Foster Care Toolkit

Children in Foster Care

At any given moment, there are approximately 400,000 kids in foster care in the United States. This number changes frequently as children enter and exit the foster care system, averaging just over a year in foster care. Children most frequently enter foster care due to neglect following parental substance use or the inability of their caregiver to cope, as well as physical abuse. Children within the foster care system have often experienced complex and chronic trauma leading to both physical and behavioral healthcare needs. However they and their families have strength and resilience which should be recognized and built upon. The primary goal for these children is reunification with their families followed by adoption or guardianship. Ensuring an empowerment-based, trauma-informed child and family focused model of care is needed to help with early intervention for children and youth in foster care.

Trauma Informed Care

All kids in the child welfare system have experienced some form of trauma. Not only have they experienced some form of trauma from the environment that precipitated them entering the system, their experience while interacting with the system is often traumatic in and of itself. There is an increasing awareness of the value of acknowledging trauma to achieve better life outcomes for children and youth in the system. Caregivers, physicians, teachers, etc., who understand the effects of trauma are better able to provide a healing environment to support each child in reaching their full developmental potential as adults.

Assessments

As children age, their strengths and needs change. Children in the foster system should be assessed routinely. Ideally, a Child Adolescent Needs and Strengths (CANS) assessment should be done every 6-12 months with a child’s family support team (FST) or with the youth and the people who are significant in their lives. Approximately 26,000 kids age out of foster care at 18 every year. 36% of those kids will experience homelessness by age 26.

Resources for Families

Foster families and kinship caregivers are the frontline caregivers of the child welfare system. Their actions are essential in helping kids heal and stabilize on their way to permanency and adulthood. Clinical providers can help them learn and apply new skills to their parenting and supplement their efforts to support the complex daily needs of the children they have taken into their homes. All children in foster care have Medicaid, which frequently comes with additional Care Management services to help kids and families navigate the complexities of the healthcare system and make referrals to resources for needs outside of healthcare.

We are a proud partner of the Nation Foster Parent Association, which provides extensive resources for families and amplifies the voice of foster families nationwide.

Behavioral Health Resources

Behavioral health issues are common with children in foster care often with trauma as and an underlying cause. In total, just under half of all children in foster care have a mental health diagnosis and are 4x more likely to use psychotropic medications than other children on Medicaid. Additionally, 20% of kids in foster care and 30% of foster alumni suffer from Post-Traumatic Stress Disorder (PTSD) compared to peers of the same age. Children in foster care are:

• 7X as likely to have depression
• 6X as likely to have behavioral problems/issues/conditions
• 5X as likely to have anxiety
• 3X as likely to have ADD/ADHD
• 2X as likely to have learning disabilities and developmental delays
• SAMHSA Report: Diagnoses and Health Care Utilization of Children Who Are in Foster Care and Covered by Medicaid

Treatment Modalities

Evidence-based, trauma-informed care that is team-based, highly-coordinated and well-monitored is essential to ensure the right care is delivered through the developmentally appropriate modality at the right time in the right location for the child.  

Collaboration and Partnership

Caring for children in foster is complex, and coordination is key. In addition to being placed with a foster family, these kids are surrounded by a number of adults, each with a unique viewpoint and role within the life of the child. From educators to child welfare workers, physical and behavioral health providers, placing agencies and biological family members are just some of people who need to work together to ensure the best possible outcomes for these kids.  Optum Health Education features a variety of trainings designed to deepen providers’ understanding of complexities these children face in the healthcare and child welfare systems. New trainings include: Understanding How Eating Disorders Impact Those in the Child Welfare System, and Understanding Human Trafficking in Children from the Child Welfare System. Additional trainings will be coming July 2023. 

70% of kids in the foster system have experienced at least two complex traumas

11.7% reported five or more traumatic events.

34% of foster parents are kinship families

45% kids are placed with nonrelative foster families.