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Nemours and Delaware Foster Care Partner to Ensure All Children Have a Medical Home

Tuesday, Sep 20, 2011


Krishna White, MD

Wilmington, DE — Nemours/Alfred I. duPont Hospital for Children now offers primary care services and a “medical home” for children in foster care in Delaware. Children are especially vulnerable at the points of transition into and out of foster care or between placements and run the risk of having their health needs go unmet or unrecognized. To address this need, Nemours forged a partnership with the state’s Department of Services for Children, Youth, and Their Families, Foster Care Program, which serves more than 1,200 children annually.

Amy Renwick, MD

A 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,” including how the child’s medical information will be updated and shared. Nemours, with its primary care network throughout the state, full array of pediatric treatment services and integrated electronic medical record, is uniquely positioned to meet the requirements. 

Nemours pediatricians Krishna White, MD, and Amy Renwick, MD, catalyzed the collaboration with the state. “We have an interest in health care issues among children in foster care,” said Dr. White. “At a national pediatric conference, we attended a session on this topic and saw what other states were doing. That sparked our interest in making Nemours the medical home for the foster care program in Delaware. And I’m happy to say the leadership embraced it.”

Before the Nemours “medical home” model was introduced, the case worker and foster family were responsible for finding medical care for the child. The average age of a foster child in Delaware is 10 years. About 45% of foster children are teenagers. The geographic distribution of foster children follows the state’s population, with about two-thirds of children in New Castle County and one-third in Kent and Sussex Counties. About 50% of children entering foster care have a chronic physical or developmental problem, and about 3% are medically fragile.

Nemours physicians now see children in foster care for an initial screening required within 72 hours of placement, and a comprehensive evaluation within 30 days. Ongoing primary and preventive care can be provided at one of eight Nemours Pediatrics sites closest to the foster care home. If specialty care is required, the pediatric specialists of duPont Hospital for Children in Wilmington and Seaford are ready to serve. In addition, the child’s medical history is incorporated in the Nemours electronic medical record to ensure coordination of care and continuity should the child leave the state, go elsewhere for care or age out of the program.

David and Lori Clouser of New Castle, DE, who became foster parents in June 2011, said their family’s introduction to the Nemours Foster Care Program was “very comprehensive and reassuring.” The Clousers are parenting a sibling group of three children under 4 years of age. “We knew very little about the children’s medical history,” David Clouser said. “So we were very happy with the thorough exam, developmental screening and explanations that they gave us.”

Dr. Renwick saw evidence of chronic ear infections in two of the children and made the necessary connections for the family to follow up with an ear, nose and throat specialist. She also explained what “red flags” the family should look for that may signal developmental concerns. “We were delighted to see this family,” said Dr. Renwick. “They are very caring foster parents and we’re pleased to help them gain an understanding of their children’s health, development and ongoing needs to make sure they stay on track physically and socially.”

“Our partnership with Nemours helps ensure children in foster care receive the medical attention they need and rightly deserve,” said Vivian Rapposelli, Secretary of the Department of Services for Children, Youth and Their Families. “We ask a lot of our foster families, so I’m pleased we can help ease their burden by thoroughly addressing the health needs of the children in our care in a timely manner.”

For more information, call 302-651-4245 or visit the Nemours Foster Care Health Program.

The Department of Services for Children, Youth and their Families (also known as the Delaware Children’s Department) provides services to children who have been abused, neglected, abandoned, dependent, or have behavioral health or substance abuse problems, and/or have be adjudicated delinquent by the Courts. Our Mission: To assist children, youth and families in making positive changes through services that support child and public safety, behavioral health and individual, family and community well-being. For more information, please visit

About Nemours

Nemours is an internationally recognized children's health system that owns and operates the two free-standing children’s hospitals: the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., and Nemours Children's Hospital in Orlando, Fla., along with outpatient facilities in five states, delivering pediatric primary, specialty and urgent care. Nemours also powers the world’s most-visited website for information on the health of children and teens,, and offers on-demand, online video patient visits through Nemours CareConnect. Nemours is a program dedicated to preventing reading failure in young children, grounded in Nemours’ understanding that child health and learning are inextricably linked, and that reading level is a strong predictor of adult health.

Established as The Nemours Foundation through the legacy and philanthropy of Alfred I. duPont, Nemours provides pediatric clinical care, research, education, advocacy and prevention programs to families in the communities it serves.