Report to Congress on Adoption and Other Permanency Outcomes for Children in
Foster Care: Focus on Older Children
The Federal Government has played a crucial role in promoting adoption and other permanency outcomes for children in foster care, especially older children. Federal contributions to these efforts include the passage of key legislation with specific mandates regarding permanency, review and accountability mechanisms for State performance, implementation of national adoption initiatives, and funding demonstration programs across the country to test promising strategies.
Congress has passed several important pieces of legislation in the last 25 years that promote permanency for children in foster care, including older children. This section summarizes six key laws that demonstrate the Federal government's leadership on these issues.
Adoption Assistance and Child Welfare Act of 1980 (P.L. 96-272). The Adoption Assistance and Child Welfare Act of 1980 is one of the earliest Federal laws that focused extensively on adoption and permanency planning for children in foster care. This legislation was passed in response to widespread discontent with the public child welfare system, including concerns about children's lengthy stays in foster care. P.L. 96-272 set forth a number of landmark measures, including:
- The requirement that States make "reasonable efforts" to prevent removal of children from their homes and make it possible for children in foster care to return home.
- The requirement that States place children in foster care in the least restrictive setting.
- The requirement that States make adoption assistance payments available to families who adopt children with special needs when the children meet the statutory eligibility requirements; a Federal match for these payments also is authorized.
- A foundation for States to define "special needs" so they may include diagnosed disabilities, membership in a sibling group, racial or ethnic minority status, and age.
In addition, this Act authorized federally funded training for States to help them implement relevant programs.
Adoption and Safe Families Act of 1997 (P.L. 105-89). The Adoption and Safe Families Act (ASFA), passed in 1997, revised numerous sections of titles IV-B and IV-E of the Social Security Act to help States move children out of foster care into safe, permanent homes more quickly. Some of the relevant provisions include:
- Reduced timeframes. The timeframe for holding permanency hearings was reduced from 18 to 12 months.
- Expedited termination of parental rights. States must file a petition with the courts to terminate parental rights in certain circumstances, including when a child has been in out-of-home care for 15 out of the most recent 22 months. Certain exceptions to these filings are allowed, such as when it is determined that terminating parental rights is not in a child's best interests and when the State has not made reasonable efforts to reunify a child with his or her family.
- "Fast track to permanency." States are not required to pursue reasonable efforts to prevent removal of children from their homes or reunify children with their birth parents if certain circumstances exist, such as when parents have already involuntarily lost parental rights to a child's sibling or subjected a child to aggravated circumstances (as defined in State law, including abandonment and chronic abuse). ASFA also clarified the meaning of "reasonable efforts" noting that the child's health and safety are of paramount concern.
The Adoption Incentive Payment Program was created in ASFA. It was the first Federal performance-based incentive in child welfare, to reward States for increasing the number of adoptions of children from foster care. It also extended and expanded the authority for the Federal Child Welfare Demonstrations. The latter program allows States to request waivers of certain provisions of titles IV-B and IV-E of the Social Security Act to test new approaches to delivering and financing child welfare services aimed at improving outcomes for children. See more in Section 3.3, "Federal Adoption Initiatives," and Section 3.4, "Federally Funded Programs."
Foster Care Independence Act of 1999 (P.L. 106-169). The Foster Care Independence Act of 1999, also known as the Chafee Act, focused on improving outcomes for older youth in foster care and those who are aging out of (emancipating from) foster care. The Act revised the program of grants to States and expanded opportunities for independent living programs to provide educational, financial, employment, housing, and other supportive services to prepare youth for emancipation from foster care and transition to adulthood. The Act also required development of outcome measures for independent living programs, identification of data elements, and development of a data collection system to track the youth who are or were participating in these programs, the services provided, and the States' performance on the outcome measures.
Promoting Safe and Stable Families Amendments of 2001 (P.L. 107-133). These amendments to title IV-B, subpart 2 of the Social Security Act expanded the Promoting Safe and Stable Families (PSSF) program which provides funding to States to support the operation of a number of programs, including community-based family support and preservation services, time-limited reunification and adoption services, and educational vouchers for youth aging out of, or being adopted from, foster care. Services provided using PSSF funds may include promotion of healthy marriages, post-reunification and post-adoption services, and promotion of timely court actions to expedite permanency for children in foster care.
Adoption Promotion Act of 2003 (P.L. 108-145). The Adoption Promotion Act of 2003 focused attention on encouraging adoptions of children ages 9 and older. Its key provision was the reauthorization of the Adoption Incentive program and, at the request of President Bush, the addition of bonus awards for adoptions of children ages 9 and older. Under this Act, States are eligible to receive financial awards for increasing the number of children adopted from foster care above established baselines. States are awarded $4,000 for each child adopted from foster care above the baseline; $4,000 for each child age 9 or older above the baseline; and if a State qualifies for either of these bonuses, and additional $2,000 for each child who has special needs and is under age 9 above the baseline. The Act authorized up to $43 million for bonuses for fiscal years 2004 through 2008.
Keeping Children and Families Safe Act of 2003 (P.L. 108-36). The Keeping Children and Families Safe Act of 2003 reauthorized a number of Federal programs, including the Child Abuse Prevention and Treatment Act (CAPTA), the Abandoned Infants Assistance Program, and the Adoption Opportunities Program. Provisions included Federal funding to implement programs aimed at increasing adoptions of older children from foster care, with an emphasis on child-specific recruitment strategies. The Act also expanded post-adoption services for families adopting children with special needs and made recommendations to facilitate interjurisdictional adoptions. In addition, the Act ordered the U.S. Department of Health and Human Services (HHS) to study the factors influencing successful adoption outcomes.
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3.2 Child and Family Services Reviews
The 1994 amendments to title IV of the Social Security Act mandated the development of regulations to review States' child and family services. In response, the Administration for Children and Families (ACF) developed and implemented the Child and Family Services Reviews, a results-oriented, comprehensive monitoring system designed to assist States in improving outcomes for the children and families they serve. The Child and Family Services Review process assesses States in two areas:
- Outcomes for children and families in safety, permanency, and child and family well-being. There are seven outcomes; each is measured using a number of indicators. Six national standards pertaining to aggregate data indicators have been developed related to these outcomes that set benchmarks for States to achieve.
- Systemic factors that directly affect the States' abilities to deliver services that can achieve the designated outcomes.
The review process involves three stages:
- Each State begins by conducting a Statewide Assessment of its services and outcome achievement based on data and input from stakeholders.
- Staff from ACF review data and conduct intensive onsite visits to review cases and interview stakeholders. A final report is produced to present findings regarding substantial conformance with each outcome, systemic factor, and national standard.
- For each outcome and systemic factor with which a State is not in substantial conformity, the State must develop a Program Improvement Plan to document how it intends to move toward substantial conformity.
Upon completion of the first full round of 52 reviews, no State was found to be in conformity with Permanency Outcome 1: "Children have permanency and stability in their living situations." Only seven States were found to be in substantial conformity with Permanency Outcome 2: "The continuity of family relationships and connections is preserved for children" (U.S. DHHS, 2004b). Full information on the 52 States' conformity with the outcomes, ratings on indicators and systemic factors, and the number of States meeting the national standards is presented in the Appendix.
Common challenges related to the permanency indicators included a lack of consistent, appropriate concurrent planning (i.e., simultaneous development of an alternative plan) in 26 States; maintaining the goal of reunification too long before reconsideration in 24 States; the tendency to adopt a goal of long-term foster care without thorough consideration of adoption or guardianship in 15 States; and in 12 States, not filing termination of parental rights petitions in a timely manner with inadequate documentation of reasons (U.S. DHHS, 2004b).
Analyses of the association between indicators for well-being and permanency outcomes revealed that all of the following factors supported substantial achievement of Permanency Outcomes 1 and 2 noted above: caseworker visits with children and birth parents; services to children, birth parents, and foster parents; and involvement of birth parents in case planning. Analyses of the association between systemic factors and permanency outcomes revealed that having sufficient services and being able to individualize services for children and families were related to ensuring permanency and stability for children in foster care. In addition, implementation of frequent case reviews (at least every 6 months) and the consistent implementation of 12-month permanency hearings were significantly associated with achievement of timely adoptions for children (U.S. DHHS, 2004b).
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3.3 Federal Adoption Initiatives
Through HHS, the Federal Government sponsors a number of initiatives aimed at enhancing permanency for children in foster care, especially the permanency outcome of adoption. The following sections describe three major Federal adoption initiatives: the Collaboration to AdoptUsKids, Adoption Incentive Bonuses, and the Adoption Excellence Awards.
The Collaboration to AdoptUsKids. The Collaboration to AdoptUsKids is a major national ACF initiative designed to "recruit and connect foster and adoptive families with waiting children throughout the United States" (Collaboration to AdoptUsKids, n.d.). In October 2002, ACF entered into a 5-year cooperative agreement with the Adoption Exchange Association and other partners to implement this initiative, and the Collaboration has convened a national workgroup of adoption experts to provide guidance and advice. The components of this initiative include:
- National recruitment campaign. In July 2004, the Collaboration to AdoptUsKids and ACF, in partnership with the Ad Council, launched a major national multimedia campaign to recruit adoptive families for children in foster care. This campaign includes television, radio, print, and Internet public service announcements. A culturally relevant Spanish language campaign launched in 2005.
- Recruitment response teams. The Collaboration to AdoptUsKids has established recruitment response teams in all 50 States, Puerto Rico, and the District of Columbia to respond to inquiries from prospective adoptive families generated by the national recruitment campaign. These teams provide information and assist prospective adoptive parents to connect with State and local agencies for adoptive home studies and services.
- Website photolisting. A major component of the AdoptUsKids initiative is the website photolisting (www.adoptuskids.org) of children waiting for adoption across the United States. More than 4,500 children profiled on this website have been placed for adoption since the website launched in July 2002; almost 70 percent are ages 9 and older (H. Owens, personal communication, April 1, 2005). The website is hosted by the Northwest Adoption Exchange.
- Training and technical assistance. Ten days of free training or technical assistance per year are made available to States, territories, and tribes to address foster and adoptive family recruitment and retention issues. Technical assistance in building capacity to respond to the inquiries generated by the national recruitment campaign also is provided. The Collaboration already has produced five Answering the Call publications to support recruitment efforts:
- Family Pocket Guide to help prospective adoptive families through the process.
- Practitioner's Guide to help staff retain parents recruited.
- Recruitment Work Plan Guide for Adoption and Foster Care Program Managers to help State adoption and foster care managers design and implement effective local and Statewide recruitment programs and effectively respond and coordinate with the national campaign.
- Lasting Impressions: A Guide for Photolisting Children to help staff enhance child-specific photolisting recruitment efforts.
- Finding Common Ground: A Guide for Child Welfare Agencies Working with Communities of Faith to help staff build effective partnerships with faith communities to recruit and support foster and adoptive families for children in out-of-home care.
In addition, guides and manuals are being created or updated on issues such as overcoming geographic barriers to adoption, matching children waiting for adoption with potential adoptive families, and recruitment of adoptive and foster families. Benchmarking strategies are being used to improve performance. Training and technical assistance providers in the Collaboration are the Adoption Exchange in Denver, CO, and the Children's Bureau's National Child Welfare Resource Center for Adoption.
- Recruitment summits. Annual summits are held for adoption and foster care managers and other stakeholders to discuss best practices related to recruitment. The 2004 summit, Answering the Call, invited representatives of faith communities from across the country along with State adoption and foster care managers, State child welfare directors, and other adoption and foster care professionals to discuss strategies for collaborating to recruit and support adoptive and foster families at the State and local levels.
- Parent support network. Annual mini-grants are awarded to adoptive parent support groups, and a national network of support groups is being developed.
- Research. AdoptUsKids includes two studies to expand knowledge about adoption from foster care. One is a prospective study that will follow families through the adoption process to learn about the barriers to adoption. The other study involves interviewing families who have adopted children with special needs to learn about factors contributing to the long-term success of special needs adoptions. Reports from both studies are expected in 2006.
AdoptUsKids also includes a national evaluation component to examine process objectives and outcomes; the Child Welfare League of America is implementing this evaluation.
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Adoption Incentive Bonuses. The adoption incentive payments program was created in ASFA to provide financial rewards to States for increasing numbers of adoptions from foster care above established baselines. The awards can be used to pay for any child welfare services allowed within titles IV-B and IV-E of the Social Security Act.
All 50 States, Puerto Rico, and the District of Columbia have received bonuses for exceeding their baseline number of adoptions for at least one year.7 Two surveys have been conducted to examine how States are using their adoption incentive bonuses (Cornerstone Consulting Group, 2001; Ledesma, 2000). The surveys found that some States chose to use the funds for one-time expenses as there is no certainty of continued bonuses, while others chose to initiate strategies that require ongoing support. In general, however, States used these funds to support activities they believe show promise of success in increasing the number of adoptions and/or reducing the time children spend in foster care prior to adoption. Examples of these activities include hiring or contracting for more adoption staff, enhancing adoptive parent recruitment efforts, contracting for adoptive family home studies, providing pre-adoption legal services, training for staff and adoptive parents, and enhancing post-adoption services. Overall, the States "… are reinvesting these funds in the way the Congress intended" (Ledesma, p. 1).
Based on its findings, Cornerstone Consulting Group (2001) offered a number of suggestions related to the adoption incentive payment program, including:
- Place more emphasis on improvements in the adoption process that lead to better outcomes (e.g., improved court processes or more timely adoptions), not just on increasing numbers of adoptions.
- Reform the existing Federal child welfare financing structure to have a greater impact on outcomes (Cornerstone Consulting Group).
In 2003, the Adoption Promotion Act reauthorized and expanded the adoption incentive payment program to provide additional incentives for adoptions of children ages 9 and older. The Act also revised the baselines from which numbers of adoptions are counted to determine eligibility for the awards, making States that had already increased numbers of adoptions more likely to qualify for awards.
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Adoption Excellence Awards. Prompted by the Adoption 2002 initiative, HHS began the Adoption Excellence Awards program in 1997. Each year, nominations are solicited for States, agencies, organizations, businesses, individuals, and families that have demonstrated excellence in providing safe, stable, nurturing adoptive homes for children in foster care. These awards "demonstrate the Department's national commitment to expedite rebuilding the lives of those children and achieving permanency for those waiting for adoption" (U.S. DHHS, 2004a, p. 1).
Each year, the Department identifies a number of award categories, such as interjurisdictional adoptions, judicial or child welfare system improvement, support for adoptive families, faith-based initiatives, individual and/or family contributions, and business contributions/initiatives. In 2004, the Department added a new category, increased adoptions of older children (U.S. DHHS, 2004a).
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3.4 Federally Funded Programss
ACF, through the Children's Bureau, funds training and technical assistance for child welfare systems and numerous research and demonstration programs across the country to test and replicate strategies that show promise for improving outcomes for children and families. The following sections describe the Children's Bureau's, training and technical assistance network, the child welfare (title IV-E) waiver demonstrations, and the Children's Bureau's discretionary grant programs; these are followed by selected profiles of individual State efforts funded through these programs.
Training and Technical Assistance. The Children's Bureau funds a training and technical assistance network that currently includes 11 national resource centers, the Collaboration to AdoptUsKids, and two information clearinghouses. Each national resource center focuses on a specific aspect or topic within the child welfare field and provides up to 10 days of training or technical assistance per year to State or local public agencies and tribes. Most also provide other services, such as publications and networking. Since the implementation of the Child and Family Services Reviews, the resource centers focus primarily on services designed to assist States with their Statewide Assessments and Program Improvement Plans.
Three national resource centers are particularly relevant to this discussion of permanency, including permanency for older youth.
- The National Child Welfare Resource Center for Adoption assists States and tribes to improve the effectiveness of adoption and post-adoption services. Examples of focus areas include adoption of older children and youth, timeliness to adoption, assisting staff in assessing and preparing families and children for adoption, and developing post-adoption services.
- The National Resource Center on Family-Centered Practice and Permanency Planning assists States and tribes in providing family-centered practices that support the safety, permanency, and well-being of children and families. Examples of focus areas include family engagement strategies, recruitment and retention of resource families (e.g., foster, kinship, guardianship, and adoptive families), concurrent permanency planning, and effective post-permanency services.
- The National Resource Center on Youth Development assists States and tribes in helping youth in care meet the goals of safety, permanence, and well-being. Examples of focus areas include positive youth development, family group decision making, permanency planning for adolescents, and preparing youth for transition to adulthood.
Through a new cooperative agreement in September 2004, the Children's Bureau is promoting enhanced collaboration among the network of national resource centers to improve provision of training and technical assistance to the States. It is hoped that this approach will result in better coordination of these supportive services to States and tribes and ultimately in better outcomes for children and families.
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Child Welfare Waiver Demonstrations. Child welfare waiver demonstrations test new approaches to delivering and financing child welfare services to improve outcomes for children in foster care. By waiving certain provisions of titles IV-B and IV-E of the Social Security Act, this program gives States greater flexibility to use these funds for various services aimed at improving the safety, permanency, and well-being of children and families served by the child welfare system. Since 1996, 17 States have implemented 25 projects; as of May 2005, nine States are actively implementing 14 different waiver projects (James Bell Associates, 2005).
One of the requirements for these waiver projects is a rigorous evaluation plan using an experimental and control or comparison group. This requirement provides more confidence in the results, but many projects are finding it difficult to isolate effects of the waiver from effects of other programs and initiatives operating at the same time.
Assisted Guardianship. Seven States (Delaware, Illinois, Maryland, Montana, New Mexico, North Carolina, and Oregon) are conducting or have conducted projects to facilitate permanence through assisted or subsidized guardianship when neither reunification nor adoption are appropriate permanency outcomes for a child. Under these demonstrations in which subsidized guardianship has been tested, the State discharges children from foster care and the court transfers legal custody of the child from the State to the guardian (usually a relative, although in some cases unrelated foster parents or fictive kin also are eligible). To help the family meet the needs of the children, the State provides a monthly stipend to caregiving families that is equal to or less than the monthly foster care payment. Some projects also provide additional services to support these families including access to medical, mental health, and social services typically available to adoptive families.
Three States - Illinois, Montana, and Oregon - have focused portions of their efforts specifically on older children. Montana has not yet reported permanency outcomes but has reported findings from family interviews indicating that guardians value their increased ability to make decisions on behalf of children and youth in their care on such matters as health care, education, and family visits. In addition, family members report that the self-esteem of the children improves when they exit foster care and enter guardianship (James Bell Associates, 2004a).
Illinois has conducted the largest and most rigorous evaluation of subsidized guardianship. Over a 5-year period, Illinois transferred custody of 6,822 children from the State to private guardians. The State's final evaluation found that the availability of subsidized guardianship as an alternative permanency option helped increase overall permanency rates for children and youth in foster care. Children assigned to the experimental group in which guardianship was available had a 7 percent higher permanency rate (including adoption, guardianship, and reunification) than children in the control group. The evaluation also found that guardianship was comparable to adoption in keeping children safe, providing a stable home and sense of belonging, and ensuring children's physical and mental well-being (Westat, 2003).
One surprising finding from the Illinois evaluation was that the availability of guardianship did not have as great an impact as expected in achieving permanency for older youth in foster care. Based on prior research, Illinois expected that guardianship would assist more youth ages 14 to 18 achieve permanence and exit foster care. In fact, smaller percentages of older youth in the experimental group entered guardianship or were adopted compared to younger children; the majority of the older children either remained in State custody or aged out of care. In exploring the reasons behind this finding, Illinois officials learned that many youth stayed in the system because they did not want to lose access to the Chafee Foster Care Independence Program and State-funded transition programs that are available only to youth who exit the child welfare system between the ages of 18 and 21 without a permanent and legal relationship with a family. Illinois will test the impact of offering independent living/transition programs to youth who are adopted or enter subsidized guardianship at or after the age of 14 as part of a five-year extension of their subsidized guardianship demonstration. It is hoped that by offering transition supports to these groups, as well as to youth who age out of foster care, a barrier to permanency may be removed (Testa, Cohen, & Smith, 2003).
Adoption Services. One State (Maine) focused its title IV-E initiative specifically on enhancing adoption services. The project consisted of two interventions: adoption-competency training for clinical social workers, case managers, psychologists, and psychiatrists, and post-adoption support services, including case management, parent education, information and referral, support groups, respite care, advocacy, crisis stabilization, therapeutic services, and residential treatment.
No statistically significant differences were found between the experimental and control groups in terms of permanency outcomes, although some statistically significant positive differences in favor of the group receiving post-adoption supports were noted in areas such as strengthening the family members' attachment to the adopted child and improving trust between the caregiver and adopted child (James Bell Associates, 2004b).
Flexible Funding. Four States (Indiana, North Carolina, Ohio, and Oregon) implemented initiatives that enabled counties or local entities to use capped amounts of title IV-E funds more flexibly to provide an array of services to prevent foster care placements and facilitate permanency for children in foster care. Examples of services funded through these include assessment, substance abuse and mental health services, family decision meetings, new utilization review and quality assurance mechanisms, in-home parenting services, post-adoption services, and subsidized guardianships.
Results on permanency outcomes from the flexible funding demonstration initiatives varied. Indiana found that children served through the initiative had shorter lengths of stay in foster care and were reunified more often with their birth parents than were children in the control groups (Institute of Applied Research, 2003). North Carolina found that children in the waiver counties had higher risk profiles than children in the comparison counties, but their lengths of stay in foster care decreased at similar rates. The higher risk profile for children is due to the waiver counties' success in reducing the likelihood of children entering care; those who did enter were generally more troubled (Usher, Wildfire, Meier, & Duncan, 2002).
Ohio's and Oregon's evaluations did not find any statistically significant differences in permanency outcomes between experimental and comparison groups. Possible reasons for the lack of significant findings on permanency outcomes in Ohio include the fact that Ohio is a county-administered system that has great variability in implementation among counties (which can blur Statewide measurements), and counties already have flexibility in spending local tax funds, which comprise more than half the agencies' budgets. This latter factor makes it difficult to isolate the effects of the waiver (Ohio Department of Job and Family Services, Office for Children and Families, n.d.). However, they both report some significant findings on other issues. Ohio saw improvements in agencies' targeting services (especially prevention services) to areas of noted insufficiency. Oregon reports significant differences in the prevention of foster care placement between the experimental and comparison groups and surmises that the types of services implemented with flexible funds made available through the waiver were those most effective in maintaining children at home (Lehman, 2004).
Proposals for New Waiver Projects. In 2004, 14 States submitted new proposals for child welfare demonstration projects. Of these, six States were proposing projects involving subsidized guardianship, and six were proposing projects focusing on kinship or reunification permanency outcomes. Two specifically mentioned older children in their target populations of children to be served (U.S. DHHS, 2004d). Two States (Minnesota and Wisconsin) have received approval for their demonstration projects, but have not yet begun implementation (U.S. DHHS, 2005); both projects will test subsidized guardianship strategies to enhance permanency outcomes for children in foster care.
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Children's Bureau Discretionary Grant Programs. Each year, the Children's Bureau announces the availability of funds for discretionary research and demonstration grant programs and designates specific priority areas within each program. These grant opportunities allow State, tribal, local, and private agencies to test innovative programs designed to improve outcomes for children and families served by child welfare systems. One of the grant programs is Adoption Opportunities, most recently reauthorized by the Keeping Children and Families Safe Act of 2003. Examples of specific priority areas related to adoption in the last 4 years include:
- Adoptive placements for children in foster care (FY 2001, four projects funded; FY 2003, eight projects funded)
- Evaluations of existing adoption programs (FY 2001, three projects funded)
- Developing projects for increasing adoptive placement of minority children (FY 2002, four projects funded)
- Projects to improve recruitment of adoptive parents in rural communities (FY 2003, 10 projects funded)
- Field-initiated service demonstration projects; includes adoption of children ages 9 and older as a topic of special interest (FY 2004, six projects funded)
- Demonstration projects in post-adoption services and marriage education (FY 2004, seven projects funded).
Another example of ACF's efforts to improve adoption outcomes is the selection of adoption as one of the topics for a Quality Improvement Center. In FY 2001, the Children's Bureau, funded a group of Quality Improvement Centers to test the feasibility and benefits of managing grant-funded research and demonstration projects regionally rather than from the central office, as has been traditionally done. The Quality Improvement Centers plan for and award grants on selected topics with input from a regional advisory group, and are designed to enhance information sharing to improve child welfare services. The Quality Improvement Center on Adoption has developed a success model for adoptions based on input from stakeholders involved in all stages of the adoption process (Atkinson, 2002). This model has three essential elements: public-private collaborative partnerships, staff adoption specialization, and use of evidence-based practices in three areas - comprehensive assessments of children, pre-placement preparation of children and adoptive families, and post-adoption support of adoptive families. The Quality Improvement Center on Adoption has solicited proposals and funded research and demonstration grants to test the impact of using this model; results are expected in 2006 (Atkinson).
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Program Profiles. The following sections offer profiles of selected federally funded or federally supported local programs to illustrate the breadth of efforts aimed at achieving adoption and other permanency outcomes for children in foster care, especially for older children. Each profile presents the program's strategies, outcomes, and lessons learned.
California - Eastfield Ming Quong Children and Family Services Wraparound. As part of California's Federal title IV-E demonstration, Eastfield Ming Quong (EMQ) Children and Family Services used State funds to work with the Sacramento Department of Health and Human Services to move 30 youth from high-level group home placements to family-living settings; the youth were primarily over age 11 (Louisell, 2004).
Strategies. EMQ sought and supported family members to become permanent placements for these youth, and recruited and supported foster families who facilitated family connections for the youth. Multidisciplinary teams provided wraparound services to support the family placements.
Outcomes. Within 6 months, all 30 youth stepped down to family living arrangements: 19 youth went to live with parents or extended family members, and 11 youth went to live with foster families who support their continuing search for relatives.
Lessons Learned. Some child welfare and group home staff were resistant to moving the youth out of the group home settings into families. Support for the philosophy of permanent families for teens, especially from public and private agency management, was reported to be critical to overcoming this resistance (Louisell, 2004).
| Success story: EMQ discovered that a youth had three generations of family living in a small town in Iowa; staff went to Iowa to meet the family. The youth's father and his current wife and children relocated to California to work toward reunification. When that is achieved, they intend to move back to Iowa where they have extended family support (Louisell, 2004). |
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Colorado - Project UPLIFT. Project UPLIFT was operated by two county agencies of the Colorado Department of Human Services and was funded by a Federal Adoption Opportunities grant. The program sought to connect adolescents with caring adults to create supportive, permanent relationships. Many of the youth served had multiple barriers to permanency, including criminal charges and developmental and mental health disorders (Louisell, 2004).
Strategies. Dedicated adolescent connections workers engaged the youth to identify important people from their past, and the workers sought out and supported these adults in becoming permanent connections for the youth.
Outcomes. Of the 56 youth referred to the project, 47 have connected with at least one supportive adult. Of these, two youth have been reunified with their birth parents, and 12 are in the process of being adopted.
Lessons Learned. Involving youth is key to achieving permanent, supportive relationships for them. Overcoming biases of child welfare and residential staff against contact with biological families is a significant endeavor; open communication and relationship-building were reported to be key strategies to accomplishing this (Louisell, 2004).
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| Success story: A youth was making no progress in a residential treatment center. The 15 members of the youth's treatment team were adamantly opposed to letting him see relatives. Two project members went to a team meeting and asked if anyone in the room was willing to make a commitment for the rest of his or her life to this youth. No one spoke. The team eventually agreed to contact between the youth and a relative if the relative would agree to participate in joint therapy sessions. Since that occurred, the child has left the residential treatment center and is living with the relative. "The youth never had a reason to improve his situation until he had hope." (Louisell, 2004, p. 8). |
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Indiana - Intensive Family Reunification. As part of Indiana's Federal title IV-E demonstration, the Marion County Juvenile Court used State contract funds to implement the Intensive Family Reunification (IFR) program, which aims to reunite adolescents (both delinquents and victims of child abuse and neglect) in institutional placements with their families (Louisell, 2004).
Strategies. IFR implements services in three phases over a 15-month period. The first phase begins immediately upon referral and lasts 42 days; it involves preparing the youth, the family, the residential staff, and other relevant parties for the youth's return home. In Phase 2, intensive services are provided for 3 to 4 weeks, using the Homebuilder's Intensive Family Preservation model to support the reunited family. Phase 3 provides services to increase the family's independence during a 12-month period. Services include case management, parent education, and links to community-based services.
Outcomes. In the last several years, IFR has worked with 35 youths per year; on average, 70 percent of them went home within the first 42 days. Of these, 85 to 90 percent remained in the home through Phase 2, and 74 percent remained home for 1 year following reunification. Follow-up research on 250 youths served by IFR in the last 10 years revealed that 52 percent of them remained with their families into adulthood.
Lessons Learned. Resistance from residential staff to returning the youth home was addressed through training and networking among project and residential staff (Louisell, 2004).
Kentucky - Kentucky Adoption Opportunities Project. The Kentucky Adoption Opportunities Project (KAOP) was a collaboration of the State child welfare agency, the courts, and the county attorney's office in one urban and one rural county. KAOP sought to expedite permanency for high-risk children in foster care. These children were primarily younger children whose parents were coping with multiple risk factors, including substance abuse, mental illness, mental retardation, or family violence (Martin, Barbee, Antle, & Sar, 2002).
Strategies. KAOP implemented three permanency planning activities for high-risk children served in the project. These were: risk assessment and concurrent planning, one child/one legal voice (a dedicated project attorney and guardian ad litem for each child), and early placement in kinship or foster/adoptive homes.
Outcomes. In the urban county, the length of stay for children served by the project was 12 months, compared to 32 months for children in the general foster care population. In the rural region, the length of stay for children served by the project was 17 months, compared to 25 months for children in the general foster care population.
Lessons Learned. The final evaluation reported the following lessons learned: early, accurate assessments of parental and child needs were critical to identify relevant services; collaboration among treatment providers was important to ensure each treatment plan complemented the others to facilitate success; dedicating one attorney to each case helped ensure continuity and seems to have had an impact on reducing lengths of stay; and early placement in kinship and foster/adoptive homes contributed to continuity for the children. The evaluation also reported that court delays continued to pose barriers to expediting permanency (Martin et al., 2002).
New York - You Gotta Believe. You Gotta Believe (YGB) is a youth homelessness prevention program that finds permanent homes for youth, primarily teenagers, in foster care in New York City. YGB has received funding from a local grant and a Federal Adoption Opportunities grant (Louisell, 2004).
Strategies. YGB staff work with teens to identify and locate adults who have been important to them, and they recruit adoptive families from the general public. Staff provide training to the families and certify the homes for adoption. Staff also offer post-placement crisis intervention, group services, and social activities.
Outcomes. From 1995 to 2001, when YGB operated as a volunteer agency, an average of three youths per year were placed in permanent homes. Since the agency received significant funding in 2001, an average of 20 youths per year have been placed in permanent homes.
Lessons Learned. The report indicated that child welfare staff often did not believe that finding permanent families for these youths was possible. This issue was addressed through training. (Louisell, 2004).
| Success story: One youth who was violent, had stopped going to school, stopped getting out of bed in the morning, and beat up his future adoptive father before the adoption finalization. The youth had never stayed longer than 1 year in anyone's house. All his former foster parents had abandoned him. Fortunately, he now had a parent who functioned parentally and orchestrated not only the hospitalization but also the best residential treatment center the system could pay for. The youth stabilized. "The day he came home and saw everything where he left it - that was the day he believed he had a father." (Louisell, 2004, p. 52). |
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Texas - Familias Para Ninos. The Familias Para Ninos project was a collaboration between two private adoption agencies - DePelchin Children's Center and Spaulding for Children in the Houston-Fort Bend counties of Texas. With funding from a Federal Adoption Opportunities grant, the project aimed to increase the number of Hispanic/Latino children placed for adoption from foster care (Stanford et al., 2004).
Strategies. Familias Para Ninos employed a number of strategies: specialized media adoptive family recruitment campaigns, use of linguistically compatible staff, and post-placement supportive services to adoptive children, families, and extended families, including support groups and information and referral.
Outcomes. The project exceeded all its primary objectives. The key objective related to permanency was to place 67 Hispanic/Latino children in adoptive homes; 124 were actually placed, and 59 percent of these children were age 5 or older. The project received 1,651 responses to the media recruitment campaign (150 responses had been the objective). Of these, 196 families followed through to complete an adoption application and 53 Hispanic/Latino families were approved (50 had been the objective).
Lessons Learned. Recommendations based on the project's experiences and successes include the need for strong management support, culturally sensitive and properly translated tools and materials, bilingual staff, enough services for Spanish-speaking clients including Spanish PRIDE training (a foster/adoptive parent training curriculum), and expanded recruitment to include extended family as kinship adoptive placements (Stanford et al., 2004).
Notes
7More information about the annual bonus awards, including lists of States receiving awards, can be found in the ACF press releases dated 9/24/1999, 9/20/2000, 9/10/2001, 9/24/2002, 9/12/2003, 10/14/2004, and 09/20/2005 online at http://www.acf.hhs.gov/acf_news.html. back
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