Thanks to a new program in Delaware, which began in the spring, children in the state’s foster care system now have a medical “home base” at the Nemours /Alfred I. duPont Hospital for Children.
The hospital and the Department of Services for Children, Youth, and Their Families recently partnered to create a specialized health care program which gives foster children complete access to medical resources at Nemours.
Dr. Krishna White and Dr. Amy Renwick initiated the partnership between their employer, Nemours and the state more than two years ago after attending a pediatric conference where they learned about the deficiencies of health care within the foster care system.
“When you come into foster care, you’re facing neglect,” explained John Bates, foster care program manager for the state of Delaware. “Many times their [the foster children’s] medical history is not consistent and in some cases we find that they have not even had any medical care.”
Upon entering foster care, children are required to get proper health care such as an up-to-date physical and immunizations, but one of the biggest challenges is maintaining the children’s records. According to Bates the state is responsible for 750-800 children in the foster care system at any given time.
“With Nemours we can make sure that we’re consistent and make sure that the records are linked together so we don’t miss anything,” Bates added. “To have a place where every foster child can go and get a comprehensive medical evaluation and then have that information electronically so they’ll always have access to it, I don’t think it gets any better than this for our kids.”
Dr. White, Co-Director of the Nemours Foster Care Health Program, explained that many foster care children suffer from more serious physical and psychological medical needs than children in the general population, making the requirement for organized health care vital within the system.
“We know that kids in the foster care system have a higher amount of infectious diseases and immunization delays and other physical and mental health problems than kids in the general population,” Dr. White explained. “They are also at risk of having more developmental delays because of not having the appropriate amount of developmental screenings and well-child visits that we do in pediatric care just because, almost by definition, they’re lives have been chaotic even before they entered the system.”
Fostering better health for Delaware's foster kids.
Excerpts of DFM News interview with Co-Director of the Nemours Foster Care Health Program, Dr. Krishna White
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She added that having a stable place for health care allows the children to begin preparing for their transition out of the foster care system, which occurs between the ages of 18-21.
“For the older kids, some of them are coming in with a caseworker who knows less about them then the kids know themselves so they’re already starting by telling us their medical history and their medical problems, their complaints and those types of things as well as any social issues they might have, so we start with that. We also give them a summary and give their caseworker a summary of their current health problems, their medicines and their immunizations and talk to them about that so we hope that that makes it easier for them.”
According to Dr. White, Nemours spent two years coming up with a pilot program that would be successful in the state and reached out to organizations such as the American Academy of Pediatrics and Fosteringconnections.org for tips and advice. They also took cues from states that have developed similar programs.
“A lot of different states were using something called a health passport that they would give to the families at the end,” explained Dr. White. “We modeled our comprehensive letter off the health passports that were being done in other states.”
Now several months into the program, Dr. White said they’re beginning to receive positive feedback from both the state and the families utilizing the program.
“We met with the caseworkers during one of their business meetings to let them know the services and ask what they wanted from us,” said Dr. White. “They really wanted information, they wanted a piece of paper that told them the issues with the kids and what we need to do to give them proper care. From the families, the response has been well. We’re able to get them in quickly, get their needs assessed and help schedule appointments and tests that they need to have.”
Nemours is currently piloting the program with foster care families in New Castle County and has long-term plans to expand to other areas across the state.
“Our focal point is New Castle County at this point although our staff can bring children up to New Castle is they chose to do so,” explained Bates. “Our pilot is in New Castle but our goal is to take this statewide. A.I. Dupont and Nemours have clinics down state that provide the same kind of service to foster care so we hope it’s a long going partnership.”