The process for setting standards involves consultations with experts, analysis of current practices, and reviews of standards developed by others. Local, State, provincial, and national agency representatives of child welfare agencies participated in its preparation. Health services for children in out-of-home care is supervised by public child welfare agencies or by voluntary agencies under contract. The unique problems of these children, who may suffer from emotional as well as medical neglect prior to placement, warrant the need for specific agency procedures. Agencies should assess each individual's health status. Health care services should include prevention, mental health, emergency, and acute and chronic care. Voluntary and public child welfare agencies at State, provincial, district, county, and local levels should create a Health Services Management Unit to direct and monitor health programs, and this unit should provide training for caretakers and caseworkers. 27 references