The Health Service Executive (HSE) has committed to developing a national policy for providing foster care services for children with special needs by the end of the year.
The move comes after an investigation by Ombudsman for Children Emily Logan found the HSE had failed to provide adequate supports for a child with multiple physical and intellectual disabilities and visual impairments.
The investigation began after the Ombudsman received a complaint regarding the 14-year-old boy who, while legally in the case of the HSE, has been living with his foster parents on a full-time basis as part of their family since he was an infant.
The boy is dependent on his foster parents in all areas of his care, including feeding, toileting, bathing and dressing.
Due to the multi-faceted nature of the child’s disabilities, the boy also requires a range of therapeutic services including speech and language therapy, physiotherapy and occupational therapy.
As a result of the investigation, the Ombudsman found the boy did not receive the level of therapeutic services he required and was without a social worker for six years. She also discovered the HSE had failed to provide safe transportation for the child's visits to therapy sessions, a situation she described as "wholly unacceptable".
Due to his medical condition, the child cannot sit, stand or bear weight, and he requires transportation to access support services to meet his needs such as attending multiple hospital appointments and school.
However, the boy's foster parents had been left with no option but to transport him in the family car with one parent sitting beside him in the back seat and holding his head for support because the HSE refused to provide funding for a specially adapted vehicle. The parents were eventually forced to borrow over €30,000 to buy their own adapted car so they could continue to transport him around.
The Ombudsman said the foster parents had understood at the time of the long-term placement the child would be allocated appropriate supports and services according to existing foster care standards. But this did not happen and the services being offered to the boy "were insufficient to meet his multiple and complex needs".
Ms Logan ruled that the lack of assistance provided to the family was in contradiction to National Foster Care guidelines and said the HSE failed to consider the best interests of the child when making decisions about addressing his needs.
Following the investigation, the HSE has allocated a social worker to the boy and reimbursed the foster family for the adapted vehicle. It has also undertaken an independent assessment of the child's therapeutic needs and committed to to developing a national policy for the provision of foster care services for children with special needs by the end of 2011.
Ms Logan said in her report she was concerned the decision of the HSE to reimburse the family for the cost of the adapted vehicle had been based on circumstances connected to the individual case rather than as part of an overall strategy to identify and address the requirements of any individual foster child with special needs.
She recommended the HSE review the status of all foster children with special needs and revise the structure and process of how the statutory reviews of care plans take place. Ms Logan also called on the HSE to prioritise services and therapies for children with special needs.
The Ombudsman said she was satisfied the HSE was intent on addressing her recommendations in relation to the child and more broadly to other children with special needs in foster care.
However, given the child's pressing needs, the Ombudsman for Children said while significant progress had been made, the HSE "must progress her remaining recommendations in a more timely manner".
Ms Logan said her office would monitor the case until she "is satisfied that the supports provided to this child and his foster family adequately address his multiple and complex needs".
The Irish Foster Care Association said it was of paramount importance that the recommendations made in the Ombudsman report were implemented as early as possible.
"It is simply not good enough that foster parents have to battle and fight, on behalf, of children in foster care, to access supports for children with additional needs," said the association's head of services Liam Cullen.
