The Special Caretakers Program: A Hospital's Solution to the Boarder Baby Problem

THE EARLY INITIATIVEDuring late 1988 and into the summer of 1989, Hahnemann University Hospital and other health care institutions in Philadelphia began experiencing the growing problem of boarder babies: newborns and children medically ready for discharge but waiting weeks, perhaps months, for an appropriate foster home. This delay in discharge represented a loss to both the baby and the hospital.The employees of Hahnemann responded to the needs of these children, many of whom were born prematurely and were exposed prenatally to illegal drugs or alcohol; several employees contacted the Philadelphia Department of Human Services to become certified foster parents. They soon grew frustrated with the foster care process and requested the help of the Hahnemann Department of Social Work Service, which began assisting interested employees to become certified. Babies and children who had been waiting for foster homes were placed with the certified Hahnemann employees.This early initiative lead to the development of a proposal submitted to the Robert Wood Johnson Foundation for program funding. The Special Caretakers Program received an 18-month demonstration grant from the foundation to run the program and test its feasibility and replicability.GETTING STARTEDThe demonstration grant funded the full-time position of a foster care recruiter. The program began to actively recruit employees to become foster parents on May 1, 1990. Brochures and flyers were developed, and recruitment activities such as orientations and display tables were scheduled.The pool of potential foster parents is large; Hahnemann has more than 4,000 employees and 2,000 students. Employees interested in the Special Caretakers Program meet individually with the foster care recruiter to discuss foster parenting in detail. If employees decide to become foster parents, they are referred to one of two community foster care agencies that the program works with to begin certification. Certification involves a written application, letters of reference, background clearances, home study, and training.When the employee completes the certification, a match can occur with a baby or child at Hahnemann. The Philadelphia Department of Human Services provides either a voluntary placement agreement, which is signed by the birth-parent, or a restraining order, which is signed by a family court judge. The certifying foster care agency provides continuing case management after the placement occurs. The Special Caretakers Program provides a voucher for a local children's store, which allows foster parents to purchase needed baby items. In addition, the foster care recruiter provides continued support and advocacy to the Hahnemann foster parents.PROBLEMS AND SOLUTIONSAlthough the Special Caretakers Program has been a success, it has faced some difficulties. The foster care system in Philadelphia was slow to accept the innovative new program. Several agencies would not certify single people. Some would not consider employed people. The foster care recruiter met with many foster care agencies early in the program to learn about their agency and certification processes. …