The health and mental health problems of the children in out-of-home care present many challenges to child welfare agencies and demand closer collaborative relationships among a variety of professional groups. Despite generally well-accepted guidelines for action and strong evidence suggesting that appropriate care may result in significant benefit to the children, many questions remain as to the most effective and efficient methods of providing these services at the individual, system, and policy levels. At the present time, a small number of programs are attempting to implement various parts of the CWLA and AAP recommendations for health and mental health services for children in out-of-home care. It is not certain, however, how efforts to reform the health care system may affect the delivery of services to this population. Research efforts should concentrate on collecting and evaluating data from existing programs at all three levels (individual, system, policy) to aid in refining and directing future policy and practice in the field of child welfare.
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