Children's Medical Services & Advocacy Center (The Center)
Grant Status: Completed
Training Category: Healthy Tomorrows Partnership for Children Program (HTPCP)
Project Director(s):
Liz Mason
Children's Aid and Family Services, Inc.
Paramus, NJ
Phone: (201) 261-2800
Email: lmason@cafsnj.org
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Problem:
Children's Medical Services & Advocacy Center uses the medical home model to provide intake assessments/exams, medical triage, acute care and health care case management for children in the agency's foster care programs to improve healthcare outcomes for this population.
Goals and Objectives:
Goal 1: To improve child health by providing access to high-quality, coordinated health care to all children in agency (CAFS) foster care programs. Objective 1: CAFS medical staff provides preventive pediatric care to program residents within their first six months of care and will coordinate all components of direct health care for these same youth for the duration of their care. Objective 2: Project staff will develop collaborative relationships with community providers of specialty medical care as needed. Objective 3: There will be written or verbal communication with all pertinent medical providers prior to a child seeing that provider. All children will have an updated ""Problem List"" and plan to address issues, plus an updated ""Medication List"" that includes psychotropic as well as other medications. Goal 2: To ensure that the child's ongoing medical needs are a key component of discharge/ transition plans established for youth in agency (CAFS) placements. Objective 1: Center staff will ensure that the child's Medical History Summary is complete and updated within 30 days of any child's planned discharge/transition from a CAFS placement. Objective 2: All parents (100%) with whom children in CAFS placement are expected to reunify will be invited by Center staff to participate in the child's medical appointments prior to discharge. Objective 3: Center staff will ensure that medical records are provided to the legal guardian, directly or via the child's case manager, upon a child's discharge and all required medical follow ups are identified and explained. Goal 3: To increase community pediatrician knowledge of the special health care needs of children in foster care while simultaneously providing health education to foster and adoptive parents. Objective 1: Provide training opportunities for community pediatric providers on an individualized basis. Objective 2: Provide health education and support to children's current caregivers, and, when feasible, to the children's parents (birth/adoptive) each year. Many of the birth parents are very dysfunctional which makes the latter goal more challenging: working with reunifying birth families is the priority. Goal 4: To meet or exceed HRSA's expectations for grantees for culturally competent programs, family and community partnerships for service delivery, and program sustainability as federal funding ends. Objective 1: Expand CAFS Advisory Board to include more stakeholders - foster parents and aged out youth - if feasible. Objective 2: Ensure that all Center staff continue to be current in trainings on working in a culturally competent manner. Objective 3: Integrate need for program sustainability throughout program development by involving Agency Board and key leadership in project goals, showcasing program success stories in CAFS publications and involving Advisory Board in fundraising.
Methodology:
Our Medical Director (Dr. Anne Armstrong) and pediatric APN (Kathy Courain) continue to develop the program. After a thorough needs assessment, and successful advocacy with the state of NJ, they now provide direct medical care to the children in our programs. Dr. Armstrong and Center staff coordinate care with both the public agency Child Health Units (CHU) and the staff psychiatrists through individual case staffings and the integration of child service plans. They have now stopped using Practice Fusion, an electronic health records system, since we were advised that this is no longer HIPAA compliant under the latest regulations, and are actively exploring a suitable, affordable alternative. Our advisory board is actively engaged and meeting regularly, focusing on achieving operational goals, including financial sustainability.
Coordination:
Key partners :child's caregivers (foster or adoptive family, treatment home, professional parent, group home staff); their public agency casework and nursing staff; an array of medical service providers, including Valley Hospital's Center for Child Development, and St. Joseph's Hospital for consultation, direct care, inc. specialty, and Chilton Hospital - specialty care for medically fragile infants. Donors and foundation represented on advisory board: fund and solicit funds for this program.
Evaluation:
Collecting: Basic demographic information; Process outcomes for tracking medical needs, home visits, interface with other providers and contributions to Medical Summaries; Number/focus of trainings. Currently determining how to gather medical outcome data against available historical information to capture, e.g.: decreased reliance on ER/PCP visits, improved immunization compliance, etc.
Experience to Date:
The past year has been a busy and exciting one. We continued to expose others to the work we are doing in a variety of different settings. A group of 6 pediatric residents from Columbia spent a day at the program.They then went back to Columbia's Pediatric Residency Council and shared their experience: they chose a group home of the children we care for as recipients of their Holiday Project A. ll 8 girls in one of the group homes were given brand new bike helmets. We met twice with State leaders who determine policies around health care for the children in foster care in the State of New Jersey. We are continuing the conversation and are hopeful our frontline experiences will help shape policy going forward. We had a fundraising event in December solely for the MSAC. The event introduced many new individuals to the work that we are doing and raised over $90,000 dollars. The Cohen Foundation was a new connection for us. They supported us with $50,000 in the past year and have just committed to the same level of support for 2016. Dr. Armstrong-Coben was unanimously selected by the Bergen County Freeholders to serve on a newly formed committee to advise on issues of the LGBTQ communities in Bergen County. Medical Student Erica Cao worked with Dr. Armstrong-Coben and staff members at one of our group homes to pilot her ""Song Project"". Selected as a Steve Miller Fellow, she presented the project at Columbia on Steve Miller Education Day. "