Extending Foster CareMark Courtney’s research paved the way for letting youth stay in foster care until they’re 21. Now he wants to find out how to make the most of those extra years.
By Carl Vogel
VOLUME 20 | ISSUE 2 | SUMMER 2013
What happens to young adults who “age out” of foster care? For a long time, that question wasn’t asked of the child welfare system. And so nobody knew how bad the answer often is.
Professor Mark Courtney’s research over nearly two decades on what happens to youth in foster care after they “age out” of the system and are emancipated as adults has shown better outcomes in a number of measures for foster care children who are able to stay in care longer. These longitudinal studies have been a key resource for advocates who have successfully pushed the federal government and state and local child welfare agencies to raise the age of emancipation to 21. His current research is now focused on what child welfare programs are the most effective for older youth, who are different in many ways than the younger children who have traditionally been in foster care.
Most children in foster care exit the system by returning to their families or being adopted. But more than 24,000 kids a year who are in care when they hit their 18th birthday are emancipated from the system: no longer the responsibility of the state.
“If you think about it, taking kids out of care at age 18 doesn’t make sense. Other families don’t do this—it’s not normative behavior today to stop all support for your kid when he turns 18—and the children in foster care typically need more help than an average teen,” argues SSA Professor Mark Courtney.
Before getting his Ph.D., Courtney had been a live-in counselor and a clinical supervisor in foster care group homes for teens, and he saw that many of the young people he knew found trouble once they were released from the system. But the child welfare system has traditionally been judged by whether kids were safe while in care—not how they fared afterward— and so little or no attention was paid to how well the system prepared its wards for their lives ahead.
That changed in 1998, when Courtney released a study of 141 Wisconsin teens that documented their experiences after leaving care. The paper reported that almost 40 percent of the youth were unemployed when interviewed and 22 percent had moved enough to live in four or more homes in the 12 to 18 months after leaving care. More than a quarter of the males and 10 percent of the females had been incarcerated at some point after leaving foster care, and 25 percent of the males and 15 percent of the females had experienced “some kind of serious physical victimization.”
The Wisconsin study had an immediate effect. Susan Dreyfus, then the administrator of the Wisconsin Department of Children and Families, says that the day the study was released, she was on the phone with the office of Wisconsin Gov. Tommy Thompson. “The findings [showed results that were nothing short of deplorable,” she says. “When a report documents that young people who recently were in state care are now sleeping under bridges and are at twelve times the national homeless rate, we knew we had to dig deeper into the research and be prepared to make significant changes at a policy and systems level.”
Dreyfus, now the president and CEO of the Alliance for Children and Families, a national association of human services organizations, went on what she calls a “road show” with Courtney, visiting county child welfare officials, staff and teens in care throughout the state to present the research and discuss how Wisconsin’s child welfare system could be improved. At the federal level, child welfare organizations used the Wisconsin study to push Congress to pass the John Chafee Foster Care Independence Act in 1999, which doubled federal funding for services to help older youth after they’re emancipated.
The Wisconsin study was the first big step in Courtney’s ongoing work to learn more about youth aging out of the foster care system. His research has framed the issue and provided the empirical data behind major policy changes, including federal funds that now give states the option of continuing foster care to age 21. “To say that the work of Mark Courtney and his entire team has been instrumental is not overstating it,” says Amy Lemley, the policy director at the John Burton Foundation, which has been a key supporter of legislation at the federal level and in California.
Now Courtney is working on a question that he expects will be the main focus of the rest of his career. “We’ve gone a long way to identify risks for this population and protective factors,” he says. “But serving older youth is different in a lot of ways from caring for minors, and we don’t know which interventions designed to influence those protective factors work well. If the child care system is going to be responsible for a young person up to age 21, how can it do the best job? That’s what we want to learn now.”
SSA Professor Mark Courtney continues to use the Midwest Study to learn more about how foster care for young adults has an impact on everything from employment to mental health.
The Wisconsin Study proved that too many youths leaving foster care at 18 weren’t doing well. But not everyone agreed that extending foster care was the answer. Some child care officials and politicians argued that extra years would just “extend the runway” and postpone the same bad outcomes. Most also said few young people would even choose to stay in the child welfare system once they were legal adults.
To answer these questions, Courtney worked with Dreyfus, other state officials and an academic team to craft what became known as the Midwest Study, a longitudinal comparison of youth aging out of foster care in Wisconsin and Iowa, where the emancipation age was 18, and Illinois, where it was 21. More than 700 youth were interviewed at 17 or 18 years old, then about every two years until they were 26.
The results were as stark as the findings of the Wisconsin study. More than two-thirds of the Midwest Study’s Illinois sample remained in care after their twentieth birthday, and more than half did not leave the foster care system until age 21. The odds that the foster youth in Illinois would attend college by age 21 were about four times higher than for those in Iowa or Wisconsin. Remaining in care between ages 17 and 19 reduced the rate of pregnancy by 38 percent for the young women in the study, and each year of staying in care was associated with earning more money from employment for both males and females.
The Midwest Study is a landmark piece of research in the child welfare field even beyond extending care. By documenting the benefits to youth of being in foster care, the research had an impact on policies from extending Medicaid to foster care youth to rethinking the appropriate programs and services for kids at different developmental stages.
“I see meaningful changes to the field of child welfare as a result of Mark’s work,” says Bryan Samuels, the Commissioner of the Administration on Children, Youth and Families at the U.S. Department of Health and Human Services. “Learning what happens after foster care made us all reconsider what we were doing while youth were in care. I think that changed everybody’s thinking.”
With the Midwest Study in hand, advocates also had a powerful tool for pushing the federal government to go beyond the Chafee legislation. The results were touted to legislators, in press outreach and in public hearings, and in 2008 bi-partisan support in Congress passed the Fostering Connections to Success and Increasing Adoptions Act, which provides states with financial incentive to extend eligibility for youth in foster care to 21 years old.
“So often in the social work world, we don’t have research to support our work. But with the Midwest Study we had very high quality, objective research from a highly respected researcher and institution showing that [extended care] has an impact and avoids future public costs. We used it relentlessly to educate legislators,” Lemley says.
It was no lucky accident that the Midwest study’s findings dovetailed so well with the key questions about the value of providing millions of dollars for extended care. From the start, Courtney had aimed to create research that would be useful and actionable, including publishing policy briefs in accessible, clear terms. “You never want to overstate your findings or ignore nuance,” he says. “But if you can’t tell a coherent story in the language of policymakers with your work framed in the current policy environment, then you won’t be heard.”
The Midwest Study has continued, as Courtney and partners revisit the participants as they get older. With the capacity to compare outcomes over time, Courtney has brought in experts in issues such as employment, mental health, education and mentoring. “It’s great because I’m able to get the smartest people in these fields I’m interested in,” he says. “I learn from them, and I can help them learn how their issues are connected to the child welfare system.”
And as new findings are added, the research from the Midwest Study continues to have an impact. For example, Amy Dworsky, a senior researcher at Chapin Hall and a coinvestigator for the Midwest Study, is working with the Illinois Department of Children and Family Services to evaluate the effectiveness of a program that supports youth who have a child while in foster care. She has begun an implementation study of a new DCFS training curriculum for foster parents and case workers to help prevent pregnancies for youth in care.
“Child welfare agencies aren’t required to collect data on how many foster care youth become parents. So before the Midwest Study, we didn’t have a sense that young women in foster care were at higher risk of pregnancy,” says Dworsky, who also works with Courtney in studying homelessness among former foster care youth. “Because of what the research has shown, the child welfare system is paying attention to these issues and changing how it works.”
“Because of what the research has shown, the child welfare system is paying attention to these issues and changing the way it works.”
Courtney has a quick example to illustrate a profound point about the change in mindset required in extending foster care: “If a 17-year-old runs away from foster care, you call the cops. If a 19-year-old runs away, you can’t call the cops—he’s not a run-away. He’s a legal adult. He’s decided he doesn’t want to be in the system.”
That’s just one difference. For instance, a lawyer advocate for a minor in the child welfare system is required to work for the best interest of her client. But a lawyer representing an adult must follow the expressed interest of the client, whether or not the lawyer thinks it’s the best option.
Young adults face all sorts of decisions that simply aren’t required of a young child, or even a high school student. Parents typically help their 19-year-old child figure out college, career, how to pay their bills, find a place to live. Shouldn’t the child welfare system, taking the responsibility for raising a healthy, capable adult, fulfill those same roles?
And there are choices for teens in foster care that aren’t issues for other youth. As adults, they must decide if, when and how they contact and have a relationship with their birth parents and family, for example, a situation that can have high stakes emotionally and even in terms of their safety and well-being.
“States and counties are being forced to rethink a lot of what they do,” Courtney says. “In many cases, they don’t have a lot of basic things in place yet, including a logic model of how they’re going to serve these young people. We’re just starting to move beyond the philanthropic impulse to help.”
Take living situations. Nearly half of young adults in the country live with friends or in a dorm. The Fostering Connections Act allows foster care youth to be placed in group care or a supervised independent living setting—but few child welfare agencies have expertise in managing that kind of arrangement. And many services provided to children in foster care—from mental health counseling to education—are different from those for adults. So child welfare systems must get up to speed on services for older youth and build new relationships with systems from community colleges to job placement agencies.
Existing child welfare programs for older youth are proving to be inadequate. As part of an evaluation program funded by the 1999 Chafee Act, Courtney has served as the principal investigator to study independent living programs for older foster care youth. Examining four programs in California and Massachusetts over the last several years, only one showed any impact, and that was limited.
“Mostly what are out there today are living-skills classes, like how to open a bank account. That treatment modality is ubiquitous—pretty much every child wefare agency in the country offers this to older teens in their care. But our findings show they make no difference,” says Andrew Zinn, an assistant professor at the School of Social Welfare at the University of Kansas who has worked with Courtney on the studies. “That kind of ‘light-touch’ treatment is too little, too late.”
To learn more about what does work, Courtney and his colleagues are returning to California, which in 2010 became one of the first states to take the federal government up on its offer to provide funding for foster care after age 18. California’s foster care population is the largest in the country, the state’s approach has been very ambitious, and because the state’s child welfare system is administered at the county level, there will be an opportunity to compare the outcomes of different policies and programs.
Courtney helped push for the passage of the California law, AB 12, including co-authoring a 2009 report that calculated the benefits and costs of extending care, which found that every dollar spent would generate more than two dollars in lifetime earnings due to increased college attendance alone. This spring, he co-authored a paper that examines how well California is implementing AB 12, which documents the process to pass the bill and early implementation issues.
Next is a new five-year, longitudinal study that will aim to unlock how living arrangements and other services for extended foster care will influence factors such as housing stability, physical and mental health, and family formation. Courtney is now in the process of launching the $2.5 million study, which will follow about 800 older youth in foster care, as well as undertake surveys of child welfare workers and in-depth qualitative research on youths’ new living arrangements as they make the transition to adulthood.
“The study will bring rigor to the anecdotal stories we’ll all hear of how things are working out,” says Christopher Wu, the supervising attorney for the California Judicial Council’s Center for Children and the Courts, who served as the executive director of the California Blue Ribbon Commission that hammered out the blueprint for AB 12. “It’s a very complex issue for agencies and courts to implement. There’s a lot of variation from county to county and court to court. Having this scrupulously done, longitudinal research on outcomes will be very valuable to everyone.”
Currently, only some states have taken up the federal government’s option of extending foster care past age 18 (although because of the size of these states’ child welfare populations, they do represent the majority of the country’s foster care youth). That’s partly because of the time it took for the new federal guidelines to be finalized and partly because the economic downturn took so much money out of state budgets that expanding social service programs has been a hard sell.
Courtney is hopeful that the momentum will keep building for giving kids in foster care the targeted, effective support they need to thrive and a few more crucial years to grow up before setting off on their own. The California study is the latest nudge to move the system in that direction. “If you were at a party and said that you just kicked your 18-year-old out of the house and weren’t going to give her anything else, you probably wouldn’t be very popular,” Courtney says. “So in today’s world, I think a lot of people can see why this is the right thing to do. Giving them the data that shows how much of a difference it can make—and how much money it saves us by helping these kids find the right path—is what it takes to get from feeling like it’s a good idea to knowing it is.”