Healthcare with unconditional positive regard: the KICS clinic medical home model for children in out-of-home care

Background: On any given day in the United States over the past five years 300,000-400,000 children and youth have been in an out-of-home (OOH) placement, typically kinship or foster care. Children living in an OOH setting commonly have health issues beyond those of a general pediatric population. To address the needs of this special population, the Kids in Care Settings (KICS) Clinic was established at Children's Hospital Colorado in May 2023. Methods: This study provides a comprehensive and descriptive summary of the novel specialty primary care medical home model used at KICS. We use early data from electronic health records to describe the patient population over the clinic's first two years (May 2023 through June 2025), including demographics, placement characteristics and foster and kinship family needs. Results: Data show that care at KICS is accessible to both foster and kin families, and barriers to keeping appointments are low. KICS provides care across a wide age range and continuous care across placement changes. Care is comprehensive, provided by a multidisciplinary team, and incorporates screening for broader concerns such as educational challenges and substance use. Data show that kinship caregivers have a substantially higher level of psychosocial need and are deeply affected by social determinants of health. Conclusions: The KICS clinic offers a novel and promising specialty primary care medical home model to deliver care for a diverse population of children and youth living in varying forms of OOH placement.