The Cook Children's Fostering Health Program serves more than 2,000 children from across North Texas and as far west as Stephenville. In March, the Clinic helped more than 200 children, a record number for the program.

“Our clinic functions as a primary care medical home and offers complete health care for children in foster care through age 21,” said Brittany Schoonover, pediatric nurse practitioner for the Fostering Health Program.

It begins with trauma-informed care.

“We recognize when a child is removed from a home that in itself is trauma,” explained Keirsten Velez, LMSW, a social worker for the Fostering Health Program. “Sometimes we see the child the day after it happens, so our goal is to empower the child.”

That empowerment includes involving children in their own health journey while helping caregivers navigate the foster care system.

“There are a lot of nuances that come with providing medical care for a kiddo in foster care,” said Velez. “For example, most agencies require the foster parent to have a nine-page form completely filled out and signed at the end of every medical visit.”

Even before the first exam, the team works to fill the gaps in a child’s medical history by tracking down records from schools, hospitals and previous pediatricians.

“Often times we find fragmented care where the child had initial medical exams but often not follow up care,” explained Schoonover. “Our clinic is helpful to connect the dots and put the puzzle pieces together to be able to provide the best care for the child.”

Velez noted often placements occur with limited time or funds for foster parents to prepare for the child’s arrival. The team strives to address immediate needs, providing patients with essentials such as clothes, toys, and diapers, while also serving as a bridge to long-term support through Cook Children’s and community support.

“We try to make navigating the system easier for the caregivers,” said Velez, “We're kind of advocating alongside of them for what they may need.”

The support does not end when a child’s case closes. Schoonover and the team ensure continuity of care by providing families with information about new pediatricians and specialists.

“We’ll send over whatever they need to the new doctor, we want to keep the continuity of care that they have had here in their medical home,” said Velez.

Jamie Miller and her husband are foster parents who have worked closely with the clinic for three years. Since then, they have fostered 14 children. Most of their placements have been two or more children at a time.

“Jamie has the patience, flexibility and resilience that are crucial in her role as a foster parent,” said Elizabeth Popeck, a nurse practitioner in the Cook Children's Fostering Health program. “Her unwavering commitment for each child and their family is always astounding. Jamie has the capability to find joy and happiness in the care she provides these children every day even if it’s a small achievement for the child which makes her an exceptional foster parent.”

In celebration of National Foster Care Month, we spoke with Jamie about her experiences as a foster parent. Read her interview below!

What inspired you to become a foster parent?
We felt called to do this as a family ministry. God kept putting families in our path that had or were currently fostering.  We felt the need to help these children who had experienced trauma.  We believe that we could offer a loving and safe place to call home.

My husband and I truly believe that were called to stand in the “gap” and love children during the healing process. Through that belief system, that means that we are fully “rooting and reassuring” the biological parents as they work through their services. We send encouraging notes, pictures, text messages and sometimes even phone calls to show our support. We also believe that clothing and food should never be a hardship when families are reunited. It is hard enough finding a new rhythm and getting to know each other all over again. So, we send an abundance of clothing, diapers, and food home with each child that leaves our home.  If the parent doesn’t have our contact information, we share it with them to offer help, advice or whatever they might need. We want reunification to be as successful as possible!

What are some of the most rewarding moments you’ve had as a foster parent?
There are too many to count! Seeing children reunite with their family.  Being invited into the family of one of the children, as an actual family. Being able to help guide them to care for their child and the child being so supported by all involved. Seeing a child’s physical and mental well-being change in a nurturing environment. The way that it has impacted our family for the better and taught our biological son lessons in empathy and compassion that he wouldn’t have had otherwise. 

Can you tell us about your experience working with the Cook Children’s Fostering Health Program?
It has been wonderful! The Cook Children’s team is extremely knowledgeable and incredibly supportive of our family and so many others that we know. If any child needs a specialist, they make the appropriate referrals in a timely manner and continue to offer other services to benefit the foster families.

What message would you like to share with the community about the importance of fostering?
It’s hard. All of it is hard. However, we can all be a part of the solution in helping these families and especially these children. You can provide a meal to a foster family when they receive a new child into their home. You can donate gently used clothing to a foster closet.  You can become a babysitter or respite care provider.  There are lots of ways to love from afar, and even more ways to love from your home. It truly is the most rewarding and humbling job you will ever do!

Children entering the foster care system often have specialized health care needs. Through Cook Children's Fostering Health program, these children receive timely and thorough medical care. Learn more about the program here.

That sense of urgency for these kids moved the state of Texas to pass a law in 2017 that made it mandatory for all children entering into conservatorship to have a medical exam within three business days after the child was removed from their home.

While the law is an important one to the well-being of the child, the reality of providing timely and thorough medical exams within three days proved to be a difficult task for many parents.

The exam is a medical screening that is intended to provide a baseline of a child’s physical health upon entering foster care. It is also an opportunity for the caregiver to obtain necessary treatment and medications for a child that may not have been obtained at the time of removal, such as an asthma inhaler or eczema cream.

The child abuse experts at Cook Children’s understood the need for foster parents in the community to meet the requirements of the state.

Jamye Coffman, M.D., medical director of the Cook Children’s Center for Prevention and Child Abuse and Neglect and the CARE team​, said it was clear there was an issue and Cook Children’s wanted to aide in the solution.

The result? The Cook Children’s Fostering Health clinic that launched in 2018. The clinic provides comprehensive services for all kids living with foster parents from foster infants to young adults, as well as foster children who have become parents.

Dr. Coffman says one of the goals of the clinic is to help foster parents better understand trauma behavior in children and to take more time with the families than just a quick appointment in a primary care office.

“We knew there was going to be a problem getting children into a clinic within three days, because they would be new patients with insurance and billing issues to figure out,” Dr. Coffman explained.

Cory and Maddie Churchman are foster parents who’ve brought four children through the clinic. The couple express their gratitude for the resource they say “has never failed them.”

“We know several families who’ve had to take their child to the emergency room or urgent care, just to have them seen within three days,” Maddie said.

The Churchman family says many offices won’t accept Medicaid insurance, or the office is full and not accepting new patients, so having the foster care clinic at Cook Children’s alleviates that stress.

The clinic allows an hour per visit for every patient they see. Dr. Coffman says this is important because evaluations usually take time because many children enter their new homes and the foster parents know little or nothing about the child.

“Before they even come in our door, we’ve already gathered medical records, immunization records and trauma history, and spoken with Child Protective Services (CPS) to help those parents transition,” Dr. Coffman explains.

The Churchmans say they are prime examples of not having any information on their children when they enter the home. The family adopted the first child they fostered, a one-year-old girl, and said they had doctors ask them for information they weren’t always able to provide.

“There are many doctors who don’t specialize in foster care who ask us as foster parents things we don’t know the answer to. We don’t know if they’re vaccinated or anything,” Maddie said. “We show up at the (Cook Children’s) clinic, and they’ve already looked into everything, which is a huge help.”

The Churchman family says they tell other foster parents to allow people to help you who are in place to do so.

“They saw a need and they are standing in the gap,” Maddie said. “I just want everyone to know they are there, they get it, and they really want to help you.”

The Churchman family is always eager to take their daughter back to see the staff when they have other appointments for their new foster placements.

“We are very grateful that they’re there for us and continue to do their jobs every single day,” Maddie said.

The parents don’t know the child’s social security number or even date a birth, but no one thinks twice because this is so normal to them.

This is part of the Cook Children’s Fostering Health program.

“Limited access to medical care is common among children entering the foster care system,” said Sharon Johnson, a nurse practitioner in the Fostering Health Program. “The goal of the Fostering Health program is to provide medical care using a trauma informed lens. We understand that removals are often due to a combination of trauma experiences and that even a visit to the doctor is unusual. Children in foster care are a very unique patient population that require unique care.”

The team follows the American Academy of Pediatrics’ health care recommendations to provide a health screening within three business days and a well-child checkup within 30 days of removal. During these visits, the team will assess behavioral, developmental and chronic health care needs. The staff also will partner with case managers to help coordinate care with required specialists and act as a continued resource for the children and biological parents.”

The Parents

On their very first date, they talked about adoption.

As Christians, the young couple felt their faith compelled them to take care of the orphaned, those who didn’t have a home or were less fortunate.

Time moved on and the couple married and they adopted their first child.

While their calling was to help children, they knew they could not afford another adoption.

“We looked into becoming foster parents,” “Janet” said. “There’s such a need and so many kids are in the foster care program. We both knew plenty of people aren’t called for it. We were.”

The couple have now been foster parents to three children. Their latest foster child is the first to have been seen by the Fostering Health program at Cook Children’s.

Raising foster children brings a new set of challenges, both logistically and emotionally. They have to:

• Be vetted legally through CPS and the foster care system.
• Be CPR and first-aid trained.
• Go through background checks and be finger printed.
• Make sure anyone who would baby sit or watch their children, also go through a similar process.

The husband and wife say they have seen children come out of very sad situations, where both the birth parents and sometimes even grandparents have a history with CPS. The children are often removed from the birth parents’ homes.

One or both of the birth parents sometimes are battling criminal charges, mental health issues or drug problems.

And then there’s always a chance, the birth family could get their life straightened out the child returns to them and leaves the foster parents.

The couple are currently fostering a daughter a little under a year old after the child’s mother was found to be unfit to care for her child because of psychiatric health care issues as well as the fact that she was homeless.

The child was brought to Cook Children’s Foster Care Program for an initial three-day evaluation. They found the concerns for the child included lack of prenatal care and possibly premature birth (estimated gestational age 36 weeks). The child was seen 10 days later for a weight check and a newborn screening and then two months later for another well-child exam.

The foster parents of the child say the experience at Cook Children’s Foster Care program was much different than previous visits to a pediatrician’s office. In the past, the staff in other pediatric offices didn’t always understand or appreciate the unique needs and concerns of the foster parents and their children. The family spoken to for this story said previous foster well-child visits might take as few as 20 minutes and the staff couldn’t understand that this child was new to the foster parents. They weren’t sure of common questions asked of birth parents such as if the child’s immunization record was updated or different behavioral aspects of the child.

“Previously, the doctor would take less than 20 minutes looking at our child,” “Janet” said. “At Cook Children’s Fostering Health program they spent well over an hour checking her. I just appreciated their understanding of our situation. We didn’t know the things most parents know. It’s not like the child came out me. We didn’t know the family history. We didn’t know anything about this baby.”

The foster mom said she vividly remembers crying on her way home following the first two placement, well-child visits.

“I tried to explain to them, I don’t know the children. I got them less than 24 hours ago,” Janet said. “There are so many elements that’s simply out of control of the foster care parents. We don’t even know the social security number, the birth mom’s name … sometimes they don’t tell you the basic things. I just appreciated the humility of the whole office. They were all walking around oohing and awing. It is a Foster care clinic. They get it like no one else does. I really loved going to Cook Children’s.”

Services provided from the Cook Children’s Fostering Health program include:

• Providing care coordination between foster and primary care physicians, specialists, therapists and behavioral health
• Helping establish a primary care medical home
• Providing sick and well-child visits
• Coordinating with Department of Family and Protective Services and child placement agencies

To schedule an appointment with Cook Children’s Fostering Health program, call 682-885-3953. The team can combine the three-day required visit and the appointment for hair follicle drug testing if the drug test is ordered by Child Protective Services.

The program provides a medical screening within three business days of removal to:

• Assess the child’s overall health and confirm that there is no evidence of abuse
• Find out if child should be taking routine medicines and help with refills if necessary
• Document behavior changes
• Provide a well-child checkup (Texas Health Steps) within 30 days of removal
• Reduce preventable hospitalizations and Emergency Department visits
• Connect children to services such as physical and occupational therapy, behavioral health and specialists visits
• Help foster parents access health care services

To Schedule an Appointment

Caregivers, Child Protective Services representatives and providers can call 682-885-3953 and ask for the fostering health care coordinator or email fosteringhealth@cookchildrens.org.

8 isn't enough ... life with 9 children

Nine children, ages 3 to 19 years old, make Mother’s Day a pretty special time for Kristy Goodnight. After all, that’s a lot of hugs and kisses to go around ... But when you consider each child has his or her own special needs, life can be amazingly hectic and difficult. And what’s the biggest challenge for the mom of nine? Click to read more.

Dr. Mom: How motherhood changed me as a pediatrician

After completing 24 years of schooling and medical training, you’d think that once I graduated from pediatric residency, I’d know a thing or two about the health of children. And I did. I knew a lot ... Then, I was blessed to have a beautiful son...who decided that I needed to be re-taught a few things about children.

And by a few things, I mean everything. Click to read more.

How being a mom shaped her practice

I am a better pediatrician because I have experienced life as a mom. I know the tears and tiredness of a new mom and so when she cries at the new baby check I can tell her it's normal and she believes me. Click to read more. Click to read more.