Health Care Standards

The American Academy of Pediatrics (AAP) and Child Welfare League of America (CWLA) have published standards for health care for children and teens in foster care. These standards are designed to help professionals from all disciplines understand the complexity of health problems and the quality of care issues in foster care. The standards specify the parameters for high-quality health care, and enable us to improve services and outcomes, as well as create an opportunity to measure the outcomes, provide a framework for child welfare to assess services for children and teens, determine the appropriateness of funding, and provide a foundation for health advocacy.

Fundamental Principles

Children and teens in foster care should be seen early

• To assess for signs and symptoms of child abuse and neglect
• To assess for presence of acute and chronic illness
• To assess for signs of acute or severe mental health problems
• To monitor adjustment to foster care
• To ensure a child or teen has all necessary medical equipment and medications
• To support and educate parents (foster and birth) and kin

Children and teens in foster care should be seen often upon entry into foster care

• Health screening visit within 72 hours of placement
• Comprehensive health admission visit within 30 days of placement
• Follow-up health visit within 60 to 90 days of placement

Children and teens in foster care should have an advanced health care schedule

• Because of a high prevalence of health care problems and often multiple transitions that can adversely impact their health and well-being, children and teens in foster care should have an enhanced health care schedule:
• To monitor signs and symptoms of abuse or neglect
• To monitor a child's or teen's adjustment to foster care and visitation
• To ensure a child or teen has all necessary referrals, medical equipment, and medications
• To support and educate parents (foster and birth) and kin

Children and teens in foster care should be seen often while they are in foster care

• Monthly for infants from birth to age 6 months
• Every 3 months for children age 6 to 24 months
• Twice a year for children and teens between 24 months and 21 years of age

Children and teens in foster care should have comprehensive evaluations

• Within 30 days of placement, children and teens in foster care should have the following detailed, comprehensive evaluations:
• A mental health evaluation
• A developmental health evaluation if under age 6 years
• An educational evaluation if over age 5 years
• A dental evaluation

Such evaluations can be conducted as part of the comprehensive health assessment by a multi-disciplinary team or through referral to specialists. It is important that they be conducted in a timely manner and information is shared among all the professionals and parents caring for the child or teen. Information from these assessments should be shared with child welfare and the courts to ensure that it is incorporated into permanency planning for the child or teen.