NCSL Child Welfare Policy Update
State Response to the Fostering Connections to Success Act of 2008
Health Oversight and Coordination Plan Provision

The Fostering Connections to Success and Increasing Adoptions Act (H.R. 6893/P.L. 110-351) was signed on Oct. 7, 2008. This law helps to: connect foster children with their relatives; better coordinate the health care and education of foster children; support permanent families through relative guardianship; and enhance adoption subsidies and supports to older youth in foster care. To view a summary of the Act, click here. 

Background

The majority of the more than 400,000 children in the nation’s child welfare system as of September 2009 have significant health, mental health and developmental needs and conditions. In addition, disruptions in foster care placement can result in disruptions in health care treatment and services. According to “Working Together: Health Care Services for Children in Foster Care 2009,” New York State Office of Children and Family Services:

• Approximately 60% of children in care have a chronic medical condition, and 25% have three or more chronic problems.
• Developmental delays are present in approximately 60% of preschoolers in foster care.
• Children in foster care use both inpatient and outpatient mental health services at a rate 15 to 20 times higher than the general pediatric population.
• Between 40 percent and 60 percent of children in foster care have at least one psychiatric disorder.

Health Oversight and Coordination Plan Provision in the Fostering Connections to Success Act of 2008:

To assist states with improving health care outcomes and access for children in foster care, the Fostering Connections to Success and Increasing Adoption Act of 2008 now requires each state to develop a plan, in consultation with pediatricians and other experts, for the oversight and coordination of health care services for foster care youth. The plan must also include consideration of mental health and dental health needs. The plan shall include an outline of:

• a schedule for initial and follow-up health screenings;
• how health needs identified through screenings will be treated;
• how medical information for children will be updated and shared (may include electronic records);
• steps to ensure continuity of health care;
• the oversight of prescription medication; and,
• how the state consults with physicians and other professionals in assessing the health and wellbeing of children in foster care.

This plan will not reduce or limit the responsibility of the state agency responsible for the child’s care.

In response to the Fostering Connections Act, at least 3 states enacted legislation related to the health oversight and coordination provisions of the Act during the 2009 through 2011 legislative sessions. Each of those states’ enactments is summarized in the chart below, or click on the box above to go directly to the chart.

Additional Resources

February 2009 GAO Report. Foster Care: State Practices for Assessing Health Needs, Facilitating Service Delivery, and Monitoring Children’s Care

National Survey of Child and Adolescent Well-Being Research Brief No. 7: Special Health Care Needs Among Children in Child Welfare

Health Care of Young Children in Foster Care