Children who live with relatives or foster parents are more likely to have behavioral and emotional problems than children who live with their parents (Kortenkamp and Ehrle, 2002; American Academy of Pediatrics, 2000; Simms, Dubowitz, and Szilagyi, 2000). Analysis of the 1997/1999 NSAF found significant differences between children in kinship or foster care and children cared for by parents in terms of limiting conditions and physical health status. A higher percentage of children in kinship and foster care reported having physical or mental impairments, being in fair or poor health, and visiting a mental health provider during the survey year (Kortenkamp and Ehrle, 2002). In a study of kin caregivers in South Carolina, relatives reported that the children they cared for suffered from "nightmares, anxiety attacks, depressionàlearning disabilities, promiscuity, and/or aggressive behavior," much of which was likely caused by past trauma (Edelhoch, 2002). While physical and emotional health is a concern of children placed in TANF child-only relative care, states are addressing this concern through policies tying cash assistance to compliance with immunization schedules and/or well-child medical visits (Romero et al., 2001; Risely-Curtiss and Kronenfeld, 2002). However, even with this tie to cash assistance, physical and emotional health care is in question. Risely-Curtiss and Kronenfeld (2002) found that fewer than 50 percent of referrals for physical, dental, and mental health care were completed by relative caregivers within a reasonable time frame.