Just like foster children need a real home to call their own, they also need a "medical home" they can turn to for their health care: doctors who know them, their health history, and what’s going on with them physically and emotionally. That’s key, considering about half of kids entering foster care have a chronic physical or developmental condition.
Why Do Foster Children Need a Medical Home?
Being a foster family can be incredibly rewarding. You have the opportunity to make a positive impact on a child’s life, offering the hope, stability, and nurturing environment every child needs. Of course, the experience also can be overwhelming and confusing as everyone gets used to each other and the new home dynamic.
When children in foster care have a “medical home,” it helps give them regular, familiar faces (and a place) that they can get to know, trust, and feel comfortable with, which is key for kids who’ve often been through so many changes and challenges in their young lives.
A medical home also ensures that:
- foster children’s health care is coordinated on an ongoing basis
- any red flags (physical and emotional) are addressed as soon
- foster parents and schools are aware of any issues and advised about what to expect developmentally at every age and stage and what might be cause for concern
Children are especially vulnerable when they transition into and out of foster care or between home placements; they run the risk of having their health needs go unnoticed or unmet altogether. To help prevent kids from falling through the cracks, federal mandate requires states to develop “a plan for the ongoing oversight and coordination of health care services for any child in foster care placement."
For Appointments: (302) 651-4200
Schedule a Visit or Get More Information: (302) 651-4245
- photo ID
- medical and pharmacy insurance cards
- preferred pharmacy name and phone number
- names and dosage of all medications, including over-the-counter medication, your child is currently taking
- guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
- Patient Presents Without Legal Guardian (PDF)
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Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families
Foster Care Resources
- Nemours Foster Care Program Brochure (PDF): Read more about our physicians and social workers.
Thanks to a partnership we’ve forged with Delaware’s Department of Services for Children, Youth, and Their Families (DSCYF), foster care children who need a medical home in the the First State can find one in our Nemours Foster Care Health Program. Throughout your family’s journey, we’re here to make it easier for kids to get the care they need to grow up as healthy as possible at every age
Stepping Up for Delaware's Foster Kids
"Our partnership with Nemours helps ensure children in foster care receive the medical attention they need and rightly deserve."
— Vivian Rapposelli, Secretary of Delaware’s
Department of Services for Children, Youth, and Their Families (DSCYF)
What We Do
Here at Nemours Foster Care Health Program, we can be the medical home for children who need one. For those who already have (and are able to continue visiting) a medical home, we can offer consultative services, as specialists trained in addressing the unique needs of children in foster care of all ages.
We also can serve as a sort of medical foster home, caring for children while they’re in foster care and then helping to transition them back to their regular medical home once they’re out of foster care.
We see Delaware’s foster care children, from infants to teens, at the primary care and adolescent clinic located within Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del.
In addition to checking children’s overall health as they grow, we also:
- monitor the child’s adjustment to foster care and visitation
- make sure the child has referrals, medical equipment, and medications
- support and advise parents (foster and birth) and their families
- can help you and the child deal with your feelings and adapt to the new situation using our on-staff social worker
- can refer you to one of our Nemours pediatric specialists right here at the hospital if the child needs specialty care for anything from asthma to diabetes, from behavioral and psychological assessments to therapy
After a child is first placed in a new foster home, our board-certified Nemours pediatricians see children for:
- an initial health screening visit within 72 hours. We’ll give you, the foster parents, as well as the DSCYF, a written summary of the child’s current medical information and recommendations for ongoing care
- a comprehensive evaluation within 30 days
- a follow-up visit within 60 to 90 days
We also like to see foster children on a routine schedule at:
- birth to age 6 months: monthly
- 6 months to 24 months old: every 3 months
- 24 months to 21 years old: twice a year
Every child’s medical history is incorporated into our award-winning electronic health record (EHR) in order to keep everyone on the same page about the child’s condition and care at the same time. With just a few clicks, any of our care team members can access the child’s entire EHR from any of our locations.
Community pediatricians who follow kids during or after their foster placement can access the child’s EHR (through NemoursLink) to get the medical summary report we prepare and information about every aspect of the child’s care at Nemours. All of this information-sharing makes it much easier for a foster child’s care to be coordinated and continued if the child leaves the state, goes elsewhere for care, or ages out of (gets too old for) the program.
Nemours Engaged in State Task Force on the Health of Children in Foster Care
According to the American Academy of Pediatrics (AAP), children in foster care have poorer health than any other group of children. The higher prevalence of a range of physical, mental and behavioral health problems can lead to greater healthcare utilization and higher costs. However, many children in this vulnerable population have undiagnosed and under-treated medical conditions, and persistent unmet health needs.
Recognizing that Delaware has an obligation to protect, support and assist children in the foster care system, the Delaware General Assembly established the Task Force on the Health of Children in Foster Care to study the health of foster care children, and their access to and utilization of health services. The task force carried out its charge by reviewing reports and publications done here in Delaware and in other states, and by analyzing health and health care data supplied by the Delaware Division of Medicaid and Medical Assistance (DMMA), and the Division of Family Services (DFS).
The Delaware task force was cochaired by Nemours pediatrician, Catherine Zorc, MD, and Vicky Kelly, Director of Family Services for the Delaware Department of Services to Children, Youth & Families.
- Only 31 percent of children new to foster care had a well visit within 30 days of entry to care.
- Among children entering foster care, 43 percent did not have Medicaid coverage in the year prior to entry into foster care and 23 percent did not upon exit from foster care. A significant number of children experience a change in insurance coverage upon entry or exit from care. Therefore, processes should be aligned to support access to care and continuity of care for the child whenever possible.
- Approximately 61 percent of children within Delaware’s foster care system present to a medical facility for care related to a behavioral health problem.
- Children in foster care are prescribed antipsychotics at about five times the rate of other children in Medicaid — 40 percent of foster care children of all ages are on psychotropic medications.
- Executive Summary: a summary of the charge, findings and taskforce recommendations
- Recommendations: task force recommendations across four main domains to improve access and quality of care, and decrease costs
- Report: an analysis of the health care services provided to children in foster care and review of the relevant literature on the health status, health needs and health care service utilization of children in foster care
- Technical appendix: additional data tables and detailed reference information