Funder: The Annie E. Casey Foundation and the Centers for Medicare & Medicaid Services

Author: Kamala Allen, Center for Health Care Strategies

November 2010 | Brief


Early assessment and intervention are critical to the well-being of children and youth entering foster care – a population with a high prevalence of physical, behavioral, and oral health needs. Delivery of timely services can help to resolve acute health issues and better manage chronic conditions. Accordingly, child welfare advocates and child health policymakers endorse early health screening and assessment for children and youth following removal from the home.

This issue brief reports on a 50-state survey conducted by the Center for Health Care Strategies (CHCS) to understand the extent to which child welfare agencies require physical, behavioral, and oral health screenings and follow-up assessments upon a child’s entry into foster care. The survey found:

  • Virtually all states require an initial physical, behavioral, or oral health screening, and more than half of states mandate all three;
  • State-mandated timeframes for initial health screenings vary significantly, and do not consistently reflect nationally recognized guidelines; and
  • State mandates for in-depth assessments are less rigorous than for initial screenings.

Findings suggest significant opportunities for states to strengthen screening requirements to more effectively guide care management and support better health outcomes for the high-risk foster care population.