Children come into foster care today primarily because they've been abused or neglected by their parents. These children enter care with far more complicated needs than ever before.

Physical health problems affect 30 to 40% of children in the child welfare system. These include delayed growth and development, HIV infection, neurological disabilities, malnutrition and asthma.

For information on mental health issues of children and youth in foster care, please visit our Hot Topics page at http://www.hunter.cuny.edu/socwork/nrcfcpp/
info_services/mental-health.html

For information on early childhood development issues for children in the child welfare systems, please visit our Hot Topics page at http://www.hunter.cuny.edu/socwork/nrcfcpp/info_services/developmental.html

For information on issues affecting children and youth with disabilities in the child welfare system, please visit our Hot Topics page at http://www.hunter.cuny.edu/socwork/nrcfcpp/info_services/children-with-disabilities.html

Guides

• Checklist of Needed Services for Children in Foster Care
  This checklist from the Child Welfare League of America identifies necessary services for children in foster care.

• A Guide to Developing Health Care Systems for Children in Foster Care
  This manual from the UCLA Center for Healthier Children, Families and Communities outlines key principles and processes for a well-functioning system of health services to children in foster care. It also outlines some of the key elements that would enable a quality improvement approach. Although delivery of health services is complex and varies by location, the processes outlined in this manual should generalize to most state and local circumstances.

• Working Together: Health Services for Children in Foster Care
  The New York State Office of Children and Family Services developed this manual with the assistance and advice of voluntary agencies and county departments of social services. The primary audiences are foster care caseworkers, supervisors, and persons responsible for the coordination of health services. It is not specifically designed for distribution to foster parents, child care workers, or health care practitioners. The policies, protocols, and legal footnotes are specific to New York State's locally administered, state supervised foster care system. However, it contains some more general information and serves as an excellent model.

Resources

• Special Health Care Needs Among Children in Child Welfare
  This research brief from the Administration for Children and Families, Office of Planning, Research and Evaluation examines the presence of special health care needs among children in the child welfare system. It specifically examines the presence of chronic health conditions (e.g., asthma, diabetes) and special needs (e.g., emotional disturbance, speech impairment, developmental delay).

• Health Care of Young Children in Foster Care
  This policy statement from the American Academy of Pediatrics gives specific suggestions for pediatricians and other health care professionals and child welfare agencies concerning the delivery of health services to young children in foster care.

• Healthy Ties: Ensuring Health Coverage for Children Raised by Grandparents and Other Relatives
  The Children's Defense Fund published this 50-state survey of Medicaid and Children's Health Insurance Program (CHIP) enrollment policies for children being raised by kinship caregivers.

• Foster Children with Special Needs: The Children's Aid Society Experience
  Children in foster care have many health needs. This article in the Mount Sinai Journal of Medicine presents the model of the Children's Aid Society (CAS) of New York City in addressing these needs.

• Children Discharged from Foster Care: Strategies to Prevent the Loss of Health Coverage at a Critical Transition
  This report discusses the importance of maintaining health coverage for children who are discharged from foster care and presents strategies that state child welfare and Medicaid agencies can employ to reach this goal. In addition, the report also addresses the needs of children who "age out" of the foster care system at age 18, and discusses state options to expand health coverage to this group.

• Children in Foster Care: Challenges in Meeting Their Health Care Needs Through Medicaid
  Summarizing the results of a study conducted for the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, this brief discusses Medicaid health care issues for children in foster care.

• The Foster Care Independence Act of 1999: Enhancing Youth Access to Health Care
  This article from the July-August 2000 Journal of Poverty Law and Policy discusses the option for states to extend Medicaid eligibility for young people who are under 21 and who on their 18th birthdays were in foster care under the custody of the state. In addition to implementing this option, states can take many steps through their child welfare agencies and Medicaid agencies to ensure that young people leaving foster care enroll in Medicaid and receive the services to which they are entitled.

• Health and Well-Being: Physical Health
  This research briefing from the British Research in Practice website discusses the health needs of "looked-after" children (children in out-of-home care). The "What Helps" sections are relevant in any child welfare system.

• Quality Health Care Services for Children in Out-of-Home Care
  This 2001 report from the Task Force on Health Care for Children in Out-of-Home Care to the Wisconsin Legislature resulted from a legislative charge to develop a model to improve the access and quality of health care for children in foster care. This report summarizes the data, findings and recommendations made by the Task Force.

Managed Care

• Medicaid Managed Care for Children in Child Welfare
  Children in the child welfare system have an extremely high prevalence of physical and behavioral health problems. This issue brief from the Center for Health Care Strategies examines the complex physical and behavioral health care needs and associated costs for children in child welfare and outlines critical opportunities and challenges within Medicaid to better manage care for this high-risk, high-cost population.

• The Implementation of Managed Care in Child Welfare: The Legal Perspective
  An overview of the legal issues raised by the implementation of managed care principles in child welfare during the early and mid-1990's. By Denise Winterberger McHugh for the NRCFCPPP (Spring 2000).

• Foster Care Evaluation Services (FaCES) Clinic and Evaluation
  This presentation describes a clinic which evaluates the health care needs of young children entering foster care in Massachusetts. Presented 10/24/2005 at the Annual National Association of State Foster Care Managers meeting by Audrey Smolkin, Director of Research and Policy Analysis at the Center for Adoption Research, University of Massachusetts.

• Healthcare Services for Children in Foster Care
  This presentation was given by Vince Champagne, Health Services Manager for Cook County, Illinois Department of Children and Family Services, and Dr. Paul Kienberger Jaudes, Medical Director for IDCFS, at the 2007 meeting of the National Association of State Foster Care Managers. It describes the Illinois model of health care for children in foster care.

• Meeting the Health Care Needs of Children in Foster Care
  This presentation focuses on some of the key components in developing strategies to address improving performance in meeting the health care needs of children in foster care. Presented 10/24/2005 at the Annual National Association of State Foster Care Managers meeting by Jan McCarthy, Director of Child Welfare Policy, National TA Center for Children's Mental Health at Georgetown University.

• Health Care Issues for Children in Kinship Care by Lauren Morse (December 2005)

• Meeting the Health Care Needs of Children in the Foster Care System
  In October of 2002, the Georgetown University Child Development Center completed a three-year study to identify and describe promising approaches for meeting the health care needs of children in the foster care system. In this study, the term health care encompassed physical, mental, emotional, developmental and dental health. The study was funded by the federal Maternal and Child Health Bureau, and supported in part by the Children's Bureau, Administration for Children and Families. In response to a national search for promising approaches, the study collected information on over 100 different approaches. Multiple products that represent the findings of the study are identified and described on this website.
  

• UCLA Center for Healthier Children, Families & Communities
  The UCLA Center for Healthier Children, Families and Communities has produced a number of materials, including several policy briefs, on health and mental health services for children in foster care.
  

• Center for Health Care Strategies, Inc.
  CHCS is working with states, health plans, and community organizations to improve the physical and behavioral health outcomes for these children by increasing coordination of care, implementing electronic medical records, and identifying best practices in behavioral health pharmacy management.

• Caring Communities for Children in Foster Care
  This project is directed through the Parent Educational Advocacy Training Center (PEATC) of Virginia, funded by the Maternal Child Health Bureau Integrated Services Initiative with the American Academy of Pediatrics. In collaboration with Fairfax County, VA, Child Welfare Agencies, the Caring Communities project has been developing strategies and identifying "best practices" to increase comprehensive health care services for children in foster care. Visit their website for a look at their health profile and online materials for folks interested in improving the lives of children in foster care.

• National Center for Children in Poverty
  Operating out of Columbia University in New York City, the NCCP has as its mission to identify and promote strategies that prevent child poverty in the United States and that improve the lives of low-income children and their families. One of its many useful tools is a Policy Database that provides state-by-state information on Medicaid and the State Children's Health Insurance Program.
  

• Healthy Foster Care America
  Resources assembled by the American Academy of Pediatrics.

• Health of Infants, Toddlers & Preschoolers in the Court System
  Resources from the American Bar Association.

• Centre of Knowledge on Health Child Development
  This Canadian web site is dedicated to providing the latest and best information on child mental health problems and the influences that shape the developmental health and well-being of children and youth.

Last updated 05/04/2008