Ohio, Missouri and Washington are key examples of collaboration and demonstrated ability to overcome challenges in care delivery. A key feature of all three states is partnership with their state chapter of the American Academy of Pediatrics. Engaging AAP chapters in the HOCP development process offers agencies health expertise and the perspective of professionals currently caring for children in foster care. Missouri’s HOCP emphasizes trauma-informed care, data collection and sharing, and ongoing quality improvement. Ohio’s HOCP also adopts a trauma-informed approach and incorporates responses to parental opioid use and FASD. The Ohio HOCP outlines partnering with school health systems, medical homes, Medicaid managed care plans, and the Fostering Connections Program at Nationwide Children’s Hospital. The Washington state HOCP reflects strengths in data and information sharing, upcoming integration of physical and behavioral health systems, and formal psychotropic medication utilization review.

Ohio, which is a county-administered child welfare system, added child-specific recruitment plans to its child welfare information system and intends to use mobility mapping as a recruitment tool. The state’s plan references engagement of tribes, experts and providers to develop data reports that are used to explore questions related to flexibility of county recruitment plans, use of county plans to inform the state plan, monitoring of county plans by the state, use by counties of a customer service approach to foster families, county access to recruitment tools and county expertise regarding sibling placement.

Created by statute in 2017, the Ohio Foster Care Advisory Group developed recommendations regarding training, simplification of certification requirements, coaching parents on substance-exposed newborns, childcare, respite, trauma-competent counseling, retention, foster parent rights and a public awareness campaign.