title: Mandates for Collaboration: Health Care and Child Welfare Policy and Practice Reforms Create the Platform for Improved Health for Children in Foster Care.
abstract: Improving the health of children in foster care requires close collaboration between pediatrics and the child welfare system. Propelled by recent health care and child welfare policy reforms, there is a strong foundation for more accountable, collaborative models of care. Over the last 2 decades health care reforms have driven greater accountability in outcomes, access to care, and integrated services for children in foster care. Concurrently, changes in child welfare legislation have expanded the responsibility of child welfare agencies in ensuring child health. Bolstered by federal legislation, numerous jurisdictions are developing innovative cross-system workforce and payment strategies to improve health care delivery and health care outcomes for children in foster care, including: (1) hiring child welfare medical directors, (2) embedding nurses in child welfare agencies, (3) establishing specialized health care clinics, and (4) developing tailored child welfare managed care organizations. As pediatricians engage in cross-system efforts, they should keep in mind the following common elements to enhance their impact: embed staff with health expertise within child welfare settings, identify long-term sustainable funding mechanisms, and implement models for effective information sharing. Now is an opportune time for pediatricians to help strengthen health care provision for children involved with child welfare.
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address: ZLOTNIKS@email.chop.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Zlotnik
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Leigh
authors.initials: L
authors.lastname: Wilson
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Safe Place: Center for Child Protection and Health, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Philip
authors.initials: P
authors.lastname: Scribano
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA; Safe Place: Center for Child Protection and Health, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Wood
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Noonan
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000534:rehabilitation*; D002662:Child Health Services / Q000458:organization & administration*; D002669:Child Welfare; D002675:Child, Preschool; D003299:Cooperative Behavior; D005260:Female; D005581:Foster Home Care / Q000458:organization & administration; D006291:Health Policy; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology / Q000534:rehabilitation*; D014481:United States / Q000453:epidemiology