What does it take to truly serve children in foster care? For Michelle Turner, the answer came not from a boardroom, but from her own living room, and from a three-year-old boy who didn't ask who the new girls in his home were, just whether they lived there now.

Turner is the founder and CEO of Here Now Health, the first virtual healthcare company purpose-built for children and families impacted by the child welfare system. In a recent episode of the Expanding Access podcast, hosted by Solome Tibebu of Behavioral Health Tech, Turner shared the personal journey that led her to build her mission-driven company.

From Foster Parent to Founder

Turner's path wasn't a straight line from healthcare executive to entrepreneur. It ran through her home. "My husband and I became foster parents in the state of Georgia," she explained. "Over about five years, we fostered over 40 children. Four of our six children are adopted out of foster care."

After closing their home to fostering, Turner became a CASA volunteer, a court-appointed special advocate, specifically requesting placement with families at risk of separation. What she encountered again and again was a healthcare system failing the children who needed it most.

"Even though I was working in the healthcare system every day, I was failing to get kids the mental health care they needed to thrive," she said. "Instead of kids getting therapy, they would sit on waiting lists or jump from home to home until they'd end up in crisis."

With a career spanning local Federally Qualified Health Centers, a global health telemedicine nonprofit, and Hazel Health, Turner had the experience to see what was possible. No one was building it for foster youth. So she did.

Care That Follows the Child

Here Now Health's core goal is straightforward and radical: ensure that lack of healthcare is never a reason a family is separated or a child enters the foster system.

Central to the model is longitudinal care, therapy that follows a child wherever they go, rather than resetting every time they change placements. "Telling your story and then having to retell your story to new clinicians is really hard and traumatizing," Turner explained. "Our number one goal is to bring that care to the child and make sure they can have that continuity even if they move."

Why Case Manager Continuity Is Everything

One of the most striking statistics Turner shared speaks to just how fragile stability can be for foster youth: when a child has just one case manager, their odds of achieving permanency are around 75%. With two case managers, that number falls to 17%.

"Case managers are the glue that holds the system together," Turner said. "They are oftentimes fresh out of undergrad, young, overworked, underpaid, and unfortunately lead to a lot of burnout. Every time a child has to start with a new case manager, it's basically starting fresh with someone who knows nothing about you."

The Most Important Variable Is the Caregiver

Here Now Health's clinical model is built on an insight that is often overlooked: the most important variable in a foster child's stability isn't the child. It's the adult caring for them.

"The number one factor of stability for kids within the foster care system is actually the stress level of their caregiver," Turner said. "Caregivers are making the decisions for the child. They decide, 'this is too hard, this child needs to go.' So if we are looking at supporting the system as a whole, we have to include the caregivers."

Caregiver support is baked into Here Now's clinical model from day one, not as an afterthought, but as a cornerstone.

Trauma-Informed Means Every Touchpoint, Not Just the Therapy Room

In behavioral health, "trauma-informed care" has become something of a buzzword. Turner pushes for a much deeper interpretation.

At Here Now, that means re-examining every touchpoint, including the intake form. "When you've been involved in a state government system like child welfare, you lose a lot of autonomy," Turner said. "So in our intake form, when we ask for information, we tell you what we're going to do with it."

Even appointment reminder emails are written with trauma in mind. "We need to think beyond just the clinical care to ensure that every aspect of our experience is truly trauma-informed. It makes our youth and young adults want to engage with us, feel safe, feel understood and seen, and makes them want to come back."

Spending the Most for the Worst Outcomes

Children in foster care account for roughly 10 times the medical spend of their counterparts on Medicaid, and that money isn't buying better care. It's buying crisis care.

"We're spending the very most for the very worst care for our most vulnerable population," Turner said. The business model is to shift that spend toward early, lower-cost, higher-quality mental health support, reducing costs for managed care plans while improving member outcomes.

Her message to Medicaid directors and MCO leaders is direct: stop treating foster youth as an add-on to standard pediatric programs. "Kids in foster care should not just be an add-on. You have to differentiate your approach and really think about meeting these needs uniquely."

Why "Here Now"?

The name came from Turner's own home, early in her fostering journey. Her toddler son had gone down for a nap. Their case manager called and asked if they could take in two little girls. Turner agreed, and by the time her son woke up, the girls were playing in the playroom with his toys. He walked downstairs, looked at them, looked at his mom, and simply asked: "Mom, do they live here now?"

"He didn't ask who they were. He didn't ask what their names were or why they were playing with his toys," Turner recalled. "He just asked if they lived here now."

That same openness was what Turner found herself fighting to get from pediatricians, therapists, and teachers working with foster children. "The most important thing we can do is we can be here now for them. Whatever that looks like in that moment."

When Here Now Health launched in Virginia, one of their first patients was a young man who had aged out of the foster system. After his first session, his feedback was simple: it was the first time therapy had ever felt like it was built for him.

"That is literally the whole reason why we exist," Turner said.

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To learn more about Here Now Health, visit herenowhealth.com. To explore more episodes of the Expanding Access podcast, visit behavioralhealthtech.com/podcast.