Assessment of Factors Influencing the Adequacy of Healthcare Services for Children in Foster Care

Children in foster care often have medical and mental health needs that cause them to depend on multiple public agencies. However, due to organizational and financing challenges, many of these children do not receive the services they need regularly and in a timely manner. Recognizing that these organizational and financing barriers to care might be resolved through greater collaboration and performance monitoring, a partnership of federal agencies headed by the Maternal and Child Health Bureau/Administration for Children and Families (MCHB/ACF) Technical Assistance Group funded CHCFC to study how health services are being provided, compare self-reported agency practices with the performance standards outlined in Child Welfare League of America (CWLA)/American Academy of Pediatrics (AAP) guidelines, and outline what roles the key state and local agencies (child welfare, Medicaid, child health, mental health) are adopting. Study components include a survey of state and county agencies and nine site visits to states/counties, as well as a supplemental study consisting of three site visits that focused on issues unique to Native American children. A final report outlines the extent to which states and counties appear to be meeting basic standards (such as timing of health assessments), and describes potential strategies for coordinating service delivery through collaboration, performance monitoring, and innovative programs. The report describes potential strategies for coordinating service delivery through collaboration, performance monitoring, and innovative programs. A series of policy briefs presents (1) policy implications of the survey for Medicaid and financing, (2) a role for maternal and child health agencies, (3) mental health, and (4) standards of health care for children in foster care. The site visit report provides more detail on innovations in health care delivery.

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For additional information, please contact Moira Inkelas, PhD, Assistant Director, CHCFC and Assistant Professor, UCLA School of Public Health.