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FOSTER CARE: Biological Parents and Reunification

At some centers the biological parent is encouraged to attend health care appointments. This may be reassuring to the child and give you an opportunity to obtain a necessary history as well as share on-going medical concerns. The biological parent should not attend medical visits if parental rights have been terminated or if the parent's presence is disruptive or too anxiety provoking to the child.

You have an important role in the child's reunification with either a biological parent or other family member, for example a grandparent or relative who is appointed as the child's guardian. A complete physical examination needs be performed at the time of discharge from foster care. This is usually done just prior to discharge or within one week of the return home. The parent/family member/guardian to whom the child is being discharged should be present at this appointment in addition to the caseworker, and in some cases, the foster parent. This appointment is an opportunity to update the parent/guardian on medical issues, medications, use of inhalers or other equipment, and future medical requirements. It is also the time to address any concerns the parent/guardian may have about the child's care. Give the parent/guardian the dates of pending appointments in writing, with a copy to the caseworker. Urge the parent/guardian to keep the appointments, or to reschedule them if necessary. The county caseworker can be a valuable resource by assisting communication of medical information to the child's new guardian.

Transferring medical information is crucial. Ask the parent or new guardian to provide the name of the physician or clinic to which the child will be taken for future pediatric care. In addition, the parent/guardian needs to sign a record release so that the new medical provider can receive the medical records generated during foster care placement. In some circumstances you or the caseworker may request a specific physician or center for future medical care. This can be arranged with the court prior to discharge and stated by the judge as an expectation of the parent/guardian. If the child was in the care of a specific medical provider prior to entering foster care, returning to that provider can enable continuity of care. In addition, you can send the next provider a written summary of the medical care the child received while in foster care, including upcoming appointments.

At times there is disagreement by the medical team regarding a child's return to a parent or family member. These concerns should be discussed with the caseworker or that person's supervisor as soon as discharge planning starts. The discharge plan can include safeguards if there are specific concerns. The court order can include ongoing oversight by the foster care caseworker as well as involvement by other agencies. It is helpful for the discharging medical provider and new medical provider to know the name and telephone of the caseworker in the event there is poor compliance for follow-up, even if there is no court order.

Reunification Checklist
  • Perform a complete exam near the time of discharge from foster care
  • Determine if the child will be transferring medical care
  • Send the new physician the medical records and a patient summary
  • Write out the dates of pending appointments for the parent/guardian

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Foster Care: Overview  Foster Care: Foster Care System  Foster Care: Health Concerns of Children in Foster Care  Foster Care: Foster Parents  Foster Care: The Caseworker  Foster Care: Biological Parents and Reunification  Foster Care: Additional Resources 

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