1. Foster Youth and the Transition to Adulthood: Findings from the Midwest Study Mark Courtney, Principal Investigator Amy Dworsky, Project Director

2. Presentation Outline Background and Policy Context Midwest Study Design and Sample Natural Experiment Major Findings Policy and Practice Implications

3. 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

4. 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)

5. 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

6. Study Design and Sample (continued) WaveYearNumber Interviewed Response Rate Age at interview 1’02 – ’0373295.8%17 – 18 2‘0460382.4%19 3‘0659080.6%21

7. 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

8. Demographic Characteristics Wave 1 (N = 732) Wave 2 (N = 603) GenderMale Female 48.5 51.5 45.9 54.1 RaceBlack White Native American Other/Multi-racial 57.0 30.9 1.4 10.7 56.7 30.8 1.3 1.2 EthnicityHispanic origin 8.68.3 StateIllinois Wisconsin Iowa 64.8 26.6 8.6 64.0 27.0 8.0

9. Findings from Baseline Interviews at Age 17 or 18

10. Placement History Characteristics Number of placements1 or 2 3 or 4 5 or more 28.6 26.8 44.4 Ran away from careAt least once More than once 46.6 30.0 Current placementTraditional 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 care22.1

11. 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 level7 th grade.

12. Psychosocial Risk Factors at Baseline MalesFemales Any mental health diagnosis14.334.7 Depression PTSD 6.6 8.2 13.4 23.6 Any substance use diagnosis26.017.8 Alcohol Other drugs 15.2 17.8 13.0 10.8

13. Findings from Follow Up Interviews at Age 19

14. Living Arrangements at Age 19 by Care Status Still in CareNo Longer in Care Own place----28.7 Supervised independent living49.6--- With biological parents----16.8 With other relatives19.117.8 With unrelated foster parents20.210.1 Group quarters6.79.0 Homeless----0.6 Other4.317.1 Ever homeless since exiting Lived in three or more places if never homeless 13.8 25.6

15. Educational Attainment at Age 19 by Care Status Still in CareNo Longer in Care No high school diploma/GED38.236.1 Enrolled in school66.730.8 High school/GED program20.910.1 Vocational training8.59.1 2 or 4 year college37.211.7

16. Employment and Earnings at Age 19 by Care Status Still in CareNo Longer in Care Worked during past year61.072.3 Currently employed33.047.0 Median hours worked3035 Median hourly wage$7.00 Earned < $5,000 past year if employed 80.472.9 Currently working or enrolled in school 75.963.0

17. Health and Mental Health: Problems and Access to Services at Age 19 by Care Status Still in CareNo Longer in Care Mental Health Diagnosis16.820.1 Depression PTSD 6.1 12.9 10.3 12.4 Substance Use Diagnosis12.928.2 Alcohol abuse/dependence Drug abuse/dependence 8.2 8.6 20.4 18.0 Received mental health treatment30.519.5 Received substance abuse treatment7.47.5 No health insurance1.852.9 Did not receive medical or dental care9.332.3

18. Pregnancy and Parenthood at Age 19 by Care Status Still in CareNo Longer in Care Ever pregnant*46.649.7 Pregnant prior to baseline*37.029.8 Pregnant post-baseline*26.337.7 Any living children Males15.112.7 Females31.331.9 * Females only

19. Criminal Justice System Involvement Since Baseline by Care Status Still in CareNo Longer in Care Arrested21.933.8 Males25.249.6 Females21.020.4 Incarcerated14.423.7 Males20.939.4 Females11.011.2 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

20. Receipt of Independent Living Services Age 17 or 18 Age 19 Still in CareNo Longer in Care Education60.060.643.9 Employment67.849.337.4 Financial management56.146.128.3 Housing51.645.027.1 Health education69.045.731.8 Youth development46.029.114.6

21. 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

22. 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

23. For more information about the Midwest Study: www.chapinhall.org