Texas Health Steps

Foster or Kinship Care and Texas Health Steps

Any pediatric clinician in any part of the state may be called on to examine and/or treat a child or adolescent in foster or kinship care, which is also known as state conservatorship and is managed by the Texas Department of Family and Protective Services (DFPS).

During fiscal year 2020, 16,500 children ages birth through 17 years entered DFPS conservatorship, and a total of 48,000 were in conservatorship at some time during the year.

These children live in every part of Texas in group homes or other community facilities, with members of their extended family (known as kinship care), or with foster care parents.

Children in DFPS conservatorship are more likely to have had Adverse Childhood Experiences (ACEs) that are associated with medical, emotional and developmental problems. Of children in DFPS conservatorship, the AAP estimates:

Children in DFPS conservatorship receive comprehensive health services—including Texas Health Steps preventive medical checkups and a dental exam—through STAR Health, which is provided by Superior Health Plan. More information about STAR Health is available in the Resources at the end of this course.

Matter of Fact

Texas Health Steps providers must join the STAR Health Network to provide services to youth in DFPS conservatorship. Learn about enrolling in STAR Health in the Resources at the end of this course.

News You Can Use

“A foster-care friendly office is a trauma-informed office.” (AAP, 2015)

Because of their special health needs and history of ACEs, the AAP recommends children in foster or kinship care receive health care in a “trauma-informed” pediatric medical home that collaborates with caseworkers and foster caregivers and provides comprehensive and frequent monitoring (AAP, 2015). A link to the AAP policy statement on caring for children in foster care can be found in the Resources at the end of this course. Links to other resources about trauma-informed care are also provided.

Keep in Mind

Before entering DFPS conservatorship, many children have had multiple caregivers, limiting their ability to form a stable attachment to a nurturing caregiver. Removal from home is emotionally traumatizing for almost all children (AAP, 2015).