Op-Ed: Washington's most vulnerable children deserve our best care — here's how we're delivering it
Date: 08/08/25
By Dr. Usha Sankrithi and Dr. Deborah Rodriguez
This op-ed was originally published in The Chronicle on Friday, August 8, 2025 and in The News Tribune, on Wednesday, August 20, 2025.
In Washington state, thousands of children and youth are in foster care — each of them deserving the same chance to thrive as any other child. But too many carry the weight of trauma. Trauma doesn’t just impact mental health but has a lasting impact on children’s physical health, too.
Addressing this reality is essential to providing effective care for foster youth in our state.
We know from research and clinical practice that adverse childhood experiences (ACEs) — potentially traumatic events including violence, abuse, or neglect during critical developmental periods — are directly tied to health outcomes. Toxic stress from ACEs can fundamentally change brain development and affect how the body responds to stress throughout life, leading to chronic health problems, mental illness, and substance use in adulthood.
Children in foster care face significantly higher risk for ACEs due to trauma, family separation and the effects of the foster system itself. Eighty percent of children in foster care navigate significant mental health needs — compared to approximately 18-22% in the general population. Seventy to 92 percent of foster children manage chronic health conditions, highlighting the importance of tailored, supportive care that builds on their strengths and potential.
Recognizing that these children require specialized attention, Coordinated Care — the health plan selected by the Washington State Health Care Authority in 2016 to serve as the sole managed care provider for children in foster care — developed the Foster Care Centers of Excellence (FCCOE) designation. The FCCOE is a revolutionary model of care designed specifically for this population that considers their unique set of circumstances, needs and risk factors. Through partnerships with key providers across Washington, what started as a pilot program in 2020 has now expanded to serve every region across our state.
Each FCCOE medical center must meet over 50 rigorous criteria to earn its designation, ensuring consistently high standards of care. Every staff member—from front desk personnel to providers—receives comprehensive training in trauma-informed practices, creating an environment where healing can truly begin.
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 is making a meaningful difference in their lives.
This whole-person care fosters resilience and healing for children and caregivers. As one caregiver of a child 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 is proud to be one of these designated Foster Care Centers of Excellence. 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 across the state. Building upon an existing holistic approach to pediatric care, the FCCOE at NWPC created an ecosystem where children and caregivers receive specialized care from providers. When children receive trauma-informed care from providers who recognize the impact of their experiences, when appointments are designed with their unique needs in mind, and when caregivers feel supported in their vital role, the entire system works better.
The success of Coordinated Care's Foster Care Centers of Excellence shows us what is possible when we go beyond just 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 community as a whole. 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 the chief medical officer and chief health equity officer at Coordinated Care. Dr. Deborah Rodriguez, FAAP, is the Foster Care Center of Excellence program director at the Northwest Pediatric Center.