Children entering foster care can have unique and urgent health needs. To help ensure their safety and well-being, the American Academy of Pediatrics (AAP), along with the Child Welfare League of America (CWLA), recommends an accelerated health screening schedule. This means children should be seen early, often and thoroughly after placement into foster care.
Why early health screening matters
Whenever possible, a child’s medical records should be reviewed at the first visit. However, in many cases, children enter foster care without complete health records. It’s important to know that care should never be delayed while waiting for this information.
When records aren't available, often some of the child's health history can be pieced together from other sources, including:
- State immunization registries, which may be helpful to identify prior locations where a child received care.
- Electronic medical records through provider portals of larger healthcare systems or healthcare billing databases may also be useful.
- The child's social worker may have information from the family of origin or the child's school or child care provider.
- The child themselves may be able to share information, depending on language ability.
These early visits help identify urgent medical needs, developmental concerns and emotional health issues so children can begin receiving the care and support they need right away.
Recommended foster care health screening schedule
Within 24 to 72 hours of placement: acute health visit
Children should be seen by a health care provider within 24 to 72 hours of entering foster care.
This visit focuses on immediate needs, such as:
Within 30 days of placement: comprehensive health evaluation
Following the initial screening visit, all children should be scheduled to return for a
comprehensive evaluation within 30 days of entering foster care. This visit gives the health care team time to review any medical records that become available and take a closer look at the child’s overall health.
Before the visit, caseworkers and medical offices work together to make sure any needed permissions are in place. Consent rules can vary by state, so it’s important to sort this out ahead of time. This is especially important if the visit may include vaccines or new medications, which often require signed forms.
During the comprehensive visit, the health care provider looks at the child’s overall well-being. This includes how the child is adjusting to their new home and checking several areas of health, such as:
Preventive screenings may be done during this visit, and caregivers will receive guidance on age-appropriate health and safety. If needed, the provider may also refer the child for additional services or specialized care.
Information from this visit is shared with the child welfare agency, juvenile court judge, parents (birth and foster) and kin and the child, as appropriate. If evaluation is not done in the child's
medical home, all relevant data should be communicated with the primary care pediatrician. They can then follow the child while in foster care.
Within 60 to 90 days of placement: follow-up health assessment
Some concerns may not be identified during the initial or comprehensive foster care placement assessment, and children may also experience changes in their placement. For these reasons, a follow-up health assessment is recommended within 60 to 90 days.
At this visit, the health care providers can:
Confirm whether referrals from earlier visits have been completed
Identify delays in care, including those related to consent or access
Screen for new medical, developmental or behavioral concerns.
This visit helps ensure the child’s care plan is on track and adjusted as needed.
Ongoing: routine health maintenance visits
After the evaluation period, the child should have health maintenance visits according to the
AAP recommendations for preventive health care.
Because children in foster care are more likely to have complex medical, social and mental health needs, additional visits may be needed. More frequent check-ins can help providers monitor progress, address concerns early and support long-term health.
Remember
Early and regular health screenings help identify medical, developmental and emotional needs in children entering foster care. Even when medical records are incomplete, prompt evaluation and follow-up care can make a difference in a child’s health and well-being.
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