Issue in Context

• Foster care provides a temporary place of safety for children who cannot remain with their birth parents, typically due to neglect or maltreatment.

  • Providing a supportive and nurturing environment in foster care is crucial to help at-risk children feel safe, heal, and attain proper development
    
    
  • Ultimately, the number of children entering foster care rose from about 300,000 children in 1980 to over 500,000 by 1998. Today, the latest data from the U.S. Department of Human and Health Services still show over 500,000 children remaining in foster care.
    
    
• What happens when children are removed from their homes?
  
  
  • They are placed in either a non-relative foster family, with relatives, in a therapeutic or treatment foster care home, or in some form of congregate care, such as an institution or a group home.
    
    
  • Length of stay in these placements vary by case to case, however, the average time is about 33 months.
    
    
  • Data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) revealed approximately 38% of children spent 11 months or less in foster care when they exited the system in 2001.
    
    
  • Still, about 32% of the children had been in care for at least 3 years in 2001.
    
    
  • The likelihood a child will experience multiple placements increases the longer the child remains in care.
    
    
• The foster care system interacts with a latticework of systems at different junctures:
  
  
  • Affected systems/agencies include: state and local child welfare agencies, courts, private service providers, public agencies that administer other government programs (such as public assistance or welfare, mental health counseling, substance abuse treatment), and Medicaid.
    
    
  • At the center of this network of systems are child welfare agencies, whose policies, practices, and organizations vary from state to state.
    
    
• Court appointed special advocate (CASA) volunteers serve as mentors and advocates for foster care children.
  
  
  • These volunteers are assigned to a child or sibling group and strive to ensure that children have a voice in the legal decision-making process.
    
    
• Two of the most influential policies affecting foster care are the Adoption and Safe Families Act (ASFA), adopted in 1997, and the Child and Family Service Reviews (CFSRs), adopted in 1994.
  
  
  • Significant aspects of ASFA include:
    
    • Shortened timelines for decisions regarding permanency
    • Kinship caregivers recognized as legitimate options for placement
    • Incentives to States to encourage adoption
    • Emphasis on accountability
      
      
  • CFSRs evaluate how well state child welfare systems are meeting established national standards
    
    
    • As of summer 2004, 32 states have completed evaluations; none of these have met national standards
      
      
• What are the current challenges facing foster care in the 21st century?
  
  
  • Expanding caseloads of children with complex needs requiring multiple services
    
    
    • Increase in number of children under age 5
      
      
    • Services needed by biological parents and children are hard to secure.
      • Often there is a mismatch between the services offered and what the families actually need.
        
        
  • Adolescents transitioning out of foster care
    
    
    • Adolescents are generally no longer eligible for services through foster care
      
      
    • These young adults are generally poorly prepared for employment and independent living
      
      
    • Furthermore, medical insurance coverage may not be available for these adolescents, as they likely do not qualify for Medicaid
      
      
    • Outcome research on youths transitioning from foster care revealed a number of negative outcomes, including:
      • Involvement with criminal justice sysem and high risk for homelessness
      • Higher rate of teenage pregnancy, alcohol and other drug abuse, unemployment and dependence on public assistance
        
        
  • High staff turnover
    
    
    • About 90% of state child welfare agencies report difficulties in recruiting and retaining high-quality, innovative, and committed staff due to:
      
      • High number of cases per worker
      • Poor working conditions
      • Poor public perception of child welfare system
        
        
    • These will require change within the child welfare system to support these workers staffed with skilled supervisors
      
      
      
  • Recruiting foster parents is difficult
    
    
    • It's a demanding job! What is expected of foster parents?
      • Provide day-to-day needs of children
      • Be mindful and respond appropriately to emotional and behavioral needs of these children
      • Arrange and provide transportation to medical appointments, mental health counseling, and court hearings
      • Advocate for children in the schools
      • Arrange visits with biological parents and caseworkers
        
        
    • Other reasons why?
      • Poor public image of foster care
      • Inadequate financial support
      • Changing family structures
      • Increase number of women working outside the home
        
        

1. Administration for Children and Families: http://www.acf.hhs.gov
   
   
2. American Academy of Pediatrics: http://www.aap.org
   
   
3. Child Welfare League of America: http://www.cwla.org
   
   
4. Future of Children: http://www.futureofchildren.org
   
   
5. Simms, MD, Dubowitz H, Szilagyi MA. Health care nees of children in the foster care system. Pediatrics. 106 (4):909-918, 2000 Oct.

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ISSUE ALERT #1 (Winter 2004) - Foster Care Children
Issue at a Glance Issue in Context
Health Care Issues What can you do? Links/Resources