health evaluation, along with interventions targeted to their individual circumstances. Ammerman and his colleagues provide confidential help to kids struggling with substance abuse, poor nutrition and such chronic diseases as diabetes and asthma—all free of charge and without passing judgment. They also provide HIV counseling, birth control and other preventive education.

"In the beginning I was worried about people in my neighborhood watching me go in and out of the van," said 22-year-old uninsured San Francisco resident Yen Ly. "But they made me feel so comfortable. They didn't just ask about my medical history. They asked about how things were going at home, how my job was going. They became more like my friends than my doctors."

Like most patients, Ly, who has been a regular patient since 2000, turned to the van for care for a variety of issues, including tobacco use, skin care and nutritional and weight concerns.

More than two out of three young adults who visit the van return repeatedly. The clinic's impact extends far beyond the van's door, however. Together the staff members work to refer their young homeless patients to other community services that provide housing and education or job training.

The idea for a mobile health clinic for adolescents and young adults can be traced to 1992, when Packard physicians participating in a community immunization project discovered many local children with unmet health care needs. In 1995, a United Way Silicon Valley study indicated that adolescents are the most underserved population of children. The van opened to patients ages 12-21 in Santa Clara County in September 1996 as one of the first mobile health programs in the country to target homeless and uninsured youth. It now sees young adults like Ly up to age 24.

"They've done so much for me," said Ly. Although she'll soon be too old to visit the van as a patient, the legacy of caring will continue in Ly's life. Inspired by her van experiences, she has decided to become a pediatrician. She's now working toward the first step: a college degree.