The Well-Being of Arizona’s Young Adults from Foster Care

1. The Well-Being of Arizona’s Young Adults from Foster Care Tonia Stott, PhD Children’s Caucus Meeting August 4, 2009

2. Acknowledgements This research was supported by: • A NIDA R36 (Dissertation) Grant (5R36DA023280-02) • A SSWR Doctoral Fellows Award (2007) • The technical analysts at DCYF were very helpful in pulling the administrative data. • Collaboration was conducted with the CPS Statewide IL Coordinator. • Assistance and mentoring was received from the committee members: Dr. Karen Gerdes, Dr. Mary Gillmore, and Dr. Nora Gustavsson. The researcher is very thankful to the young adults who invested their time and energy by participating in the interview.

3. Study Selection • The Arizona Division of Children, Youth, & Families (DCYF) supplied the names and last known contact information for Young Adults (YAs) who turned 18 years old while in the legal custody of DCYF between 7/1/04 and 6/30/08. • Recruitment packets were mailed and offered the YAs a $10 gift card for enrolling or declining participation and a $45 gift card for participating in the interview.

4. Recruitment • 2045 Young Adults (YAs) were identified over the course of the study who were under the age of 21 at the time the recruitment packet was mailed. • 10.5% did not have a valid mailing address • 1859 recruitment packets were mailed • 32% were retuned as undeliverable • 10 returned a decline form • 183 YAs enrolled in the study • 2 later withdrew • 48 lost contact with the researcher

5. Interview Participants • 123 YAs participated in the interview • 5 were excluded from the study because they did not meet selection criteria or could not be competently interviewed • 4 were not listed on the DCYF files has having turned 18 while in the legal custody of CPS • 114 participants were included in the study analysis

6. Age 54% age 18 32% age 19 8% age 20 6% age 21 Gender 73% female 22% male Race 9% Black 37% Hispanic (White) 2% Native American 48% White (non-Hispanic) 4% More than one Sexual Orientation 82% straight 13% bi-sexual 5% lesbian/gay Demographics

7. Foster Care Stability • Lifetime number of placements • Mean = 8.02 • Range = 1 - 38 • Placements since last entry • Mean = 7.29 • Range = 1 – 38 • Average yearly change rate for placements since last entry • Mean = .49 (changed placements, on average, every half a year or every 6 months) *All figures exclude post 18 placements

8. Lifetime Placements Before Age 18 21% 19% 17.5% 15% 11% 8% 8%

9. Foster Care Experiences • Mean age at first entry was 14.27 • 22% experienced at least one re-entry • Mean age at last entry was 15.14 • 32% ran away while in foster care at least once • 24.5% were placed in detention or corrections while in foster care at least once

10. Age at Last Entry 27% 22% 21% 11% 10% 6% 2%

11. Young Adult Outcomes • The participants in this study are not completely representative of the population of young adults who aged out between 7/1/05 & 6/30/08. • Study participants’ mean number of placements was 8, while the mean number of placements for the population was 10. • 45% of the study participants were receiving subsidy on the day they were interviewed while 29% of the population were on a Voluntary 18 + agreement on 10/1/07. • The study participants’ outcomes are likely a little skewed toward more positive well-being. • The most vulnerable in this population may not be represented in this study.

12. Educational Attainment 35% had not received their GED or HS Diploma 19% had a GED 47% had a High School Diploma Educational Enrollment 51% were attending school 49% were not in school Education

13. Employment & Income • Employment • 46% were working • 54% were not working • Income of those working • 61% earned $1000/month or less (this is about at the poverty threshold for a single person) • 35% earned between $1001 & $2000/month • 4% earned $2001 or more a month

14. 21% live alone 14% live with friends/roommates 12% live with extended family 11% live with former/current foster parents 6% live at a transitional program 2% live with a parent 21% live with a significant other 7% live with sig other and his/her family 2% live with sig other and his/her own family 5% are homeless Housing

15. Homelessness Homeless • 74% had not been homeless • 26% had been homeless since turning 18 Longest Episode of Homelessness • 30% up to two months • 13% two to six months • 20% seven months or more

16. Health Insurance • 86% have health insurance • 96% had public insurance (YATI/ AHCCCS) • 4% had private insurance • 14% do not have health insurance

17. 45% were receiving subsidy 55% were not 16% had received subsidy in the past, but were no longer receiving it. Reason for not being on subsidy 53% were denied 15% didn’t want to be involved with CPS 10% were not aware of it 10% had turned 21 7% were waiting for it 3% were still in IV-E paid placements Independent Living Subsidy

18. Emotional & Social Well-Being • Depression scale mean score = 15.26 • Norm mean scores = 8.7 • Self-esteem scale mean score = 36.58 • Norm mean score = 37.27 • Network Orientation mean score = 45.62 • Norm mean score = 58.06 • Feelings of Connectedness in Last Placement before 18 • 46% felt connected most of the time or more • 64% felt connected some of the time or less

19. Substance Use • Current Use • 25% had used substances or been intoxicated in the past 30 days • Recent Use • 32% had used substances or been intoxicated once a month or more in the past 5 months • Past Abuse • 35% used substances in the past, (more than 5 months ago) twice a week or more

20. Recent Substance Use Scale

21. Risky Sexual Behaviors Takes into account number of sexual partners, condom use, and use of birth control other than condoms over the past 3 months.

22. Pregnancies Females • 46% had never been pregnant • 54% had ever been pregnant • 18% were currently pregnant Males • 77% had not been responsible for a pregnancy • 23% had ever been responsible for a pregnancy

23. Entered care at older ages Moved more frequently Were less likely to have a HS Diploma Were less likely to use contraceptives Were more likely to be pregnant Were more likely to have health insurance Were less likely to be currently using substances AZ Outcomes in Comparison to Other Outcome Studies

24. Effect of Placement Stability on Outcomes • Regression analysis was used and controlled for traumas often associated with poor young adult outcomes: • parental substance abuse • parental domestic violence • parental poverty • parental incarceration • neglected • physically abused • sexually abused • intimate partner violence before the age of 18

25. Effect of Placement Stability on Self-Sufficiency Outcomes • As the number of placements increased, educational attainment decreased (b=-.51, p<.05) • As the number of placements increased, the likelihood being employed in young adulthood decreased (log odd = -.09, p<.05) *While controlling for the effect of the traumas associated with poor outcomes.

26. Effect of Placement Stability on Emotional and Social Well-Being Outcomes • As the number of placements increased, the depression score increased (b=.31, p<.05) • As the number of placements increased network orientation decreased (b=.26, p<.05) • As the number of placements increased, feelings of connectedness in the last placement before turning 18 decreased (b=-.75, p<.01) *While controlling for the traumas associated with poor young adult outcomes.

27. Effect of Placement Stability on Risk Behaviors • As the number of placements increased, recent substance use frequency increased (b=.06, p<.05) • As the number of placements increased, risky sexual behaviors increased (b=.06, p<.1) *While controlling for the traumas associated with poor young adult outcomes.

28. Take Away Points • Placement instability may be diminishing youths’ capacities to develop the emotional and social competencies necessary for young adult self-sufficiency and well-being. • Older adolescents, especially those who age out, move 4 times more often than is recommended in the federal Child and Family Services Review standards. • AZ’s young adults who age out, enter care at older ages • AZ may be doing a better job at achieving permanency for younger children (they’re not aging out) • AZ may be taking in more older adolescents (10% of the participants were 17.5 or older at their first entry into care)

29. Take Away Points • Only 30% of AZ’s Young Adults who aged out were receiving CPS case management services (on an 18+ Voluntary) • This percentage does not include those receiving ETV, YATI, or TILP services only. • This 30% are likely the higher functioning young adults, as the most vulnerable are often excluded from 18+ services due to eligibility restrictions for IL Subsidy. • AZ surpasses its Chafee funding on these 30%. • AZ will need to incorporate the provision of the Fostering Connections Act which would allow states to receive IV-E reimbursement for placements for young adults up to 21 years old in order to serve more of its young adult population.

30. Take Away Points • This population is very hard to find and is quite transitory. • For AZ to fulfill the data collection mandate now required for the National Youth in Transition Database, it will need to: • Develop positive relationships with youth in care before they leave so they are willing to participate in the young adult surveys. • Before youth leave care, ask them about the people in their lives who would always know where they were and record this information. • Allocate funding for incentives for the young adults to participate in the surveys. • Develop relationships with YATI and other state programs to allow for the disclosure of contact information pertaining to this population. • Employ researchers not necessarily affiliated with CPS to conduct the surveys, engage the young adults in participating, and maintain the contact information.

31. The Road to Success… Research tells us that young adults from foster care who succeed: • Had opportunities and were supported in their efforts to develop long-term connections with positive adults. • Obtained a high school diploma and are supported in obtaining post-secondary degrees/certificate s. • Have adequate safety nets, resources, and supports. • Remain in care until age 21.

32. Placing Our Young Adults on that Road Areas of Improvement Action Steps Minimize placement instability Provide more resources to homes to meet youths’ mental/behavioral health needs. Allow youth to be empowered participators in their placement planning. • Increase opportunities for youth to engage in connected relationships. • Increase High School Graduation Rates.

33. Placing Our Young Adults on that Road Areas of Improvement Action Steps Maximize the state’s ability to serve this population (we are currently only serving about 30%) Provide for more young adults to remain in care until age 21. Allow more young adults to to remain in care until 21 even if they make mistakes. • Increase safety nets, resources, and supports for young adults from foster care. • Increase the number of young adults remaining in care until age 21.

34. Thank You • For more information, contact Tonia Tonia Stott, PhD School of Social Work Arizona State University 602-496-0077 tonia.stott@asu.edu