The Foster Care Health Program (FCHP) is committed to meeting the health care needs of every child in out-of-home placement. All children in out-of-home placements through DCYF will receive the on-going care they need to achieve and maintain optimal physical, emotional and developmental health.

Why is the Foster Care Health Program Needed?
Documentation shows that children in out of-home placements have more health and well-being needs than other children. They often have not received basic and preventive primary health care services. Well child exams and screenings have not been completed on a regular basis, if at all. Immunizations are not up-to-date. Many physical and mental health problems have resulted in poor health prior to placement. Some of the factors that have contributed to this poor health are abuse and neglect, separation and frequent moves, lack of consistent medical care and followup with medical treatment, and daily unmet health needs.

What is the Comprehensive Health and Developmental Assessment?
Each child receives a Comprehensive Health and Developmental Assessment within one month following placement. Because health is not only the absence of disease but a sense of physical, social and emotional well-being, the child's overall functioning is considered at the assessment.

The assessment includes:

• a complete physical exam, including any necessary immunizations;
• screening for vision, hearing, and lead;
• intensive screening/monitoring for mental and emotional problems, cognitive and motor delays;
• referrals for preventive dental care and treatment;
• how the child handles peer relationships;
• how the child manages his or her behavior;
• how the child is coping with the changes in his or her life;
• school status and progress reports.

The medical provider completes a Child Health Profile. A "Medical Passport" is developed for each child that includes prenatal care, past medical history, family medical history, complete immunization records, current medical status, and other medical, dental and developmental information as well as a listing of the medical providers whom this child has seen.

         
Who Provides Medical Care for Children in placement?
Comprehensive health services are provided by community health care providers. Whenever possible, the child remains with the family's own medical provider. Extra efforts are made to keep the same medical provider to allow continuity of care for the child's benefit. Referrals for specialty services are coordinated with the primary provider.

What is the Role of the Foster Care Health Program's Nurse Coordinator?
Nurse Coordinators are registered nurses who are located in the New Hampshire Department of Health and Human Services District Offices and are available to:

• assist the Child Protection Service Worker (CPSW) and Juvenile Probation and Parole Officer coordinate health care needs of the child in placement;
• assist the medical community by providing information about the special needs of children in care;
• identify a health care provider;
• provide Medical Authorization and insurance information to the health care provider;
• provide health information to the child's family and the foster family;
• act as a resource and liaison to those involved in addressing the health care needs of children in placement;
• assist in obtaining the signed Medical Authorization form from the parent(s) or guardian;
• gather and provide available health information to all involved;
• coordinate services for immediate and comprehensive health care;
• coordinate and conduct the health care planning meeting;
• distribute the written plan to all individuals involved;
• follow-up on all recommendations in the health care plan.

This health care plan becomes part of the
Case Plan on each child.

What is the Role of the Parent?
Each parent of the child is expected to:

• be an active participant in decisions regarding the child's health care needs;
• provide child and family health information to DCYF;
• sign the Medical Authorization and a Release of Information;
• receive a description of services and explanation of comprehensive medical care;
• participate in the child's health care by going to healthcare appointments, discussing treatment options, and learning about medications, therapy and special care needs of the child.

What is the Role of the Foster Parent?
Each Foster Parent must:

• receive training on available program services and related health topics;
• make the necessary medical care appointments with the help of the Nurse;
• receive necessary information for meeting the health care needs of the child in their care;
• attend health care visits and meetings;
• provide valuable health information on the child while in placement,
• provide updates on medical visits and immunizations to the Nurse Coordinator.

What Happens After the Comprehensive Health Assessment?
A health care planning meeting is coordinated and conducted by the Nurse about three to four weeks after the exam is completed. The purpose of this meeting is to review the assessment,

including:

• the physical and mental health status;
• make recommendations for ongoing care;
• set-up diagnostic testing and treatment as indicated;
• identify those responsible for carrying out the plan; and to do a written plan.

Those attending should include parents, foster parents, health care providers, Child Protection Service Worker (CPSW) or Juvenile Probation and Parole Officer new name, the Nurse, and others involved in the care of the child. The Nurse assists with any necessary follow-up, distributes a copy of the health care plan to everyone involved, and reviews the plan every three months for progress and identification of additional medical needs.