STANFORD, Calif-- 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, recently celebrated its 10th anniversary of doing just that. It’s a lifeline for local homeless and uninsured youths and young adults, but not just because of the comprehensive exams and free medications. The van delivers 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 Seth Ammerman, MD, who is also a clinical associate professor in adolescent medicine at the Stanford University School of Medicine. “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.” It’s a model that works: Ammerman estimates that about two thirds of the van’s homeless patients eventually find someplace to live.
 
But 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. In fact, 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 philanthropic donations, rotates monthly through six sites in San Francisco, Santa Clara and San Mateo counties. It is affiliated with the Children’s Health Fund, a national network of clinics for underserved youth.
 
Although tens of thousands of adolescents around the country still lack basic medical care, teens making it to the van are in good hands. Each receives 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 chronic diseases like 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.
 
“Many homeless adults started as homeless youth who didn’t get the help they needed,” said Ammerman. “The good news is that we’ve made a difference during the past ten years. The bad news is that there are still many more kids who need our services.” There are approximately 2,500 homeless adolescents in San Francisco and 50,000 uninsured teens in San Mateo and Santa Clara county.
 
The idea for a mobile health clinic for adolescents and young adults began to germinate in 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 its door to patients ages 12-21 in Santa Clara County in September of 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.
 
 “I know they really care,” said Ly. “They’ve done so much for me.” 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, Ly has decided to become a pediatrician. She’s now working toward the first step: a college degree. No doubt she’ll keep Ammerman and his colleagues posted about her progress. After all, that’s what friends do.
 
About Lucile Packard Children's Hospital
Ranked annually as one of the best pediatric hospitals in the nation by U.S.News & World Report, Lucile Packard Children's Hospital at Stanford is a 264-bed hospital devoted to the care of children and expectant mothers. Providing pediatric and obstetric medical and surgical services and associated with the Stanford University School of Medicine, Packard Children's offers patients locally, regionally and nationally the full range of health care programs and services — from preventive and routine care to the diagnosis and treatment of serious illness and injury. For more information, visit www.lpch.org.