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Barriers to Healthcare in Foster Children

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Barriers to Health Care in Children in Out of Home Placement
Michele Burnette, RN
Nur/440
July, 22, 2013
Leslie Rowan

Barriers to Healthcare in Children in Out of Home Placement

Vulnerability can be described as a concept of susceptibility or risk of health problems. (Chesnay & Anderson, Vulnerable Populations, 2012) One population that meets this description is children in out of home care. These children come from diverse backgrounds with different cultural and religious beliefs related to medical care. They also have been exposed to a cadre of situations such as violence, substance abuse, and untreated mental illnesses of caregivers, etc. It is not uncommon for a child in out of home placement to be behind on routine vaccinations, physical examinations, dental care and to experience developmental and educational delays. “Children and adolescents in foster care have more intensive service needs as compared to the general pediatric population or even other children who are poor” (“Fostering Health: Health Care for Children and Youth in Foster Care,” 2011, p. 201). When a child first enters foster care there is an opportunity to help the child while reaching out to the family. This perfect opportunity to catch the child up regarding the medical and dental neglect that has transpired in their lives can be met with several barriers. One of the most common barriers to care is the inability to obtain proper medical histories for this population (“Fostering Health: Health Care for Children and Youth in Foster Care,” 2011). Locating medical records can be time consuming, especially if the child has bounced from one practitioner to another. In many situations, once the medical history is released, it has to be examined and redacted before the information can be shared with the caregiver. Another barrier to care is placement stability. In the state of Rhode Island in FY 2010, 14.1% of the 1,694 children in out of home placement had experienced three or more moves during their first year in foster care (“Fostering Health: Health Care for Children and Youth in Foster Care,” 2011). This placement instability only exacerbates the problem of obtaining medical information and delaying care. My role as a nurse has led to many encounters with children in out of home placement. I currently work with the Medicaid population in the state of Maryland and have helped foster families navigate the Medicaid program. In addition to this exposure, on a personal note, I have been a foster parent for over 15 years, caring for over 40 children in out of home placement. I continue to advocate for changes in the political arena to help break down barriers to the medical and educational care associated with this population. Congress is beginning to take note of some of the advocacy efforts and in 2008 enacted the Fostering Connections Act. This law “recognized that the health of children in foster care is a priority and that there must be up to date health records for children in care” (“Fostering Health: Health Care for Children and Youth in Foster Care,” 2011, p. 201). Since 2008, there have been other laws regarding foster children such as McKinney-Vento that addresses the issue of homelessness and educational rights in this population. Advocating for the needs of children in out of home placement can be a difficult job. Foster children experience neglect, abuse, and exposure to horrific things in their lives. This only complicates the situation when trying to address, care for, and repair the medical insufficiencies in their lives. Hopefully, continued advocacy will be well received and further laws will be enacted to protect the educational and medical needs of children in out of home care.

References

Chesnay, M., & Anderson, B.A. (2012). Caring for the vulnerable (3rd ed.). Retrieved from The University of Phoenix eBook Collection database.
Fostering Health: Health Care for Children and Youth in Foster Care. (2011, July). Medicine & Heatlh/Rhode Island, 94(7), 200-202.

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