A Passport to Better Health, Better Grades

Julee Newberger
June 14, 2003
Connect for Kids Interactive
ePassport - How Does It Work?

Nikki*, a 15-year-old in Silver Spring, Maryland, didn't start her new school on time this year. Administrators wouldn't let her enroll because her health and academic records were not up to date. When she started a few days after her peers, she had already missed out on introductions and assignments. She didn't have her textbooks, and her name had not been added to the free lunch program. Hungry and too embarrassed to bring attention to herself, she skipped a meal and spent her first school day feeling sad and alone.

Like many of the estimated 500,000 children in foster care in the United States, Nikki has moved from home to home and school to school all her life. Her academics and her health have suffered, and she runs the risk of dropping out of school, which kids in foster care do at twice the rate of other children.

Now a California organization is using new technology to help manage health and education records for youth in foster care. The secure, portable, Internet-based system tracks immunizations, drug allergies, school admissions activity and other important information. The data is accessible 24 hours a day and seven days a week through an encrypted, password-protected smart card called a "Foster Youth ePassport".

The Community College Foundation, which has operated training and education programs for foster youth for more than 10 years, estimates that $1.5 billion is spent annually on duplicative services for foster youth. Their incomplete records result in over immunization, poor follow-up for health problems, delayed enrollment in school and missed opportunities. According to the foundation, the Foster Youth ePassport program will significantly increase the quality of life for foster youth and save millions of dollars in duplicative services and manual processes.

Currently, the Statewide Automated Child Welfare Information Systems (SACWIS) tracks certain data on services to foster youth, but no data systems links children to their health and education records simply and efficiently as they move through the system. The Foster Youth ePassport system is designed to compliment SACWIS and other existing databases as the central repository of information for a foster child.

"Wherever the youth goes, he can have access to the data," says David Springett, president of the Community College Foundation.

The program is currently in its first phase, operating three pilot programs in California. The foundation, which has invested $1 million in the program so far, is seeking funding to expand the program nationally. Overall, the program is estimated to cost approximately $100 per youth each year.

Everything in One Place
ePassport uses two types of smart cards with microchips that store information. The first is the Youth Card, which stores the child's or youth's complete data record. This card remains with the youth or caregiver. The second, an Operator Card, controls access to the database.

A child or caregiver takes the Youth Card to a new school or health care provider, who uses an Operator Card to update the child's records. In addition to the Operator Card, providers need ePassport software and a card reader about the size of a floppy disk drive that attaches to a personal computer. Once the provider inserts the card into the reader, she can view the child's records on the screen. Providers can add new information on school enrollment, test scores, health or academic records.

"We have designed the system to be user friendly," Springett says. "After you put a smart card in and bring up the information on the screen, it's like you're looking at pages in a loose leaf notebook."

For security reasons, the application is not hosted on the Web. The information is synchronized, or swapped, between servers via the Internet. The data is encrypted on the card and the operator must use a password to access the information. The operators, or providers, have limited access to a child's records based on their role in the child's life. The information that particular operators see is controlled by their cards.

The First Phase
Currently, pilot programs in Antelope Valley (a region in Los Angeles County) and Amador County are in the process of issuing ePassport cards to foster youth. The Foundation uses their eBuses (mobile computer labs) and local community service centers for foster youth and their care providers to enter the youths' records into the database. From there, the records can be accessed and updated by professionals. The Foundation has issued an estimated 500 ePassport cards.

Christopher Edwards, project manager of the ePassport program, has dedicated the last four years to creating and testing the technology for the system. "We've spent a lot of time with our ESTEP (Early Start to Emancipation Program) and ILP (Independent Living Program) advisors working out details as far as what information needs to be captured," Edwards says.

"The idea is to begin in community centers and create a nucleus," Edwards says, "and build a model out from there."

In the next phase of the program's development, the foundation will target schools, doctors' offices, human service providers, and juvenile court facilities. Administrators will be trained to use the ePassport system to view and update children's records.

According to Springett, the program can be learned in one or two hours, and the card readers cost as little as $25. The ePassports program offers a help desk open 24 hours a day to answer questions about how to update records.

Beyond Foster Care
Dorothy Ansell of the National Resource Center for Youth Services at University of Oklahoma says that the ePassport concept has the potential to help both kids in care and kids who have left and are on their own.

When foster youth age out of the system, usually at 18, depending on state law, they lose access to child welfare agency records on their own cases. Unless a young person has been very diligent about gathering and recording his or her own vital information, the loss of information can be a serious problem, making it hard to complete college applications, seek financial aid or assess medical risks.

"The value of a smart card for use after they've left care is being able to have all that information in one place," Ansell says.

The biggest challenge Ansell sees for the ePassport program is training service providers on the system and persuading them to use it. "You could have young people with an ePassport and no place to get it read," Ansell says.

Edwards understands that service providers may initially be resistant to learning a new system, but he is confident that they will appreciate the ability to have immediate access to current information for foster youth. "Nobody wants a bigger workload," Edwards says, "but the nice thing about this is they won't have too much to learn."


Julee Newberger is a freelance writer based in Washington, DC.