United States House of Representatives Subcommittee on Income Security and Family Support

July 12, 2007

The Child Welfare League of America (CWLA), representing public and private nonprofit, child-serving member agencies across the country, is pleased to submit testimony to the Subcommittee on Income Security and Family Support. CWLA commends the Subcommittee and its members for focusing on the issue of youth transitioning out of foster care to adulthood. We appreciate the Subcommittee’s continued focus on youth. This hearing is an important follow up to your hearing on June 19, on disconnected and disadvantaged youth.

Many issues confront young people as they transition from foster care to adulthood. Aside from the challenge of becoming independent they face higher levels of unemployment, no health insurance, substance abuse and homelessness and many other serious obstacles. These young people leave care not because they have been reunified with their families, have been adopted, or found another form of permanency but simply because there is an age limit on federal funding.

Youths Leaving Foster Care Due To Age

Certainly there is no group of America’s youth more deserving of the attention of Congress than those in foster care or who leave foster care after turning age 18. Every year 20,000-25,000 young people exit the foster care system. 1 These young people leave care simply because there is an age limit on federal funding. While some states may extend this support beyond age eighteen and the Chaffee Independent Living Program offers limited funding for transitional services to these young people, all too often the end result is that foster children find themselves on their own at age eighteen.

Barriers to a Secure Adulthood

Adolescents constitute a major segment of the youngsters the child welfare system serves. In 2005, 29 percent of children in care were 15 years of age or older. 2 Most youth enter out-of-home care as a result of abuse, neglect, and exploitation. Others have run away from home or have no homes. Young people transitioning out of the foster care system are significantly affected by the instability that accompanies long periods of out-of-home placement during childhood and adolescence. These young people often find themselves truly “on their own,” with few, if any, financial resources, no place to live, and little or no support from family, friends, and community. The experiences of these youth place them at higher risk for unemployment, poor educational outcomes, health issues, early parenthood, long-term dependency on public assistance, increased rates of incarceration, and homelessness. The resulting harm to the youth themselves, their communities, and the society at large is unacceptably high.

Housing Needs
Young people aging out of the foster care system need economic security and affordable, safe and stable housing. The 2000 Census reported that nearly 4 million people between the ages of 25 and 34 live with their parents due to economic realities – jobs are scarce and housing is expensive. This phenomenon has been identified as “adultolescence”, an extended period of adolescence during which it is has become common and expected for young people to live with their parents. Unfortunately, youth in foster care do not always have the option of turning to their families for financial support. Former foster youth are often prematurely confronted with the harsh reality of the gap between the wages they earn and the cost of housing. As a result, young people aging out of the foster care system are becoming homeless at disconcerting rates.

Twenty-five percent of foster youth stated they have experienced homelessness at least one night within 2.5 to 4 years after exiting foster care. 3 In fact, three in ten of the nation’s homeless adults report foster care history. 4

Education Needs
Similarly, the correlation between out-of-home care and low academic performance has been documented nationwide. For children in foster care, schools should offer an opportunity at continued stability while most of that child’s life is being turn inside out. In addition to the abuse and neglect they experience, these children must deal with the consequences of being removed from their homes and communities. This often times includes separation from siblings and may include making several moves from home to home. For these children and youth their lives now include dealing with a child welfare agency and court system.

Schools should be safe havens for children during times of transition and instability, but poor coordination and communication between schools, agencies and other parties may result in added instability and at times no school at all. With no federal law to ensure school stability and access to supportive services for children in foster care there is often as much movement among schools as there is in living arrangements.

There are many challenges for these children. A child who moves to a different home may all of a sudden find they are now in a new school district. This all too often means they must wait for a transfer of school records before a new school allows them to continue their education. In some instances a child may have to wait for a transfer of medical records to document they meet any health care requirements such as immunizations. All of these barriers mean a delay in meeting their education needs, and these foster children are being left behind not just in education but in the stability they vitally need. These children and youth not surprisingly fall behind academically, cognitively, and socially. They often need to repeat courses and are unable to access the support services that could improve education outcomes.

Although all children are entitled to education services under federal, state, and local laws, the specific educational needs of children and youth in care often go unmet. The rate at which foster youth complete high school (50%) is significantly below the rate at which their peers complete high school (70%). The rate at which college-qualified foster youth attend postsecondary education (20%) is substantially below the rate at which their peers attend postsecondary education (60%). 5 However, it is important to note that 70% of former foster youth express the desire to attend college. 6 The impact on future earnings is enormous. The census Bureau reports college graduates make $24,000 more per year than those with high school diplomas. 7

Health Needs
In addition, for young people leaving foster care lack of health care poses a substantial challenge. According to a recent study, approximately twenty-five percent of foster care alumni or adults who had experienced foster care later experienced post traumatic stress. The general population by comparison experienced post traumatic stress at a rate of four percent. 8 Earlier this year at a briefing conducted by CWLA and sponsored by the Subcommittee Chair, Representative Jim McDermott, Dr. David Rubin, MD, MSCE, Director of Research & Policy, Safe Place, Center for Child Protection & Health Children’s Hospital of Philadelphia, indicated that only half of children with behavioral problems in foster care receive services, up to one-third of children failed to receive appropriate immunizations, and one in eight were not receiving preventive care. 9

The Chafee program allows states to extend Medicaid coverage to former foster children between ages 18 and 21. Despite Medicaid’s tremendous advantage for youth in foster care, only 17 states had implemented the extension as of December 2006.

Given the high rates of physical and mental health problems extensively documented among children and youth in foster care, access to health services is a critical factor as young people transition to adulthood. Because most children and youth in foster care are covered by Medicaid, use of the expansion option would allow a state to readily facilitate the transfer of a youth’s Medicaid eligibility from one category to another without any gap in coverage as they exit foster care. Medicaid coverage should continue for all youth in foster care until at least age 21.

Keeping medical records up to date and accessible is another challenge for young people involved with child welfare. Advances have been made in electronic record keeping, but more are needed.

Legislative Recommendations

Support Through Age Twenty-One
The 110th Congress has an opportunity to make significant progress in improving the lives and outcomes for this segment of disconnected and disadvantaged youth. Senator Barbara Boxer (D-CA) introduced the Foster Care Continuing Opportunities Act, S. 1512. This legislation would simply amend the current law that defines foster children to age eighteen. States would have an option to extend this to age twenty-one. This extension would allow these youth more time to appropriately prepare for transitioning to adulthood. It is imperative that youth work in partnership with their caseworker to create an effective plan for transitioning out of foster care. An effective transition plan focuses on the development of independent living skills, including securing housing, developing a financial plan, obtaining and maintaining employment, continuing education, and creating social networks and connections.

In an effort to close the gaps that allow so many youth to fall through the cracks, it is necessary to have effective collaboration and coordination. Creating connections, developing effective transition plans and integrating services will prevent the intersection of foster care with homelessness, health issues, incarceration, unemployment, pregnancy and early parenthood. Instead, these partnerships along with a solid transition plan, will allow these resilient youth to become thriving, productive, and contributing members of society.

Support Independent Living
For youth transitioning out of foster care, expanding eligibility for critical support for independent living services will ensure a successful transition to independence and self-sufficiency, and reduce the numbers of young people who become homeless, unemployed, incarcerated, and/or at high risk of becoming victims and victimizers. To accomplish this improvement and expansion, funding for the Chafee Foster Care Independence Program needs to be increased significantly.

McKinney-Vento Homelessness Assistance Act/Education Reform
The reauthorization of the the McKinney-Vento Homelessness Assistance Act as part of the reauthorization of the No Child Left Behind (NCLB) Act provides an opportunity to better address the needs of children and youth in foster care. McKinney-Vento provides access to essential federal education protections and rights for children and youth who are homeless. Children and youth who are eligible for McKinney-Vento have access to supports for school success that many children involved in child welfare lack: school stability or immediate enrollment if stability is not possible, school staff charged with ensuring their prompt enrollment, and more. While these protections currently apply to a subset of children involved in foster care, the current definition is not clear and states provide coverage differently and in a limited way for children in foster care. The reauthorization of McKinney-Vento provides an opportunity to ensure these protections are available to all children in foster care, with special accommodation for the needs and family dynamics that face children in foster care.

Funding for Tuition Vouchers
The Education and Training Voucher program provides assistance of up to $5,000 per year for the cost of attendance at an institution of higher education for youth who age out of foster care or are adopted after age 16. Funding for this program has never reached the amount requested by President Bush-$60 million-which itself is not enough to meet the need. The ETV program began receiving funds in 2003 and was set at $42 million, and has been increased slightly in subsequent years. The benefits of a college education are significant. Funding for the ETV program should be expanded to at least the level proposed by the President.

Further improvements to the ETV program are needed, including requiring technical assistance for states to make sure the funds are fully utilized. Also, it should be required that any ETV funds not used in one state be transferred to other states’ ETV programs rather than being returned to the federal treasury.

Access To Health Care
The Medicaid Foster Care Coverage Act of 2007, H.R. 1376, has been introduced by Representative Dennis Cardoza (D-CA-18). This bill addresses a critical issue for young people leaving foster care, lack of health insurance. As stated previously, given the high rates of physical and mental health problems, access to health services is a critical factor as young people transition to adulthood. While some states have taken the option to extend Medicaid coverage to age 21, we agree with the growing number of advocates that the best way to assure this coverage is simply to require Medicaid coverage for these former foster youth.

Studies have revealed that when compared to the general population, in addition to severely lower rates of graduation from college and employment and higher instances of homelessness, foster care alumni experienced a disproportionate amount of both physical and mental health issues, including post-traumatic stress disorder and major depression. Compounding this problem is the fact that 33% of foster care alumni lack health insurance-a rate almost twice as high as the general population.8

Current law does provide mechanisms by which to cover this vulnerable population with the support needed as they leave the care of the child welfare system. Some states, for example, have implemented the Chafee option to extend Medicaid to youth aging out through the Foster Care Independence Act of 1999. Strides have been made, but because young people who age out of the system often lack financial resources and a place to live, and have little or no support from family, friends, and the community there is much more work to be done. By extending Medicaid coverage to former foster youth until the age of 21, we would be guaranteeing a critical piece of the equation that would help them make a successful transition to adulthood-comprehensive health care.

In addition actions of the past several years by the Centers on Medicaid and Medicare Services (CMS) have undercut the state’s ability to use Targeted Case Management services (TCM). CWLA has great concerns about these actions and we feel it undercuts access to care to the entire child welfare population. This is not a cost saving issue, rather it is an issue of access to health care. We are also concerned about future regulatory action that may restrict state Medicaid systems use of rehabilitative services. We urge Congress to be vigilant and in fact to take action to stop any regulations that overreach and have the effect of restricting access to care by youth and all children in foster care.

Data Collection Needs
Congress should provide the resources necessary for the implementation of the National Youth in Transitions Database. This new initiative is a tremendous opportunity to provide valuable information that will inform future improvements in services to young people. The funds for this implementation should be a priority for Congress and should not come at the expense of existing services or supports or reduce services to adolescents receiving Chafee and ETV funding.

Support for Kinship Care
Finally, CWLA would be remiss if we did not highlight one legislative solution which is showing growing bipartisan support, kinship care. Kinship care is an important permanency option for child welfare systems. In some instances support for these grandparent and other relative families can provide a vital support for these youth. In 1997 the Adoption and Safe Families Act (ASFA) was adopted by this Subcommittee and many of the members of this Congress voted for it. It recognizes kinship placements as a critical permanency option. We now have bipartisan bills in both houses, S. 661 in the Senate and H.R. 2188 in the House, to extend Title IV-E funding to these kinship placements. CWLA strongly believes that extending Title IV-E support in this way can play a vital role in assisting young people leaving the foster care system and can help before they reach the age of eighteen.


CWLA appreciates the opportunity to offer our comments to the Subcommittee in regard to youth transitioning out of foster care. As this Subcommittee moves forward we look forward to a continued dialogue with the members and all Members of Congress. We hope this hearing serves as a building block for future efforts that will create the means for reforms that result in increased successful transitions for these youth.



  1. Children who aged out of foster care are captured by the AFCARS emancipation data element. Children who exit care to emancipation are those who reached the age of majority; CWLA, Special tabulation from AFCARS. 
  2. Adoption and Foster Care Analysis and Reporting System (AFCARS) data submitted for the FY 2005, 10/1/04 through 9/30/05. 
  3. Cook, R. (1991). A national evaluation of Title IV-E foster care independent living programs for youth, phase 2. Rockville, MD: Westat. 
  4. Roman, N.P., & Wolfe, N. (1995) Web of failure: The relationship between foster care and homelessness. National Alliance to End Homelessness. 
  5. Wolanin, T. (2005). Higher education opportunities for foster youth: A primer for policymakers. Washington, DC: Institute for Higher Education Policy. 
  6. McMillen, C., Auslander, W., Elze, D., White, T. & Thompson, R. (2003). Educational experiences and aspirations of older youth in foster care. Child Welfare, 82, 475-495. 
  7. Census Bureau data underscore value of college. (October 2006). Available online. Washington, DC: U.S. Census Bureau. 
  8. Pecora, P.J., Kessler, R.C., Williams, J., O’Brien, K., Downs, A. C., English, D., White, J., Hiripi, E., White, C. R., Wiggins, T., & Holmes, K. (2005). Improving family foster care: Findings from the Northwest Foster Care Alumni Study. Available online. Seattle, WA: Casey Family Programs. 
  9. CWLA briefing, May 21, 2007. Sources: GAO, 1995; Burns et al. JAACAP, 2004; Rubin et al. Pediatrics 2004; Hurlburt et al. J Gen Psychiatry 2004; Harman et al. Arch Ped Adol Med 2000; Halfon et al. Pediatrics 1992 MD MSCE. 
  10. Pecora, P.J., Kessler, R.C., Williams, J., O’Brien, K., Downs, A. C., English, D., White, J., Hiripi, E., White, C. R., Wiggins, T., & Holmes, K. (2005). Improving family foster care: Findings from the Northwest Foster Care Alumni Study. Available online. Seattle, WA: Casey Family Programs.