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April 22nd

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Special Health Needs of Children in the Child Welfare System


By Phyllis Christensen, RN

As a registered nurse for Upbring, I serve children with special health needs at our many Foster In Texas offices across the state.  Along with my colleague Mary Appl, LVN, we make it a priority to provide the very best care possible to what we call our Primary Medical Needs (PMN) children. These are children with serious medical needs who are often harder to find homes for due to the demands of caring for them. Many have terminal illnesses.

At Upbring, we support our excellent foster families in caring for children with special health needs by:

  • Visiting PMN families at least quarterly to conduct assessments, answer questions and ease concerns.
  • Helping parents navigate Medicaid, provide training on medication administration and regularly attend doctor appointments.
  • Providing extra supports for children with special health needs.
  • Providing training and support for foster parents whose children exhibit behavioral health needs.

Due to the importance of this issue, I am pleased to announce the release of our third white paper in a series: “Special health needs of children investigated for maltreatment: An analysis from the second National Survey of Child and Adolescent Well-being” by Orsi, Timpe and Kistin.

Read Complete Paper.

This paper analyzes the results of a national survey of children in the child welfare system to determine if certain physical or behavioral health needs are more prevalent among children than others, and if these health needs are statistically correlated with children being put in out-of-home placements.

The authors find that behavioral needs like ADHD are common, and are also predictive of out-of-home placement. Other behavioral needs include emotional developmental delay, mental retardation or development delay, and emotion problems such as depression or anxiety.

Implications for child welfare agencies include re-examining the decision making processes that lead to out-of-home placement for these children; ensuring the availability of behavioral health services for system-involved children; and providing supports for foster parents whose children exhibit behavioral needs.  Upbring takes these recommendations seriously by providing extra supports to our families caring for children with special health needs, such as training and on-staff nursing expertise.

Upbring is always in need of excellent, qualified foster parents, particularly for PMN children. For those who might consider this commitment, but worry about the challenges of caring for children with special medical needs, we will be there for you! To learn more about becoming a foster parent, visit

Read Complete Paper here.

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