Services to Pregnant and Parenting Foster Youth :

1. Services to Pregnant and Parenting Foster Youth: It Really Does Take a Village Version 1.0, 2013

2. Agenda • Introductions / Learning Objectives • Video - A Crucial Connection • Prevalence / Statistics • Costs • Cultural Considerations • Relevant Research • AB12/Pregnant and Parenting Youth and Young Adults • Exercise / Communication and Assessment • Building Relationships with Pregnant and Parenting Foster Youth • Lunch • Foster Alumni Panel • Placement and Caregivers • Closure

3. Introductions • Who are you and why are you here? • What are your interests and/or investments in learning about this population?

4. Goals for Today • Develop a lens through which we can understand behaviors of foster youth who are pregnant and parenting • Enhance our understanding of pregnant and parenting teens in the foster care population • To highlight and contextualize adolescent behavior around issues of guilt, shame and fear • To review the goals and values of AB12 as it pertains to these youth

5. Learning Objectives Knowledge • K1. The trainee will be able to identify how foster care and pregnancy affect the process of independence and emancipation. • K2. The trainee will recognize physical, physiological, and psychological changes associated with pregnancy. • K3. The trainee will be able to identify special housing/placement needs of pregnant youth, parenting youth with infants. • K4. The trainee will be able to identify practice behaviors that convey support for dependent minor parents and non-minor dependent parents and young adult parents (including parents who choose to leave care and parents who choose to stay in extended care). • K5. The trainee will be able to identify strategies for improving placement stability for pregnant and parenting teens, including tools to assist caregivers to address the caretaking, safety, permanency and independence issues for parenting foster youth and their infants.

6. Learning Objectives Skill • S1. The trainee will be able to identify independence related tasks and decisions associated with becoming a parent and achieving parental competency as stated in case plan for placement and/or for court if infant/toddler is a dependent. • S2. Trainee will be able to initiate discussions around mental health and well-being pertinent to reproductive and sexual health and safety, and to provide local referrals to appropriate service providers. • S3. Trainees will be able to initiate discussions of well-being pertinent to caregivers and assess the caregiver’s appropriateness and comfort level in parenting and reproductive health discussions with foster youth.

7. Video – A Crucial Connection • Debrief / Discussion • What surprised you on the video? Were you aware of the size of the problem? • Does this video give you some insight regarding the plight and perspectives of pregnant and parenting teens in foster care?

8. Statistics and Prevalence- Data • Not a lot of county or state information regarding foster youth who are pregnant or parenting • Issues around compilation of information, variety of data sources, varied methodologies • More outcome information is available • Problems around age, information, sensitivity of gathering information

9. Prevalence and Statistics- Samples • Who are the youth? • Young women who had been in foster care are more likely to have been pregnant than same age peers who had not been in foster care (Courtney et al, 2007) • How big is the issue? • Geographical • Age group peak • Cultural Issues • Trends by race • What about California? • Trends – age, race, SES

10. Statistics – California • As of July 2012, California has 60,230 children and youth in state supervised foster care • In 2010, 43,149 babies were born to girls age 15-19 in CA • Of those, 7,517 were second or subsequent births • 2010 CA teen birth rate: • Girls age 15-17 was 16.4 per 1000 • Girls age 18-19 was 53.4 per 1000

11. Statistics – National • US birth rate for girls 15 – 17 (2010) • 17.3 per 1000 • US birth rate for girls 18- 19 (2010) • 58.2 per 1000

12. Statistics by Ethnicity, Race • Pregnancy rates • Hispanic 125 per 1000 • African Am 123 per 1000 • Whites 43 per 1000 • Birth rates • Hispanic 62.9 per 1000 • Afr. Am 43.2 per 1000 • Native Am 24.2 per 1000 • Whites 14.7 per 1000 • Asian/Pac Islander 11.7 per 1000

13. Why It Matters…. • Taxpayer costs associated with teen pregnancy: • $1.127.6 million for California • $10 million - Nationwide

14. Key Research Reports and Findings • Chapin Hall at the University of Chicago (2002-2007) • Longitudinal survey of youth which gathered data at 3 time points (ages 17, 19 & 21) • Interviewed around issues of sexual behavior, pregnancy, children and parenting • The Midwest Evaluation of the Adult Functioning of Former Foster Youth (Midwest Study)

15. Key Research Reports and Findings – Chapin Hall (2) • 17 y.o. – almost twice as likely to ever have been pregnant (33% vs. 19%) • 19 y.o. – nearly half of the young women who had been in foster care reported having ever been pregnant, compared to 20% of their peers • 21 y.o. – 71% of young women had ever been pregnant, as compared to 34% of their peers

16. Key Research and Findings – UCAN and National Campaign (3) • UCAN and National Campaign to Prevent Teen and Unplanned Pregnancy – Fostering Hope • Mixed method study • Foster youth often had mixed emotions including wanting to continue their education while wanting to establish a family by having a baby (Love et al, 2005) • Youth cited embarrassment, foster parents not bringing up the subject, lack of trust in foster parents and a desire to receive more personal attention around these issues • Substantial number of programs for pregnant and parenting teens did not have a specific plan for assisting adolescent to avoid a subsequent pregnancy

17. Key Research and Findings (4) • Public Health Institute Study (2009) • Wanted to look at the sexual/reproductive health needs and challenges of foster and transitioning youth in CA • Large number of staff believed that adolescent pregnancy was largely accepted in the youth’s family of origin and by peers • Unmet needs for love and belonging by foster youth • History of sexual abuse may create increased vulnerabilities • Having knowledge does not imply using knowledge

18. Key Research and Findings (5) • John S. Burton Foundation report highlighted current unmet needs of parenting young adults and proposed recommendations to address them • Proposed 6 policy recommendations: • create a digital clearinghouse of information • periodic screening of pregnancy and parenting needs • Expand nurse-family partnerships • exclude foster care payments from child care subsidy calculations • create a statewide child care program for parenting foster youth • give parenting young adults priority housing access

19. After 18 Goals • Establishing connections • Achieving permanency and stability • Moving toward competence and independence

20. After 18 Values • Voices of Young Adults • Assistance and Partnering • Love and Belonging • Unique Needs • Eligibility is Maintained • Development is Supported

21. Applying After 18 Goals and Values • At each table, discuss how the social worker might put these values into action when working with pregnant and parenting teens in an out-of-home care setting? • In other words, how might you demonstrate these values when working with these youth? • Remember to keep the goals of After 18 and ASFA in mind…

22. Pregnant and Parenting Foster Youth • Discussion - How might the services and supports differ for foster youth and young adults who are pregnant and parenting?

23. Communication and Adolescent Youth Culture • Foster youth and relationships • Characteristics of peer and romantic relationships • Adolescent youth culture in general • Initiating and maintaining open communication • Establishing a relationship • Trust • Purpose of the communication • Difficult Messages • Results

24. Coping In The Caseload • The Talk • Avoidance • Passing the buck • Elephant in the room

25. Some Acknowledgements • Not an easy population to communicate with due to generation gap, other factors (misunderstanding, stigma, judgment) • Key: Listen for pain, fear • Seek to hear and understand, use active listening skills • Social workers may be biased, judgmental • Pre-conceived notions or history • Foster youth may be biased, judgmental • Pre-conceived notions or history • History may be an obstacle to communication – try to chip away at this by establishing trust • How do we do this? Return calls, establish a relationship via best practices

26. Preparation for the Panel • Questions – • Use index cards • Concerns

27. Young Adult Parent #1

28. Young Adult Parent #2

29. Young Adult Parent #3

30. Case Management Considerations • Case Management - Working with Caregivers and Pregnant and/or Parenting Teens

31. Assessments – Parental Readiness and Safety • Handout – Review • Discussion

32. Placement Considerations – Shared Living Arrangement • Household Values • Household Composition • Accommodation and considerations • Shared living arrangement • Education • Caregiving for the Infant/Toddler • Child Care • Transportation • Employment/Training/School/College

33. Working With Caregivers • Caregiver characteristics • Communication Style • Strength-based • To avoid miscommunication, be direct, use open-ended questions • Use probing questions to understand complexities • Caregiver Temperament • Is caregiver temperament a fit for the youth, given youth behavior, background, presentation? • Explore caregiver biases • Caregiver Experience • Has this caregiver fostered teens? • Does this caregiver demonstrate tolerance for adolescent behavior • Has this caregiver fostered teen parents? Infants?

34. Exercise • Developmental Issues of Adolescence vs. Impact of Pregnancy and Parenting

35. Closure and Evaluations • Taking Stock of Learning Objectives • Directions for Further Exploration • Evaluation

36. Thank You!