Texas requires that all children entering foster care receive three critical health assessments within 30 days. Known as 3 in 30, this new initiative requires that all children entering foster care receive timely assessments related to their medical, behavioral, and developmental health. Within three days of entering care, children must receive an initial medical exam, to assess for injuries and illness and receive any related treatment. Within 30 days, children must also receive a Child and Adolescent Needs and Strengths (CANS) assessment, a tool that can help professionals determine the level of trauma a child has experienced, the services that may help them, and the strengths they currently have to build upon. Also required within 30 days is a complete check-up with lab work in accordance with the state’s Early and Periodic Screening, Diagnosis and Treatment program, known as Texas Health Steps.

In 2019, Virginia enacted SB 1339 requiring dedicated staff at the state agency to monitor medical services provided to children in foster care. The act also creates the position of Director of Foster Care Health and Safety within the state department.

A tribal ordinance provides guidance on daily activities that promote optimal physical, social, mental and emotional health and development of children in care, including activities that enhance children’s appreciation of their cultural heritage. For example, the ordinance requires that infants have ample opportunities for freedom of movement every day in order to promote large-muscle development. For toddlers, the ordinance requires that each child be provided with limits consistent with age and understanding in order to protect the child’s and others’ safety. Similar requirements exist for preschool, school-age and adolescent children. The ordinance also includes a daily food guide, including food groups, average serving sizes and recommended number of servings for children in each age group.