Alice Cahill draws a mural of points discussed at the symposium “Children at Risk: Optimizing Health in an Era of Reform.” The meeting was held in November at the NASW national office in Washington, D.C.

NASW’s Social Work Policy Institute, in collaboration with PolicyLab of Children’s Hospital of Philadelphia and contributing partner the University of Southern California School of Social Work, held an interdisciplinary symposium in November to discuss ways to better meet the health care needs of children served by the child welfare system and those at risk of involvement in the system.

The think-tank symposium, called “Children at Risk: Optimizing Health in an Era of Reform,” was held at the NASW offices in Washington, D.C., and focused on improving and streamlining the health care children receive, looking at both policy and service delivery structures and cross-system communications. Research findings regarding the health care characteristics of children in the system — especially drawn from the National Study of Child and Adolescent Well-Being — identified an array of behavioral, developmental and medical issues faced in greater numbers than the general population, including that asthma is the most common ailment for children within the child welfare system. Findings were provided by Janet Schneiderman, academic chairwoman of the symposium and a researcher at USC.

Discussions addressed the health care reform changes set to take place in 2014, and which changes in Medicaid and Children’s Health Insurance benefits will give children and their parents more health care coverage.

“This conversation can serve to spark better ways for us to work together,” said social worker and PolicyLab Senior Strategist for Communications and Partnerships Sarah Zlotnik, who discussed the high behavioral health needs of children. “Collaborative relationships are key.”

“Children in foster care are a special-needs population,” said Kamala Allen, director of child health quality at the Center for Health Care Strategies.

“We can start working on the things that we have more control over,” said David Berns, director of the Department of Human Services in Washington, D.C., who spoke about gaining a sense of control and expressed optimism regarding the resources that are available.

“We can move forward in a positive direction.”

Additional speakers were from the National Quality Forum, the Georgetown University Center for Children and Families, the Center for Health Care Strategies, the Substance Abuse and Mental Health Services Administration, the Making all the Children Healthy Program of Baltimore and Morehead State University in Kentucky. Other participants represented health and child welfare programs at the state and local levels; national advocacy and provider organizations; and federal agencies, including the Department of Defense, the National Institutes of Health, the Agency for Healthcare Research and Quality, the Health Resources and Services Administration and the Children’s Bureau.

A summary of recommendations for symposium participants includes:

• Improving communication between agencies, providers and managed care organizations;
• Ensuring that the voice of families, communities and foster care alumni are represented in decisions;
• Asking children and families what outcomes are important to them;
• Creating a more coordinated focus on children’s health at the highest levels;
• Clarifying and expediting authority to consent for health, early intervention and indicated services for those is foster care and at home;
• Promoting cross-disciplinary collaborations within universities to examine how to improve health outcomes and enhance interprofessional education;
• Creating communication and data collection systems to achieve enhanced outcomes and accountability.