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Dear County and Tribal Child Welfare Directors, Managers and Supervisors:
The Minnesota Department of Human Services (department), Child Safety and Permanency Division Leadership Team members encourage child welfare agency leaders to discuss options for a coordinated vaccination plan with local health departments. This includes engaging in conversations with staff, parents, children/youth, foster families, and residential facility staff to address barriers and increase access to COVID vaccinations.
The U.S. Food and Drug Administration (FDA) expanded eligibility of emergency use authorization for the COVID-19 vaccine for children as young as age 5 on Oct. 29, 2021. This expanded eligibility includes many children/youth involved in child welfare services. The Minnesota COVID-19 Response Vaccine Data webpage includes statewide and county-specific data, including information on who is being vaccinated, and progress with vaccination by race, ethnicity, and among populations with greater social vulnerability risk. Vaccination locations in Minnesota are on the Find My Vaccine and COVID-19 Vaccine for Children and Teens webpages.
Children in foster care
The process for obtaining the COVID-19 vaccine is no different from other immunizations for children in foster care, including children under guardianship of the commissioner. This includes:
- When children are in foster care, their parents retain the right to consent for medical treatment (except for emergency care and other limited situations not relevant here). As a result, a parent retains the right to consent to their child receiving a COVID-19 vaccination. If there are concerns about a parent’s decisions, the local agency must seek a court order authorizing the local agency to act for the child. For questions about whether a decision requires parental or judicial consent, agencies must consult the court. [ Rules, part 9560.0552, subp. 2]
- When children are under guardianship of the department’s commissioner, responsibility to consent for most medical care, including receiving vaccinations, is delegated to the responsible county agency, as the commissioner’s agent. [ Stat., section 260C.615, subd. 2]
During routine caseworker visits with children in foster care, their parents, foster parents or facility staff, conversations should occur about health care. This includes COVID-19 vaccination, discussing authorization, and youth’s preference, as applicable. As with other medical care requiring consent, foster parents, including pre-adoptive parents, are not authorized to make decisions on whether or not a child receives a vaccination. For children with medical conditions, consult with their physician or care team.
When children are in foster care, out-of-home placement plans must include efforts to ensure oversight and continuity of health care services. [Minn. Stat. section 260C.212, subd. 1(c)(10)] This includes:
- Who is responsible to coordinate and respond to children’s health care needs, including the roles of parent/s, agency staff, and foster parent/s or facility staff
- How children’s medical information will be updated and shared, including immunizations, and
- Determining where their vaccine card will be stored, ensuring it remains available for them.
Legally responsible agency staff must ensure that a child’s ongoing health and dental needs are met. Caseworkers must give foster care providers and facility staff information about children’s immunizations, and other pertinent health data, with instructions for medical records to be up to date. This also includes written authorization for obtaining routine health care for children, with clear instructions as to which health care provider is to treat a child, and who is responsible for payment. [Minn. Rule, part 9560.0600]
Older youth and young adults in foster care
Child welfare staff can play a critical role in engaging with older youth/young adults (ages 14-23) to encourage them to learn more about COVID-19 vaccination, make informed decisions for themselves, and help them access vaccination. This includes:
For minors, the consent of a parent or another authorized adult is generally required. However, state law does allow certain youth to consent for medical care. [Minn. Stat. section 144.341.] Resources regarding medical consent for adolescents are available on the Minnesota Department of Health website.
Information for parents, foster families, and other caregivers
During initial placement and ongoing monthly contacts, caseworkers can discuss information about vaccination, authorization, and when applicable, plans for accessing vaccination for children in foster care. Child welfare staff can help support parents and foster families to find vaccine locations and, if interested in vaccination for themselves, to ensure there is a plan allowing them access, including addressing child care plans.
The CDC has developed age-specific parental resources kits to help caregivers understand and address impacts on children and young adult’s social, emotional and mental health due to the COVID-19 pandemic.
For questions about immunizations and medical care for:
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