Child Welfare Services



HHS Information on Child Welfare and Homelessness: This Information Memorandum outlines federal efforts and resources to enhance child welfare's response to family and youth homelessness. The memo is here, promising practices here, and key federal partners here.

Enhancing Permanency for Youth in Out-of-Home Care: This HHS publication highlights successful models and strategies of foster youth permanency planning and reviews background statistics and outcomes.


Working with Youth on a Transition Plan:  This HHS brief provides information on federal requirements and state examples of transition plans to help child welfare professionals and others who work with transitioning youth to develop a plan that builds on a youth's strengths and supports their needs. (8 pp.)



Health Coverage


ACA Coverage of Former Foster Youth: CMS has circulated an FAQ on Medicaid and CHIP, including coverage under the ACA of former foster youth up to age 26, among other issues. This  four page brief from First Focus summarizes what it covers and outstanding implementation issues.


Toolkit for Former Foster Youth and ACA Coverage: Youth formerly in foster care are eligible for health care coverage through Medicaid until age 26, regardless of income, due to a provision in the Affordable Care Act. The Former Foster Care Youth and the Affordable Care Act (ACA) Toolkit, developed by the Schuyler Center for Analysis and Advocacy, presents an array of resources for service providers that describes the new health-care provision. Links to videos, PowerPoint presentations, factsheets, and webinars are available.


HHS Memo on Health Insurance for Child Welfare Involved Families: This Informational Memorandum (IM) provides information to title IV-B and IV-E agencies regarding ways in which children, youth, and families who are involved with the child welfare system may be eligible for health insurance coverage under Medicaid, CHIP and the ACA.





Education Records of Children in Foster Care: The State PolicyAdvocacy and Reform Center has published this brief outlining collaboration between education agencies and the child welfare system. It also reviews the recently-enacted federal Uninterrupted Scholars Act.


Educational Needs of Foster Care Children: The Legal Center for Foster Care and Education, a collaboration of the American Bar Association Center on Children and the Law, Juvenile Law Center, and Education Law Center, has issued a new Question and Answer factsheet on the educational needs of children in foster care, entitled How Can We Ensure Educational Success for Dependent Youth in Congregate Care?


HHS and Education Dept. Urge Coordination Between CWS and Schools: On May 30, HHS and the U.S. Dept of Education sent a letter to state child welfare and education departments to highlight the school stability provisions for foster children in the Fostering Connections Act. The letter emphasizes that the Act places specific obligations on local education agencies as well as child welfare agencies and urges that child welfare and education agencies to work together this summer to develop policies and procedures that ensure both educational stability and the appropriate, immediate enrollment of all school-aged children in foster care in the upcoming school year. A website dedicated to the issue has been created to encourage these efforts.


Education Dept. Releases Guidance on Foster Youth Education Records: The U.S. Department of Education has released guidance on the Uninterrupted Scholars Act (USA) amendments to the Family Educational Rights and Privacy Act (FERPA). The provisions permit educational agencies and institutions to disclose personally identifiable information from the education records of students in foster care placement, without parental consent, to an agency caseworker or other representative of a State or county child welfare agency or tribal organization authorized to access a student's case plan when such agency or organization is legally responsible, in accordance with State or tribal law, for the care and protection of the student. The guidance is a question and answer document that explains how the new law works. 



Credit Protection


Protecting the Credit of Youth in Foster Care: A new federal law requires child welfare agencies to request annual credit reports for foster youth age 16 and older and to work to resolve credit issues arising from them. This Annie E. Casey Foundation guide provides information for case workers and other groups and individuals working with foster youth so that they know how to help youth understand credit and, in the event of identity theft or fraud, to clear credit problems. (32 pp.)   


Helping Youth Access Credit Reports: For a youth transitioning out of foster care, poor credit can add to the challenges of getting an apartment, a bank account, or a student loan and achieving financial stability. A new reference guide provides child welfare agency staff with detailed information on accessing credit reports for youth in care and helping resolve common credit report errors, as required by Federal mandate. The guide-developed by the Credit Builders Alliance and supported by the Annie E. Casey Foundation-also presents tips on educating youth about the importance of building credit and protecting against identify theft. Links to other resources are at the end of the guide. In addition to the report, a set of three fliers is available for caseworkers and others to share with youth and young adults regarding credit issues. 


College Financial Aid Resources for Former Foster Youth: Voice for Adoption receives many requests from students and adoptive parents who are looking for resources for college scholarships and other financial aid resources. This list provides information about potential financial aid opportunities.


Tools to Help Foster Youth Fight Credit Fraud: In an effort to better protect children in foster care from credit reporting problems that could compromise their future credit, the Consumer Financial Protection Bureau has prepared action letters for child welfare caseworkers to use if they find errors on the credit reports of the children in their care. Tip sheets on how to start and maintain good credit are also available. For caseworkers, it provides instructions on how to check the credit records of youth in foster care and respond to errors or evidence of identity theft.



Trauma Informed Care


Tackling Toxic Stress: Harvard University's Center on the Developing Child has posted this article, Using Science to Drive New Approaches to Child Welfare, outlining recent developments in this field, with links to numerous resources.


Long-Term Consequences of Child Abuse and Neglect: From HHS, this ten page Fact Sheet summarizes the long-term physical, psychological, behavioral, and societal consequences of child abuse and neglect. Resources are available at the end of the brief.


Reducing 'Toxic Stress' in Kids: This five-minute video, narrated by Dr. Jack P. Shonkoff, director of the Harvard Center on the Developing Child, suggests how adults can use the science on childhood trauma to improve the lives of children in poverty. 


HHS Agencies Release New Guidance on Child Trauma & Well-Being: The Administration for Children and Families (ACF), Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) released a letter in July 2013 encouraging the integrated use of trauma-focused tools and practices in child-serving settings. It discusses the appropriate role of psychotropic medications, and how other components such as functional assessment, trauma screening, mental-health assessment, evidence-based practices and individual outcome measurement can be used to provide better care. (17 pp.)


Trauma Toolkit: Understanding trauma in the lives of youth is essential for those working in child welfare. This one-stop resource was released by the Center for Advanced Studies in Child Welfare (CASCW) at the University of Minnesota School of Social Work. "Trauma-Informed Child Welfare Practice" provides an overview of traumatic stress, how to recognize and understand its effects and how to address it. Trauma is discussed from a number of perspectives and the information may be helpful to a number of individuals and families involved in the child welfare system.



Sexual Exploitation of Children


HHS Guidance on Human Trafficking: HHS has released guidance on child trafficking to child welfare systems and runaway and homeless youth programs. Click here to read it. 


Child Welfare and Child Sex Trade Victims: NACHSA members discussed this issue at their meeting held in 2013 at the NACo Annual Conference. An article from Salon outlines how the issue is emerging on the national front. And the summer issue of HHS's Children's Bureau Express looks at the intersection between child welfare and human trafficking. Click here to access those resources.


Federal Action Plan on Human Trafficking: In January 2014, the Obama Administration released the final version of the "Federal Strategic Action Plan on Services for Victims of Human Trafficking." It may be read here.


Sex Trafficking of Youth: Georgetown Law's Center for Poverty and Inequality has published a report entitled, Blueprint --A Multidisciplinary Approach to the Domestic Sex Trafficking of Girls. It analyzes the ways in which girls are at the intersection of child welfare, juvenile justice, and sex trafficking and highlights the innovative programs that are serving them in an effective, multidisciplinary manner.



Psychotropic Medications 


Foster Children and Use of Medicaid: Studies have found that children in foster care have a higher prevalence of psychiatric symptoms and health-risk behaviors compared to their peers. This SAMHSA study examines the prevalence of mental and physical illnesses and the use of health care services among children in foster care covered by Medicaid and compares it to other youth.


Pregnant & Parenting Foster Care Youth & Psychotropic Use: This Center for the Study of Social Policy brief discusses the use of psychotropic medications for girls who become pregnant or give birth while in foster care. It begins with a discussion on the increased use of psychotropic medications among youth in foster care, misinformation and stigmas surround the use of psychotropic medication during and after pregnancy, and the impact of psychotropic medication use during and after pregnancy. Key points for consideration when treating pregnant youth with mental health needs are reviewed and recommendations are made that stress knowledge, advocacy, and support.


Use of Antipsychotic Meds by Foster Youth: Another study documenting the "atypical antipsychotic" drug use among youths with ADHD, comparing age groups, Medicaid eligibility, and presence in foster care are presented in the Journal of Child and Adolescent Psychopharmacology. The article is available free. The study found that nearly one-third of the ADHD-diagnosed foster care youth ages 2-17 years of age included in the assessment received atypical antipsychotics. 


House Focuses On IV-E Psychotropic Use: The House Ways and Means Committee held a hearing last month on the high rate of psychotropic drug prescriptions among foster care children. According to data compiled by the Congressional Research Service, between 2008 and 2010, nearly one out of every four children in foster care was using a psychotropic medication on any given day-more than four times the rate among all children.  A recent Wall Street Journal story and a multi-part Denver Post series highlighted how youth in foster care may be prescribed these powerful, mind-altering drugs because they are misdiagnosed as having mental health disorders instead of being recognized as having problems stemming from the abuse and neglect they have experienced.


GAO Issues Foster Care & Psychotropic Use Report: The Government Accountability Office (GAO) released a report last month, Foster Children: Additional Federal Guidance Could Help States Better Plan for Oversight of Psychotropic Medications Administered by Managed-Care Organizations, which examines the extent to which the use of psychotropic medications was supported by foster and medical records for selected case studies of children in foster care who were prescribed these medications. The report also describes selected states' policies and procedures intended to address oversight of psychotropic medications, and assesses what, if any, actions HHS has taken to help states oversee psychotropic medications prescribed to children in foster care since the December 2011 GAO report on psychotropic medications prescribed to children in foster care.


Improving Behavioral Health Care for Child Welfare Kids: It is widely recognized that children and youth in the US foster care system are at high-risk for significant behavioral health challenges. As a result, these children and youth --generally covered by Medicaid -- are more likely to use behavioral health services, including psychotropic medications. How likely? A new infographic from the Center for Health Care Strategies (CHCS) contrasts the differences between behavioral health care use and expense for a typical Medicaid-enrolled child and a child in foster care. Children using behavioral health care represented under 10 percent of the overall Medicaid child population, but an estimated 38 percent of total spending for children in Medicaid; Children in foster care and those on SSI/disability together represented one-third of the Medicaid child population using behavioral health care, but 56 percent of total behavioral health service costs; and, almost 50 percent of children in Medicaid who were prescribed psychotropic medications received no identifiable accompanying behavioral health treatment. Read a fact sheet here



Unaccompanied Minors


Number of Unaccompanied Alien Children Escalates Dramatically: This New York Times article reviews the huge increase in unaccompanied minors entering the United States. Since October 1, 2013 over 47,000 children traveling without parents had been caught crossing the southwest border of the U.S. -- a 92 percent increase over the same period in 2013. Most are coming from three Central American countries: El Salvador, Guatemala and Honduras. More than 33,000 minors were apprehended in the Rio Grande Valley of Texas. 


UAC Facts: ORR has produced this fact sheet on the UAC program and this chart providing information on the current migration of children to the U.S. 


Webinar on Unaccompanied Children Crisis: On Monday, August 4, 2014, at 3 p.m. ET, the National Association of Counties (NACo) will host a webinar/conference call on the unaccompanied children crisis. On this call, White House and Administration officials will provide an update on the unaccompanied minors and Central American migrants along the US/Mexico Border. County officials will have the opportunity to ask questions regarding this issue. Register here


Placements of Central American Unaccompanied Minors: The federal government continues to reach out to localities to temporarily house and process the thousands of unaccompanied minors from Guatemala, El Salvador and Honduras. HHS published a state-by-state list of the numbers of children placed with sponsors. It may be accessed here


Education Requirements for Unaccompanied Minors from Central America: While the flow of minors into the U.S from Central America has slowed somewhat, there are thousands of children already here with the school year approaching. The Administration has released this fact sheet and FAQ highlighting their right to attend public school once they leave HHS temporary custody. Read more about status of these youth in this Hill newspaper story.



Home Visiting


Home Visiting Programs: Reviewing Evidence of Effectiveness: This three-page HHS brief shows that of 35 home visiting program models reviewed so far, 14 have met HHS criteria for evidence-based early childhood home visiting service program models. This brief also describes the review process and other results.


How Home Visiting Achieves Cost Savings Through Reduced Child Maltreatment: A new study from Mathematica Policy Research and Chapin Hall explores evidence that certain home visiting models may help prevent child maltreatment and prove cost-effective for governments. The study presents the estimated costs of implementing these models and states what additional information is needed to assess whether they are cost-beneficial through reductions in child maltreatment and other outcomes. 


New Resources Available on Home Visiting: HHS has launched a new website reviewing home visiting research and assessments of program model effectiveness. 



Data & General Reports


Foster Care Statistics 2012: HHS has published this brief containing the most recent national statistical estimates for children and youth in foster care from FY 2012 and earlier data from FY 2003 to demonstrate trends over time. (13 pp.)


50 State Chartbook on Foster Care: Published by Boston University, this Chartbook provides data on current foster care programs, policies and financing for every state, with a particular emphasis on therapeutic foster care. It also highlights innovative initiatives and best practices being implemented in states throughout the country.


2014 Prevention Resource Guide: Making Meaningful Connections: This HHS Resource Guide is intended to support service providers in their work with parents, caregivers, and their children to strengthen families and prevent child abuse and neglect. The guide includes information about protective factors that help reduce the risk of child maltreatment, strategies for changing how communities support families, and evidence-informed practices. It also has a directory of national organizations that work to strengthen families, and tip sheets in English and Spanish on specific parenting topics.


Protective Factors Approaches in Child Welfare: This HHS brief provides an overview of protective factors and approaches to the prevention and treatment of child abuse and neglect for policymakers, administrators, child welfare and other interested individuals.


Disproportionality Rates for Children of Color in Foster Care: This bulletin utilizes 2011 Adoption and Foster Care Reporting System (AFCARS) data and census data estimates to calculate current disproportionality indexes for every state and select Model Courts across the country. It makes comparisons between 2000 and 2011 disproportionality rates to illustrate changes that have occurred in the last decade regarding overrepresentation of children of color in the foster care system.


Housing Resources for Youth Aging Out of Foster Care: The Department of Housing and Urban Development (HUD) has released a report, The Family Unification Program: A Housing Resource for Youth Aging Out of Foster Care, which chronicles the housing needs of youth leaving foster care and the different housing options available. The Family Unification Program (FUP), a special-purpose voucher program under the HUD's Housing Choice Voucher (HCV, also known as Section 8) program, is one resource for such youth. The primary purpose of FUP is to provide housing vouchers to child-welfare involved families for whom the lack of adequate housing is the primary reason for imminent out-of-home placement of children or delays in family reunification.  


Report Issued on Dual Status Youth: Dual status youth cross the agency lines of the juvenile justice and child welfare systems, yet the agencies do not always communicate or collaborate on plans to serve the youth.  Research and experience indicate that an integrated, multi-system approach can effectively yield better outcomes for youth and families, enhance system performance, and produce significant cost savings within communities. The Robert F. Kennedy National Resource Center for Juvenile Justice, has issued a white paper, From Conversation to Collaboration: How Child Welfare and Juvenile Justice Agencies Can Work Together to Improve Outcomes for Dual Status Youth. It highlights strategies to develop a more integrated approach and looks at examples where system integration and coordination led to transformations with better outcomes for youth.


Differential Response Final Report Available: The National Quality Improvement Center on Differential Response in Child Protective Services (QIC-DR) has released the final report from the Cross-Site Evaluation on Differential Response. Not unlike the debate over family preservation more than twenty years ago, states are implementing the practice in differing ways sometimes with much less fidelity to established models but critics are bundling all programs into one set of conclusions and criticisms. As a result there is a growing debate with some arguing that all DR practices are endangering children. To read materials from past webinars on the topic, including efforts in Colorado, Illinois and Ohio, click here


Sexual Activity of Foster Teen Girls: This one-page brief from HHS summarizes the high rates of risky sexual activity and pregnancy of teenage girls in the foster care system.


Housing for Youth Aging Out of Foster Care: This HUD report discusses the empirical evidence documenting the link between aging out of foster care and the experience of homelessness, findings about how communities can, and do, use the Family Unification Program to address the housing needs of youth aging out of foster care who do not have adequate housing, and strategies for rigorously evaluating housing programs for youth aging out of foster care to better understand the effectiveness of various housing models.