program-models

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Program/Project Name Care4Kids Foster Care Medical Home Program
Affiliation Name Children's Hospital of Wisconsin
Website URL https://childrenscommunityhealthplan.org/providers/Provider-Resources/Care4Kids-Provider-Info
Model Type Preferred Provider
City Milwaukee
State WI
State specific location Racine, Kenosha, Washington, Ozaukee, Waukesha
How is program/project funded? Federal Funding, State Funding
Describe how it's funded

Care4Kids is a State of Wisconsin Medicaid benefit for children in out of home care.

What services does it provide Entry to care health assessment, Comprehensive health assessment, Standardize screening (developmental, mental health), Subspecialty referrals, Ongoing primary care/medical home, Health care coordination services, Comprehensive Health Care Plan
Where does it provide services County-based
Description of program/project

​Care4Kids is a new Medicaid benefit that provides comprehensive health care for children in Out-of-Home Care that reflects the unique health needs of these children. To strengthen the quality, access, and timeliness of care, Care4Kids creates a "medical home" for each child entering care. This "medical home" is not a physical place, but rather a philosophy that children in Out-of-Home Care deserve coordinated and comprehensive healthcare that addresses their unique needs. Care4Kids provides children with primary care physicians who are trained in the needs of children in Out-of-Home Care, and also creates a team of professionals who coordinate care for the child.

Facilitated by a Health Care Coordinator, this team is comprised of the county caseworkers, health care professionals, Out-of-Home care providers, and the child's family. This team works together to ensure that children entering Out-of-Home Care will receive timely, individualized and developmentally appropriate care by physicians trained in evidence-based and trauma-informed care. This new approach to healthcare will improve physical and mental health outcomes for children, as well as promote improved resiliency and create stronger natural support systems for children in Out-of-Home Care.

Through Care4Kids, children in Out-of-Home Care (OHC) will receive:
- An OHC Health Screen within 2 business days of entering care
- A Comprehensive Initial Health Assessment within 30 days of entering care
- A mental health evaluation (if needed)
- Dental and Vision Care
- Coordinated ongoing health care from providers trained in the unique needs of children in OHC
- A Comprehensive Health Care Plan tailored to the child's individual health needs

How are patients tracked? Specialized database for your program
Provide special focus
Program/Project strengths

​The major strength of the Care4Kids program is the provision of health care coordination for children in foster care. The Care4Kids team focuses on ensuring access to care, timeliness of care, and quality of care for these children. Each child in the program has a Comprehensive Health Care Plan developed which summarizes the child’s health and social needs. This living document is modified during a child’s time in out of home care, and is shared with stakeholders (primary provider, subspecialists, child welfare workers, foster parents, biological parents, etc.) so that all those involved in the child’s life understand the child’s needs. Child welfare is provided with the Comprehensive Health Care Plan and kept informed on health care issues with the child, and that information is meant to be used during permanency planning.

Program/Project challenges

​The Care4Kids program was launched in January of 2014, and in just over a year of operation has identified many opportunities for improvement. There has been a tremendous effort to educate all those peripherally involved with the program (foster parents, child welfare workers, biological parents, medical providers, mental health providers, etc.) as to why it is important for these children to receive the recommended health care services. This has helped to overcome some of the barriers, but many still remain due to the novelty of the program. The requirement for consent beyond the general “routine health care” consent for certain medical visits (dental, mental health evaluation, birth to three evaluation, etc.) was a barrier prior to the Care4Kids program launching, and remains a challenge still. Lack of consent often slows down or impedes the process of getting health needs met, and the program is reliant on others to obtain these consents (usually the child welfare worker). Care4Kids has numerous quality measures that are being tracked, and there is ongoing program improvement efforts to try and address areas where quality can be improved.

For others looking to replicate this type of model, focusing on educating partners is a big key to success. It is important that particularly child welfare workers, foster parents, and primary pediatricians/medical providers in the community are willing to partner with the health care coordination team to ensure that recommended services are obtained for these children.

Contact Name Kelly Hodges, MD, FAAP, and Lisa Zetley, MD, FAAP
Email Address khodges@chw.org
Phone Number (414) 277-8980