APPENDIX C:
RECOMMENDATIONS OF
THE CALIFORNIA FOSTER CHILDREN'S
HEALTH PROJECT TASK FORCE

A Model System of Health Care for Children in Foster Care

State Responsibility: Quality Assurance

• develop Data analysis of population-based outcomes
• evaluate county processes and outcomes
• provide technical assistance to planners and providers

State Interagency Coordinating Council
(possibly under the auspices of the Health and Welfare Agency)

• adopt guiding principles (see below);
• ensure immediate and continuous MediCal eligibility;
• create a comprehensive health benefit package;
• blend existing funding streams and identify additional resources;
• increase provider pools by reducing barriers;
• provide technical assistance to local systems of care;
• provide training for all foster care providers and health care providers;
• expand and systematize data collection;
• conduct oversight, monitoring and evaluation.

County-Level Responsibilities: Local Delivery System

Let's be honest, many of these children are removed because of parental neglect or abuse. Chances that they have scabies, lice or some contagious disease are high. Failure to immediately do a health screen means that other children might unnecessarily be infected or die of a treatable condition while in the custody of the state.

• develop a unique health care plan for each child

• implement a needs-based referral process for assessments and treatments

• provide adequate and quality health services based on child need

• provide a health and/or medical assessment screen within 72-hours of entrance into foster care

• provide a comprehensive assessment within 30/60 days of entrance into foster care

County Interagency Coordinating Council

• assure that standards of care are being met by local providers
• identify, train and certify providers
• coordinate services throughout the county
• maintain a data base, including the creation and updating of a Health and Education Passport for each foster child
• oversee and evaluate programs⁽¹⁷²⁾.

Guiding Principles to Create a Responsive Health Care System for Foster Children

The Task Force recommends that the state adopt guiding principles to steer development and implementation of a statewide system of care for children in foster care, whatever form that system might take. These principles should also guide decisions that would modify the current set of services.

The following principles are presented to launch discussion:

Adaptable The system must work in urban and rural counties, areas with or without managed care plans, and regions with or without a large supply of primary or specialty care providers. The system should be accessible to California's diverse populations, and provide services that are culturally sensitive.

Clear lines of responsibility and accountability A state and local governance system should be developed that clearly identifies who is responsible and accountable for the implementation and enforcement of the standards, procedures, guidelines, etc.

Minimum standards of care Statewide standards are necessary to ensure that appropriate care is provided on a consistent basis by all providers.

Statewide data system Information needs to be collected and recorded to reliably track the medical and other history of foster children, and this information needs to be available to providers regardless of county boundaries.

No disincentives for permanent placement In no case should a separate health care system for children in foster care act as a disincentive to permanent placement, whether placement is through family reunification or adoption.

Immediate and continuous eligibility for Med-Cal Eligibility for Med-Cal should be presumed upon physical removal of the child from the home, as well as for `12 months after the child has left the foster care system.

Consistent and individual health case management Each child should receive health care services based on their unique needs as identified in a care plan.

Comprehensive benefit package Foster children should receive benefits that are portable and available throughout the state.

Seamless care The system of health care should be seamless as the child moves into and out of foster care.

County-of-origin placements as a priority Every effort should be made to keep the child in his or her county of origin unless the child is being placed with relatives or the child's treatment needs suggest otherwise.

Access to providers The system should be designed to allow access to traditional safety-net providers.

Larger provider pool Incentives should be developed to increase the provider pool, including offering adequate provider payment for services rendered.

Quality assurance the system should be outcome- and performance-driven and meet quality-assurance measures. Providers and decision-makers should receive information on the quality of health care provided to foster children.

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