National standards for health care for children in out-of-home care call for comprehensive, timely, and coordinated health services. Medicaid, child welfare, health, and mental health agencies increasingly are seen as accountable for assuring health care access, yet this requires policy and administrative coordination. In a recent national study, states and a sample of county agencies were surveyed on standards, policies, interagency coordination, performance monitoring, and perceptions of system capacities and provider-related barriers to appropriate health services. Few agencies other than child welfare knew (1) whether the child welfare agency had adopted the CWLA/AAP standards for health care for children in out-of-home care, or (2) what policies and procedures were in place. Medicaid and child welfare agency reports of Medicaid policies (eligibility, managed care requirements, and reimbursement) were not always consistent. Few agencies had policies for ongoing health care, or for health evaluations when changes in placement occur. Services were mostly decentralized and low levels of interagency collaboration were reported. Few agencies reported the requested capacity and utilization indicators, suggesting suboptimal information available to the agencies themselves, as well as to caretakers and caseworkers for needs assessment, performance or health status monitoring, and reporting functions. The special needs of this population require close coordination between the agencies addressing the multiple areas of care they require. Relationships and systems of accountability are needed to monitor the services that children are receiving. Increased collaboration, accountability, and information exchange are needed within and between agencies and providers caring for this vulnerable population.
Learning Objectives: At the conclusion of the session, the participant in will be able to: 1.Identify organizational barriers to coordinated and comprehensive health care for foster children. 2.Describe opportunities for performance monitoring by public health agencies 3.Describe current level of collaboration among public health agencies serving children in foster care.
Keywords: Children With Special Needs, Health Care Delivery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.