Navigating a Complicated System of Care: Foster Parent Satisfaction with Behavioral and Medical Health Services

According to the 2014 AFCARS Preliminary Report, more than half (53 %) of children in foster care nationally are placed with a licensed non-relative foster family (U.S. Department of Health and Human Services 2014). Foster parents serve a critical role in the child welfare system, caring for children and youth who experienced maltreatment, many of whom present with significant behavioral health and medical needs. Foster parents’ ability to care for the emotional, medical, and dental needs of children in their care is dependent on the availability and delivery of quality services. However, previous studies indicate that foster parents report having little say in decision-making and services for the children in their care (Buehler et al. 2006; Hudson and Levasseur 2002). This is concerning as foster parents can provide unique insight into the behaviors, progress, and service needs as they interact with the children and service providers on a regular basis. There is a need to understand the perspectives of foster parents regarding their experiences with children’s behavioral, dental, and medical health services, to promote positive examples of service provision as well as offer important considerations for improvement.

Child welfare agencies are charged with providing the necessary medical, dental, and behavioral health care for children while in foster care. It has been well documented that children in the foster care system demonstrate a variety of medical and behavioral health conditions (e.g., Heflinger et al. 2000; Kortenkamp and Macomber 2002; McCrae 2009; McMillen et al. 2005; Mekonnen et al. 2009; Oswald et al. 2010; Pecora et al. 2009; Sawyer et al. 2007; Steele and Buchi 2008; Vandivere et al. 2003) and require a range of treatments, medications, and specialized care. Rubin et al. (2005) reported that an estimated one in every two children in foster care has a chronic medical problem, and an estimated 40–80 % of youth in foster care have a serious behavioral or mental health condition requiring treatment (Clausen et al. 1998; Garland et al. 2000; Glisson 1994; Halfon et al. 1995; Landsverk et al. 2002; Stahmer et al. 2005). Children of all ages who experience maltreatment are susceptible to various developmental delays, behavioral problems, and health conditions (Clausen et al. 1998; Glisson 1994; Halfon et al. 1995; Heflinger et al. 2000; Landsverk et al. 2006; Urquiza et al. 1994). For example, a study of children entering foster care in Utah from 2001 to 2004 experienced high rates of obesity, oppositional defiance disorder and conduct disorder, reactive attachment, adjustment disorders, and mood disorders (Steele and Buchi 2008). Research on children placed in out-of-home care revealed that between 23 and 61 % of children under the age of five were significantly developmentally delayed upon screening compared with 10–12 % of the general population (Urquiza et al. 1994; Klee et al. 1997). Such delays can be attributed to prenatal exposure to alcohol/drugs or abuse or neglect in the home. In addition, studies have documented the increased prevalence of posttraumatic stress disorder (PTSD), alcohol abuse and dependence, various forms of depression, and social phobia among children and youth in foster care at higher rates than their peers who are not in care (Auslander et al. 2002; Clausen et al. 1998; Dos Reis et al. 2001; McMillen et al. 2004). Such conditions left untreated and unresolved can have negative long-term consequences into adulthood such as incarceration, relationship and financial problems. With an increased number of children entering foster care and the high levels of need among children and youth in foster care, experts are calling for improved access and treatment that is child and family-centered, community-based, and culturally competent (Pasztor et al. 2006, 2009; Stroul 2002; Stroul and Friedman 1996). However, concerns continue about inconsistencies in the availability and included in the initial survey, and meetings with foster family community stakeholders prompted the need for further clarification of foster parent experiences specific to behavioral health and medical, dental, and vision services. In response to this feedback, a second anonymous online survey was created that elicited further data regarding health, dental, vision, and behavioral health services.

DMU Timestamp: February 03, 2020 23:30

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Feb 10

2020 Angeth Makol 2020 Angeth Makol (Feb 10 2020 5:43AM) : more than half of foster children are placed in care of non-relative foster families more

foster parents have a severe role in the child welfare system they have to care for the children mentally and physically. but foster parents have little say in decision making and services for the children in their care. It’s concerning because the foster parent spend the most time with the child and would most likely understand the child better than anyone else

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