May 16, 2005 

WORCESTER, Mass. − A new study from the University of Massachusetts Medical School’s (UMMS) Department of Pediatrics puts numbers to a foster care problem long suspected but hitherto undocumented: Investigators found that 82% of children studied went into foster care needing prescription medication for a chronic illness, but did not have access to the required medication. 

Data compiled for 75 children indicate that 86% of children surveyed did not have fluoride; 79% did not have asthma medications; and 90% did not have eczema medications, even though they were prescribed. Implications of these findings include foster children’s health risks when they do not have access to their medications; foster parents’ frustration with the lack of information and resources available to help them properly care for children in their care; and risks to placement stability as sick children are harder to place, and harder to keep in placement. 

With over 8000 children in foster homes in Massachusetts alone, the study’s finding underscores the challenges of meeting the health care needs of these already vulnerable and at-risk children. "The numbers we came up with, albeit from a small sample, were dramatic," noted study author Heather Forkey, MD, a pediatrician at UMMS clinical partner, UMass Memorial Medical Center. "These children were only one to five years old; we would be concerned that older children, who are more likely to have medical conditions requiring chronic medication, might have significant rates as well." 

"It has been well documented that children in foster care often come into care with little or no medical information and, once in foster care, may suffer from poor coordination of health care," Forkey added. "In particular, foster children may not receive needed medications even after placement in a new foster home because medication history is often difficult for foster parents and primary care physicians to obtain." 

Forkey and co-investigator Linda Sagor, MD, MPH, associate professor of pediatrics at UMMS and director of pediatric primary care at UMass Memorial Medical Center, were able to obtain data from a unique program they run, the UMass Foster Children Evaluation Services Clinic (FaCES). FaCES is a pilot program developed by UMass Memorial’s Division of General Pediatrics in collaboration with the Massachusetts Department of Social Services. Its goal is to provide medical screening within seven days, and comprehensive health evaluations within 30 days, of placement for all children age five and under entering foster care in Worcester, MA. "Through this program, we have the resources to obtain and review these children’s medical records – a necessary prerequisite to comprehensive care, but one usually unavailable to foster parents and pediatricians," explained Forkey. 

Further, all information, including previous medical information and immunization records, is kept at the FaCES clinic, and a copy is sent to the child’s primary care hysician, who will monitor the child’s health while in foster care. If a child is moved to another home, the clinic will provide ongoing access to the medical history and will help obtain the record of health care services; this model thus offers one potential solution to the chronic medications in foster care problem. 

While further study with larger groups and older children are needed, Forkey et. al. conclude that, "Systematic medical record review is necessary to insure that foster children receive chronic medications while in foster care." 

The study abstract, "Information Gaps Cause Discontinuity of Chronic Medications for Children in Foster Care," will be presented by Dr. Forkey at the  Pediatric Academic Societies (PAS) 2005 Annual Meeting to be held in Washington, DC, from May 14-17. The study is one of just forty out of 2000 abstracts selected by the meeting’s peer reviewers for widespread announcement due to the potential impact of their findings. The Pediatric Academic Societies comprise the American Pediatric Society, Society for Pediatric Research and the Ambulatory Pediatric Association as well as a score of specialty affiliates. This year the American Academy of Pediatrics is participating in the PAS meeting, which will bring together 7000 participants representing pediatric academic institutions worldwide. 

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One of the fastest growing medical schools in the country, the University of Massachusetts Medical School attracts more than $167 million in research funding annually, and is ranked third in the current US News & World Report ranking of primary care medical schools. UMMS is the academic partner of UMass Memorial Health Care, the largest health care system in Central Massachusetts. For more information go to and . 


Contact: Sandra Gray, 508-856-2000