WhitePaper ImprovingOutcomesOlderYouth FR

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Casey Family Programs

Improving Outcomesfor Older Youth in Foster Care


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Improving Outcomes or Older Youth in Foster

Introduction

In 2005, the U.S. Department of Health and Human

Services reported that 24,407 foster youth exited carethrough emancipation. 1 In other words, youth whohad been removed from their families and communi-tiesprimarily due to allegations of maltreatmentor child behavior problemsleft care by virtue of their age, not because they had achieved a speci cpermanency outcome such as reuni cation, adop -tion, or guardianship. When the state fails to connecta youth to a permanent legal family, youth struggle tocreate their own family or support network to meetlegal, emotional, psychological, and cultural needs.Many youth who age out of foster care will return tolive with their birth families. If the circumstances of their families of origin have not changed, however, itis unlikely that the family will be prepared to providethe supports youth need to successfully transition toadulthood.

In todays society, many young people do not be-come self-suf cient adults until well after their 18 th birthdays. They often depend on their families for

emotional and tangible support until they have suf -cient education and/or training to obtain good jobs,support themselves, and establish their own homesand families. Preparing to become an adult is incre-mental; the process begins in childhood and contin-ues into the teen years and beyond. Young peoplegenerally learn key life skills, such as learning tomanage money and making independent decisions,in the context of family. As young people moveinto adulthood, many families continue to provide

emotional, social, and material support. The continu-ing, interdependent relationships that make up family identity are generally considered to last a lifetime.

Youth in foster care often lack this critical founda-tion of family support and the relationships they need to build emotional security and future work-

place and family success. Without strong, stableconnections with parents, extended family members,siblings, or other signi cant adults, youth leaving foster care are often left on their own to face key developmental tasks. As they approach the age of majority, they must make the transition to adulthood

without family relationships to support them, withfewer nancial resources, and without the family safety net most other young people possess. Study after study shows that, as a group, these young people fare poorly as they attempt to negotiate the

world of adulthood.

A great deal of attention has been paid at the federaland state policy levels to the challenges encounteredby youth who age out out of care. While there arestories about how child welfare services have helpedyouth succeed, the limited data on the outcomes of many youth who age out consistently paint a grimpicture. Youth who age out are less likely than theirpeers in the general population to achieve academicmilestones, including high school graduation andpostsecondary education, that signal the founda-

tions of self-suf ciency. These youth are less likely to be employed and, even when they are employed,are more likely to be in jobs that do not pay a living

wage. They are more likely to experience violence,homelessness, mental illness, and other poor healthoutcomes. They are more likely to be incarcerated, toabuse substances, and to experience early parenthoodout-of-wedlock.2

Historically, federal policies to address the needs of older youth in care have focused on providing servic-

es and supports to help youth transition from fostercare to independent living. Two questions emerge:

1. Are these policies the right policies?

2. Are they meeting the needs of youth in fostercare?

Improving Outcomes for Older Youth in Foster Care


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In order to address these questions, this white paperbegins by suggesting a rede nition of this popula -tion and a discussion of the desired outcomes forthem. It then provides a snapshot of the outcomesfor youth who do, in fact, age out of foster care,

followed by a brief description of current federaland state policies designed to meet their needs. Thepaper concludes with recommendations for federalpolicies to improve the outcomes of older youth

who are in care or transitioning out of care. Theserecommendations are based on research about thedevelopmental and transition needs of these youthand the limited research on the ef cacy of existing programs targeted at this population.

How Should This Population o Older Youth inFoster Care Be Defned?

In order to assess the needs of a population, andto develop policies that appropriately address theseneeds in a way that helps the population achievedesired outcomes, clear de nitions are essential.

This paper begins with our working de nition of older youth in foster care and discusses servicesand supports needed to help them navigate transi-tions brought on by changes in age/development,

as well as changes in life circumstances. Prepara-tion for adulthood is a phrase that clari es andnormalizes the distinct dimension of child welfarepractice aimed at strengthening the present andfuture well-being of youth in foster care. Terms liketransition, emancipation, and independentliving have historically been part of the commonlanguage used to describe a youths passage fromstate custody to self-support after aging out of care. Such terms perpetuate a limited view of child

welfare practice related to youth in care by focus-ing on the event of transitioning or emancipating,rather than the process of being prepared for it.

The phrase preparation for adulthood offers analternative to the common language of the past andmore readily guides us to consider the opportunities,skills, and resources necessary to be successful in theadult world.

All of us experience transitions throughout variousages/developmental stages, whether from infancy to being a toddler, from being a toddler to being of school age, from being of school age to adolescence,from adolescence to young adulthood, and from

young adulthood to middle and older adulthood.3

Inaddition, transitions occur due to major changes inlife circumstances, including marriage/divorce, deathof a family or friend, moving to another location, anew job, or attending college.

In contrast to age or developmental transitions thatare experienced similarly for most individuals, transi-tions due to changes in life circumstances can occurat any age or developmental stage and vary in theadjustments needed by the individual. In addition,unlike developmental transitions, transitions due tochanges in life circumstances are deliberately chosenor created by the person themselves, or by otherindividuals in their lives. For children in foster care,these changes might include the removal from theirfamily, placement with family members or strangers,movement from congregate care to family-basedcare, changes in school, or the start of a new job.

Most children and young adults receive the ser-

vices and supports needed to help them make bothdevelopmental and circumstantial transitions withinthe context of families, often from parents or othercaregivers. For children in foster care, the servicesand supports needed to make transitions must beprovided by the state until the youth is permanently reunited or placed with a family of their own. Mostyoung people who age out of care are eligible for arange of independent living services and supports,including those provided with federal resources, butthese cannot compensate for the lifelong absence of family support. Appropriately providing supportsto help youth prepare for and successfully enteradulthood is critical to achieving the goals set forthfor all children in foster care: safety, permanency,and well-being. The foundation for all policies tomeet the needs of older youth must be based on theoutcomes that any parent would want for their own


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child: having a permanent family and being preparedto enter adulthood with con dence and purpose.But embodied in these two broad outcomes are anumber of more speci c outcomes that need to beachieved, including helping youth address education-

al and career benchmarks, physical health and mentalhealth needs, and other developmental milestones.

What Are the Current Outcomes or YouthWho Age Out o Foster Care?

Many older youth in care struggle academically. 4 A 2006 report by the EPE Research Center indi-cates that the nationwide high school completionrate for all students is 70 percent. More students arelost in 9th grade than in any other grade (9 th: 35%;

10th: 28%; 11 th: 20%; 12th: 17%). Studies have founddiffering rates of high school completion (througha degree or GED) by youth in out-of-home care,though the measures have been de ned somewhatdifferently. In a Washington state study, 59 percentof youth in foster care enrolled in 11 th grade com-pleted high school by the end of 12 th grade. Theyoung adults in the Northwest Alumni Study and theCasey National Alumni Study completed high school(via diploma or GED) at rates of 85 percent and 86

percent, respectively, by age 25, which is comparableto the general population rate. Both studies found,however, much higher GED completion rates com-pared to the general population (5 percent): overone in four (29 percent) in the Northwest Study, andnearly one in ve (19 percent) in the Casey NationalStudy. In a Midwest study, approximately 58 percentof youth in foster care had a high school degree atage 19, compared to 87 percent of their same-agepeers in a comparable a national sample.

A national study in 1994 of young adults who hadbeen discharged from foster care found that 54percent had completed high school. In the ChapinHall study of Chicago public school youth, fteen-year-old students in out-of-home care were about

half as likely as other students to have graduated 5years later, with signi cantly higher percentages of students in care having dropped out (55 percent) orbecome incarcerated (10 percent). A 1997 study onlong-term outcomes for children in foster care on

a national level found that youth in foster care aremore than twice as likely (37 percent vs. 16 percent)to have dropped out of high school than youth inthe general population. Five years later, 77 percentof the former foster youth who had dropped out of high school had completed a high school diploma orGED, compared with 93 percent of the youth in thegeneral population who had dropped out.

Youth who age out of foster care struggle tohold jobs and support themselves nancially.

They are more likely than youth in the general population to rely on public assistance. 5 Up tofour years after leaving state care, only 49 percentof youth nationwide had secured a job. 6 Youth whoaged out reported that they had a dif cult time

nding jobs for a variety of reasons, including lack of transportation, lack of opportunities, inadequateeducation, and lack of experience.7 On average,youth who aged out in California, South Carolina,and Illinois earned less than $6,000 a year in 1997.

This same study found that 24 percent of the youthhad absolutely no earnings for their rst two yearson their own. 8 A 2005 report of older youth in theMidwest states of Illinois, Iowa, and Wisconsinfound that former foster youth were twice as likely as youth in the general population to report nothaving enough money to pay their rent or pay utility bills. In addition, youth who aged out of foster carereported sometimes or often not having enoughfood to eat. 9

Finding and keeping a stable home is one of thebiggest challenges that youth face after agingout of foster care. One out of every four youth

who age out of care report experiencing homeless-ness for at least one night.10 Over one-third (36


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percent) of youth who aged out in Nevada reportedhaving no place to live at times. Half of these youthlived in homeless shelters while half were forced tolive on the streets.11 Nationally, 32 percent of youthchanged living situations ve or more times in 2.5 to

4 years after aging out of care.12

Youth who age out of foster care are at highrisk for mental and physical health problems. Casey Family Programs Northwest Alumni Study found that one in four foster youth were still coping

with symptoms of Post-Traumatic Stress Disorder(PTSD) after leaving foster care. This is double thePTSD rates of veterans returning from recent wars,and over six times the rate among the general U.Spopulation.13

In studies that spanned four states, nearly one out of every three young adults (30 percent) who aged outof foster care struggled with mental health prob-lems such as major depression, substance abuse,social phobia, and anxiety.14 In a small study of 22foster care alumni, almost one-fourth (23 percent)of Texas young adults who had aged out had a his-tory of suicide attempts.15 At the same time, many youth who age out of foster care lose their health

care when they age out. Nationally, one in threeyoung adults reported not being able to get neededhealth care once they left the system.16 The majority of youth in studies across the states had no healthinsurance whatsoever. For example, of all the studiesfocusing on young adults who had aged out of care,the highest percentage of insured foster care alumni

was 47.1 percent.17 The only exception was a study of older foster care alumni, many of whom hademancipated from care from public agencies. Eventhough about 67 percent of the alumni had healthinsurance, this proportion was below the nationalaverage (75 percent for adults age 18 to 24). 18

Youth who age out of foster care are apt tobecome parents at a young age. Young women infoster care are 2.5 times more likely than those notin foster care to have been pregnant by age 19. In

addition, by age 19, 46 percent of teen girls in fostercare who have been pregnant have had a subsequentpregnancy, compared to 29 percent of their peersoutside the system.19 Without the resources to carefor themselves and without the support of family

or community, these young mothers are more likely than the general population to rely on public as-sistance and experience homelessness in addition tothe panoply of negative outcomes that affect many youth who age out of foster care. 20 Research sug-gests that these young mothers are more likely thanother homeless parents to lose their children to thestate, creating a tragic cycle of involvement in thefoster care system.21

Youth who remain in foster care until age 18 aremore likely to enter the criminal justice sys-tem. The 1991 national study of foster care alumnifound that one out of four young adults had beenin trouble with the law since their discharge fromcare. Half of these problems were related to drugsand alcohol.22 A more recent study found that thistrend remains constant. 23 Some of these young adults move quickly from the foster care system tothe criminal justice system. The 2005 Midwest Study reported that 30 percent of the male youth had

experienced incarceration by age 19.24

What Predicts Improved Success in Transitionsrom Foster Care?

As the outcomes documented above indicate, many alumni of foster care experience challenges in adult-hood in a number of areas, including education,employment, parenting, mental and physical health,and criminal justice system involvement. However,research indicates that improving speci c aspects

of foster care can lead to better transitions andimprovement of adult outcomes. 25 For example, sta-tistical simulations indicate that reducing placementchanges and runaway incidents as part of a childsplacement experience can signi cantly improve men -tal health and education outcomes; similarly, youth

who have concrete resources when they leave care


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(i.e., $250 in cash, dishes and utensils, and a driverslicense), which likely indicates that they experiencedmore comprehensive independent living preparation,have better employment and nance outcomes. 26

Youth who have an early positive engagement with

employment appear to do better as adults.27

Finally,preliminary evidence from the Midwest study indi-cates that youth who stay in foster care beyond age18 fare better across many areas. 28

Current Federal PoliCies For Youthtransitioning From Care

In 999, Congress enacted the John H. Cha ee Fos-

ter Care Independence Program (FCIA), replacing theIndependent Living Program o 986. FCIA doubledthe amount o unding available or independent livingservices, rom $70 million to $ 0 million per year,and made all children, regardless o age and amilyincome, eligible or the program. FCIA also authorizedthe use o program dollars to provide housing sup-ports or youth who had aged out o oster care. How-ever, it limited the amount available or such purposesto 0 percent o overall unding. The law also gave

states the option to extend Medicaid to youth who hadaged out o oster care to age . Seventeen stateshave used the Cha ee option to extend coverage, ando fcials in another fve states reported that they wereconsidering doing so in the near uture.9 The ederalprogram o ers supportive services to youth, includinglimited housing assistance, job training, education,and other independent living services. In 00 , Con-gress passed legislation (P.L. 07- ) to authorizean education and training voucher program (worth up

to $ ,000 annually per youth) or current and ormeroster care youth. This program provides support or

postsecondary education to youth who have agedout o oster care and those who exited oster care toadoption at age 6 and older. 0

Policy Recommendations

In recent years, state and tribal child welfare systemshave begun to recognize the urgent need to meetyoung peoples family permanency needs. Perma-nency is de ned as adoption, legal guardianship,

reuni cation with birth family, or placement with at and willing relative. State and tribal systems have

also worked to improve independent living servicesand expand supportive housing options for youthaging out of foster care. Too often, however, theseinitiatives are not integrated. In fact, in some cases,permanency and preparation for adulthood servicesare mutually exclusive or competitive. Federal policy can help support these individual initiatives andencourage states to integrate these efforts to achieve

permanency and instill interdependent living skills.

Changes in three policy areas would help olderyouth in foster care more successfully prepare foradulthood:

1. Permanency incentives and the elimination of barriers to permanencyfederal policies thatsupport programs to help older youth achievepermanency and remove barriers to permanen-cy that currently exist.

2. Ongoing and integrated services and supportsthat are youth- and family-centered and drivenby their needs in the targeted areas of housing,health/mental health, education, and employ-ment that includes coordination with otheryouth-serving agencies (e.g., Workforce Invest-ment Act [WIA] and U.S. Department of Hous-ing and Urban Development [HUD]).

3. Research and communication about effective

programs.

Policy Recommendation #1: Create perma-nency incentives targeted at older youth and re-move policy barriers. Addressing the permanency needs of older youth in foster care by connecting them to a family or caring adult who is committed


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to the youth for a lifetime is a critical component of their successful preparation for adulthood. Ensur-ing that youth exit foster care through a permanentconnection to a caring adult(s) requires overcoming signi cant policy and service delivery challenges.

i c v y f p cy c , bj c v p b c f p y c , -

/ , , c fp cy w v y c y y

f p .

Physical permanency relates to a sa e and stableliving environment.

Emotional/relational permanency relates to the

primary attachments, amily, and other signifcantrelationships that o er trust and reciprocity.

Legal permanency relates to the rights and beneftso a secure legal and social amily status.

Cultural permanency relates to a continuous con-nection to amily, tradition, race, ethnicity, culture,language, and religion.

Source: Frey, L.L., Greenblat, S.B., & Brown, J. ( 00 ). A Call to Action: An Integrated Approach to Youth Permanency and Preparation or Adulthood .New Haven, CT: Casey Family Services.

Eliminate policy barriers and support incentives

to permanency or older youth.

Support promising approaches to placechildren with families, reduce the reliance oncongregate care, and connect older youth witha permanent family. Older children in foster careare more likely to be placed in congregate care.Research makes clear that children and youth grow and thrive in the context of families, not institu-tions.31 In addition, children placed in congregatecare are more likely to reenter care.32 States andlocal communities have begun to take action toreduce the overreliance on congregate care. Many communities have employed strategies such asfamily group decision making (FGDM), family

nding tools to identify relatives, and use of ctive

kin who can provide care for children and youthin a family setting and provide a permanent family outside the foster care system, enhanced commu-nity-based mental health services, as well as effortsto improve the recruitment and retention of foster

care families. In order for more youth to bene tfrom these promising approaches, federal policy should support the creation and expansion of these innovative approaches.

Create a federal subsidized guardianship pro-gram. Reuni cation, or as an alternative, promptly

nding a t and willing relative to provide a per -manent home for older youth outside the formalfoster care system can be the rst step in helping older youth nd permanency. Many relative care -givers are willing to care for these youth but needadditional support and resources to do so. Thesesupports are particularly important for older youth

who transition out of congregate care and may have a higher level of need. Thirty-nine states andthe District of Columbia have created subsidizedguardianship programs to help relatives care forchildren outside of formal foster care. In theabsence of federal policy on this issue, the depthand scope of these supports vary from state to

state. Federal child welfare funds should supporta range of permanency options, including reuni-

cation, adoption, and guardianship. Title IV-Efoster care funding rules limit nancial support tochildren to the period while they are in foster careor, to a more limited extent, if they exit to adop-tion. These limits often place nancial barriersin the way of relatives who wish to assume legalguardianship of youth placed with them in fostercare. The absence of federal guardianship support

is a critical impediment for children placed withrelatives, for whom adoption and reuni cation hasbeen ruled out, and whose relative caregivers areprepared to provide a permanent, safe home forthe children in their care but cannot do so with-out ongoing nancial support. Policy should beamended to support a federal state partnership forsubsidized guardianships.


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Create incentives for the permanent place-ment of older youth in foster care in a rangeof permanency options. In an effort to movethe backlog of children waiting for a permanenthome, policymakers created the Adoption Incen-

tive Program as part of the Adoption Safe Families Act (ASFA) of 1997. The program proved highly effective in increasing the number of children whoexited foster care to adoptive homes. However,research demonstrated that older children, particu-larly those age 9 and older, were less likely to beadopted. When the program was reauthorized in2003, as part of the Adoption Promotion Act (P.L.108-145), it was expanded to provide additional in -centives for adoptions of children age 9 and older.

The Adoption Incentive Program must be reau-thorized in 2008. Federal policy should build onthe success of the adoption incentive program,by expanding the program so that states receiveincentive payments for permanent placement of youth in foster care in other forms of permanency,including legal guardianships. Over one-fourth (26percent) of the 114,000 children waiting for adop-tion are between age 13 and 17.33 Nearly 95,000(30 percent) of the 311,000 children who enteredfoster care in 2005 were between age 13 and 18.Research suggests, however, that youth who enterfoster care as teenagers are highly unlikely to beadopted.34

Provide an array of post-permanency servicesand supports to families, whether a childexits foster care through reuni cation, adop -tion, or guardianship, in order to ensure that achild remains safely in their permanent home. Research shows that teenagers who exit foster careare most likely to reenter. The group of youth age13 to 17 have highest reentry rate at 28 percent. 35 In order to assist older youth who leave foster careto permanently remain out of care, it is critical thatfamilies continue to receive necessary services andsupports, including access to physical health and

mental health care. In addition, older youth whoexit foster care through any permanency alterna-tive should continue to receive the services andsupports necessary to help them make the transi-tion to adulthood, including independent living

skills training and education supports.

Continuing these services and supports can notonly help prevent reentry into foster care but canremove any disincentives to exit foster care as well.Policies designed to help older youth make thetransition to adulthood must factor in the unin-tended consequence that losing eligibility for suchservices upon exit from foster care may serve as adisincentive to permanency. No youth should have

to choose between permanency and needed services and supports. Recent federal policy designedto assist older youth have begun to move in thisdirection. The Education and Training VoucherProgram (ETV Program) provides nancial as -sistance to help defray the costs of postsecondary education both to youth who age out of fostercare and youth who leave care at or after age 16 toadoption. The ETV program should be fully fund -ed and modi ed so that youth who exit throughany permanency option can access the bene ts of the program.

Although many youth who exit foster care throughpermanency or aging out have access to Medicaid,services, especially mental health services, oftenare inadequate, inappropriate, inaccessible, ornonexistent. Changes are required in federal/stateMedicaid programs to assure that behavioral healthcomponents are readily available, are appropriate tothe needs of this population, and are of high quality.

Clarify permanency goals for older youth infoster care. In 2005, the year for which the mostcurrent statistics are available, nearly 180,000 (35percent) of children in foster care were betweenage 13 and 17. Of all children in foster care, 37,628(7 percent) had a case goal of long term foster


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care and 31, 938 (6%) had a case goal of eman -cipation.36 The federal law and accompanying regulations about the use of long-term fostercare and other permanent living arrangementscommonly used for older youth are limited and

confusing. The Adoption and Safe Families Act(ASFA) made clear that reuni cation, adoption,legal guardianship, or permanent placement witha t and willing relative were the only appropriatepermanency plans for children and youth in care.

The law and regulations provided a limited excep-tion to this rule. Federal policy allows for anotherplanned permanency living arrangement (APPLA)only after the state rules out the enumerated perma-nency options. The state also must document a com-pelling reason for the alternate plan.37 APPLAreplaced the permanency plan of long-term fostercare in federal law. This change stemmed from anunderstanding that long-term foster care was not a

valid permanency option and that many states werechoosing this option by default for older or harder-to-place youth, rather than as part of a thoughtfulprocess.38 The Department of Health and HumanServices Administration for Children and Families(ACF) explicitly stated in the nal rules for ASFA

that long-term foster care placement is not apermanent living situation for a child. However,

ACF also suggests in the nal rules that any living arrangement other than the four enumerated goalsfalls within APPLA, including long-term foster careand emancipation.

Further complicating matters is the limited guidanceprovided in regulations about the use of APPLA.

The federal regulations only provide examples of when APPLA can be employed. De nition is need -

ed to clarify that any placement other than reuni ca -tion, adoption, guardianship, or permanent place-ment with a relative is not a permanency placementand should be limited in use, if it is used at all, foryouth in foster care. In addition, policy should makeclear that, in addition to documenting the compel-ling reason for the alternative placement, the statemust demonstrate how it will ensure that each youthreceives a permanent connection to a caring adult.

Recommendation #2: Improve services to help young people prepare for adulthood. Older youthin foster care need early preparation to develop aspi-rations, learn and practice life skills, have normalformative experiences, and otherwise become ready

for adult life in a number of areas, such as hous-ing, accessing health and mental health services,education, and employment. The ability for a young person to achieve success in any of these domainsis often linked to the ability to access services inanother domain. For instance, young people may re-ceive targeted employment counseling and training,but, once out of foster care without adequate hous-ing, access to appropriate health care, and transpor-tation, they will struggle to obtain and hold down a

job. An integrated approach to transition services isessential for improving outcomes for youth in care. Two recent reports have identi ed barriers that existin the eld. The Government Accountability Of ce(GAO) examined the impact the Chafee Programhad on states ability to provide independent living services and supports for youth in care who wereexpected to age out at 18 or older.

The GAO found that fewer than half of all eligibleyouth in foster care are being served by the Chafee

program, with some states serving a greater propor-tion of eligible youth than others. It reported thatgaps in mental health, employment, and mentoring services, particularly in rural areas, may have con-tributed to the low numbers of eligible youth being served. The lack of transportation and housing options, and limited efforts to engage foster youthand foster parents, were cited as additional barriers.41 Similarly, Caliber Associates, in their review of 10years of State Independent Living Reports (ILP),

found that the three most commonly reported barri-ers to successful ILP implementation were resourceavailability, federal eligibility requirements, and trans-portation. Most agencies are unable to provide thefull range of transition services necessary. In orderto better serve older youth in foster care, we makethe following speci c policy recommendations:


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Provide funding for the Chafee IndependentLiving Program and the Education and Train-ing Vouchers Program at levels necessary toreach all eligible youth. The Chafee Indepen-dent Living Program is designed to serve all youth

who have aged out of foster care between age 18and 21. In addition, it is intended to provide lifeskills training and services to youth in foster care

who are likely to age out of foster care. The cur-rent authorization level of $140 million per yearis not suf cient to meet these needs. Each year,more than 20,000 youth age out of foster care. If states were serving only those youth who aged outof care, each youth would receive $2.33 of Chafeedollars. Current law also limits the amount of

Chafee funds a state can use to provide housing supports for youth who have aged out of fostercare. With resources that are already stretchedthin, it is little wonder that so many youth former-ly in care experience homelessness and housing instability. We recommend that funding authority be modi ed to ensure that every youth who doesnot exit to permanency by age 18 continue toreceive the necessary housing assistance neededto help them transition to adulthood successfully.

These supports should be structured in a way thatensures that housing supports are age- and devel-opmentally appropriate and are part of a continu-um of services and supports a young adult needsto become nancially independent by age 21.

Promote collaboration across various youthserving agencies. Federal policy should supportincreased employment experiences for youth infoster care and for those who have transitionedout of care. These policies should support strate-

gies that combine traditional employment andtraining programs with support services such ascounseling, mentoring and peer support, childcare,and transportation assistance. Speci cally, thereshould be greater communication and integrationbetween systems, including child welfare, educa-tion, and workforce development. Preparation for

adulthood does not end when youth leave care.Data from the Midwest study indicate that youth

who remain in care after age 18 have improvedoutcomes.42 In addition, new data from the Foster

Youth Employment Demonstration Project

indicate that youth require extensive services afterthey leave care prior to becoming viable employ-ment candidates. Further, youth in these programsfare better the longer they remain in the program 43 and have early employment experience.44

model Program

Shared Youth Vision Initiative, a collaborative led bythe US Departments o Labor, Education, Justice, andHealth and Human Services that asks state systems toprioritize services to the neediest youth. The Initiativebegan in 00 as a response to the White House Reporton Disadvantaged Youth, and in 007, DOL unded 6pilot projects that brought systems closer together. Othe 6 states unded in 007 008 or a one-year pi-lot, list youth in oster care as a priority population.

Ensure that all youth who age out of fostercare have access to medical insurance to age21 at a minimum.

Policy Recommendation #3: Support the col-lection of data about outcomes of older youthin foster care, and more rigorously evaluate theservices and supports that are being providedto help older youth transition through variouschanges in life circumstances. More up-to-dateresearch is needed about how youth who have aged

out of foster care fare as adults. While a number of state studies have been conducted, most national re-search is more than ten years old and represents theoutcomes of youth who were in care before the pas-sage of two major changes in federal policy designedto better address the needs of older youth in care:the Foster Care Independence Act of 1999 and the


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0

Education and Training Voucher Program, createdin 2001 with the passage of the Promoting Safe andStable Families Act. The National Youth in Transi-tion Database will collect some data, but the fol-low-up for that study ends at age 21, and we know

that many key young adult accomplishments occurafter that age. More research is needed to explorethe relationship between the experiences of formerfoster youth after they transition from care and theexperience that brought them into foster care in the

rst instance as well as their experiences while incare. Although the next wave of the Midwest study and the state alumni studies in Texas and Michigan(conducted by Casey Family Programs) will examineoutcomes for 23-year-old alumni in Illinois, Iowa,

Wisconsin, Michigan, and Texas, it is necessary togather data for more states.

Even more urgently needed are rigorous evalu-ations of transition programs and life skills

preparation approaches, as we know little about what is effective, and scarce funds need to bespent in the most cost-effective ways. State andcounty agencies need to know which strategies they should invest in or require of their Independent Liv-ing contract agencies.

Recommendation #4: In addition to the threespeci c recommendations on changes to federal

policy to help youth in foster care nd perma -nent homes and prepare for their transitionto adulthood, tribes should have the option toadminister IV-E foster care and adoption as-sistance programs directly. Tribal child welfaresystems are disadvantaged by the way that federalchild welfare funding is provided for child welfareservices. Tribes are not eligible to directly receivefederal Title IV-E foster care and adoption funds.

As a result, their ability to provide the necessary careand services for vulnerable children and their fami-lies is severely limited. Currently, access to Title IV-E

funds must be negotiated with the state in which thetribe is located. This pass-through approach is oftencumbersome, costly to tribes, and inconsistently applied across states. American Indian and AlaskaNative children in the care of tribal social services

agencies should have the option to receive directfederal child welfare support through direct accessto Title IV-E funding. In order for children andyouth in tribes to bene t from the policy recom -mendations included in this white paper, they musthave access to the underlying IV-E program. As aresult, we recommend that tribes be given the au-thority to directly administer federal foster care andadoption programs funded through IV-E.

Some of these recommendations have scal implica -tions at both the state and federal level. Casey Family Programs believes, however, that these investmentsare cost-effective and will produce savings in bothhuman and economic terms. When older youth havea permanent connection to a supportive and loving family and receive the supports and services they need to successfully transition to adulthood, they are more likely to avoid the negative consequencesthat affect youth under the current policy struc-ture, including poor educational outcomes, poverty,

greater reliance on public assistance, involvement inthe criminal justice system, health and mental healthdisorders, and early and unplanned pregnancy. Thecosts associated with maintaining the status quo istoo highand is borne by both the young people infoster care and society as a whole.


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U.S. Department o Health and Human Services, Administra-tion or Children and Families, Childrens Bureau. ( 006).The

AFCARS report No. 13: Preliminary FY 2005 estimates as o September 2006. (AFCARS). Retrieved April 0, 008, romwww.ac .hhs.gov/programs/cb/stats_research/a cars/tar

/report .htm

Cook, R. ( 99 ). A national evaluation o Title IV-E Foster Care Independent Living Programs or Youth, phase 2, fnal report. Rockville, MD: Westat, Inc. See also Courtney, M.E., Terao, S.& Bost, N. ( 00 ).Midwest evaluation o the adult unctioning o ormer oster youth: Conditions o youth preparing to leave state care. Chicago, IL: Chapin Hall Center or Children at theUniversity o Chicago; Dworsky, A. and Courtney, M.E. ( 000).Sel su fciency o ormer oster youth in Wisconsin: Analysis o unemployment insurance wage data and public assistance data. Madison, WI, ound at http://aspe.os.dhhs.gov/hsp

/ osteryouthW 00/index.htm); and Courtney, M.E., Dworsky, A., Cusick, G.R., Keller, T., Havlicek, J., Perez, A., Terao, S. &Bost, N. ( 007).Midwest evaluation o adult unctioning o ormer oster youth: Outcomes at age 21. Chicago, IL: Universityo Chicago, Chapin Hall Center or Children.

See the American Academy o Pediatrics description o develop-mental stages online at www.aap.org/healthtopics/stages.c m,and psychoanalyst Erik Eriksons well-known developmentalstages.

The ollowing is an excerpt rom: National Working Group onFoster Care and Education. ( 007). Fact sheet: Educationaloutcomes or children and youth in oster and out-o -homecare. Retrieved April 0, 008, rom www.abanet.org/child

/education/National% EdFactSheet% 008.pd

Cook, 99 . See also Courtney, Terao, & Bost, 00 ; Dworsky& Courtney, 000; and Courtney, et al., 007.

6 Cook, 99 .

7 Cook, 99 .

8 Goerge, R. M., Bilaver, L. A., Lee, B. J., Needell, B., Brookhart, A., & Jackman, W. ( 00 ).Employment outcomes or youth aging out o oster care.Chicago, IL: University o Chicago,Chapin Hall Center or Children.

9 Courtney, M., Dworsky, A., Ruth, G., Keller, T., Havlicek, J., &Bost, N. ( 00 ).Midwest evaluation o the adult unctioning o

ormer oster youth: Outcomes at age 19.Chicago, IL: ChapinHall Center or Children at the University o Chicago.

0 Cook, 99 . See also Courtney, 00 , and Pecora, P. J., Kes-sler, R. C., Williams, J., OBrien, K., Downs, A. C., English, D.,et al. ( 00 ).Improving amily oster care: Findings rom the Northwest Foster Care Alumni Study.Seattle, WA: Casey Fam-ily Programs.

Reilly, T. ( 00 ). Transition rom care: Status and outcomes oyouth who age out o oster care.Child Wel are, 82 (6), 7 7-7 6.

Cook, 99 .

Pecora, et al., 00 . The study looked at ormer oster youthwho had le t oster care a ter age 6. All o the sample werebetween the ages o 8- with an average age o about years old. Many o the alumni had aged out o the oster care.

Courtney, et al., 00 , pp. - ; Hormuth, P. ( 00 ). All grown up, nowhere to go: Texas teens in oster care transition. Aus-tin, TX: Center or Public Priorities. The our states are Illinois,Wisconsin, Iowa, and Texas.

Hormuth, et al., 00 .

6 Cook, 99 .

7

Courtney, et al., 00 .8 Pecora, P. J., Kessler, R. C., OBrien, K., White, C. R., Williams,

J., Hiripi, E., et al. ( 006). Educational and employment out-comes o adults ormerly placed in oster care: Results romthe Northwest Foster Care Alumni Study.Children and Youth Services Review, 28, 9- 8 . Online version available atwww.sciencedirect.com; Institute o Medicine. ( 00 ). Cover-age matters: Insurance and health care. Retrieved April 0,

008, rom www.iom.edu/CMS/ 809/ 660/ 66 .aspx, p. .

9 Bilaver, L. A., & Courtney, M. E. ( 006).Science says: Foster care youth. Washington, DC: National Campaign to PreventTeen Pregnancy. Available online at: www.teenpregnancy.

org/works/pd /ScienceSays 7_FosterCare.pd0 Cook, 99 . See also Homes or the Homeless. ( 997).Home-

lessness: The Foster care connection. New York, NY: Author.Retrieved September 6, 00 , romwww.homes orthehomeless.com/index.asp?CID= &PID= .Go to www.homes orthehomeless.com. UnderFoster Care ,click r p s c.

Homes or the Homeless, 997.

Cook, 99 .

Reilly, 00 . The study ound that ormal charges in court hadbeen pressed against 6% o youth who had aged out.

Courtney, et al., 00 .

Kessler, R. C., Pecora, P. J., Williams, J., Hiripi, E., OBrien, K.,English, D., et al. (in press). The e ects o enhanced ostercare on the long-term physical and mental health o ostercare alumni. Archives in General Psychiatry ; Pecora, P. J.,Kessler, R. C., Williams, J., Downs, A. C., English, D., White,J., et al. ( orthcoming).What works in oster care? New York:Ox ord University Press.

Endnotes


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6 Pecora, et al., 00 .

7 The Urban Institute, University o Cali ornia Berkeley, & Uni-versity o North Carolina at Chapel Hill. ( 008). Coming o age:Employment outcomes or youth who age out o oster carethrough their middle twenties. Retrieved April 8, 008, romhttp://aspe.hhs.gov/hsp/08/ osteremp/index.html

8 Courtney, et al., 007.

9 The American Public Human Services Association. ( 007).Medicaid Access or Youth Aging Out o Foster Care (APHSA

007). Retrieved April 9, 008, rom www.aphsa.org/Home /Doc /Medicaid-Access- or-Youth-Aging-Out-o -Foster-Care-Rpt.pd

0 For more in ormation about the Cha ee Program, visit TheNational Child Wel are Resource Center or Youth Developmentat: www.nrcys.ou.edu/yd/programs/cha ee.html

Harden, B. J. ( 00 ). Sa ety and stability or oster children: A developmental perspective.The Future o Children, 14 ( ),

0- 7.

Wulczyn, F., Chen, L., & Hislop, K. B. ( 007).Foster care dynamics 2000-2005: A report rom the Multistate Foster Care Data Archive.Chicago: Chapin Hall Center or Children at theUniversity o Chicago.

AFCARS, 006.

Wulczyn, Chen, & Hislop, 007.

Wulczyn, Chen, & Hislop, 007.

6 AFCARS, 006.

7 CFR 6. (h) i-iii ( 00 ).

8 Casey Family Services, & Childrens De ense Fund. ( 006).Making permanence a reality or children and youth in ostercare: Strengthening policy at the ederal level. Retrieved April

0, 008, rom www.childrensde ense.org/site/DocServer/ MakingPermanenceReality.pd ?docID= 6

9 6 Fed. Reg. 0 9- 09 ( 000) (to be codifed at C.F.R.

, 6, and 7). Retrieved April , 008, romwww.ac .hhs.gov/programs/cb/laws_policies/cblaws/ ed_reg

/ r0 00.htm

0 CFR 6. (h) i-iii ( 00 ).

U.S. Government Accountability O fce. ( 00 ).HHS actions could improve coordination o services and monitoring o states independent living programs , GAO-0 - . Retrieved

April 0, 008, rom www.gao.gov/new.items/d0 .pd

Courtney, et al., 007.

Institute or Educational Leadership. ( 008).Foster care youth employment demonstration project: Final evaluation report. Washington, D.C.: Author.

The Urban Institute, University o Cali ornia Berkeley, & Uni-versity o North Carolina at Chapel Hill. ( 008). Coming o age:Employment outcomes or youth who age out o oster carethrough their middle twenties. Retrieved April 8, 008, romhttp://aspe.hhs.gov/hsp/08/ osteremp/index.html

The twelve states include: AL, AZ, DE, IA, FL, KS, MI, MN, MS,NH, OK, and RI.


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