The Future of Children

3 downloads 90467 Views 1MB Size Report
It is usually in the best interests of children to live with their families. .... Sacramento, CA: Commission on California State Government Organization and ...
Children in Foster Care Eugene M. Lewit

Eugene M. Lewit, Ph.D., is director of research and grants for economics at the Center for the Future of Children.

I

t is usually in the best interests of children to live with their families. Sometimes, however, families are unable to provide the care that children need or the environment within a family may, in fact, be harmful to a child. In these circumstances, it falls upon the child welfare system to provide substitutes for the functions parents and families have difficulty performing. Today, the placement of children in out-of-home substitute care, commonly called foster care, is regarded as something of a last resort.1,2 Experts emphasize the need for preventive and rehabilitative services to help keep families together. To preserve families, child welfare agencies may provide a variety of supportive (for example, counseling to help families cope with problems and learn appropriate parenting skills) and supplementary (for example, financial assistance) services to families with children. Emphasis is also placed on stable, permanent placements for children who cannot return home by limiting the duration of placements in foster care and by finding permanent living arrangements for these children. Statistics on the population of children in foster or substitute care, the subject of this Child Indicators article, can serve as indicators both of the well-being of children in our society and of the functioning of the child welfare

system. Information on the number and characteristics of children in foster care provides rough indices of social conditions and the conditions within families which pose substantial risks to children. Family instability, poverty, crime and violence, homelessness, substance abuse, and serious illnesses such as HIV/AIDS may all contribute to the need to find alternative living arrangements for children. In addition, because a well-developed network of therapeutic services and tangible support may go a long way toward preserving families in stressful circumstances,3 data on the number, characteristics, conditions, and outcomes for children in foster care provide indicators of how well the child welfare system is functioning to protect children and preserve families. This Child Indicators article reviews a small set of statistics about children in foster care. The foster care system is but a piece of the extremely complex child welfare system. Child welfare services may in-

The Future of Children

HOME VISITING

Vol. 3



clude investigation of allegations of child abuse, neglect, and exploitation; provision of services to children and families to end maltreatment; placement of children in temporary or permanent out-ofhome care; and supervision of children in foster care.1 Many nonprofit, private and government entities deliver and oversee child welfare services, but primary responsibility rests with the states.1 In addition, the federal government has been involved in child welfare programs for many years. The federal role has been primarily to provide funds to the states for activities that are consistent with federal policies.1 States and local governments, via delegation from state governments, have substantial latitude in running their child welfare systems.1 Because each state has its own administrative, legal, and programmatic structures, child welfare and foster care programs vary from state to state, and care must be taken in interpreting data from different reporting entities.

No. 3 - Winter 1993

193

In the next section, we examine the reasons children are placed in foster care, as well as the various living arrangements that constitute foster care. Then an examination of trends in foster care case loads provides an opportunity to review sources of national data on foster children and leads to an examination of factors influencing the recent rapid growth of the foster care population.

Defining Foster Care The term foster care refers to the formal out-of-home placement of children in alternative residential settings. There are a number of reasons children are placed in foster care and a number of different settings into which they may be placed. Figure 1 provides data on the reasons children were removed from their homes in California in 1991. 4 Most often these children and their families were the subject of abuse and neglect allegations and proceedings. About 20% of children were removed for physical or sexual abuse. Most children, however, were removed because of neglect (failure to provide adequate food, clothing, shelter, supervision, or medical care for a child or exposure of a child to dangerous situations) and caretaker absence (as a result of illness, incarceration, or death) and incapacity (as a result of disability or illness). Neglect and incapacity are related because sometimes a problem with drugs or alcohol makes a parent unable to care for a child and leads to citation for neglect.4 In addition, approximately 7% of children in

California who were placed in foster care were removed from their homes because of status offenses such as running away, delinquency, or truancy. Children who are awaiting adoption as well as those requiring special services for a disability or handicap which cannot be provided in the child’s own home also are included in the foster, or substitute, care system. Children removed from their homes are placed into a variety of facilities (see Figure 2). The majority of children are placed in foster family homes. 4 Run by foster parents, foster family homes are intended to come as close as possible to a “regular” family’s home. They take a limited number of children and typically do not provide onsite professional support services. The second most frequent type of placement for foster children is in various group homes and residential care facilities which provide some forms of special treatment, support, and supervision either for children with severe disabilities and/or behavioral problems, or for children in trouble with the law. Other special shelters or medical facilities are used for short-term emergency care or specialized services. Although intended for only brief episodic care, these facilities may be used for longer periods when alternative placements cannot be found or in other special circumstances. Children living in nonfinalized adoptive homes as well as some children living in maternity homes, college dormitories, mental retardation facilities, and correctional institutions may be included in the foster care population in some states.5

Over time, an individual child may be placed in many of these settings. In an emergency, a child may be placed in a shelter while awaiting placement in a foster family home, and children who do not do well in foster family homes may be placed in group homes. The variety of reasons children are placed out of home and the variety of settings into which they are placed can create confusion in referring to this population of children. The terms foster care and substitute care appear to be used fairly interchangeably in the literature to describe the system for making out-of-home placements for children who cannot remain with their families. Typically, these children are said to be in foster care, although they may be placed in settings other than foster family homes. In this article, the term foster care is used to refer to this population of children in keeping with common usage, although the term substitute care may be technically more appropriate and is used in some official national data sources.

National Data on Foster Care Although government agencies at the national, state, and local levels spend billions of dollars annually on foster care, no precise data are available to describe the population of children in foster care in the United States.1 The primary source of national data on foster care is the Voluntary Cooperative Information System (VCIS).5 The VCIS is based on a voluntary survey of states conducted annually by

194

THE FUTURE OF CHILDREN - WINTER 1993

Figure 1

Reasons for Removing Childen from Their Homes, California, Calendar Year 1991

Neglect 42%

Other 5%

Legal offense 7%

Sexual abuse 8%

Caretaker absent or incapacitated 26%

Physical abuse 12%

Children are removed from their nuclear families and placed in substitute (foster) care to protect them from abusive adults, to assure them of adequate supervision and support, to provide them with special services, and to assure them of a different environment because they have broken the law. These data from California suggest that children are placed in foster care primarily because their parents cannot care for them adequately. More than two-thirds of foster children were removed from their homes because of neglect and caretaker incapacity or absence. Anecdotal evidence suggests that, in many of these cases, parental use and abuse of alcohol and illegal drugs were important contributing factors to the decision to remove the children from their homes. Despite the increased attention given to physical and sexual abuse of children in the press and a steady increase in the frequency of reporting of physical and sexual abuse of children, these forms of abuse have actually constituted a decreasing percentage of all reasons for removing children from their homes in California in recent years. Source: Little Hoover Commission. Mending our broken children: Restructuring foster care in California. Sacramento, CA: Commission on California State Government Organization and Economy, April 9, 1992.

195

CHILD INDICATORS: Children in Foster Care

Figure 2

Living Arrangements of Children in Substitute Care in 32 States, Fiscal Year 1989 Foster family homes 73.4%

Other 6.8%

Group homes or shelters 17.1% Nonfinalized adoptive homes 2.7%

There are a variety of facilities into which foster children are placed. Some, such as family foster homes, are limited in size and do not typically provide any special support services on site. They are supposed to replicate “regular” family homes as much as possible. Other facilities, such as group homes, are more institutional in nature and provide some special treatment, support, or supervision either for children with severe disabilities or for those who are in trouble with the law. Special shelters are also used on an emergency basis for a short time for children awaiting more durable placements. Children awaiting finalization of their adoption, as well as some children residing in maternity homes, college dormitories, mental retardation facilities, and correctional institutions, may be included in the substitute care population in some states. Children residing in the later grouping of miscellaneous facilities are included in the category called Other in the figure. ■

A growing trend in states faced with a strong upswing in the demand for foster care placement is kinship care, the placement of foster children with close relatives. For example, in California, only 27% of foster care placements in 1984-85 were with relatives. By 1991, kinship care accounted for more than 43% of all placements. It appears that the growth in kinship care placements may have accounted for two-thirds of all the growth of the foster care population in California between the mid-1980s and the early 1990s. Children in kinship care would be included in the family foster care category in the VCIS. But states seem to have very different policies on accounting for kinship care so it is difficult to assess the true national situation regarding kinship care.5

Source: Voluntary Cooperative Information System/American Public Welfare Association data for 1989. Data from these 32 states accounted for about 75% of the total substitute care population in FY 1989.

196

THE FUTURE OF CHILDREN - WINTER 1993 the American Public Welfare Association (APWA). The most recent year for which complete survey data are available is fiscal year 1989.5 In addition, some preliminary data are available for fiscal year 1992.6 There are a number of reasons care should be exercised in interpreting VCIS data on foster care. First, since the VCIS survey was first conducted in 1982, the number of states responding to the survey has fluctuated from year to year. In 1989, 45 states and Puerto Rico responded. Also in each year, not all responding states answered all of the detailed questions in the survey, and the definitions of terms and reporting periods varied among the states. For example, states report data for either the federal fiscal year or their own individual fiscal years. In addition, although data are collected on all children in substitute care, states do not report uniformly. Nine states do not count children residing in nonfinalized adoptive homes (VCIS definitions include these children) in their substitute care populations, and eight states include former foster children returned to their own homes who are still receiving supervision from child welfare agencies (VCIS definitions exclude such children).5 Because definitions, reporting periods, and response rates vary among reporting states, it may be difficult or impossible to make some interstate comparisons, and some imprecision is introduced in aggregate national data over time as different states report in different years. In response to these limitations in the VCIS data, APWA bases its detailed analyses of the substitute care system on subgroups of states for which specific data items are available. Although suggestive, these analyses are not definitive because data from different groups of states are used to answer different questions. In this article, aggregate VCIS data are used to describe na-

tional trends, but information from large states (California, New York) with large foster care populations is used to illustrate and explore topics that are not well addressed in national data sets. Figure 3 presents data on the total U.S. foster care population as reported by the VCIS and on the total number of children served by the U.S. foster care systems for 1982 through 1992. The U.S. child substitute care population, as reported by the VCIS, is the total number of children in care at a specific point in time (typically the end of the fiscal year). The U.S. child substitute care population reached 442,000 at the end of (state) FY 1992.6 In contrast, the total number of children served by the nation’s substitute care system includes all children who spent at least one day in care at some time during a fiscal year. Nationally, an estimated 659,000 children were served by the states’ foster care systems in FY 1992.6 Typically, the number of children served, which includes all the children in care at the beginning of a fiscal year plus all the children who entered care during the year, is much greater than the total foster care population which is a point-in-time statistic. Also shown in Figure 3 is the average monthly number of foster care children who received federal funding from 1982 through 1990.7 These children receive support under the federal Title IV-E foster care program, a permanently authorized entitlement program that provides open-ended matching funds to states for children in various substitute care placements who are eligible for Aid to Families with Dependent Children (AFDC). Children in the Title IV-E program are eligible for Medicaid and for maintenance payments for the cost of food, shelter, clothing, daily supervision, school supplies, general incidentals, liability insurance, and travel. Federal matching rates for these expenditures are at least

50% and are the same as a state’s Medicaid matching rate. The total foster care population as reported by the VCIS is greater than the Title IV-E population because it includes many children in state foster care programs who are not eligible for federal funds. During 1990, approximately 168,000 children were in the Title IV-E program, 41% of the total foster care population in that year.7

Growth in the Foster Care Population As can be seen in Figure 3, the number of children in foster care as reported by the VCIS remained fairly constant between 1982 and 1986, but increased rapidly between 1986 and 1990. Although VCIS national data cannot adequately explain the upswing in the foster care population beginning in 1986-87, detailed data from several states with large foster care populations are highly suggestive. Data from New York, Illinois, and California are particularly telling and suggest that the increase in the foster care population resulted in large part from the introduction of crack cocaine into the United States in the mid-1980s. Although the increase in parental substance abuse led to a general increase in child abuse and neglect, its greatest impact has been in the number of very young infants entering foster care as a result of prenatal drug usage, drug toxicity at birth, abandonment at birth, and inadequate parenting in the period immediately after birth.1,4 Data from New York and Illinois document a substantial increase in infant foster care admissions in the late 1980s. Between 1985 and 1988, infant foster care admissions increased by 89% in New York and by 58% in Illinois.1 By 1988, almost 3% of all infants born in New York City were placed in foster care. l Most of these placements occurred within days

CHILD INDICATORS: Children in Foster Care

197

Figure 3

U.S. Foster Care Population, 1982-1992

There is no uniformly defined, complete source of national data on foster care. Most national data come from the Voluntary Cooperative Information System (VCIS), a voluntary annual survey conducted by the American Public Welfare Association with support from the Department of Health and Human Services. VCIS foster care data should be interpreted cautiously because the number of jurisdictions reporting have fluctuated from year to year, not all reporting states answered all the questions in the survey, and the definitions of terms and reporting periods varied among the states. ■

The number of children in foster care in the United States increased by 69% between 1982 and 1992. As a result, the proportion of all children in foster care increased from four per thousand in 1982 to six per thousand in 1992.



Figure 3 presents data on the foster care population, the total number of children in care at a specific point in time (typically the end of the fiscal year), and the total number of children served by the nation’s substitute care system during a year. For any year, the number of children served will be greater than the population at a point in time so long as some children leave the system during the year.



Data on foster children receiving support via the federal AFDC/Title IV-E programs are tied to the flow of matching funds from the federal government to the states to support the services provided and the administration of the program at the state level. Between 1982 and 1990, the population of children eligible for Title IV-E assistance increased by 73%. During this period, the population of foster children eligible for federal reimbursement under Title IV-E grew more than twice as rapidly as the population of foster children not in the federal program and supported largely by state funds. This has led to some concern that, as an open-ended entitlement, the Title IV-E program may provide strong incentives to place children in foster care without strong efforts at family preservation, which are not reimbursed under the program.l,3

Sources: U.S. House of Representatives, Ways and Means Committee. Overview of entitlement programs. Washington, DC: U.S. Government Printing Office, May 15, 1992, pp. 102-44; Tatara. T. Characteristics of children in substitute and adoptive care: A statistical summary of the VClS National Child Welfare data base. Washington, DC: VCIS/APWA, May 1993; Tatara, T. U.S. child substitute care flow data for FY 1992 and current trends in the state child substitute care populations. VCIS Research Notes (August 1993), No. 9.

198

THE following birth. Data from California suggest that the number of children of all ages entering foster care because of endangerment related to parental substance abuse more than doubled between FY 1984-85 and FY 1991-92.4 Data from states like California, New York, and Illinois are not only suggestive of national trends, but may in fact dominate national statistics because of the size of the foster care populations in these states. In 1989, the 10 states with the largest substitute care populations as reported in the VCIS (California, Florida, Georgia, Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, and Pennsylvania) accounted for almost 63% of the total national foster care population. 5 The substitute care populations of California, New York, and Illinois were more than 40% of the national substitute care population in 1989, and the growth of the foster care population in these three states accounted for more than 60% of the growth in the national foster care population between 1986 and 1989.5 The rapid growth in the U.S. foster care population seems to have abated somewhat beginning in FY 1990.6 Data from the 1990s are preliminary; and although it is difficult to identify the reasons for the recent deceleration in the growth of the foster care population, anecdotal evidence suggests it may be related to changes in policies regarding the placement of infants and young children whose mothers abuse illegal drugs. 8

Kinship Care The very substantial demands placed on the child welfare system by the crack cocaine epidemic of the late 1980s led to an increase in the formal foster placement of children with relatives. This practice, called kinship care, appears to be most common in African-American communities, where children are fre-

FUTURE OF CHILDREN - WINTER 1993

quently placed with their grandmothers or other close relatives.4 Again, data from New York, Illinois, and California are particularly suggestive. In New York City, the number of children placed in foster care with relatives increased from 1,000 in 1986 to more than 20,000 in 1990. In Illinois, the numbers were 3,700 in 1986 and 8,200 in 1990.1 In California, 33,000 children were placed in foster care with relatives in 1991, and almost half of all foster care placements for African-American children were with relatives.4 Assessing the role of kinship care in the national foster care population is difficult because of limitations in the VCIS data. Of 35 states responding to the 1987 VCIS survey, 34 reported that they counted in their substitute care populations children living with relatives who are licensed, approved, or paid as foster parents by the primary state child welfare agency. One state did not include these children in its substitute care data, and policies in the remaining states could not be determined. More problematic is the fact that 19 of 36 states reported that they also counted in their substitute care population children residing with relatives who were not licensed, approved, or paid as foster parents by the primary state agency. Such children were not included in population counts from 17 states. While it may be that kinship care arrangements are relatively infrequent in states that do not specifically account for them, it is very difficult to know the true situation when reporting practices are so varied. The increase in kinship care has generated considerable controversy. Some worry that foster care data may be misleading if kinship care arrangements merely formalize, subsidize, and count traditional child-rearing practices that relied, especially in some ethnic groups, on extended family care for chil-

dren. In some states, concerns about the financial incentives for kinship care arise because more public support money is available for children in foster care than for children who are cared for in their own immediate family.3 In these situations, kinship care can discourage family preservation and reunification efforts by making it easy and financially attractive for parents to maintain contact with their children without regaining custody. This may also pose a risk to children where parents are abusive. On the other hand, in some states, foster parents who care for relatives receive less reimbursement than do nonrelative foster parents. This practice may impose a financial hardship on the child and serve as a disincentive for the foster parents who care for relatives. Yet, kinship care is frequently invoked to make up for shortages in the supply of foster family homes and to satisfy requirements that foster children be placed with families of the same racial or ethnic background. 4 Such objectives are difficult to satisfy in a world where a disproportionate share of children in foster care are from ethnic minorities, and available ethnic minority homes are scarce. Although relatively little research has been done on the effects of kinship care placements on children, authoritative groups such as the National Commission on Children have endorsed kinship care as “often a desirable arrangement” if adequate support is provided for children living in such arrangements. 2

Need for Better Data Uncertainty about the precise number and characteristics of children in the foster care system, the reasons for the apparent growth in the size of the foster care population in recent years, and the consequences of increased reliance

CHILD INDICATORS: Children in Foster Care

on kinship care all underscore the need for a better information management system for the nation’s substitute care programs. At a minimum, such a system would contain relevant but concise placement history data on each foster child in the United States.9 Data bases would be organized longitudinally rather than as point-in-time snapshots to enhance their utility to track and manage the placement of individual children and would offer the capacity to undertake statistical analyses to form the basis of informed policy choices. 9 In 1986, Congress passed legislation mandating both a review of the data requirements for the adoption and foster care system nationwide and recommendations for the methods of establishing, administering, and financing a

data collection system for the United States.l,9 Although the legislation required that mandatory data collection begin no later than October 1, 1991, implementation of the new system is currently on hold pending review and action by the new administration. The current director of the VCIS suggests that, under this scenario, the earliest date the new data system could be in place would be in FY 1995.10 Until such a system is in place and operational, interpretation of statistics on the foster care population will be difficult, and it will be hard to evaluate how well the multifaceted child welfare system is serving the nation’s children. But it is likely that an improved data reporting and tracking system will be only a necessary, but not a sufficient, first step toward improving

199

the child welfare system and addressing the needs of children in foster care. More resources, creative problem solving, and a strengthened commitment to improve the system will also be required. Better data, however, should make the process easier and more efficient by enabling policymakers to identify and focus attention on problem areas and to monitor the effects of remedial policies. Don Hoban prepared a preliminary version of this article. The helpful comments and supplemental data provided by Toshio Tatara are gratefully acknowledged, as are the comments of Richard Behrman, Deanna Gomby, Carol Larson, and Linda Quinn. Cheri Gaither helped with manuscript preparation. The usual caveats apply.

1. U.S. House of Representatives, Ways and Means Committee. Overview of entitlement programs. Washington, DC: U.S. Government Printing Office, May 15, 1992, pp. 102-44. 2. National Commission on Children. Beyond Rhetoric: A new American agenda for children and families. Washington, DC: National Commission on Children, 1991. 3.

Jost, K. The CQ Researcher: Foster care crisis. Congressional Quarterly Inc. in conjunction with EBSCO Publishing (September 27, 1991) 1,20:705-29.

4. Little Hoover Commission. Mending our broken children: Restructuring foster care in California. Sacramento, CA: Commission on California State Government Organization and Economy, April 9, 1992. 5. Tatara, T. Characteristics of children in substitute and adoptive care: A statistical summary of the VCIS National Child Welfare data base. Washington, DC: VCIS, APWA, May 1993. 6. Tatara, T. U.S. child substitute care flow data for FY 92 and current trends in the state child substitute care populations. VCIS Research Notes (August 1993), no. 9. 7. Authorized under Title XX of the Social Security Act, the Social Service Block Grant is the largest federal program to provide funds for foster care and other services for children and families. It provides an annual block grant to each state to spend on any social service program it chooses. There are no comprehensive data on how the money is spent, so it is impossible to determine how much of the money is spent on foster care. In addition, states receive 75% matching funds under Title IV-B of the Social Security Act for direct child welfare services, including preventive services, placement services, and services to reunify families with children in foster care. Funds for both the Title XX and Title IV-B programs are limited and need to be appropriated annually. In contrast, the matching fund program under Title IV-E of the Social Security Act for maintenance of AFDC-eligible children in foster care has been operating as an open-ended entitlement with spending levels determined by the level of qualified claims submitted by the states. As a result of the open-ended structure of the Title IV-E program, the cost of this program has tended to grow rapidly in recent years, even as funding for Title XX and Title IV-B services has stagnated or declined in real terms. (See note no. 1.) 8. For example, in New York City prior to 1991, infants whose mothers abused illegal substances during pregnancy were routinely placed in foster care and kept in hospitals awaiting nonkinship placement. Policy changes have allowed these children to be placed in kinship care or released with their mothers if the mothers agree to seek

200

THE FUTURE OF CHILDREN - WINTER 1993

counseling for substance abuse. Personal communication, Andrew Racine, M.D., pediatrician at Bronx Municipal Hospital Center, August 1993. 9. Finch, S.J., Fanshel, D., and Grundy, J. Data collection in adoption and foster care: The state of the art in obtaining organized information for policy analysis. Washington, DC: Child Welfare League of America, 1991. 10. Personal communication, Toshio Tatara, August 1993.