Designing Policy to Serve Children With Special Medical Needs in Child Welfare: Lessons From New York City

Abstract

Despite the heightened vulnerability of children with special medical needs (CSMN), few child welfare systems have explicit policies, training, or case management procedures designed to ensure their identification and monitor their safety. This study highlights an innovative approach in New York City that aims to enhance staff's ability to work more effectively with CSMN families. The results of these efforts are compelling, and include targeted training of child protective staff, the development of a comprehensive policy for working with CSMN families, and practice changes designed to ensure staff access to medical expertise. Drawing on interviews and focus groups with staff and experts in the field of CSMN, the study describes the challenges that all child welfare agencies face in their efforts to serve CSMN, and provides recommendations for how agencies can design viable policies to address those challenges.