Foster Youth and the Transition to Adulthood: Findings from the Midwest Study

Mark Courtney, Principal Investigator

Amy Dworsky, Project Director

Presentation Outline

• Background and Policy Context• Midwest Study• Design and Sample• Natural Experiment• Major Findings • Policy and Practice Implications

Background

• Approximately 20,000 foster youth who do not achieve permanency “age out” of care each year

• Their transition to adulthood is likely to be more challenging than that faced by youth with the financial and emotional supports that parents typically provide

• Title IV-E Independent Living Program created in 1985 to help states prepare their foster youth to live on their own

• Replaced by the Foster Care Independence Act of 1999 which created the Chafee Foster Care Independence Program

Foster Care Independence Act of 1999

• Doubled the amount of federal funding available to states • Allowed states to use up to 30 percent of their funds to pay

for room and board (prohibited under Title IV-E)• Requires states to provide after-care services to former

foster youth until age 21 (state option under Title IV-E)• Granted states the option of extending Medicaid coverage

to 18- to 20-year-old former foster youth but only 17 states have exercised this option

• Education and Training Voucher (ETV) program provides foster youth with up to $5,000 per year for post-secondary education or training (2001 amendment)

Design and Purpose of the Midwest Study

• Largest longitudinal study of foster youth making the transition to adulthood under FCIA

• Provide states with information about the outcomes of these youth that can be used to better address this population’s needs

• Sample included foster youth in Iowa, Wisconsin and Illinois who: • Were still in care at age 17• Had entered care before their 16th birthday• Had been placed in care because they were

neglected or abused

Study Design and Sample (continued)

Wave Year Number Interviewed

Response Rate

Age at interview

1 ’02 – ’03 732 95.8% 17 – 18

2 ‘04 603 82.4% 19

3 ‘06 590 80.6% 21

Natural Experiment • State laws differ with respect to extending court

supervision of foster youth beyond age 18

• Illinois has been one of the few states that allows foster youth to remain in care until age 21

• 47 percent of the youth interviewed at age 19 were still in care---all but two from Illinois

• Compare their outcomes to the outcomes of the other 53 percent

Demographic Characteristics

Wave 1(N = 732)

Wave 2(N = 603)

Gender MaleFemale

48.551.5

45.954.1

Race BlackWhiteNative American Other/Multi-racial

57.030.91.4

10.7

56.730.81.3

1.2

Ethnicity Hispanic origin 8.6 8.3

State IllinoisWisconsinIowa

64.826.68.6

64.027.08.0

Findings from Baseline Interviews at Age 17 or 18

Placement History Characteristics

Number of placements 1 or 2

3 or 4

5 or more

28.6

26.8

44.4

Ran away from care At least once

More than once

46.6

30.0

Current placement Traditional foster home

Relative foster home

Group home or residential treatment

Other

35.8

30.5

16.1

15.6

Ever placed in a group home

Ever placed with relatives

59.9

56.7

Ever re-entered care 22.1

Educational Risk Factors at Baseline

Ever suspended

Ever expelled

67.3

16.6

Changed schools at least 3 times

Missed at least one month of school

53.9

24.5

Repeated a grade

Received special education services

37.3

47.3

Median reading level 7th grade .

Psychosocial Risk Factors at Baseline

Males Females

Any mental health diagnosis 14.3 34.7

Depression

PTSD

6.6

8.2

13.4

23.6

Any substance use diagnosis 26.0 17.8

Alcohol

Other drugs

15.2

17.8

13.0

10.8

Findings from Follow Up Interviews at Age 19

Living Arrangements at Age 19 by Care Status

Still in Care No Longer in CareOwn place ---- 28.7Supervised independent living 49.6 ---With biological parents ---- 16.8

With other relatives 19.1 17.8With unrelated foster parents 20.2 10.1

Group quarters 6.7 9.0Homeless ---- 0.6Other 4.3 17.1

Ever homeless since exitingLived in three or more places if never homeless

13.825.6

Educational Attainment at Age 19 by Care Status

Still in Care No Longer in Care

No high school diploma/GED 38.2 36.1

Enrolled in school 66.7 30.8

High school/GED program 20.9 10.1

Vocational training 8.5 9.1

2 or 4 year college 37.2 11.7

Employment and Earnings at Age 19 by Care Status

Still in Care No Longer in Care

Worked during past year 61.0 72.3

Currently employed 33.0 47.0

Median hours worked 30 35

Median hourly wage $7.00 $7.00

Earned < $5,000 past year if employed

80.4 72.9

Currently working or enrolled in school

75.9 63.0

Health and Mental Health: Problems and Access to Services at Age 19 by Care Status

Still in Care No Longer in Care

Mental Health Diagnosis 16.8 20.1

Depression

PTSD

6.1

12.9

10.3

12.4

Substance Use Diagnosis 12.9 28.2

Alcohol abuse/dependence

Drug abuse/dependence

8.2

8.6

20.4

18.0

Received mental health treatment 30.5 19.5

Received substance abuse treatment 7.4 7.5

No health insurance 1.8 52.9

Did not receive medical or dental care 9.3 32.3

Pregnancy and Parenthood at Age 19 by Care Status

Still in Care No Longer in Care

Ever pregnant* 46.6 49.7

Pregnant prior to baseline* 37.0 29.8

Pregnant post-baseline* 26.3 37.7

Any living children

Males 15.1 12.7

Females 31.3 31.9

* Females only

Criminal Justice System Involvement Since Baseline by Care Status

Still in Care No Longer in Care

Arrested 21.9 33.8

Males 25.2 49.6

Females 21.0 20.4

Incarcerated 14.4 23.7

Males 20.9 39.4

Females 11.0 11.2

By age 19, 68% of males and 46% of females had ever been arrested. By age 19, 52% of males and 29% of females had ever been incarcerated

Receipt of Independent Living Services

Age 17 or 18 Age 19

Still in Care No Longer in Care

Education 60.0 60.6 43.9

Employment 67.8 49.3 37.4

Financial management 56.1 46.1 28.3

Housing 51.6 45.0 27.1

Health education 69.0 45.7 31.8

Youth development 46.0 29.1 14.6

Summary of Findings

• Youth aging out of foster care continue to face significant and often multiple challenges during the transition to adulthood and many are still not prepared to live independently

• However, foster youth who were still in care at age 19 were faring better across a number of domains than their peers who had left

• Results raise questions about the wisdom of federal and state policies that require or encourage states to discharge youth at age 18

Policy Implications

• Need for policy change at both the state and federal level so that foster youth can remain in care until age 21 regardless of whether they are working or in school

• Federal government could modify Title IV-E so that states can claim reimbursement for foster care maintenance payments made on behalf of youth beyond age 18

• All states could increase access to health and mental health care services by extending Medicaid coverage to former foster youth until age 21

For more information about the Midwest Study:

www.chapinhall.org