Coordinating Healthier Lives for Kids in Foster Care

As a child in foster care, especially one with previous or current health issues, each day can be a constant struggle.

Tara, age 5, knew that struggle for years. Diagnosed with asthma at the small age of 2 and experiencing homelessness for most of her years, Tara didn’t begin receiving health care until she was placed in the foster care system. Shortly after her placement, her foster mom noticed she had difficulty breathing. Taking swift action, she scheduled an appointment at Randall Children’s Clinic-Emanuel paving the way for a coordinated effort with her care. “This is not the kind of start a child needs to have a healthy life,” said Holly Hermes, a social worker and care coordinator. “Once Tara came to the clinic and started receiving the care she needed, she made great strides in her development,” says Hermes. “She got her asthma under control. This little girl now has a better chance at a healthy life.”

After years of seeing the lack of health care for foster children like Tara, staff at Randall Children’s clinic obtained a grant to create a program, both identifying the gaps in care and finding ways to coordinate each child’s care. Each foster child that is referred to the clinic is assigned a care coordinator, who works with the foster parents and caseworker to follow up and help monitor the child’s care. The difference in this model is the coordination doesn’t stop there but continues until the child reaches adulthood.

Research shows that people who had difficult childhoods –– as many foster children have –– often have poorer health as adults. “We know that if we can intervene early, we have a better chance of heading off bigger issues down the road,” says Kelly Alexander, R.N., the clinic’s other care coordinator for foster children.

Randall Children’s Pediatric clinic has been the only clinic in the Portland metro area with this model of care for foster children for years. Over the course of the Children’s Levy grant (2009-2014), the clinic served 203 kids. Since 2014, the clinic doubled its referrals, serving over 400 children in eight years. Currently, 194 children in foster care are receiving care, with the hopes of serving more children in the future.

Hermes and her team have seen some good results with many of the foster children in the program: a higher rate of immunization, fewer trips to the emergency room and generally better health. They created a model of practice that is being picked up by other clinics.

The clinic, on the Legacy Emanuel Medical Center campus in North/Northeast Portland, initially received funding for the program from the Portland Children’s Levy. The program received funds from CareOregon; that support ended in September 2016. “While we are hopeful that we will be able to extend our agreement with CareOregon, we continue to look for alternative funding sources,” Hermes says.

Both Hermes and Alexander say they find their roles rewarding, but the job is also eye-opening. “You hear about kids being in foster care,” Alexander says. “But do you really know what these kids have gone through? Often, they have gone through a lot. And anything we can do to help them has huge benefits.”

For media inquiries, contact Ashley Stanford Cone at or 503-276-6585.

By Ashley Stanford Cone