CHECK Foster Care Clinic

Sue Collins, Summer 2013

The CHECK (Comprehensive Health Evaluations for Cincinnati’s Kids) Foster Care Clinic provides services to children experiencing transitions in foster care. There are 19,000 children in foster care in Ohio and 2,100 in Hamilton County. Every child in foster care in Hamilton County is seen at the clinic within 5 days of placement for a state-mandated doctor’s visit. At these visits, the children are evaluated for abuse and neglect, tested for communicable diseases, updated on vaccinations, given a full physical exam, given any necessary referrals, and any foster parent problems are addressed. Thirty days after their placement, children return for a follow-up visit. At this visit, another full physical exam is completed and any medical needs are addressed. In addition, mental health, developmental, vision and hearing screenings are completed. These screenings are especially important because it is estimated that up to 70% of children in foster care have behavioral concerns and up to 60% have developmental delays. Therefore, when these problems are identified in the screens, the children are referred to appropriate services.

My project for the summer was to help complete a database to be used for research within the clinic. Because little is known about the specific health problems encountered by children in foster care, the goal of the database is to improve the amount of information available. Specific information about each individual visit is included in the database, such as specific medical, developmental, and psychiatric diagnoses; laboratory tests completed; screening tests and questionnaires performed; and current medications. Other information such as immunization status, height, weight, and BMI are also recorded. Also recorded in the database is any information about counseling; speech, occupational, or physical therapy; special education services; or early intervention services that the child is already receiving. Any referrals for any of these services or specialty medical clinics are also recorded in the database.

I spent a majority of my time this summer working for UHP inputting data for the patients seen in the clinic since it opened. Because this database was new at the start of the summer, I also spent some time learning the database program, helping to decide what information should and should not be included, and learning about foster care in general. Inputting the information for each visit involves going through Epic notes to find the necessary information. Later, I hope to complete a research project on my own looking at a specific topic within the database. The hope is that this database will provide important information about what medical, developmental, and psychiatric problems are commonly encountered by children in foster care. The database will also provide better information about what services transition successfully through placement changes and what services do not. The trends that are found will be used to make improvements within the CHECK Foster Care Clinic and hopefully in foster care systems in other counties as well.

Because much of my project for the summer involved less direct work with patients, I was also encouraged to shadow often as part of my time for UHP. I spent a majority of my time shadowing the well-child checks within the CHECK Clinic, which allowed me to gain a lot of insight both into how the foster care system works and into some of the problems and experiences that these children have endured. I was also allowed to shadow in the Department of Developmental and Behavioral Pediatrics to observe a full developmental evaluation on a young foster child who had screened positive in the initial developmental screening completed in CHECK. I spent some time shadowing in the Mayerson Center for Safe and Healthy Children in order to observe evaluations of suspected abuse. I was also given the opportunity to spend time shadowing in other specialties that I was interested in within Children’s or in other locations in the city.