Team Model of Primary Care to Improve Health, Healthcare, and School Outcomes for Children in Foster Care and Health Certification Training for CASA and other advocates
1) The study will conduct a randomized control trial to evaluate a model of care for children in foster care versus the current standard of care in the Foster Care Clinic. Three hundred children from birth through 18 years old who are new to Foster Care Clinic during the enrollment period will be randomized to either the test model of care or the control group. The 150 children that receive the test model of care will receive: (1) comprehensive multi-disciplinary assessments that integrate needs and strengths assessments, treatment, service referrals, and ongoing follow-up by a team consisting of the child and amp;apos;s primary care provider, a child development specialist, psychologist, and nurse coordinator; (2) nurse coordination that provides monthly tracking of the child and amp;apos;s progress on his/her treatment plan and court case, as well as 60 day telephonic transition support after a child changes clinics or leaves foster care; (3) a Health Continuity Plan which lists concise summaries of past, current, and expected future healthcare issues and service needs. The Health Continuity Plan will be developed and maintained by the Clinic team, and will be given to caregivers as the child transitions out of Foster Care Clinic, to assist with continuity of care; (4) individualized and group psychoeducational trainings based on needs based on current standard of care in parenting and behavioral health fields. All health visits will offer only assessments and treatments that are considered reasonable or appropriate as part of standard of care for the patient and amp;apos;s needs.
One hundred fifty children in foster care will be randomized to receive current standard of care in Children and amp;apos;s Medical Center Foster Care Clinic. Current standard of care involves phone support and follow-up on an as needed basis based on primary care provider decision making. Current standard of care includes referrals and coordinations with CPS on an as needed basis, as well. Because caregivers will receive part of the intervention, all children in one caregiver home will be assigned to the same group. Current patients, including patients lost to follow-up who reestablish care within the last 3 years, will not be eligible for the study. Each subject will receive survey questions and assessments at baseline, three months, six months, 12 months, and 18 months after enrollment and questions at the time of transition.
2) An in-person and web-based training for fifteen Court-Appointed Special Advocates (CASA) will be provided that teaches how to access healthcare services for children in foster care, the impact of abuse and neglect on health, and the importance of healthcare services in the recovery of maltreated children. Additionally, a CD-ROM will be developed for other advocates, foster caregivers and parents.
A. Foster Care Model Component:
1. Child has his/her 19th birthday more than 18 months after first visit;
2. Child is placed in CPS Custody due to concerns of abuse, neglect, or abandonment;
3. Child is placed by CPS with relatives, other non-familial, but approved caregivers, group homes, or with licensed foster parents;
4. Child has not visited the Foster Care Clinic in at least 36 months;
5. Medical Consenter intends to continue at the Children[Single Quote]s Foster Care Clinic for primary care
6. Child turns 18 during the study must also sign the Study Consent Form as Medical Consenter.
B. Health Advocate Training Component:
1. Dallas CASA Volunteer for 12 months or more
2. English proficient, written and oral communication
3. Commitment to participating in face to face interview and web-based learning modules