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California Voter |
Juvenile Justice in California
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| Addressing Issues Surrounding Child Abuse and Neglect | ||
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California Voter |
Juvenile Justice in California
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| Addressing Issues Surrounding Child Abuse and Neglect | ||
| The League of Women Voters of California | Fall 1999 |
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In this section... ADDRESSING ISSUES SURROUNDING CHILD ABUSE & NEGLECT  TABLE OF CONTENTS
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Health care for children within the dependency system continues to be an area of concern. These children typically enter the system with severe physical, emotional and developmental problems as a result of the neglect and abuse they have suffered. As wards of the state, they are dependent on government-funded health care to meet their varied needs.
The California Foster Children's Health Project Task Force, meeting in 1997-98, made these recommendations:
Numerous obstacles stand in the path to reach these goals. The mobility of foster children impacts continuity of care and good medical records needed for both prevention and treatment of chronic conditions; foster care providers often are not trained to access complex public health systems; many health care providers are not prepared to deal with the complex physical, mental and developmental health issues these children bring, and hesitate to treat Medi-Cal patients because of the complex billing system and low reimbursement rates; social workers are typically overburdened with large caseloads and lack medical training; and lack of coordination among health care providers and social service agencies can limit access to and continuity of care, among others.
There is no state policy to guide the development of a system of care. While state law and regulations make the Department of Social Services ultimately responsible, the department must rely on existing county-based health care systems to serve these children. Stronger coordination between children's protective services, health and mental health are needed at both the state and county levels.
Recent changes reflected in the 1999-2000 state budget simplify the application process for health care and expand the outreach through community-based agencies. This is a work-in-progress as California attempts to provide health care for all children, including those who are wards of the state.
Other health care issues focus on the use and monitoring of mood-altering drugs to children in foster care. The law requires careful monitoring of the administration of drugs to children under state care, but typical caseloads do not provide the resources to do this properly. While there are many responsible residential treatment programs that have appropriate psychiatric services for their charges, other small group homes with low reimbursement rates have a high turnover of low paid staff and training is often not adequate. This staffing problem, coupled with a low reimbursement rate that contributes to the shortage of psychiatrists willing to treat these children, makes medication management an ongoing concern.
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