Youth Institute Session 2 Program Best Practices

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Youth Institute- Session 2 Program Best Practices

• August 29,2006
• Jessica Forsyth, MSW
• Jenny Scanlon, FNP

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Goals of Presentation

• Identify the best practices of the Childrens
  Hospital Immunodeficiency Program (CHIP) of
  Denver for
• Identifying, engaging and retaining youth
• Designing youth-centered services
• Opportunities and challenges in peer work
• Effective community collaborations in meeting the
  diverse needs of youth

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CHIP an overview

• CHIP is a Title IV program serving children,
  youth, women and families. Began as Pediatric
  AIDS Clinical Trials Group site.
• The CHIP Youth Project (CYP) includes a
  multidisciplinary team (social work, nursing,
  physicians, nutritionist, pharmacist, mental
  health) that serves 65 youth living with HIV and
  their affected support network.

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CHIP Youth Project Continuum of Care

• Care services youth-specific, youth friendly
  clinic, social work/case management, GLBT
  culturally proficient providers, support groups,
  mental health treatment.
• Counseling and Testing OraSure and rapid tests
  in xxx sites xxx youth tested.
• CYP becoming well-known as point of entry for
  youth living with HIV.

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What does it mean to engage?

• Must have the core belief that youth can, and
  will, make good decisions about their health if
  given accurate information and consistent
  support.
• Must know how to enter into a therapeutic
  alliance with youth building on their strengths
  to develop their capacity to advocate for
  themselves

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Challenges of Engagement

• Developmental present-time orientation,
  reliance on peers, unstructured lives,
  establishment of independence and feelings of
  immortality.
• Mental health - Seventy percent of CYPs clients
  have a mental health diagnosis 43 have
  substance abuse issues.
• Pediatric infrastructure not prepared to handle
  complex social issues of youth living with HIV

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CYP Engagement and Retention

• One consistent point of entry helps to streamline
  process (social work)
• Basic support services help keep youth engaged
  initially food vouchers for clinic,
  transportation, etc.
• Real engagement is due to the exceptional
  staffing staff are culturally proficient and
  dedicated to youth. Have flexible schedules,
  clinic times and low case loads.
• Strong team collaboration Nurse Practitioner
  and social worker see clients together, work
  seamlessly to meet the needs of youth.

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CYP Retention

• Effective engagement often leads to retention but
  when it doesnt..
• Case finding critical to retention. Entire CYP
  team participates (social worker, nurse
  practitioner, outreach coordinator, etc). From
  youth entered into the program since 8/04, CYP
  has a 93 retention rate.
• Peers as team members are critical to having
  success in recruiting, engaging and retaining
  youth in care.

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Peers Invaluable Team Members

• Peer demographics have run the gamut living
  with HIV, affected, ages have varied, but most
  share life experiences with youth living with
  HIV.
• Excellent representatives of youth programs and
  effective relationship builders. Can reach youth
  in a way adult professional staff often cant.
• CANNOT be tokens must be involved in the
  design, implementation and evaluation. Effective
  youth-adult partnerships see Advocates for
  Youth materials

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Challenges in Peer Work

• Often have high supervisory and mentoring needs.
  Critical for programs to allow for that and not
  underestimate issues that arise for young people
  in doing their work.
• Aging up what happens as they get older/need
  more challenging work?
• Hiring youth who receive care from your program
  do they switch their care? How does the team
  manage boundary issues?

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Community Collaborations

• Testing sites
• Youth serving agencies Mental Health, shelters,
  GLBT youth drop-in centers. Staff must know that
  the referrals they make are to youth-friendly
  places. Youth-serving does not always equal
  youth-friendly and culturally competent.
• State health department Prevention Case
  Management, prevention with positives, CDC
  prevention initiatives (DEBI)
• Cross-Title Collaborations how are the Titles
  (I, II and III) addressing the needs of youth
  (WICY)? How do we ensure that youth-friendly
  services are in places? How do we convince
  people that youth are 13 to 24?

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CYP Challenges in Youth Work

• Staff does not reflect clients racial and
  ethnic- a particular challenge in Colorado
• Challenges of developing youth-sensitive systems
  of care within a pediatric-focused facility. How
  do childrens hospitals address the changing
  epidemic?
• Mental health (psychiatry) and substance
  abusefunding and community capacity to serve is
  lacking for youth.
• Transition of youth to adult care how do get
  the adult care providers to engage?

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Contact Information

• Jessica Forsyth, MSW
• Youth Program Director
• Children's Hospital - CHIP
• forsyth.jessica_at_tchden.org
• 303-861-6758