The state should continue to monitor the health status of children in foster care after they exit out-of-home care and use the data to evaluate a pilot health-care project, La Follette School students recommend in a new study.
Strengthening Health Outcomes for Foster Care Children
Prepared for the Wisconsin Department of Health Services and the Wisconsin Department of Children and Families by Susan Cosgrove, Carlton Frost, Rebecca Chown, and Tawsif Anam
Wisconsin children who enter foster care automatically are enrolled in Medicaid, and most stay on Medicaid after they leave foster care, which indicates a substantial degree of continuity in their health coverage, says Susan Cosgrove, one of the authors of the report produced for Wisconsin's Department of Children and Families and Department of Health Services.
"Maintaining quality health care for all children is important, but especially for children who go through foster care because, as we found, they show a substantially higher prevalence of almost all physical and mental health conditions than other children on Medicaid and the general child population in Wisconsin," Cosgrove says.
The two agencies tapped the La Follette School students to conduct their analysis as part of the Workshop in Public Affairs taught by professor Robert Haveman. The other authors are Carlton Frost, Rebecca Chown and Tawsif Anam. The state is starting a pilot project in six counties in southeastern Wisconsin to implement a Foster Care Medical Home project that will assign a primary care physician and care coordinator to each child so physical and mental health needs can be addressed in a comprehensive, integrated fashion.
"We recommend the Foster Care Medical Home project make full utilization of the health screening tools already in place to identify physical and mental health conditions," Cosgrove says. "Follow-up care and additional diagnostic tests are also very important."
The students emphasize the need for mental health screening in addition to physical checkups. "Thirty-nine percent of foster children received a primary diagnosis of a mental illness from 2009 through 2011, compared to 11 percent of the Medicaid children who were not in foster care," Cosgrove says. "These childhood mental illnesses include conduct disorder, hyperactivity, emotional disturbance and developmental delays."
By tracking the health outcomes of children after they leave foster care, the state can best evaluate the Foster Care Medical Home project, the students conclude.