Society for Social Work and Research 18th Annual Conference: Research for Social Change: Addressing Local and Global Challenges

January 15 - 19, 2014

Background and Purpose:  Public child welfare systems have long recognized the significant health care needs of the children that they serve.  Early research has found disproportionately high rates of chronic health conditions, developmental delays, and mental health issues.  The intersection of maltreatment, removal from the home, and placement instability all combine to impact the health of children in contact with the child welfare system.  While children in foster care have access to healthcare through the Medicaid program, many child welfare systems have realized that access alone does not ensure health care utilization and improved outcomes.  Ultimately, children’s caregivers play a pivotal role in ensuring health care utilization.  This symposium will present three papers that address some aspect of the role of the caregiver in the health care utilization of children served in the child welfare system.   

Methods:  Each of the three papers focuses on children involved with the child welfare system either solely as a result of investigated maltreatment or as a result of placement in foster care.  Each study uses an observational design to examine health service use for distinct populations including a population of Medicaid children in one state, a population of children entering foster care in one state, and a matched sample of maltreated and non-maltreated adolescents living in the same area.  The papers will use bivariate and multivariate analysis to examine the relationship of caregivers either implicitly or explicitly to healthcare service use and costs.

Results:  The first paper will use data from the second assessment of a longitudinal study on child maltreatment to identify differences between the health status, medications, and health care usage for maltreated versus non-maltreated youth.  This analysis will explicitly examine the affect of caregiver characteristics on health status and usage.  The second paper will implicitly examine the effect of caregivers on health care utilization as defined by the type of foster care placement setting (i.e. relative foster care, traditional foster care, congregate care).  The third paper implicitly examines the effect of a foster care provider on health care costs by comparing costs prior to and after placement in foster care.  In addition, this paper will implicitly consider the impact of caregivers as defined by foster care placement type. 

Conclusions:  The symposium will provide attendees with a clear understanding of the state of the knowledge with respect to the role of caregivers on the health of children involved in the child welfare system.  Each of the papers will provide an opportunity to discuss the policy implications of developing and financing systems of care for children with child welfare system involvement.