Inside Medically Fragile Foster Care: A Foster Mom's Real Story

Sep 4, 2025

According to the American Academy of Pediatrics, about 10% of children in foster care are considered medically fragile or complex. Without committed, devoted foster parents, these vulnerable children often spend their days in a hospital, rather than home setting.

Medically fragile foster care, also known as special needs foster care, involves providing a nurturing environment as well as specialized care for children with unique medical or physical needs - and the rewards can be even greater for their foster parents.

In fact, Tacole Robinson, a foster parent with Mentor Foster Care, is a champion of children with medical needs in foster care. Here, she shares her inspiring words and experiences as a medically fragile foster parent.

You don't need a medical background to provide medically fragile foster care, and you are never without support. All you need is an open heart and a willingness to improve the life of a child in foster care with medical needs.

What Does "Medically Fragile" Mean in Foster Care?

Children are considered medically fragile if they have one or more conditions that require ongoing, specialized medical care.

Such care may include dependence on oxygen support, feeding tubes, or medication. However, you can rest assured that foster parents receive the skills needed and ongoing professional support to confidently manage these needs.

While some children in medically fragile foster care might have conditions like prematurity, it's important to remember two key facts:

1. You are not expected to have any knowledge of or background in medical care. Experts will teach, provide, and show you everything you need to know to create a stable, nurturing environment for a child in medically fragile foster care. Then, they'll continue giving you support every step of the way.
2. Any child with medical needs who is placed in a foster home has the ability to live outside a hospital or long-term care facility. In fact, these children thrive in the homes of loving foster families.

With less than one percent of the pediatric population in North America considered medically fragile, advancements in medical technology and treatments continue to allow for more time spent in a home rather than in hospital environments.

Foster parents who open their hearts to children with medical needs often find their own lives transformed, gaining a profound sense of purpose through giving a child the chance to experience love, belonging, and the simple joys of home life.

Tacole describes the rewards beautifully:

"I just love to see how wonders can happen and how we can be in awe of what can happen when children are nurtured, when they're supported where they're loved."

Tacole Robinson stays close so her little one never feels alone.
The children pictured in this article are Tacole or Marlon's biological children,
or have been adopted after originally being placed with the Robinson family through foster care.

What Is Medically Fragile Foster Care?

Medically fragile foster care involves specialized caregiving for children in foster care who have significant medical needs. Children can range from infants to 21 years old, and their medical issues can range from moderate to serious.

Foster parents involved in medically fragile foster care provide homes, love, and support for these children - allowing them a much-needed and deserved sense of belonging and family.

Though each child's specific needs determine their level of care, children with medical needs in foster care are generally stable enough to live in a home environment. This is much more preferable to a hospital or long-term care facility for their quality of life and chance to heal.

When Tacole first learned about medically fragile foster care, she found her calling immediately. As she explains: "After we met with Mentor Maryland, we knew this is what we were purposed to do. Just hearing about the ability to sit with children who are medically fragile really clicked for us. We didn't know anything about medically fragile foster care initially. We just knew that those were where our gifts are. And that's how we ended up there."

Tacole's tiny fighter: Even the smallest hearts deserve a home.

Being a foster parent to a child with medically fragile needs might seem challenging. However, it's a rewarding opportunity to make a difference in the life of a child who may otherwise never experience a loving home environment and family.

Tacole describes the triumphant progress of her daughter Parrish, who was placed with her family as a toddler with medical needs. Over time, Tacole and her husband were able to adopt Parrish, who has bloomed under the family's care:

"The doctor sat at the table, and they told us she might not walk. She might not talk. She might not ever eat. Let me tell you, she's 13 years old. She's running, she's jumping, she's talking."

Why become a medically fragile foster parent?

Medically fragile foster care can have a deep and lasting impact on the life and purpose of foster parent caregivers. This caregiving role can be demanding, challenging, and stressful at times, but the rewards are worth it.

When asked why she decided to become a foster parent for children with medically fragile needs, Tacole mentions her personal experience with foster care as a child:

"I spent some time in foster care, and I've always had people who were not my biological parents who stepped up to help meet my needs."

For Tacole, the decision to focus on children with medical needs came from recognizing her unique gifts and a deep sense of purpose during a difficult time in her life:

"I have these gifts, I have education. I have all these things to give. And so I said to my husband, I have to do something with this. We're both caregivers, and that's how we ended up there."

Tacole and her husband felt called to choose the medically fragile foster parent program as a way to tend "to those that are sick, those that need healing."

Each person who dedicates themselves to foster parenting has unique reasons for wanting to improve the lives of children longing for home and family. And, in fact, many prospective foster parents are unaware of the opportunity to nurture and care for a medically fragile child in foster care.

Tacole and Marlon ensure their newborn feels loved in the hospital.

Tacole and her husband felt called to choose the medically fragile program as a way to tend "to those that are sick, those that need healing."

Each person who dedicates themselves to foster parenting has unique reasons for wanting to improve the lives of children longing for home and family. And, in fact, many prospective foster parents are unaware of the opportunity to nurture and care for a child with medical needs in foster care.

The Benefits of Medically Fragile Foster Care for Foster Parents

Though the circumstances are different, the path to becoming a medically fragile foster parent is just as rewarding and meaningful as that of traditional foster parenting - if not more so.

Some benefits for medically fragile foster parents include:

• Improving the life and future of a child who needs not just specialized care, but a home, and a family to call their own
• Sharing joy and love with a child through each step of their medical journey
• Opportunities to build trust, connection, and a lasting relationship
• Making a difference in both the health care and foster care systems
• Finding purpose and personal growth by advocating for and supporting children in need
• Firsthand experience of human empathy, cooperation, and resilience

The Joys of Medically Fragile Foster Care

Foster care always involves emotional highs and lows, but caring for children with medical needs brings unique rewards and a profound sense of purpose.

Tacole speaks honestly about the transformation she's experienced through this journey:

"The best part of fostering has been the joy of being a mom to so many children.

"I discovered joy along this journey, and I did not know that the joy would look like this, but I have learned to be content no matter my circumstances. So whether that means sitting in a hospital with a baby hooked up to machines, or whether that means saying goodbye at the courtroom, I am really experiencing joy.

"I have no doubt this is what I'm supposed to be doing right now in my life. There was a season of my life where I knew I was supposed to be a teacher. There was a season of my life where I knew I was supposed to be a wife. And I'm telling you, right now in my life, I have no doubt I'm supposed to be a mom. You can't tell me differently.

"And so to be able to wake up every morning and do what I was created to do and to enjoy it - there are so many people who are doing things every day and they don't get to enjoy it - I am blessed and experience so much joy."

For Tacole, this joy extends to the permanency that comes when children in their care become adopted family members. It's not just Tacole and Marlon who experience this joy; it extends to the whole family.

Speaking about a young child currently in their care whose plan recently changed from reunification to adoption, Tacole shares:

"The kids realize now that it's official when your last name changes. They keep asking, 'Did the judge say she could change her last name to Robinson? Is she a Robinson yet?' We're looking forward to making her an official Robinson, but in every other way, she's already a Robinson."

This sense of belonging and official family status represents the ultimate goal for many children in foster care.

Different paths have led to one home with Tacole and Marlon.

Benefits of Medically Fragile Foster Care for Children

Imagine being a child with a chronic, debilitating condition - and spending your days surrounded by the sounds of a hospital. Without home or family, it's a circumstance surrounded by isolation and loneliness.

But medically fragile foster care provides hope thanks to the possibility of real family connections and the comfort of a loving home. That's why both the American Academy of Pediatrics (AAP) and Department of Health and Human Services assert that children belong in families, regardless of their medical status.

Of the many benefits for kids in medically fragile foster care, a few of them include:

• Secure and nurturing home environment
• Emotional support and stability
• An individualized care plan
• Specialized medical care and attention
• Educational resources for growth and development
• Sense of belonging and family
• Long-term, meaningful relationships

How to Become a Foster Parent for a Child with Medical Needs in Foster Care

The process to become a licensed foster parent for a medically fragile child is similar to standard foster care licensing, with a few additional steps.

Choose a Foster Care Organization

Working with a foster care organization is essential for medically fragile foster care. Their experts will ensure that you have support, information, and guidance for each step of the process.

Foster care organizations will also continue to support you and the child in your care after the process is completed. This is vital for the child's health and well-being, as well as your own.

The relationship with your foster care agency becomes deeply personal over time. Tacole describes her experience with her coordinator and the family-like bond that develops:

"Our coordinator, Emily, has become a part of our family. We've had her consistently. Our children know her by name. She comes in the house, and all the kids love her, even the ones who weren't a part of the fostering process.

"Mentor Foster Care is a part of our community. I know that if and when I need something, they would be there.

"When we had an unexpected issue with Parrish, so she had to have surgery, and it was going to be overnight. It was last minute, and Emily said, 'What are you going to need? Do you want me to find someone to give respite?' Just her offering was a blessing."

Tacole's husband, Marlon, with their smiling family.

Personal and Home Requirements

Like traditional foster parents, those interested in providing medically fragile foster care must meet several personal and home requirements. This ensures that children are placed in safe and stable environments with nurturing, loving caregivers - vital criteria for children with medical needs in foster care.

While the specific requirements vary by state, in general, the main qualifications for all foster parents include:

• Background checks
• Health screening
• Financial evaluation
• Interviews
• Home study and safety inspections
• References

Preservice and Ongoing Sessions

Foster parents of children with medical needs can also expect to complete all required preservice sessions for traditional foster care. You'll also receive specialized sessions that prepare you for providing the necessary medical care for the child over time.

With comprehensive sessions and ongoing support, you'll become proficient in:

• Administering medication and other treatment
• Operating technological and medical equipment
• Coordinating medical service schedules and appointments
• Monitoring symptoms, changes, and potential emergencies

Medically fragile fostering does not require a background in health care, medicine, or related fields. However, potential foster parents of children with medical needs do need to learn, manage, and uphold procedures to meet the child's health needs.

Matching and Placement Process for Children with Medical Needs in Foster Care

Once you have met all the requirements and received your license as a foster parent for children with medical needs in foster care, the matching process can begin. Professionals will ensure that the child in foster care with specific medical needs is matched with a foster parent to create the best fit for everyone.

A professional team will collaborate with you to provide comprehensive care, including caseworkers, nurses, and primary care physicians. Foster parents will receive detailed information about the child's medical history and condition, instructions for managing their care, and how to access resources and ongoing support.

The priority in placement of children with medical needs in foster care is to encourage open communication among all parties and access to professional resources to support the child's safety and health. This improves the child's quality of life and eases the transition for foster families.

Stability is important for the well-being of children in medically fragile foster care. This is why foster care organizations work carefully to ensure good matches and provide ongoing support to help placements succeed.

Ultimately, the goal for children with medical needs in foster care is a safe, loving, and permanent home where their needs are met and they feel part of a family.

Common Responsibilities Faced by Medically Fragile Foster Care Parents

Every foster parent has responsibilities to the child in their care, and medically fragile foster care is no different. Examples of the specialized care unique to this type of therapeutic foster care include:

• Administering medications properly, routinely, and carefully
• Keeping a daily schedule
• Attending to and operating medical equipment
• Monitoring daily progress or problems
• Navigating complexities in the health care system
• Staying vigilant regarding potential medical emergencies or changes in condition

Remember, you'll have full professional support throughout this journey, and preparing your family for what's ahead will help everyone succeed.

Support Services for Foster Parents of Children with Medical Needs

The most important thing to remember for foster parents of children with medical needs in foster care is that you are not alone. There are many support services in place to provide help to you and your child in care.

Proper case management for medically fragile foster care is vital to ensure the precious health and well-being of the child and stability of their condition.

The medical support available to foster parents is comprehensive and reassuring. Tacole describes the invaluable nursing support she receives and the peace of mind it provides:

"There's a nurse available 24 hours a day. And so, depending on the needs of the child, a lot of times for the first week or so, I am constantly texting or calling. They calm me down, saying 'Oh, come on, you've done this before,' or 'I can talk you through this,' or 'Do you want me to come out and see you?'

"They're there. I've cried over the phone, and I've laughed with them over the phone. And so I thank God for the longevity of the relationship, because these nurses that I'm talking about have been there this whole time. And so they know me, they know my family. And so I'm grateful to have that type of support."

Tacole's family steps into the school day together.

Children with medical needs are typically enrolled in medical assistance programs such as Medicaid to cover costs for medical care. And though the amount varies depending on the state where you live, the foster care stipend is usually higher to meet the special needs of children with medical needs in foster care.

You will also have access to assistance and guidance for all medical issues that are relevant to the child with medical needs in foster care. Coordination for health care services and appointments is also provided, in addition to necessary education and information for the child's specific medical needs.

Self-Care for Foster Parents of Children with Medical Needs

When you are parenting a child with medical needs in foster care, self-care becomes an important part of your journey. Being there for a child with medical needs means prioritizing your physical, mental, and emotional health.

That's why it's important to take care of your needs and well-being, including:

• Adequate sleep and nutrition
• Participating in therapy, support groups, and other services
• Making use of services that provide assistance or substitute care (also known as respite)
• Getting support, guidance, or advice from professionals if any concerns or issues arise

Talk to an Expert to See if Medically Fragile Foster Care Is Right for You

Becoming a foster parent to a child in medically fragile foster care is an important decision and life-changing commitment.

You don't have to navigate the journey alone.

Talk to a foster care expert to see if providing medically fragile or therapeutic foster care is right for you and your life circumstances. Get personalized advice about steps to take and what to expect about the process.

You don't need to be a medical expert for medically fragile foster care - just someone who is willing to provide the dedicated, loving, and nurturing care for a child with medical needs in foster care.

Foster Care