As the COVID-19 pandemic continues, foster and adoptive youth are at risk for a variety of issues. PCPs and caregivers continue to be responsible for adhering to the escalated well-child exam schedule set forth by the American Academy of Pediatrics. These escalated visits are covered by the child’s health plan and have additional requirements to be covered within the visit. For more information on the requirements for escalated well-child visits for the foster care population, please review Serving Youth in Foster Care and Adoption self-paced guide of these requirements.
COVID-19 has presented some additional concerns in the child welfare world. In the state of Missouri, child abuse/neglect hotlines decreased 50 percent during the time that school went to an online modality. Polaris, the federal hotline for trafficking, anticipates that there has been a 40 percent increase in human trafficking activity. These numbers are of great concern for child welfare advocates as youth in foster care are at greater risk for re-victimization. It is estimated that 70% of youth who are trafficked are from the foster care system.
As healthcare professionals, an awareness of the signs and symptoms of trafficking is essential, whether providing services via telehealth or in person. Trafficking signs and symptoms may be social, emotional/behavioral or physical. Often, the social signs and symptoms or indicators are intimidation by person accompanying child, delay in presentation for care, inconsistencies in information and reports of hazardous or crowded living, working or transportation conditions.
Medically, youth who have been trafficked may present with sexually transmitted infections, reports of multiple sexual assaults, malnutrition and/or dehydration, reports of excessive or preventable work-related injuries, exhaustion and acute or chronic pain.
Emotionally, youth often experience feelings of self-blame and struggle with complex trauma and/or dissociative disorders. Behaviorally, youth may exhibit substance use, self-harm, dissociation, aggression and/or running away. Non-offending caregivers may notice youth having extra keys, extra cell phones, spending time with older or unknown peers or paramours and may express concern about gang activity or youth being unable to account for his/her whereabouts and activities. You may note concerns about caregivers coaching children, not letting them speak for themselves and seeming unconcerned about their symptoms or diagnoses.
If you have noticed or have concerns about trafficking in a minor, you should report these concerns to the Missouri Child Abuse and Neglect Hotline at 800-392-3738. If you have concerns about trafficking in an adult or questions about trafficking, you can reach out to Polaris by calling 888-373-7888.
For any member with a foster care or independent foster plan code, members can receive care management services at no cost from care managers with experience and expertise in these areas. Please contact 844-450-5201 to speak with a foster/adopt intake coordinator to refer a foster/adopt member to care management.