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Every Step Community of Care helps reshape Oregon foster care

Every Step Community of Care helps reshape Oregon foster care

Young boy in a park

Health Share of Oregon leads, convenes and collaborates on major systems change initiatives. One of those major systems changes is underway in the foster care system. Kids in foster care face unique challenges. Health Share initiated a collaborative journey six years ago to transform this system.

The highest quality of care

Children in the foster care system face extreme challenges. So do the families that care for them. Every Step teams of experts make sure each child gets the highest quality care including ongoing and holistic care - both during their time in foster care and beyond. The idea for Every step was to bridge the gaps in a child’s journey between services. Now, each child has their own dedicated team. Highly skilled, trauma-informed nurses, doctors, social workers and specialists work closely with kids. Every Step clinics offer an advanced primary care model designed to meet the needs of children in foster care. This starts day one to understand their individual needs. Teams of experts make sure each child gets the highest quality care. This includes ongoing and holistic care. Both during their time in foster care and beyond. The mission is to ensure that all children experiencing family separation or system involvement receive the highest quality of care.

From idea to reality

Every Step services have increased significantly since their inception in 2017. Now, there are currently 11 Every Step clinics. Health Share began funding Every Step clinics at Legacy Randall Children’s Clinic, OHSU Doernbecher, and Hillsboro Pediatrics in 2017. Six Metropolitan Pediatrics clinics and Gladstone Health Center began providing Every Step services in 2019. Hillsboro Pediatrics spread the model to a second clinic site. Clinics served over 1,000 youth in foster care in the first half of 2020. Approximately 1,700 children have received services from an Every Step clinic since 2017. Approximately 5,100 Health Share youth members qualify for the Oregon Health Plan through DHS involvement, and about 8,200 have current or past foster care involvement.

Every Step clinics outperform the overall Oregon Department of Human Services population and the overall Health Share population on quality incentive metrics. Youth in Every Step clinics received increased primary, dental, and behavioral health care and decreases in emergency department visits in the year after they started receiving these services. The majority of youth remained assigned to their Every Step clinic for at least a year, even those youth with a history of multiple care assignments.

Health Share is partnering with Portland State University to complete a more detailed evaluation, to assess feedback from foster youth and families who have received Every Step services, with results expected in late 2020.

While the model may sound simple enough, getting to this point was not easy. Getting here took years of incredibly hard work spanning systems, crossing the bridges the Health Share team has built with community partners. Shepherding those processes and facilitating that transformation is what Health Share does.

Every Step Community of Care represents the essence of what Health Share and community partners can achieve together through our collaborative model," said James Schroeder, CEO of Health Share of Oregon. :By focusing on health equity and better integrating social determinants as part of overall health, we were able to identify gaps, devise solutions, and align care. Kids in foster care are already seeing better health outcomes. With this structure now in place, the network of clinics can support ongoing improvement efforts going forward, ensuring that foster kids' journey is just that much easier - and healthier."

To be sure, there are still many challenges across care systems, especially for the most at-risk members of our community. Health Share will continue to seek out opportunities for change and to meet these needs by aligning complex systems for better outcomes.


Every Step Community of Care from the American Academy of Pediatrics.

Learn more about Every Step services and find an Every Step clinic in the area.