Improving outcomes for foster youth

Before making investments in this strategy, city and county leaders should ensure this strategy addresses local needs.

The Urban Institute and Mathematica have developed indicator frameworks to help local leaders assess conditions related to upward mobility, identify barriers, and guide investments to address these challenges. These indicator frameworks can serve as a starting point for self-assessment, not as a comprehensive evaluation, and should be complemented by other forms of local knowledge.

The Urban Institute's Upward Mobility Framework identifies a set of key local conditions that shape communities’ ability to advance upward mobility and racial equity. Local leaders can use the Upward Mobility Framework to better understand the factors that improve upward mobility and prioritize areas of focus. Data reports for cities and counties can be created here.

Several indicators in the Upward Mobility Framework may be improved with investments in supports to improve outcomes for youth in foster care. To measure these indicators and determine if investments in these interventions could help, examine the following:

• Access to health services: Ratio of residents to primary care physicians. These data are available from the U.S. Department of Health and Human Services’ Area Health Resource File.
• Housing stability: Number and share of public-school children who are ever homeless during the school year. These data are collected by local public school districts.
• Safety from trauma: Number of deaths due to injury per 100,000 people. These data are available from the National Center for Health Statistics’ Mortality File and the CDC’s WONDER database. 

Mathematica's Education-to-Workforce (E-W) Indicator Framework helps local leaders identify the data that matter most in helping students and young adults succeed. Local leaders can use the E-W framework to better understand education and workforce conditions in their communities and to identify strategies that can improve outcomes in these areas.

One indicator in the E-W Framework may be improved with investments in this strategy. To measure these indicators and determine if investments in this strategy could help, examine the following:

• Childhood experiences: Percentage of individuals with fewer than three adverse childhood experiences (ACEs).
• Access to health, mental health, and social supports: Percentage of programs offering health, mental health, and social services, or staff or consultants providing infant and early childhood mental health consultation (IECMHC) services.

• Build a kin-first approach to out-of-home placements: There is strong evidence that children in out-of-home placements benefit from being placed with biological relatives or chosen family. In recent years, local, state, and federal child welfare officials have increasingly promoted kin-first placements. However, the proportion of out-of-home placements that are with relatives still varies considerably across jurisdictions. In practice, experts recommend that child welfare agencies adjust their policies and procedures to prioritize and enable placements with kin. Conducting high-quality placement searches, meaningfully incorporating child and family perspectives into the placement process, and providing specialized support services to kin caregivers are key steps to actualizing a kin-first approach. (For more on how to implement a kin-first culture, see the Harvard Kennedy School’s Government Performance Lab’s guide.)

• Create opportunities for relational and cultural connectedness: When a removal is necessary, an out-of-home placement with kin is among the most effective ways to keep a child connected to their family and community. However, there are other practices – like frequent, high-quality “family time” between parents and children – that can preserve these connections. When structured appropriately, family time can also be an opportunity for programming, like coaching on parenting skills, that supports the goal of reunification. (For a deeper dive on best practices for family time, see Casey Family Programs’ resource.)

• Work with urgency to achieve permanency: A permanent, stable living situation supports a child’s ability to develop healthy, lasting relationships. As such, child welfare agencies work to minimize the time that elapses before children are reunited with their families, adopted, or placed with a guardian. Concurrent permanency planning, a practice in which child welfare agencies simultaneously develop and implement more than one permanency plan (generally one for reunification and one for an alternative placement), is considered a best practice for achieving permanency quickly. (For additional guidance on concurrent permanency planning, see the Children’s Bureau’s resource.) When foster youth reach the age of majority (18 years old in most states) without a permanent placement, achieving legal permanency (i.e., a relationship with a par­ent­ing adult that is rec­og­nized by law) may become less important. However, the importance of relational permanency remains. Helping these youth develop and maintain long-term, supportive relationships with parents, other relatives, mentors, and others – as is discussed below – is crucial to their wellbeing.

• Offering comprehensive support services to youth and their families: When youth enter foster care, their care team will typically facilitate the development of an individualized care plan. This plan will help identify the types of supports that the child needs to recover and build resilience while awaiting reunification or another permanent placement. When a child’s parents need support services to enable reunification, these services will also be included as part of care planning. Both youth and their parents will vary in the types and intensity of supports they need based on their background. Common support services include behavioral health and substance use counseling, mentoring and tutoring programs, life and career planning, among many others. Often, these services will be provided through referral to or via a contract with community-based organizations.

• Supporting youth and caregivers post-permanency: Around 17 percent of youth who leave foster care for guardianship and about 27 percent who are reunited with their families later return to foster care. Post-permanency services (also called, "post-reunification" and “after-care” services) encompass a wide-range of supports that aim to prevent the need for re-entry into the foster care system. Common post-permanency services include education on parenting skills, clinical and behavioral health care for the child and/or parents, and mentoring or peer support programs, among others. (For information on specific models, see the California Evidence-Based Clearinghouse’s topics pages on post-permanency and post-reunification services.)

• Providing specialized services for youth who age out of foster care: When a young person in foster care reaches the age of majority without a permanent placement, they may exit foster care, losing access to relationships and support services at a time when they are transitioning into adulthood. Recognizing this challenge, the majority of states offer extended foster care (or similar services), which allows young adults to remain in or return to foster care until the age of 21. Experts note that these services should be developmentally appropriate for older, “transition-age” youth. Often, this means engaging youth more deeply in decision-making about their futures and providing supports – like workforce training, transitional housing, or education on financial management – that help them navigate early adulthood. For an example of an evidence-based model for transition-age youth, see Results for America’s case study on Youth Village’s LifeSet model in Louisiana.

• Emphasize prevention: In most communities, LGBTQIA+ youth and youth of color are overrepresented in foster care, often as the result of systemic issues outside the child welfare system. Preventative services that strengthen families and communities and reduce the need for out-of-home placements are a key strategy for reducing the number of youth – and of youth from marginalized backgrounds – in the foster care system. To learn more about family- and community-level supports, see the Economic Mobility Catalog’s guides on “Supports for expecting parents and families with young children” and “School-based supports for child health and well-being.”

• Provide training to promote cultural competency: Experts emphasize the importance of youth feeling accepted and affirmed in their identities while in the foster care system. Providing evidence-based training programs focused on building cultural competency is an emerging practice that may help parents, caregivers, and child welfare staff be more skilled in supporting youth in their identities.

• Use data to identify, promote accountability for, and act on disparities: Experts also advise that child welfare leaders can proactively use data to identify and close disparities between youth of different backgrounds. For example, data on the reasons that youth enter foster care can be disaggregated by race, sexuality and gender identity, disability status, and other characteristics. This can not only inform the types of preventative interventions a community may prioritize, but also point to the types of supports youth may need to recover and build resilience while in foster care. On the “back-end,” disaggregated outcomes data – like length of stay in foster care and post-placement outcomes – can help child welfare agencies prioritize subgroups of youth that may need different or more intensive services.

• Foster youth and families: Youth in foster care – and their families – should be engaged in developing their individualized treatment plans. At a macro level, as participants in many child welfare interventions, youth and their families can be engaged to provide feedback on or even co-design programming (for more on engaging foster youth, see the best practices section below).

• Federal government: The federal government is a major funder of child welfare services, including for foster youth. Most federal funding comes through the U.S. Department of Health and Human Services.

• State child welfare agencies: In the majority of states, state-level child welfare agencies lead foster care policymaking, licensing, training, and other administrative functions. Regardless of the division of responsibilities, state governments generally provide funding for foster care services.

• County child welfare agencies: In states with a centralized child welfare model, counties have a more limited role, focused primarily on investigations, service provision, and other “client-facing” functions. However, in a subset of states, counties are primarily responsible for administering child welfare services and take on greater authority.

• Municipal and county housing, health, and human services officials: Local government agencies often provide a range of social services that can support foster youth and their families.

• Community-based organizations: Community-based organizations similarly provide social services and other programming that can support foster youth, young adults in extended foster care, and their families. Practitioners providing day-to-day programming to foster youth and their families can also provide concrete insights into community needs.

• K-12 and post-secondary education organizations: Many K-12 school districts designate a liaison to work with child welfare agencies to remove barriers that students involved in the foster care system face to regular attendance and academic success. Particularly for transition-age youth, close relationships with post-secondary institutions and workforce programs can be important for facilitating youths’ transition into adulthood

• Judicial system: Juvenile or family courts are involved throughout a child’s time in the foster care system, from removal to permanency planning to their ultimate placement.

• Engage youth with lived experience: Experts recommend that the design and implementation of programming for foster youth be informed by the perspectives of those with lived experience in the foster care system. Common approaches to engaging youth include advisory groups, often used prospectively when designing a program or service, and surveys and focus groups, used to collect feedback during or after youth participate in a program. (For more detailed guidance on how child welfare agencies can engage youth, see Casey Family Programs’ resource.)

• Recognize developmental variation across child- and early adulthood: Providing developmentally appropriate programming to youth can help build their sense of normalcy and agency while in foster care. Typically, child welfare agencies are working with individuals from infancy to early adulthood. As such, child welfare leaders should ensure programs and practices flex to meet the needs of youth across their lifespan. How youth are engaged in permanency planning is a prime example: as part of the same permanency planning process, it may be appropriate for youth to take on a greater role in determining their placement decisions. One way for child welfare agencies to encourage developmentally appropriate practice is by allowing staff to focus their caseloads on specific age groups, enabling specialization.

• Select interventions with organizational capacity in mind: Interventions for foster youth and young adults transitioning out of foster care are most effective when implemented with a high degree of fidelity. When identifying interventions, experts advise that child welfare leaders select program models that their organization has the capacity (or could build the capacity) to implement as intended.

• Reasons for entry: Tracking the primary reasons youth enter the foster care system can help communities identify preventative measures and ensure child welfare agencies have the appropriate resources to meet the needs of foster youth.

• Assessment data: Child welfare agencies commonly use standardized assessments at intake to understand the behavioral, relational, cultural, and other strengths and needs of foster youth (an example is the Child and Adolescent Needs and Strengths assessment). When repeated throughout a child’s time in foster care, assessment data can be used to continuously inform care decisions and to speak to the effectiveness of interventions.

• Programmatic and process measures: Child welfare agencies commonly track programmatic and process measures, like the number of youth entering foster care, the average time until permanency, and the number and types of placements (e.g., reunification versus guardianship versus adoption) achieved.

• Post-care outcome measures: Tracking outcomes for youth after they exit foster care and are no longer regularly in contact with an agency can be challenging. However, post-care outcomes measures can help child welfare agencies better understand the strengths and weaknesses of their approach to preparing youth for their transition out of foster care. To encourage youth to share information on their wellbeing, some agencies offer incentives for youth who complete surveys and/or check in with a social worker.