You can see why a state might require minors to have a parent's OK before they receive medical care. But Maryland law has made life especially difficult for homeless teenagers who have no adults watching out for them.
It's the sort of problem that drives Lisa Stambolis crazy. As director of pediatric and adolescent health at Health Care for the Homeless in Baltimore, she organized people — including homeless teens — to press for change. It worked. A new law offering more leeway for minors' medical treatment goes into effect Oct. 1.
In July, Stambolis was honored for her efforts and named a White House "Champion of Change," one of 13 selected for their efforts on behalf of homeless youth.
Stambolis, 50, earned a nurse practitioner degree in 1993 from the University of Maryland, Baltimore. She's worked for the nonprofit Health Care for the Homeless in two stretches — for four years fresh out of graduate school and again for the past two years — and in between worked for Baltimore's health department, assigned to a city high school.
Stambolis, who has two children, lives in Baltimore's Lauraville neighborhood with her partner, Lania D'Agostino. She chatted with The Baltimore Sun recently about her work, her award and the rough economy's effect on the homeless — and in making people homeless.
The name offers a pretty good clue, but what does Health Care for the Homeless do?
We provide integrated health services to individuals and families who are experiencing homelessness. And how we do that is by direct service, is by community engagement and by advocacy. … Some of those direct services are, of course, medical care — primary medical care to infants, children, teens and adults.
How were you named a Champion of Change?
I'll give you a little context. … Two years ago, [Health Care for the Homeless] built this brand-new building at 421 Fallsway and they tapped me to be the director of pediatric and adolescent health, which essentially meant starting the first on-site clinic for homeless children and teens.
It's a huge culture shift. Children, teens and families are way different than individuals on their own. … I said, "This is great, you guys, we're open, but we're not going to be able to see our teens because they can't consent to their own medical treatment under the age of 18." … I can do a health assessment, right, and see a 17-year-old, but if he has asthma or she has an ear infection, I can't treat it.
So [we] went about introducing a law that the governor signed into law this year so minors under the age of 18 living without their parents can consent to their own medical treatment.
These kids who came to testify, their stories were really compelling. One boy was like, "My mother was a prostitute and now she's gone," and he doesn't know his father. Another boy, his parents died. … These are just kind of typical, you know?
You must be counting down the days until Oct. 1.
I am — it's a big deal.
What was the White House event like?
That gave us the opportunity as leaders in the field of homeless youth to network with each other. … It was very energizing.
What's a typical day like, if there is such a thing? A typical week?
We're going out to shelters, in the street, wherever children and youth are, meeting them where they are, and having the ability to bring them to our health center.
People may say: "Well, why do you need that? They have medical assistance — why can't they just get to their clinic?" Well, there are a lot of barriers. Shelters have set rules. Your kids are in camp, your kids are in school, so you have to wait [until they return]. Some clinics are like, "You're 15 minutes late — we're not seeing you."
The way we work, we just have an open schedule. We give appointment times; we laugh about it — we call them "suggested times." People come when they come.
What convinced you that you needed to go back to Health Care for the Homeless?
It's funny, I wasn't really looking. I still had some ties and I ran into someone who worked there, and they told me: "Hey, we're opening this clinic. We might be looking for somebody part-time." So I gave a call, and that was that. I said, "Wow, that sounds really exciting."
How have things changed for the population you serve since the housing bust and recession?
Oh my God, it's horrible. Let me tell you what we're seeing. There's not nearly enough emergency beds for families and children. … We're meeting whole families sleeping on bus stops.
We're also seeing a whole lot more single fathers with their children who have nowhere to go because there's nothing for them.
Why? All the family shelters are for women with children?
Mm-hmm. It gets a little bit worse, too. [At] all the family shelters for women … 14-, 15-year-old boys are not allowed. … You can see the problems in congregate living, with little girls — I don't have to spell that out.
What do you like best about the work you do?
Getting to meet people where they are and bringing health care to where they are. Giving people a little glimmer of hope, you know? Sometimes, I'm not going to fix their problem, but I can bear witness to their life, and that can mean volumes, just having someone witness what you're going through.
That can be stressful, can't it?
I try to do a lot of things for my own self-care.
I spent three and a half years getting my master's degree in acupuncture. … The whole Eastern philosophy, it's not compartmentalized like Western medicine. That's really allowed me to do the personal work, I think. To feel really motivated and energized. So I have a little part-time acupuncture practice on Monday evenings. I see three or four clients, and it's great. It's like a little treatment for me. I also do meditation and go to Buddhist temple. All those things really help.
What's the most frustrating or challenging part of the job?
When it comes to patient care and the systems are letting people down, that's really frustrating to me. When a child needs a service and they fall through the cracks, and it's because two systems are fighting with each other, that frustrates me. So in my work, I get to do things like help fix those problems … one at a time.