The caregiver as gatekeeper for accessing health care for children in foster care: A qualitative study of kinship and unrelated caregivers
The objective of this qualitative study was to examine issues that unrelated and kinship foster caregivers in Los Angeles, CA, have in seeking help and accessing and using health care for children in foster care. There were four themes identified for all caregivers: (1) “Doing Our Best” (caregivers advocated persistently and creatively for health care); (2) “Support from Others Helped” (caregivers relied on caseworkers, organizations, and their social network); (3) “Child has Complicated, Serious, Chronic Health Problems” (caregivers had difficulty securing specialty services and with Medicaid insurance to meet health care needs); and (4) “Caregiver Competence in Meeting Health Needs” (caregivers noted their ability to attend health appointments and understand instructions). An additional theme of “Differences between Unrelated and Kinship Foster Caregivers” highlighted more difficulties among kinship caregivers in finding and using primary health care services and more financial stress, whereas unrelated caregivers were less satisfied with child welfare caseworker help. Despite wide-ranging stressors and serious frustrations with the child welfare and health care systems, caregivers emerged as powerful drivers of health care for foster children. National adoption of a medical home model would ameliorate some of the access barriers identified by foster caregivers in this study.
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- Villagrana, Margarita, 2010. "Mental health services for children and youth in the child welfare system: A focus on caregivers as gatekeepers," Children and Youth Services Review, Elsevier, vol. 32(5), pages 691-697, May.
- Baker, Amy J.L., 2007. "Client feedback in child welfare programs: Current trends and future directions," Children and Youth Services Review, Elsevier, vol. 29(9), pages 1189-1200, September.
- Schneiderman, Janet U. & McDaniel, Dawn & Xie, Bin & Arnold Clark, Janet S., 2010. "Child welfare caregivers: An evaluation of access to pediatric health care," Children and Youth Services Review, Elsevier, vol. 32(5), pages 698-703, May.
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