Children in foster care comprise some of our most medically at-risk and vulnerable children. A 2015 American Academy of Pediatrics report states that 35-45% of all children in foster care were reported by their caregivers to have a chronic health condition, such as asthma, cognitive disorders, visual and auditory problems, dental decay and malnutrition, as well as birth defects and developmental delays. As the result of circumstances such as poor prenatal care, maternal substance use, and erratic past medical care, these children also may have significant unrecognized or under-treated illnesses, immunization delays, and failure to thrive. In addition, developmental delays occur in about half of all children who are less than age three when they enter foster care, and 20% have significant dental health issues.

Despite the overwhelming evidence of need, studies consistently demonstrate that many health care needs for children in the foster care system go unmet. However, through the aid and advocacy of a CASA volunteer, children in foster care are better supported with their medical needs. CASAs perform a variety of functions to advocate for and support medically challenged and medically fragile children. Common types of cases that CASAs encounter are preemies and full-term term babies who were born addicted to drugs and/or have fetal alcohol syndrome; children with traumatic brain injuries, often diagnosed with “shaken child syndrome”; and children with conditions like Down Syndrome. CASAs encourage timely responses for the children they serve, connecting them with vital medical services, and overseeing their preventative, planned, and/or crisis care. For CASA Jan Miller, her work with a child who was medically fragile not only led her to oversee critical medical care for her child, but ultimately, help him to connect with a loving parent who became his adoptive mother.