Fostering Health Clinic: Roadmap to Health

Brothers Tyler, 11, Jeremiah, 12, and Edward, 13 ( from left), during a recent visit to the Fostering Health Program. When children are removed from their homes to be placed in foster care, the priority is to provide a safety net, often with little time for planning. Frequently, they must leave behind important things: clothes, toys, even medicines.

In the following days, as foster parents help the children adjust to a new home, they must sort through a maze of health questions: Does my foster child have a pediatrician? Insurance? Prescriptions? Have they been immunized?

Because of a well-intentioned but overburdened child welfare system, answers are slow in coming. Serious health issues remain unaddressed, compounding the risks caused by neglect or physical or sexual abuse.

Now foster parents can turn to the Fostering Health Program at Children’s Hospital of Philadelphia (CHOP) for help.

“The obstacles a foster parent faces in just trying to provide the basic supports for a child to succeed in life are daunting,” says program founder Philip Scribano, DO, MSCE, Director of Safe Place: The Center for Child Protection and Health at CHOP. “The child’s health is one key piece. Our program is designed to help lighten the load in navigating the child’s health needs.”

Collecting scattered pieces

The program, which includes pediatricians, a nurse coordinator and an occupational therapist, has served more than 200 children in its first year.

Pediatricians or caseworkers refer children to the program, or the foster parent makes an appointment directly. Before the visit, the program coordinator searches databases, painstakingly assembling the child’s health history.

Then, the child comes in for a comprehensive evaluation, seeing the multidisciplinary team that links the child to a primary care provider and other specialists, if needed. More than 40 percent of children require mental health referrals.

Every child receives a health roadmap, a summary of medical history and needs. It is invaluable to clinicians who will manage the child’s health, and is a bulwark against deterioration of communication and services for children who will experience numerous foster-care placements.

Children’s Care Collaborative

Safe Place physicians joined in an innovative public-private partnership with the city of Philadelphia and St. Christopher’s Hospital for Children to better serve children who have been abused.

The clinicians provide clinical services in the Children’s Care Collaborative facility. In addition to new exam rooms, it houses Philadelphia’s Police Department Special Victims Unit, Department of Human Services Sexual Abuse Investigations Unit, the Philadelphia Children’s Alliance and staff from the District Attorney’s Office. The co-location site allows team members to coordinate care and streamline the investigative process to lessen the trauma on victims.

Positive parenting

Safe Place and PolicyLab physician and principal investigator Joanne Wood, MD, MSHP, has initiated PriCARE (Child Adult Relationship Enhancement) Program, a six-week positive parent group training program designed to improve child behavior, improve parent-child relationships and decrease stress for parents. PriCARE is offered in primary care settings to parents and caregivers of preschool-aged children at two CHOP Care Network sites: Karabots Pediatric Primary Care Center and South Philadelphia Community Health and Literacy Center.

“Often for mental health interventions, children have to have a diagnosed condition to receive services,” says Wood. “The PriCARE intervention offers a preventative approach to keep kids from needing more intensive mental health supports.”

* Total children in foster care.
** Children who entered foster care in 2016.
Source: Pennsylvania Partnerships for Children 2017