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Addressing Barriers

 

Children and teens in foster care have a high prevalence of chronic medical, dental, mental health, developmental, and educational issues requiring that they receive more frequent and detailed health monitoring than other children and teens. Despite the best of intentions, foster care has inherent barriers resulting in health care that is fragmented and often crisis-oriented. When children and teens are removed from their families, they are also often removed from their usual system of health care, if they have one.

Some barriers to good health care include:
  • Lack of a medical home
  • Lack of, or difficulty accessing, medical records and information
  • Delay in health insurance enrollment
  • Inadequate and delayed assessment of needs upon entry into system
  • Lack of follow-through in addressing identified needs
  • Lack of access to other health services, including mental health screening and care, respite care, developmental, and educational screening and care, dental and medical subspecialty care
  • Poor coordination and communication among disciplines and systems of care and among professionals and families
  • Diffusion of authority and responsibility among parents, (foster and birth) and kin and child welfare, creating challenges in areas of consent and confidentiality
  • Lack of knowledge of health providers about child welfare and legal systems and vice versa due to:
    • Multiple systems involved in the child’s life
    • Myriad language and cultures of various disciplines involved
    • Lack of knowledge among various professionals involved about standards of practice, mandates, and roles of other systems
    • Lack of alignment of the goals and incentives of different disciplines
  • Inadequate resources
    • Medicaid
    • Insufficient funding for complexity of health needs
    • Lack of practitioners accepting Medicaid reimbursement
    • Human resources
    • Lack of health professionals trained in needs of young people in foster care
    • Treatment resources
    • Lack of treatment resources, especially for mental health, respite and dental service
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