• ​Type of Practice: Foster Care Medical Clinic
  
• Location: Bronx, New York; Dobbs Ferry, New York; Harlem, New York
  
• Population Served: The clinic serves approximately 10,000 children in foster care and the juvenile justice systems.
  

• ​Co-locate the following services within a clinic:
• General pediatrics
• Developmental pediatrics
• Social work
• Nursing
• Psychiatry
• Psychology
• Facilitate frequent team meetings and communication with the aforementioned professionals to ensure coordinated care.
• Partner with local medical schools and universities to provide education to medical students on how to care for children and youth in the foster care and juvenile justice systems. Recruit medical students to assist in the provision of care at the clinic.
• Screen all children and youth for symptoms of depression, post-traumatic stress disorder, and other psychiatric conditions at each visit. Promptly refer children for further psychiatric team intervention as necessary.
  
• Implement a joint Electronic Health Record system for pediatricians and psychiatrists to enhance integration of behavioral/mental health and primary care.
• Establish a 24/7 telephone answering service, allowing caregivers to contact physicians during evening hours and weekends.
  
• Engage biological and foster parents in health care visits and care planning for children. 
• Recruit and support a parent advocate to work within the clinic and provide peer support to biological and foster parents.
  
• Convene a parent advisory committee that provides guidance and direction to the clinic's Executive Team on activities to enhance family-centered, culturally competent care. 
• Employ bilingual and bicultural clinicians and staff.
  
• Implement an "Undoing Institutional Racism" program and steering committee to facilitate activities which address the disproportionate number of African American and Hispanic children in foster care and the juvenile justice systems.
• Coordinate behavioral health interventions with schools.
• Facilitate parent/caregiver support groups and mother-baby sessions with specialists.
  

• It is often challenging to provide comprehensive care to children and youth in foster care and the juvenile justice systems. These populations are faced with extraordinary medical, psychiatric, and developmental needs. To meet these needs and address this challenge, the clinic implemented a routine computer-based developmental screening process for children under 3 years of age. Physical proximity of all team members within the same clinic location allows for enhanced team communication and coordination of care.
• The clinic has faced challenges in integrating care with outside sub-specialty providers and community services. The clinic conducts outreach to community organizations and tertiary care centers to facilitate effective care coordination with sub-specialty providers and community services.
• The clinic conducts screening, treatment, and follow-up for Fetal Alcohol Spectrum Disorders (FASD). Due to a lack of awareness and education about this disorder among professionals, screening and caring for children with FASD is often a challenge. The clinic provides education on FASD to its clinicians, staff, foster and biological parents, and partnering organizations in order to increase awareness and improve quality of care.
  
• Lack of community-based mental health services for children after discharge from foster care and juvenile justice systems creates challenges in continuity of care. To bridge this gap, the clinic offers mental health services to children after they are discharged from the foster care system.
  

• ​For more information on The Keith Haring Clinic at Children's Village, contact Doug Waite, MD, Medical Director, at dwaite@childrensvillage.org.
• The Children's Village is a charitable organization founded in 1851. The mission of the Children's Village is to help children and families who are struggling to become productive, independent citizens who will enrich their communities and their future families. For more information about the Children's Village, visit www.childrensvillage.org.
  
• For more information on caring for children and youth in foster care, visit the American Academy of Pediatrics Fostering Health Web site.
• For more information on Fetal Alcohol Spectrum Disorder, visit the American Academy of Pediatrics Fetal Alcohol Spectrum Disorders Program.