The American child welfare system placed approximately 442,995 children and youth in foster care in 2017—a 10.6 increase from 2013, according to the Department of Health and Human Services (HHS) Administration for Children and Families (ACF) latest AFCARS Report.
The circumstances for their removals varied: Neglect, abuse (drug, physical, alcohol, and sexual abuse), housing, incarceration, abandonment, disability, relinquishment, death. Yet, the placements aligned with the system’s goals of providing for the safety, permanency, and well-being of children.
Family Support and Preservation Social Services in the Child Welfare Continuum
The system, for years, focused on child removal to meet its goals due to an increase in reported child abuse and neglect cases. However, several research studies have shown the harmful developmental effects of separating children from their families—and legislative efforts, such as the Omnibus Budget Reconciliation Act (OBRA) of 1993 and the Family First Prevention Services Act (FFPSA) of 2018, have resulted in better balancing child protection and family preservation.
Family support and preservation resources strengthen the family unit through the provision of:
- Community-based services that promote parental strength enhancement and competency (family support services)
- Short-term services to help families cope with stressors and other obstacles that affect parental nurturing (family preservation services)
The Following are examples of two-state systems working to strengthen family relationships—and prevent foster care placement when safely possible—through such services.
The Michigan Department of Health and Human Services
The Michigan Department of Health and Human Services (MDHHS) “provides support programs to families with Children’s Protective Services.” Its Family Preservation Program engages in collaborative partnerships at the local and state level to provide supportive services, such as home-based crisis intervention and family education, in-home clinical counseling, family reunification, skill-based interventions for substance affected families, and wraparound support for at risk children and families.
The Illinois Department of Children and Family Services
The Illinois Department of Children and Family Services (Illinois DCFS) is “dedicated to providing unrivaled professional service to ensure safe, loving homes, and brighter futures for every child in Illinois.” A child welfare agency, it provides several family support and preservation services, including counseling, crisis intervention, parental training, day care services.
Community-Based Care Coordination to Address Needs
Most children involved with the child welfare system generally have more specialized medical, mental, behavioral, and social needs than those living with their biological parents. They have experienced maltreatment and traumatic experiences that can affect them well into adulthood. For this reason, the above state programs, and others like them, work with community-based service providers and organizations to address these needs by providing a range of services.
This community-based care coordination enhances communication and data sharing between systems and providers for evidence-based decisions. It also results in improved outcomes because it keeps these vulnerable children from falling through the cracks of fragmented care due to structural barriers.
The System’s Connection to Youth Homelessness
Efforts to reduce the foster care population through early intervention and prevention have gained traction, but the system can’t preserve some families. In such cases, they remove children from their home settings.
The problem is that many children never find permanent homes when removed. Instead, they age out of the foster care system—and risk youth homelessness. Of the 215 homeless youth participants in a University of Chicago Chapin Hall Voices of Youth Count (VoYC) survey, for example, 94 had foster care histories and 23% aged out.
On a national level, nearly 20,000 youth aged out of foster care in 2017, and unlike their counterparts with families, more than half left the system without family, emotional, and financial support. The lack of such vital resources leaves them to cope in a few ways: living on the streets, sleeping in shelters, or surfing from one couch to another. And the consequences, especially over a prolonged period, are alarming.
Known health challenges for this vulnerable group include: chronic health illnesses, trauma-related injuries, malnutrition, poor hygiene, and high-risk behaviors. The Chapin Hall data also confirmed social, mental, and behavioral challenges of this vulnerable group: Nearly 31% struggled with mental health issues and 21% struggled from substance use disorder (SUD).
Social determinants of health (SDoH) factors can also worsen these health challenges. “The many health issues of homeless individuals cluster with, and are exacerbated by, other social determinants of health such as psychological trauma, poverty, unemployment, domestic violence and social disconnection,” researchers said in a study published in the International Journal of Environmental Research and Public Health.
Altogether, these youth face difficult circumstances daily and often need access to care for their well-being. Equally important to meeting their medical needs is meeting their social needs—one of which is housing. And there is good news. Cross-sector partnerships in communities across the country are working to provide these youth with access to stable shelter and other relevant social resources they need to maintain independence.