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58 Ct. Rev. 16 (2022)
The Role of Information Sharing to Improve Case Management in Child Welfare

handle is hein.journals/ctrev58 and id is 16 raw text is: The Role of Information Sharing to Improve Case Management in Child Welfare Sarah J. Beal, Paul DeMott, Rich Bowlen & Mary V. Greiner Congress enacted the Adoption and Safe Families Act to improve outcomes concerning the permanency, safety, and wellbeing of children in the care of child welfare agencies. However, achieving its goals for the more than 700,000 children who spend time in the custody of child protective services (CPS) every year in the United States is made more difficult by their poorer health compared to the general population.i Common health concerns among children in CPS custody include develop- mental delay (e.g., intellectual delay or disability, gross or fine motor delay, speech delay), infections diseases, mental and behav- ioral health concerns, and medical concerns. Higher levels of healthcare compared to other children who live in poverty are often required.2 While health concerns may have been identified before children entered CPS custody, connections to healthcare providers and services are disrupted when children are removed from their families of origin and placed in out-of-home care. Efforts to collect a child's complete medical history upon entering care may be difficult, and incomplete histories negatively impact health and disease management. Moreover, disruptions in health- care can continue even after children enter CPS custody and out- of-home care-for example, when children change placements or caseworkers-leading to additional challenges managing chil- dren's health needs and increasing healthcare use.3 The Adoption and Safe Families Act has been instrumental in ensuring that children in CPS custody have adequate access to healthcare services, monitored through child and family service reviews.4 While this has been beneficial, it has not addressed challenges around disruptions in healthcare access and the shar- ing of healthcare information with entry into CPS custody or with placement changes while children are in out-of-home care. Better sharing of health information and coordination of health- care services to address health concerns is essential to close these gaps. This coordination must, at a minimum, span the duration of a child's time in CPS custody. Cincinnati's Children's Hospital Medical Center and Hamilton County Job and Family Services have worked together to improve health outcomes for children in CPS custody by devel- oping an automated software platform to exchange healthcare and child welfare information between these organizations. In this article, we will discuss why the exchange of information is important, when information exchange can be difficult due to legal and institutional barriers, and how we have overcome these barriers with an automated software platform called IDEN- TITY.5 Finally, we will discuss the benefits of sharing informa- tion through this software platform and areas for future develop- ment. HEALTHCARE ACCESS AND UTILIZATION WHILE CHILDREN ARE IN OUT-OF-HOME CARE Children in CPS custody and out-of-home care (e.g., foster care, kinship care) can have their already elevated health risks compounded when they enter out-of-home care due to disrup- tion of healthcare services and discontinuity with every place- ment change. This lack of coordination and consistent healthcare means preventive care is missed and chronic disease manage- ment is poor due to limited availability of records and lack of fol- low-up with a consistent healthcare provider. Instead of preven- tative care, foster and kinship caregivers rely on urgent and emer- ACKNOWLEDGMENTS: Funding was secured from the Academic Research Committee (ARC) at Cincinnati Children's Hospital Medicine Center, and through the National Center for Advancing Translational Sciences of the National Institutes of Health, under Award Number 1UL1TR001425-01. Dr. Beat's time was supported through NIH 1K01DA041620. Any opinions, findings, and conclusions or recom- mendations expressed in this publication are those of the authors. They do not necessarily reflect the views of the institutions that provided funding to support this work. Footnotes 1. See U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau, The AFCARS Report: Preliminary FY2019 estimates as of June 23, 2020, https://wwwacf.hhs.gov/sites/default/ files/documents/cb/afcarsreport27.pdf; Laura Gypen et al., Out- comes of Children Who Grew Up in Foster Care: Systematic-review, 76 CHILD. & YOUTH SERVS. REV 74, 74-83 (2017). 2. Amy D. Engler et al., A Systematic Review of Mental Health Disorders of Children in Foster Care, 23 TRAUMA, VIOLENCE, & ABUSE 255, 255- 264 (2020); Rebecca R. Seltzer et al., Medical Complexity and Place- ment Outcomes for Children in Foster Care, 83 CHILD. & YOUTH SERVS. REV 285, 285-293 (2017). 3. Mary V Greiner & Sarah J. Beal, Developing a Healthcare System for Children in Foster Care, 19 HEALTH PROMOTION PRAC. 621, 621-628 (2018); Sarah J. Beal et al., Effects of Child Protective Custody Status and Health Risk Behaviors on Healthcare Use among Adolescents, ACAD. PEDIATRICS (2021). 4. Adoption and Safe Families Act of 1997, Pub. Law No. 105-89, 111 Stat. 2115; Zlotnik et al., Improving Child Well-Being: Strengthening Collaborations between the Child Welfare and Healthcare Systems, CHILD.'s HOSPITAL PHILA.'S POI'Y LAB & SAFE PLACE (2014). 5. Mary V Greiner et al., Improving Information Sharing for Youth in Fos- ter Care, 144 PEDIATRICS at 1 (2019), https://publications.aap.org/ pediatrics/article/144/2/e20190580/38518/Improving-Information- Sharing-for-Youth-in-Foster. 16 Court Review - Volume 58