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Introduction: Children experiencing homelessness face structural and informational barriers that limit access to pediatric care. These barriers manifest in delayed vaccinations, poorly controlled acute illnesses, unmanaged chronic conditions, and increased prevalence of developmental delay and severe autism, compared to the general population. At a shelter in Skid Row serving approximately 75 families, only 1 in 4 families reported having health insurance and an established pediatric provider at a recent town hall. This study aimed to identify barriers to pediatric care and inform targeted, community-responsive solutions.

Methods: This study was conducted at a homeless shelter in Skid Row and through on-site visits in the surrounding community. Semi-structured interviews were performed with parents, shelter staff, social workers, local school nurses, an LAUSD Homeless Students Liaison, a family specialist, and childcare providers serving children experiencing homelessness. Interviews explored barriers to pediatric care, access to preventive services, and opportunities for targeted solutions.

Results: A total of 24 interviews were conducted, including 16 families and 8 community stakeholders, representing approximately 20% of families in the shelter. Commonly cited barriers included insurance challenges, limited awareness of resources, lack of documentation, legal status concerns, competing priorities, and lack of transportation. Key high-need areas identified included: (1) immediate insurance enrollment to facilitate reconnection to services such as Medi-Cal, (2) on-site, full-scope pediatric care, including immunizations, and (3) improved navigation of community resources. One incidental finding was that parents expressed concerns about hearing and vision deficits in their children.

Conclusion: Our study corroborated that children experiencing homelessness face worrisome barriers that limit access to care. Several immediately actionable and sustainable solutions were identified including the development of an updated resource guide distributed at intake, provision of organizational tools to support care continuity, and expansion of on-site pediatric services. Additionally, ongoing efforts include implementing regular on-site, supervised student-led hearing and vision screenings to address gaps in preventive care. Community-engaged needs assessments remain critical to identifying barriers and informing practical, low-cost strategies, such as facilitating insurance enrollment and providing in-person navigation of available resources. These findings support targeted approaches to improve care access and delivery for underserved children while underscoring the importance of sustained community partnership in developing meaningful, accessible solutions.