Youth in the foster care system often have no one person who is clearly authorized to make medical decisions for them. From a caseworker insisting upon a vaccine to a birth
How does the fostering service deal with children with medical conditions?
Wherever possible, taking into account the age and understanding of the child/young person, the child will be consulted about proposed medical treatment and their views taken into account; The fostering service also has a duty to foster carers.
How will the foster carer manage the child's medication?
The foster carer will keep all the documentation in relation to the child's medication in a file in a safe and secure place. The records should be properly completed, legible and current and should be available for inspection at all times;
Can children in foster care receive Medicaid or other health insurance?
This issue brief reviews the eligibility pathways for children and youth in foster care to receive Medicaid or other health-care coverage and looks at some of the newer benefits now mandated through the Patient Protection and Affordable Care Act (ACA), especially those for older youth in or formerly in foster care.
How do foster children get visits with biological family?
Each agency and state also has different arrangements for how foster children get visits, so your case worker might bring your foster child to visits and you don’t have any interaction with biological family members. If you do, however, these visits are always supervised and monitored by caseworkers.
Who runs the foster care system in the US?
This is one of the most misunderstood facts of foster care: While government regulations generally direct how foster care operates, independent non-profit organizations (licensed by the state) do a huge amount of the actual work in some areas.
Who oversees foster care in Texas?
When children can't live safely at home, CPS tries to find relatives and family friends who can provide stability while the children can't live with their parents (see kinship care). If no one can be found, the court can give temporary legal custody to CPS, who then places the children in foster care (learn more).
What do you see as the primary responsibility in fostering a child?
Responsibilities to the child Provide for the child's basic physical and emotional needs. Provide for school attendance; monitor progress, note special needs and accomplishments. Attend to medical and dental needs. Cooperate with visitation plans.
What is treatment foster care in Texas?
Treatment foster care (TFC; or professional foster care) is a type of out-of-home placement provided by foster parents who receive specialized training to care for children and with intensive emotional or behavioral needs.
How much does CPS pay foster parents in Texas?
Minimum Daily Amount to be Reimbursed to a Foster Family *Service LevelPayment RateModerate$47.37Specialized$57.86Intense$92.43Treatment Foster Family Care$137.521 more row
How much do foster parents get paid monthly in Texas?
Monthly foster care payments in Texas range from $812 to $2,773 per child, while relative caregivers currently receive a maximum of $406 per month for up to one year, plus a $500 annual stipend for a maximum three years, or until the child's 18th birthday.
Does a foster parent have parental responsibility?
Foster carers never have parental responsibility for a fostered child, so they can only take decisions about the fostered child where that authority has been delegated to them by the local authority and/or the parents.
What is safer caring in fostering?
Safer caring is the means by which foster carers can ensure the safety and well-being of children and young people. Because the business of foster caring happens in the home of the carer, safer caring also aims to protect the well being of carers and their families.
What is the role of your supervising social worker?
The role of the supervising social worker is to assist the foster carer in their task of providing care to a child in care which will improve the child's well-being and life chances by promoting the individual outcomes for children.
What is therapeutic foster care NC?
Therapeutic Foster Care (TFC) is a proven mental health service provided to a child in a family setting by specially-trained foster parents. Children receiving this service typically have manageable behaviors with moderate behavioral and emotional needs.
How does medical foster care help children?
When this occurs, the medical foster care system can provide the necessary health care and supervision to permit these children to live outside of hospitals. However, foster children with medical complexity experience extremes of social and medical risk, confounding their prognosis and quality of life beyond that of similar children living with biologic parents. Medical foster parents report inadequate training and preparation, perpetuating these health risks. Further, critical decisions that weigh the benefits and burdens of medical interventions for these children must accommodate complicated relationships involving foster families, caseworkers, biologic families, legal consultants, and clinicians. These variables can delay and undermine coordinated and comprehensive care. To rectify these issues, medical homes and written care plans can promote collaboration between providers, families, and agencies. Pediatricians should receive specialized training to meet the unique needs of this population. National policy and research agendas could target medical and social interventions to reduce the need for medical foster care for children with medical complexity, and to improve its quality for those children who do.
What is medical foster care?
Medical foster care, funded via Medicaid, permits children whose medical complexity outstrips their parents’ resources to be cared for outside of institutions. Data regarding medical foster care are not systematically collected. AFCARS does require reporting of “special needs status,” but criteria for special needs is determined independently by each state welfare agency and can include minority race, older age, belonging to a sibling group, having another (unspecified) special need, or having a medical condition or disability. For reporting purposes, the state can assign only one special needs criteria for each child, which results in variability of reported medical needs across states ( 28 ). AFCARS data for all children adopted with state agency involvement between 1996–2003 demonstrated that 82% met special needs criteria. During that time period, the percentage of children classified as special needs based on a medical condition or disability rose from 13.7 to 24.3% ( 28 ).
What is the role of pediatricians in complex care?
Pediatricians who are motivated to take on complex patients also require targeted training and resources to provide the appropriate level of care ( 57 ). In 2003, the Institute of Medicine recommended that all pediatric clinicians should be trained to provide medically complex patients with safe, efficient, effective, and equitable care ( 57 ). This recommendation has yet to promote widely available continuing medical education on topics relevant to complex care management, including care coordination, shared decision making, setting and communicating treatment goals, and working with interprofessional teams ( 14, 57 ). All pediatric clinicians should receive training about navigating their state’s foster care system and collaborating with foster families ( 49 ).
What are the responsibilities of a pediatrician?
Pediatricians at the center of medical homes for these children have complex responsibilities including eliminating gaps in relevant medical and social information, providing comprehensive care, and serving as a liaison to specialists in and out of the hospital ( 44 ). During the inpatient hospitalizations that occur frequently for these children, primary clinicians play important roles in critical decision-making ( 56 ). This commitment of time and resources to provide quality care may deter pediatricians from serving these patients ( 31 ). To counter this, third party payers must be lobbied to reimburse for time spent in care coordination, documentation, care plan development and oversight, and counseling ( 54 ). Some child welfare agencies utilize Title V Medicaid funding dedicated to case management services in order to help with care coordination ( 54 ), but this does not currently address physician reimbursement.
What is the role of a foster parent?
Foster parents are typically responsible for determining when a child needs medical attention , and may possess information important to medical decisions ( 46, 49 ). But unless parental rights are terminated or relinquished, biologic parents are legal custodians and usually retain authority for consenting to medical treatment ( 49 ). In some locales, biologic parents may sign generic consents for routine heath care, but nonroutine evaluations and interventions require specific consent from the biologic parent ( 31 ). Attempts to locate a biologic parent for consent can delay medical care, or may compel a court-appointed guardian or court-ordered treatment ( 49 ).
Why is it important to consider medical complexity in foster care?
Children with medical complexity in foster care deserve special consideration with respect to medical decision-making. Many endure life-limiting conditions that trigger recurrent considerations about the benefits vs. burdens of medical and surgical interventions. Their unique medical and social risks may impact prognostic certainty. It is important for clinicians to know who should be included in important medical decisions for these children and to consider how foster care itself should be factored into medical decisions, if at all.
How do social and medical factors affect health outcomes?
Social and medical risk factors can also contribute significantly to health outcomes. Stein et al. ( 4) reviewed 2002 National Health Interview Survey data from 8,174 children and concluded that children who experienced both the highest biomedical and social risk factors together had significantly greater odds of poorer health and higher health care utilization than those with only biomedical risks. Children entering foster care have typically already experienced multiple psychosocial stressors such as parental substance abuse, mental illness, poverty, or homelessness ( 44 ). Social risks have a cumulative effect, and can result in toxic stress, or the “extreme, frequent, or extended activation of the stress response, without the buffering of a supportive adult” ( 45 ). Toxic stress can cause biologic adaptations of the brain, neuroendocrine response, and immune system, leading to poor health outcomes that persist into adulthood ( 45 ). Because children with medical complexity often spend long periods in medical foster care, it is important to understand how the foster care environment might impact their health outcomes.
Why are medical advances so distressing?
On the other hand, they are distressing, as they inevitably result in new ethical dilemmas that render decision-making even more challenging. Prior to these medical advancements, most premature babies often died at birth and most babies with major birth defects could not survive for long. This might be seen as the ‘lesser of the two evils’, as God or nature spared traumatised parents from making tough decisions over their children’s fate.
What is the judicial approach to withholding treatment?
In cases where parents challenge a doctor’s decision of withholding treatment, the judicial approach is more consistent in upholding the latter’s decision. Judges have always refused to follow parental wishes by holding that it is undesirable to insist that doctors treat children in cases that run counter to their medical judgment and conscience. This is evident in some cases where judges have adopted the categorisation method introduced by the RCPCH in coming to their decisions. There are five circumstances where withholding or withdrawing treatment is justified: when a child is classed as ‘brain dead’, in a ‘permanent vegetative state’, in a ‘no chance’ situation, in a ‘no purpose’ situation, or in an ‘unbearable’ situation. Although it is less controversial to withhold treatment in the first two circumstances, conclusions might vary and be difficult in the last three situations.
How can a physician influence patients and families?
A physician’s personal and professional values can influence patients and families. The reflective practitioner is aware that personal values should not be allowed to restrict or bias such things as options offered to patients or families.
What information should be presented to patients, families, or the child or adolescent's legal guard?
All information presented to patients, families, or the child or adolescent’s legal guardian should be truthful, clear and presented with sensitivity. This information should include evidence available in the literature, and the clinical experience of the physician and his or her colleagues.
Why should parents be given developmentally appropriate information?
As such, they should be given developmentally appropriate information so that they may understand their situation . However, cultural norms or family values may underlie some parents’ reluctance to discuss the child or adolescent’s condition, diagnosis or prognosis in his or her presence. While parents’ views regarding disclosure are important, the child or adolescent’s desire or need for information should remain paramount.
What is the basis of medical decision making?
All decisions are based on a combination of known facts and personal values. In health care, treatment decisions relate to medical information and personal evaluation of this information. For people to make appropriate decisions, they must have the pertinent information, be able to understand how it applies to themselves, and then make a voluntary, or non-coerced, decision. These bases of medical decision-making actually define the three hallmarks of informed choice:
What is the principal obligation of a physician?
The principal obligation of the physician is to the individual patient rather than to society or the health care system. Physicians should act as advocates for their individual patients when scarce resources seem to limit access to care.
Why is it unclear what is the best interest of a child?
There remain conditions in which a child or adolescent’s best interests may be unclear, either due to uncertainty about the outcome or about whether the outcome is likely to be beneficial or harmful. In acute situations, and pending clarification of the circumstances, the presumption should be in favour of life-saving or life-sustaining treatment. However, when it is possible to defer or delay acute treatment, such a delay is encouraged while further information is gathered to clarify the issues.
Who makes the best decisions for children?
To ensure that the best decisions are made for children and adolescents, these decisions should be made jointly by members of the health care team, the child or adolescent’s parents, and sometimes the child or adolescent. Children and adolescents should be involved in decision-making to an increasing degree as they develop, until they are capable of making their own decisions about treatment. End-of-life decision-making, whether or not the child or adolescent is involved, is especially complex.
What are the traumas of being in foster care?
The trauma could involveabuse, neglect, the death of someone close, violence in the neighborhood, or a combination of these and other trau-matic experiences. Although children with complex health needs may have experienced these types of trauma, theymay also have faced the trauma of painful and invasive health care procedures as a result of their medical conditions.The process of being taken from their home and family and entering foster care is, in and of itself, a traumatic experi-ence, as are many medical procedures, especially without parental support. Foster parents should be trained in theimpact of trauma on children and approaches to managing it in their home and in health care settings where the childmay face re-traumatization by undergoing painful or invasive procedures. This factor becomes a part of the treatmentteam’s plan for the child. Appropriate psychosocial services, such as mental health and behavioral psychology inter-ventions, and other therapeutic modalities must be identified by the team. The social worker supports the child andthe foster parents by providing direct clinical services to the child in the foster parents’ home. When appropriate, thechild’s birth family should be involved in the child’s treatment. As with any child in foster care, there should be an on-going assessment of the foster family’s ability to meet the child’s psychosocial needs.
Who wrote the resource guide for treatment foster care?
It was written and edited by Judith M. Levy, MSW, LCSW-C,MA, with contributions from the following Treatment Foster Care professionals:
What is FFTA medically fragile?
The FFTA Medically Fragile Treatment Foster Care Workgroup has developed this guide for foster care programs that wantto serve this special population. This resource guide, when used in conjunction with the FFTA Program Standards for Treatment FosterCare, can help programs modify their practice to provide safe, effectivecare for children and youth with developmental disabilities or medically fragile conditions.
What is recruitment in foster care?
Recruitment is about convincing interested people that they have the personal and financial resources to care for achild with a complex set of medical conditions and caregiving requirements. Decisions must be made about what in-formation to give at what point in the process, and each program may have a different protocol for achieving this bal-ance. At a minimum, information about the individual child as well as about financial support, such as room and boardpayments, stipends for treatment foster parents, and Medicaid funding for the child’s health care and for home modi-fications and furniture, must be provided early on. Although it’s clear that people who do this work don’t do it becauseof money, some programs may be reluctant to provide informationabout money too early in the process. However, the absence ofconcrete financial information up-front may make some qualifiedpotential foster parents turn away, fearing that theycannot affordto become treatmentfosterparents.
What is a TFC nurse?
The nurse may be on the staff of the TFC agency or contracted to provide nursing services to specific children. Depending on the organization and structure of the Treatment Foster Care program, the nurse provides support to TFC placements in any number of ways with the purpose of providing medical support for the children and their foster parents.
What are the medically fragile children?
Children who are medically fragile have at least one chronic physical condition that results in prolonged dependencyon medical care. However, they can have any number of acute or chronic medical problems and, because of the medicalcondition, may require assistance with activities of daily living (ADL) such as personal hygiene and grooming, dressingand undressing, self-feeding, bowel and bladder management, and walking with or without an assistive device. Theseconditions require daily administration of specialized medications and treatments and may be life-threatening or ter-minal. The children are dependent upon tracheotomies, heart monitors, gastrointestinal tubes, dialysis machines, orventilators as well as wheelchairs, lifts, adaptive equipment, and communication devices. Their diagnoses includechronic health conditions, such as diabetes, traumatic injuries to the brain and/or spinal cord, sickle cell anemia, AIDS,or kidney failure, and developmental disabilities, such as cerebral palsy, seizure disorder, spina bifida, intellectual im-pairments, ADHD, autism, and mental health problems. Medically fragile conditions and developmental disabilities fre-quently coexist. People with developmental disabilities also are at increased risk of having a mental health condition.
How important is permanency in foster care?
It is extremely important that potential foster parents understand the concept of permanency. Foster care is not in-tended to be permanent, and a permanency plan must be developed for each child. Foster parents have varying reasonsfor taking children into their care. Sometimes foster parents hope to raise the children until they are adults. This out-come may or may not be possible, depending upon the needs of the individual child. In order to make a fully informeddecision about becoming a foster parent, candidates need complete information about the concept and reality of per-manency, especially when the plan includes returning the child to a family where abuse or neglect once occurred. Per-manency planning should begin on admission to Treatment Foster Care, and both the birth parents and foster parentsshould play a role in the process.
What happens when a foster child's parental rights are terminated?
When a foster child’s parental rights are terminated (sometimes referred to as TPR, or termination of parental rights), it might seem like the logical next step would be for the foster family to adopt the child.
Do you need a mansion for a child?
You need a little extra space. You don’t have to have a mansion, but you do have to meet the minimum space requirements set by child and family services. That usually means a bedroom with a certain amount of square footage per child.
Can a foster child go to daycare?
Foster kids can go to day care. Foster kids can attend daycare, provided it’s approved by child and family services. Sometimes a spot at a day care takes a little while to open up, so it might not be immediate, but it’s definitely possible.
Can you share your foster child's face on social media?
You can’t share their faces on social media. You’ve probably seen foster parents sharing photos of their foster children with hearts over their faces, and that’s because you can’t share your foster child’s face on social media.
Is foster care a good idea?
There are certainly problems and injustices in the foster care system, but even though there are rules or facts you might not have known about before, it’s still a worthy and worthwhile pursuit. If you have the extra space and love to give, these are a few of the things you’ll encounter along your foster care journey.
Do foster children get visits?
Visitation varies with every case. You might have a foster child who has visits with their biological parents or extended family every week, or they might not have visits at all. Each agency and state also has different arrangements for how foster children get visits, so your case worker might bring your foster child to visits ...
What are some examples of medical decisions parents make?
For example, parents need to decide when to seek medical care and treatment for their sick child or whether or not to vaccinate a healthy child. What seems like an easy decision for one parent is often a difficult decision for another parent.
What are the consequences of denying medical care to a parent?
Possible Consequences for the Parent. A parent who denies his or her child necessary medical care could face the following consequences: · Loss of custody. The state may find that the parent is neglecting the child and place the child in state custody in order to protect the child. · Criminal charges.
What is the expected outcome of a treatment?
The expected outcome of that treatment is a relatively normal life with a reasonably good quality of life; The child would die without the treatment; and. The parent is refusing consent for the treatment. If any of the criteria described above are not present in a given case then many states will defer to the parent’s decisions regarding medical ...
Can a state make medical decisions for a minor?
When the State Can Make Medical Decisions for a Minor Child. State laws typically give much leeway to parents and allow them to make medical decisions for their own children unless their decisions endanger the life of a child. Many courts will allow a state child protection agency to make medical decisions for a child if:
Can adults refuse medical care?
Adults have the right to refuse medical care for religious or personal reasons . However, they may not impose religious practices or personal beliefs which endanger the welfare of a child on minor children. Instead, most states require parents to provide a reasonable degree of medical care for their children or else face legal consequences.
Who is entitled to protection?
Children are entitled to protection. Often, that protection comes from their parents. However, when it does not then the state has the responsibility to step in and act in the best interest of the child until such time as the parent is deemed capable of protecting the child or the child reaches the age of majority.
Can a parent refuse hospice care?
For example, if a child has a terminable condition and several doctors are in agreement that treatment is no longer beneficial for the child then the parents have the right to refuse treatment and seek hospice care for their child.
