Packard Children's Adolescent Health Van Celebrates 15 Years of Helping Uninsured and Homeless Youth

-- Today, Cathy Arines is a healthy, independent 22-year-old with a steady job, a long-term boyfriend and her own apartment. But in January 2007, her life was different. Barely 18, she ran away to escape verbal abuse at home. She didn't have a place to live or enough to eat. With five months left in her senior year, Cathy desperately wanted to graduate, but didn't know how she would make it.

That’s when Cathy first visited the Lucile Packard Children's Hospital Adolescent Health Van, a mobile health clinic that treats impoverished and homeless adolescents. 
"I wasn't comfortable, but I needed help," Cathy said recently, remembering the first time she approached the doors of the big blue clinic-on-wheels. "If I didn't have the help then, I would probably be sick or have died by now."
The Health Van, celebrating its 15th anniversary in September, has been a safe haven for more than 3,500 young people like Cathy. What she found quickly put her at ease: friendly staff who gave free, confidential care that addressed all her health care needs.
"When we started the Health Van, our idea was that we would specifically target uninsured youth and provide easily accessible, comprehensive care," said Seth Ammerman, MD, medical director and founder of the Van. The Van uses a "Medical Home" model, a one-stop shopping approach in which patients aged 10 to 25 receive primary health care, specialty care, medications, laboratory work, nutrition counseling, mental health care and social work services. Since uninsured and homeless youth often lack transportation, the van comes to them, making regular visits to seven Bay Area schools and community agencies in San Francisco, San Mateo County and Santa Clara County. The goal is continuity – patients can build trusting relationships with their caregivers.
To ensure that the Teen Van feels welcoming, the 8- by 36-foot rolling clinic is outfitted with pre-teens, teens and young adults in mind. Everything from the posters to the pamphlets is oriented toward youth.
"Most important, we have a staff that likes to work with this age group," Ammerman said. "They're caring and helpful regardless of a young person's situation."
"They don't judge at all," Cathy says of the staff.
Cathy's first visit lasted about an hour. Like each new patient, she met the Van's entire team, including Ammerman, nurse practitioner Lisa Lestishock, physician assistant Rosa Maldonado, a nutritionist, a social worker, and John Donovan, the Van driver and clinic registrar. She had a physical in one of the Van's two fully-equipped exam rooms.
"I was not well," she remembers. "I didn't have any food; I was very skinny." The caregivers were worried she was malnourished.
Like most Van patients, Cathy was also sexually active. But no one in her family had explained the potential risks. She had emigrated from the Philippines just 18 months earlier and hadn't received sex education at school, either. The Van staff told her about STDs and the risk of unplanned pregnancy. She was relieved to have the facts. "Right now I'm so happy that I'm not pregnant, and it’s because Dr. Ammerman educated me about birth control," she said, adding that she has returned to the Van for care and guidance a number of times since 2007.
The efforts also save health care costs. Every dollar of the Van's $650,000 annual budget, which is primarily funded by the Lucile Packard Foundation for Children's Health and the nonprofit Children's Health Fund, saves $10 in averted expenses such as hospital stays and emergency room visits. And three-quarters of the van's patients, just like Cathy, return for follow-up care.
In the future, Ammerman would like to obtain funds to expand the Van's services from half- to full-time. "Unfortunately, the need for our program is greater than ever," he said, noting that the economic downturn has brought many kids to the Van whose parents lost jobs and health insurance.
Ammerman is proud of the Van's mission. "When kids start taking care of their health, they can really turn their lives around," he said. "Some people write off these kids, especially the more marginalized. We've shown you shouldn't – they can do really well."
That's definitely the case for Cathy, who graduated from high school with her class in June 2007. Well-spoken and energetic, she now has a full-time job at Macy's and a part-time business doing freelance makeup for weddings and special events. She talks excitedly about her future, describing ambitions for expanding her business, traveling the world and starting a family of her own. Oh, and one more thing:
"My plan, when I'm successful, is to donate a big chunk of money to the Health Van," Cathy says. "That's one of my dreams. They helped me and I really want to help them."
To make a tax-deductible donation to support the Health Van, you can visit the Lucile Packard Foundation for Children’s Health at The current schedule for the Health Van is available at