A “Foster Care” Clinic for Virginia’s Children

In the heart of Richmond exists the Children’s Hospital of Richmond at VCU, which was recently named one of the Best Children’s Hospitals in 2018. While the hospital at large has earned national recognition, many people don’t know about a special program within the hospital, the Child Protection Clinic (which is also home to the Foster Care Clinic). The team is headed up by experts in pediatrics and child abuse prevention, providing both medicine and child welfare treatment. Currently this is the only clinic of its kind in the state of Virginia. The VCU child protection teams provides crucially important services to children entering foster care.

We recently had a chance to interview the team, lead by Dr. Robin Foster, about the details of their work, why the services are so important for children in care, and how people can get involved in helping the program grow.

1. Why was this clinic developed?

The Child Protection Team/Clinic (CPT/CPC) was developed in 1992 by three pediatricians at VCU. At the time, there was only one other medical child abuse team in the Commonwealth of Virginia. The Department of Social Services (DSS) proposed to start a second university based medical team because of the severe lack of resources available to evaluate children who were alleged victims of physical abuse, sexual abuse, or neglect. These three physicians partnered with DSS and opened our clinic doors in July 1992. We saw 150 children that first year and now see on average 850-1000 cases per year from throughout the Commonwealth of Virginia, serving well over 40 jurisdictions.

2. Who does the clinic serve?

The CPC accepts referrals from other physicians, social services or law enforcement for the evaluation of alleged physical abuse, sexual abuse, neglect victims, and/or substance-exposed children. We also host a clinic on Tuesdays for the comprehensive evaluation of children who are placed in foster care. We started this service as a pilot program with Richmond City in October and now offer it to all jurisdictions. This evaluation includes an ability to screen for medical and developmental issues. We can provide immunizations and referrals for subspecialty services that the child needs including dental, development, neurology, urology and pulmonary. We also are working in conjunction with our mental health team at the Virginia Treatment Center for Children (VTCC) to provide mental health evaluations for these children and interim mental health services with one of the child psychiatrists from VTCC. We evaluate children from over 40 different jurisdictions in the Commonwealth.

3. What does the clinic hope to resolve?

Our dream is to bring an end to child abuse and maltreatment, but our active goal is to provide comprehensive services for abused and neglected children. We strive to provide expert medical assessment/evaluations and make the appropriate referrals for higher acuity and/or long term service providers (medical and psychological).

4. What services do you offer?

The CPT offers medical evaluations and treatment for child physical and sexual abuse. We serve as an inpatient consultative service for cases of suspected Non-Accidental Trauma (NAT), sexual abuse, and neglect. CPT participates with Greater Richmond SCAN (Stop Child Abuse Now) Child Advocacy Center as medical provider for multiple jurisdictions and we participate in multiple MDT meetings with other jurisdictions (such as Cumberland, Dinwiddie, Prince George, and Emporia). We are happy to provide education to agencies that work with children who would benefit from additional training in the recognition and evaluation of child abuse and neglect.

5. Why are the services your clinic provides so important to children in foster care?

The services offered by the CPT for foster care patients are invaluable, particularly because a significant percentage of these children have not had appropriate medical care for long periods (in some cases never). We are able to perform a complete head-to-toe physical assessment to identify any major medical issues. We are able to refer them to primary health and dental care. We are also able to connect them with specialty care services as needed. This service is also particularly helpful to foster parents who are taking in these children (some whom have special needs or behavioral challenges) who may not know where to begin to make care arrangements.

6. What challenges/roadblocks are you facing in serving children in foster care?

One of, if not the most significant, challenge in providing care for children in foster care is the lack of medical care or records of care. We strive to provide all the necessary medical treatment without being repetitive. That is a difficult task to complete when there is no point of reference. Some of the children, depending on their age, have had no medical care and some have had it to a certain point or on an inconsistent basis. It makes all the difference when we can prevent unnecessary or duplicative services/treatments.

7. Will the foster care clinic grow to encompass more cities in the state of VA?

It is our goal to expand the Foster Care Clinic to other jurisdictions. We are actively working to meet that goal.

8. What can people do to help spread the word about the clinic and its services?

Exactly that, spread the word! Talk to any groups that you know come into contact with children in these situations. If you have friends who are starting to foster children in care, let them know about us! We have handouts available to help get the word out. While we have partnered with many foster care agencies and other groups all over the state, new providers enter the “pool” annually from everywhere. Some of the newer providers may not be as familiar with the concept of a Child Protection Center, let alone our particular clinic. We are available to give presentations to explain our role to both medical and non-medical providers, and are happy to provide training on the recognition of signs and symptoms of child abuse and neglect. Just reach out and connect with us!

To learn more about the Child Protection Clinic’s services or trainings, contact them via their program page at Children’s Hospital of Richmond at VCU.