Youth in foster care across the globe show disproportionate rates of child maltreatment, developmental delays, mental health challenges, and chronic health conditions, which are all compounded by factors like placement instability and ongoing traumatic incidents. These youth in the United States (US) face significant hurdles in accessing high-quality, integrated care and achieving optimal mental and physical health outcomes. Despite international and national guidelines and recommendations, there remains considerable variety in state healthcare and child welfare policy influencing outcomes for this vulnerable population, who require tailored, coordinated, and trauma-informed care. Public insurance programs and specific foster care initiatives in the United States intend to facilitate enhanced care coordination, yet fall short of delivering optimal care and meeting benchmarks. A community assessment in one county showcased multiple stakeholder perspectives and areas for improvement, highlighting the need for a thorough investigation of the relevant policies and systems that impact care. This policy analysis follows Bardach and Patashnik’s framework. It provides background on US federal and state policy impacting healthcare for foster youth, considers alternative healthcare policies and care delivery models, weighs potential outcomes, and offers recommendations for policy change. The ultimate policy recommendation is a hybrid of multiple frameworks, drawing on the strengths of several care delivery models. Designated Preferred or Enhanced Integrated Medical Homes that provide entry to care assessments, ongoing primary care and consultant services, screening, mental health care, referrals, and care coordination will best serve foster youth in Michigan. • Foster youth are a vulnerable population with disproportionately poor health • Foster youth require tailored, coordinated, and trauma-informed care • Despite guidelines, healthcare and child welfare policy show considerable variation • This policy analysis weighs changes to improve measures of health and well-being • The analysis pointed to a composite policy supporting enhanced integrated care
Bemben et al. (Fri,) studied this question.