Comprehensive assessments for children entering foster care: a national perspective.
OBJECTIVE
To 1) investigate the status of policies for comprehensive health assessments of children entering out-of-home care, 2) develop a profile for each primary sampling unit (PSU) regarding the comprehensiveness of its assessment policies with respect to physical, mental, and developmental health, and 3) examine the relationship between inclusiveness and the estimated percentage of children assessed, primary assessment location, and principal assessment provider type.


METHODS
In collaboration with the National Survey of Child and Adolescent Well-Being, a national probability sample of 92 PSUs was identified. Detailed telephone survey data, addressing policies for the assessment of physical, mental, and developmental needs of children on entry into out-of-home care, were collected from child welfare key informants. Descriptive statistics were used for analyses, and were weighted to account for the sampling strategy.


RESULTS
Over 94% of PSUs surveyed assessed all children for physical health problems. The percentage of PSUs with inclusive policies regarding mental health and developmental assessment was much lower (47.8% and 57.8%, respectively). Only 42.6% of PSUs provided comprehensive physical, mental health, and developmental examinations inclusive of all children entering out-of-home care. Community locations and primary care providers were most often used to conduct assessments for physical and developmental problems.


CONCLUSIONS
Despite the publication of national guidelines regarding assessment, many PSUs do not have comprehensive policies or routine practices that address all children entering out-of-home care. Given the high use of primary care providers, these providers must be educated regarding the prevalence and types of problems experienced by children entering foster care.
Leslie
Laurel K
LK
University of California San Diego, San Diego, California, USA. lleslie@casrc.org
Hurlburt
Michael S
MS
Landsverk
John
J
Rolls
Jennifer A
JA
Wood
Patricia A
PA
Kelleher
Kelly J
KJ
D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002669:Child Welfare; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology; D005581:Foster Home Care / Q000592:standards*; D006130:Growth Disorders / Q000175:diagnosis / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006291:Health Policy; D006306:Health Surveys; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D020380:Needs Assessment / Q000592:standards*; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012494:Sampling Studies; D014481:United States / Q000453:epidemiology