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- Definition: Number of children ages 0-17 in foster care on March 31 receiving medical exams in accordance with Child Health and Disability Prevention Program periodicity schedules effective July 1, 2016 (e.g., among California children in foster care on March 31, 2019, 31,242 received timely medical exams).Percentage of children ages 0-17 in foster care on March 31 receiving medical exams in accordance with Child Health and Disability Prevention Program periodicity schedules effective July 1, 2016 (e.g., among California children in foster care on March 31, 2019, 73.3% received timely medical exams).
- Data Source: Webster, D., et al. California Child Welfare Indicators Project Reports. UC Berkeley Center for Social Services Research (Jul. 2019).
- Footnote: Child Health and Disability Prevention Program periodicity schedules require medical and dental exams by the end of specific age periods; children are out of compliance if they leave an age period without a required exam. Periodicity schedules adopted July 1, 2016—which increased the frequency of examinations for children in most age groups—are used to measure compliance for all time periods; as a result, data for 2016 and earlier may be lower than performance measured against prevailing standards of the time. Data are based on unduplicated counts of children under the supervision of county welfare departments and exclude cases under the supervision of county probation departments, out-of-state agencies, state adoptions district offices, and Indian child welfare departments. Data are excluded for children in out-of-home placements shorter than 31 days. The notation S refers to data that have been suppressed because there were fewer than 20 children who had been in foster care for at least 31 days on March 31.
- Measures of Foster Care on Kidsdata.org
Kidsdata.org provides the following indicators of children and youth involved in the foster care system:
Other measures related to foster care include:
- Children ages 0-17 entering foster care for the first time, by age group, race/ethnicity, reason for removal from home, and type of foster care placement
- Children and youth ages 0-20 in foster care on July 1st, by age group, race/ethnicity, and type of placement
- The number of foster youth enrolled in public schools on the first Wednesday in October, along with the percentage of foster youth in the total student population
- The percentage of children in foster care who receive timely medical exams and timely dental exams
- Among children in care longer than eight days, the median number of months in foster care
- For children in foster care at least 12 months, the number of placements and placement distance from home after one year in care
- Exit status (the number and percentage of foster children who are reunified with their parents, adopted, discharged to guardianship, emancipated from care (age out), and still in care) one year and four years after first entry
- Among foster children who are reunified with their parents, the percentage who re-renter care within a year, and among children who are adopted, the length of time from latest entry to adoption
- Foster Care
- First Entries into Foster Care
- Children in Foster Care
- Foster Youth in Public Schools
- Timely Medical Exams for Children in Foster Care
- Timely Dental Exams for Children in Foster Care
- Median Number of Months in Foster Care
- Number of Placements After One Year in Foster Care
- Placement Distance from Home After One Year in Foster Care
- Exit Status One Year After Entry into Foster Care
- Exit Status Four Years After Entry into Foster Care
- Re-Entries into Foster Care
- Length of Time from Foster Care to Adoption
- Child Abuse and Neglect
- Childhood Adversity and Resilience
- Prevalence of Childhood Hardships (Maternal Retrospective)
- Foster Care Placement (Maternal Retrospective)
- Prevalence of Adverse Childhood Experiences (Adult Retrospective)
- Why This Topic Is Important
Foster care is intended to provide temporary, safe living arrangements and therapeutic services for children who cannot remain safely at home because of risk for maltreatment or inadequate care. The U.S. foster care system aims to safely reunify children with their parents or secure another permanent home, e.g., through adoption; however, too often this goal is not achieved, especially for older youth and children with disabilities (1, 2). Instead, many children spend years in foster homes or group homes, often moving many times (1, 2).
Children in foster care are at increased risk for a variety of emotional, physical, behavioral, and academic problems, with outcomes generally worse for children in group homes (3, 4). Recognizing this, advocates and policymakers have made efforts to prevent children from entering the system and to safely reduce the number of children living in foster care, particularly in group homes (5, 6). While the number of children in foster care nationally has decreased since the 2000s, it has risen in recent years, and California continues to have the largest number of children entering the system each year (1, 7). Further, children of color continue to be overrepresented in the foster care system; in California, for example, African American/black children make up 23% of foster children but only 6% of the general child population (8).Among older youth exiting foster care, more than half (51% nationwide and 65% in California) age out of the system without being reunited with their families or connected with another family (8). Recognizing the need to support these youth in the transition to adulthood, California and many other states now extend foster care services past age 18, and the Affordable Care Act ensures that health coverage continues until age 26. However, aging out of the system still creates challenges for many youth—a high percentage experience inadequate housing, low educational and career attainment, early parenthood, substance abuse, physical and mental health problems, and involvement with the criminal justice system (4, 8). Continued efforts are needed to ensure these young people have the support, skills, and resources to successfully transition to life as an adult (4, 8).
For more information about foster care, see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. U.S. Department of Health and Human Services, Children's Bureau. (2018). Child welfare outcomes 2015: Report to Congress. Retrieved from: https://www.acf.hhs.gov/cb/resource/cwo-2015
2. Child Welfare Information Gateway. (2019). Foster care statistics 2017. U.S. Department of Health and Human Services, Children's Bureau. Retrieved from: https://www.childwelfare.gov/pubs/factsheets/foster
3. Children Need Amazing Parents (CHAMPS). (2019). Policy playbook (2nd ed.). Retrieved from: https://playbook.fosteringchamps.org
4. Courtney, M. E., et al. (2018). Findings from the California Youth Transitions to Adulthood Study (CalYOUTH): Conditions of youth at age 21. Chapin Hall. Retrieved from: https://www.chapinhall.org/research/calyouth-wave3
5. National Conference of State Legislatures. (2019). Family First Prevention Services Act. Retrieved from: https://www.ncsl.org/research/human-services/family-first-prevention-services-act-ffpsa.aspx
6. California Department of Social Services. (n.d.). Continuum of care reform. Retrieved from: https://www.cdss.ca.gov/inforesources/Continuum-of-Care-Reform
7. KIDS COUNT Data Center. (2019). Children entering foster care in the United States. Annie E. Casey Foundation. Retrieved from: https://datacenter.kidscount.org/data/tables/6269-children-entering-foster-care?loc=1&loct=2#ranking/2/any/false/871/any/13036
8. Annie E. Casey Foundation. (2018). Fostering youth transitions: Using data to drive policy and practice decisions. Retrieved from: https://www.aecf.org/resources/fostering-youth-transitions
- How Children Are Faring
In 2018, 2.4 per 1,000 California children ages 0-17 entered foster care for the first time, a drop of more than 30% compared with twenty years earlier. Across time periods, infants consistently have higher rates of first entry into care than older children. Statewide, the rate of children under age 1 entering foster care for the first time in 2016-2018 (12.2 per 1,000) was more than three times the rate for children ages 1-2, nearly five times that for ages 3-5, and more than 6 times the rates for older groups. Among all children entering foster care for the first time in 2016-2018, 87% were removed from their families due to neglect, 7% due to physical abuse, and 2% due to sexual abuse.
The number of California children and youth ages 0-20 living in foster care on July 1, 2018 was 59,172—a rate of 5.3 per 1,000. Of these, 19,111 were placed in kinship care, 13,229 with foster family agencies, 7,452 in foster homes, and 6,147 in guardianship. At the county level, rates of children/youth in care ranged from 1.2 per 1,000 (Marin) to 18.8 per 1,000 (Trinity) among regions with data. In-care rates for African American/black and American Indian/Alaska Native youth statewide are substantially higher than rates for their peers in other groups—more than 20 children/youth in care per 1,000 in 2018, compared with 5.3 per 1,000 (Hispanic/Latino), 4.4 per 1,000 (white), and 1 per 1,000 (Asian/Pacific Islander).
Among California children under age 18 in foster care on March 31, 2019, 73% had received timely medical exams and 67% timely dental exams. Across counties with data, percentages ranged from 42% to 98% for timely medical exams and from 7% to 95% for timely dental exams.Statewide, the median length of stay for children entering foster care in 2017 was 17.4 months. After declining from 17.2 in 2001 to a low of 13.2 in 2009, the median number of months in foster care increased in seven of the eight years that followed. For children entering care for the first time in 2017, 34% were reunified with their families and 64% were still in foster care one year after entry.
- Policy Implications
Children and youth in foster care interact with a range of public and private systems that can support them and help them obtain permanent, safe homes. Policymakers have an important role in helping to prevent children from entering foster care, ensuring the health and well being of those in care, and facilitating connections and opportunities to enable youth aging out of the system to thrive as adults.
Policy and program options that could help prevent children from entering foster care and improve outcomes for those in care include:
For more information, see kidsdata.org’s Research & Links section, or visit the Child Welfare Information Gateway or the California Evidence-Based Clearinghouse for Child Welfare.
- Ensuring effective implementation of the Family First Prevention Services Act (FFPSA), which aims to prevent children from entering foster care by authorizing federal reimbursement for mental health services, substance use treatment, and in-home parent education; as part of this, integrating FFPSA resources into a coordinated and comprehensive continuum of accessible prevention services (1)
- In addition to services for families at risk of involvement with the child welfare system, continuing efforts to build a coordinated, accessible system of high-quality physical and mental health services for children and youth in foster care; such services should be trauma informed and culturally appropriate (2, 3, 4)
- Promoting efforts to recruit, strengthen, and support foster homes provided by relatives of children in care, removing barriers that make it difficult for relatives to provide care, and, when children cannot be placed with kin, prioritizing placements in other family settings over group settings (5, 6)
- Continuing to address family separation issues related to immigration enforcement (7)
- Supporting effective strategies to reduce the overrepresentation of, and improve outcomes for, children of color in foster care (8)
- Implementing and strengthening laws and child welfare practices to protect and support LGBTQ youth in foster care (9)
- Continuing to increase awareness of and improve responses to the commercial sexual exploitation of youth in foster care (10)
- In accordance with California's Local Control Funding Formula, supporting the educational success of foster children by addressing social, health, and academic issues, school enrollment and specialized services barriers, and the need for communication and data sharing; also, ensuring that foster youth have the support and resources to pursue postsecondary education and workforce opportunities (2, 11)
- Strengthening and ensuring effective implementation of existing laws, programs, and strategies that support foster youth in the transition to adulthood, such as building on lessons learned from early implementation of the California Fostering Connections to Success Act, and increasing youth participation in transition services (11, 12, 13)
- Incorporating youth voices into foster care decision-making processes and increasing collaboration across sectors (e.g., child welfare, education, health care, juvenile justice, housing, workforce systems, etc.) to better serve the diverse needs of foster youth, including those with disabilities, parenting and pregnant foster youth, those facing homelessness, and other vulnerable populations (11)
Sources for this narrative:
1. Center for the Study of Social Policy. (2019). Supporting all families: Financing streams to support prevention programs. Retrieved from: https://cssp.org/resource/supporting-all-families
2. Children Now. (2018). 2018 California children's report card. Retrieved from: https://www.childrennow.org/portfolio-posts/18reportcard
3. California Department of Social Services. (n.d.). Pathways to well-being. Retrieved from: https://www.cdss.ca.gov/inforesources/Foster-Care/Pathways-to-Well-Being
4. Gardner, P. (2017). California's children and youths' system of care: An agenda to transform promises into practice. Young Minds Advocacy. Retrieved from: https://www.ymadvocacy.org/promises-into-practice-report
5. Children Need Amazing Parents (CHAMPS). (2019). Policy playbook (2nd ed.). Retrieved from: https://playbook.fosteringchamps.org
6. California Department of Social Services. (n.d.). Continuum of care reform. Retrieved from: https://www.cdss.ca.gov/inforesources/Continuum-of-Care-Reform
7. Desai, N., & Adamson, M. (2018). Child welfare and immigration: Implications for funders. Youth Transition Funders Group, et al. Retrieved from: http://www.ytfg.org/wp-content/uploads/2018/06/YTFG_FC_ChildWelfareAndImmigration_V1R5.pdf
8. Miller, O., & Esenstad, A. (2015). Strategies to reduce racially disparate outcomes in child welfare. Alliance for Racial Equity in Child Welfare. Retrieved from: https://cssp.org/resource/strategies-to-reduce-racially-disparate-outcomes-in-child-welfare
9. Human Rights Campaign. (n.d.). LGBTQ youth in the foster care system. Retrieved from: https://www.hrc.org/resources/entry/lgbt-youth-in-the-foster-care-system
10. Dierkhising, C. B., et al. (2018). Commercially sexually exploited girls and young women involved in child welfare and juvenile justice in Los Angeles County: An exploration and evaluation of placement experiences and services received. National Center for Youth Law & California State University, Los Angeles. Retrieved from: https://youthlaw.org/publication/csec_la_childwelfare_juvenilejustice
11. American Youth Policy Forum. (2017). Supporting pathways to long-term success for systems-involved youth: Lessons learned. Retrieved from: https://www.aypf.org/resource/supporting-pathways-to-long-term-success
12. Courtney, M. E., et al. (2018). Findings from the California Youth Transitions to Adulthood Study (CalYOUTH): Conditions of youth at age 21. Chapin Hall. Retrieved from: https://www.chapinhall.org/research/calyouth-wave3
13. Annie E. Casey Foundation. (2018). Fostering youth transitions: Using data to drive policy and practice decisions. Retrieved from: https://www.aecf.org/resources/fostering-youth-transitions
- Websites with Related Information
- Administration for Children and Families: Abuse, Neglect, Adoption and Foster Care. U.S. Dept. of Health and Human Services.
- Annie E. Casey Foundation: Child Welfare
- California Dept. of Social Services: Foster Care
- California Evidence-Based Clearinghouse for Child Welfare
- Center for the Study of Social Policy: Child Welfare
- Chapin Hall: Child Welfare. University of Chicago.
- Child Trends: Child Maltreatment/Child Welfare
- Child Welfare Information Gateway. U.S. Dept. of Health and Human Services, Children’s Bureau.
- Child Welfare League of America
- Children Need Amazing Parents (CHAMPS)
- Children's Data Network. USC School of Social Work.
- Continuum of Care Reform. California Dept. of Social Services.
- Healthy Foster Care America. American Academy of Pediatrics.
- Juvenile Law Center: Extended Foster Care
- National Center for Youth Law: Foster Care
- Represent: The Voice of Youth in Care. Youth Communication.
- State Policy Advocacy and Reform Center. First Focus.
- Key Reports and Research
- 2020 California Children's Report Card. Children Now.
- Advancing Healthy Outcomes: Eight Ways to Promote the Health and Well-Being of LGBTQ+ Youth Involved with Child Welfare through FFPSA. (2019). Center for the Study of Social Policy. Citrin, A., & Martin, M.
- California Youth Transitions to Adulthood Study (CalYOUTH) (2018). Chapin Hall. Courtney, M. E., et al.
- Child Welfare and Immigration: Implications for Funders. (2018). Youth Transition Funders Group. Desai, N., & Adamson, M.
- Children Living Apart from Their Parents: Highlights from the National Survey of Children in Nonparental Care. (2016). U.S. Dept. of Health and Human Services. Radel, L., et al.
- Embracing a “Youth Welfare” System: A Guide to Capacity Building. (2018). Capacity Building Center for States.
- Entangled Roots: The Role of Race in Policies that Separate Families. (2018). Center for the Study of Social Policy. Minoff, E.
- Family First Prevention Services Act. (2020). National Conference of State Legislatures.
- Foster Youth Education Toolkit. (2016). Alliance for Children’s Rights, et al.
- Fostering Youth Transitions: Using Data to Drive Policy and Practice Decisions. (2018). Annie E. Casey Foundation.
- LGBTQ Youth in the Foster Care System. Human Rights Campaign
- Mental and Physical Health of Children in Foster Care. (2016). Pediatrics. Turney, K., & Wildeman, C.
- Strategies to Reduce Racially Disparate Outcomes in Child Welfare. (2015). Alliance for Racial Equity in Child Welfare. Miller, O., & Esenstad, A.
- Strengthening Child Welfare Practice for Immigrant Children and Families: A Toolkit for Child Welfare Professionals in California. (2019). National Center for Youth Law & Immigrant Legal Resource Center. Prandini, R., et al.
- Supporting Pathways to Long-Term Success for Systems-Involved Youth: Lessons Learned. (2017). American Youth Policy Forum.
- County/Regional Reports
- 2021 California County Scorecard of Children's Well-Being. Children Now.
- Annual Report on the Conditions of Children in Orange County. Orange County Children's Partnership.
- Commercially Sexually Exploited Girls and Young Women Involved in Child Welfare and Juvenile Justice in Los Angeles County. (2018). National Center for Youth Law & California State University, Los Angeles. Dierkhising, C. B., et al.
- Important Facts About Kern’s Children. Kern County Network for Children.
- Live Well San Diego Report Card on Children, Families, and Community. San Diego Children’s Initiative.
- Pathway to Progress: Indicators of Young Child Well-Being in Los Angeles County. First 5 LA.
- Santa Clara County Children's Data Book. Santa Clara County Office of Education, et al.
- Santa Monica Youth Wellbeing Report Card. Santa Monica Cradle to Career.
- Sexual and Gender Minority Youth in Foster Care: Assessing Disproportionality and Disparities in Los Angeles. (2014). Williams Institute, et al. Wilson, B. D. M., et al.
- More Data Sources For Foster Care
- California Child Welfare Indicators Project. UC Berkeley & California Dept. of Social Services.
- Children’s Bureau: Statistics and Research. U.S. Dept. of Health and Human Services.
- DataQuest. California Dept. of Education.
- KIDS COUNT Data Center. Annie E. Casey Foundation.
- National Data Archive on Child Abuse and Neglect
- National Survey of Children in Nonparental Care. Centers for Disease Control and Prevention.
- State-Level Data for Understanding Child Welfare in the United States. Child Trends.
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