Busy CPS-UT ClinicGives Care to Neglected and Abused Kids
"They Need Someone to Take Care of Them"

Dr. Kim Cheung (left) and nurse Gina Dorman: "We want to bring them back to good health."

"Of course, we've seen it all," says Willie Nelson, R.N., director of the clinic at Harris County Children's Protective Services. The clinic - in its 27th year of operation - will be moving soon from its location near the intersection of the 610 West Loop and the Southwest Freeway, along with the CPS central office, to a location near the Astrodome.

"The move will mean that more foster families will be conveniently located to the clinic, and we hope we continue with our present ones," says Nelson, a pediatric nurse who attempted retirement after 28 years of nursing at St. Luke's Episcopal Hospital and eight more years at Texas Children's Hospital. He came out of retirement to work at the CPS clinic.

The clinic is medically staffed by the pediatric department of The University of Texas-Houston Medical School.

Children's Protective Services receives between 2,000 to 3,000 referrals each month. "Quite a few of the children are in poor health when they initially come to us," says Dr. Kim K. Cheung, medical director of the clinic and professor of pediatrics at UT-Houston. "They lack immunizations, for example, or are underweight. We want to bring them back to good health and then keep them like that."

The clinic sees children from infancy to age 18. In 1998, there were over 5,200 clinic appointments.

CPS has had a contract with UT-Houston since 1994, and this has benefited both the agency and the university, as well as the children. "The Harris County Children's Protective Services clinic is a real Houston success story," says Dr. L. Maximilian Buja, dean of UT-Houston Medical School, "and our department of pediatrics is proud to have a direct role in providing medical services to the children and training opportunities to our students."

The clinic always has two or three third- and fourth-year medical students in rotation; the clinic is part of the required pediatric curriculum at UT-Houston.

"We are always `here'," says Dr. Cheung. "I mean that a physician is available, day or night. In the middle of the night, for example, our doctor on call can assess the situation and make an immediate referral to one of the hospitals or UT clinics in the community, or schedule an appointment at our clinic for the following morning. When I arrive here, there will be a message detailing the phone call."

For convenience to the child and caretakers, referrals are made to pediatric and specialty clinics at Lyndon B. Johnson General Hospital, Ben Taub General Hospital, Memorial Hermann Hospital, or Texas Children's Hospital. "Or any private physician who accepts Medicaid," says Nelson. Ninety-two percent of the CPS children are Medicaid-eligible. The clinic sees about 12 percent of the total CPS caseload, as well as a percentage of children under investigation. (In July, of the 318 clinic visits, 134 were children currently under investigation and the remainder were children in custody.) Children are typically brought to the clinic initially by the caseworker; foster parents and case aides will bring the children for follow-up or periodic visits.

Gina Dorman, R.N., has been at the clinic for seven years. The staff call her the "detective" because of her thorough searches for immunization records of the new referrals. "I start with the city, and I can go to Austin. But if we cannot find any records, we just start all over again with the immunization schedule," she says. Dorman keeps statistics of the clinic visits.

"We've become pretty full-service," says Dr. Cheung. "Well child exams, of course, and all the minor illnesses, bruises and abrasions, diagnoses for measles and mumps, asthma treatments. And the state asks that we do vision and hearing screening. We do some lab work here on site, and send some others out."

"We've come a long way since 1972," says Nelson. "Then, the clinic mostly did referrals."

Dentist Elizabeth Lubanski and clinic director Willie Nelson.

Dr. Elizabeth Lubanski has been providing dental services to the clinic's children for 21 years. "I used to work more in private practice, but my work here takes time and I've just gotten to the point where this is my major work." The clinic dental program includes cleanings and preventive exams, restorative work, oral surgery, some prosthetic work, root canals and aesthetics (crowns and white fillings).

What's a busy day at the clinic?

"Oh, last Friday was pretty busy," says Dr. Cheung. The clinic staff agree, laughing now at just how busy it was. "We had 17 patients in the morning, and the intakes - the new patients - take quite a bit of time."

"They need someone to take care of them. That hasn't been a part of their lives," says clinic director Nelson. "So you develop an attitude. You want to help, and, yes, you see very positive results."

For many of the children, this clinic will be the very first place in their young lives where they have come for health care. It is obvious that this dedicated staff thoroughly enjoys providing it.

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©2006 Texas Medical Center

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