National Foster Care Awareness Month

 

The foster care program provides safe, temporary living arrangements and support services for children who have been removed from their families due to an unsafe home environment, inadequate supervision or care, or suspected maltreatment or abuse.

 

All too often, these children present with complex and serious physical, mental health, developmental, and psychosocial problems rooted in childhood adversity and trauma. As a result, they are designated as children with special healthcare needs.*

 

In recognition of National Foster Care Awareness Month this May, we highlight a resource in the community that addresses the special health care needs of children in foster care. This unique organization partners with parents and caregivers to build health, resilience and hope through the delivery of trauma-informed care.

 

*American Academy of Pediatrics 

Starlight Pediatrics provides primary care services to children entering or already in foster care in Monroe County. The trauma-informed perspective of the Starlight pediatricians is what sets them apart from other healthcare providers.

 

“At Starlight Pediatrics, our providers go through specialized training and have a direct connection to casework teams,” said Kristen Marrese, MSHA, RN, CPN, Program Coordinator for Starlight Pediatrics. “Our trauma-informed perspective enables us to piece together the puzzle of what the child/family has gone through, to give the best care for the child.”

 

Typically these health care issues are unidentified and undertreated at the time of admission to foster care. Many are chronic and may have a continuing impact on all aspects of life, affecting these children long after they leave the foster care system and are reunited with their families.

 

“Our goal is to promote the best outcomes for the child,” said Marrese. “In a standard primary care office, a child may be seen for only 15-30 minutes. At Starlight, our clinic is designed for longer visits, to tease out what is going on and provide the best supports for the child and caregiver.”

 

Overall, 30% to 80% of children come into foster care with at least one physical health problem, with fully one-third having a chronic health condition. In addition, 46% to 60% of children younger than 6 years have a developmental disability that qualifies them for services. Up to 80% of children in foster care enter with a significant mental health need, and 20% have significant dental issues.*

 

*American Academy of Pediatrics 

All staff at Starlight Pediatrics go through trauma-informed training and infant mental health training through the Society for the Protection and Care of Children. The 15-week course focuses on interpersonal connections and how safety and security bonds are formed as a child.

 

“The training looks at how children form attachments as they grow,” explained Marrese. “It explores how you connect to your world from 0-5 years old and how that can impact your actions and behavior as you grow into adulthood.”

 

For a child impacted by a parent involved in domestic violence, for example, trauma-informed care allows the healthcare provider to better understand the factors involved, how to get the child to a safe place, and how to begin to reshape their outlook on the world.

 

In a foster home, the value of trauma-informed training may come into play when coaching a parent toward reunification, giving them the skills to move forward in a positive and productive way.

The Starlight Pediatrics clinic is based on a model started by the American Academy of Pediatrics. Created through a collaboration between the University of Rochester Medical Center, the Monroe County Department of Public Health, and the Monroe County Department of Human Services, Starlight Pediatrics is now fully funded through the county, which has become a hub for human services and healthcare programs.

 

“Children who enter foster care through the child welfare system come to Starlight Pediatrics within 72 hours for an assessment,” explained Marrese. “Unlike traditional clinics, we work directly with the caseworkers to create a care and/or safety plan, while we educate the family on the child’s medical concerns.”

 

A follow-up appointment and ongoing checkups at regular intervals cover the child’s past medical history, including any medications, and coordinate referrals to specialists, in addition to conducting a more formal physical exam for comprehensive medical care.
 

“As a mandated reporter,” said Marrese, “I recognize that it can be overwhelming when reporting a suspected case of child abuse or neglect.”

 

“People don’t want to ‘start trouble’ or even believe that neglect or maltreatment is happening in their backyard, on their street, in their community,” she continued. “But the reality is that it is so much closer to home than you think.”

 

Child neglect and maltreatment, sexual abuse, domestic violence, and sex trafficking happen in all communities, from the inner city to the suburbs. Marrese cautions that you don’t want to wonder if you should have reported.

 

“If we can interrupt Adverse Childhood Experiences (ACEs) and help build resilience,” she said, “we can work on establishing corrective behaviors for better outcomes for children who have been traumatized.”

 

“We are all also healing from past experiences,” Marrese concluded. “We are making our own connections to the world and those around us. Educate yourself and be aware.”