Foster children and their developmental outcomes

Foster Children/Foster Care

Issues of a Foster Child

Child Abuse

Families and Children Served through Foster Care

The Policy Framework

This thesis reviews foster care in the United States: the reasons why children fall into the category of children who need to be taken out of their families and placed in care, the numerous emotional and psychological responses of children in foster care, and the psychological and emotional care that is given to children that are placed in foster care. The numerous laws covering foster care institutions and the policies they implement regarding the treatment of children in their care are also discussed. An extensive list of references is also given at the end of the thesis.

Introduction

Everyday more children are born into this world. Yet everyday there is a mother or a father who child is placed in a foster care facility, for many different reasons. Children are taken from their home because of neglect or in cases of child abuse, yet others are left abandoned by their families and are left at the door of family services. The foster care service has continued to expand in the last decade, and there are so many foster children in the country that the facilities are overcrowded and under staffed. The age of the parents of children in foster care is most commonly found to range from 14 years to 44 years. Many children are placed in foster care by their parent or parents because the parents are on drugs or are not ready to take on the responsibility, or because they are not mentally, or financially, ready for a child. Other parents may just be afraid of the change that a child would bring to their lives.

The life changing decision to have a child often isn't thought out long enough by the parents. Parents don't consider the fact that they are giving up their flesh and blood in order to make their lives easier. They also don't consider the struggles that the child will go through in their life following a life in care. Struggles such as identity, wanting to know who their real family is, and also wondering why their real parents didn't want them. Also, not every child will receive the perfect loving foster family.

Chapter 1 - Issues of a Foster Child

In the State of Missouri, children are regularly removed from their biological family over the short or long-term. Some of the reasons that the state government has removed these children are due to suspected child abuse or neglect, an inability of the biological parent to provide a safe and nurturing environment, neglect of the medical or educational needs of the child, severe behavior and disciplinary problems manifested by the child, which the parents cannot cope with, or simply the children in foster care are children that are waiting adoption. Many times, children can be removed as a precautionary measure or while the local authorities investigate the validity of every report.

Foster care is a complicated service. It serves children who have experienced abuse or neglect, from their birthparents and families and their foster parents. Children in foster care may live with unrelated foster parents, with relatives, with families who plan to adopt them, or in group homes or residential treatment centers. The State of Missouri Foster care program is a temporary service that responds to crises in the lives of children and families. Children who enter foster care will either return to their parents as soon as possible, or become provided by the state government with safe, stable, and loving families through placement with relatives or adoption. Some children, however, remain in foster care for extended periods of time. Many "age out" and go on to live on their own. Over the past decade, the population of children and young people in foster care has grown dramatically.

Many factors have shaped foster care over the past several decades. One key force has been the heightening of societal expectations and standards for acceptable family functioning, a social shift that began in the 1960s and continues to the present. In 1962, Dr. Henry Kempe and colleagues published "The Battered Child Syndrome" (Kempe, Silverman, Steele, Droegemueller, & Silver, 1962), which raised public awareness about child abuse. Child Abuse Prevention and Treatment Act (CAPTA), which provided funding to assist states in developing their child protective services systems. As amended in 1996 (PL. 104-235), CAPTA requires states to have in place procedures for reporting suspected child maltreatment, investigating such reports, and taking immediate steps to protect children found to be at risk of harm (U.S. House of Representatives, 2000).

At the same time as child abuse and neglect reporting and intervention laws were govern by each states to raise awareness of child abuse and neglect. The general public and professionals responded to these efforts. Professions included individuals from pediatrics, psychology, child welfare, social policy, legal advocacy, speech-language pathology, physical therapy, theology, and early intervention. People from these professions work to help the children adjust to the changes in their life.

Loss issues appear to be a common theme among children in foster care and among foster care workers, as well as foster parents, and all need training in this area. Children must feel comfortable in expressing their feelings in a safe and nurturing environment. In many cases, the children in foster care homes become isolated by the state, and even punished for expressing the normal grief that is associated with leaving biological parents and siblings. If not detected and addressed early, the issue of loss can lead to angry outbursts, school problems, withdrawal, and depression.

The first key development is that the number of child abuse and child neglect reports are increasing. Neglect and abuse is still present in society, which has important implications for foster care. The second key development that has led to a greater number of families at increased risk of child abuse and neglect are drug abuse, teen pregnancy, and violence. Poverty, homelessness, discrimination, declining informal and extended family supports, and other forces are undermining the resilience and coping capacity of families (Freundlich, 1997). At the same time, the service systems on which families have traditionally depended on have not kept pace with demand. The capacity of key systems such as mental health and substance abuse treatment are being strained, meaning that service reductions and long waiting lists are commonplace.

Prevention and early intervention services are difficult to obtain, and treatment resources often are not available, except in crisis situations. In addition, previous safety nets for families, most specifically Aid to Families with Dependent Children and the Children's Disability Program under the Supplemental Security Income program, are redesigned for foster children so that financial and health benefits are not available to the extent to which they were in the past (Freundlich, 1997). As family needs increase and intensify and other service systems are unable to respond, child welfare both legally and socially, is expected to intervene.

The third development affecting foster care relates to the child welfare system itself and ongoing tensions regarding its role. These tensions play out at both the philosophical and service delivery levels and are evident in law, policy, and practice. Over the past three decades, child welfare services in general -- and foster care in particular-have changed, reflecting prevailing values about the role that such services should play in preserving and reunifying families or in promoting alternatives for children other than reunification with their families (example as adoption and long-term foster care). In this context, the child welfare system continues to struggle to define and achieve appropriate outcomes for children.

Training methods should include technology for self-discovery, in terms of how foster parents have dealt with their personal loss issues and a list of available resources for on-going assistance. Many people feel that the public child welfare systems are in desperate need of reform due to the lack of community involvement. This type of reform should include adopting a system that is less disruptive to the lives of the children and their families. The services need to be more community based, culturally sensitive, individualized, available as an alternative to institutional placement, and family oriented.

Child abuse is a problem that seems to be growing more rapidly every year. This problem increases the population in foster homes, which increases the need of children to have families. There needs to be more strict laws on child abuse and neglect, which could decrease the occurrence of recurrent crime. There are no guarantees that a child taken away from their home will be placed in a home that is any better from where they came from, or even that they will be placed in a home at all.

Chapter 2- Child Abuse

Child Abuse and Neglect

One factor impacting foster care is the steady growth in the number of substantiated reports of child abuse and neglect. Many children that are abused or neglected are placed in foster care, in friend's homes, or are taken in, to be under the care of another family member. Beginning in the 1960s, the numbers of reports of child abuse and neglect grew dramatically -- from ten thousand in 1962 (Lindsey, 1996), to almost three million in 1999 (U.S. Department of Health and Human Services, 2001a). Consistent with legal mandates that certain professionals report suspected child maltreatment, more than half (54.7%) of the reports in 1999 were from professionals (educators, medical staff, law enforcement personnel, social services personnel, and others); the remaining reports were from relatives, friends, neighbors, and anonymous sources (U.S. Department of Health and Human Services, 2001a). 1.8 million reports that were investigated were substantiated for child abuse or neglect (U.S. Department of Health and Human Services, 2001a).

According to the National Child Abuse and Neglect Data and the 1997 AFCARS report, children die 5.25 times more as a result of abuse in foster care than children in the general population. In 1997, 2.1% of all child fatalities took place in foster care. Children who received service from Child Protection Agencies die as a result of abuse 16 times more often than children in the general population.

Most children who enter foster care do so following a substantiated report of abuse or neglect, although the proportion of substantiated reports that result in a foster care placement vary from state to state. In 1999, 21% of children determined to be abused or neglected were placed in foster care (approximately 171,000 children, based on the reports of 41 states) (U.S. Department of Health and Human Services, 2001a). In addition to those children for whom abuse or neglect are substantiated, 3% of the children who were the subjects of unsubstantiated reports (an estimated 49,000 children in 49 states) are placed in foster care (U.S. Department of Health and Human Services, 2001a).

The number of children in foster care rebounded in the late 1980s, began to grow at an even faster pace in the 1960s and 1970s. This growth in the number of children in foster care persists today. The number of children in care in March 2000 was approximately 588,000, more than double the number of children in care in 1984 (U.S. Department of mental Health and Human Services, 2001c).

There are three reasons associated with the increasing number of children in foster care: higher rates of entry into foster care than of exit from care; high rates of re-entry into care; and placement of children in foster care through other systems. Consistently, more children are entering foster care each year than those exiting. For the six-month period from October 1, 1999 to March 31, 2000, 146,000 children entered foster care while 124,000 children exited care (U.S. Department of Health and Human Services, 2001c). National as well as state-based analyses of foster care caseloads in the United States have shown that yearly admissions and discharges from foster care, which were fairly equal until 1986, are exhibiting ever-widening disparities (U.S. Department of Health and Human Services, 1991).

Finally, the growing number of children in foster care is also related to placements from other systems, specifically the mental health and juvenile justice systems. Increasingly, foster care is used to care for children and young people who previously have served through children's mental health programs or in correctional facilities. Landverk and Garland (1999) estimate that between one-half and two-thirds of the children who enter foster care have behavioral or emotional problems that warrant mental health treatment. Similarly, Gilbert (1999) found that growing numbers of children with serious emotional problems are relinquished to child welfare agencies by the state so that residential treatment is being arranged for them. Others point to the increasing trend to divert youth into foster care from the juvenile and criminal justice systems (Horn by & Collins, 1981; Timberlake & Verdict, 1987).

The 10% or greater annual growth rate of the population of children in foster care -- a trend affected by increasing disparities between the number of children entering and exiting foster care, high re-entry rates, and placements of children in foster care from other systems -- poses substantial practice and policy challenges related to case planning, decision making, and service delivery. These challenges are likely to become even more significant in the future should the population of children in foster care continue to grow at recent rates.

Average Time Spent in Foster Care

Many children who enter care remain in care for significant periods of time. Throughout the 1980s, the length of time that children spent in care decreased (Tatara, 1993). Beginning in 1990, however, the average length of time that children were in care began to increase (Tatara, 1993). With some fluctuations, the average length of stay in foster care has remained at consistently high levels, with a median length of stay for children in foster care in March 31, 2001 of 21 months (U.S. Department of Health and Human Services, 2001c). In a number of states, the average length of stay of children in foster care is even greater. The median length of stay for children in care as of October 1, 1997 was 30 months in the District of Columbia; 35.6 months in Illinois; and 32.1 months in New York (U.S. Department of Health and Human Services, 2000b).

Characteristics of Children in Foster Care

Key characteristics of children in foster care -- age, racial and ethnic backgrounds, and health status -- have important implications for the services needed by the children, their foster parents, and their birth families, and impact the nature of foster care today.

Age of Children in Foster Care

Two aspects of the age of children in foster care are key: the age at which children enter foster care and the distribution of children in foster care by age group. The age of children at the time of foster care entry has followed a cyclical pattern. In 1977, 12% of children entering foster care were under the age of 4, 1998a). Federal data for the period October 1, 1999 through March 31, 2000 indicates that the proportion of very young children entering foster care has fallen. Paralleling the data of the late 1970s, 13% of the children entering care during that six-month period were under the age of 1 (U.S. Department of Health and Human Services, 2001c). A significantly larger percentage of children (42%) were 11 and older at the time they entered care (U.S. Department of Health and Human Services, 2001c).

The age of children at time of entry into foster care and the age distribution of children residing in foster care are not directly related. As of March 31, 2000, an extremely small percentage of children in foster care (4%) were under the age of 1; about one-quarter were between 1 and 5 years old; another quarter were between 6 and 10 years old; close to half (45%) were age 11 and older; and a small percentage (2%) were 19 or older (U.S. Department of Health and Human Services, 2001c). This data indicates that although younger children continue to constitute a meaningful percentage of the children in foster care, a significant proportion of children who enter foster care, and who are currently in care, are older.

Racial and Ethnic Background

Historically, a large percentage of the children in foster care have been children of color. Although people of color currently constitute approximately 25% of the U.S. population (U.S. Census Bureau, 2001a), moderate to significant increases in the populations of nonwhite ethnic groups were documented. Between 1980 and 1998, the African-American population increased by 25%; Native Americans and Alaskan Natives by 51%; Latinos by 107%; and Asians and Pacific Islanders by 177% (U.S. Census Bureau, 1999). Increased representation of people of color in the U.S. population as a whole is reflected in the increasingly diverse racial and ethnic makeup of children in the child welfare system. In 1980, 47.3% of children in foster care were children of color; by 1990, the proportion had reached 60.7%; and by 1999, it had increased to 64% (Tatara, 1993; U.S. Department of Health and Human Services, 2000a).

Despite the increasing representation of people of color in the U.S. population overall, children of color continue to make up a disproportionate proportion of the population of children in care. In 1990, for the first time, more African-American children than white children were in foster care (Tatara, 1993), a trend that has continued to the present (U.S. Department of Health and Human Services, 2000a).

Some studies have shown that increases in the number of children in foster care can be attributed to increased entry rates for children of color. Wulczyn and Goerge (1990), for example, found that the dramatic increase in the number of children in foster care in Illinois between 1987 and 1988 was due entirely to African-American children entering care in numbers disproportionate to their membership in the general population.

Nationwide, Latino, Native American/Alaskan Native, and Asian/Pacific Islander children (who, in 1999, respectively represented 9%, 1%, and 4% of the U.S. child population) are proportionally represented in the foster care population (U.S. Census Bureau, 2001b; U.S. Department of Health and Human Services, 2000a). Minority children from some of these groups, however, are disproportionately represented in the foster care populations of some states. In California, for example, the percentage of children in foster care who were Latino rose from approximately 20% in 1988 to more than 30% in 1994 (Wulczyn, Harden, & Goerge, 1997). Similarly, Native American/Alaskan Native children in NY 1998 represented 34% of the children in foster care in North Dakota, 13% of the children in care in Minnesota, and 15% of the children in care in Oklahoma (U.S. Department of Health and Human Services, 2000b).

The implications of the large and growing number of children of color in foster care extend to the quality of services these children receive while in care. Children of color often receive differential treatment in the foster care system. Research indicates that African-American children remain in foster care for longer, receive fewer services, are less likely to have service plans, and visit with their parents less often (Close, 1983; Olson, 1982; Stehno, 1990). Similarly, Latino children are less likely to have plans for regular parental contact than white children in care (Shyne & Schroeder, 1978).

These findings raise important issues related to the cultural competence and responsiveness of the child welfare system. The disparate nationwide impact of child welfare practices and policies on African-American children and families and the state-level impact on other communities of color reflect race and culture-based factors that cause interventions to last longer, families to be separated more frequently, and reunification to occur less often for these children and families (Morton, 1999). As early as 1972, Billingsley and Giovanni observed that racism had pervaded child welfare services in three key ways: in the kinds of services provided, in inequitable treatment based on race, and in inadequate efforts to change the system to ensure equivalent services for all racial and ethnic groups. Courtney (1996) concludes that race and ethnicity remain central issues in child welfare and that inequity, based on racial and cultural factors, continues to characterize both services and outcomes.

Children in foster care are at high risk for emotional, behavioral, developmental, and physical health problems (Halfon & Klee, 1991). In the 1980s, studies began to document the extent to which children in foster care suffered from emotional, behavioral, and developmental problems. A 1984 New York study found that 40% of the children in state foster care manifested emotional and behavioral problems, including thought disorders, paranoia, suicide attempts, eating disorders, self-abuse, and attention deficits disorders (Ingalls, Hatch, & Meservey, 1984). More recent studies have contributed to a broader understanding of the extent to which children in foster care experience emotional, behavioral, and developmental problems. A 1990 study found that the incidence of emotional, behavioral, and developmental problems among children in foster care (including depression, conduct disorders, difficulties in school, and impaired social relationships) was three to six times greater than the incidence of these problems among children not in care (Dubowitz, 1990).

1994 study by the U.S. Department of Health and Human Services (1997a) found that 27% of the children in foster care were emotionally disturbed; 18% had learning disabilities; 11% had developmental disabilities; 8% had hearing, speech, or sight impairments; and 4% had other disabilities. Researchers in Texas conducted comprehensive assessments on 300 children at the time they entered foster care; they found that 60% of the children under age 7 exhibited developmental delays or behaviors that warranted additional evaluation or specialized interventions (Perry, Conrad, Dobson, Schick, & Runyon, 2000). Of the older children and adolescents assessed, 22% reported very severe posttraumatic stress symptoms and 50% had academic problems (Perry, et al., 2000). The American Academy of Pediatrics (2000) estimates that 30% of children in foster care have severe emotional, behavioral, or developmental problems.

The number of children affected by mental health, developmental, and physical health problems, as well as the severity of these problems, has increased over time (U.S. General Accounting Office, 1998). In 1990, child welfare experts testified before the U.S. House of Representatives Budget Committee "children coming into the system today are significantly different from the children we saw five years ago... [With] a growing number of seriously handicapped infants at one end of the spectrum, and a preponderance of emotionally disabled teenagers at the other end" (American Public Welfare Association, 1990). Without the proper care and attention, many of these children end up in the juvenile centers or hurting themselves permanently.

To a great extent, the increasing number of children in foster care with serious health problems are associated with the abuse and neglect they experience prior to foster care entry. One study of three major cities found that between 1986 and 1991, the rising number of young children in foster care with serious health-related problems (from 43% in 1986 to 58% in 1991) are associated with prenatal alcohol and drug exposure (U.S. General Accounting Office, 1994). Similarly, a more recent study of infants in foster care in two large California counties found that growing numbers of children in foster care have been parentally exposed to illegal drugs (62% of the infants had documented histories of prenatal substance exposure and exposure was suspected in another 17%); the infants with known or suspected histories of prenatal drug exposure had significantly more health problems than the infants who were not exposed (McNichol, 1999).

Although many children come into care with significant health, mental health, and developmental problems, the foster care system itself may sometimes further exacerbate these problems. As children move from one setting to another, their already compromised physical and mental health and development may deteriorate further. Fanshel and colleagues (1989) found a direct relationship between the number of placements children experienced and the level of hostility they displayed. A Florida study found that children who experienced multiple placements tended to have higher levels of behavioral and emotional problems, remained longer in foster care, and had difficulty either returning home or making the transition to adoption (Office of the Auditor General, 1989). This problem needs to be look at closely. The reason children find it difficult to entering new homes is because they feel that they will be removed once again. Some children that move around a lot are most likely to run away a lot also.

The compromised health and developmental status of many children in foster care has important implications. The nature and severity of children's health problems present critical issues related to services for children, permanency planning, and supporting children and their families (whether their birthparents, relatives, or adoptive families) after they exit foster care.

Chapter 3 - Families and Children Served Through Foster Care

Historically, broader economic and political realities have affected the welfare of families and children. These factors impact the overall functioning and well being of families, and consistently play a key role in the extent to which child abuse and neglect occur and foster care are needed.

In 1933, as the Depression affected families across the U.S., the U.S. Children's Bureau, in collaboration with the Child Welfare League of America, convened a Conference on Present Emergencies in the Care of Dependent and Neglected Children.

Contributors to a special issue of Child Welfare (1999) that focused on family foster care in the next century noted the potential impact on families as a whole, and poor families in particular, as health care and welfare services were being reorganized, financed in new ways, and delivered through new service models (Simms, Freundlich, Battiselli, & Kaufman, 1999).

Many of the same stresses that historically are associated with increased risks of child maltreatment and the need to place children away from their families and into foster care characterize the current economic and social environment. These factors include poverty, homelessness, adolescent parenthood, parental substance abuse, and the effects of HIV / AIDS.

Poverty

Poverty has always affected the well being of children and families. Although the U.S. is one of the richest nations in the world, it has high rates of poverty, particularly child poverty (U.S. Census Bureau, 1993, 2000b). In 1999, almost 17% of U.S. children (12.1 million) lived at or below the federal poverty line (U.S. Census Bureau, 2000b), which means a percentage of those children were abused, neglected, and placed into foster care.

In the U.S., poverty disproportionately affects children of color and the children of single parents. 15% of white children live at or below the poverty line, compared to 34% of Latino children and almost 37% of African-American children (U.S. Census Bureau, 2000a), the combination of race and single parenting places children of color at an increased risk of poverty.

Poverty severely limits the ability of some families to provide basic necessities for their children, including food, shelter, clothing, health care, and transportation to school and needed services. In 1999, 17% of U.S. children experienced hunger and 30% of children raised by single mothers are determined to be "food insecure" (that is, "uncertain of having, or unable to acquire, adequate food sufficient to meet their basic needs at all times due to inadequate household resources for food") (Andrews, Nord, Bickel, & Carlson, 2000, p. 1).

Poverty and poor health are related also. The health of poor children is worse than that of their better-off peers, and poor children are less likely to receive adequate health care (Klerman & Parker, 1991). In a national survey, the Urban Institute (1999) found that low-income children and youth were more than three times as likely to be in fair or poor health than higher-income children. African-American children and Latino children were more likely to be reported as being in fair or poor health than were white children (8% vs. 11% vs. 3%, respectively) (Urban Institute, 1999).

Given the impact of poverty on the ability of many families to provide adequately for their children, it is not surprising that children living in poverty are far more likely to be reported to child protective services as victims of child neglect (Duncan & Brooks-Gunn, 1998). Homelessness and unstable housing also pose challenges to the reunification of children in foster care with their families (Child Welfare League of America, 1990). The service deficiencies and biases that may result in homeless families losing custody of their children often stand as obstacles to reunification. At the same time, the housing issues that many families confront may be further complicated by parental substance abuse (Robertson, 1991) and mental health problems (Roll, Toro, & Ortola, 1999).

Homelessness also has a significant impact on young people who leave foster care. Adults, who as children, were placed in foster care or another out-of-home setting; experienced physical or sexual abuse (often precursors to out-of-home care); were raised by parents who abused alcohol or other drugs; or experienced homelessness or housing instability, often face an increased risk of homelessness (Burt, 1999). As many as three in ten homeless adults were formerly children in foster care (Roman & Wolfe, 1995). Parents who spent time in foster care as children and who experience homelessness as adults are almost twice as likely to have their own children placed in foster care as parents who are homeless but who were never in foster care (Roman & Wolfe, 1995).

The complex relationship between homelessness and foster care involves a number of social, familial, and institutional factors. At issue are the relationships between homelessness and parental substance abuse and mental illness; the connection between a history of physical or sexual abuse and the risk of later homelessness; and the extent to which the risk of homelessness is related to the quality of services that are provided to youth as they prepare to leave foster care at the age of maturity (Roman & Wolfe, 1995).

Adolescent Parenthood

The children of adolescent mothers face particular risks because of higher rates of pregnancy complications among their mothers, including premature delivery; a lower likelihood that the mothers obtained prenatal care; and the academic and employment disadvantages that the mothers face (a higher likelihood of not completing high school than their non-parenting peers and half the lifetime income of women who do not give birth until they are in their 20s) (Alan Guttmacher Institute, 1994). Likewise, children of teenage fathers face the disadvantages associated with their fathers' lower incomes and more limited education (Alan Guttmacher Institute, 1994).

Adolescent parenting has also been associated with increased rates of child maltreatment. In Illinois, researchers found that the age of the mother was associated with higher rates of abuse and neglect and foster care entry. Children born to teenage mothers were twice as likely to be victims of abuse and neglect as children born to 20- or 21-year-old mothers (Goerge & Lee, 1996). The realities that adolescent parents and their children face raise key questions about the extent to which services are available to young parents whose ability to care for their children may be compromised by their own personal abilities as well as by limited resources and supports. The same factors that heighten the risk of foster care entry for children of adolescent parents -- factors related to maturity, sound decision making, and ability to support a child -- affect efforts to reunify children in foster care with their adolescent parents. With absent effective, ongoing services to strengthen and support them, young parents are likely to face significant challenges in their efforts to regain custody of their children.

Parental Substance Abuse

The impact of parental substance abuse extends to children who, though not prenatal exposed to drugs or alcohol, are subject to their parents' drug- or alcohol-related behavior. In 1996, some 8.3 million children lived with a parent who abused alcohol or other drugs (U.S. Department of Health and Human Services, 1999a).

Parental alcohol and other drug abuse has been linked to domestic violence (National Clearinghouse for Alcohol and Drug Abuse, 1995), as well as to poor results for children, including depression and anxiety, poor academic performance, and substance abuse by children themselves (Children of Alcoholics Foundation, 1999). Parental substance abuse has been associated directly with child abuse and neglect and foster care entry (U.S. Department of Health and Human Services, 1999a; North American Commission on Chemical Dependency and Child Welfare, 1992). The U.S. Department of Health and Human Services (1999a) found that parental substance abuse is a factor in one-third to two-thirds of all reports of child abuse or neglect. In particular, prenatal alcohol and drug exposure has been found to account for the growing number of very young children entering foster care (U.S. General Accounting Office, 1997).

Children who enter foster care because of parental abuse of alcohol or other drugs tend to remain in foster care longer than children whose parents do not abuse substances. One study found that children whose parents abuse alcohol or other drugs remain in foster care an average of 11 months as opposed to 5 months for children whose parents are not substance abusers. Children with parental abusers and are less likely to leave foster care within a year (55% as opposed to 70%) (U.S. Department of Health and Human Services, 1999a).

The relationship between parental substance abuse and foster care entry and length of stay is important with implications for the delivery of services to children and families and for permanency planning. This large and growing group of children may have a range of physical health and developmental needs, particularly if they were prenatally exposed to alcohol or drugs, and reunification may pose special challenges.

1996). Other children are in need of temporary care because of parents who are experiencing episodes of serious illness associated with HIV, but who will likely regain sufficient health to resume the care of their children. This latter population of children needs temporary placement services to support them during their parents' health crises (American Academy of Pediatrics, 1999). Some of these children automatically go to the closest family member or relative. A lot of the children removed from their home don't realize the reason for why they are leaving.

Chapter 4 - The Policy Framework

The Adoption Assistance and Child Welfare Act of 1980

The Adoption Assistance and Child Welfare Act of 1980 (PL. 96-272) has played and continues to play a role in shaping foster care. In the late 1970s, criticism of foster care began to mount as the number of children entering care mushroomed, the length of stay began to increase significantly, and children in care were neither being returned to their families nor placed with adoptive families. The term foster care drift was coined to describe the deleterious effects of the foster care system on children and families (Guggenheim, 1995). P.L. 96-272 legislatively introduced the concepts of permanency and "reasonable efforts" as the touchstones for services for children in foster care and their families. The law required child welfare agencies to make "reasonable efforts" to keep families together and, when children entered foster care, "reasonable efforts" to reunite them with their families.

It also outlined alternative permanency outcomes for children in foster care who could not or would not be reunited with their families, including placement with relatives and adoption. By the mid-1980s, however, as the economy became less vital, and families began experiencing the first effects of the crack cocaine and HIV / AIDS epidemics, the number of children in foster care and their length of stay both began to rise. By 1992, the population of children in foster care had increased by 54% over the number of children in care in 1984; length of stay had risen as well (U.S. Department of Health and Human Services, 1999c). Gershenson (1990) observed that "the initial gains resulting from the new philosophy of permanency planning [as set forth in P.L. 96-272] have seemed to disappear as far as reducing the number of children in foster care."

The Family Preservation and Family Support Program/Promoting Safe and Stable Families Program

In the late 1980s and early 1990s, professional concern grew that appropriate efforts were not being made to keep or reunify children with their families and that foster care was being used in situations in which children could remain at home or be returned to their families if services were provided. Practice evolved into models that were "family-centered," "family-focused," and "family-based" -- approaches that assessed the needs and welfare of children within the context of their families and their communities. In line with these developments, Congress enacted the Family Preservation and Family Support Program (P.L. 103-66) in 1993 to provide funding to states for family preservation and community-based family support services.