Homelessness impacts children. One of the impacts is that homeless children get sick four times more often than other children. However, local nonprofit A Child’s Place (ACP) works hard to erase the impact of homelessness on children, including ensuring homeless children receive proper medical care. For ACP client child, Stephanie, that care saved her life.
Volunteer doctors discovered Stephanie had a heart problem during a physical examination for admission into ACP’s free summer day camp. Stephanie was referred to Sanger Heart & Vascular Institute for more testing and diagnosis. However, Stephanie’s mother – pregnant, unemployed and without transportation – was unable to take her to the appointment. Stephanie not only missed camp last year; her medical care was also delayed.
In April 2012, Stephanie underwent open heart surgery at Levine Children’s Hospital in Charlotte. She experienced some complications, forcing her to stay at the hospital for several weeks. Stephanie’s ACP volunteer mentor visited her regularly in the hospital, while ACP provided her with snacks, hygiene products and educational support to ensure she did not fall behind in school.
“This has been a life-changing journey about the importance of life and people,” Stephanie’s mentor said. “We almost lost her a few times, but she’s a tough cookie and a fighter. She has taught a lot of people a lot of things about life and loving it, no matter what your circumstances!”
Homelessness makes children more prone to sickness, particularly since 20 percent lack a regular source of medical care and 15 percent rely solely on hospital emergency rooms1. Homeless children get twice as many ear infections and hospitalizations; four times as many asthma attacks; and five times as many stomach problems1. Stephanie’s case is just one of many that come to ACP.
“The odds are against children who, through no fault of their own, do not have a stable place to lay their heads at night,” said Annabelle Suddreth, ACP Executive Director. “It’s difficult to learn in school if your tooth hurts, you can’t see the board or you don’t feel well.”
In the 2011-12 school year, ACP served 2,228 homeless students in Charlotte-Mecklenburg Schools (CMS). This year, CMS has 4,922 homeless children enrolled in Mecklenburg County public schools, up from 4,711 homeless students last school year. The typical ACP client family is among the working poor, includes two or three children, and has at least one working adult when they become homeless.
“A lot of our families are in crisis all of the time,” said Joy Montzka, ACP Social Worker. “They are thinking, ‘I don’t know where I am going to stay. I am having an issue with my family. I am in a domestic violence situation. I am about to get evicted.’ It is all about, what is the most urgent crisis we are facing. For many of our families, ‘Where am I going to sleep?’ and ‘How am I going to put food on the table?’ are daily questions.”
Kim Parker, ACP Program Director, said homeless families are often without health insurance because it is too expensive or their employer does not offer it. Only 50 to 60 percent of homeless families are enrolled in Medicaid, although most are eligible1. Ninety-seven percent of homeless children move, many up to three times1. When homeless families move, Medicaid coverage can lapse, Parker said.
Even if a homeless family has medical coverage, that does not guarantee they can afford it. For homeless families living in shelters, campgrounds, trailers and even cars, spending money on a co-payment hurts their already-limited budget. In addition, families have to find transportation to the doctor if they do not have a vehicle or a bus pass. These barriers deter parents from taking their children to get physicals, dental and vision exams and immunizations, among others.
“A mother with three children has to work 40 hours a week making $11.08 per hour to meet the annual income threshold of $23,050 for a family of four, according to federal poverty guidelines,” Suddreth said. “Few jobs like this exist, but when they do, there is little time or money to take her children to a medical appointment.”
ACP Social Worker Shonise Kennedy said finding a willing doctor is sometimes the biggest challenge for homeless families, even if they do have Medicaid. ACP client child, Brandon, needed a new dentist to take care of his braces after his regular dentist died. It had been so long since Brandon received dental care that the brackets on his braces were broken.
“It was a challenge finding someone who would take Medicaid with the braces, and then also, in the middle of treatment,” Kennedy said. “I found one dentist in Huntersville that offered to take Brandon, but it was too far away and the bus did not stop there. I must have gone through at least a dozen dentists before I finally found one in Charlotte that agreed to take over his dental care.”
More than 1.6 million children are homeless during a year’s time1 and those numbers do not seem to be slowing down as the economy tries to recover from a deep recession. More providers, like Brandon’s new dentist, need to be willing to help ACP client families. They can take some of the burden off by simply opening their doors, and hearts, to uninsured and homeless children.
“Having almost 5,000 homeless children in Charlotte is a community problem. Action from the entire community is required to solve this challenge,” Suddreth said. “Everyone can do something. If everyone did a little, it would make a great impact.”
1 National Center on Family Homelessness
Mecklenburg Medicine, page 8
Sept. 2012 (Vol. 42, No. 8)
Mecklenburg Medicine is a publication of the Mecklenburg County Medical Society