Children in Washington’s foster care system have unique medical needs | Opinion

In Washington state, thousands of children and youth are in foster care — each deserving the chance to thrive. Yet many carry the weight of trauma which can have a lasting impact on mental and physical health.

Research and clinical practice show Adverse Childhood Experiences (ACEs) — such as abuse or neglect — can lead to lifelong health issues. Toxic stress from ACEs can alter brain development and increase the risk of chronic illness, mental health disorders and substance use.

Children in foster care face significantly higher risk for ACEs due to trauma and family separation. Eighty percent of children in foster care navigate significant mental health needs — compared to 18-22% in the general population. Between 70-92% manage chronic conditions, underscoring the need for tailored, strengths-based care.

Recognizing this, Coordinated Care — selected by the Washington State Health Care Authority in 2016 as the sole managed care provider for children in foster care — developed the Foster Care Centers of Excellence (FCCOE) designation. This model of care is designed specifically for foster youth, addressing their unique needs and risk factors. Through partnerships with providers across Washington, what started as a pilot in 2020 now serves every region.

Each FCCOE must meet over 50 rigorous criteria, ensuring consistently high standards of care. Every staff member — from front desk personnel to providers — receives training in trauma-informed practices, promoting a healing environment.

The results speak for themselves. Children receiving care at an FCCOE show a 25.4% higher rate of well-child visits and 17.1% higher immunization rates compared to other facilities. Perhaps most significantly, these children have fewer interactions with crisis systems — a clear indicator that proactive, specialized care fosters resilience and healing for children and caregivers.

As one caregiver shared: “I felt listened to, heard, and validated. I walked away with resources and support, very clear on my next steps, and the clinic room was the perfect environment for my child.”

Northwest Pediatric Center (NWPC) in Centralia, WA is proud to be one of these designated FCCOEs. Together with our partners at Coordinated Care, we’ve redesigned our model around the unique needs of foster children and their caregivers.

The work at NWPC reflects what is happening at FCCOEs statewide. Building upon an existing holistic approach to pediatric care, the FCCOE at NWPC created an ecosystem where children receive trauma-informed care from providers who recognize the impact of their experiences, and caregivers feel supported in their vital role.

The success of Coordinated Care’s Foster Care Centers of Excellence shows us what is possible when we go beyond treating symptoms. As our state faces budget pressures and difficult funding decisions, we must continue to prioritize investments in specialized, trauma-informed care for foster youth. This isn’t just the right thing to do, it’s economically wise. Society benefits when every child is supported, and this approach can transform not just individual lives but also strengthen our whole community. Building healthier communities starts with ensuring every child has access to compassionate, expert care that helps them thrive. Our state’s future depends on it.

Dr. Usha Sankrithi is chief medical officer and chief health equity officer at Coordinated Care, and Dr. Deborah Rodriguez is pogram director of Foster Care Center of Excellence, Northwest Pediatric Center.

This story was originally published August 20, 2025 at 3:00 AM.