CCPEC Foster Care Initiative

Foster Care Initiative

Children, including teens, in foster care are a highly vulnerable patient population.

These children, notes the North Carolina Pediatric Society (NCPEDS), “suffer high rates of debilitating and expensive health conditions.” In fact, healthcare costs for the estimated 10,000 children in our state’s foster-care program average three to four times those of other Medicaid-covered children (nearly everyone in foster care is automatically eligible for Medicaid).

Children and teens in foster care sometimes face abrupt and frequent changes in residence, moves that can lead both to gaps in care and interruptions in relationships with primary-care doctors/medical homes, which likely accounts for much of the disparity in their treatment costs.

Such harsh realities have led the American Academy of Pediatrics (AAP) to classify children and youth in foster care as “Children with Special Healthcare Needs.”

The Community Care of North Carolina (CCNC) Foster Care Initiative was developed in response to these children’s heightened healthcare needs, to improve coordination between medical practices (including the coordination of medical records), local Departments of Social Services (DSS), and foster parents.

Of primary concern for CCNC and its member networks is getting these children access to trauma-focused therapies and regular doctor visits that can assess the relationship between parent(s) and child, identify signs of potential problems, and provide prompt referrals to specialty care that can help prevent crises.

This is why care managers with Community Care Plan of Eastern Carolina (CCPEC), the CCNC regional network, link foster-care children to a medical home as soon as possible after those children enter Department of Social Services custody, to:

    • Assess them for signs and symptoms of abuse and neglect
    • Assess for the presence of acute and chronic illness
    • Assess for signs of acute or severe mental health problems
    • Monitor adjustment to foster care
    • Ensure that these children have all necessary medications and medical equipment
    • Support and educate their parents (foster, and birth) and relatives

Once children have been placed in foster care, they should have specific types of medical visits at specified times:

    • Within 72 hours of placement: a health-screening visit
    • Within 30 days of placement:
    • A comprehensive health admission
    • A mental health evaluation
    • A developmental health evaluation if children are 6 years old
    • An educational evaluation
    • Within 60-90 days of placement: a follow-up health visit

Better coordination of care not only improves health outcomes for these at-risk children and youth, but it also saves the state money.

Resources to Help with Treatment of Foster-Care Children/Youth

    • The AAP “Healthy Foster Care America” initiative provides a set of online Primary Care Tools to assist healthcare professionals.
    • The NCPEDS resources page also includes tools on providing care to foster children, while their video gallery contains discussions on why foster-care children should be seen early and often, due to the potential physical and emotional trauma, and toxic stress, to which they’re often exposed.

For More Information

Contact Donna N. Jones, BSN, RN, CCPEC Pediatric Quality Nurse Specialist, at (252) 847-9954, or