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Foster Care Policy, Advocacy and Research
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  • Foster Care Policy, Advocacy and Research

Foster Care Policy, Advocacy and Research

We're on a mission to promote the health and well-being of children and families involved in the child welfare system.

Children in foster care face persistent health care barriers and disparities that can create lifelong harm. The Rees-Jones Center for Foster Care Excellence has served thousands of children in the Texas child welfare system. We believe that these barriers and disparities can be overcome by adopting systemic reforms. To accomplish our goals, we partner with organizations across North Texas to:

  • Identify structural issues and deficiencies in the child welfare system
  • Develop and propose solutions
  • Advocate for ways to reform and improve the child welfare system

We believe that the right reforms, implemented in the right way, can significantly improve the lives of the state’s most vulnerable children and make Texas foster care a model for the nation.

  • Policy priorities related to children in the child welfare system

    • Increase access to trauma-informed, high-quality medical and behavioral health services for children with experience in the child welfare system.
    • Ensure services and supports provided to children with child welfare experience are trauma-informed.
    • Increase support for kinship caregivers.
    • Strengthen supports for youth aging out of care.
  • Partnerships

    • Child Protection Roundtable 
    • First Three Years-Safe Babies 
    • Prenatal to Three (PN-3) Collaborative 
    • Region 3 Foster Care Consortium 
    • Children’s Commission Collaborative Council
    • Texas Pediatric Society Foster Care Committee 
    • Texas Statewide Collaborative on Trauma-Informed Care
  • Policy briefs and white papers

    • Addressing the Health of Children in Foster Care
    • Caring for Children with Intrauterine Drug Exposure
    • Trauma Treatment for Children in the Child Welfare System 
    • Addressing the Health and Safety of Children in Foster Care
    • Transitioning from Foster Care to Adulthood
  • Publications

    Development of an Integrated Medical and Behavioral Health Care Model for Children in Foster Care: The Rees-Jones Center for Foster Care Excellence

    This book chapter discusses the evolution of the Rees-Jones Center for Foster Care Excellence; initiatives for quality improvement, research, and advocacy; and future goals for evaluation, education, policy, and collaboration to improve the lives of children in foster care.

    Healthcare utilization among children with a history of neonatal opioid withdrawal syndrome: A matched cohort study

    This study is a retrospective matched cohort study that uses billing data extracted from between 2003 and 2016 from North Texas hospitals to compare longitudinal healthcare utilization patterns in children with and without a history of neonatal opioid withdrawal syndrome (NOWS).

    Description of Audiologic, Developmental, Ophthalmologic, and Neurologic Diagnoses at a Primary Care Clinic for Children in Foster Care

    This study aimed to describe the prevalence of medically diagnosed audiologic, developmental, ophthalmologic, and neurologic conditions in a foster care primary care clinic and to identify any associations among these diagnoses and patient characteristics, placement type, and maltreatment type.

    Trauma-Informed Care Training for Medical Students

    Trauma-informed care (TIC) is an approach that is designed to address the needs of individuals who have experienced trauma; however, TIC training is not consistently integrated into the curriculum of medical and allied health students. This article reports the results of an evaluation of a brief, online TIC training adapted for medical and allied health care students.

    Pediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured

    This study seeks to better understand (1) what pediatric subpopulations are receiving integrated care, (2) which models of PIC are being studied, (3) what PIC outcomes are being explored and what measures and strategies are being used to assess those outcomes, and (4) whether the various models are resulting in positive outcomes. These questions have significant policy and clinical implications, given current national- and state-level efforts aimed at promoting integrated health care.

    Research Participation of Minor Adolescents in Foster Care

    This study evaluates published studies about foster care to: (1) determine the types of data used; (2) describe the degree to which a sexual/reproductive health topic was addressed; and (3) describe the consent process.

    Caring for Children in Child Welfare Systems: A Trauma-Informed Model of Integrated Primary Care

    This article describes a model of trauma-informed, primary care serving children involved with child welfare, including information about its development, structure and organization, and programs. It concludes with a discussion of lessons learned and remaining challenges.

    Healthcare Utilization Patterns Among Children With a History of Child Protective Services Investigations

    This article examines whether children with a prior child protective services (CPS) investigation had different healthcare utilization compared to children without a history of CPS investigations.

    Developmental Status of Young Children in Foster Care

    This study sought to determine (1) the percentage of children in foster care with developmental problems seen at an integrated primary care clinic and (2) whether the presence of various risk factors was associated with increased odds of developmental problems in general and across developmental domains.

    Laboratory screening practices and results in a dedicated primary care clinic for children in foster care

    This study addressed the lack of available data on routine laboratory screening in children in foster care to assess the rate at which a dedicated foster care clinic is completing recommended lab tests and to compare existing guidelines to current trends in this population. (Infectious disease screening in a dedicated primary care clinic for children in foster care)

    Prevalence and risk factors for developmental concerns in children involved in the child welfare system

    This study addressed the following questions: (1) What are the rates of developmental delay in children in foster care aged 0-5 years? (2) Are rates of delay in foster children different for motor, cognitive, communication and personal-social skills? (3) Are certain risk factors experienced by children in the foster care system more strongly associated with developmental delay? (Developmental status of young children in foster care)

    Integrated care for substance-exposed infants:  an innovative approach for providing care to children in the child welfare system

    This study explored the rates of prenatal drug exposure in infants and young children in foster care seen at primary care clinics in North Texas. It describes barriers to care for this vulnerable population and offers an innovative approach to meeting their unique needs. (Trauma-informed, integrated primary care: A medical home model for children with prenatal drug exposure who enter foster care)

    Caring for children in foster and kinship care during a pandemic

    Through qualitative feedback from professionals in health care, mental health and child welfare, this study explored the impact of the COVID-19 pandemic on the health and well-being of children involved with the child welfare system. (Caring for children in foster and kinship care during a pandemic: lessons learned and recommendations)

    Foster parent perceptions of feeding infants prenatally exposed to substance use

    Research has shown that infants who are substance-exposed display feeding challenges, and foster parents struggle to meet the infant’s needs. This study examined foster parent perceptions of competence in feeding substance-exposed infants before and following an educational training.(Foster parent perceptions of feeding infants prenatally exposed to substance use)

    Healthcare Utilization among children with a history of neonatal opioid withdrawal syndrome

    This study compares longitudinal healthcare utilization patterns in children with and without a history of neonatal opioid withdrawal syndrome (NOWS). Specifically, the study examines the number of hospitalizations, outpatient and emergency department visits, average length of stay, and healthcare expenditures across patients with and without NOWS.

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