FOSTER CHILDREN WITH UNTREATED HEALTH ISSUES FACE BARRIERS TO CARE

Tuesday, September 29, 2015

Children with untreated physical and mental health issues living in foster care face several barriers to care, according to an American Academy of Pediatrics report by researchers from California and other states, NPR's "Shots" reports (Neighmond, "Shots," NPR, 9/28).

The report -- which was published in the journal Pediatrics -- supports a policy statement issued by AAP.

Background on Foster Children's Medical Needs

According to the report, about 500,000 kids are living in foster care at any given point.

The report states, "Children and adolescents involved with the child welfare system, especially those who are removed from their homes of origin and placed in out-of-home care, may present with complex and serious physical, mental health, developmental and oral health problems rooted in childhood adversity and trauma. As children and adolescents with special health care needs, they require more intensive pediatric, mental health, developmental and educational services" (Szilagyi et al., Pediatrics, October 2015).

Specifically, the report found that:

• ·    80% have been exposed to significant violence;
• ·    More than 70% have a history of child abuse or neglect; and
• ·    Up to 80% have an untreated medical condition ("Shots," NPR, 9/28).

Details of Barriers

According to the report, many foster children face barriers to care, including:

• ·    Consent and confidentiality issues;
• ·    A lack of care coordination;
• ·    A lack of health information; and
• ·    Financing not aligning with health care goals and outcomes (Pediatrics, October 2015).

For example, the process for foster parents to receive permission from a parent or guardian for a child to receive care can be difficult and often goes unfinished.

Further, Moira Szilagyi -- a co-author of the report and a professor of pediatrics at the David Geffen School of Medicine at UCLA -- said it typically is not clear how many caregivers a child has had and there often is no available information on:

• ·    Behavioral or mental health;
• ·    Past treatments;
• ·    Psychological development; and
• ·    Vaccination histories ("Shots," NPR, 9/28).

The report suggests that "[p]ediatricians have a critical role in ensuring that children and adolescents in out-of-home care receive high-quality pediatric health services that are comprehensive, compassionate, culturally sensitive, coordinated and specific to their overall health needs." In addition, it states, "Pediatricians also have a role in health care coordination and advocacy on behalf of this vulnerable population" (Pediatrics, October 2015).