Interest in the transition of foster children to adulthood is not new. Over eighty years ago, the State Charities Aid Association of New York commissioned Sophie van Senden Theis (1924) to attempt to find 910 of their former wards who, by that time, were adults. Working with a thoughtfully selected sample and achieving a respectable follow-up rate, Theis provided a rich description of the post–foster care well-being of the association's former wards. Although some were doing well, many of the former foster children experienced problems that troubled the leaders of the State Charities Aid Association. To this day, youth who age out of the nation's foster care system are a population at high risk of having difficulty managing the transition from dependent adolescence to independent adulthood. They experience high rates of educational failure, unemployment, poverty, out-of-wedlock parenting, mental illness, housing instability, and victimization. They are less likely than other youth to be able to rely on the support of kin.
Child welfare agencies are required to make “reasonable efforts” to prevent placement of children in out-of-home care, usually in the form of social services for their families. When the child welfare agency and court deem these efforts unsuccessful and the child enters out-of-home care, the court must approve a “permanency plan” for the child according to timelines provided in federal law. Most commonly, the initial plan is for the child to return to the care of parents or other family members. Once again, the court generally requires the child welfare agency to make reasonable efforts to preserve the child's family of origin, in this case by providing services intended to help reunite the child with the family.
In many cases, however, children and youth cannot return to the care of their families. In these cases, the child welfare agency and the court attempt to find another permanent family for the child through adoption or legal guardianship. Although the vast majority of children in out-of-home care exit care to what are considered, in the parlance of the child welfare system, “permanent” placements (reunification with family, adoption, and legal guardianship), about twenty thousand exit care each year through legal “emancipation,” usually when they reach the age of majority or graduate from high school. In practice, few states allow youth to remain in care beyond their eighteenth birthday, though some will continue to make payments to an out-of-home care provider if the youth in their care is likely to obtain a high school diploma before their nineteenth birthday (Bussey et al., 2000). As a result, of the 513,000 children and youth who were in out-of-home care in the United States on September 30, 2005, fewer than 5 percent, or about 24,000, were eighteen or older. Illinois is the only jurisdiction to discharge a significant number of youth at twenty-one (Bussey et al., 2000). Youth eighteen and older are a unique population in out-of-home care in that the state continues to play a profound parental role in their lives even though they are adults and can choose to leave “the system” at any time.
A recent longitudinal study of the placement trajectories of older foster youth (i.e., those in a position to age out of the foster care system) puts their experience in out-of-home care into perspective. Fred Wulczyn and Kristen Brunner Hislop (2001) analyzed placement histories and discharge outcomes of all youth in twelve states (n = 119,011) that were in out-of-home care on their sixteenth birthday. Four findings stand out. First, most of these youth had entered care since their fifteenth birthday, and only 10 percent had entered care as preteens (i.e., twelve or younger). In other words, few of the youth who aged out of care actually grew up in the foster care system. Second, these older youth were less likely to be living with kin and much more likely to be living in congregate care (group homes or children's institutions) than the overall foster care population. Some 42 percent of these youth were living in congregate care, and only 12 percent were living in kinship foster care. Third, nearly one-half (47 percent) of these youth returned to their families when they were discharged from foster care. Finally, more youth experienced “other” exits (21 percent, mainly transfers to other child-serving systems) or ran away from care (19 percent) than were emancipated (12 percent).
These facts raise important issues when one examines the young adult outcomes of older youth leaving the foster care system, the potential role of “permanency” in adult outcomes for this group of youth, and the policy and practice framework established to help them during this transition. Foster children in general face the disadvantages associated with family backgrounds where they have been subjected to maltreatment. Because youth generally enter foster care during adolescence, youth who age out of care have often spent many years in challenging family circumstances before intervention by child protection authorities. Thus, the outcomes experienced by former foster youth during the transition to adulthood may largely be a function of the problems they experienced before they entered foster care.
Support from family is recognized as an important contributor to successful adolescent transitions to adulthood (Furstenburg and Hughes, 1995; Mortimer and Larson, 2002). Yet, placement in out-of-home care, by its very nature, threatens a youth's family relations and can undermine family support. It may be unlikely that a youth's parents will be of much assistance during the youth's transition to adulthood or they may be a potential source of risk to the youth. Members of the extended family, however, may be available for support, but they may not play this role if their relationship to the youth has been negatively affected by the youth's placement in out-of-home care. The potential disturbance in family relations may be particularly likely for youth who age out of foster care. Relatively few of these youth are placed with relatives, the placement setting that is arguably most likely to facilitate continuing relations with extended family. Moreover, a large percentage of these youth live in congregate care settings that are generally staffed by relatively young shift workers who tend to remain in their position for short periods of time. Thus, youth in congregate care may find it difficult to form the kind of lasting relationships with responsible adults associated with the care setting that will help them move toward independence. In addition, congregate care programs are often charged by public child welfare authorities with providing care and supervision of youth but are not expected to play much of a role in family casework associated with youths’ placement in out-of-home care. When this is the case, it is likely that congregate care providers will not place a high priority on helping youth maintain their relations with family members. The circumstances of youth who age out of care raise an important question for policymakers and practitioners: How can child welfare policy and practice help maintain supportive family relations for foster youth and build new relationships that can support youth during the transition to adulthood?
In this chapter I describe the challenges facing foster youth as they leave the protection of the child welfare services system. I review the literature on the young adult outcomes of former foster youth and consider the implications of these findings for practice and policy. These implications are framed with recognition that the research conducted to date provides little firm ground to guide policy and practice. Existing research seldom employs the kinds of longitudinal designs needed to make strong inferences about which factors predict later outcomes; the few longitudinal studies conducted to date have seldom made use of appropriate multivariate statistical models to identify predictors of adult outcomes, and there is no rigorous research on the effectiveness of independent living services (Courtney and Bost, 2002). I conclude the chapter with directions for future research.
In this review I examine the findings from twenty-two studies with samples of youth who had aged out of foster care (see Appendix A). Several limitations of this research literature deserve attention. First, most of the studies are quite dated and do not reflect the significant changes that have taken place since the early 1980s in the nature of the foster care population, including the foster care “baby boom” associated with the crack epidemic of the late 1980s and early 1990s and the rapid growth of kinship foster care. Even fewer studies took place after states had begun implementation of the 1986 federal law that provided funds for independent living services for foster youth, and only one study provides data on outcomes for a representative sample of youth who left out-of-home care since the passage of the Foster Care Independence Act of 1999 (Courtney et al., 2005). Thus, much of the available research may not accurately depict the characteristics of the population that is aging out of care today and the services and supports that are available to them. Second, many of the studies employ rather idiosyncratic samples that may not do a good job of describing the experiences of the general population of former foster youth. Third, most of the studies suffer from high rates of sample attrition because the researchers were often unable to locate many of the former foster youth after they left foster care. The only national study of youth that aged out of foster care, for example, suffered a follow-up attrition rate of more than 50 percent (Cook et al., 1991).
Research findings address several domains of outcomes experienced by former foster youth during the transition to adulthood: education, physical and mental health, substance abuse, criminal justice system involvement, employment and economic self-sufficiency, housing and homelessness, family formation, and family relations. All of these outcomes are important indicators in their own right of the success, or lack thereof, of foster youth in managing the transition to adulthood. In addition, problems in any one domain can make success in another less likely. Indeed, making sense of the outcomes described here is complicated by the fact that research has seldom examined the relationship among these outcomes or the relationship between the outcomes and the experiences of foster youth before and during their stays in out-of-home care. Nevertheless, this review provides sobering evidence of just how difficult the transition to adulthood can be for former foster youth.
Human capital is clearly important for success during the transition to adulthood, but studies of former foster youth find poor levels of educational attainment and that the population fares poorly when compared with its peers. In addition to showing that former foster youth have fewer years of education (Zimmerman, 1982; Jones and Moses, 1984), most studies show that they are less likely to earn a high school diploma or their GED (Zimmerman, 1982; Festinger, 1983; Frost and Jurich, 1983; Jones and Moses, 1984; Barth, 1990; Cook et al., 1991; Courtney et al., 2001, 2005). Ronna Cook et al. (1991), for example, found that 66 percent of the eighteen year olds discharged from care in the United States between July 1, 1987, and June 30, 1988, had not graduated from high school. Only 54 percent of subjects had completed high school 2.5 to 4 years after they were discharged, a low percentage when compared with the 78 percent of the eighteen to twenty-four year olds in the general population with a high school degree. More recently, Mark Courtney et al. (2005) found that roughly 58 percent of their sample of former foster youth had a high school degree at age nineteen compared with 87 percent of a national comparison group (other nineteen year olds in the National Longitudinal Study of Adolescent Health). In contrast, Peter Pecora et al. (2006), in their study of Casey Family Programs alumni and alumni of selected public agency jurisdictions in Oregon and Washington ages eighteen to twenty-nine, found high school completion rates that were comparable with those of the general population. However, they note that over one-third of former foster youth who had completed high school had obtained a GED rather than a high school diploma, a much higher rate than that of the general population.
Not surprisingly, given their low high school graduation rate, most studies find that former foster youth have low rates of college attendance (Zimmerman, 1982; Jones and Moses, 1984; Barth, 1990; Cook et al., 1991; Courtney et al., 2001, 2005; Pecora et al., 2003, 2005, 2006). A study of former foster children in West Virginia, for example, found that only 7 percent of a sample of young adults who had spent at least one year in foster care had accumulated any college credit, though they were twenty years old on average at follow-up; in comparison, over one-quarter of the U.S. population between eighteen and twenty-four years old attended college during the period of the study (Jones and Moses, 1984). More recently, Pecora et al. (2006a, 2006b) found that participation in postsecondary education and bachelor's degree completion rates among former foster youth were much lower than among the general population. Courtney et al. (2005) found the young adults in their study to be much less likely than their age peers to be enrolled in postsecondary education of any kind.
In summary, former foster youth must face the transition to independence with significant deficits in educational attainment, and they do not appear to make up for these deficits during the transition. These educational deficits put them at significant disadvantage in the labor market and likely contribute to some of the other negative outcomes they experience.
Former foster youth suffer from more mental health problems than the general population (Robins, 1966; Festinger, 1983; Jones and Moses, 1984; Courtney et al., 2005; Pecora et al., 2005). Support for this conclusion comes from data on youth's use of mental health services and research assessments of their mental health. Trudy Festinger (1983), for example, found that subsequent to discharge from care, 47 percent of the sample of former New York foster youth, all of whom had spent at least five years in care, had sought help or advice from a mental health professional, a far higher rate of help seeking than is found in the general population. The Virginia study (Jones and Moses, 1984) reported that 3 percent of their subject population resided in residential or group care facilities after they left the foster care system, an extremely high rate when compared with the 0.3 percent admission rate into psychiatric hospitals in the United States in 1983 (McDonald et al., 1996). Courtney et al (2005) found that nineteen year olds making the transition to adulthood from foster care were more than twice as likely as their peers to receive psychological or emotional counseling. Studies indicate that former foster youth suffer from higher levels of depression than does the general population (Barth, 1990; Cook, 1992). Moreover, Pecora et al. (2005) found that young adults who had been in out-of-home care as adolescents were twice as likely as the general population to have a current mental health problem.
Some research finds little difference between the physical health status of former foster youth and their peers, though this may be largely a function of a lack of attention to this outcome in research to date. Festinger (1983), Jones and Moses (1984), and Cook et al. (1991) found no evidence of abnormal levels of physical health problems in the populations they studied. In contrast, Rosalie Zimmerman (1982) found that the young adults in her sample (nineteen to twenty-nine years old at follow-up), all of whom had spent at least a year in foster care in New Orleans, were more likely to report their health as “fair”’ or “poor” than the general population. Among the former foster youth studied by Courtney et al. (2001), Caucasians reported poorer health on a standardized self-report health measure than the general population, whereas African Americans reported health that was comparable with their peers. Courtney et al. (2005) found that the young adults in their sample tended to describe their overall health less favorably, were more likely to report that health conditions limited their ability to engage in moderate activity, and reported more emergency room visits and more hospitalizations during the previous five years than their peers. Although there is mixed evidence that former foster youth experience poor physical health, studies have found that they have difficultly obtaining affordable medical coverage (Barth, 1990; Courtney et al., 2001, 2005; Pecora et al., 2003), leading them to report medical problems that are left untreated (Barth, 1990; Courtney et al., 2001, 2005).
In summary, research is consistent in finding former foster youth to experience mental health problems during the transition to adulthood, but it is less consistent in finding physical health problems. The mental health problems experienced by this population are significant in their own right and raise concerns about the ability of these youth to achieve other important outcomes, such as maintaining healthy relationships and obtaining and maintaining employment.
Studies report mixed findings with respect to the use and abuse of alcohol and illicit drugs by former foster youth. In a case control study, Lee Robins (1966) compared male subjects who had been diagnosed as alcoholics with those who had no clinical diagnoses. The alcoholics reported a higher rate of having lived in out-of-home care (76 percent) than those without clinical diagnoses (39 percent). One in eight (13 percent) of subjects in the study by David Fanshel et al. (1990) of young adults (mean age of twenty-four at follow-up) who had been in private agency foster care in the State of Washington reported extreme difficulty with drug abuse in their lives. Richard Barth (1990) found that 19 percent of his convenience sample of youth who had “emancipated” from foster care in northern California (mean age of twenty-one at follow-up) reported drinking once a week or more while in care (comparable with high school students at the time) and that 17 percent had done so since leaving care. In contrast, 56 percent of Barth's (1990) subjects had used “street drugs” since aging out of care. In contrast to studies that suggest a high level of drug and alcohol use among former foster youth, the national study by Cook et al. (1991) found that they used alcohol and other drugs at rates similar to or lower than those found in national surveys of young adults. Pecora et al. (2005) found that the young adults in their study reported drug dependence at a much higher rate than that of the general population but alcohol dependence at a rate similar to that of their peers. Courtney et al. (2005) reported much higher lifetime prevalence of drug (10.9 percent) and alcohol (10.5 percent) abuse than dependence (drug dependence at 3.8 percent; alcohol dependence at 4.3 percent).
In summary, the research literature to date does not provide a very clear picture of the extent of substance use or abuse among former foster youth during the transition to adulthood, although more recent studies suggest that significant percentages of former foster youth suffer from alcohol or drug dependence and abuse.
Former foster youth have a higher rate of involvement with the criminal justice system than the general population (McCord et al., 1960; Zimmerman, 1982; Frost and Jurich, 1983; Jones and Moses, 1984; Fanshel et al., 1990; Barth, 1990; Courtney et al., 2001, 2005). Some 44 percent of the subjects in the Fanshel et al. (1990) study had been picked up by police on charges at one time or another. Among youth participating in the Cambridge-Somerville Youth Study, former foster youth were more likely than youth never in foster care to have had criminal records in adulthood (McCord et al., 1960). Zimmerman (1982) found that 28 percent of her male subjects and 6 percent of her female subjects from New Orleans had been convicted of crimes and served at least six months in prison, a much higher rate than that of the general population. Some 5 percent of the young adults in the West Virginia study were in jail at the time of the study (Jones and Moses, 1984), an extremely high rate compared with the adult imprisonment rate of 1 percent in West Virginia in 1983 (McDonald et al., 1996). Some 27 percent of the males and 10 percent of the females in the study by Courtney et al. (2001) reported having been incarcerated at least once in the twelve to eighteen months since leaving out-of-home care. The young adults in the later study by Courtney et al. (2005) were more likely to have engaged in several forms of delinquent and violent behavior in the past year than their peers. Moreover, 29.8 percent of the males and 10.7 percent of the females reported being incarcerated at least once between the first wave of interviews for the study (at age seventeen to eighteen) and the second wave (age nineteen).
The rates of criminal justice system involvement described in these studies are cause for serious concern about the prospects of former foster youth during the transition to adulthood. Arrest and incarceration are troubling outcomes in their own right. In addition, a criminal record can limit the future employment and housing prospects of these youth.
Nearly all studies of former foster youth and all studies done since the late 1980s suggest that these youth face a difficult time achieving financial independence. Availability of national and regional data makes it possible in many cases to compare this population with relevant samples and standards, such as poverty level. Data from several studies show that former foster youth have a higher rate of dependency on public assistance than the general population (Pettiford, 1981; Zimmerman, 1982; Barth, 1990; Jones and Moses, 1984; Cook et al., 1991; Courtney et al., 2001, 2005; Pecora et al., 2005, 2006b). About 30 percent of the young adults in the national study by Cook et al. (1991) were receiving some form of public assistance at the time of the study. One-quarter of the young people in the study by Courtney et al. (2005) were receiving one or more need-based government benefits at age nineteen. Pecora et al (2005) also found a much higher rate of public assistance receipt among the foster care alumni in their study than is typical of the general population.
Former foster youth have a higher unemployment rate than the general population (Zimmerman, 1982; Jones and Moses, 1984; Cook et al., 1991; Goerge et al., 2002; Courtney et al., 2005; Pecora et al., 2005, 2006b). They also have lower wages, which frequently leave them in poverty (Zimmerman, 1982; Festinger, 1983; Barth, 1990; Cook et al., 1991; Dworsky and Courtney, 2000; Goerge et al., 2002; Courtney et al., 2005; Pecora et al., in press). Two relatively recent studies that used unemployment insurance claims data to examine the employment patterns and earnings of former foster youth found that their mean earnings were well below the federal poverty level for up to two years after leaving out-of-home care (Dworsky and Courtney, 2000; Goerge et al., 2002).
Not surprisingly, many former foster youth experience financial difficulties during the transition to independence. Young adults in the study by Courtney et al. (2005) were twice as likely as the nineteen year olds in a nationally representative comparison group to report not having enough money to pay their rent or mortgage (12 percent), twice as likely to report being unable to pay a utility bill (12 percent), and 1.5 times as likely to report having their phone service disconnected (21 percent).
In summary, the research consistently shows former foster youth fair poorly in terms of economic self-sufficiency outcomes during the transition to adulthood. They are less likely to be employed than their peers and more likely to rely on public assistance, and they earn, on average, too little to escape poverty.
Information on the housing instability experienced by former foster youth comes from research on this population and research on homeless populations. Former foster youth have high rates of mobility and housing instability (Jones and Moses, 1984; Fanshel et al., 1990; Courtney et al., 2001, 2005; Pecora et al., 2005, 2006b). Cook et al. (1991) found that 32 percent of the youth in their study had lived in six or more places in the two-and-one-half to four years since they left foster care. Similarly, Courtney et al. (2001) found that 22 percent of the youth in their sample had lived in four or more places within twelve to eighteen months of exiting care.
Former foster youth also experience high rates of homelessness (Susser et al., 1987, 1991; Sosin et al., 1988, 1990; Mangine et al., 1990; Cook et al., 1991; Courtney et al., 2001, 2005; Pecora et al., 2005, 2006b). Most information comes from studies of adult homeless populations. Researchers have found that when compared with the domiciled population, former residents of out-of-home care are represented at much higher rates across a variety of samples of street homeless populations, shelter residents, and psychiatric facilities that serve homeless populations (Susser et al., 1987, 1991; Sosin et al., 1988, 1990; Mangine et al., 1990). Longitudinal studies of former foster youth also show this population to be at a heightened risk of homelessness. More than one-fifth of the participants (22.2 percent) in the study by Pecora et al. (2005, 2006b) reported having been homeless at least one day within one year of leaving foster care, and 13.8 percent of the participants in the study by Courtney et al. (2005) reported having been homeless at least one night since leaving care.
In summary, former foster youth experience considerable housing instability, including frequent periods of homelessness. Given the limited economic prospects of this group and other problems, such as mental illness and corrections system involvement, it should not be surprising that many former foster youth struggle to maintain stable housing. However, poor housing stability among former foster youth may also be a function of their inability to rely on extended family for housing assistance to the same degree as other young adults.
With regard to family formation issues for former foster youth, studies have examined marriage rates, divorce and separation, marital separation, child bearing, and parenting. With respect to marriage, Elizabeth Meier (1965) and Sandra Cook (1992) found former foster youth were more likely to remain single than their peers. In contrast, Festinger (1983) found no difference between the marital status of her subjects and those of their peers in New York City. Cook et al. (1991) found the marriage rate of former foster youth to be similar to that of poor young adults, though much lower than that of all young adults in the comparable age range. Courtney et al. (2005) found the nineteen year olds in their study to be much less likely than their peers to be married or cohabiting.
Meier (1965) found a higher rate of marital separation and divorce among a sample of former Minnesota foster youth than that in the general population at that time, whereas Festinger (1983) found no difference. Cook (1992) found the former foster children represented in the National Survey of Families and Households to express less marital satisfaction than those in the overall national sample, whereas Festinger (1983) found no difference in marital satisfaction between her sample and national norms. With the exception of the study by Festinger (1983), all studies with data on the subject suggest relatively poor outcomes for this population.
Studies have found that former foster youth have higher rates of out-of-wedlock parenting than their peers (Meier, 1965; Festinger, 1983; Cook et al., 1991; Courtney et al., 2005; Pecora et al., 2003). Some 31 percent of mothers in Festinger's (1983) sample were raising children on their own, and fewer than one-third of the parenting females in the study by Courtney et al. (2001) were married. Zimmerman (1982) found that 46 percent of former foster youth reported that their children had some type of health, education, or behavior problem. Other studies have found that the children of former foster youth become involved in the child welfare system (Meier, 1965; Jones and Moses, 1984). About 19 percent of former foster youth in the West Virginia study reported that they had a child in out-of-home care (Jones and Moses, 1984). In contrast, Courtney et al. (2005) found that while former foster youth were much more likely than the general population to report having children, they were no less likely than their peers to be living with their children.
In summary, research findings are mixed regarding the success of former foster youth in forming their own families. No studies show them to have better outcomes than their peers, and most show less than desirable outcomes.
One finding that is strikingly consistent across studies is the considerable ongoing contact former foster youth have with their families of origin after they leave out-of-home care (Harari, 1980; Zimmerman, 1982; Festinger, 1983; Frost and Jurich, 1983; Jones and Moses, 1984; Barth, 1990; Cook et al., 1991; Courtney et al., 2001, 2005). The studies are not strictly comparable since they reported contact at different points in time after the youth left foster care and measured contact using dissimilar metrics, such as weekly, monthly, or annually. Nevertheless, taken together, the studies suggest that former foster youth report that they are in contact with their mothers and, to a somewhat lesser degree, their fathers well into young adulthood. At least monthly contact between former foster youth and their mothers ranged across studies from one-third to one-half of respondents (Harari, 1980; Zimmerman, 1982; Festinger, 1983; Courtney et al., 2001, 2005), with the same studies finding monthly contact with fathers to range from one-quarter to one-third of respondents. Those with siblings also maintained contact with their siblings over time. Courtney et al. (2001) found 88 percent of former foster youth with at least one sibling to have visited with a sibling at least once since discharge from out-of-home care.
This level of family contact is important because it suggests a possible source of natural support for former foster youth during the transition to adulthood. Indeed, most former foster youth who maintain contact with their family of origin report good relations with their kin. Festinger (1983) found that a majority of her New York respondents who were in contact with their biological families felt “very close” or “somewhat close” to their relatives. Courtney et al. (2005), using the same survey questions as Festinger, found similarly high levels of expressed closeness between former foster youth and their mothers, siblings, and grandparents but less favorable relationships with their fathers. Studies also consistently show that a majority of former foster youth maintain ongoing contact with their former foster families, another potential source of support during the transition (Harari, 1980; Festinger, 1983; Jones and Moses, 1984; Courtney et al., 2001).
Family relations are sufficiently strong for many former foster youth that they live with relatives after they leave care. Cook et al. (1991) found that 54 percent of their respondents had lived in the home of a relative at some point after discharge from out-of-home care, and one-third were living with a relative when interviewed two and a half to four years after leaving care. It should be noted, however, that this rate is much lower than was typical of the general population of young adults at the time of the Cook et al. study. More recently, Courtney et al. (2005) found that the nineteen year olds in their study who had been discharged from out-of-home care were more likely to be living with family than in any other living arrangement: 16.8 percent were living in the home of one or both of their biological parents, and another 17.8 percent were living in the home of a relative. This combined percentage (34.6 percent) is over three times the percentage of youth who were living with a former nonrelative foster parent (10 percent) and higher than the percentage who reported living in their “own place” (28.7 percent). These young people, however, were still about half as likely as their peers to be living with kin; three-fifths of nineteen year olds in the National Longitudinal Study of Adolescent Health were living with family at age nineteen.
As might be expected, given the troubled histories of most of these families, ongoing family relations were not without their problems. Courtney et al. (2001) found that one-quarter of the young adults in their sample reported experiencing problems with their family most or all of the time. Barth (1990) found that 15 percent of his California subjects felt that they had no “psychological parent” or person to turn to for advice. Thus, while the family of origin remains a source of support for many former foster youth during the transition to adulthood, these youth are still less likely to be able to rely on this support than their peers and they also must often weigh the benefits of ongoing family contact against the risks.
In summary, a review of the outcomes for former foster youth during their transition to adulthood is sobering. On average, they bring to the transition very limited human capital on which to build a career or economic assets. They often suffer from mental health problems that can negatively affect other outcome domains, and these problems are less likely to be treated once they leave care. Although they were placed in out-of-home care as a result of abuse or neglect and not delinquency, the youth often become involved in crime and with the justice and corrections systems after aging out of foster care. Their employment prospects are bleak, and few of them escape poverty during the transition. Many former foster youth experience homelessness and housing instability after leaving care. Interestingly, in spite of court-ordered separation from their families, often for many years, most former foster youth can rely on their families to some extent during the transition to adulthood, though this is not always without risk.
Two indisputable facts should guide both policy and practice directed at older youth in foster care and those making the transition to adulthood from care. First, these young people are on average significantly disadvantaged across a number of domains as they approach and later negotiate the transition to adulthood. They also have many strengths, including an optimistic view of the future, high educational aspirations, and generally positive views of the child welfare system, all of which bode well for efforts to engage them in services (Festinger, 1983; Courtney et al., 2001, 2005). Nevertheless, a sober review of the research literature leads inevitably to the conclusion that most young people approaching the point at which they will “age out” of foster care are not ready to be on their own.
Second, youth in foster care are much less likely than their peers to be able to rely on family for support to compensate for their disadvantages during the transition. Research consistently shows the importance of family financial and emotional support and advice to young people during the transition to adulthood. According to the 2001 U.S. Census Bureau Survey of Income and Program Participation, approximately 63 percent of men between eighteen and twenty-four years old and 51 percent of women in that age range were living with one or both of their parents. Former foster youth are much less likely to be living with a parent or any adult member of their family during this time in their lives. They are also less likely to be able to rely on financial support. Parents provide roughly $38,000 in material assistance for food, housing, education, or direct cash assistance throughout the transition to adulthood, or about $2,200 per year (Schoeni and Ross, 2004). Although no comparable data are available on young adults who have left foster care, it seems highly unlikely that they receive support at this level from their parents.
Taken together, these facts suggest that sound social policy would provide state agencies responsible for youth in out-of-home care with the ability to continue to serve as a surrogate parent for these young people during the transition to adulthood. Ongoing parental support during this period has become normative in the United States, and former foster youth are in greater need of this support, on average, than their peers. Recent research comparing outcomes between young people allowed to remain under the care and supervision of child welfare authorities past age eighteen and those who have left care before that provides some evidence that extending care results in improved outcomes in the areas of service access, educational attainment, housing stability, pregnancy, and crime (Courtney et al., 2005). Similarly, a study of alumni of Casey Family Services—comparing young adult outcomes between Casey alumni that were adopted, exited care prior to age nineteen, or exited care after age nineteen—found that extending services past age nineteen was associated with better self-sufficiency and personal well-being (Kerman et al., 2002). Extended services for Casey Family Services alumni who reached age nineteen while in Casey foster care averaged about $6,000 per year (median of $5,942) between ages nineteen and twenty-four, although the figure was lower when youth who incurred no expenses were taken into account (Kerman et al., 2004). Unfortunately, current federal law does not provide resources to support the work of child welfare agencies that seek to play the parental role after a young person reaches his or her eighteenth birthday:1
• The $140 million per year provided to states under the John Chafee Foster Care Independence Program, the primary federal source of funds for independent living services, is woefully inadequate (Courtney and Hughes-Heuring, 2005). This funding is designed to be used by states to prepare foster children and youth of all ages for the transition to adulthood and to support former foster youth between eighteen and twenty-one who have left care. Yet, even if states only used their Chafee Program funds for youth who are sixteen or older and still in care, they would have less than $1,400 per youth per year in Chafee funding to support the wide range of services called for in the enabling legislation.
• Funding has been particularly anemic when it comes to providing housing support for foster youth in transition. In 2008, federal law authorized for the first time federal reimbursement for board and care and associate administrative costs for out-of-home care past age 18 under the Title IV-E Foster Care program of the Social Security Act, the primary federal source of funding for out-of-home care. This state option may prove to be important given the fact that although states can use up to 30 percent of their share of Chafee Program funds to provide housing to current and former foster youth between eighteen and twenty-one, this amounts to less than $150 a month per year for these young people.
• Many states have failed to take up the option of extending Medicaid coverage to former foster youth (Eilertson, 2002). Given the health needs of foster youth, particularly their relatively high rate of mental health problems, and the fact that they are less likely than their peers to be able to rely on their parents’ health insurance during the transition to adulthood, it is important that continuity of their access to health care be ensured by extending Medicaid.
• Poor integration and coordination of independent living services for foster youth with the efforts of other public institutions (such as educational institutions, welfare-to-work programs, and housing programs) limit the effectiveness of existing services. The service systems that constitute the “extended family” of formal institutional supports for former foster youth do not communicate with one another very well, leading to duplication of effort and unnecessary gaps in service availability.
There is no solid evidence for the effectiveness of the independent living services that states have chosen as their primary approach to supporting foster youth in transition (U.S. General Accounting Office, 1999; Courtney and Bost, 2002).
• Perhaps the most important limitation of current policy is its target population. Fewer older youth in care actually age out of the child welfare system than exit foster care in other ways, yet this population is the primary focus of federal legislation. Too little attention has been paid to the needs during the transition to adulthood of older youth who exit out-of-home care via other routes, such as family reunification, adoption, guardianship, and running away.
Practitioners are limited in their efforts by the poor policy context and the virtually nonexistent knowledge base regarding effective services for this population. One message that emerges from the research for practitioners, however, is that they must pay more attention to a youth's connections to their family of origin. Although foster youth may not be able to rely on family as much as their peers do, most have strong relations with family, relationships that can be both helpful and harmful. Caseworkers should focus on helping young people maximize the benefits of these relationships while minimizing the potential risks. Although foster parents and other out-of-home care providers do not appear as important as members of the family of origin during the transition to adulthood, they too should be a central focus of practice with foster youth and former foster youth (Courtney et al., 2001).
Research has documented the generally poor outcomes of foster youth making the transition to adulthood, but it provides less guidance regarding what specifically should be done to improve their outcomes. Large-scale longitudinal studies of foster youth making the transition to adulthood can help identify correlates of their successes, thereby providing targets for intervention. Had the outcome monitoring elements of the Foster Care Independence Act of 1999 been implemented in a timely manner, child welfare managers and researchers would have a rich multijurisdictional source of data from which to identify promising policies and practices.2 In the absence of such data, the field must make do with only a handful of reasonably recent and ongoing studies. Solid evidence for the effectiveness of specific services will only come from experimental evaluations. Funding from the Chafee Program is supporting a few ongoing experimental evaluations of independent living programs, but additional research is needed if the knowledge base for intervention is to advance significantly in the next decade. Finally, qualitative research on foster youth's transitions to adulthood is sorely needed. The voices of the young people themselves will be best heard through this type of research.
One would be hard-pressed to find an adolescent population in greater need during the transition to independence than youth in foster care approaching adulthood. Too often, when the state has stepped in to be these youth's parent, it has failed to do justice to this solemn responsibility. The current federal policy framework is not ideal. The resources devoted to helping youth are inadequate. There may, however, be sufficient support in place in certain jurisdictions to build the political will necessary to make needed changes in federal policy.
Studies of Postdischarge Outcomes
See following pages:
Some of this chapter has been adapted from M. E. Courtney and D. Hughes-Heuring, The transition to adulthood for youth “aging out” of the foster care system, in W. Osgood, C. Flanagan, E. M. Foster, and G. Ruth, eds., On Your Own Without a Net: The Transition to Adulthood for Vulnerable Populations (Chicago: University of Chicago Press, 2005).
1. For a more detailed critique of U.S. policy regarding foster youth in transition, see Courtney and Hughes-Heuring (2005).
2. The 1999 law called for states to collect data on all independent living services provided to current and former foster youth and to track outcomes for youth leaving care across a number of important dimensions (e.g., employment, housing, education, and avoidance of risk behaviors). Implementing regulations for this part of the law were only proposed in July 2006, leaving states little choice but to wait for federal guidance in the interim (Federal Register 71, no. 135 [July 14, 2006]:40345–382).
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