University of Wisconsin–Madison Medical College of Wisconsin

GunderKids: Design of a Clinical Care Management Program for Parents With Substance Abuse and Their Newborn Children with a Focus on Preventing Child Abuse

Ann E. Budzak-Garza, MD; Allison L. Allmon Dixson, PhD; Renee A. Holzer, RN; Kaitlin E. Lillard-Pierce, RN; Carolynn J. Devine, CSW

WMJ. 2018;117(1):29-33.

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Background: In response to an increased need to care for babies born to mothers with substance abuse issues, we developed GunderKids, a care management program that provides integrated medical care beyond standard-of-care, well-child appointments for these socially complex families.

Methods: The program incorporates frequent visits to the pediatrician and the care team, which includes pediatric nurses, a pediatric social worker, and a child psychologist. Enrollment is voluntary. Each visit addresses parenting challenges, home environment, basic needs, safety issues, and maintenance of sobriety, as well as child development and health issues.

Results/Discussion: We found that mothers and fathers (or parents) welcome intense support following delivery, appreciate the relationship that is built with the care team, and prefer frequent visits at the medical center over in-home visits, which they perceive as potentially intrusive. We describe here the planning and implementation of the program, as well as insights gained in our first year.


Author Affiliations: Department of Pediatrics, Gundersen Health System, La Crosse, Wis (Budzak-Garza, Dixson, Holzer, Lillard-Pierce); Department of Social Services, Gundersen Health System, La Crosse, Wis (Devine).

Corresponding Author: Ann E. Budzak-Garza, MD, FAAP, Mail Stop FB0-004, Gundersen Health System, 1900 South Avenue, La Crosse, WI 54601; phone 608.775.2450; fax 608.775.5951; email

Acknowledgements: The authors acknowledge James K. Burmester, PhD, and Cathy Mikkelson Fischer, MA, ELS, for their assistance in preparation of the manuscript.

Funding/Support: None declared.

Financial disclosures: None declared.