Chats on Change: Supporting At-Risk LGBT and Homeless Youth

Chats on Change: Supporting At-Risk LGBT and Homeless Youth

Event Date: 
Wednesday, February 27, 2013

Thank you for participating in the Chat on Change held February 27, 2013. During the TweetChat, we were joined by Lara Brooks from the Broadway Youth Center in Chicago, IL. The Innovations Exchange also provided several examples of relevant innovations during the Chat.


Lara Brooks is the Director of the Broadway Youth Center (BYC) and has worked with street-based and homeless youth, survivors of violence, and LGBT youth for more than a decade. The BYC, a program of Howard Brown Health Center and its community partners, uses a comprehensive, “one-stop-shop” model that offers integrated services to LGBT youth, youth experiencing homelessness and housing instability, and street-based youth. These services include (1) medical services; (2) crisis intervention counseling and psychotherapy; (3) resource advocacy/case management services (linking youth to programs that help meet their more complex basic needs, like housing, public benefits and state-issued identification); (4) HIV/STI testing, outreach, and prevention programs; (5) basic need drop-in services (i.e., food, showers, hygiene supplies, clothing, laundry, etc.); and (6) tutoring sessions for youth interested in obtaining a GED high school equivalency diploma.

Paying special attention to the intersection of trauma, harm reduction, oppression and resilience, Brooks speaks locally and nationally on issues related to LGBT intimate partner and sexual violence; harm reduction; alternatives to policing; and community accountability/transformative justice. As a former board member for the Young Women’s Empowerment Project, Lara continues her support as an adult ally. Brooks is currently on the Community Advisory Council for Sage Community Health Collective, a Chicago-based healing justice worker collective that offers sliding scale payment options for alternative health care.


AHRQIX: Our TweetChat on improving #HIV & #STD screenings for #LGBT homeless youth with Lara Brooks of @hbhclifeline is about to begin! #AHRQIX

AHRQIX: We’re using #AHRQIX for the chat. Please include it in your tweets. #AHRQIX
AHRQIX: If you have a question and want to tweet during the chat, be sure your tweets are not protected. #AHRQIX
AHRQIX: We may collect, save, & post transcripts from monthly chats on our Web site. See our privacy policy at #AHRQIX
AHRQIX: Lara will be tweeting along with us @hbhclifeline, so please follow the stream of tweets at #AHRQIX
AHRQIX: If you’re having problems viewing the TweetChat site, you can also follow the live stream by searching on Twitter for #AHRQIX. #AHRQIX
AHRQIX: The focus of this chat is improving #HIV & #STD screenings for LGBT homeless youth. Please be respectful of others during the chat. #AHRQIX
AHRQIX: Welcome to our TweetChat on improving #HIV & #STD screenings for #LGBT homeless youth! I’m Nicole & I’ll be moderating the chat. #AHRQIX
AHRQIX: I’m pleased to be joined by Lara Brooks, Director of the Broadway Youth Center (BYC), a program of @hbhclifeline & its partners. #AHRQIX
AHRQIX: Please note the Innovations Exchange does not provide advice on health-related issues or experiences. #AHRQIX
AHRQIX: We’ll ask/answer questions w/ @hbhclifeline & participants, as well as share resources on #HIV & #STD screenings & #LGBT healthcare #AHRQIX
AHRQIX: When did the BYC open and who were its founding members? #AHRQIX
hbhclifeline: The BYC opened in 2004 through the amazing vision of four organizations. #ahrqix
hbhclifeline: These included: HBHC, The Night Ministry, Teen Living Programs, and Ann & Robert H. Lurie Children’s Hospital of Chicago. #ahrqix
hbhclifeline: These founders combined expertise in LGBTQ health and homeless youth services to launch a comprehensive, ‘one-stop-shop’ model. #ahrqix
AHRQIX: .@hbhclifeline, what’s the purpose of the BYC? #AHRQIX
hbhclifeline: We serve youth, ages 12-24, who are experiencing homelessness, housing instability, and/or are LGBTQ-identified. #ahrqix
AHRQIX: For those of you joining us today, please ask questions – @hbhclifeline is here to answer! #AHRQIX
hbhclifeline: We try to make our services as accessible as possible, using a harm reduction model of care. #ahrqix
FieldsTom: Approximately how many youth do you provide services to annually? #ahrqix
hbhclifeline: We served about 3,000 unique youth in 2012 and provided more than 20,000 contacts during that time. Services include… #ahrqix
hbhclifeline: basic needs drop-in services, walk-in clinic, STI/HIV testing, counseling, homeless youth case management, and an LGBT GED program. #ahrqix
AHRQIX: Here is the BYC’s innovation that we are talking about today.… #AHRQIX
hbhclifeline: About 1,200 youth come through our walk-in sexual health clinic as well, making us one of the largest providers of STI dx/treatment. #ahrqix
SexualityLab: Did you know? 20 and 42 percent of all #homelessyouth are #LGBT, but only 5 to 10 percent of the overall population is LGBT. #AHRQIX
hbhclifeline: These numbers reflect what we’re seeing at the BYC. In fact, about 20% of youth accessing homeless youth services are transgender. #ahrqix
illadelphgirl: how many providers work at the health services clinic? #AHRQIX
hbhclifeline: In our sexual health clinic, about 70% of our patients are LGBTQ. #ahrqix
hbhclifeline: Our clinic is operated by one full-time RN who is incredible! We are supported by mid-level providers for 2.5 hour/week. #ahrqix
HassellS: I’m interested to hear more about the harm reduction model- I’m not familiar with that. #AHRQIX
hbhclifeline: Harm reduction is a model that meets people where they are at, without judgement. HR respect self-determination. #ahrqix
hbhclifeline: HR incorporates safety planning, harm/risk reduction, and emphasizes long-term relationship building. #ahrqix
hbhclifeline: Some great information on this modality can be found at #ahrqix
AHRQIX: Here is the model that @hbhclifeline is referencing: #AHRQIX
AHRQIX: In addition to the Q&A, we’ll share some related innovations that are featured on our website during this event. #AHRQIX
hbhclifeline: Check out the link to our model of care at the BYC. It centers the importance of engaging youth in basic needs services… #ahrqix
hbhclifeline: as a tool to engage youth in more ‘traditional’ models of care, like therapy, case management, and medical services. #ahrqix
AHRQIX: .@UCSFHospitals implemented policies for culturally competent care to LGBT patients, making them feel safer #AHRQIX
SexualityLab: RT @ahrqix: Here is the model that @hbhclifeline is referencing: #AHRQIX
AHRQIX: What are some of the tools/resources that healthcare systems or clinicians should know about? #AHRQIX
hbhclifeline: Many tools inform our work. These include participatory action research studies on institutional violence from a community partner. #ahrqix
HassellS: Thank you, I look forward to reading about this more. How do you reach your target population and let them know about your services? #AHRQIX
hbhclifeline: Check out the Young Women’s Empowerment Project at for results of the Bad Encounter Line. #ahrqix
SexualityLab: RT @hbhclifeline: Harm reduction is a model that meets people where they are at, without judgement. HR respect self-determination. #ahrqix
hbhclifeline: We’ve learned a lot from youth who have had negative experiences accessing health care due to stigma. #ahrqix
SexualityLab: RT @hbhclifeline: HR incorporates safety planning, harm/risk reduction, and emphasizes long-term relationship building. #ahrqix
AHRQIX: Participants: What is your experience w/ healthcare providers/clinics addressing the needs of LGBT youth experiencing homelessness? #AHRQIX
SexualityLab: RT @hbhclifeline: Some great information on this modality can be found at #ahrqix
hbhclifeline: We use trauma-informed frameworks to enhance the work–knowing that many street-based youth are engaged in the sex trade, etc. #ahrqix
hbhclifeline: HBHC also has an accessible hormone protocol called THInC, a model based on informed consent. #ahrqix
hbhclifeline: Here’s the link to some FAQs:… #ahrqix
SexualityLab: In our UHIP study, 17% of sample of young MSM & transwomen in Detroit Metro area spent >= 1 night in last month homeless/transient #AHRQIX
AHRQIX: Lara, what advice do you have for HCPs/clinics on improving access for LGBT youth & youth experiencing homelessness? #AHRQIX
hbhclifeline: This is our advice: Low-threshold means minimizing registration forms and identification requirements. #ahrqix
hbhclifeline: We also love our walk-in model because youth can access us when they need us. #ahrqix
hbhclifeline: We are also really effective at engaging hard-to-reach youth because we are incredibly relationship based. #ahrqix
hbhclifeline: It’s also really important to train reception staff–and to see the entire team as a group of youth workers, first and foremost. #ahrqix
AHRQIX: The @REALtalkDC campaign targets DC youth & provides HIV, LGBT, STD & other health info online & via text #AHRQIX
hbhclifeline: It’s amazing to have a clinic with one main nurse–it really feels like the continuum of care you would receive from a PCP. #ahrqix
hbhclifeline: Another best practice: Using gender neutral language and asking youth to self-identify needs–without us placing labels on them. #ahrqix
AHRQIX: Lara, who are some of the community partners you work with at BYC? #AHRQIX
hbhclifeline: Our community partners really ground the work. Some ones we would like to highlight include: Young Women’s Empowerment Project. #ahrqix
hbhclifeline: YWEP provides a peer-based syringe exchange for youth injecting drugs and/or injecting hormones. #ahrqix
hbhclifeline: We also collaborate with The Night Ministry. They build relationships with youth through street-based outreach efforts… #ahrqix
hbhclifeline: Additionally, TNM houses many LGBTQ youth through low-threshold shelter called the Crib. #ahrqix
hbhclifeline: We also collaborate with theTransformative Justice Law Project ( to connect youth with name change advocates. #ahrqix
miller7: @hbhclifeline How are you all documenting some of your great work? How do you evaluate your efforts? #ahrqix
hbhclifeline: Another amazing partner is the Youth Empowerment Performance Project, an LGBTQA youth theater project. #ahrqix
SexualityLab: You can learn more about our UHIP study here & here #AHRQIX
hbhclifeline: We document our programs through electronic health records. #ahrqix
hbhclifeline: We also evaluate our programs through weekly youth-led community meetings (with youth and staff). #ahrqix
hbhclifeline: We have written a few documents about our violence prevention efforts as well. #ahrqix
hbhclifeline: Here’s the link:… #ahrqix
miller7: @hbhclifeline It would be great if you could share those links! Thanks! #ahrqix
AHRQIX: Lara, what does a ‘medical home’ look like for #LGBT youth and youth experiencing homelessness? #medicalhome #AHRQIX
hbhclifeline: For us, a youth-centered medical home means having as many supportive services onsite as possible. #ahrqix
hbhclifeline: Success for us means a young person accessing everything from GED session to an apt with our nurse to dx/treat an STI in one visit. #ahrqix
miller7: @hbhclifeline Onsite services are highly innovative but also costly. How do you financially support your innovations? #ahrqix
hbhclifeline: We’ve reduced costs by using a nurse-led clinic–and it’s produced amazing results. #ahrqix
hbhclifeline: We also generate revenue through a really diverse portfolio of funders (everything from corporate/foundation to City funding). #ahrqix
AHRQIX: .@ISISorg & @SanFranciscoDPH have a texting program to raise awareness/concern about STDs among at-risk youth #AHRQIX
illadelphgirl: are there any costs for the youth who access services? #AHRQIX
hbhclifeline: All of services and treatment are free of charge. Amazing! #ahrqix
AHRQIX: .@hbhclifeline, how do you reach homeless youth to let them know your services are available? #AHRQIX
hbhclifeline: In the past 8 years, we’ve done very little outreach. Youth with positive experiences are the best kind of marketing. #ahrqix
hbhclifeline: Word also travels fast in the street-based LGBTQ youth community. #ahrqix
hbhclifeline: Youth also learn about us through The Night Ministry’s street outreach efforts. #ahrqix
illadelphgirl: how did you recruit youth to participate in the weekly community meetings? do you provide incentives? #AHRQIX
AHRQIX: We’ll be closing the live chat in 10 mins. Does anyone have any questions for @hbhclifeline before our time is up? #AHRQIX
hbhclifeline: The drop-in youth community participate in weekly community meetings to provide feedback. We offer incentives for facilitators. #ahrqix
hbhclifeline: We have about 40 youth who participate in these meetings–just to provide a context. #ahrqix
AHRQIX: .@hbhclifeline, what are some of the services that you offer? #AHRQIX
hbhclifeline: To learn more about our services, check out:… #ahrqix
hbhclifeline: We have about 17 staff operating all of our programs and services–as well as 20+ active volunteers. #ahrqix
hbhclifeline: About 18 different community partners also contribute to our day-to-day operations. #ahrqix
FieldsTom: What mental health services do you provide? #ahrqix
hbhclifeline: We could not do this innovative work without the support of our community. Donations, like hygiene supplies, support homeless youth. #ahrqix
hbhclifeline: We provide therapy services, an LGBT GED (Vocation/Education) program, homeless youth case management services, and HIV/STI testing. #ahrqix
hbhclifeline: Drop In services include youth-led programming, food, showers, hygiene supplies, clothing, transit assistance, and access to tech #ahrqix
hbhclifeline: Our therapist also spends time in the drop-in program providing crisis intervention support and services. #ahrqix
AHRQIX: .@crewsnhealth operates a free-standing clinic & mobile medical unit for #Arizona’s homeless & at-risk youth. #AHRQIX
hbhclifeline: This reduces barriers around therapy–which has proven effective in engaging youth. #ahrqix
hbhclifeline: We also offer evening programs. For example, TYRA–a program for transgender and gender non-conforming young people. #ahrqix
AHRQIX: This program enhanced access to care by providing web-based health info & service to homeless & runaway youth #AHRQIX
AHRQIX: One last question for Lara: How can you model be adopted in other communities? #AHRQIX
FieldsTom: RT @hbhclifeline: We provide therapy services,LGBT GED (Vocation/Education) program, homeless case management, and HIV/STI testing. #ahrqix
hbhclifeline: I think the BYC is an important model that can be replicated and adapted for different communities, esp. those exp. homelessness. #ahrqix
hbhclifeline: The BYC proves that collaborations DO work–and that we can pull together ‘experts’ in various services to increase our impact. #ahrqix
hbhclifeline: This model truly depends on being clear about what your center is: In this case, it’s LGBTQ youth experiencing homelessness. #ahrqix
hbhclifeline: All of our decisions, program designs, and collaborating partners revolve around that center. #ahrqix
AHRQIX: Thank you to everyone who joined & participated in our TweetChat today! You can review the archive using #AHRQIX after the event #AHRQIX
illadelphgirl: RT@hbhclifeline:proves that collaborations DO work-and that we can pull together experts in various services to increase our impact. #AHRQIX
AHRQIX: Feel free to continue sharing questions, info, and what’s working for you via Twitter @AHRQIX & @hbhclifeline #AHRQIX
AHRQIX: And a special thanks to Lara Brooks for providing great information! We’re so glad you were able to join us today! @hbhclifeline #AHRQIX
rosecasanova: Join in the tweetchat about innovations in healthcare #ahrqix
rosecasanova: I have used @hbhclifeline services in Chicago. Everyone there is really nice. Thanks for being there when I had no insurance and $. #ahrqix

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