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SCIENTIFIC ARTICLE
This study was also constrained by the nature of the administrative data sets used in our analysis. A more complete picture of the health- related needs of children in foster care could be gained by access to additional information regarding foster care placements through the Delaware Division of Youth Rehabilitation Services (e.g. detention centers) or the Division of Prevention and Behavioral Health Services (e.g. intensive inpatient and outpatient mental health facilities).
In addition, different analytical approaches, such as qualitative interviews or more detailed chart reviews, could complement the quantitative analyses and contribute to a more holistic understanding of the needs of children in foster care in Delaware.
CONCLUSION
Children in foster care represent a particularly vulnerable population of children with unique needs and health care status and health care utilization patterns among children in foster care in Delaware using Medicaid claims data. It highlights two key areas of concern related to the system of health care available to children in foster care: the need to focus more attention on early screening and timely preventive health visits; and the need to identify opportunities for better care coordination, including further integration of behavioral health into primary care. Importantly,
we examined the experience of 1,458 children in foster care that
implications for many more children in our state at risk of neglect, abuse, or who are otherwise connected with the child welfare system.
REFERENCES
1. Task Force on Health Care of Children in Foster Care. Fostering health: Health care for children and adolescents in foster care (2nd Edition ed.) American Academy of Pediatrics, District II, New York State. 2005.
2. Thompson RA, Haskins R. Early stress gets under the skin: Promising initiative to help children facing chronic adversity. (Policy Brief No. Spring). Princeton, NJ: Brookings. 2014.
3. Rosenbach M. Children in foster care: Challenges in meeting their health care needs through Medicaid. Princeton, NJ: Mathematica Policy Research, Inc. 2001.
4. dosReis S, Zito JM, Safer DJ, Soeken KL. Mental health services for youths in foster care and disabled youths. Am J Public Health. 2001;91:1094-1099.
5. American Academy of Pediatrics. Health care of young children in foster care. Pediatrics. 2002;109:536-541.
6. Office of the Inspector General. Not all children in foster care who were enrolled in Medicaid received required health screenings. Washington, DC: U.S. Department of Health & Human Services. 2015.
We believe this study provides valuable baseline information to better equip providers and policymakers interested in improving the system of care for children in foster care. Further, this work represents an important partnership between DSCYF, DMMA, the Center for Community Research and Services at the University of Delaware, and Nemours. This partnership and the data infrastructure that has resulted from this effort, provides critical opportunities for ongoing research and analysis that is needed to better understand the complex health-related needs of children in foster care. A complete report of
CONTRIBUTING AUTHORS
■ ERIN K. KNIGHT, PhD, MPH is a Health Policy Fellow in the Center for Community Research and Service at the University of Delaware in Newark, Del.
■ MARY JOAN MCDUFFIE, MA is an Associate Policy Scientist in the Center for Community Research and Service in the School of Public Policy and Administration at the University of Delaware in Newark, Del.
■ KATIE GIFFORD, MS is a Research Associate in the Center for Community Research and Service and a Doctoral Candidate in the School of Public Policy and Administration at the University of Delaware in Newark, Del.
■ CATHERINE ZORC, MD, MSHP is President of the Delaware Chapter
of the American Academy of Pediatrics. She is a pediatrician at Nemours DuPont Pediatrics and a Physician Consultant at Nemours Health and Prevention Services, Nemours Children’s Health System in Wilmington, Del.
7. Child Protection Accountability Commission (CPAC) and Child Death, Near Death and Stillbirth Commission (CDNDSC). Joint Foster Care Medical Committee Report: Safety, Permanency, Health and Well-being. Wilmington, DE: CPAC & CDNDSC. January 2015.
8. Landers G, Snyder A, Zhou M. Comparing preventive visits of children in foster care with other children in Medicaid. J Health Care Poor and Uninsured. 2013;24:808-812.
9. Hernandez S, Doty M, Shea K, Davis K, Beal A. Closing the divide: How medical homes promote equity in health care. New York, NY: The Commonwealth Fund. 2007.
10. Bachrach D, Pfister H, Wallis K, Lipson M. Addressing patients’ social needs: An emerging business case for provider investment. New York, NY: Manatt Health Solutions & The Commonwealth Fund. 2014.
11. Jaudes PK, Champagne V, Harden A, Masterson J, Bilaver L. Expanded medical home model works for children in foster care. Child Welfare. 2012;91:9-33.
12. DiGiuseppe D, Christakis D. Continuity of care for children in foster care. Pediatrics. 2003;111:208-213.
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