TABLE 4

Participant Suggestions to Improve the Care of CMC in MFC

Themes and SubthemesQuotes
Care-team related Enhance communication“Communication of each team member, meaning the doctors, foster care, child welfare, and the parent…One person can’t see everything, so if you got an opinion from each branch of it, we can make this thing work. Like I said, it takes a village to raise a child now because you have all different kinds of things going on…we could communicate a little better.” Foster parent
 Ensure accountability across team members and systems“Somebody does need to make sure that everybody’s on top of what they’re supposed to be doing. Because it would be terrible if something was to happen because somebody dropped the ball and wasn’t really paying attention. With [this MFC agency], they’re in the house. They come in every week, checking on the kids, and there is a lot of people, work that needs to be done, and the backup systems that the child welfare agency has…they have a file, they make sure the appointments are being made. All the extra precautions that they take are good.” Foster parent
 Increase medical training for care team“What I could say is to add more training, not just for the foster parents. For parents, for the agencies, for us as well. More training would be really good for everyone…For us, if we had more trainings about different disorders and different diseases out there, not just once in a while but more frequent, that will help us to have an idea of what to expect.” Child welfare worker
Child welfare–system related
 Create medically fragile unit in child welfare agency“They need to have a special unit here, a specialized unit that only deals with children, medical children. They need a special team with less caseload, maybe 5–6…to make sure nothing happens to the children, make sure their needs are well maintained.” Child welfare worker
 Timely permanency“Sometimes I think that the kids get stuck in limbo because the goal to find permanency isn’t rolling as fast as it should be…parents are given way too much time to show that they’re able to take care of their kids. . .[There is] just not enough cut and dry of what’s appropriate, what’s not, ‘this is what you need to do’. . .If you don’t do it, they [should] just move it forward as opposed to giving too many chances and letting it linger for way too long.” MFC caseworker
MFC-system related
 Need for more MFC placements“I had to go [out of state] to get her because there was no one in her area that did medically fragile. Child welfare was thinking of putting her into a…like an institution. There’s that need for us, a lot more parents.” Foster parent
 Increase awareness of MFC programs“I think our [MFC agency] is really good. I didn’t even know about them. I lived in the same area as they are. . .Some of the child welfare workers don’t even know, and so I’m letting the social workers know about our program.” Foster parent
 Ensure adequate supports“I think giving the foster families as much support, whatever that may mean, is best. Sometimes that does mean making changes to their houses or whatever to meet the needs of that child.” –Child welfare worker
“I think having a little bit more respite providers in this area would be helpful.” Foster parent
Health care–system related
 Access to medical records“That I could get access to all of her medical records. See what has been done in the past and who has done it. Sometimes you need to go back and find out. Sometimes that’s not available.” Foster parent
 Access to medical equipment“I know particularly with this client there’s been barriers with getting her some of the equipment things that she needs…There may be a better system of getting equipment to the client when she’s in need of it. It would be a more-expedited process. Usually these things take a while.” MFC caseworker