Health and Wellness of Foster Children in West Virginia

BACKGROUND: Due to abusive or neglectful experiences that result in removal from their natural home, foster children are at increased risk for special health care needs. Consequently, these children are placed in the custody of the WV Department of Health and Human Resources and receive Medicaid. To improve the health of foster children, a partnership with the Early Periodic Screening Diagnosis and Treatment (EPSDT) Program exists to ensure foster children are routinely screened for special health care needs, including social and emotional needs, after placement in foster care.

METHODS: The EPSDT program uses age-specific screening forms based on Bright Futures’ guidelines. The Fostering Healthy Kids (FHK) project ensures all foster children in the state are scheduled for a comprehensive well visit after placement, receive preventive medicine according to the periodicity schedule established by the American Academy of Pediatrics and have a primary care physician (PCP). The FHK Project collects data on height and weight, tobacco use, exposure to secondhand smoke and drug use from the EPSDT form. Foster children in three counties are referred to the Children with Special Health Care Needs (CSHCN) Program for care coordination services.

RESULTS: Of the 4,232 foster children in WV at the time of this study, 97% were assigned a PCP. Of foster children ages 2 - 19, 56% were at a healthy weight and 44% were at an unhealthy weight (BMI less than 5^th percentile or greater than 85^th percentile). Of all foster children with EPSDT data, 15% reported cigarette use, 2% reported chewing tobacco use, 11% reported drug use and 5% were exposed to secondhand smoke. There were 207 children placed in foster care in September 2013. After two months, 89% were scheduled for an initial well visit and 73% kept their initial well visit appointment. To date, 243 children have been referred to the CSHCN Program and 32 received services.

CONCLUSIONS: The FHK Project is supporting the medical home by linking most foster children with a PCP and scheduling them for comprehensive preventive medicine. However, the timeliness of these initiatives can be improved, and the agencies involved are currently cooperating to remedy this. Overweight and obesity is more prevalent among females than males. Tobacco and drug use among foster children increases with age and is most prevalent among high school aged adolescents and males. The FHK Project has plans for interventions to combat obesity and tobacco use within this population.