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Health Matters: Meeting health needs of kids in foster care

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Jennifer Olson


When families are in crisis, health care can fall by the wayside. This means children entering foster care often have significant untreated medical and dental needs. If those needs are not met, the issues can affect their lives as adults.

KidsFirst was created to help meet the health care needs of children placed in foster care in Yellowstone County. The effort is a partnership between the Montana Department of Health and Human Services Division of Child and Family Services in Billings and RiverStone Health.

Nearly 775 children in Yellowstone County are in foster care or have been placed in the care of relatives. The majority enter foster care because of neglect. Their health care has often been fragmented and crisis-oriented rather than preventive. Some have experienced abuse, financial instability, homelessness or unstable living conditions, domestic violence, or the lack of food or nourishment. Some of their caregivers were addicted to drugs or alcohol, or had a mental illness. Some were exposed to drugs or alcohol during their mothers’ pregnancy. Children in foster care range from newborns to 18-year-olds.

Child and Family Services has referred 498 children to KidsFirst since the program began in August 2016. A registered nurse from KidsFirst sees the children when they enter foster care and coordinates their health care while they remain in foster care. The nurse assists foster families in coordinating medical care to make sure the children have appropriate, consistent and comprehensive care following American Academy of Pediatrics guidelines.

During an initial home visit, the nurse reviews medical records and does a thorough assessment of each child’s current medical health. The nurse helps schedule initial physical and dental appointments. If children had an existing relationship with a health care provider, they can continue receiving care at those clinics. If not, they can be seen at RiverStone Health, which has four specially trained providers and time set aside for children in foster care.

KidsFirst nurses continue to visit the children in their foster homes throughout their time in foster care. They also help coordinate ongoing medical appointments along with dental, vision, hearing, development and specialist appointments, if requested by the foster family. The health care system can often seem overwhelming, and it helps to have someone who knows how to navigate that system.

The nurses screen for development delays and can help line up needed services. Working with the Child and Family Services case worker, they can also help manage children’s mental health needs. Part of the nurses’ role is educational. They help foster families learn about managing medical conditions, caring for children who have experienced trauma, parenting issues and developmental milestones. They can also refer families to community resources and government assistance.

By working to meet children’s medical needs, Child and Family Services and RiverStone Health KidsFirst seek to improve their lives beyond foster care and into adulthood.

Jennifer Olson, R.N., Supervisor for KidsFirst and Nurse-Family Partnership, can be reached at 651-6443 or


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