foster care generally, care of children on a full-time, temporary basis by persons other than their own parents. Also known as boarding-home care, foster care is intended to offer a supportive family environment to children whose natural parents cannot raise them because of the parents' physical or mental illness, the child's behavioral difficulties, or problems within the family environment, e.g., child abuse , alcoholism , extreme poverty, or crime. Such children are usually wards of the state. They may be placed by a state-approved agency in group homes, institutions (such as residential treatment centers), or with families who receive some payment toward care. The child's parents may retain their parental rights, and the child may ultimately return home. Under permanent foster care the agency has guardianship; the child may then be available for adoption by the foster parents or others. Foster care can also provide a supervised setting for adults with mental or emotional disabilities who cannot care adequately for themselves. The concept of foster care has been extended in recent years to include care for elderly persons, on a fee basis, in the homes of people who are not family members.

Foster care

Definition

Foster care is full-time substitute care of children outside their own home by people other than their biological or adoptive parents or legal guardians.

Description

Children who are removed from their biological or adoptive parents, or other legal guardians, are placed in foster care in a variety of settings. They may be placed in the care of relatives other than the family members involved in the neglect or abuse (kin placement), non-relatives, therapeutic or treatment foster care, or in an institution or group home.

Children come to foster care for a number of reasons. In many cases, they have suffered physical or sexual abuse, or neglect at home, and are placed in a safe environment. A small percentage of children are in foster care because their parents feel unable to control them, and their behavior may have led to delinquency or fear of harm to others. Some children have been neglected by their parents or legal guardians, or have parents or legal guardians who are unable to take care of them because of substance abuse, incarceration, or mental health problems. These children are placed into custodial care while the parents or guardians receive treatment or counseling, or fulfill their sentences.

In all foster care cases, the child's biological or adoptive parents, or other legal guardians, temporarily give up legal custody of the child. (The guardian gives up custody, but not necessarily legal guardianship.) A child may be placed in foster care with the parents' consent. In a clear case of abuse or neglect, a court can order a child into foster care without the parents' or guardians' consent. Foster care does not necessarily mean care by strangers. If a government agency decides a child must be removed from the home, the child may be placed with relatives or with a family friend. Children may also be placed in a group home, where several foster children live together with a staff of caregivers. Therapeutic or treatment foster care can be in a group home or foster home with a specific structure and treatment focus. Foster homes are the most well-known option. The child temporarily becomes a part of another family, either with other foster children, the family's biological or adoptive children, or alone. State or county social service agencies oversee foster care decisions, although they may also work with private foundations.

Foster parents must be licensed by the agency that handles a specific region's foster care. The foster home must pass an inspection for health and safety and, in most states, the parents must attend training sessions covering issues of x how to deal with problems. When a child is placed, the foster family takes responsibility for feeding and clothing the child, getting the child to school and to appointments, and doing any of the usual things a child's parents or legal guardians might be called to do. The foster parents might also need to meet with the foster child's therapist and will meet regularly with the child's caseworker as well. The foster parent aims to help the foster child develop normally in a safe, family environment.

Foster parents usually receive money for taking in foster children. They are expected to use the money to buy the child's food, clothing, school supplies, and other incidentals. Most of the foster parent's responsibilities toward the foster child are clearly defined in a legal contract. Foster parents do not become the guardians of foster children; legal guardianship remains with the state agency.

Foster placements may last for a single day or several weeks; some continue for years. If the parents give up their rights permanently, or their rights to their child are severed by the court, the foster family may adopt the foster child or the child may be placed for adoption by strangers. Foster parenting is meant to be an in-between stage, while a permanent placement for the child is settled. As such, it is stressful and uncertain, but for many families very necessary.

Federal money supports most foster care programs, and federal law governs foster care policy. The Adoption Assistance and Child Welfare Reform Act of 1980 emphasizes two aims of foster care. One is to preserve the child's family, if at all possible. Children are placed in foster care only after other options have failed, and social service agencies work with the family to resolve its problems so that children can return to their homes. The second aim of the Child Welfare Reform Act is to support the so-called "permanency planning." This means that if a child must be removed from the home, the social service agency handling the case can decide quickly whether or not the child will ever be returned. If it seems likely that parents will not be able to care for their children again, their parental rights may be terminated so that the child is free to be adopted. This policy is articulated in this law in order to prevent children from living too long in an unstable and uncertain situation.

The goal of foster care is the care of the child within the child welfare system, but also is to place all appropriate and available services at the disposal of the parents so that they can create a safe, fit home environment for their children when they are reunited. Children in the child welfare system are also overseen by a multitude of agencies. The caseworker from the state or county social services agency oversees the child's placement and makes regular reports to the court. Others involved in the child's case are private service providers (including foster homes and group homes), welfare agencies, mental health counselors, substance abuse treatment centers (for the child or the parent), and Medicaid (federal medical insurance for seniors and children at risk).

Demographics

In 1980, about 300,000 children in the United States spent some time in foster care placement. By 2001, there were nearly 800,000 children in foster care, with 540,000 children in the system at any given time. The majority of these children were the victims of abuse. The emergence of widespread homelessness, substance abuse (especially crack and methamphetamines), unemployment, increased incarceration rates, street violence, and HIV/AIDS have all impacted poor communities. Children from families with multiple problems flooded the child welfare system. Young children with physical handicaps, mental delays or mental illness, and complex medical conditions have become the fastest-growing foster care population.

The foster care population is quite young. About one-fourth of all children entering foster care for the first time are infants. Sixty percent of foster children are under four years old. Teenagers comprise one-third of the foster care population. Minority children comprise most of the foster care population, with the largest groups being African American and American Indian children.

Poor children are more likely to be in foster care than middle-class children because their families have fewer resources. Illness or loss of a job may be devastating to a poor family with no savings and no relatives who can afford to assist them. These children are also more likely to stay in foster care longer or to have been in foster care since infancy. Also, children of alcoholics or drug abusers are at high risk for neglect or abuse, and comprise 75 percent of all placements.

More than half (57 percent) of all children in foster care are returned to their original homes; however, reunification rates have declined in the 1990s and early twenty-first century. Children also spend more time in the system. The average length of stay for a child in foster care is 33 months. However, some spend a very short time in a foster home, and others are there for their entire childhoods, "aging out" at 18 when they become legal adults.

Instead of reunification, more children are being adopted from foster care. Most states doubled, and some tripled, the number of foster care adoptions since 1997. This steady increase is a response to the Adoption and Safe Families Act (ASFA) of 1997 that recommends termination of parental rights and encourages adoption if a child has been in foster care for 15 out of the previous 22 months. This can be waived by the court if the parents are making substantive progress or the caseworker believes that legal guardianship, but not adoption, is in the child's best interests.

Half of all children in foster care live with nonrelative foster caregivers; about one-fourth live with relatives, and this number is growing. ASFA also recognized kinship caregivers as legitimate placements. It was customary for many poor families to take in a child informally when the child's parents or legal guardians were incarcerated, in treatment, or had died, but ASFA allowed relatives to take care of a child legally and receive financial help, and also opened the doors to a number of agencies and services the relatives could not afford.

Common problems

In most cases, children placed in foster care have been subjected to some form of abuse or neglect, and being removed from familiar surroundings is, in itself, usually highly traumatic. Children in foster care may have nightmares , problems sleeping or eating, and may be depressed, angry, and confused. Many young children in foster care are unable to understand why they have been taken from their parents. Even if a child is in some sense relieved to be out of a home that was dangerous, the child may still miss the parents or legal guardians, and may imagine that there is something he or she must do to get back to them. There is evidence that children from abusive and neglectful homes start to feel better in foster care; however, separation is almost always difficult for children, regardless of the circumstances.

Half of all foster children spend as much as two years in foster care and are moved from placement to placement at least three times. This leads not only to uncertainty and lack of stability in the child's life, but some of these placements may be inappropriate for the child's specific circumstances. This often is due to the lack of qualified, licensed foster caregivers, but it can also occur as a result of inexperienced or overloaded caseworkers trying to get through their caseloads.

Foster care can be difficult for foster parents as well. A child who has been neglected or abused suffers psychological damage that may make him or her withdrawn, immature, aggressive, or otherwise difficult to reach. Children with severe medical and mental problems can tax caregivers. Foster placements sometimes fail because these surrogate parents simply cannot handle the demands of a troubled foster child.

Unfortunately, the number of foster caregivers has been declining since the mid-1980s as the demand for placements has increased. States have responded by licensing responsible adults who were not married (even divorced men and women) and reaching out to seniors and children's relatives. In some areas, single mothers make up a large proportion of foster parents.

In 2002, about 405,000 children were placed in court-appointed kinship care. Caseworkers placed almost 140,000 more in the care of relatives, without court intervention. Many of these kinship caregivers are grandparents or elderly aunts and uncles. Kinship caregivers offer family support and stability, and more frequent contact with parents or legal guardians, and siblings. They also are more apt to get children to talk to them about their problems, and the presence of relatives can help ease the trauma of separation from parents.

Nevertheless, kinship caregivers, especially grandparents, face a number of challenges. Most of the formal and informal kinship caregivers experience economic hardship as they take in one or more of their relative's children. Nearly two-thirds of these placements are with financially strapped families who may not have essentials such as a car seat, crib, or toys . They also may not have adequate medical insurance; however, Medicaid often will cover the foster child in a formal kinship arrangement. Grandparents may not know how to raise a child in today's world, with the amount of freedoms or lack of them that children experience today. They may not be able to help their foster children with homework. Many social service agencies offer counseling, homework help, and even home tutoring for both the child and caregiver.

One other problem inherent in the child welfare system is the teenager who "ages out," or turns 18 and moves out of foster care to live independently. Many teenagers mark time within the system, without adequate preparation for the transition to adulthood. Less than one-fourth of social service agencies provide employment services for teenagers. Only 17 percent provide employment and career assessments, and 16 percent provide job-training. One-fourth offer vocational training. Without help, these teenagers often never go on to college, do not find good jobs if they find jobs at all, and become prey to bad influences on the street. If they have children of their own, these offspring fall back into the child welfare system just as they did. Adequate training, counseling, and preparation can break this cycle.

In addition, children in all types of foster care face more challenges financially, emotionally, and developmentally. A study by the Child Welfare League of America in 2004 showed that children in foster care experienced more health and developmental problems than children who had similar economic circumstances but lived with their parents or legal guardians. Foster children also have more neglect, abuse, family dysfunction, poverty, and emotional problems. This may be a direct result of the reasons for their initial placement, but these conditions continue throughout foster care. Another reason for these results may be that foster children are given more frequent and thorough medical and psychological care than their counterparts.

Parental concerns

Other foster care placements are made by families who cannot afford medical or psychological services for their children. These children may have multiple disabilities or severe social or mental disorders that have depleted the family's financial and emotional resources. Convinced by social workers that this option is the only one available to them, they give up their parental rights in order to get their children into proper treatment. According to the U.S General Accounting Office, 12,700 children were placed into the child welfare system or the juvenile justice system to receive mental health services in 2001. Despite the noble reasons for placing these children in foster care, the parents' names are placed on state registries as child abusers, and they have to petition the court and prove their fitness to get their children returned to their homes.

KEY TERMS

Adoption —The legal process that creates a parent and child relationship between two individuals who are not biologically related at birth.

Age out —Become a legal adult at age 18 and move out of foster care.

Medicaid —A program jointly funded by state and federal governments that reimburses hospitals and physicians for the care of individuals who cannot pay for their own medical expenses. These individuals may be in low-income households or may have chronic disabilities.

See also Child abuse.

Resources

BOOKS

Davies, Nancy Millichap. Foster Care. NY: Franklin Watts, 1994.

PERIODICALS

Bass, Sandra, et al. "Children, Families, and Foster Care: Analysis and Recommendations." The Future of Children. 14, no. 1 (Winter 2004): 4–30.

Hansen, Robin L., et al. "Comparing the Health Status of Low-Income Children in and out of Foster Care." Child Welfare 83, no. 4 (July-August 2004): 367–81.

The David and Lucile Packard Foundation. "Children, Families, and Foster Care: Analysis." (Executive Summary) The Future of Children 14, no. 1 (Winter 2004): S1.

ORGANIZATIONS

Foster Care Children. 507 North Sullivan Road Suite A-6. Spokane Valley, WA 99037. (509) 924-3175. Web site: <www.fostercarechildren.com>.

WEB SITES

Pew Commission on Children in Foster Care. Available online at: <http://pewfostercare.org>.

Janie Franz A. Woodward

community care An imprecise and much abused concept embracing a diverse set of policies for dependent persons—particularly those chronically dependent by virtue of age, mental illness, or mental or physical handicap—which involve, in some way or another, looking after them in the community. In its most general sense, the community is here merely negatively defined as ‘not the institution’; that is, not the large-scale, long-stay institution, such as the asylum or workhouse. Inherent in the concept is, therefore, a contrast between old institutional policies that encouraged the separation of people from the community (ordinary everyday life), and new policies according to which individuals are cared for and integrated into community life as far as possible. This basic opposition is associated with contrasting stereotypes: the vast, impersonal, isolated, impoverishing, harsh, and bureaucratic institution, on the one hand, and on the other the friendly, supportive, enriching, and caring (with its connotations of love) community. It is this contrasting imagery that gives the notion of community care such strong symbolic power, accounts for the ready acceptance of policies put forward in its name, and (regrettably) distracts attention from any precise examination of the care, if any, that is provided.

The actual character of community-care provisions varies enormously and changes over time. Only detailed knowledge of service arrangements and policies allows us to determine their exact nature. In its early usage in the 1930s, community care referred to the boarding out (fostering) of those identified as mentally subnormal. Here and elsewhere the model was of publicly funded and administered alternatives to institutional care. After the Second World War, when community care became a very widely accepted policy objective, it still referred to publicly provided services, including ‘half-way’ houses and small residential units for the chronically dependent, or units in general hospitals for those with acute problems. Not surprisingly, the main obstacle to policy implementation was the capital investment required, in a context of low capital expenditure on state welfare services; studies showed that in Britain the implementation of community-care policies was slow.

In the United States community care spread more rapidly. Although some new state-funded services were established, such as Community Mental Health Centres (which in practice primarily dealt with acute problems), many people with chronic problems were discharged into private facilities such as nursing homes and boarding houses. The introduction of community care consequently went hand in hand with the privatization of care—a trend exacerbated in the 1970s by the cutbacks in federal support for facilities like CMHCs.

A similar pattern emerged in Britain from the mid-1970s, prompted by the state's fiscal crisis, and compounded by public expenditure cuts. Community care increasingly meant private care, whether provided by commercial or charitable groups, or family and friends—a transformation which ensured that public expenditure pressures accelerated rather than curtailed policy implementation. It also ensured that, with the run-down in public services, many individuals faced neglect and marginalization (rather than enjoying care and support) in the community, or else experienced a process of ‘trans-institutionalization’, discharged from one (large-scale) institution only to end up in another—albeit smaller. The marked failures of community care in Europe and the United States, as well as its somewhat limited successes, are now well documented.