Young adults aging out of the foster care system have received a good deal of attention over the years from policymakers, child welfare practitioners and researcher. In the last two decades, three major federal policies have been enacted to address the needs of older youth transitioning out of foster care by mandating independent living services and expanding funding to states that extend foster care past age 18 (Rosenberg & Abbott, 2019). Despite these efforts, youth aging out of the foster care system continue to have well-documented challenges when transitioning to adulthood.

In this article, we assess the outcomes of emancipated youth after the initiation of an extended after care program that allows young adults to access an array of financial and support services without remaining in the foster care system. We compare these results with the outcomes drawn from a prior study conducted twenty years earlier. In 2001, former foster care youth from Clark County Nevada, in the Las Vegas Valley, were interviewed about their experiences (Reilly, 2003). Although youth reported exposure to independent living training, while in care, few reported concrete assistance. Multiple placements while in care and less education correlated with more difficult post-discharge functioning. Training, services, positive support networks and job experience were associated with more positive adjustments.

Since this study, Clark County has enacted several important programs aimed at preparing and supporting former foster care youth including a Voluntary Jurisdiction and Step-Up programs. Under these programs, youth receive their former foster care payment until the age of 21 and are entitled to other supportive assistance such as housing assistance, transportation, stipends, and case management services. Approximately 96% of former foster care youth participate in these programs (A. Barrett, Personal Communication, March 8, 2022).

Using the same 2001 survey instrument, youth participating in the Voluntary Jurisdiction and Step-Up programs in 2021 were interviewed to understand their experiences and to compare outcomes to the previous study. The goal of this research is to add to the growing academic literature on former foster care youth and evaluate the effectiveness of new programs that provide financial, supportive, and case management services. Clark County provides an interesting case study as it conducted a foster care outcome study twenty years before these important services and financial assistance were made available to foster care youth exiting the system. This will serve as a point of comparison, and it can help highlight differing participant outcomes from before and after the program was implemented.

Literature Review

In 2020, the number of youths who were emancipated from the foster care system in the U.S. surpassed 20,000 (The AFCARS Report, 2021). Hampered by experiencing multiple placements (Lockwood et al., 2015; Stott, 2011), trauma (Dorsey et al., 2012), and a lack of emotional and financial support, emancipated youth face difficulty navigating various aspects of their adult life (Courtney et al., 2011, 2020; Fernandes, 2019a). Transitioning into emerging adulthood is a complex and gradual process during which young adults grapple with achieving financial and psychological autonomy (Arnett, 2007; Furstenberg et al., 2005). The U.S. Congress enacted the Independent Living Initiative to mitigate the adversities endured by emancipated youth (usually 18) and expanded its funding under the John H. Chafee Foster Care Independence Act of 1999.

Yet, emancipated youth still need more assistance beyond the age of 18 years old to reach self-sufficiency (Courtney et al., 2011, 2020). At that age, the adolescent brain shows signs of vulnerability, and recent research revealed the brain does not reach its maturation until the early twenties (The Teen Brain, 2011). Armed with data showing continued poor outcomes for many former foster care youth, Congress passed additional federal legislation, the Fostering Connections to Success and Increasing Adoptions Act of 2008 (P.L. 110-351), which provided federal reimbursements to the states for extending care until the age of 21. Additionally, the Family First Prevention Services Act (FFPSA) of 2018 gave states the discretion to extend foster care services for youth until they reach 23 years old while receiving matching federal reimbursement for the cost of care (National Conference of States Legislatures, 2020). The legislation also gives incentives to reduce the amount of youth placed in group homes in addition to availing funds for preventive measures. According to the Government Accountability Office (2019) there are 26 States with specific legislations regarding an extended foster care option until 21 years old. From 2019, Arizona and Nevada have approved bills on this issue, increasing the number of States with specific legislations to 28 (Nevada Legislature, 2021a, 2021b; Arizona Legislature, 2021a, 2021b).

Under this legislative framework, emancipated youth qualify for mandatory Medicaid coverage, job training under Job Corps and Youth Training, federal financial aid for higher education, and housing vouchers for up to three years for the homeless (Fernandes, 2019b). Most recently, Congress passed the Consolidated Appropriations Act of 2021 to include provisions to expand the funds available to the Chafee program. In addition, the federal funding participation rate increased to 100% for some foster care programs and finally temporarily extended some services to youth until the age of 26 (Summary of Child Welfare Provisions, 2021).

To track the outcomes of youth transition out of care, the Administration for Children and Families (ACF) established the National Youth in Transition Database (NYTD) (About NYTD, n.d.). NYTD functions as a monitoring network to assess state operations of programs and services provided to youth transitioning out of care. As required by the law, the U.S. Department of Health and Human Services (HHS) reports the experiences of youth who left the care at the age of 17 and age of 19 and 21 (National Youth in Transition Database, 2020). Based on the surveys conducted in 2014, 2016, and 2018, youth who exit care at age 17 or 18 had complex needs and would benefit from extra support. Noticeably, youth who extended their stay in the foster care system to 19 or 21 years old had better outcomes. They reported higher educational outcomes, with the majority of the youth receiving their GED. The data also showed that youth who spent less time in foster care with fewer placements had more employment-related skills at age 18 and 21. Furthermore, the number of placements and their type is correlated with youth experiencing homelessness and incarceration. Youth who reported fewer placements and were placed with foster families had experience at age 18 and 21 of being homeless or being incarcerated in the last two years. NYTD acknowledges the limitations of the data in their reports such as small samples and low survey responses. It also recognizes that it is premature to establish reliable benchmarks with the data available.

With the resources available for youth under various federal legislative frameworks, the research still paints a challenging picture of youth who have aged out of foster care. Studies have shown that youth post-discharge have resulted in a myriad of negative outcomes including the ability to obtain adequate housing, maintaining employment, poor educational attainment, involvement with the criminal justice system, homelessness and unplanned parenthood (Courtney et al., 2005, 2007, 2010, 2011; Courtney & Dworsky, 2006; Dworsky et al., 2013; Fowler et al., 2017; Goerge et al., 2002; Lockwood et al., 2015; NYTD, 2020; Reilly, 2003). Emancipated youth also reported struggling with mental health issues spanning depression, Post-traumatic Stress Disorder, and alcohol abuse (Courtney & Dworsky, 2006; Courtney et al., 2011).

While research shows that youth who are not forced out and voluntary extend their care beyond their 18th birthday fare considerably better with respect to various outcomes such as educational attainment, employment, housing stability, less criminal involvement and income security (Courtney & Dworsky, 2006; Courtney & Hood, 2017; Courtney et al., 2018; Dworsky et al., 2013; Okpych & Courtney, 2020; Rosenberg & Abbott, 2019); a sizeable number of youth opt not to stay citing frustration with the system (McCoy, McMillen & Spitznagel, 2008). The available evidence from the Midwest and CalYOUTH studies suggests that most youth in care who approach their 18th birthday will remain in care well past their 18th birthday, provided the state in which they reside allows them to remain and if the state policy in place helps meet their basic needs and provides helpful services (Courtney, 2015; Courtney et al., 2005, 2011, 2017, 2021).

However, the option to remain in care is underutilized. While many states offer some version of extended foster care, utilization among youth beyond their 18th birthday remains low across the U.S. (Rosenberg & Abbott, 2019). Even when foster care youth have the option to remain in care past their 18th birthday, many opt to leave because they are not receiving the type of preparation and services needed to assist them beyond foster care.

The Step-Up Program

Clark County, Nevada has taken a different approach to support youth who “age out” of foster care. Aiming to assist emancipated youth to reach self-sufficiency, Clark County forged a “Step Up” program. Under Step Up, the state delivers many forms of financial assistance that cater to the various needs of youth at that age. Services include housing assistance, educational assistance, employment assistance, transportation, resources, and case management (Step Up, n.d.). Moreover, the hallmark of the Clark County approach is the youth's ability to receive services, including direct monthly payment, while not being in a supervised living setting. The Step-Up program provides financial assistance under two principal programs: Voluntary Court Jurisdiction (VOL JUR) and Funds to Assist Former Foster Youth (FAFFY).

As long as youth enter into a voluntary agreement to remain under the supervision of the court, they will be eligible to receive services and direct payment from the child welfare agency. Notably, youth are no longer under the legal guardianship of the welfare agency. Another safeguard to aid youth reach self-sufficiency is the Independent Living Transitional Plan. The court and youth put forth a plan for the transition process into independent living (Protection of Children from Abuse & Neglect, 2017a, 2017b). This plan may include numerous goals such as saving three months’ worth of expenses, obtaining a high school diploma or GED, planning for postsecondary education, retaining employment for at least 80 h a month, maintaining stable housing, finding mentors, connecting to relevant services, and addressing mental health or developmental delays. Furthermore, youth have the right to ask for court termination at any time, and at the moment the FAFFY program comes in. For FAFFY, Nevada Revised Statute (NRS) 342 instated a framework to financially aid former foster care youth who are not under the voluntary supervision of the court (Extended Foster Care in Nevada, n.d.). Youth between the ages of 17 and 21 would receive services and payments from welfare agencies. The difference is that monthly payments are paid directly to landlords while youth only receive the remaining amounts. This program also offers other invaluable services such as housing, educational aid, health insurance, job training, and mental health services. However, a major limiting factor of these programs is the inability to access any federal matching funds. These programs are 100% funded by Clark County and the state of Nevada.

Nationally, few state initiatives deviated from the pathway the federal government drew for extending care. States that extend care beyond the age of 18 acquire matching federal funds for the amount states spend. Choosing not to follow the eligibility criteria for Title IV-E for extended foster care results in states providing 100% of the extended care spending budget (Extended Foster Care in Nevada, n.d.). That is the case for the Step-Up program that does not conform to the federal eligibility criteria. Another notable example is the Universal Basic Income program for former youth Santa Clara County in California initiated. In June 2020, the Board of supervisors allocated funds to provide an amount of $1000 to a number of 72 former foster care youth in a pilot program first in the nation (County of Santa Clara, 2021). The program lasted for 12 months and in June 2021 was renewed for another six months. The County is still assessing the success of the program but reported many improvements in youth who participated in the program. Additionally, the success of the Santa Clara program pushed for a state-wide initiative. In July 2021, California Senate allocated an amount of $35 million for a non-string attached monthly payment for former foster care (Amon, 2021). Even though these programs are a novel phenomenon and limited in their impact, studying them can make a strong case for amending the way extending care is provided to older foster youth.

This comparative study complements the existing literature on emancipated youth outcomes in Clark County, Nevada. It assesses the current outcomes of the emancipated youth after the initiation of the Step-Up program and compares the results with the outcomes drawn from a prior study conducted in 2001. Evaluating the emancipated youth transition outcomes assesses how effective enacted policies are in smoothing youth emancipation. The study also focuses on quantifying the youth experience in the following areas: employment stability, education attainment, stable housing, health care, safety, legal involvement, community integration, support systems, overall adjustment, and indicators of difficulties and successes.

Methods

Procedures

Twenty years later, in 2021, this study was replicated using the same survey instrument and inclusion criteria. This criterion included youth who had been out of foster care for at least 6 months and are part of the Clark County Voluntary Jurisdiction / Step-Up program. Two-hundred and forty-one (241) individuals were part of the Clark County Voluntary Jurisdiction / Step-Up program at the time of the study, 114 were interviewed resulting in a 47% response rate.

Clark County gave email and cell phone contact information for all participants of both programs. Interviews were conducted by a certified team of graduate students between June 2021 through November 2021. Students were given the option to interview via Zoom, telephone calls or in-person. The majority (80%) participated by phone. Nobody was interviewed in-person, and no participants chose to have their interview in Spanish.

On average, interviews lasted between 45 and 60 min after receiving informed consent from each youth. Stipends began at $50. In August 2021, the Institutional Review Board (IRB) protocol was modified to increase participant stipends to $75 to increase the response rate. Clark County also sent two reminder emails to increase response rates.

Measures

As previously noted, the same survey instrument used in the 2001 study (Reilly, 2003) was used in this current study, with slight modifications in collecting broader information for gender identification and separating out racial and ethnic identities.

Demographics Information, Living Arrangements, Education and Employment

Interviewers obtained standard demographic information (age, race or ethnicity, gender, income, education, employments status, and financial health).

Health and Substance Use

Questions include gathering information on the young adult’s current health, serious illnesses, access to health care as well as alcohol, ingested or inhaled recreational drugs, or intravenous drug use in the last 30 days as well as in care.

Support Systems

Questions were adapted from Courtney and Piliavin’s (1998) study about current contacts, how close participants were to various individuals, dating relationships, children, sexual activity, violence in dating relationships, and perceived social support.

Foster Care Experiences and Legal Issues

Open-ended questions adapted from Cook’s (1991) and Courney & Piliavin’s (1998) studies regarding participants’ foster care experiences, including preparation (formal and informal instruction) and concrete assistance to prepare them for living on their own and with the quality of their foster care experience. Interviewers also asked respondents a series of questions about any involvement with the law or illegal activity since leaving care.

Positive Values and Thriving Indicators

Positive values and thriving indicators consisted of a series of positively worded statements (adapted from the Search Institute’s, 1996, Profiles of Student Life: Attitudes and Behaviors).

Personal Adjustment

The study used the Rosenberg Self-Esteem Scale (Rosenberg, 1965) to measure self-perceptions. The scale is from 1 (strongly agree) to 5 (strongly disagree). After the results were reverse coded, the researcher compiled each metric into a composite measure. General mental health was measured with a. shorten version of the Mental Health Inventory (MHI-5). The MHI-5 is a screening test to detect a number of disorders, including general depression, affective disorders, and anxiety disorders. Finally, the study used by Diener’s (1980) Satisfaction with Life Scale was used to rate respondent’s satisfaction with life.

Our Approach

The main approach of this research was to compare the profiles of those who underwent the process of transition from foster care in the sample of 2001 with the results of the sample collected during 2021. When it was possible, we provide a direct comparison between both samples. However, since some information was collected in a different way, some adjustments are presented to ensure some degree of comparability.

Data from the 114 surveys of former foster youth were cleaned and analyzed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. Survey items that were part of a previously published scale underwent scale construction. Descriptive statistics were calculated and reported. Four scales (Rosenburg Self-Esteem, Mental Health Inventory (MHI), Deiner Life Satisfaction, and Social Network) were tested for correlations with demographic and experience variables (educational attainment, number of placements, time in care, number of services received before leaving foster care). Spearman’s Rho was employed to test for correlations between the four scales and the four demographic variables; while t-tests were employed to test for mean differences between if youths were employed or in school full-time compared to youths who were not in school or employed full-time.

Results

Demographic Information

The participants in 2001 (n = 100) presented the following characteristics: female 55%, white 46%, never married 79%. Participants’ ages ranged from 18 through 25, with an average of 20.2 years. The mean entry into foster care was 9.3 years. Seventy-five percent of youth had four or more placements while in care. In 2021 survey (n = 114), participants were: female 50%, African American 43%, never married 99%. Participants’ ages also ranged from 18 through 25 with an average of 19.4 years and the mean age of entry into foster was 12.4. Thirty-two percent have four or more placements while in care. For a straight comparison, the questions regarding gender were updated to cover broader definitions of gender identification. The 2021 interview included other gender identity categories such as Transgender and other gender identity not listed. Regarding the race/ethnicity question, race and ethnicity were separated out in 2021. In that context, prior to ethnic identification, the sample of 2021 reported thirty-four of youth that defined themselves as having Hispanic/Latino/Spanish origin and sixty-one percent did not (Table 1).

Table 1 Youth demographic factors
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Services

In 2021, the number of youth who had exposure to independent living training during their time in care was lower than the 2001 cohort. For example, in 2001, 73% of respondents said they received job-seeking services, compared to 39% in 2021. However, there was a dramatic increase in the percentage of youth that received concrete assistance while in care. In the 2001 study, only 30% of youth said they received assistance with health insurance compared to 100% in 2021. In 2001, 69% of respondents reported having a place to live at discharge compared to 86% in 2021. Participants also were far more likely to have a portfolio of important papers (77% compared to 38% in 2001). Youth contact with their caseworker increased significantly in 2021. During youths’ last year of foster care, 58% of youth in 2021 reported 10 or more visits compared to 20% in 2001. Young adults in the 2021 study were more likely to be satisfied with the services they received to prepare them to live on their own, 27% compared to 53% in 2001 (Table 2).

Table 2 Trainings and interactions that participants received in care
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Outcomes

Education

Before leaving foster care, 52% of respondents had finished high school or their GED in 2021 compared to 50% in 2001. At the time of the interview in 2021, these numbers shifted towards higher educational attainment as the number of youths who had not completed some high school fell to 27%, with 24% completed some college. Forty-one percent of youth were still in school, compared to the 69% in the same situation on 2001 sample.

Legal Issues

There was a significant decline in the number of young adults involved in the criminal justice system in 2021. In the 2001 sample, almost half of the participants reported having trouble with the law, 41% spent time in jail and 7% were incarcerated. In the 2021 cohort, only 18% of youth reported criminal involvement, 11% spent time in jail, and no youth were incarcerated. There was also a reduction in the number of youth that had dealt drugs or had sexual intercourse in exchange for goods and services.

Living Arrangements

Of the youth surveyed in 2021, 51% said they were living in an apartment building and 34% in a single-family home, followed by other at 11% and mobile home 2%. No youth said they were presently homeless, incarcerated, or institutionalized. Eighty-two percent of youth said they are extremely or somewhat satisfied with their living situation, 10% neither satisfied nor dissatisfied, and 8% somewhat or extremely dissatisfied.

In 2021, 18% of young adults lived in five or more places since leaving foster care. This was a 20% decrease then what was reported in 2001. Since leaving foster care, 27% of respondents said they did not have a place to live which was 9% lower than in 2001. None of the young adults were currently homeless in 2021; however, 27% reported at least one instance of having nowhere to live since leaving foster care. This was less than the 2001 cohort.

The 2021 cohort appears to be more financially solvent than youths in the 2001 study as there are fewer individuals with not close to enough money at the end of the month and more with a little, and just about enough. Regarding the income dimension, 13% of the 2021 respondents preferred to not disclose their income. Then, the percentages should be interpreted in terms of relative proportion to income distribution. In relative terms, the respondents of 2021 are performing better than the 2001 cohort. Accordingly, the average hourly hour in 2021 was 12.51, compared to the USD 7.25 in 2001 (10.8 USD adjusted to 2021 dollars).

Health Care

Young adults in 2021, reported better health care outcomes. Most notably, 100% of youth had medical insurance, compared to 36% in 2001. Sixty-five percent of young adults reported their health as very good or excellent compared to 54% in 2001 and 15% reported a serious health problem compared to 30% in 2001. Eighteen percent of respondents had a child or were currently pregnant in 2021, substantially lower than the 2001 study (38%).

Employment

The comparison of outcomes for employment data, shows the same distribution in 2001 and 2021 samples. Sixty-three percent of the respondents had a job, and 37% were unemployed at the moment of the interview. Regarding their job experience, 25% of respondents reported having at least one terminated employment relationship once they left the foster care, compared to 55% in 2001 (Table 3).

Table 3 Participant outcomes in 2001 and 2021
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Correlations

Positive and Negative Correlations in the 2021 Study

In 2001, although youth reported exposure to independent living training, while in care, few reported concrete assistance. Multiple placements while in care and less education correlated with more difficult post-discharge functioning. Training, services, positive support networks, and job experience were associated with more positive adjustments.

A key narrative that comes from the 2021 study is the importance of services before leaving foster care. Total services received have a larger positive association with mental health than educational attainment. The level of education and total services received before leaving foster care have a low to moderate positive association with youth’s self-reported life satisfaction (rho = 0.323, p < 0.001, and rho = 0.247, p < 0.05).

Total services are positively associated with social network size, indicating that additional services at the end of foster care may help build the networks that youths need after they leave foster care (rho = 0.249, p < 0.05) and could also be a positive factor in their mental health and self-esteem. Total placements had a negative association with social networks (rho = -0.255, p < 0.05).

There is a negative correlation between total placements and total services received (rho = -0.196, p < 0.06). This may indicate that individuals who have more placements may actually receive fewer services, which can put them at an even greater disadvantage when they leave foster care because they have not built the social networks that can sustain their life satisfaction (and other metrics listed in the results above).

There is a strong correlation between time in care and number of placements, (rho = 0.629, p < 0.05). This may indicate that individuals who stay in the foster care system longer tend to bounce around instead of remaining in one place while they await adoption or timing out of the system (which may also lead to fewer services provided, smaller networks, and less life satisfaction) (Tables 4, 5).

Table 4 2001 Positive experiences
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Table 5 2021 Positive experiences
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In addition, there is a statistically significant difference in mental health between youths who are employed or in school full-time and those who are unemployed or not in school. Although not statistically significant at the 95% confidence interval, Life Satisfaction is significant at the 94% confidence interval (Tables 6, 7).

Table 6 2001 Negative experiences
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Table 7 2021 Negative experiences
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Comparing the 2001 and 2021 Cohorts

Similar to the 2001 study, the 2021 study shows that areas of training and services before leaving foster care play a large role in overall satisfaction with life. The 2021 study also shows that a youth’s level of education has a positive effect on their life satisfaction (more youths had higher educational attainment in the 2021 study compared to the 2001 study). Social support networks are also positively correlated with training in the 2021 study.

In the 2001 study, the number of placements was negatively correlated with violence in their dating relationships, trouble with the law, time in jail, being homeless at any time after leaving foster care, and the number of times that youth had caused someone to be pregnant. There were much lower incidences of these factors in the 2021 study compared to the 2001 study, which may be one reason why these correlations did not yield statistical significance in the 2021 study (low statistical power).

Discussion

Overall, young adults in the 2021 study fared significantly better than their 2001 counterparts. Youths in the 2021 study had increased positive health outcomes, were more financially secure, had a notable decline in involvement with law enforcement, were engaged in less illegal activity, had better educational outcomes, fewer job terminations, were experiencing less homelessness, were less likely to be married, and had fewer pregnancies and children than youth in the 2001 study. Youth foster care experiences also differed in important ways. The youth in the 2021 study had fewer foster care placements, increased visits with their caseworkers during the last year before they exited, were older when they entered out of home care, received significantly more concrete services, and were more satisfied with their time in care than youth interviewed in 2001. Undoubtedly, these more positive experiences for youth in the 2021 study impacted their outcomes in a dramatic fashion.

However, surprisingly, young adults in 2021 reported receiving a good deal less independent living training while in foster care to prepare them to live on their own. Independent living training is essential for this population and has been associated with more positive adjustments (Brandford & English, 2002; Mares, 2010; Reilly, 2003). It was reported by Clark County that the COVID epidemic had adversely impacted participation rates of foster care youth in independent living skills training. In 2019, 40% of eligible youth participated in formal training. This percentage dropped to 25% in both 2020 and 2021. According to Clark County officials, the last couple of years have been difficult because everything has had to be online. Young adults in these programs have been transparent that after receiving online schooling, they were not willing to participate in additional online encounters, such as the independent living skill training (J. Tudor, Personal Communication, February 9, 2022).

Although youth in 2021 had some increase in educational attainment, high school graduation/GED rates remain disturbingly low. The educational needs among foster care youth are well recognized; however, efforts to promote academic success have been lacking (Smithgall et al., 2004). In 2021, close to half of all youth still left foster care without a high school degree or GED. Increased education attainment was positively associated with self-reported life satisfaction and improved mental health for youth exiting in the 2021 study. There clearly remains a need to forge closer connections between schools and child welfare agencies to monitor and enhance the educational progress of this population (Best et al., 2009; Courtney et al., 2011; Pecora, 2012).

While none of the youth in the 2021 study were currently homeless at the time of the interview, 27% reported at least one instance of having nowhere to live since leaving care. While less than the 2001 cohort (36%), this is a concerning number of youth facing instability in their living arrangements. Homelessness continues to be a pervasive problem among young adults existing foster care (Berzon, Rhodes & Curtis, 2011; Bender et al., 2015; Okpych & Courtney, 2014). Dworsky and Courtney (2009) in their seminal study on the occurrence and predictors of homelessness among foster care youth found youth who had close trust with at least one family member or perceived more social support increased their odds of avoiding homelessness.

In both studies, the longer a youth was in out-of-home care and had multiple placements while in foster care were linked to several negative circumstances. Reducing the time youth are without a permanent placement and minimizing the number of movements for foster care youth remain the most important negative factors impacting foster care populations (Rubin et al., 2007; Taber & Proch, 1987).

The provision of concrete services to foster care youth timing out of the foster care system were correlated with better outcomes including stronger social networks, self-reported life satisfaction, and more positive mental health outcomes. In both cohorts training and services before leaving foster care played a large role in overall satisfaction with life. Extending the time youth can remain in foster care past their 18th birthday is one of the most positive steps federal and state legislators have taken over the past twenty years. Young adults who remain in care past their 18th birthday do better. Research from Midwest and CalYOUTH studies demonstrate that states can offer extended care services where youth will choose to voluntarily stay (see Courtney, 2015). But, the reality is that utilization is low across the country (Rosenberg & Abbott, 2019). A significant number of states force youth to leave after their 18th birthday and a sizeable number of youth who can remain opt to leave citing frustration with the system or a feeling the child welfare system is not providing them the type of services needed for their transition. The foster care experiences are not positive experiences for a sizeable portion of foster care children and youth.

Implications

Alternative programs such as the Step-Up model that is offered in Clark County, Nevada can be key to more positive outcomes for youth who are exiting foster care. This program provides direct financial assistance (the equivalent of the payment provided to foster parents), health care coverage and access to case management and support services to the foster care youth up until the age of 21. Most importantly, the youth can access these vital services without remaining in foster care system and has the potential to reach a significantly larger portion of youth leaving the foster care system. In the Clark County program, practically every eligible youth participated in the program beyond their18th birthday. Given the reality that many young people will choose to not remain voluntarily past the age of 18, programs like the Step-Up program provide the much needed, concentrated assistance and support to youth as they encounter emerging adulthood (Arnett, 2000, 2004) and allows for an effective transitionary period to adulthood (Berzin, Singer & Hokanson, 2014).

It is not surprising that there are few places nationally that offer this type of model. The federal government does not reimburse and provide matching financial assistance to state and local child welfare agencies for youth who are not under the care and jurisdiction of a child welfare agency. State or local governments that operate programs similar to Step-Up are required to assume 100% of the cost to operate. As previously noted, the Title IV-E Program, is the primary mechanism for reimbursing states for the cost of child welfare services (roughly 50% match), including foster care maintenance costs as well as case management services. Title IV-E will not reimburse states who provide this type of direct payment and case management services for foster care youth not under the legal jurisdiction of the child welfare agency. However, the Step-Up model does require youth to remain under court jurisdiction. Perhaps this oversight by the courts may provide the necessary safeguards the federal government needs to consider extending matching financial support to these types of programs. The U.S. Department of Health and Human Services should take a closer look at models such as Step-Up and consider funding these programs under the current matching scheme that are available to state and child welfare agencies for youth remaining in care past the age of 18. Researchers, policy makers and practitioners should advocate for models such as Step-Up that offer extended and flexible support.

Limitations

It is important to consider the limitations to the 2001 and 2021 studies. First, the data collection method relied on self-reports of behavior, which are susceptible to response bias. Second, one-large county-operated agency in the West was handling child welfare and transition-related services. The extent to which young adults in other states have similar or different experiences during their discharges from foster care is not clear. Third, the data do not capture the duration and severity of unmet needs. Fourth, the young adults interviewed may not be representative of nonrespondents. Finally, although some of the correlational analyses were low, the variables were observed in the data at a statistically significant rate regardless of the strength of the observation. Although this may result in limited predictive value, the findings reinforce other research as to the type of concrete services that can reduce negative outcomes. Despite its limitations, this research offers important insights for intervention efforts for youth exiting foster care.

Conclusion

Keeping in mind the limitations of this study, this research compares two cohorts of youth transitioning from foster care twenty-years apart, and it offers important insights into the factors associated with achieving more positive outcomes for youths. Providing transitioning youth with extended care concrete services past their 18th birthday without requiring them to remain in foster care can minimize the array of negative outcomes identified in previous research for this population. Youth who received these services post foster care fared significantly better than their counterparts who were discharged without them.

The success surrounding the passage of federal legislation allowing states to extend foster care past the age of 18 is notable. Youth who are allowed to stay past their 18th birthday and who voluntarily choose to remain in care do better and evidence suggests that states can implement extended care services where youth will choose to voluntarily stay. However, this option is underutilized. A sizeable number of youth are forced out of care on their 18th birthday or opt-out of staying in care when given the option because of their frustration or negative experiences with the foster care system. Programs such as Step-Up, where former foster care youth can leave foster care while receiving direct financial assistance, health care coverage and access to case management services up until the age of 21, have shown to produce positive outcomes while covering the vast majority of exiting youth. The major limiting factor to expanding programs like this rest with the inability of states to receive federal matching funds.