The Child and Family Agency has admitted there is "work yet to be completed" when it comes to comprehensive supports for children with disabilities in care after it and the HSE were criticised by the Ombudsman for Children.
A new report issued by the Office of the Children's Ombudsman (OCO) looked at the case of Molly, a 15-year-old with profound disabilities in foster care, a year after an initial report found serious shortcomings in State supports for her and her family.
The latest review said there had been progress, both in Molly's case and others involving children with disabilities in care, but said progress was still required in a number of areas.
Speaking on RTE's Today with Sean O'Rourke show, Children's Ombudsman Dr Niall Muldoon said the system should allow the foster carer to have as much ease as possible in accessing practical supports and items, rather than foster carers having to pay up front and seek reimbursement.
"They have been an invisible cohort," he said, referring to Tusla and the HSE separately identifying a single child rather than collaborating more comprehensively on their care.
It meant children like Molly were falling through the cracks.
Dr Muldoon praised the work that has been done to improve Molly's life in the year since the first report, but he said there were still issues, including a lack of HSE disability managers to oversee the outlay of resources.
He added that it was "incredible" that the HSE could not agree on a figure of 483 children identified by Tusla as being in a similar position to Molly, and said the HSE needed to improve its efforts.
Tusla interim CEO, Pat Smyth, welcomed the Ombudsman’s findings.
“There have been very positive developments in relation to Molly’s care," he said. "And in Molly’s local area the collaboration between Tusla and the HSE in joint working on behalf of Molly has been excellent.
"This partnership has involved daily, weekly and quarterly meetings. Her dietary and educational needs have also been agreed in multi-disciplinary meetings and are under constant review.
“We acknowledge there remains a body of work yet to be completed to assist all children with a moderate or severe disability in foster care, across the country.
We intend to build on the work that has been done in association with the HSE, under the Joint Protocol for Interagency Collaboration between the Health Service Executive and Tusla - Child and Family Agency to promote the best interests of children and families.
Meanwhile, autism advocacy group AsIAm has said half of parents of autistic children have been waiting more than a year for a suitable school place, with hundreds excluded from school altogether.
It said a survey showed 33% of parents have been waiting one-to-two years, 10% for between two-and-three years and 7% for more than three years. Some had children who have been expelled or withdrawn from school due to inadequate support. The organisation said the single main barrier to accessing a school place is a lack of places.
Chief Executive of AsIAm Adam Harris said: "There is no one solution to this. We need more autism classes, improved infrastructure, better teacher training and an obligation placed on schools to be fully inclusive. The Department of Education must recognise that there is a problem and take decisive action."