Adapting Pediatric Medical Homes for Youth in Foster Care: Extensions of the American Academy of Pediatrics Guidelines

Abstract

This article provides recommendations for adapting the pediatric medical home (PMH) model for health care needs of youth in foster care. Recommendations are based on key informant interviews regarding experiences at an established PMH for youth in foster care. Major clinic recommendations include expanding the PMH framework to include proficiency in Medicaid billing, promoting true interdisciplinary care teams, improving care accessibility via phone consultation, providing a stable place for medical records to be housed, delivering services throughout stages of the child welfare case, incorporating all family members, and implementing trauma-informed practice. Preliminary evidence suggests that the PMH model of care may be ideal for addressing the complex and often underserved needs of youth in foster care and their families. The present recommendations provide a logistical framework for establishing a clinic that thoughtfully considers the unique needs of this population. Future research is needed to examine best practices for implementation.

Knowledge, Attitudes, and Practices of Dental Practitioners in Providing Care to Children in Out-of-Home Care: A Scoping Review

“…If children in OOHC cannot find a dental practitioner to accept Medicaid insurance, then they may not be able to access any dental care. In the US, children in OOHC are overwhelmingly insured by Medicaid; however, some children do retain private insurance or have alternate means of health care [ 37 ]. One of the biggest hurdles children in OOHC face in accessing dental care is finding a provider who accepts patients enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) [ 38 ].…”

Allied health professional support for children and young adults living in and leaving care: A systematic scoping review

“…The wider body of international literature clearly highlights that AHPs should have a place in interdisciplinary services for children living in care across the care trajectory and in different care settings to mitigate communication challenges and ensure a shared understanding of a child's behaviour and needs across agencies and services (Hickey et al, 2021; Swann & York, 2011). It is evident that the complexity of need among children and young people living in and leaving care, including their trauma and care histories (Cross et al, 2019; Krüger et al, 2017; Zanders, 2015), requires skilled trauma‐informed AHP involvement as part of a wider multidisciplinary integrated care team‐around‐the‐child (Espeleta et al, 2020; Kinniburgh et al, 2017; Lang et al, 2016; Raman et al, 2017). Where are the gaps in the existing evidence?…”

“…These include addressing barriers to accessing AHP services and multidisciplinary working (Armstrong‐Heimsoth et al, 2020; Byrne & Lyddiard, 2013; Cross et al, 2019; Maguire et al, 2021; McCool & Stevens, 2011). Given the multifaceted and intersecting needs of children and young people living in and leaving care, the wider literature confirms that there is a requirement for integrated coordinated services to overcome the inherent fragmentation of children's lives, needs and services (Espeleta et al, 2020; McClean et al, 2020; Raman et al, 2017). It is also important to consider that when children have high levels of chronicity and comorbidity in emotional, developmental and functional difficulties, this puts further strain on foster and kinship carers, with evidence of placement breakdown known to further exacerbate detrimental outcomes for children (Chateauneuf et al, 2022; Konijn et al, 2019; Osborne et al, 2021; Rock et al, 2015).…”