The Kansas City Medical Society and the Medical Group Managers Association of Greater Kansas City are partnering with Cornerstones of Care to recruit physicians who will provide physical examinations for some children taken into foster care in Jackson and Cass Counties. Through Help@hand—an initiative of the three organizations to better serve children the state takes into custody—the physicians will be contacted through the Medical Society’s DocBook MD, a HIPAA-compliant texting service that is free to society members. Volunteers will receive messages from Cornerstones when the usual resources for seeing children within 24 hours of being brought into care cannot be accessed.
Children brought into state custody in Jackson and Cass Counties are enrolled in Cornerstones’ Nurse Case Management Program for a minimum of 30 days. During this initial enrollment, a Registered Nurse evaluates each child’s health needs, creates a health summary, collects medical records, assigns them to a program category relative to their health status, and determines and coordinates the health care they need. To do this, every child needs a complete physical examination; the standard is these exams are conducted within 24 hours after coming into care. This is primarily a check for acute medical needs.
A system is being established that facilitates communication between a Cornerstones’ triage nurse and volunteering physicians that safeguards the privacy of the children, avoids excessive contact with any physician, and provides for appointments to be geographically accessible. When appointment needs are filled, a follow-up text simply stating “exam need filled” will be sent to the group of physicians contacted.
Physicians volunteering to participate in Help@hand should be aware:
• children brought into foster care are often sets of siblings, which the state’s Division of Families strives to keep together. Sometimes requests for appointments may be for more than one child. Physicians and medical practice managers can still be helpful if they can only see one child.
• children brought into foster care have often experienced trauma. While they are removed from their homes for their own protection and well-being, that experience in and of itself is distressing to a child, and they may arrive at their appointments upset, angry and/or withdrawn.
• there is not likely to be much, if any, information about these children and their health histories when they are seen. These physicals are critical to developing this record so decisions can be made about the care these children need.
• children in foster care are on Medicaid. Physicians may choose to bill Medicaid or donate their services.
• even though providing the initial examination is the need Cornerstones is asking to be filled, physicians may choose to continue to see children needing ongoing care.
The three organizations are developing a system to document the success of the initiative and to improve upon shortcomings that may be identified. Baseline information will include the number of physicians participating, the number of children served, the number of examination hours provided and of that time, how much was donated.