Research and policy focus - Foster Care

The Rees-Jones Center for Foster Care Excellence at Children's Health℠ continues to lead conversations relevant to the health of children in the child welfare system through our research and policy work.

Policy Briefs

• Caring for Children with Intrauterine Drug Exposure
• Trauma Treatment for Children in the Child Welfare System
• Addressing the Health and Safety of Children in Foster Care
• Ensuring the Health and Well-Being of Children in Foster and Kinship Care During a Pandemic

Policy Priorities Related to Children in the Child Welfare System

• Increase access to and funding for integrated care - Access to timely and effective pediatric and mental health care is particularly critical for children in foster care given the growing body of science documenting the short- and long-term effects of trauma and childhood maltreatment on the developing brain, immune system, disease potential and adult health and behavioral outcomes. Instigating more flexible payment models, such as bundled payments, is needed to advance integrated care.
• Improve access to quality, evidence-based mental health screenings and treatments - Children coming into care should be screened, with the involvement and input of their caregivers when possible, to determine their mental health needs and related symptoms across developmental stages by licensed and trained professionals. A positive screen should result in a more comprehensive assessment conducted by a mental health provider using validated measures. Positive screens should result in the provision of evidence-based treatments.
• Increase availability of resources and evidence-based services for children involved in the child welfare system with intellectual or developmental disabilities (IDD) - Functional Behavioral Assessments with resulting behavior support plans have a strong evidence base for addressing problematic behaviors in children with IDD and credentialed behavior analyst services (Board Certified Behavior Analyst) should be covered by Star Health. Resources should also be expanded to help children in the foster care system with IDD as they transition to adulthood. For example, more funding should be provided for Supervised Independent Living programs. Respite care services should be more readily available for caregivers of children with IDD.
• Ensure a sufficient provider network - Improving access to quality and easily accessible health providers will require streamlining the administrative requirements placed on providers and increasing reimbursement rates to be competitive. The provider directory should be screened regularly to ensure it is current and that network requirements are being met. Pilots using telehealth to deliver healthcare services should be conducted in an effort to increase accessibility, especially for families in rural areas. For example, the delivery of Parent-Child Interaction Therapy using telehealth has been tested and shown to be effective.
• Appoint an ombudsman within HHSC to work with medical professionals who seek redress in specific cases or who identify processes that are failing; lead automatic expedited review of denials of in-home supports, including in-home private duty nursing, respite care for caregivers of children in foster care and so forth; and set in motion process improvements based on medical breakdowns and “near misses.”