Policy and Supports to Facilitate the Transition to Adulthood Part 4

Table 30: Summary of Outcomes Employment • Unemployed • Not looking • Focusing on school Housing • On-campus • 2 roommates • Comfortable Carla • Employed • Good pay but inconsistent schedule • Looking for better job Katie • Employed • Looking for better job • Wants to work with kids – CORI is problem • Employed with two PT jobs • Worked and volunteered for [organization] for last 6 yrs • Rents from grandmother (who pays half) • Looking for larger apt to share, closer to city • Group setting Doug Anna Fernanda • Unemployed • Looking for PT work • Transportation is difficult Danyl • Employed • Looking for new job w/ benefits • Hopes to be social worker Samuel • Employed FT at factory • Satisfied Education Health • Steady • Enrolled • Going very well • Seeks additional help when needed • Good • Enrolled • “Passionate” about school • Interested in education Relationships • Strong with mother • Friendships have drifted since college • Enrolled • Going well • Interested in social work, child psych, criminal justice • Dual enrolled (college courses for high school credit) • Going very well • Enrolled in GED and vocational program • Good • Good, especially with sisters • Good • MassHealth • Family and friends are good • Good • Asthma • Rents • Lives alone • Would like to own home • Received GED • Good • Distant with family • Black sheep • Close w/ siblings • Dating same girl for 3 years • Rents • Lives alone • Has what he wants • Healthy • Enrolled • Takes courses • Exercises frequently at night • Business Mgmt • Good • Good • Wants own place in a year 54 • Problems with trust • Starting to shut down close friendships • Close with brothers • Counseling helps • Spends time w/ son Nina • Looking with no • Rents success • Wants larger apt for her and daughter • Looking for job • Stays with boyfriend half • CORI has been of week problem • Working under table Jasmine • Newly • Currently employed moving • Rents with friend Angelina • Employed FT at • Likes apt but fast food looking for new restaurant one • PT as bartender • Needs to move around Sarah • Employed • Looking for new place • Loves it! • Rent increased Iago Chris Tiffani Dillon • Unemployed • Currently looking • Difficulty getting hired • Currently employed while 8 months pregnant • Saving money for baby • • • Jesi • • Group setting • The place “isn’t terrible” • Wants own apartment • On wait list for Section 8 • Currently living with; may not be able to stay w/baby Unemployed • Living with friend’s family Currently • Appreciates looking and getting advice temping from friend’s Applied for mother restaurant • Overcrowded position Currently 30 • Living in a hours a week at residential a large retail facility for teen store moms • Good • Starting school in spring for GED/Medical Billing • Very good • Starting summer at • Asthma community college • Good • Enrolled at • Healthy UMass • Enjoys current situation • Hoping to get • Good GED • Great with inner circle • Enrolled at community college • Passing classes • Criminal Justice • Starting GED classes in fall 07 • Poor communication with family • Great with fiancé • Has 1 close friend • Received GED • Good • Trouble sleeping • Doesn’t have relationships outside of work • Pretty healthy • Wants to reconnect w/ son • Smokes and pay support cigarettes • Rarely talks to mother • Baby’s father is • Good in jail for longterm • Applied to • Decent community • Recently got college for fall MassHealth 07 • Interested in social work or education • Plans to return • Good to vocational school in October 55 • Very good • Currently focusing on friendships rather than romantic relationships • Good Findings: Stakeholder Interviews The data in this section represent the perspectives of a variety of stakeholder respondents. Consequently, the data reflect perceptions of the problem, current efforts, potential solutions, and the political environment. What is the problem regarding youth transition that needs to be addressed? Respondents tended, appropriately, to speak from their own particular area of expertise (for example, housing, education, group care, etc.). Perceptions of the problem were categorized into two broad categories: system-oriented problems and individual-oriented problems. Some respondents noted that transition is not a problem for every youth; some youth transition well. System-oriented problems. The system-oriented problems that were described included the following: 1) The core focus of the child welfare system is not congruent with the needs of this population. The existing child welfare system (primarily DSS) is focused on children, not adolescents, and definitely not young adults. Moreover, the existing system is focused on child protection, not development or wellbeing. These statements were not a criticism of the public child welfare system, but reflected the reality of the current mission of DSS. 2) There are multiple inter-system collaboration problems; youth frequently “fall through the cracks” because the state systems to serve them are not well-coordinated. This was noted about many service systems – Department of Youth Services, Department of Education, Department of Mental Retardation – but particularly the Department of Mental Health. “Huge frustration for kids who need ongoing supported specialized supports. Mental health and developmental disabilities – it takes a lot of effort to get them access to services. Other piece is education system – unwilling to take responsibility for these kids. Avoid them. I’ve heard of conversation between systems, at commissioner/secretary level, but nothing definitive.” Several spoke about the “silo nature of services” with different agencies and funding sources. The result is that “Kids’ needs are defined in such away as to fit funding streams.” 3) There is a lack of existing opportunities and options for former foster youth at age 18, including barriers to education and employment. The more frequent comments, however, were about the lack of housing options: “Housing is an issue for any young adult – they can’t or won’t go home. At 18 can’t be on own in Boston. Who is population? Some aging out will be fine, some will need a little guidance, some will need more intensive supportive housing. This third group is who we’re most concerned about.” 4) Implementation of new initiatives is a challenge. While there may be vision and intent to serve transition-age youth better, there are problems with implementing this intent “on the ground”; “there is all the right words but it isn’t acted out”. 56 5) There is no accountability for poor outcomes with this population. If the systems focused more on measuring and evaluating outcomes, “eventually we’ll get better practices.” 6) The problem with poor transition reflects poor practice at earlier stages. First, this includes better family intervention to avoid child removal in the first place. It is necessary to address: “How do youth end up in foster care? How to keep children at home who have mental health/behavioral issues? How to serve youth and keep connection to family? Large percentage of foster youth come in because of their behavioral needs, not family.” Second we need better work with youth regarding transition earlier in their care experience: “Need to start dealing with them as adults – give lifelong companion/advocate earlier, then it is not an enormous task.” Individual-oriented problems. Another set of responses highlighted the individual-level problems which were related to the young person and his/her challenges. Primarily these included: 1) a lack of relationships, 2) a high level of trauma experiences (maltreatment, loss, etc.), and 3) a lack of basic knowledge about how to exist in the world at age 18. Illustrative quotes included the following: • Lack of relationships: “Many young people don’t have unpaid caring adults. Number one problem is lack of focus on need for permanent adult connection. Prevailing view that teens cannot develop connections, that teens are unadoptable. Funding should be focused on permanent connection.” • High level of trauma: “By the time the kids age out, they are the product of system failures (DSS, schools, attorneys). Have fallen through the cracks although we have spent a lot of time on them. But really by the time that DSS gets them, they may already be damaged.” • Lack of basic knowledge: “Challenge is that they are adults when 18, look forward to signing out of care. At 18 they are not ready for independent living. In an apartment they have a lot of freedom, little to fall back on. They are pretty immature but that’s where they are.” Youth needs. Some respondents spoke to the needs of these youth as they discussed what the “problem” is to be solved. Commonly, as already described, the focus was on the youths’ needs for life skills and relationships. Some of the other needs described by respondents included the following: • Visibility – a lot of negative perceptions of teens in foster care. Public perception, media, focused most on negative. • More youth voice, more opportunities to speak, more youth leadership, led by youth in care not graduates from care. • Resources, to attend college. • Resources for biological family, to help keep youth in biological family, prevention work with families before child removal. • Youth have some negative experiences in foster care and group homes. Severe overmedication. There are still “nasty things” that happen behind closed doors. Need some effort to survey youth to hear about their experiences. 57 • Youth with substance abuse or mental health have greatest needs for housing. Those that come out of residential or group care are less community savvy. Also youth from residential or group are likely to be on psych meds, they need to know where they are going to be living – have a psychiatrist, therapist, and way to get meds. • The “ability to be a kid” -- sleepover at friend’s house, normal everyday things, especially kids in residential. Residential kids are systemized, something lost about freedom. • Need for a skilled health care provider in their lives; making sure someone is thinking about these youth in the new health care reform initiative. What are potential solutions? Create a sense of permanency: This was a common response addressing perceived lack of relationships in young people’s lives. Although common, the data suggested that permanency has a range of meanings for respondents. It is not clear that the field has consensus about the meaning of the term “permanent relationship” or how it should be used as an intervention to create better outcomes for this population. This mirrors the field of child welfare which also struggles to define permanency and operationalize it for use in guiding intervention. Historically “permanency” was defined as reunification with birth family or adoption. Young people for whom these outcomes did not occur were the ones that left care for independent living and often faced challenges because of this lack of connection. One development in the past few years has been to reconsider the possibility of adoption for this population. For the most part, however, respondents discussing permanency for this population focused on a broader view of permanency. For example, “[We need to] change people’s perceptions regarding permanency and what it means to be a connection to a child. It does not have to be 24/7 but more of an emotional support system. Permanency is not about adoption or legal commitment; have to look at individual situations to see what is appropriate.” Many respondents noted that recent initiatives by DSS, private agencies, and others in the field are promising: “DSS is doing good things regarding finding a person and that’s good but not enough.” The focus of most respondents was to “[have] an adult in their lives. It is impossible to have good outcomes without back-up support and connection with adult.” Also, “Be sure that every single child approaching the 18th birthday has life-long connection.” Other elements of the discussion focusing on helping youth establish permanent relationships identified the following. Permanency … • includes reconnecting kids to birth families. Even in cases in which parental rights were terminated, there is less of a safety issue when kids are older. • includes being flexible to considering adults and not ruling out people because of previous arrests or alcohol/drug problems. • within DSS it involves establishing permanency as a case plan goal rather than independent living, because “what you write down and aim for drives the work.” 58 • needs to be youth-driven. Efforts must ask youth “who are the important people in your life?”. • can involve multiple adults and as many connections as possible. • can include connection to the broader community as well as individuals. • should be dependent on the youth’s definition of permanency: legal adoption, stable place to live, someone you can call when you need to. • can be very labor intensive. One respondent noted that the field has some confusion between permanency and stability. A foster home may be stable but not permanent; “We can be afraid to move youth to more permanent settings; it is a risk that needs to be weighed.” In addition to the solutions offered which focus on permanent relationships for youth, several other categories of solution were offered. These included: Data/research/evaluation: In order to address the lack of accountability, it was suggested that data, research, and evaluation are needed. Similar to the use of the MCAS to drive education reform, the use of data regarding young people in transition could promote accountability from systems. Data and dissemination will drive long term change. Question becomes: why aren’t we looking at the available data? It was also noted that although DSS (and other agencies) have taken steps toward increasing permanency, efforts are not being evaluated. Programming: Several ideas about programming were offered by respondents. A comprehensive approach is the following: “Programs that embrace a positive youth development philosophy. Programs that give youth a sense of agency. Programs that teach youth how to advocate for themselves. So much of DSS and related nonprofits focus on the placement and short-term steps rather than long-term plans to support a youth to be self sufficient. We need to do better and ensure greater resources, responsibility and coordination to support youth with employment training and independent living skills. We cannot put this on the radar screen for the first time when youth turn 18. Every youth in care should have a clear action plan for how they will be connected to these education, employment and independent living resources. Perhaps that is too much for a caseworker to manage realistically. What if there were a hub for employment and education planning and every youth who is in care (and those in need of services to help prevent being in care) could access support for employment, education, internships, etc.? Caseworkers cannot be expected to manage all these pieces, nor are they trained to do so.” Other specific aspects of programming that were mentioned included: • programs with wraparound case management for 18-21 year olds • additional services on college campuses • supervised apartment model for those who transition out • programs that allow young people to make mistakes. 59 Enhanced coordination: Several respondents spoke again of the problem of lack of coordination among state agencies and the need to address this. Some specific suggestions included: • “Need to streamline adult eligibility for DMH for those graduating from DSS. Right now determine adult eligibility after 18 – trying to move it up 6 months. Possibly move to presumptive eligibility.” • “Had created a solution in the past – Office of Children – an interdepartmental team brought Area Directors of all state agencies together to solve difficult cases. It worked, needed to be done quickly. Then eventually deputies started coming, didn’t have authority to make decisions, model faded away.” • “Utilizing youth development as a unifying concept across systems. Need to look at kids over time. Youth development puts kids at the center, not the agency. Youth development is also a way to look at system. Need a developmental focus, not just age 18 – but also the years before and after age 18.” • “State systems need to find way to blur funding lines regarding separate funding streams. Cannot get the problems solved with current separate funding. Because of money flow – communication follows; separate funding streams leads to separate conversations.” Legislation: Some respondents noted that legislative change is needed or the problems will remain. Some of the legislation change that was suggested included: eliminating long term foster care as a category (according to DSS, this will change as of 1/2/08), lowering caseloads, more specialized set of interventions for adolescents (e.g., adolescent outreach), special services triggered for every youth in care (for example, at age 10 if in foster care more than 18 months child becomes automatically eligible for a set of services). Encourage signing back in: “Need much broader open door for kids to come back into system, not just the compliant ones. Need safety net for those who leave at 18.” Another respondent stated, “Feel the need for consistency and permanency in relationships has not trickled all the way down at DSS. There continues to be a need for a shift in attitudes towards youth in DSS. Specifically, I think supervisors and area managers are selective about policy of allowing youth to sign themselves back in care. Not always clear that youth are welcomed to return to care. There is a punitive and not affirming tone about returning to care.” Some other specific solutions identified included: • • • • “Community colleges are a huge link – a great resource.” “Massachusetts has adolescent workers – seems pretty effective. But youth have to repeat themselves. How about having one worker who specializes in adolescents?” “We believe in housing FIRST, don’t need to do XYZ before housing, need to meet them where they are. Single missing piece is housing costs and few subsidies – one group is pitted against another.” “We need to make some really solid assessments regarding education. DSS does not keep track of education attainments. We must insist that they have educational plan for youth.” 60 Who is responsible? “Stop knee jerk responses to crisis events -- there are better ways to learn from mistakes. Finger pointing and laying blame at DSS are not useful. The kids belong to all of us.” Commonly it was described that we all have a role to play in making sure that youth successfully transition but that DSS has the largest role (e.g., “DSS has to be at the top but there must be partners”). Many respondents also made the analogy to the role of parents in family life and the need for the public response to mirror that of the private family in terms of the obligations to young people. “Every state agency, every citizen is responsible as long as they are in the custody of the Commonwealth. Even though the legal obligation ends at age 18 we have an ethical obligation to support youth through young adulthood – all agencies. Parents do not kick out at age 18.” Further comments about the role of DSS specifically included the following: • “DSS as custodian has a special role in making sure that they have resources. To the extent they fail, they are culpable. They’re protectors but they don’t make very good parents. Their role is to get them parents.” • “State has become parent – at age 18 state is still parent, same commitment to them as younger. State has already invested millions. Will be a waste of those millions – it is worth it to continue the small amount of dollars that go into independent living. The more flexibility (contracting) around older kids the better. Department has gotten away from contracts.” • “Works best when DSS works collaboratively with community based organizations – new ideas, leveraging funds. Responsibility ultimately lies with state agencies who have removed them from their homes.” • “DSS is responsible as guardian. Same laws that apply to a parent should be parallel within DSS. Kids in college -- parents are responsible for health insurance to age 24 – should demand same from the Department.” • “State pretty good at teaching basics: shopping, checkbook; much less good when safety net is so thin -- one thing goes wrong, sets off a chain of events.” Others discussed the relationship of DSS to private agencies. There were different views on this: • “[Private agencies] need to do more to help youth transition; it is part of the contract. A social worker has a caseload of 20 and does not live with transition youth. The foster parent and residential provider are getting paid to help with this.” • “Private providers are in awkward position. Required to do all these different things but always need approval from DSS.” We have already discussed the problem of state agencies working together. Here are some further comments on this theme: 61 • “The entities don’t work together. Passing the buck often. Especially with kids with mental illnesses. DMH does not have enough group care dollars. We get a lot of people in homeless and runaway system – not functioning up to par but on paper not ill enough. The 688 system is broken. The children’s system seems to be OK but really 18 to 24 is a no man’s land. Extraordinary amount of these kids in homeless shelters.” • “Currently not an integrated seamless system among state agencies. In Massachusetts, state agencies seem a little protective, don’t see a lot of resource sharing, paranoid about lawsuits. In other states see a lot more collaboration. Hard to collaborate, share resources, pretty parochial – ‘what’s mine is mine’.” • “[Regarding housing] … each system thinks ‘we know our population.’ Welfare, like DSS, doesn’t understand housing; they start to design their own housing programs. Welfare and social services should not define the housing need, often end up with bureaucratic response for 20 kids. Spend too much time and spending for control, not trusting others to do the work.” • “Working together is key word and sooner rather than later. Otherwise face falling through the cracks with no funding to help – DSS, DMH, DMR only want to take responsibility for their core population. Barriers are so numerous, no sense of ownership. DSS has definition of role, the others have theirs. DSS has no legal responsibility after 18. They all work as silos, takes a lot to get people together.” Others with responsibilities include: • Youth: “Youth who have had a successful transition should take some of the leadership – especially in terms of being an advocate and voice for this population.” • Biological parents: “Biological parents have a role. More wraparound services to keep the family together.” • Federal government: “The federal government should provide more Chafee and Education and Training Vouchers. Also, monitor that youth are involved in case plans, case reviews, permanency hearing. Share what other states are doing, what’s happening with research. Changing mindsets about when youth are adoptable – this is a major barrier.” • Schools of Social Work: “Schools of Social Work can show leadership by adding curriculum content that focuses on needs of children/youth in foster care.” • Foster parents: “Responsibility is shared. Includes foster parents, particularly agencies paid to work more intensively.” • Legislature: “State could ante up some money. All of outreach program paid with federal dollars, except tuition wavier. State does pay for placement costs. Social workers usually don’t have time to do this work.” • Local community: “Need better state to local collaboration. We need to do better job of finding areas of greatest need to get resources to them. State could play a role in helping localities develop youth development partnerships. State could create opportunities for locals to come together and share best practices. Present data to locals regarding issues used to start initiatives.” 62 • Non-profits and academics: “Have a role by holding conferences, producing data.” Respondents noted that part of the problem on this issue is that leadership is currently too fragmented and decentralized. Plus, a change-over in leadership can stall progress. It was further noted that there is no agreement about what are the best practices for working with youth. Criteria defining successful transition Respondents were in general agreement on the criteria defining successful transition, although they may have emphasized one or two criteria more than others. Criteria included: GED or diploma as well as being on a productive educational/employment track that includes some secondary education or training; stable housing situation; connection to health care; relationship with adult; connection to community. Although these domains were commonly acknowledged, some respondents noted the high level of variability that defines success. “Different for different kids. For some kids it’s about blowing out of the program and going on. Getting to the next place, so that you can begin. Getting them ready for the next place. A lot of kids transitioning from DSS, their success might be making the break and then coming back.” Other, more unique responses included the following: problem solving and critical thinking skills; internal locus of control; ability to see their role in their life; sense of hopefulness; a particular skill or talent; a place to go at Christmas; ability to dream of a future, a vision of where they want to get to. “Those that are more successful seem to hold on to a belief that people will be there to help them. Differences in outcomes related more to attitude of the youth rather than skill sets. If they believe in themselves (some confidence and self esteem) and believe others will help them, they seem to do much better.” Massachusetts organizations Respondents were asked to identify organizations that were doing a particularly good job on this issue as well as those that were not. A number of DSS initiatives were mentioned. Frequently, and not unexpectedly, respondents suggested that their own organization was at the forefront on this issue. For example, one respondent from a private agency said: “We are doing good work. Majority of our programs are not DSS purchased services, allows some autonomy, not bound by a lot of rigidity of system. Have been able to influence the system. We do well because we ‘get it’ – we understand what the developmental phase is. We work a relational model with the kids.” Other than identification of their own organization, most commonly respondents noted the efforts that were particularly youth development focused and in which youth were involved in and leading interventions and efforts. These included: More Than Words Bookstore, Massachusetts Families for Kids Speak Out Team, and Adoption and Foster Care Mentoring. Partnering with youth It appears that some respondents’ organizations work in partnership with youth already; others were not at this level. Thus, some respondents were able to speak to this issue better than others. Responses were categorized into two areas: efforts to partner with youth within DSS and partnership efforts more generally. 63 Within DSS: Respondents suggested two ways in which DSS could better partner with youth: regarding a youth’s individual case plan and in policy/program development through Youth Advisory Boards. Many noted that there are existing efforts in both these areas but that they could be strengthened. Illustrative comments regarding youth partnerships in their own case planning included the following: • “Kids are pretty savvy – kids need to be in the room; to the degree possible their voice needs to be heard. To the degree possible also involved in case planning – although not always easy to manage to get them there. Would be good if some of this was written into policy and not just caseworker discretion.” • “Hearing them speak, hear what they have to say. Need to be open and upfront and hear their perspective. Not be overly protective. Get child more involved in decisions about work with them and have input regarding permanency plan.” • “Can’t give this lip service. Youth has to be perceived as critical to decision-making, a lot of them have a better sense of what they need. At Care and Protection hearings kids should always be invited. They may not elect to come but should always know about them.” • “Legislation that youth become more engaged in processes needs to be mandated. Growing awareness of increasing kids in decision-making process.” • “Typically kids are not notified about foster care reviews, not learning they can be there and that they have rights to say what it is they want. If you have kids in the room during decisions it can be a lot harder to have negative views about them, leads to more responsible decision-making.” Illustrative comments regarding youth partnership in policy development included the following: • “Youth Advisory Council – have been trying to revitalize, but youth involved with this may be the more resilient. Some states do surveys of youth, anytime they change care or annually. Children and Family Service Reviews will be asking youth how engaged they were in care.” • “Youth Advisory Board at DSS exists but I don’t know how effective they are. I think the Youth Advisory Board kids are less likely to speak freely.” • “Enabling youth voice when developing programs/initiatives. Youth Boards can be tokenized, not a true voice. System should make efforts to get real youth voice. People are often shocked about what they hear from youth.” Two additional suggestions were offered to help facilitate more partnerships with youth within DSS. First, “the system needs to develop expertise in working with teens – have caseworkers who specialize in working with teens.” Second, it would also be “optimal for DSS to be able to offer developmental opportunities for youth” including leadership forums, challenge courses, and more purely social events; however, all of this “takes time, staff, and funding.” More general than DSS: Others spoke more generally on this topic, not specific to a youth voice within DSS but rather partnering with youth in a wide variety of initiatives and programming. Some 64 examples of these comments include the following: • “Give kids an opportunity to be in leadership positions. Kids who do the best are those that are given an opportunity for leadership.” • “They need to be given the skills on how to self-advocate, influence, and articulate thoughts. They need to be able to speak ‘adult’ and adults needs to be able to speak ‘youth’.” • “A youth-adult partnership model which allows youth to be more than advisory but also decisionmakers. Youth need more venues where they can participate as partners: hiring young people to work in state bureaucracies, having youth sit at the table, funding organizations that have demonstrated youth involvement.” Political environment “Massachusetts perceives itself to be liberal and cutting edge. In reality, it has been a long time since we’ve been liberal or cutting edge.” When discussing the political environment for increasing efforts to assist youth transition, there were three common themes: 1) children do not get a fair share of attention to their needs, and within this group adolescents get less attention than younger children; 2) resources are constantly inadequate; 3) there is potential optimism due to new governor and commitment of members of legislature. Each of these is discussed further below. 1) Children do not get a fair share of attention; these were not unsurprising comments as it is well known that children’s needs are frequently neglected: • “Children don’t have as much leverage/impact in the legislature. National issues regarding children’s issues are not the same as corporate interests. Kids don’t vote.” • “Population does not lend themselves to sympathetic attention – not big political draw. And there may be race issues involved – are these mostly youth of color?” • “We tend to be a population that people don’t want to think about. People don’t talk about it. May not be at forefront of what constituents want.” A particularly thoughtful response on the topic is the following: “Politics too often gets in the way of doing what is best for young people. Decisions are too often made without real understanding of the needs of the people for whom decisions are being made. The climate determines how bad that dynamic gets. When the climate is more transparent and rooted in authentic connections with the people, and policymakers sincerely want to inform their work with the voice of the youth themselves, then I think we move closer to addressing the roots of our most intractable social problems. I would also add that there is often little evaluation of policy decisions; a big hoopla is made when a new initiative or decision or plan is made and then we do not effectively address the end part of the policymaking cycle which is evaluation.” 65 2) Resources are constantly inadequate: • “Budgets always balanced on back of vulnerable.” • “Mostly manifested in caseloads of DSS.” • “Problem is the economic environment not the political environment – financial issues stop programs, the will is there.” • “Need more money. Children should not be throwaways. We have culture that looks at poor kids and kids of color as throwaways. U.S. sees itself as child-centered but it’s not.” 3) Potential optimism due to new governor and commitment of legislature: • “New political reality, a lot of energy. Government has ear for children/family issues.” • “So far the legislature has been great to us. Political atmosphere great. Have most amount of legislators from foster care than any other state.” • “At the state house, a group of elected representatives who are committed to foster care have served an important role in the legislature.” • “I don’t know that people get it, what the problems are – legislators, people. There are pockets of informed persons in positions of policy making – it is their responsibility to influence others.” A few comments were also made about the political environment internal to DSS. Primarily these comments focused on the positive force of the former commissioner on this issue, but concern that this force does not “filter down” throughout the bureaucracy. The messages and efforts need to “permeate the system” and “get to everyone at every level across the state.” The other comment related to DSS was the following: “DSS has real hesitancy to evaluate anything, real lack of wanting to know.” Additional comments related to the political environment for serving youth included the following: • “Concern that some are perceiving that the problem has been solved – see some progress, people may move on.” • “Federal auditors are pushing DSS via the Children and Family Services Review, pressure to change goal to more permanency goals.” • “Interest in this area waxes and wanes. Resources may not grow with need. Not a real understanding of contributing factors. This issue can be crowded out – lack of long term attention regarding prevention of homelessness. Agencies are focused on this issue but not always supported by the legislature.” • “Consolidating data systems of human services, education, and courts are a great opportunity. Concerns about privacy need to be addressed but should not be an excuse.” • “The way the budget is organized is issue-specific which makes it hard to get advocates to support an overall youth development model. Advocates line up for their specific or pet issue area 66 reducing the impact of a larger constituency. Programs need to be funded over time for the long haul so outcomes can be adequately measured.” Respondents’ messages to governor and legislature Respondents were asked what message they would like to give to the governor and legislature about this issue. Many of these have already been stated and reflected earlier in this report. Primarily these responses focused on: • • • • • • More resources to serve this population Greater collaboration among state agencies Enhanced efforts to listen to young people More prevention work with families Need to start preparation for transition earlier Need for permanent connection to adults. Throughout the interviews, these were consistently mentioned by a wide variety of respondents. 67 Conclusions and Recommendations This report has provided extensive data regarding the leaving care transition for foster youth in Massachusetts. These data lead to numerous conclusions and recommendations. Here, we highlight what we believe are the most important findings, consistently supported in the data, and the resulting recommendations. Concrete assistance, especially with employment and housing, is warranted. In other domains, such as health care and education, positive outcomes are more apparent. The challenges of employment and housing appear more difficult, hence they require concentrated attention. Additionally, these are the two service areas that youth most frequently suggested would be helpful to them (Table 10). Good employment opportunities not only provide skills and entrée into the world of work, but can also provide the natural mentoring opportunities that provide sustained interpersonal connections as well as enhanced linkage to the world of work and the possibility of career trajectories. We found very little evidence of concentrated planning and linkage to sustained employment. It was noted by some respondents that although federal, state, and local employment and training programs are technically open to foster youth, in reality it can be hard to get these young people into these slots. While education is important, and may lead to good jobs in the long term, more immediate employment options are also needed. Many youth spoke about completing high school or obtaining a GED while others spoke about enrolling in college. These are obviously fine accomplishments. It is important to consider, however, the appropriateness and timing of continued educational pursuits. Young people described instances in which education was pushed on them in order to receive services. This practice should be reexamined. Youth who are not ready to attend secondary or proprietary schools should be allowed to explore alternative transition pathways, namely employment. Although education is an important and easily measured outcome, it should not be a standard pathway by which all youth are measured. Housing assistance is definitely needed and we believe this may be the most difficult challenge for this population because of the high cost. When asking respondents about the housing assistance they received, most responses focused on foster homes and group care or independent living arrangements. This is not the kind of housing assistance the questions sought to elicit but the answers are indicative of the rather short-term approaches that seem to be in play. The high percentage of young people who reported episodes of homelessness since age 18 also indicated problems in this area. Housing experts participating in the stakeholder interviews spoke well on this issue, but other stakeholders rarely addressed housing needs at all. Further efforts in this area need to make use of housing experts, who identified the need for additional rent subsidies as part of the solution. Given the feedback provided by the surveyed youth about their experiences in the foster care system (Appendix B), we suggest greater attention to the selection and oversight of foster parents, as well as mechanisms by which youths’ voices about their foster care experience while in placement can be heard. Respondents’ statements of their negative earlier experiences in foster care surprised us because this was not the focus of the survey. It clearly must be important if so many youth speak to it when not even prompted by a specific question. We had expected the feedback that youth would provide would be more focused on their transition experience; instead, a sizable number focused on their earlier, negative experiences in foster care. Aside from the need to address this issue for all the current young people in foster care, it may also suggest that for transition-age youth this continued focus on their painful earlier experience and the associated trauma, may inhibit their ability to be fully successful in their transition. 68 We recognize that the lack of sufficient quality foster homes is a substantial problem. DSS needs assistance to address this problem; citizens of the Commonwealth need to share this responsibility by stepping forward to serving as foster parents and to support foster parents and foster children in their communities. DSS is responsible for recruiting, training, and licensing foster homes, but this work can only be done if there is a sufficient supply of quality foster homes available. Much of the data gathered from young people illustrate their “likeability” and similarity to other young people in their age group. Other data spoke to the negative public perceptions regarding adolescents in care. Greater efforts to change these negative inaccurate perceptions of young people are needed and may serve foster home recruitment efforts. As for mechanisms by which youth voices can be heard regarding their current foster care experience, there are multiple options for this and we assume that DSS already has some mechanisms in place. Review of these options should be conducted, including the establishment of a children’s ombudsperson to receive and address these complaints. Additionally, periodic surveys of all youth in foster care, independently conducted, might be used as a protective mechanism. The data suggest, for the most part, young people who had access to the DSS adolescent outreach program found this experience to be helpful and felt a good rapport with their outreach worker. Data also suggest that many young people do not have access to this service. Expansion of the DSS adolescent outreach program to serve a greater number of youth is recommended. Unlike many other child welfare services, providing outreach services, like other post-18 services, can be relatively low cost. Much of the work involves guidance, check-in, and concrete assistance by a supportive, knowledgeable worker. This type of service does not carry the same expense as residential or therapeutic services, for example. Currently all funding for the adolescent outreach program is provided by the federal government. State funding is needed to expand the program. Much of what we heard from young people in this study seems reminiscent of the challenges of the vast majority of young adults. To the extent possible, programming should emphasize a normative model of intervention. Interventions need to treat them like young adults. They appear to respond well to guidance rather than rules. Several spoke of their greater satisfaction with post-18 care than pre-18 care because of this difference. Furthermore, the voluntary nature of post-18 services makes a big difference to the young people. Enhanced efforts to allow young people as much real choice and voice as possible prior to 18 may lead to greater satisfaction with DSS services. The extensive lack of collaboration among the state agencies who serve this population was identified as a problem by many. This is a long-standing problem for children’s services in nearly every state in the country and there appears to be virtually no progress on this problem. It is clearly related to state agency resources. When state agencies have difficulty meeting the needs of their core populations they will always remain reluctant to expand their services to other populations served by other agencies. Appropriate incentives need to be created at the executive level that will induce better cooperation. Another problem, identified in this study, and common across child welfare is the implementation of initiatives both within and outside DSS. Leaders often get extensive credit for the unveiling of new efforts, but comparatively little attention is addressed to the difficult and unheralded work of translating ideas, vision, and frameworks into the reality of day-to-day practice. There was evidence in the data that practices related to permanency initiatives, adolescent outreach services, and connections with family can vary across DSS offices and the contracted agencies. Greater standardization is needed across the agency. Furthermore, state agencies should utilize the expertise of front-line workers in identifying and removing barriers to implementation of new practices. 69 Allowing former foster youth to sign back into care seems to be an idea that is supported by the youth and the policy/program stakeholders. There have been problems in the implementation of this policy, however. First, the study identified concerns that the criteria for signing back into care are too stringent, and consequently that DSS serves the easier and more compliant youth. This is a particular concern because some youth with great needs may not be able to access services post-18. Youth expressed some concern and also partial confusion about the criteria. Some also identified, however, that having these criteria forced them to take some positive action. The data are inconclusive as to whether this is a problem, how big it is, and the reasons for it. We would suggest that it is in part a resource issue; there are not enough resources to serve all eligible youth and, therefore, the agency must engage in rationing. It may also be an implementation issue; the return-to-care policy is relatively new and procedures may need refinement. It may also be true that DSS does “cherry-pick” the cases. Greater attention to this issue is needed, as overall it does appear that youth who returned valued the opportunity to do so. There is no doubt that relationships and social networks are of vital importance to these young people. Many young people seem to have relationships with adults and their brief descriptions in these interviews suggest some healthy and strong bonds. The science of creating sustained relationships in natural environments is not strong, however. While the desire to help youth have permanent relationships is reasonable and should be pursued, it should be pursued cautiously. Connection with birth family is common among these young people. This finding is consistent with other studies and continues to raise questions about how we might better facilitate connection and reconnection between foster youth and members of their families of origin. These are often highly complicated situations and reconnection with family is not a panacea for helping young people find connection. Yet, sometimes our efforts can be overprotective, especially with adolescents and young adults who have or can learn the ability to assess relationships and make choices about what works for them. We have written about this at length elsewhere (Collins, Paris, & Ward, in press). In this study we did not hear many youth express the desire for greater connection with their birth families. Some already have a connection, either facilitated by DSS or developed on their own. Others spoke about earlier efforts at reconnection that did not work. Only small percentages (Table 10) thought additional efforts in this area would be helpful to them. Young people with special circumstances did not receive as much attention in this study as they deserve. Groups with special needs might include youth with serious developmental disabilities or mental illness, youth with substance abuse issues, and immigrant youth. This study aimed to examine the broad population of youth transitioning from care. Youth with needs such as those listed are likely to need some specific and concentrated attention. We did have a fairly large sample of parenting young adults and can draw some conclusions for this sub-population. Youth who become parents at an early age most likely will experience some challenges, regardless of whether they experienced foster care. Surveyed youth described challenges related to maintaining custody of their infants and accessing financial resources that would allow them to care for themselves and their child. Parenting youth need more independent living housing and day care options in order to support continued educational and training opportunities and to lower the risk of current foster care youth being investigated for neglect. Running away is a serious issue that does not receive enough research, practice, or policy attention. These youth are often, but not always, vulnerable while on the run. Often they are known to “run to” family and friends where they want to live instead of a foster home or group care placement where they do not want to live. Running from care was not a core focus of this study but several 70 components of the study indicated it to be a problem requiring attention. From the administrative data we learned that sizable percentages of youth run from care. Many in the survey or the qualitative interview spoke about their experiences running and the reasons for doing so. Generally, they had unstable living situations and were less likely to have consistent educational instruction. Furthermore, youth who run from care seem to have a history of running, and for some, running is linked to their desire to have voice about what happens in their lives. Efforts to increase attention to youth voice may help limit running behavior and thus keep youth connected to safe environments and educational systems. Some youth have relatively good experiences in foster care and in their connection with the child welfare system. Others do not. It is clear from the data that a “good worker” (whether DSS or private agency) can make an important difference. Our aim should be to insure that more youth receive the kind of concentrated and personal attention provided by some. Caseload size is a chronic problem that prevents the best of care. Additionally, some respondents (both youth and stakeholders) suggested, and we concur, there is a need for greater specialization in adolescent-focused child welfare work. Analyses of demographic data on gender, race, and sexual orientation suggested that DSS services were reaching young people in equal proportions to their distribution in the population; no apparent bias is seen in terms of one group getting more or less service than another. Some of the risks were not evenly distributed, however. For example, females were more likely to be parents and to express feelings of depression. Latino and Black youth were more likely to report recent unwanted sexual contact. Gay, lesbian, and bi-sexual youth appeared to be at risk for a variety of poor outcomes; consequently, enhanced intervention is needed by DSS and other service agencies. Data regarding risk behaviors suggest that these young people are vulnerable to violence and victimization. These appear to be much greater risks than illegal behavior, drug abuse, or heavy alcohol use. The reasons for this vulnerability may be many, including some of the unstable housing situations that may put youth at risk. The data also suggested that many youth are challenged by poor emotional health. These may not be problems specific to former foster youth; further efforts to support the protection and well-being of all young adults are needed. Some stakeholders addressed the issue of politics regarding children’s services; the tendency of various sectors and organizations to jockey for positioning on this issue. Although this is a reality of social service systems it is a danger to advancing the well-being of children and youth. One mechanism to withstand some of the politics of children’s services is greater attention to evaluation and outcomes, although we are well aware that evaluations can be used for political purposes rather than measuring and improving services. All of the agencies serving children and youth, especially the state agencies, must be more open to independently conducted evaluation of their services. Internal evaluations and those done in partnership will not suffice. If agencies are unwilling to do so voluntarily the legislature should mandate this. In conclusion, the data presented in this report suggest that some former foster youth are doing quite well; others are struggling in several ways. Additionally, services are available to many youth and there are indications that these services are needed, appreciated, and helpful. The data also clearly suggest that more might be done to assist former foster youth with the transition from care and have provided some guidance on next steps in policy and program development. The costs of assisting this population would likely be relatively small compared to the vast placement and therapeutic costs that have already occurred. Moreover, the potential pay-off in terms of long-term healthy, productive, engaged adults is substantial. 71