	Foster Care Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-FC 10: Physical and Mental Health Care

Children receive all necessary health, dental, developmental, and mental health examinations and treatment within appropriate timeframes.

PA-FC 10.01

Health care services are coordinated for each child to ensure:

continuity of care;
receipt of comprehensive healthcare services;
appropriate communication among health care providers; and
foster parents and families receive needed information and support.

Interpretation: When possible, children should continue receiving healthcare services from familiar providers, and a medical home should be established for each child with special health care needs.

Interpretation: Agencies that have the responsibility for placing Indian children should be aware of health care services that the child may have access to through tribally contracted health facilities or through the federal Indian Health Service. The agency should work with the tribe or a local Indian organization to ensure they have access to needed medical information.

Research Note: A study of foster parent retention suggests that the difficulty some foster parents have accessing medical providers and dentists who accept Medicaid contributes to foster parent turnover.

PA-FC 10.02

The child’s relevant health information, including family medical history, is recorded in an efficient and secure system and shared with providers and foster parents, as appropriate.

Interpretation: Medical passports and electronic medical records systems can be used to store and share health information. The agency should have mechanisms in place for cross-agency information sharing that respects confidentiality.

PA-FC 10.03

Qualified professionals provide the child with age-appropriate health services including:

medical examinations according to well child guidelines;
dental examinations every 6 months;
developmental, mental health, and alcohol and drug screenings within 30 days after entry into care, and when indicated to identify the need for further diagnostic assessment; and
needed therapeutic and treatment services.

Update: Added Fourth Interpretation - 12/01/10

Added Fourth Interpretation

Interpretation: See Recommendations for Preventative Health Care published by the American Academy of Pediatrics.

Interpretation: When documentation of recent examinations is unavailable or incomplete, the agency must ensure that examinations are completed within 30 days after entry into care. Medical assessments include, as appropriate to the child’s age and circumstances: lead exposure, TB testing, and HIV/STD risk assessment screening. Dental assessments should be provided for children over age 3.

Interpretation: The agency should recognize the value of incorporating culturally-grounded interventions into the treatment plan, and include traditional practices or customs of the child’s culture, tribe, or faith-based community to the greatest extent possible and appropriate. Whenever possible, Indian children should receive health services from qualified professionals who have experience working with the tribe and knowledge of tribal customs and practices.

Interpretation: Best practice suggests that dental exams should occur every six months and more frequently for children based on clinical need. In situations where resources are not provided for preventive care to occur every six months, the agency can receive a rating of 2 if there is an annual preventive exam and evidence that recommendations from the clinician indicate the child is not in need of more frequent care. In addition, children with dental issues or at high risk of dental problems must be receiving the care they need.

Research Note: Literature suggests that the experience of maltreatment and the trauma of being removed from parental care place children at risk of psychological and developmental problems. Research has shown that children in foster care are more likely than other children to have significant medical and mental health needs. Some research suggests that despite regulations and policies requiring the provision of comprehensive and routine healthcare, many children do not receive routine and specialized services.

PA-FC 10.04

Youth receive age appropriate support and education regarding:

pregnancy prevention and responsible parenthood; and
prevention and treatment of sexually transmitted diseases.

PA-FC 10.05

Prior to discharge, the child receives assistance to maintain or obtain:

health insurance;
health records;
medical, dental, developmental, mental health, and substance use treatment services; and
needed medication.

Interpretation: The agency should provide information regarding alternative health care options when insurance coverage is not available, and provide assistance to promote access to coverage, including coverage provided through the child’s tribal affiliation when one has been established.

QUICK JUMP TO


	PURPOSE: Children and youth who receive Foster Care Services live in a stable home, remain safe and healthy, and achieve permanency and well-being.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	FOSTER PARENTS State- or county-licensed adults who provide a temporary home for children whose birth parents are unable to care for them. Foster parents are not considered employees or personnel and are specifically referenced in all relevant standards.


	MEDICAL HOME A team approach to health care that coordinates the family and all involved health care providers to promote communication and effective service delivery. The medical home maintains a centralized record of all health related services to promote continuity of care.


	INDIAN ORGANIZATION As defined in ICWA, "Any group, association, partnership, cooperation, or other legal entity owned or controlled by Indians, or a majority of whose members are Indians."


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	CONFIDENTIALITY An ethical and practice principle that requires the protection of information shared within a professional-client relationship. An organization that upholds confidentiality prohibits personnel from disclosing information about persons served without their written consent.


	QUALIFIED PROFESSIONAL An individual licensed by the state in which the organization operates to perform duties outlined in the regulation requirements. Similar terms include: qualified health practitioner, qualified clinician, and qualified medical practitioner.


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	CULTURE The customs, habits, values, skills, technology, beliefs, and religious, social, and political behaviors of a group of people in a specific period of time.


	TREATMENT PLAN See SERVICE PLAN


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	RESEARCH For purposes of COA accreditation, all forms of internal or external research involving persons served except internal program evaluation and outcomes research, or educational projects performed by students and interns that are part of their professional training.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.


	MEDICATION A prescribed or over-the-counter drug that is injected, taken orally, applied topically, or otherwise administered.