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Foster Care in Utah

Marlayna Despres
Foster Care in Utah

4,739 603
Kids receiving Kids adopted
Foster Care in Utah through Foster Care
last year last year in Utah
Becoming a foster parent
• Be a US citizen or legal resident
• Must pass a background check
• Must be financially stable without assistance from the state
• Medically fit to care for a foster child
• Home in good condition
• Must complete continuing education (“In-service Training”) requirements
(16h per year)
• Level III families that care for children with special behavioral challenges, have
additional requirements
What we know about the health of children
entering the foster care system in Utah
• Study published in 2008 by Julie Steele, MN, FNP and Karen Buchi, MD
• All children entering the foster care system from Jan 2001 – Dec 2004
• 6, 177 children
• Intake health assessment within 30 days of entering the system
• Entered into the State Automated Child Welfare Information System for Utah (SAFE database)
• The first state-wide cohort study of foster children
Medical Health of Children Entering Foster Care
54% of children entering the Utah foster care system had one or
more chronic medical condition.
• Overweight/obese: 35% (18% had BMI >95%ile)
• Referral for specialty care: 30%
• Dental conditions: 22%

Common conditions found in other studies with smaller cohorts: dental


conditions, asthma, ENT conditions, skin conditions, short stature &
growth failure, and communication & developmental delay.
Mental Health of Children Entering Foster Care
44% of children entering the Utah foster care system (68% of those
>12 years old) had one or more mental health condition
• Oppositional defiant disorder or conduct disorder: 18%
• Reactive attachment and/or adjustment disorder: 17%
• Mood disorders: 15%
• Anxiety: 12%
• ADD/ADHD: 10%
*Of these children, 35% were taking psychotropic medications
(antidepressants and stimulants are the most common)
Why?
• Most children placed in foster care are done so because of
neglect, abuse, or behavioral issues.
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• Confounded by: domestic violence, parental substance abuse
and/or mental illness, unstable living conditions, and/or
poverty
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• Complicated, unmet health needs
In conclusion…
• Children entering foster care are more likely to have many
health care needs compared to the general population of
children that we see.
• Databases such as the SAFE database can be helpful in
identifying key health conditions in foster children that have a
big impact (ie. obesity).
• As providers we not only need to be aware of these increased
risk but also help for patients to establish a medical home and
continuity of care in the setting of frequently changing
circumstances.
• Advocacy for these patients is needed at the political level to
ensure that these children have the access to the services that
they need.
Foster Health Care Program at the UofU
• Specializes in providing Our Specialists
comprehensive health care services
and consultation for youth in foster • Julie Steele, DNP, MN, FNP
care and out-of-home placements.
• Wendy Hobson-Rohrer, MD, MSPH,
• WCCs and education FAAP

• Sick visits and follow-up care • Karen Buchi, MD, FAAP

• Gynecological and reproductive


health for teens
• Care coordination with case workers,
mental health professionals, and
other specialists as needed
References
• https://utahfostercare.org/
• Steele, J. S., & Buchi, K. F. (2008). Medical and mental health of children
entering the Utah foster care system. Pediatrics, 122(3), e703-e709.
• Szilagyi, M. A., Rosen, D. S., Rubin, D., & Zlotnik, S. (2015). Health care issues
for children and adolescents in foster care and kinship care. Pediatrics, peds-
2015.
• https://healthcare.utah.edu/locations/south-main-clinic/foster-health-
clinic.php
• Child Welfare Information Gateway. (2017). Foster care statistics 2016.
Washington, DC:U.S. Department of Health and Human Services, Children’s
Bureaiu