Over 715,000 children received foster care services for some period of time in 1995, and compared to other children in the United States, children in foster care are more likely to be in poor health, both physical and behavioral. Obtaining appropriate health care for these children is often complicated by a number of complex factors. In the final year of a three-year project funded by The Nathan E. Cummings Foundation, the National Academy for State Health Policy conducted site visits to nine states, many of which have made significant efforts to improve health care for children in foster care. This report is based on those site visits and chronicles how the participating states have sought to improve health care for this vulnerable and needy population. Participating states included: Alaska, California, Colorado, Iowa, Maine, Massachusetts, New York, Texas, and Utah.