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Health Systems of Care

 

An effective health system of care is a coordinated health system where multidisciplinary partners — including child welfare, judicial, pediatric, mental and dental health professionals, and parents (foster and birth) and kin — work collaboratively to respond to, manage, and improve the health and well-being of children and teens in foster care.

Cross-systems collaboration and cooperation are based on a foundation of trust and respect. This foundation can be developed by:

  • Recognizing a common mission is the foundation for collaborative work. Health, mental health, child welfare, legal, and judicial professionals share a common mission with parents (foster and birth) and kin around children and teens in foster care:
    • To improve the health and well-being outcomes of children and teens in foster care
    • To keep children and teens safe while they are in foster care
    • To promote the stability of children and teens in foster and kin placements
    • To provide education and support to parents (foster and birth) and kin, children, and teens in foster care
    • To foster the permanency of children and teens through timely and safe reunification, or adoption if reunification is not possible
    • To provide teens in foster care the education and skills they need to achieve a healthy independent adulthood
    • To ensure that professionals working with children and teens in foster care have the knowledge and skills to provide high quality care

  • Professional communities develop language and practices that reflect the training, mission, and roles of their members. Professional jargon and practices may, however, be difficult for others outside of each discipline to fully understand. Professionals who wish to collaborate to meet the health needs of children and teens in foster care must work to understand each others’ language, culture, rules, ethics, and legal mandates. Collaboration will be most successful when each member of the team understands and respects the others and his or her work.
  • Improving health outcomes for children and teens in foster care requires cooperation, communication, and collaboration among the various professionals, systems, children, and families involved in providing care, including professionals in health care, child welfare, family court, mental health, and education. Learning from children and teens who are or have been in foster care, as well as parents (foster and birth) and kin, is also critical to developing this collaboration. Learning one another’s language allows for a much more effective communication that provides benefits to children and teens in foster care.

    Collaboration needs to occur at both the systems level and the level of the individual child or teen. This requires that those in leadership roles in each discipline work with each other to set up mechanisms for communicating information in a manner that:
    • Is useful to other professionals, helping them to do a better job for children and teens
    • Promotes the health and well-being of children and teens in foster care
    • Maintains appropriate confidentiality

    An example of a systems-level approach to developing this interdisciplinary communication and collaboration is to institute Inter-disciplinary Advisory Boards, with representatives from each discipline. Download consent form.

  • From 2001-2003, Casey Family Programs and the Institute for Healthcare Improvement (IHI) partnered on a Breakthrough Series Collaborative (BSC) — Improving Healthcare for Children in Foster Care — which involved convening teams throughout the country to address and then test strategies to address the health care needs of children in foster care. The National Institute for Child Health Quality (NICHQ) worked with IHI to inform the components necessary to build these health systems of care for children and teens in foster care.

    Several strategies identified by the BSC collaborative include:

    • Improving communication and collaboration across systems in an effort to
    • Identify and work with interdisciplinary partners
    • Connect with multidisciplinary partners
    • Identify the roles and responsibilities of each partner
    • Develop ideas on how to align incentives of different systems
    • Incorporate the BSC model of collaborative partnerships (ie, leadership team, technical experts/advisors, setting common goals, rapid change model)
    • Reforming health care financing
    • Identifying strategies for building health systems for children in foster care
    • Identifying the pediatrician's role
    • Sharing information (eg, health records access, health information/records)
For more information, visit the Resource Library and search by the topic "Systems of Care".

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