[House Hearing, 106 Congress] [From the U.S. Government Publishing Office] FOSTER CARE INDEPENDENT LIVING ======================================================================= HEARING before the SUBCOMMITTEE ON HUMAN RESOURCES of the COMMITTEE ON WAYS AND MEANS HOUSE OF REPRESENTATIVES ONE HUNDRED SIXTH CONGRESS FIRST SESSION __________ MAY 13, 1999 __________ Serial 106-22 __________ Printed for the use of the Committee on Ways and MeansU.S. GOVERNMENT PRINTING OFFICE 61-229 CC WASHINGTON : 2000 ------------------------------------------------------------------------------ For sale by the U.S. Government Printing Office Superintendent of Documents, Congressional Sales Office, Washington, DC 20402 COMMITTEE ON WAYS AND MEANS BILL ARCHER, Texas, Chairman PHILIP M. CRANE, Illinois CHARLES B. RANGEL, New York BILL THOMAS, California FORTNEY PETE STARK, California E. CLAY SHAW, Jr., Florida ROBERT T. MATSUI, California NANCY L. JOHNSON, Connecticut WILLIAM J. COYNE, Pennsylvania AMO HOUGHTON, New York SANDER M. LEVIN, Michigan WALLY HERGER, California BENJAMIN L. CARDIN, Maryland JIM McCRERY, Louisiana JIM McDERMOTT, Washington DAVE CAMP, Michigan GERALD D. KLECZKA, Wisconsin JIM RAMSTAD, Minnesota JOHN LEWIS, Georgia JIM NUSSLE, Iowa RICHARD E. NEAL, Massachusetts SAM JOHNSON, Texas MICHAEL R. McNULTY, New York JENNIFER DUNN, Washington WILLIAM J. JEFFERSON, Louisiana MAC COLLINS, Georgia JOHN S. TANNER, Tennessee ROB PORTMAN, Ohio XAVIER BECERRA, California PHILIP S. ENGLISH, Pennsylvania KAREN L. THURMAN, Florida WES WATKINS, Oklahoma LLOYD DOGGETT, Texas J.D. HAYWORTH, Arizona JERRY WELLER, Illinois KENNY HULSHOF, Missouri SCOTT McINNIS, Colorado RON LEWIS, Kentucky MARK FOLEY, Florida A.L. Singleton, Chief of Staff Janice Mays, Minority Chief Counsel ______ Subcommittee on Human Resources NANCY L. JOHNSON, Connecticut, Chairman PHILIP S. ENGLISH, Pennsylvania BENJAMIN L. CARDIN, Maryland WES WATKINS, Oklahoma FORTNEY PETE STARK, California RON LEWIS, Kentucky ROBERT T. MATSUI, California MARK FOLEY, Florida WILLIAM J. COYNE, Pennsylvania SCOTT McINNIS, Colorado WILLIAM J. JEFFERSON, Louisiana JIM McCRERY, Louisiana DAVE CAMP, Michigan Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Ways and Means are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined. C O N T E N T S __________ Page Advisory of May 6, 1999, announcing the hearing.................. 2 WITNESSES U.S. General Accounting Office, Cynthia M. Fagnoni, Director, Education, Workforce, and Income Security Issues, Health, Education, and Human Services Division......................... 15 ______ Casey Family Program, Ruth W. Massinga........................... 6 Courtney, Mark E., University of Wisconsin-Madison............... 23 DeLay, Hon. Tom, a Representative in Congress from the State of Texas, and House Majority Whip................................. 36 Keys for Life, Sonja Matheny..................................... 50 Lighthouse Youth Services, and Child Welfare League of America, Inc., Mark Kroner.............................................. 11 Orphan Foundation of America, Eileen McCaffrey................... 43 Our House, Inc., Montrey Bowie................................... 52 People Places of Charlottesville, Kelli Sutton Block............. 46 SUBMISSIONS FOR THE RECORD Grasso, Kathi L., Baltimore, MD, letter.......................... 56 National Independent Living Association, Jacksonville, FL, statement and attachment....................................... 58 FOSTER CARE INDEPENDENT LIVING ---------- THURSDAY, MAY 13, 1999 House of Representatives, Committee on Ways and Means, Subcommittee on Human Resources, Washington, DC. The Subcommittee met, pursuant to notice, at 10:05 a.m., in room B-318, Rayburn House Office Building, Hon. Nancy L. Johnson (Chairman of the Subcommittee) presiding. [The advisory announcing the hearing follows:] ADVISORY FROM THE COMMITTEE ON WAYS AND MEANS SUBCOMMITTEE ON HUMAN RESOURCES FOR IMMEDIATE RELEASE CONTACT: (202) 225-1025 May 6, 1999 No. HR-6 Shaw Announces Hearing on Foster Care Independent Living Congresswoman Nancy L. Johnson (R-CT), Chairman, Subcommittee on Human Resources of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on ways to assist States in strengthening and expanding programs for youth emancipating from foster care to help them establish independent living. The hearing will take place on Thursday, May 13, 1999, in room B-318 Rayburn House Office Building, beginning at 10:00 a.m. In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. Witnesses will include scholars, program administrators, foundation executives, and adolescents now participating in programs designed to help foster children achieve independence through employment or post- secondary education. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing. BACKGROUND: The Federal Government now provides States with about $70 million per year to conduct programs for adolescents leaving foster care that are designed to help them establish independent living. Research and numerous reports from States conducting these programs indicate that adolescents leaving foster care do not fare well. As compared with other adolescents and young adults their age, they are more likely to quit school, to be unemployed, to be on welfare, to have mental health problems, to be parents outside marriage, to be arrested, to be homeless, and to be the victims of violence and other crimes. After conducting hearings, talking with program administrators and adolescents who are in foster care and who have left foster care, and reviewing research and program information, the Subcommittee is preparing to consider reform legislation. The central feature of the legislation now being developed would provide States with both a new framework and new resources to improve and expand their programs for adolescents likely to stay in foster care until age 18 and for young adults who have left foster care and are attempting to further their education or to work. In announcing the hearing, Chairman Johnson stated: ``The legislation we are developing gives States an opportunity to revise and expand their programs for this group of very needy and often victimized adolescents. Both research and our hearings have shown that most of these young people have tremendous potential and inner strength. With timely and concrete assistance, they can establish themselves as successful employees, spouses, parents, and citizens. This is a job that we as a nation can and must do.'' FOCUS OF THE HEARING: The hearing is being conducted to stimulate public comment on the Independent Living legislation that Chairman Johnson and Rep. Ben Cardin (D-MD) are expected to introduce before the hearing. Members of the Subcommittee are especially interested in comments on whether States should be required to have programs for youths leaving foster care that provide services to both adolescents still in school and young adults who have left school up to age 21; whether the major goals of State programs should be to prepare adolescents for work or for post-secondary education or both; whether States should be required to help these young adults pay for health care; whether penalties should be imposed on States for violating Federal rules; and the types of program evaluation that should be used to determine the impacts of State programs. DETAILS FOR SUBMISSION OF WRITTEN COMMENTS: Any person or organization wishing to submit a written statement for the printed record of the hearing should submit six (6) single- spaced copies of their statement, along with an IBM compatible 3.5-inch diskette in WordPerfect 5.1 format, with their name, address, and hearing date noted on a label, by the close of business, Thursday, May 27, 1999, to A.L. Singleton, Chief of Staff, Committee on Ways and Means, U.S. House of Representatives, 1102 Longworth House Office Building, Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Human Resources office, room B-317, Rayburn House Office Building, by close of business the day before the hearing. FORMATTING REQUIREMENTS: Each statement presented for printing to the Committee by a witness, any written statement or exhibit submitted for the printed record or any written comments in response to a request for written comments must conform to the guidelines listed below. Any statement or exhibit not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee. 1. All statements and any accompanying exhibits for printing must be submitted on an IBM compatible 3.5-inch diskette WordPerfect 5.1 format, typed in single space and may not exceed a total of 10 pages including attachments. Witnesses are advised that the Committee will rely on electronic submissions for printing the official hearing record. 2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee. 3. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments by the Committee, must include on his statement or submission a list of all clients, persons, or organizations on whose behalf the witness appears. 4. A supplemental sheet must accompany each statement listing the name, company, address, telephone and fax numbers where the witness or the designated representative may be reached. This supplemental sheet will not be included in the printed record. The above restrictions and limitations apply only to material being submitted for printing. Statements and exhibits or supplementary material submitted solely for distribution to the Members, the press, and the public during the course of a public hearing may be submitted in other forms. Note: All Committee advisories and news releases are available on the World Wide Web at ``http://www.house.gov/ways__means/''. The Committee seeks to make its facilities accessible to persons with disabilities. If you are in need of special accommodations, please call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event (four business days notice is requested). Questions with regard to special accommodation needs in general (including availability of Committee materials in alternative formats) may be directed to the Committee as noted above. Chairman Johnson of Connecticut. Good morning, everyone. Mr. Cardin and I have called this hearing to get reactions to the independent living bill that we introduced this morning. It is our intention to mark up the bill in Subcommittee next week; Full Committee the week after, and go to the floor early in June. The most fundamental principle in our legislation is that States must be responsible for designing and implementing activities to help young people emancipating from foster care to prepare for and achieve independent living. The Federal Government will help by establishing a general framework for State programs by financing the programs, by providing technical assistance, and by evaluating the programs, but States must bear primary responsibility for the structure and design of those programs. If welfare reform is any example, they are definitely up to the challenge. The framework established by our bill is that States must conduct a program with two major parts. The first part helps children prepare for independence while they are still living in foster care. The second part maintains contact with young people once they leave foster care and are struggling to establish themselves on their own. Our bill also requires States to prepare children to enroll in postsecondary education--either trade schools or college--and to move immediately into jobs after they leave foster care. We are looking for hard-nosed programs that actually get adolescents ready for either additional education or a real job on the very day they leave foster care or a combination thereof. Within this broad framework, States are expected to organize their own programs to help as many young people as possible and to decide how to divide their resources between young people still in foster care and those who have left foster care and are trying to achieve independent living. To this end, our bill doubles, from $70 million to $140 million, the amount of Federal money Sates receive to conduct these activities. Ben Cardin and I want to do everything possible to help these young people get health insurance. While they remain in foster care, they are automatically covered by Medicaid, but once they leave, they are usually on their own. In the bill we introduced today, States are required to provide Medicaid coverage to young people who have left foster care and are under the age of 21. However, CBO has informed us that the cost of this provision is $400 million over 5 years. Because we don't have enough money to finance the entire $400 million and still double the funding for the Independent Living Program, we will probably be forced to adjust this provision to a State option on Medicaid. However, even an option will result in around half of these children getting health coverage. Ben and I are going to continue to do everything we can to find the money to fully fund this provision, but at the very least we want to make them eligible for Medicaid or CHIP, Children's Health Insurance Program, funding. Finally, let me emphasize how important it is that the Congress consider and pass this legislation. Every year, around 20,000 of our Nation's young people are emancipated from foster care. They must adapt to the demands of becoming an adult, which is an exceptionally difficult and perilous undertaking in any society at any time, but in 21st century America, with its emphasis on education and technology, the transition is even more difficult, and these young people must face these perils without the safety net provided by a family. Imagine that--we do less for children aging out of foster care--young people aging out of foster care than we do for welfare recipients moving into the work force; than we do to help disabled people looking for work. Look at the whole infrastructure of supported work--the supported work system that we have for disabled people, and it is simply a crime that we do so little to prepare and support young people who are going to become independent at the age of 18 with literally no backing from an organized adult community. I am filled with both admiration for how hard most of these young people try and shame that our society provides so little assistance to these richly deserving kids. Our bill by no means solves the problem, but it is a great step in the right direction and more important, still, is a signal to these young people that the rest of us recognize their plight, believe in them, and are willing to help. Ben. Mr. Cardin. Well, Madam Chair, let me first thank you and congratulate you for your strong leadership in this area. You have made foster children a major focus of this Subcommittee, and we are going to be able to achieve some, I think, very commendable results as a result of what you have been able to do. Two months ago, we held a hearing on foster children, and as a result of that hearing we heard firsthand the problems that foster children are having who age out of foster care; that we don't do enough as a society to deal with their needs for independent living. As a result of that hearing, as a result of your leadership today, we have a bipartisan bill that I have joined you in filing that provides additional assistance to children aging out of foster care. I look forward to marking up that bill shortly and being able to see the benefits of that legislation. As you point out, it doubles the amount desperately needed of Federal funds for the Independent Living Program; it strongly encourages the States to provide Medicaid coverage to all former foster children between the ages of 18 and 21, and it gives the States the flexibility to use a portion of the Independent Living funds to cover housing needs of children. I think each of those provisions is extremely important and will have major impact on having a more successful transition from being a foster child to an independent living arrangement. The needs have been documented; you and I have talked about this at great length; the people who have testified previously have brought out the reason why we need to move forward with legislation. I introduced a bill earlier. The bill that we introduced today doesn't cover everything that was in that bill, but I am very satisfied that we have reached an agreement that can make major progress in this area. I should also point out that the administration in its budget came forward with an initiative for foster children, and I think our action today is consistent with the administration. So, Madam Chair, I really do look forward to the witnesses today and moving forward on this legislation. Every year, 20,000 children are aging out of foster care, and it is important that we move forward with this initiative, and I thank you again for holding this hearing. Chairman Johnson of Connecticut. Thank you, Ben, and while the first panel is coming forward, Ruth Massinga from the Casey Family Program; Mark Kroner, director of the self-sufficiency division of Lighthouse Youth Services; Cynthia Fagnoni, the Director of Income Security Issues for the GAO; Mark Courtney, associate professor of social work at the School of Social Work and Institute for Research on Poverty at the University of Wisconsin-Madison, and while you are getting yourselves assembled, let me just say that it really has been a enormous pleasure to work with Ben on this. You know, it is wonderful to have a colleague who has had a long and serious interest in this area, that comes to it with a lot of background and dedication, and his first bill was an enormous help. It is also a pleasure to have the administration both really seriously interested in dealing with a problem and a realistic partner in trying to shape the best bill we can within the context of our current circumstances, so we look forward to your testimony today. I am sorry, is it Massinga? Ms. Massinga. Yes. Chairman Johnson of Connecticut. Thank you. STATEMENT OF RUTH W. MASSINGA, CHIEF EXECUTIVE OFFICER, CASEY FAMILY PROGRAM, SEATTLE, WASHINGTON Ms. Massinga. Good morning, Madam Chairman and Representative Cardin. I really want to thank you for the opportunity to testify today in support of the bill which you and Representative Cardin have introduced about the transitions of young people from foster care to adulthood. This is an issue that has been a longstanding concern to many in the organization that I serve. As I said, I am Ruth Massinga, and I am chief executive officer for the Casey Family Program, a national operating foundation headquartered in Seattle serving children and families in 14 States. Established in 1966 by Jim Casey, the cofounder of the United Parcel Service, and his family, this program has been working for more than 32 years with nearly 3,300 individual young people who are or have been in foster care with the goal to help them achieve self-sufficiency and become productive adults. Your strong commitment and diligent efforts to improve the opportunities for success to the more than 20,000 youths who emancipate from the Nation's foster care system each year, are laudable. Too many of them leave with a resume of sustained child neglect and abuse, repeated losses of primary family member, emotional immaturity, and uneven development of basic skills. Your introduction of this bill is a clear signal that you are truly committed to helping young people transition out of foster care and succeed. As a former State secretary of human resources responsible for child welfare services in Maryland from 1983 to 1989, as well as from the vantage point of 10 years at the Casey Family Program, I know that these young people can succeed and know what it takes for that to happen. Your bill moves us closer to accepting the challenge to match the complex needs of these youths with the commitment of more resources to create responsive, reliable support that will help them address the hazards facing them as they venture out into the world. What does practice wisdom and the best of the limited research available tell us about what works to help these young people find their way in the world? Of course, it begins with the primary care givers--the foster parents, the family members--knowing how and when to unlock each child's potential for learning and achieving just as it does for your children and mine. Foster parents need to know how to stimulate and motivate, enlisting the aid of teachers and nurturers to systematically determine the skills and potential assets that can be cultivated in each child as early as possible after they enter care and certainly earlier than age 16. Based on that systematic skill assessment, parents and other professionals can pursue strong educational opportunities and independent living skills training to meet the specific needs of the child or youth. Because we know that youth leaving foster care invariably seek support and direction from birth family members, there needs to be a special focus on engaging all of these adult players as part of the young person's transition. These aspects of best practice are likely to be put in place under the broad directions of the bill as you are proposing them, and I would ask that you make these as explicit as possible. There are two other areas of the bill that I urge you to consider strengthening: creating accountability structures based on child outcome or results and underscoring the need for promoting the need for systems integration. To know whether or not the bill that you are introducing is effective, we really must know what actually happens to these young people. Therefore, accountability must be based on child outcomes not just on the services provided. The child outcome identified in your bill could be sharpened and strengthened. In measuring the effectiveness of services, it is important not just to inquire about educational activities and the number of years in school but rather to determine whether the young person has graduated or earned a GED; to verify completion of vocational training, attainment of employment and at what wage level, and to inquire about stable housing, for how long, and whether it is subsidized or not. Now, I know more than most that we have not been diligent in this field in collecting the data necessary to measure the outcomes achieved by the young people served by the foster care system. For us at the Casey Family Program, a private organization with resources to focus on results, we have come late to the recognition that we now need outcomes stated preferably in comparison with cohorts of young people with similar circumstances. To remedy this data deficit during the early nineties, the program took the first longitudinal look at how 106 young adults from our Boise Division fared after leaving Casey between the years 1974 and 1992. The results revealed the importance of comparing youths with education and parenting skills. In 1998, we began to look at our alumni more systematically and with the collaboration of the University of Washington, the University of Michigan, and Harvard University, we started to design a comprehensive outcome study of over 700 youths who left the Casey Program between 1988 and 1998 along with youths who emancipated from the public child welfare systems in Washington and Oregon State. We will be happy to share these data as they become available with the Subcommittee. So, as you double Federal outlays for independent living and at the same time extend the age of eligibility, I believe it is critical to develop fair and firm ongoing accountability systems capturing the results associated with the implementation of the bill. One place where I can offer you some data is in strong support to extend eligibility for Medicaid coverage from age 18 to 21. In 1998, the Casey Program served approximately 250 youths with transitional services. Eighteen of our total costs were spent on health care and 15 percent were spent on mental health services. In the same time period, we provided scholarship assistance to students attending 2- and 4-year, postsecondary education programs. Of these costs, 13 percent were spent on health care. Absent our support for these services, these young people would have gone untreated, because they were ineligible for other publicly funded programs. This, as you know, is a population at risk for chronic, expensive, disabling conditions if left untreated. In addition to tracking results, we need to understand how these results were achieved and to capture the key factors that make an appreciable difference in achieving good or bad outcomes. Equally important to accountability is the need to promoting systems integration. My bias is that these youth need systems that bundle services in groups or patterns that are easy for young people and their foster families or adult mentors to navigate. The bill, as drafted, identifies the different services and resources for young people but doesn't speak to the need for them to operate in a user-friendly way. I know that you are acutely aware that, for sometimes good and sometimes indefensible reasons, professionals from health and disciplines operate as if we are hermetically sealed from one another. In truth, to be effective, the child welfare system must talk to the education system or the skills assessment of the young adults will be less robust than needed. The job training system needs to work with the transportation system or young people can't get to the jobs for which they must be prepared. Housing services must connect with social services or young people may not sustain themselves. We ask that this legislation promote the integration of service delivery and promote ease of access for these young people. In sum, I thank your for your efforts and hope that the development of permanent connections among and between people in these systems as well as accountability for results end up with a better system for these young people emancipating from foster care of which we can all be proud. In that regard, I am reminded of Jay, a young person who came to us at age 14 following years of trauma and abuse. Not long after, he became involved with the juvenile justice system, struggled with drugs, and refused all efforts of help. It would have been easy for people to write him off, but his foster parents and the staff stuck with him, and now he is a sous chef and wanting to give back to other young people. What you propose in this bill is what we want for Jay and all young people, and I thank you for your efforts. [The prepared statement follows:] Statement of Ruth W. Massinga, Chief Executive Officer, Casey Family Program, Seattle, Washington Good morning Madam Chairwoman, Representative Cardin, and members of the Committee. Thank you for the opportunity to testify today about the transition of young people from foster care to adulthood, an issue that has been of long-standing concern to me and to the organization that I serve. My name is Ruth W. Massinga and I am Chief Executive Officer of The Casey Family Program, a national operating foundation headquartered in Seattle, Washington serving children and families in 14 states. Established in 1966 by Jim Casey, co-founder of United Parcel Service (UPS), and his family, the Program has been working for more than 32 years with nearly 3,300 individual young people, who are or have been in been foster care, with the goal of helping them develop into self-sufficient, productive adults. I want to begin by thanking Chairwoman Johnson and Representative Cardin for their strong commitment and diligent efforts to improve the opportunities for success for the more than 20,000 youth who emancipate from the nation's foster care system each year; too many of them leave care with a resume of sustained child neglect and abuse, repeated losses of primary family members, emotional immaturity and uneven development of basic skills. Your introduction of this bill is a clear signal that you are truly committed to helping young people transitioning out of foster care to succeed. As former State Secretary of Human Resources responsible for child welfare services in Maryland from 1983 to 1989, as well as from the vantage point of ten years at The Casey Family Program, I know that these young people can succeed, and know what it takes for that to happen. This bill moves us closer to accepting the challenge to match the complex needs of these youth with the commitment of more resources to create responsive, reliable supports that will help them address the hazards facing them as they venture out into the world. What does practice wisdom and the best of the limited research available tell us about what works to help these young people find their way in the world? Of course, it begins with primary caregivers knowing how and when to unlock each child's potential for learning and achieving, just as it does for your children and mine. Foster parents need to know how to stimulate and motivate, enlisting the aid of teachers and mentors, to systematically determine the skills and potential assets that can be cultivated in each child, as early as possible after they enter care (certainly earlier than age 16). Based upon that systematic skills assessment, parents and other professionals can pursue strong educational opportunities and independent living skills training to meet the specific needs of the child or youth. Because we know that youth leaving foster care invariably seek support and direction from birth family members and other significant community connections, there needs to be a special focus on engaging these players as part of the young persons' ``transition team.'' These aspects of best practice are likely to be put in place under the broad directions of the bill as proposed, though I would ask this Committee to make these as explicit as possible. There are two specific areas of the bill that I urge you to consider strengthening: (1) creating accountability structures based on child outcomes, and (2) underscoring the need for promoting the need for systems integration. To determine the effectiveness of services and programs, we must know what actually happens to these young people. Therefore, accountability must be based on child outcomes, not just on services provided. The child outcomes identified in the bill should be sharpened and strengthened. In measuring the effectiveness of services it is important to not just inquire about educational activities and number of years of school, but rather to determine whether the young person has graduated or earned a GED; to verify completion of vocational training, attainment of employment and at what wage and to inquire about stable housing, for how long and whether it is subsidized or not. I know more than most that we have not been diligent in collecting data necessary to measure the outcomes achieved by the young people served by the foster care system. The Casey Family Program, a private organization with resources to focus on results, has come late to the realization that we need outcomes data, preferably in comparison with other cohorts of young people in similar circumstances. To remedy this data deficit, during the early 1990's The Casey Family Program took the first longitudinal look at how 106 young adults from our Boise Division fared after leaving Casey between 1974 and 1992. The results revealed the importance of preparing youth with educational, employment and parenting skills. In 1998, we began to look at our alumni more systematically and, with the collaboration of the University of Washington, University of Michigan and Harvard University, have started to design a comprehensive outcomes study of over 700 youth who left The Casey Family Program between 1988 and 1998, along with youth who emancipated from the public child welfare systems in Washington and Oregon states. We will be happy to share these data when they become available. As you double federal outlays for independent living, and at the same time extend the age of eligibility, I believe it is critical to develop fair and firm ongoing accountability systems capturing the results associated with implementation of the bill as well as the broadly defined summative evaluation of this total effort that is a part of the current language of the bill. We cannot continue to settle for the significant lack of data about effective uses of the federal and state funds spent on independent living programs to date. One place where I can offer you some data is in strong support to extend eligibility for Medicaid coverage from age 18 to 21. In 1998, The Casey Family Program served approximately 250 youth with transition services across this age group. Eighteen percent of our total costs, which were $631,900, were spent on healthcare and 15 percent were spent on mental health services. In the same time period we provided scholarship assistance to students attending 2- and 4-year post-secondary education programs at an average cost of $10,873. Of those costs, 13 percent were spent on healthcare. Absent Casey support for these services, these young people would have gone untreated because they were ineligible for other publicly- funded programs. This is the population at-risk for chronic, expensive disabling conditions if left untreated. In addition to tracking results we need to understand how they were achieved and to capture the key factors that make an appreciable difference in achieving good or bad outcomes. Among the questions to be pursued by additional research include: what interventions are most effective for which children, the duration of their delivery and by whom (the foster parent, social worker, teacher, etc.), and what service configuration or program models are most cost-effective. Equally important to creating accountability structures based on child outcomes is the need for promoting systems integration. My bias is that these youth need systems that bundle services in routes or patterns that are easy for young people and their foster families or adult mentors to navigate. Sometimes we use professional jargon, such as systems integration, to describe this. The bill as drafted identifies the different services and resources for young people, but does not speak to the need for them to operate in a user-friendly way. I know that you are acutely aware that, for sometimes good and sometimes indefensible reasons, professionals from helping disciplines operate as if they are hermetically sealed one from the other. In truth, to be effective, the child welfare system must talk to the education system or the skills assessment and development work will be less robust than is needed. The job training system needs to work with the transportation system or young people cannot get to jobs for which they may be prepared. Housing services must connect with social services or the young people may not sustain themselves in housing or jobs, or secure the primary or mental health resources they need. We ask that this legislation promote the integration of service delivery and promote ease of access for these young people. We at Casey have come to learn that to a young person, permanent connections among and between people in these systems are the key to success. I am reminded of Jay, a young man who came to us at age 14, following years of trauma and abuse. Not long thereafter he became involved with the juvenile justice system, struggled with drugs, and refused all offers of help. It would have been easy to write Jay off. Yet his foster mother and his social worker stayed connected to him and were vital links for him to the resources in the community that finally enabled him to kick his habit, establish a work history and to stick with vocational training. He is now a chef at a highly respected restaurant in Seattle, married and the committed father of a small child, dedicated to speaking out for the young people that follow him in the system. Thank you for your hard work on behalf of Jay and the thousands of young people who make that transition from the foster care system into adulthood each year. What you propose in this bill is what we all want for our own children--the opportunities, supports and in the end connections to significant adults in order to become healthy, productive and contributing citizens in their communities. I thank you all for your commitment to these young people. Chairman Johnson of Connecticut. Thank you very much. Dr. Kroner. STATEMENT OF MARK KRONER, DIRECTOR, SELF-SUFFICIENCY SERVICES, LIGHTHOUSE YOUTH SERVICES, CINCINNATI, OHIO, AND CHILD WELFARE LEAGUE OF AMERICA, INC. Mr. Kroner. Madam Chair and Members of the Subcommittee, good morning. My name is Mark Kroner, and I am the director of self-sufficiency services for Lighthouse, a nonprofit organization based out of southern Ohio. Since 1986, I have been running our agency's Independent Living Program, and over that period of time, we have assisted between 600 and 700 young adults who are trying to make the difficult transition to life on their own after the child welfare system, and we have no doubt that this legislation would greatly increase the chances of success for these young people and also decrease the suffering of many youth in the country who leave the foster care system and can't go back home to their families. The youth in our program in Cincinnati have mothers who are mentally ill and are chemically dependent, fathers who are in jail or nowhere to be found, and these are kids who the local professional system has fully realized that they cannot go back to live with their families for any extended period of time. Many of the youth that we are working with enter the system for the first time at 16 or 17, and it is often a little too late to find an adoptive family or a foster home who is willing to take in an older teenage with a tattoo and an attitude. A lot of the teens that we work with have made it clear that if they were placed in a group home or any type of group situation or even a family foster home, that they would run away, because they were used to being on their own, fending for themselves. What they are really asking for is a place free from their chaotic and abusive natural family households. Permanency for a lot of the kids in the system I think means learning to live independently, and I would like to quickly share some of our agency's observations. We learned early on, back in the eighties, that if we were really going to prepare these kids quickly for life on their own that they would need to learn from the direct experience of living independently while still in the custody of caring adults, and, as Mrs. Johnson said, using the hard-nosed approach, we began placing kids in their own apartments as young as 16, 17, and 18 back in the early eighties, and we immediately saw that they were, indeed, learning something, and they were being caringly coerced into taking on adult responsibilities. We have had any number of 16- to 17-year-olds who have done very well in this situation. The teens that have come through the program over the years have shown us what they need to do and learn in order to become more self-sufficient, and a lot of times what that means is putting them out on their own and allowing them to make dozens of crazy mistakes and foolish choices. For example, going for a day without food, because they spent the food allowance on a new CD or make-up--or coming at night and standing out in the snow, because they can't find out what they did with their key. We have kids that have gotten evicted from their apartments, because they couldn't control their noisy friends of family members, and we have had kids who have actually had their entire savings stolen by mothers who came to visit them who were addicted to crack. What I am trying to say is we want these kids to make these mistakes while they are still in the custody of an agency that can help them process what happened; and go over the situation. This bill's provision of funding for housing is exactly what the field of independent living needs to get to the next level of effectiveness. Our State has amended licensing rules to allow for the living arrangement options, and we have many landlords here willing to give our kids a chance. We also have a local service system that has finally gotten to the point where we focus more on what kids need to do and learn rather than on all the possible things that can go wrong. We have also learned that no one living arrangement works for all the youth that are sent to us, and over the last decade and a half we have developed a continuum of housing options that include individual scattered-site apartments, shared homes in which three or four youths live in a house with a live-in adult, host homes in which we find an adult or two that will allow a youth to move in with them if they have a spare room. We use boarding homes, all different types of roommates situations, and temporary shelters for youth who need to be removed from their apartments or any of these other places, sometimes on very short notice. Extending the period of care to 21 is also a no-brainer for us in Cincinnati, especially for youth with developmental disabilities. We are seeing probably a third of our caseload that had diagnosable developmental disabilities, and these kids are functioning at a 12- to 15-year-old level by the time they reach 18. They probably will not be able to graduate from high school until they are in their twenties or even later than that. In sum, what we are trying to do in Cincinnati is design a system that somewhat resembles that of a healthy family who is trying to help one of their own kids move out for the first time. I think this legislation is going to help make the system get more in touch with modern realities. Virtually no American teenagers are expected to be totally self-sufficient at 18. I noticed the other day that most of the college seniors that are doing their field placements with our agency right now still live at home with mom and dad. It is obvious to us that foster youth in our country need what all teens need--time to grow up, ongoing support from caring adults, financial support for a reasonable amount of time, health insurance covered by mom and dad or us until they can afford it, an affordable place to live when cut off from adult support and second chances when they fail, and I think that this proposed legislation wisely addresses all of these points. We can never do enough for our own kids or the kids in the system, but we certainly can do better than what we are doing now. There is no magic in this legislation or what we are doing in Cincinnati, just the common sense that says we cannot expect kids in the foster care system to do what any normal teen cannot do without years of financial and emotional support. We appreciate your efforts. [The prepared statement follows:] Statement of Mark Kroner, Director, Self-Sufficiency Services, Lighthouse Youth Services, Cincinnati, Ohio, and Child Welfare League of America, Inc. Good morning Madam Chairwoman and Members of the Subcommittee. My name is Mark Kroner and I am the Director of Self-Sufficiency Services for Lighthouse Youth Services--a private nonprofit organization based in Southern Ohio since 1969. Lighthouse Youth Services is one of over 450 member agencies of the Child Welfare League of America that provides independent living services to youths leaving foster care. I have been involved in training and consulting with dozens of organizations nationwide that are trying to develop independent living programs. Since 1986 I have been running our agency's independent living program in Cincinnati. Over that period of time we have assisted nearly 700 youths who are trying to make the difficult transition from foster care to living on their own. We are greatly encouraged by this Subcommittee's interest in providing supports to youths exiting foster care. The Foster Care Independence Act will provide much needed support and flexibility to the states so they can provide better services to kids making the transition from foster care to independence. Many of the youths in our program at Lighthouse have mothers who are mentally ill or chemically dependent, or have fathers who are in jail or nowhere to be found. These youth were abused, neglected or abandonedto the point where caring professionals realized that they would never be able to count on living with their families of origin for any extended period of time. We have to focus our energies on helping youth build workable futures for themselves. Many of the young people in our county entered the child welfare system for the first time when they were 16 or 17-- often too late to find an adoptive family or a foster home willing to take in an older teenager with a tattoo and an attitude. Many of the teens referred to us made it clear that they would run from a foster or group home if placed there. They were used to being on their own and fending for themselves. They just wanted a place free from the abuse and chaos of their natural family households. Up to a third of the teens we serve have a diagnosable developmental disability. Many of these youth are functioning at a 12-14 year old level at age 18. They are usually several years behind in school and are not ready to graduate from high school until they are 20 or 21. They will in no way be able to become totally self-sufficient at age 18. Permanency for many of these youths means learning to live independently. Even if they do spend time with family members, their chances for success are improved if they learn to count on themselves to solve their daily problemsand have the knowledge, experience and skills to do so. These foster youth receive a ``double-whammy'' when they reach 18. First, they learn emphatically that their families of origin are not going to help them. Then, they learn that the services and supports they had received in the child welfare system abruptly end. The Foster Care Independence Act recognizes that these youths need additional help. This legislation provides new and expanded opportunities for us to help these young people. The services supported by this bill would greatly increase the chances of success for these youths who need to venture out on their ownmany years ahead of their peers who often receive full or partial support from their families until their mid twenties. The services offered under the existing Title IV-E Independent Living program have begun to address the needs of youth leaving foster care, but we need to do much more. The Foster Care Independence Act addresses three important areas that will greatly increase the chances of success for youth aging out of foster care: Helping young people acquire the skills and knowledge they need to become self-sufficient. Providing health care coverage for youth up to age 21. Increasing housing options for youths who have left foster care. I know you have heard testimony from many others that will give you a clear national picture of the situation and relevant statistics. I would like to give you more of a perspective from the front line and share some of our agency's observations. We learned early on that the best preparation for independence that the youth in our program could have was the direct experience of living on their own while still in the custody of caring adults. We learned that independent living services without housing was like driver's training without the car. Life skills training without the actual experience of living alone and using those life skills was not enough--young people need real-life practice in order to really learn. At Lighthouse Youth Services, we started placing foster youth in their own apartments a number of years ago so that they could have the experience of learning to live on their own. Despite a lot of gray hairs and after-hours pages, we saw that these kids were indeed learning, and could be ``constructively coerced'' into taking on adult responsibilities at 18 or 17. We even have had a number of young people live on their own and do very well at age 16. Using Title IV-E Independent Living funds, we began a countywide self-sufficiency training program for all youth in out-of-home care. This training has made a noticeable difference in the ability of youth referred to our apartment program to make a quick adjustment to living independently. Allowing youth to participate in this program beginning at age 14, which would be made possible by the Foster Care Independence Act, would make our efforts even more effective. The teens coming through our program taught us what they needed to do and learn in order to become more self-sufficient. Sometimes it meant letting them makes dozens of crazy mistakes and foolish choices: going to school without lunch because they spent their food allowance on a new nose ring. getting evicted because they couldn't control their noisy friends. losing a job after forgetting to budget for bus fare. having their hard earned savings stolen by a visiting mother, addicted to crack. receiving a $200 phone bill after allowing ``friends'' free use of the apartment phone. standing out in the snow at 2 a.m. wondering where the key went. But our teens made these mistakes while they were still in our care--and have our support in going over the events leading up to the mistake, the consequences, and the ``what to do next time'' speech. Over the last decade Lighthouse Youth Services has created a continuum of housing options that include: individual scattered-site apartments; small shared-homes that house 3-4 youth and a live-in adult; host homes in which a youth shares a house with one or two adults; access to a boarding home for females in the city center; roommate situations; and temporary shelters for youth that can't stay in their own apartments. All states need support and flexibility to establish similar continuums, and to extend services to youth leaving foster care. The Foster Care Independence Act would allow states to use up to 30% of Title IV-E Independent Living funds, which are increased in the Foster Care Independence Act, to be used for the room and board costs for youths ages 18-21. These additional funds will foster the creativity that states need to develop their own housing continuum and related services for these very vulnerable youth. Our state has amended licensing rules to make the less- restrictive and semi-supervised living arrangements possible. We have found many landlords who are willing to give our kids a chance. (They tell us our kids are no worse than the general public.) We have a local system that focuses more on what youth need rather than on all of the things that could possibly go wrong. We expect our youth to make a lot of mistakes until they get it right. What they really need is help acquiring the skills they need to become self-sufficient. In short, what we are trying to do in Cincinnati is to create a system that somewhat resembles the caring but challenging atmosphere that healthy families try to create when helping their young adults leave home. Our model might not work in some of the larger cities where rents are sky high or apartments are scarcebut some version of it could. We are fortunate in Cincinnati. We have one of those rare situations in which the public children's service staff, juvenile court personnel, and private providers have reached a general agreement as to what services need to be provided. We see a lot of successes and even some miracles from time-to- time. But we also see a larger group of youth leaving us with a long way to go before they are totally self-sufficient. We know we're not yet doing enough. Next month, 18 youths in our Independent Living Program will graduate from high school or receive their GEDs. It would be a real shame to hand them their diplomas and then tell them they are totally on their own. Extending services and housing assistance to youth until 21 is a no-brainer. It is obviously what is needed to best help all foster youth, and especially those with developmental disabilities. In summary, it is obvious that the foster youths in our country need what all teens need: time to grow up; ongoing support from caring adults; financial support for a reasonable period of time; health insurance until they can afford it; chances to learn from mistakes and direct experience; an affordable place to live when cut off from adult support; and second chances when they fail. The Foster Care Independence Act addresses all of these needs. With this legislation we have a wonderful opportunity to make a significant positive difference in the lives of one of the most vulnerable groups of people in our country. We can never do enough for our own kids or for the kids raised in the child welfare system but we can do better than what we are doing now. The existing Independent Living program has done a lot to help prepare youths leaving foster care for adulthood. Since that program began operating in 1987, the number of teens in the foster care has increased dramatically. We also now recognize that these youths leaving care need a broader range of supports and serivces than are available within existing programs. There is no magic in what we are doing in Cincinnati or in what this bill proposesonly the common sense that says we can't expect foster youth to do what any normal youth couldn't do without years of sustained help and financial support. Our foster youth need the additional supports provided by the Foster Care Independence Act. Chairman Johnson of Connecticut. Thank you very much. Ms. Fagnoni. STATEMENT OF CYNTHIA M. FAGNONI, DIRECTOR, EDUCATION, WORKFORCE, AND INCOME SECURITY ISSUES, HEALTH, EDUCATION, AND HUMAN SERVICES DIVISION, U.S. GENERAL ACCOUNTING OFFICE Ms. Fagnoni. Thank you, Madam Chair and Members of the Subcommittee. I am pleased to be here today to discuss the Independent Living Program and the needs of youth leaving the foster care system. I would like to focus my remarks on the problems faced by foster care youth once they leave care; what is currently known about the extent of services provided by the ILP, and what is known about the effectiveness of the ILP. My testimony is based on ongoing work for the Subcommittee, including a visit to locations in California, Maryland, New York, and Texas and a preliminary review of about one-third of the 1998 annual ILP reports that States provide to HHS. Research has shown that many former foster care youth face difficulties in making the transition from foster care to self- sufficiency. Many of these youths have serious educational deficiencies, rely on public assistance, and often find themselves lacking adequate housing. At the same time, research has also shown that addressing these deficiencies can have a positive effect on former foster care youth. For example, completing high school prior to leaving foster care was positively related to stable employment, not being a cost to the community, and overall self-sufficiency. To better enable youth to make the transition from foster care to self-sufficiency, State ILPs provide a wide array of services. These include helping youth complete high school or get a GED, prepare for postsecondary or vocational education, and prepare for employment. To cite just one example, youths in Baltimore receive employment-related training that covers topics, such as writing resumes, preparing for interviews, conflict resolution, and job retention. However, in some of the sites we visited, we find that the ILPs could not fully provide services that matched the employment potential of foster care youth to appropriate employment pathways. For example, officials in three of the sites we visited cited a lack of vocational opportunities that could be appropriate for youths. Many States also help youths develop daily living skills, such as money management, health, safety, and hygiene, self- esteem, parenting, cooking, and problem-solving. For example, youths in Contra Costa County, California attend a series of workshops that cover money management, health and hygiene, parenting and sexual responsibility, and effective communication skills among others. However, we also found that important hands-on activities designed to provide youth with practice and daily life tests and experience were limited in some of the sites we visited. Issues such as safety regulations in group homes inhibit or prevent certain activities from occurring, such as practicing cooking. States also offer a variety of additional services to further help youth transition to living on their own. These include supervised practice living arrangements, such as transitional housing programs, and after-care services for youth who have just left the foster care system. In Baltimore, for example, the Challengers Independent Living Program provides youth with apartments for 18 to 24 months that are furnished and supervised by service providers. Program staff offer educational, vocational, clinical, and home life support, including additional independent living skills training. However, the transitional housing programs we visited have a limited number of spaces available--from 6 to 12 spaces. One transitional housing provider in Texas told us that while the program has space for 6 youths, the provider had identified an additional 80 to 100 youths who could benefit from this type of housing program. Both current and former foster care youth in California and Texas also told us of the need for additional transitional housing arrangements. Youth who have left the foster care system often encounter hardships and need aftercare services from time to time once they are living on their own. Although all of the sites we visited provide aftercare services for youth who have left the foster care system, officials noted that the services offered are not extensive. For example, Texas officials noted that aftercare services are only available for 6 months after the youth exits care. Given the significant challenges that foster care youth face in moving from foster care to adulthood, it is important to understand how effective ILPs are in moving these children and ensuring positive outcomes. However, few data are available to help in understanding what outcomes are achieved through these programs. We found three studies from Baltimore County, Maryland, Harris County (Houston, Texas), and New York City which linked participation in the ILP with improved education, housing, and other outcomes. In the Maryland study, youth who received ILP services were more likely to complete high school, have an employment history, and be employed when they left foster care. In Texas, graduates of the State's ILP achieved full-time employment earlier and were more likely to complete high school or a GED at a younger age than youth that did not receive independent living services. In New York City, studies showed that 75 percent of the youth in one program had completed high school; 72 percent had full-time employment when they left the care, and 65 percent had savings accounts. While information on program outcomes is limited, State and local officials we spoke with indicated that determining outcomes for former foster care youths is important, and two locations have begun to design strategies to capture this much needed information. Contra Costa County, for example, has funded a 2-year study geared toward measuring outcomes. Similarly, the Maryland Association of Resources for Families and Youth, an association of private service providers, recently began a project to collect key data on youth in foster care, upon exit from care, and at various intervals after leaving care. In our ongoing work, we plan to explore innovative practices States are using to provide services to foster care youth and also to examine HHS's role in developing and implementing performance measures. Madam Chair, this completes my statement. I would be happy to answer any questions. Thank you. [The prepared statement follows:] Statement of Cynthia M. Fagnoni, Director, Education, Workforce, and Income Security Issues, Health, Education, and Human Services Division, U.S. General Accounting Office Madam Chair and Members of the Subcommittee: I am pleased to be here today to discuss the Department of Health and Human Services' (HHS) Independent Living Program (ILP) and the needs of youths leaving the foster care system. While some foster care youths may be adopted or reunited with their families, each year approximately 20,000 exit the foster care system with the expectation that they will be self- sufficient. Yet many of these youths face serious problems, including homelessness, lack of employment stability, incarceration, and pregnancy at an early age. Recently, the Congress has raised concerns that ILP, designed to help foster care youths transition to living independently, does not provide the necessary life skills to complete basic education, find and maintain employment, or to otherwise live self- sufficiently after leaving care. Today, I would like to focus my remarks on (1) the problems faced by foster care youths once they leave care, (2) what is currently known about the extent of services provided by ILP, and (3) what is known about the effectiveness of ILP. My testimony is based on our ongoing work for this subcommittee, including our visits to locations in California, Maryland, New York, and Texas and a preliminary review of about one-third of the 1997 annual ILP reports submitted by states to HHS. In summary, the few available studies that track youths who have exited foster care reveal that many have a difficult time making the transition to living on their own. The studies found that a substantial portion of these youths have not attained basic education goals, such as completing high school, and are dependent on public assistance. In addition, many experience periods of homelessness after leaving care and have other difficulties that impede their progress toward self- sufficiency, such as being unemployed. In an effort to help foster care youths become self-sufficient, state ILPs offer a wide array of independent living services, including education and employment assistance; training in daily living skills, such as managing money, housekeeping, and personal hygiene; and additional transitional services, such as supervised practice living. However, program administrators acknowledge that independent living services fall short in key areas. These administrators report that developing appropriate employment opportunities for foster care youths, providing supervised transitional housing arrangements, and developing program activities that provide opportunities to practice the skills learned or enhance youths' self-esteem has been difficult. Moreover, there are few evaluations that link program objectives to outcomes, leaving questions concerning the effectiveness of the current array of independent living services. BACKGROUND ILP was initially authorized by P.L. 99-272 and reauthorized indefinitely as part of the Omnibus Budget Reconciliation Act of 1993 (P.L. 103-66). The act authorized federal funding of $70 million per year for states to establish and implement services to assist youths aged 16 and over make the transition to independent living from foster care. Services are provided for a short period of time, and states have the flexibility to design services to meet a wide range of individual needs. A portion of the federal funds--$45 million-- are distributed to states as an entitlement based on each state's proportion of all youths receiving federal foster care payments in federal fiscal year 1984 across the United States.\1\ States are eligible to receive an additional share of the remaining $25 million in federal funds if they provide funds to match the federal dollars received. Recently, the Congress and the Administration proposed new initiatives designed to further help adolescents move from foster care to adulthood, including increased program funding, medical care coverage, and housing supports. --------------------------------------------------------------------------- \1\ Under title IV-E of the Social Security Act, federal matching funds based on the state's Medicaid matching rate are provided to states for foster care maintenance costs to cover a portion of the food, housing, and incidental expenses for foster care children from families eligible for benefits under the former Aid to Families With Dependent Children program using 1995 eligibility criteria. States incur all foster care costs for children not eligible for federal support. --------------------------------------------------------------------------- HHS issued instructions to states in December 1993 outlining allowable ILP services. These services include education and employment assistance; instruction in daily living skills; and transitional support services, such as supervised practice living. In addition, states must provide youths written transitional independent living plans based on an assessment of their needs and may establish outreach programs to attract individuals eligible to participate to the program. Further, ILPs may include counseling and other similar assistance related to education and vocational training, preparing for a general equivalency diploma (GED) or higher education, and counseling and training to enhance basic living skills and interpersonal and social skills. Eligible participants for independent living services include all youths aged 16 and over for whom federal foster care payments are being made.\2\ At their option, states may also serve foster care youths not receiving federal assistance and former foster care youths who were in foster care after the age of 16. Likewise, states may provide services to any of these youths until the age of 21. Youth participation in ILP services is voluntary. --------------------------------------------------------------------------- \2\ States can receive federal foster care maintenance payments for eligible children while in foster care family homes, private for profit or nonprofit child care facilities, or public child care institutions. Youths become ineligible for federal foster care maintenance payments at age 18. --------------------------------------------------------------------------- RESEARCH SUGGESTS THAT FOSTER CARE YOUTHS STRUGGLE TO REACH SELF- SUFFICIENCY Many foster youths have a difficult time making the transition from the foster care system to self-sufficiency. While there are few available studies tracking youths who have exited foster care, our review of these studies reveals some consistent findings. Research has shown that many former foster care youths have serious education deficiencies and rely on public assistance. For example, a 1991 Westat study of foster care youths interviewed 2.5 to 4 years after they left care found that 46 percent of these youths had not finished high school.\3\ Additionally, almost 40 percent were determined to be a cost to the community, such as being dependent on some form of public assistance or Medicaid. Other research shows similar results. A 1990 study of former foster care youths in the San Francisco Bay Area who had been out of care at least 1 year but no more than 10, showed that 55 percent left foster care without graduating from high school and that 38 percent still had not graduated at the time of the study.\4\ Similarly, the University of Wisconsin recently studied youths who had been out of care between 12 and 18 months and found that 37 percent had not finished high school and 32 percent were receiving public assistance.\5\ --------------------------------------------------------------------------- \3\ Westat, Inc., A National Evaluation of Title IV-E Foster Care Independent Living Programs for Youth (Washington, D.C.: HHS, 1991). \4\ Richard P. Barth, ``On Their Own: The Experiences of Youth After Foster Care,'' Child and Adolescent Social Work, Vol. 7, No. 5 (Oct. 1990). \5\ Mark E. Courtney and Irving Piliavin, Foster Youth Transitions to Adulthood: Outcomes 12 to 18 Months After Leaving Out-of-Home Care (Madison, Wisc.: University of Wisconsin, 1998). --------------------------------------------------------------------------- In addition, former foster care youths often find themselves lacking adequate housing. The Westat study reported that 25 percent of the youths were homeless at least 1 night. Likewise, the University of Wisconsin study found that, since leaving care, 14 percent of the males and 10 percent of the females had been homeless at least once and 22 percent had lived in four or more places in the previous 12 to 18 months. The connection between homelessness and prior episodes of foster care can also be seen in a 1997 study of 400 homeless individuals.\6\ This study found that 20 percent had lived in foster care as children and 20 percent had one or more children currently in foster care. --------------------------------------------------------------------------- \6\ Homes for the Homeless, Homelessness: The Foster Care Connection (updated Apr. 1997), http://www.opendoor.com/hfh/ fostercare.html (cited Dec. 9, 1998). --------------------------------------------------------------------------- Additional difficulties may further impede former foster care youths' ability to become self-sufficient. For example, the Westat study found that 51 percent of the youths were unemployed and 42 percent had given birth or fathered a child. Similarly, the University of Wisconsin found that 39 percent of the youths were unemployed and that 27 percent of the males and 10 percent of the females were incarcerated at least once. At the same time, research has shown that addressing these deficiencies can have a positive effect on former foster care youth. The Westat study found a connection between certain variables and the youths' ability to live independently. For example, the study showed that completing high school prior to leaving foster care was related to stable employment, not being a cost to the community, and overall self-sufficiency. Further, youths who held at least one job during their stay in foster care were more likely to maintain a job after care. Findings from the three studies we reviewed are summarized in table 1. Table 1: Outcome Information on Former Foster Care Youths Reported in Three Recent Studies ------------------------------------------------------------------------ Study and samples on which percentages are Outcome information on based former foster care youth ------------------------------------------------------------------------ Westat (1991) study of 810 former foster Education: care youths in eight states at 2.5 to 4 --46 percent had not years after leaving care. completed high school. Employment:--51 percent were unemployed. --62 percent had not maintained a job for at least 1 year. Other:--40 percent were a cost to the community. --25 percent were homeless at least 1 night. --42 percent had birthed or fathered a child. Courtney and Piliavin (1998) study of 113 Education: former foster care youths in Wisconsin at --37 percent had not 12 to 18 months after leaving care. completed high school. Employment: --39 percent were unemployed. --19 percent had not held a job since leaving care. Other:--32 percent received some kind of public assistance. --12 percent were homeless at least once (14 percent males and 10 percent females). --22 percent had lived in four or more places. --44 percent reported problems with acquiring needed medical care. --27 percent of males and 10 percent of females were incarcerated at least once. Barth (1990) study of 55 former foster Education: care youths in the San Francisco Bay Area --38 percent had not at least 1 year and no more than 10 years completed high school. after leaving care. Employment: --25 percent were unemployed. Other: --53 percent reported serious financial hardships. --47 percent received some form of public assistance or had problems paying for food or housing. --35 percent were homeless or moved frequently. --38 percent did not have health or medical coverage.--13 percent reported hospitalization for an emotional problem. --40 percent of females reported a pregnancy. --35 percent had been arrested or spent time in jail or prison. ------------------------------------------------------------------------ MULTIPLE SERVICES ASSIST YOUTHS IN ACHIEVING INDEPENDENCE BUT FALL SHORT IN KEY AREAS To better ensure foster care youths are prepared to live as self-sufficient adults, state ILPs provide an array of services, including assistance with completing education and finding employment; developing the basic skills needed to live independently, such as money management, hygiene, housekeeping, and nutrition; and transitional services, such as supervised practice living arrangements. However, state and local administrators acknowledge that their current ILPs fall short in key areas. For example, some programs do not sufficiently seek out employment opportunities in the community and offer few opportunities for youths to participate in real-life practice opportunities or esteem-building experiences. Moreover, some programs could not provide adequate housing or other transitional assistance for youths still in care and those who have left care. Education and Employment Assistance Our review of annual state reports and our visits to four locations show that states provide services to help youths (1) complete high school or a GED, (2) prepare for post-secondary or vocational education, and (3) prepare for employment. For example, in Contra Costa County, California, an education specialist meets with youths to discuss education goals, review grades, and assess education needs. If a youth is behind academically, tutoring services are provided. The specialist also sets up tours at local colleges and vocational programs and assists youths in completing financial aid applications. A job development specialist assists difficult to employ youths find self-supporting employment through such means as coaching, counseling, and on-site job development training. The specialist also coordinates career fairs. Youths in Baltimore receive employment-related training that covers topics such as writing resumes, preparing for interviews, conflict resolution, and job retention. However, in the locations we visited, we found that the ILPs could not fully provide services that matched the employment potential of foster care youths to appropriate employment pathways. For example, officials in three of the locations we visited cited a lack of vocational opportunities appropriate for youths. State and local coordinators in Texas indicated that few apprenticeship positions are available, while officials in Baltimore and New York City reported a lack of affordable vocational programs or funds to pay for such programs. Baltimore officials also reported that culinary arts and technology-related programs--two programs popular with foster youths--are very expensive. Of the four locations we visited, only Texas offers statewide tuition waivers for all state-supported vocational, technical, and post-secondary schools. We also found that connections between ILP and potential employers are not thoroughly developed. For example, ILP coordinators in one location said they did not have time to establish relationships with many employers and that employment development efforts in their location were informal. State officials in California and Maryland indicated that they recognize more public-private partnerships to provide youths with employment opportunities are needed. In addition, New York City officials reported that they are just beginning to devise ways to link with employers to enhance youth job prospects, such as developing internship opportunities. Several officials also pointed out that more staff need to be assigned to accomplishing this task. Assistance in Learning Daily Living Skills Our review of annual state reports shows that many states help youths develop daily living skills. Each location we visited conducts independent-living skills classes to teach youths tasks that are necessary to live self-sufficiently. For example, youths in Contra Costa County, California, attend a series of workshops that cover life skills such as money management, health and hygiene, parenting and sexual responsibility, and effective communication skills. Money management covers topics such as how to prepare a budget and how to open and use a checking account. In the San Antonio, Texas, area, life-skills classes meet for 8 weeks and cover core areas, including personal and interpersonal skills, health and safety, money management, and planning for the future. In New York City, life-skills classes provide similar instruction as well as instruction on housekeeping, health care, interpersonal skills, food management, transportation, and family planning. However, important hands-on activities to practice daily life tasks and experiences to develop self-esteem were limited in some of the locations we visited. Some state and local program officials acknowledged the importance of allowing youths to attempt (and perhaps initially fail) daily tasks-- including cooking, cleaning, doing laundry, and comparison shopping--until they become proficient at these tasks. Program officials in two locations and foster care youths in three locations reported that issues, such as safety regulations for group homes, inhibit or prevent certain activities, such as practicing cooking. In some group homes, laundry products and cooking utensils may be locked away from youths. In addition, esteem-building experiences are often limited to a small number of youths. For example, local officials in Texas reported that opportunities for foster care youths to participate in post- secondary school conferences or extended outdoor activities were limited. In addition, programs offering adult mentors--in an attempt to build positive and lasting relationships--serve a small number of youths. For example, a foster care service provider in Texas--contracted by the state specifically to develop mentor programs--reported difficulties finding mentors. However, officials in all locations saw some type of mentor program as one method to provide youths with a vocational role model and opportunities to practice other independent living skills they have learned. Housing and Other Transitional Support Services Based on our review of annual state reports and site visits, states offer a variety of additional services to further help youths transition to living on their own. These include supervised practice living arrangements--such as transitional housing programs--and aftercare services for youths who have left the foster care system. Transitional housing programs--while designed slightly differently in each location--provide an opportunity for youths to experience living independently while still receiving supervision and financial support. In Baltimore County, Maryland, for example, the Challengers Independent Living program seeks to provide youths who have previously lived a dependent lifestyle with different or improved means to cope with present and forthcoming independence once they leave foster care. Foster care youths can reside for 18 to 24 months in apartments furnished and supervised by the service provider and receive a weekly stipend to purchase clothing, food, and household supplies. They also are responsible for cleaning their apartments and doing their laundry. Each youth's foster care payment covers the cost of rent, utilities, and administration of the program. Program staff also offer educational, vocational, clinical, and home-life support, including additional independent-living skills training. Officials in the four locations we visited reported that the number of supervised transitional housing sites is very limited and that they could not provide adequate housing assistance for both youths in care and those who have left the system. The programs we visited have a restricted number of spaces available--from 6 to 12 spaces. One transitional housing provider in Texas indicated that while the program has spaces for 6 youth, an additional 80 to 100 youths with no housing upon exiting foster care could benefit from this type of housing program. A transitional housing provider in a second location explained that program staff carefully screen youths for readiness and accept only the most promising teens into the program. Current foster care youths in Texas and former foster care youths in California also emphasized the need for additional transitional housing arrangements. Youths who have exited foster care face a number of obstacles in finding housing, according to officials in the locations we visited. For example, many landlords are reluctant to rent apartments to a youth without work experience or credit history. In addition, foster care youths who live in urban areas often do not earn a sufficient income to pay the rents found in large cities and may find it difficult to save enough money to pay for a security deposit. Officials in Baltimore reported that the local social services department often writes a letter to the landlord on behalf of youths to help them obtain housing. Finally, officials at the locations agree that youths who have left the system often encounter hardships and need aftercare services from time to time. Although all of the locations we visited provide such services, some officials noted that their aftercare services are not extensive. For example, in Texas, aftercare services are only available for 6 months after the youth exits care. The services consist mainly of referrals to other service agencies, visits to colleges, and a small stipend for 4 months. Aftercare services in Baltimore County and New York City are limited to referring the youths to other agencies who can assist them. However, at both of these locations, youths have the opportunity to remain in foster care until age 21 under certain circumstances. Contra Costa County, California, previously offered aftercare to youths up to age 19 on a case-by-case basis; new state legislation mandates that ILP now serve youths to age 21. INFORMATION ON PROGRAM EFFECTIVENESS IS LIMITED Given the significant challenges that foster care youths face in moving from foster care to adulthood, it is important to understand how effective ILPs are in better ensuring positive outcomes. However, few data are available to help in understanding what outcomes are achieved through these programs. States are required to report to HHS participant achievement 90 days after program completion, such as the number of youths who are employed, have completed high school or a GED, are attending college, and are living independent of public assistance. However, state and local officials reported much difficulty in finding youths to determine their living status once they leave care. These officials indicated they either do not follow up with youths after leaving foster care or have little success finding youths. For example, a Maryland official stated that response to follow-up contact in the past was very limited and that only 15 percent of youths returned follow-up letters. Local officials in Texas estimated that about 30 to 35 percent of youths disappear during the initial 90-day period and that some can only be located through word- of-mouth or sibling contacts. They noted that following up with youths who received a stipend as part of aftercare is less difficult. In addition, few formal studies have been conducted that measure ILP effectiveness. We found three studies--from Baltimore County, Harris County (Houston, Texas), and New York City--that linked participation in ILP with improved education, housing, and other outcomes. In the Baltimore County study, youths who received ILP services were more likely to complete high school, have an employment history, and be employed when they left foster care.\7\ In the Harris County study, the authors found that graduates of the Texas ILP achieved full- time employment earlier and were more likely to complete high school or a GED at a younger age than youths who did not receive independent living services.\8\ The New York City study of independent living services provided by Green Chimneys Children's Services showed 75 percent of the youths had completed high school or a GED, 72 percent had full-time employment when they left care, and 65 percent had savings accounts.\9\ Another study linked certain foster care placements with greater attainment of practical living skills.\10\ This study found that foster care youths placed in apartment-type transitional housing scored higher on life- skills knowledge assessment. Finally, the Westat study found that youths who received training in money management, obtaining a credit card, and buying a car, as well as help in how to find a job and appropriate education opportunities were more likely to maintain a job for at least a year. However, in some instances, ILP did not have the desired effects. For example, in the Westat study, researchers found that receiving independent living services did not significantly reduce the probability of early parenthood. In addition, the Harris County study found that program participants younger than 21 were more likely to be dependent on different forms of public assistance--specifically subsidized housing and food stamps-- than the group of nonprogram participants under age 21. --------------------------------------------------------------------------- \7\ Maria Scannapieco and others, ``Independent Living Programs: Do They Make A Difference?'' Child and Adolescent Social Work Journal, Vol. 12, No. 5 (Oct. 1995). \8\ Jane T. Simmons, ``PAL Evaluation Final Report,'' unpublished report submitted to Harris County (Texas) Children's Protective Services (Mar. 6, 1990). \9\ Gerald P. Mallon, ``After Care, Then Where? Outcomes of an Independent Living Program,'' Child Welfare, Vol. 77 (Jan./Feb. 1998). \10\ Edmund V. Mech and others, ``Life-Skills Knowledge: A Survey of Foster Adolescents in Three Placement Settings,'' Children and Youth Services Review, Vol. 16, Nos. 3/4 (1994), pp. 181-200. --------------------------------------------------------------------------- State and local officials indicate, however, that determining outcomes for former foster care youths is important, and two locations have begun to design strategies to capture this much needed information. Contra Costa County, California, for example, has funded a 2-year study geared toward measuring outcomes. The study will determine the status of youths at the time they enter ILP--such as foster care placement stability, academic performance, and living-skills assessment--and measure youth outcomes after ILP services are given. One goal is to use the information to develop better aftercare programs. Similarly, the Maryland Association of Resources for Families and Youth--an association of private service providers--recently began a project to provide the answers to three questions: Whom do we serve? What services do we provide them? and What are the outcomes of those services? The project requires data collection while the youths are still in care; upon exit from care; and at 6-, 12-, and 18-month intervals after leaving care. In our continuing analysis of ILPs, we plan to explore in greater detail many of these issues, including any innovative strategies being implemented in the states. We also plan to look at HHS' role in ensuring that performance measures are identified and implemented. This information will be presented in our final report to the Subcommittee. Madam Chair, this concludes my prepared statement. At this time, I will be happy to answer any questions you or the other Members of the Subcommittee may have. Chairman Johnson of Connecticut. Thank you very much. It is a pleasure to welcome Mark Courtney from Wisconsin. We are glad your plane got you here in time, and we are looking forward to hearing what you have to say. STATEMENT OF MARK E. COURTNEY, ASSISTANT PROFESSOR, SCHOOL OF SOCIAL WORK AND INSTITUTE FOR RESEARCH ON POVERTY, UNIVERSITY OF WISCONSIN-MADISON Mr. Courtney. It is a pleasure to be here; thanks for inviting me. Today, I am going to share with you the results of a study that I have been conducting with Irving Piliavin and Andrew Grogan-Kaylor in Wisconsin of youth that have aged out of the foster care system in Wisconsin during 1995 and 1996. I am also going to share with you my observations regarding the Foster Care Independence Act of 1999. Our study is following foster youth from before they left the system until 3 years after they exited. Thus far, we have interviewed 141 youths while they were in care, and we have been able to follow about 80 percent of them, or 113, for about 12 to 18 months after they have left the system. All of them have been in care at least 18 months and on an average over 5 years. So, from our perspective, we believe the system had a clear responsibility to prepare them for independence. We asked a number of questions about whether they had been trained in areas specified in law and regulations, and we found that on average about three-quarters of them claimed that they had been trained in any given area. However, far fewer had actually been provided concrete assistance in carrying out essential tasks associated with independent living. For example, fewer than one-fifth have received any job training; participated in a mock job interview; been told how to apply for public assistance; received help finding a job or help obtaining housing, personal health records or health insurance. Not surprisingly, then, over one-quarter of the foster youth felt either not at all or not very well prepared in a number of important areas, including getting a job, managing money, obtaining housing, knowledge of community resources, parenting, and living on one's own. Almost a third of the youths were at or below an eighth- grade reading level when we first contacted them near the time when they should have been graduating from high school. Not surprisingly, given their educational deficits, by 12 to 18 months past discharge, 37 percent of the young adults had not completed high school; 55 percent had completed high school or an equivalent, and only 9 percent had entered college. The former foster youths had significant unmet health and mental health needs. Forty-four percent of them reported having trouble obtaining medical care most or all of the time since leaving the system. Of these, 90 percent reported that this was due to a lack of health insurance coverage or care simply costing too much. Nearly half of our respondents had received mental health services in the year prior to our interview with them while they were in the system, yet only one-fifth had received any mental health services since leaving the system in spite of no change in their overall, relatively poor mental health. The bottom line is that achieving self-sufficiency is difficult, to put it mildly, for a large percentage of the former foster youth. Fewer than half had at least $250 when they left the system. Only three-fifths were working when we interviewed them postdischarge, and even those employed, on average, earn less than someone working full-time in a minimum wage job. All told, 44 percent of the group had either been homeless, incarcerated, or received public assistance since leaving the care of the State. These findings give pause. At the same time, they provide support for the provisions of the Foster Care Independence Act of 1999. The proposed legislation recognizes the considerable unmet health and mental health needs of youth aging out of foster care. From our perspective, common sense calls for extension of Medicaid eligibility for this population through the age of 21. The act would also make available substantial, additional funding for support for youth making the transition to independence both before and after they leave the protection of the formal foster care system. Currently, most services focus on educating foster youth about independent living skills through training programs prior to their discharge from the system, while providing limited, if any, hands-on experience for youth. What is most sorely lacking are adequate opportunities for former foster youth to return to the system for help when that help is most needed and appreciated after they are on their own. As an aside, we found that three-quarters to four-fifths of them expected that they would be able to do that, and that was one of the most troubling findings, that they actually believed they could go back to the system and get help. In addition to providing a much needed increase in basic funding for independent living programs, the Foster Care Independence Act would allow States the flexibility to use Federal funds for much needed concrete assistance in dealing with obstacles to self-sufficiency, particularly noteworthy, given the level of homelessness and housing instability of this population, both in our study and others, the provision of allowing a portion of the funds to be used for housing assistance for former foster youth under the age of 21. Last, the legislation would ensure that independent living programs would be subjected to much more thorough outcome evaluation than in the past. our Nation has spent over $1 billion on these programs in the past decade while learning almost nothing about what works for whom. In summary, available evidence suggests that many if not most foster youth who age out of foster care, our children, have a very difficult time landing on their feet when they are pushed out of the door of this system. The Foster Care Independence Act would give States the funds and flexibility to better support these youth in achieving self-sufficiency as well as hold States accountable for demonstrating the effectiveness of their efforts. That completes my remarks. [The prepared statement follows:] Statement of Mark E. Courtney, Assistant Professor, School of Social Work and Institute for Research on Poverty, University of Wisconsin- Madison Today I am going to share with you some results from a study conducted by myself, Irving Piliavin, and Andrew Grogan- Kaylor at the University of Wisconsin-Madison of the experiences of foster youths who aged out of the Wisconsin foster care system in 1995 and 1996. I will also share with you my observations regarding the Foster Care Independence Act of 1999. Our study is following foster youth from before they left the system until three years after they exited. Thus far we have interviewed 141 of them while they were in care and 113 of those, or about 80 percent, 12 to 18 months after they were discharged from the system. The youths had been in care at least 18 months, an average of over five years, and therefore we believe that the system had a clear responsibility to prepare them for independence. We asked whether they had been ``trained'' in a number of areas specified in law and regulations. The average percentage of sample members reporting that they had been trained in a given area was 76 percent. However, far fewer had actually been provided concrete assistance in carrying out essential tasks associated with independent living. For example, fewer than one fifth had received any job training, participated in a mock job interview, been told how to apply for public assistance, received help finding a job, or help obtaining housing, personal health records, or health insurance. Not surprisingly, over one-quarter of the former foster youth felt either not at all, or not very well prepared in a number of important areas including getting a job, managing money, obtaining housing, knowledge of community resources, parenting, and living on one's own. Almost a third of the youths were at or below an eighth grade reading level when we first contacted them. Not surprisingly, given their educational deficits, by 12 to 18 months past discharge 37 percent of the young adults had not yet completed high school, 55 percent had completed high school or an equivalent, and only 9 percent had entered college. The former foster youths had significant unmet health and mental health needs. Forty-four percent of them reported having trouble obtaining medical care most or all of the time. Of these, 90 percent reported that this was due to a lack of health insurance coverage or care costing too much. Nearly half of our respondents had received mental health services in the year prior to our interview with them while they were in out- of-home care. Yet, only about one-fifth had received any mental health services since leaving care in spite of no change in their overall relatively poor mental health status. The bottom line is that achieving self sufficiency was difficult for a large percentage of the former foster youth. Fewer than half had at least $250 when they were discharged from the system. Only three-fifths were working when we interviewed them 12 to 18 months after discharge. Even those employed earned on average slightly less than a full-time minimum wage worker. All told, 44 percent of the group had either been homeless, incarcerated, or received public assistance since leaving the care of the state. These findings give pause, but at the same time they provide support for the provisions of the Foster Care Independence Act of 1999. The proposed legislation recognizes the considerable unmet health and mental health needs of youth aging out of foster care. Common sense calls for extension of Medicaid eligibility to these youth through the age of twenty- one. The Act would also make available substantial additional funding for support to youth making the transition to independence both before and after they leave the protection of the formal foster care system. Currently, most services focus on educating foster youth about independent living skills prior to their discharge from the system, while providing limited if any ``hands-on'' experiences for youth. What is most sorely lacking are adequate opportunities for former foster youth to return to the system for help when that help is most needed and appreciated, after they are on their own. In addition to providing a much needed increase in basic funding for independent living programs, The Foster Care Independence Act would allow states the flexibility to use federal funds for much-needed concrete assistance in dealing with obstacles to self sufficiency. Particularly noteworthy, given the level of homelessness and housing instability of this population, is the provision allowing up to 30% of funds to be used for housing assistance to former foster youth under the age of 21. Lastly, the legislation would ensure that current and future independent living programs would be subjected to much more thorough outcome evaluation than in the past. Our nation has spent over one billion dollars on these programs over the past decade while learning almost nothing about what works for whom. In summary, available evidence suggests that many if not most youth who age out of foster care, our children, have a very difficult time landing on their feet when they are pushed out the door of the system. The Foster Care Independence Act of 1999 would give states the funds and flexibility to better support these youth in achieving self sufficiency as well as hold states accountable for demonstrating the effectiveness of their efforts. Chairman Johnson of Connecticut. All right. I thank the panel for their testimony, and I thank you, Mark, for this report on some concrete research. Unfortunately, we haven't been doing this kind of research very long and don't know a lot more about what we are doing. So, we do appreciate your research and look forward to actual follow up on children, of young people. I want to ask you--you have all commented on the lack of data and the need to really look at outcomes and what that tells us. I assume most of you are familiar with the AFCARS, Adoption and Foster Care Analysis and Reporting System, which we put a lot of money into, a lot of time, and a lot of years to establish. There is resistance, naturally, to altering the AFCARS system, and there is some concern about how much we can alter it and not cause some really big problems. So, I am not intimately acquainted with the AFCARS system; I am merely spouting this information. I theoretically know it, but I don't practically. For those of you who have a lot more practical understanding of the system than I do, do you think we--are there specific modest changes that we could make that you think wouldn't be too difficult for the system to absorb but would give us better information? Ms. Massinga. Ms. Massinga. Thank you. I suggested some measures like knowing whether or not kids have graduated from high school; like knowing whether or not kids drop-out and how long they have been a drop-out. I appreciate the difficulty for States to make adjustments, because as you say we are just raising the level of data gathering, and I know that those are difficult decisions, but it seems if we really pressed for results- oriented data as well as information on how kids progress; results that are key--like ``Are kids well? Are they receiving health services?''--and so forth. I think it might be very useful. Mr. Kroner. I think that one of the hardest things to do in the field of independent living is to keep track of kids once they leave the system. One study we were involved with actually hired a team of researchers to call kids every 3 months to make sure they knew where they lived and saw how they did, and it showed a lot of positive success for independent living programs, but if you don't have a group of people assigned to do that, these teens are like every other teen in America--they tend to move around a lot. One move and they are out of your research pool. So, we have to find some way to keep track of these kids; give them some kind of card that they can call in every now and again to report on what they are doing and give them some type of financial incentive for calling back in. But, other than that, it is really tough to keep track of them. Ms. Fagnoni. I should point out, as we note in our testimony, HHS does require States to provide annual reports on the independent living programs, but the one measure that tries to track to what happens to youth after they leave the foster care system asks for information on what has happened to them 90 days after they leave the system. And there are two issues with that. One is, even with the 90 days, which is a fairly short period of time, we were told by officials that they had difficulty locating the youth even within that short period of time, but the issue is they will also note that 3 months is not a long enough period of time to really know youth are faring once they leave the system. Mr. Courtney. I think if the primary concern--and I believe the primary concern should be what is happening after they have left the system--that AFCARS isn't really the best mechanism for doing that for a number of reasons. I believe that the Federal Government should, through the States, periodically do the kind of assessment that we are doing on a sample of children who are leaving the system, so we periodically have a sense, generally, how these folks are doing after they leave the system. And combine that with some systematic assessments of different approaches to doing independent living services, because there are myriad approaches to try and prepare people and then support them after they are on their own, and we haven't done rigorous evaluation really of any of those. I think doing both of those things would, one, give us the sense of generally how folks are doing, and then, two, give us a sense of what works for whom. It is very difficult to follow them. We think we are pretty good at this. We have the highest response rate of any study we know of, and we spent between $250 and $300 per interview to find these folks after they left the system. Chairman Johnson of Connecticut. Since we are, for the first time, giving them real money for the program after age 18 to 21, we certainly do have to require something other than that one interview that was really related to an old foster care program. It really doesn't reflect the kind of program that we are setting up. So, one of the reasons you just got the draft this morning are that there are a lot of things that have been discussed and negotiated around this kind of issue, and so I do look forward to your input in the next week as to what you think we should do in that area; also, as to what you think of the sections of the bill that say ``These are the kinds of services you can provide or these are goals,'' because it is not easy to describe in spite of the fact that you have probably Members in this Subcommittee who are more interested in these kids than often is the case in the Congress and know more about it. I find it hard to find a way to talk about the issue of personal maturity in the legislative language, and since in the end that is what this is all about, we do need to be able to do that. I have a couple of other questions, but I am going to come back to those if we have time. We do have another panel, so we want to be sure to get as much testimony in the record before one of our key Members has to leave. Ben. Mr. Cardin. Thank you, Madam Chair. Of course, it is a pleasure to have Ruth Massinga with us today. She was secretary of our human resources agency when I was in the State legislature. We worked very closely together, and she brought a lot of creative solutions to problems that we have in Maryland. It was our loss when you moved on, but it is nice to have you here today, so, welcome. I did appreciate your testimony as to trying to get better information on outcomes. Following on what Mrs. Johnson has said, it is important that we have adequate information to be able to evaluate how programs are working and whether additional resources will be needed, and we do look forward to working with all of you in developing that. We have language in our bill that requires HHS and the States to establish and track outcomes, so it is part of our interest, and we think it is very important. I am curious as to how you would rank the different obstacles that face young foster children who are aging out of foster care? Is it the lack of education? Lack of independent skills? Is it the lack of health insurance? Is it lack of job training? Lack of housing? I mean, I know all of these are factors, but could help us rank where you think the highest priorities of needs are for those children aging out of foster care? Who wants to take a crack? Mr. Kroner. I will jump right in on that. I think the number one thing that all these kids need is real life experience. They need to get out there and feel what it means to live on their own and to have that daily real life experience hit them on the head--budgeting their money, managing their time, controlling their friends, dealing with their family members, dealing with a real life landlord, real life tenants, and things like that. The second thing is I think we need to start a lot earlier. There is a provision in the bill to start at 14, and I think that makes total sense. What our county has done is we have a countywide self- sufficiency program for youth regardless of where they are at-- foster homes, group homes--everybody starts at 16, and the kids that come from that program into our apartment program, you can tell that they really kind of understand what they are getting themselves into, but it is a combination of starting earlier; doing a lot of life skills training before the kids are placed out on their own; placing them out on their own; doing life skills on top of that, and then I think then you will see things happen. Ms. Massinga. I think, though, Mark, let us not underestimate the fact that there is continuity of relationships, because part of what I think Mrs. Johnson and you, Mr. Cardin, alluded to is how do you bring it all together? All those things that you ticked off are needs, but if kids don't have adults that they trust to help them figure out, ``OK, I made this mistake, so what am I going to do tomorrow, because I still have this need around health care; I still have a need around housing?'' That is where they get in trouble. So, it is the lack of knitting it all together and having adults who systematically help them figure it out, just like your own kids that your program addresses. You know, if they make a mistake, you have got to have real life experiences, but you also have to have those experiences under the tutelage of people who will help you and say ``It is not fatal. Pick yourself up and move ahead.'' And, frequently, we give people skills but not human support, and so they fall apart. Ms. Fagnoni. In our examination of research, we do note that the research that has tried to look at outcomes and link different efforts of outcomes has shown that something really important is that youth complete high school before they leave foster care. So, there are some concrete sorts of actions that are most helpful if they can complete those before they are out on their own. Mr. Cardin. Mr. Courtney. Mr. Courtney. I would really agree with the argument that real life experience is very important. We found that training per se was not at all related to any of the important outcomes we looked at. Now, granted, this is one study in Wisconsin, and we are looking globally at the State of Wisconsin. We did find that youth who had engaged in some of the concrete experiences I talked about (they had their medical records; they had actually gone out and looked for jobs; they had had to deal with landlords) fared better in terms of employment and housing stability, and so forth. Another thing is I like the part of the bill that provides flexibility for providing housing, because we find a huge amount of homelessness and housing and stability in this population. My partner in this got involved in this kind of research, because he is a very prominent homelessness researcher, and he was struck by the high percentage of adults who are homeless who lived in foster care. And then, last, social support--sort of another way of talking about having stable relationships with adults. We find that social support is actually the best predictor in our study of favorable outcomes; that they report that they have various kinds of social support to back them up, the ones who don't fall through the cracks. Mr. Cardin. Well, I appreciate all of your testimony particularly as to specific State studies. Obviously, I was most impressed with the results from Baltimore County. Ms. Fagnoni, your conclusion is that those children who had participated in independent living did better in graduating from high school and finding employment. Do you know how many of the children who were aging out of foster care had an opportunity to participate in the program for independent skills? Ms. Fagnoni. I don't have the statistics on that specific program. I do know that of the 70,000 or so foster care youth who fall into the category of being in the age group close to aging out, that, perhaps, half of those receive some sorts of independent living services but a far smaller percentage actually receive some of the concrete types of assistance and are able to be in independent living types of programs and transitional housing programs that seem to be very helpful. Mr. Cardin. I would be interested--if you could make that available, I would be interested in seeing what percentage we are currently reaching in the jurisdiction I represent. Ms. Fagnoni. OK. Mr. Cardin. Thank you. [The information follows:] At the independent living hearing on May 13, 1999, Representative Ben Cardin asked GAO to provide him the percent of youth served under ILP in his congressional district. Unfortunately, Maryland does not keep statistics by congressional district. However, following is information on Baltimore City and Baltimore County. This information is for FFY 1998--the most recent year data is available. ------------------------------------------------------------------------ Youth Youth Location Eligible Served by Percent for ILP ILP Served ------------------------------------------------------------------------ Baltimore City................... 878 823 94% Baltimore County................. 165 135 82% ------------------------------------------------------------------------ Chairman Johnson of Connecticut. Mr. English. Mr. English. Thank you, Madam Chair. This has been a truly worthwhile public hearing and enormously informative. I can attest to the fact that I came into this with scant knowledge of the independent living programs for youth and foster care. This hearing has been helpful for me to appreciate, for one thing, how little we in Washington know about what is going on out there. I think there seems to be consensus on this panel that there ought to be some form of performance measurement applied to State programs that we fund. Can you comment-- starting with Mr. Courtney, on how difficult it would be to develop a worthwhile system of performance measurement, and what would be your thoughts on what would necessarily be included at a minimum? Mr. Courtney. The difficulty would really depend on what it was you wanted to know. Mr. English. What should we know? Mr. Courtney. Well, we should know certainly whether they graduate from school--that is relatively easy although not trivial to come up with that information. We should know about employment stability and housing stability, and we should know about institutionalization, because we find one-fourth of the males in our sample who were abused and neglected (they were not adjudicated delinquents) were incarcerated within a year of leaving the system. So, those are some basic things. Institutionalization history, education history, many States could get that information together. When you look at housing stability, employment stability, you have got to survey them, and the problem is they won't all be involved in your program. This is a problem with a lot of the research. We have research on people who choose or are able to participate in these programs, and you have a huge group that are not participating, and to get that kind of information on everyone would be an expensive proposition. To do it periodically, so that you have an idea, a representative idea, of what is happening in every State, I think is feasible and could be done with the funding you are talking about. Mr. English. Ms. Fagnoni, what would you add to that? Ms. Fagnoni. Well, I would agree that those are some of the key measures--graduating from high school, employment, obtaining and retaining employment, housing stability, and whether or not there are other poor outcomes, such as institutionalization, but I also agree that the difficulty lies more in trying to get some of the information than it does in sort of figuring out what the key things you want to know about people who are self-sufficient adults. Mr. English. Mr. Kroner. Mr. Kroner. Yes, I think most of what I was going to say has been said. I think that the issue--one of things I wanted to make a point of is that we have noticed that a lot of young people that didn't do well right after they left the program came back a year later and were doing really well, so I think that there is a problem here in the sense that you are going to see this roller coaster effect with these kids for a couple of years. The other fact is there is no control group since we can't compare this group to a normal group of teens that would be forced to go out on their own. Even whatever we find is not really going to give us a clear picture, but I think I would look at housing stability; I would look at involvement with the criminal justice system, and I would look at the involvement with the mental health system and any type of reinvolvement with the county welfare of State welfare systems. Mr. English. Is there any way of measuring the safety of the people that are participating in these programs? Mr. Kroner. If you could have contact with these kids, you could get a lot of information about how safe they felt and how safe they were and things that happened to them. Again, the issue is trying to find them once they are out of the system. Mr. English. Ms. Massinga, what do you think? Ms. Massinga. Well, I think the list that you have heard is a list that I agree with. To go to the question of how to gather the data, it seems to me that this is not unlike the issues that you are looking at as you look at what happens with people who are leaving public assistance, that the longer we look at it, if we have relatively decent data, we can start to make some judgments about what is happening, and you know that the States are beginning to step up to the challenge, not all in the same way, but States are beginning to really step up to the challenge of providing much longer term data about results. You can't get it all on everybody, as Mark points out--both Marks--but I think if there is some expectation that there is rigor associated with the measures--and you have heard about half a dozen which we all think are important, I think it is possible to start to develop the mindset in States and localities that outcomes, the results, are the real things that matter. So, I think that that is why you are focusing on accountability structures in that way as you have, as you tried to look at other systems particularly reform of public welfare is an important statement and signal for your Subcommittee to make that it is important to work on this issue of results- oriented measures. Mr. English. Ms. Fagnoni, you made a comment during your testimony that you have discovered that in some cases group home regulations are an impediment to the implementation of independent living programs. Could you elaborate on that in my remaining few seconds? Ms. Fagnoni. For example, one of the things we found is that sometimes the utensils one would need to cook with are locked away, and when I inquired about the reason for that, it is a safety issue, and among cooking utensils are knives which could be used by one youth against another, but it clearly limits their ability to have practical experience in cooking which is a key element in independent living. So, that is one example. Mr. English. Do you run into other examples where State regulations create a barrier to independent living programs being successfully carried forward, and is there something we should ask the States to do in the way of deregulation that would make it easier to move independent living programs forward? Ms. Fagnoni. I think I don't have a great deal of detail on that. This is an ongoing study we are doing, and we have some anecdotal examples. That is something we could think about exploring a little more. I don't know whether people who are in the field have dealt with that. Mr. Kroner. Mr. English, yes, I think there are a lot of States that still do not allow youth to be placed into their own apartments without 24-hour supervision, and that is the biggest impediment to making something like this happen. They are so concerned about liability issues, and I think what a lot of States are doing is allowing the private nonprofits to take on that role and assume some of the liability for the individual placements. Now, we have a similar situation with a lot of our foster parents. They will not allow the youth in their homes to go into the kitchen, because they don't want them to mess the kitchen up. They won't let the kids use their washers and driers, so not only are these kids not learning from a regular family, they are being systematically kept from learning things that they are going to need to know. So, I think that there are policies at the program and there are policies at the State level that are blocking a lot of this from happening except in Ohio. Mr. English. Thank you. That is an important qualifier---- [Laughter.] And I thank the panel. Madam Chairman, I thank you for your patience. Chairman Johnson of Connecticut. Mr. Camp. Mr. Camp. I am not from Ohio; I am from Michigan, but thank you all for your testimony very much, and obviously the concern is that kids walk off a cliff after they leave foster care, and I really don't have any questions for you, but I appreciate the testimony, and I have read your statements. I may not be here for all of your verbal testimony, but I think obviously the idea of trying to have self-sufficiency for kids after they leave the foster care system is very important and getting the information to understand what their needs are. But I--when you hear that many of them are below the eighth-grade reading level at least in the Wisconsin-Madison data, I think that is a real concern, and I want to thank the Chairman for introducing this independent living bill and having this hearing, and I do want to work with the Subcommittee also particularly on the issue of health care and Medicaid, potentially, for some of the young people who need it transitioning out of what probably was a pretty difficult situation or they wouldn't have been in foster care in the first place, and hoping to see them become productive citizens. I certainly wasn't productive at 18, and I think many people aren't, and it takes a couple of years to get the skills needed to be productive. So, I want to pledge my efforts to work with the Chairman and thank all of you for your testimony. Thank you. Chairman Johnson of Connecticut. Mr. Watkins. Mr. Watkins. Thank you, Madam Chair. I would like to thank all of you for your dedication and interest in this legislation. I would like to share some of my experiences of having been a foster parent. We adopted a young lady when she was age 15. My wife and I had a home licensed and available for young ladies. You have them for a while, and you lose a chunk of your heart every time they leave. I think for every child there is a different variable. I think it is just like raising your own kids; they are all different. We never worry about messing up the kitchen; there are foster parents that probably do. I think our biggest problem, Madam Chair, is that we probably need more and better foster homes. We need more incentives for families who have been successful, to have foster children. Let me tell you, there is no one raised anymore poorer than I was as a kid. We had a hard time working things out as family, because a lot of the administrative people in the welfare program and DHS. They thought our family, because of its economic class, didn't qualify. Instead of looking at it as, ``Hey, if you have got a family that has been able to have some success''--and I don't want to be saying it is that successful, but it is a process to follow. I think, those children to go through instead of putting them back into a situation of just a little bit of survivability out there. We should give them a way that they can see and feel and touch and be a part of successful families. Families that have--maybe worked their way through college, maybe worked scrubbing floors and worked on farms and done all those things, but the children see that there is a work ethic there, too. Now, what that experience, Nancy, has done for the Wesley and Lou Watkins family, we ended up finally adopting a young lady, 15 years of age, who was going to be thrown back into a worse situation. We were fortunate enough, she came to us and said ``Will you adopt me?'' We said we would, and she is now a professional lady. We put every dollar back into a college account for her, every single dollar. I think that we need to look at how to lure more families into having foster children and possibly even adoption. I think some type of tax credits that would allow these type of families opportunities would do that. We had to try to make sure that the dollars--if I can just take a moment or two on this--didn't become a tax burden for us in bringing up that little girl. We wanted to let her become successful in her right. She didn't know who her father was; her mother was an alcoholic and a drug person, but now I would like to say she is a very professional person. She has given us a granddaughter, a Native American. I just think we have got to get more successful families in the foster care program and help them to have a little independence. We must try to figure out how we get some more solid families involved in trying to help one-on-one with these families. Madam Chair, I would like to really work in some direction along that line how we can lure more successful families into becoming foster parents. You know, it didn't pertain to everything, but I think every one of us in this room is different, and I think every one of these foster children is different. Chairman Johnson of Connecticut. Thank you. Thank you, Congressman Watkins. It is very frustrating legislating from the Federal level, because I honestly don't know how prescriptive to be or how clearly to delineate things, but when you tell me that foster parents don't want their kids to do the laundry, have they no understanding at all of what their responsibility is as foster parents? Wes' comments about he and his wife putting aside the stipends so these kids would have some savings is really wonderful. All my kids are asking, ``Could we have a say in how that money is spent?'' How do we get foster parents to teach kids if you have $100, go to the store, see what you would really like, see that you can get maybe one and a half garments with that significant amount of money, and then go back at the sales and compare and see how much further the $100 will go? So, they learn--take them to second-hand clothing shops. My kids both outfit all of their children at tag sales. It is now beneath them to pay full price. They won't even let me pay full price. When I go and talk to single parents about this, they think that somehow I am demeaning them by suggesting that they look at these other places. How do we teach this kind of economy? We all grew up on it, so we have no feelings about checking out those sources, but we don't teach this. On health care, most of our foster kids live in cities. There is not a city in America, big city, that doesn't have a community health center provided with Federal funds at which anyone over 18 can get everything but hospital care on a sliding scale fee. For them it would be free. Even if you pay the maximum cost for a full physical, it is $27. Why aren't we--talk about real life experience--walking them over there, helping them sign up, making sure they see their physician the first time. When you say hands on, I really see what you mean, but how do we also get the system to think about all the things there are you need to do just to run your life hands on and help them do that. Now, to get back to something that you brought up, Ms. Massinga, that really struck me. How are we going to get the agencies to cooperate and integrate better? And, most importantly, how are we going to get that larger family--I thought that was a very interesting point you made, and you just breezed over it in one sentence--it is absurd that we don't--just like when a kid now under the Safe Homes Act comes into the system, we get the larger family involved in thinking about how do we manage this child and how you get them out, and we do a lot more on welfare reform with kinship care. In other parts of the system, we are beginning to look at the larger family and where the resources are to support this child. We really do need to build that, and we don't have that yet. So, I want to just hear any of your comments on how do we create some continuity of relationships for that child in their larger community? What should be our responsibility in this bill to urge the States to have some continuity of relationship between the individual, the kid, and the system, and the integration of the resources and getting really some language about practical education, or how do we talk about that to ourselves so that the States will really think about that? We don't have very much longer for this panel, so I am throwing that out. I just want to throw out one other thing, then I will give you a brief comment, but please get back to us on these things. Once we get done with foster care, there are similar kids who are not under the State's charge, and they are brave, courageous kids. They can't live at home; they won't live at home the circumstances are so bad; they want to stay in high school; they are sleeping in cars; they are sleeping from one friend's house to another, because our shelters cannot accept them. And one last comment, we do in this bill prohibit the use of money for housing under 18. That is because that is the way the old system was. We may need to change that. So, think about those things, and if you want to make any closing comments and then get back to us on some of these things, but we need to do a good job on this, because we have got another group of kids out there we have got to think about next. Ms. Massinga. Well, you know, I certainly--and I am sure my colleagues--welcome the idea to think further about the issues that you have raised, but I want to say to Mr. Watkins, you are very right. One of the issues about this bill, I hope, is that we start to build some continuity over time between foster parents and extended kin so that the attachment they feel for these kids will help to create that web of relationships that help them do well. And if we can--one of the things we have got to do is figure out how to incentivize foster parents and value them, because we don't do that well in this country, by and large, and that is part of why these kids feel and we in the system act as if 18 is the place when you fall off the cliff with the relationships, and in real life that really doesn't work that way. So, I will be happy to think further about other ways to build on those kinds of---- Chairman Johnson of Connecticut. And as you look at the final draft of the legislation, help us see where it is we need to say what. Anyone else? Mr. Kroner. Yes, I think extending the age to 21 is going to do us a world of wonders for establishing that continuity. It just gives everybody more time to get to know each other, and we have kids that are referred to us at 17 that are out--at 17 and a half that are out at 18, and 6 months is nowhere long enough to get to know somebody much less develop a meaningful relationship. I think we also need to recognize the role that foster parents have played and adoptive parents in some cases in the lives of these kids and try to keep them involved with the kids when they move over to independent living; have some kind of incentive, even if it is financial, for those foster parents to maintain contact--have those kids over for dinner and things like that. That would make a big difference to both the independent living programs as well as the kids that are making that transition. Ms. Fagnoni. I think the focus on outcomes can help in the sense that to the extent that we can see more studies and get a better understanding of outcomes associated with different programs and then start to look at what do those programs have as elements that help achieve certain outcomes, I think that may help reinforce some of things you have heard today in terms of the need for the real hands-on experience and the concrete experience. So, I think you are right. It is difficult to figure how much you prescribe in terms of what goes to these kids, but I think your focus on outcomes can really help over time, at least, shed some light on what does and doesn't work. Mr. Courtney. I would like to really second that. I think it will be very difficult at this point to be very prescriptive in terms of telling the States, ``These are the things you need to do.'' However, I can say from Wisconsin that the example of providing data, concrete data on what has happened to kids has completely transformed that State's point of view on this subject. I mean, there was very little attention to it, and, to their credit, the minute these data came out, the State said, ``Well, we have to do something about this.'' There was a lot of media attention to it, and now we are putting together a commission that is going to meet around the State; share this information; get information from community members, foster parents, foster kids, and completely revamp the system in Wisconsin, I expect. That is certainly the intention. So, I think concrete data periodically on how kids are actually doing is enormously powerful information to have, and we simply haven't had that. Mr. Watkins. Do we have a study, because we should be measuring outcome, I think--I know I am out of order here, Madam Chair--but we need to be able to measure it. You know, my wife and I, we lost--I felt like I was a failure for the first three or four or five foster children we had, and each time one of them left, thank God my wife was insistent on the last young lady, because she is the one that later we ended up adopting, and we got a wonderful daughter out of it, but you lose part of it. You just don't want to go through it again after you lose your heart enough times, but we need some way to have a way to measure successes, and I think it would breed success. It is just like, Madam Chair, trying to get families make it more conducive to get families that have achieved certain success to bring young people in those so they can witness that. They can witness success and role models and realize, hey, they can do it, and I think we can get maybe the outcome up a little higher and keep raising that on up if we possibly can, but I would like to look at that and see. Chairman Johnson of Connecticut. I thank the panel very much for your testimony and its conciseness, and I look forward to any comments you might have on the draft which is still evolving. Thank you. And now it is my pleasure to call as a witness our Majority Whip, Tom DeLay, who comes to this subject with a great deal of personal experience as a foster father, and thank you, Tom, for your long interest in this subject and your encouragement and support. STATEMENT OF HON. TOM DELAY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS, AND HOUSE MAJORITY WHIP Mr. DeLay. Well, thank you, Madam Chairman. I am really excited and confident that you are doing this bill and that you are holding this hearing, and I do appreciate the opportunity to speak here today on behalf of the Foster Care Independence Act of 1999, introduced by yourself, Madam Chairman, and the Ranking Member, Ben Cardin. It is very difficult to put my experiences down in a short presentation, and I wanted to touch on a couple of issues, but having foster children opens your eyes to what is going on in the world with our children, and I have got a lot of story to tell, but I will try to keep it as brief as possible. As you know, this legislation recognizes that youth who are turning 18 and leaving foster care, they experience serious problems trying to make it on their own. They are not prepared by the present system for that terrible word called ``emancipation day.'' We just really need to change that word. It frightens them when you talk about emancipation. It sort of implies that they were incarcerated in the foster care system. Many of those youth have not even graduated from high school; they are not employable, and they lack the basic skills like cooking and making a paycheck last through the week. It has been our experience that children we had gotten from other foster homes were not even taught how to shop for clothes. They were issued t-shirts and blue jeans and never had been into a store and didn't even know the sizes that they wore much less being turned out on the street to fend for themselves when they don't even know how to shop for clothes. When these young people leave foster care, they are not only leaving the emotional support of foster families, but they are also forced to leave behind their housing and their Medicaid. The Johnson-Cardin legislation is vitally important, because all of these problems are addressed in this proposal while at the same time you allow the States to design and conduct their own programs, and I think that is vital and key to the success that you are trying to reach. I am also pleased that the Subcommittee has worked so hard to produce a bill that will be revenue neutral before it leaves this Subcommittee, yet will effectively address the imminent needs of our children aging out of the foster care system. I plan to cosponsor this legislation, but it is not as a Congressman that I am here today but as a foster parent. My wife, Christine, and I currently are blessed with two adolescent foster children, the older of whom will be emancipated on June 24, and I wanted to share with you several of the situations that the current system has placed us in. Let me just say at the outset my concern is not for our family. I share these examples with you on behalf of other foster families who may not have the financial means to address some of these issues. I believe that too many adolescents leave their foster homes unable to meet their most basic needs for survival. It is my experience that the current system leaves children who exit the foster care system without the skills, the tools they need to live independently. They also--the system leaves children in deep fear. One of the most traumatic things that happened to my foster daughter was the day that we told her that she would have to start planning for emancipation day. She went back down to her room-- we didn't know this till later--and cried herself to sleep, because she was scared to death, and she is about to be 18. And the second traumatic experience for her was meeting with CPS, Child Protective Services, and making her make decisions and making her face the fact that on June 24 she was on her own. My oldest foster child, though, she will attend college starting in August; she is officially emancipated in June, and of course we will care for her for the interim 6 weeks, but there are many foster kids whose foster families can't afford to keep them after the funding stops. She will also lose her Medicaid benefits in June, and I just ask the question, what do children who have medical needs do after emancipation? I am fortunate enough to be able to care for my foster daughter's needs after her emancipation, but, again, I am worried about all those foster children whose foster families do not have the resources to pay out of pocket for medical expenses, and an important skill to have as these kids make the transition to adulthood and independence and attempt to find jobs or attend college, is the ability to even drive a car. We recently enrolled our two kids in driver's ed and discovered that we had to pay $570 for their course out of our pocket; again, not a problem for us, and we did it willingly, but circumstances might be very different for another family, and it is for those families that this bill is so vital. We are sentencing our kids to failure and chronic dependency if we do not arm them with the skills and the resources that they need as they transition out of foster care. The result time and time again is more of these young adults are on welfare; more former foster kids are homeless, and more and more of them are in jail and committing crimes. We must empower State and local governments to cut bureaucracy with increased flexibility and enable them to provide the children in our foster system with a transition system that actually prepares them to live as independent functioning productive members of our society, and I thank you, Madam Chair. [The prepared statement follows:] Statement of Hon. Tom DeLay, a Representative in Congress from the State of Texas, and House Majority Whip I am Tom DeLay, House Majority Whip from the 22d District in Texas. Madam, Chairman, I appreciate the opportunity to speak here today on behalf of the Foster Care Independence Act of 1999 introduced today by yourself and Ranking Member Congressman Ben Cardin. This legislation recognized that youth who are turning 18 and leaving foster care experience serious problems trying to make it on their own. Many of these youth have not graduated from high school, are not employable and lack basic skills like cooking and making a paycheck last through the week. When youth leave foster care they are not only leaving the emotional support of foster families but are also forced to leave behind their housing and their medicaid. The Johnson-Cardin legislation is important because all of these problems are addressed in this proposal while at the same time allowing the States to design and conduct their own programs. I am also pleased that the committee has worked so hard to produce a bill that will be revenue neutral before it leaves committee, yet will effectively address the imminent needs of our children again out of the foster care system. I plan to co-sponsor this legislation, but it is not as a Congressman that I am here today, but as a Foster Parent. My wife and I currently are blessed with two adolescent foster children, the older of whom will graduate from high school June 24th. I want to share with you several of the situations the current system has placed us in. Let me say at the outset, my concern is not for our family, I share these examples with you on behalf of other foster families who may not have the means to address some of these issues. I believe that too many adolescents leave their foster homes unable to meet their most basic neneds for survival. It is my experience that the current system leaves children who exit the foster care system without the skills and the tools they need to live independently. My oldest foster child will attend our local community college starting in August. She is officially ``emancipated'' in June. Of course, we will care for her in the interim 6 weeks; but there are many foster kids whose foster families cna't afford to keep themn after the funding stops. She will also lose her medicaid benefits in June. What do children who have medical needs do after emancipation? I am fortunate enough to be able to care for my foster daughter's needs after her emancipation. But again, I am worried about the foster children who's foster families do not have the resources to pay out of pocket for medical expenses. An important skill to have as these kids make the transition to adulthood and independence, and attempt to find jobs or attend college, is the ability to drive a car. We recently enrolled the kids in Drivers Ed and discovered that we had to pay the $570 dollars for their course out of pocket. Again, not a problem, and we did it willingly. But circumstances might be different for another family, and it is for those families that this bill is so vital. We are sentencing these kids to failure and chronic dependency if we do not arm them with the skills and the resources they need as they transition out of care. The result, time and again, is more of these young adults on welfare, more former foster kids homeless, and more in jail and committing crimes. We must empower state and local governments to cut bureaucracy with increased flexibility, and enable them to provide the kids in our foster system with a transition system that actually prepares them to live as independent, functioning, productive members of society. Thank you. Chairman Johnson of Connecticut. That is a very interesting story about even the driver's license. We take that so for granted. Mr. DeLay. Yes, my daughter was 17 years old. The other problem, too, is no one allows them to drive, because your insurance goes through the roof, and, therefore, none of them have driver's licenses. And the second is the foster care agency--this is all before emancipation--doesn't want the liability of the child being in a wreck. Our foster care agency had the unfortunate experience of a foster mother allowing her daughter to drive the car having never driven the car, and she had a wreck and was killed. They almost were out of business. So, now they don't want any of their kids to drive. So, when they turn 18, they can't even drive. Even if they wanted to, they can't drive. Chairman Johnson of Connecticut. Mr. Watkins. Excuse me, Mr. English. Mr. English. Madam Chair, I don't have any questions, but I thank Mr. DeLay for coming in and walking us through some of his personal experiences which I think are very compelling. We very much appreciate your insight, sir. We hope we are going to be able to produce legislation that will go the distance. It has clearly already attracted bipartisan support and with the leadership of the Chair, hopefully, the House will act on this legislation this year. So, we thank you for being with us. Mr. DeLay. Well, I will do my part, Mr. English, to make sure it is going to the floor. Chairman Johnson of Connecticut. Mr. Camp. Mr. Camp. Well, thank you for--I am way down here. I am still in the room, though; that is all that counts. [Laughter.] Chairman Johnson of Connecticut. This is the arbitrariness of the Subcommittee's election system. He has actually been on this Subcommittee longer than most of us. Mr. Camp. Thank you very much for your testimony and for what you are doing for your foster children, because your support of this issue and these concerns will help move this along in the Congress. You know, it is interesting, because I have had other foster families tell me about the driving issue, and it is tough to get on your own without being able to get some work especially in rural areas in this country where there isn't any mass transportation. So, thank you for being here and for your testimony, and I look forward to working with you on this legislation. Thank you. Mr. DeLay. I just might say, I thank you for your comments, Mr. Camp, but I also say it is very, very tough to have a 17- year-old boy that wants to drive and telling him he isn't driving, that creates many problems inside the home. [Laughter.] Chairman Johnson of Connecticut. That is right. Mr. Watkins. Mr. Watkins. Tom, I am interested in what you are doing. It is a blessing. My wife and I have gone through that as we have shared and we opened our home for girls. They provide all kinds of unbelievable experiences, and I guess you try to work through it. You know, we are fortunate. Like you say, you were a businessman before you came here, and you are now in Congress, and I was a businessman and now Congress, and we are able to do some things, and thank God that we have been fortunate enough to do that. But how do we attract more families? We are a product of our environment, and, believe me, I grew up in a small community of less than 200; everyone knew each other; I mean, everybody. However, let me tell you, I do, though, worry and have laid awake at night over how do you save inner city kids? They have no chance of having a role model in many cases, and how do you give them a chance to see the other side of that mountain, that there is something there? Fortunately, my wife, Lou, and I--I married a preacher's daughter, she has a heart. I will be very honest, when we lost one of our foster children, Debbie--we had her for 11 months, and she ran away, I refused to have any more foster children. I told my wife, ``No.'' You know, she called me when I was in the State senate and says, ``There is a young lady named Sally that needs a place to stay,'' and I first said, ``No.'' She said to me, ``So, you mean you will not let Sally come over for dinner?'' ``No, I didn't say that Lou. Yes, she can come for dinner.'' Well, she put Sally right across from me. [Laughter.] All during that night, I had to sit there over dinner and look at this little, beautiful, young lady that had come to our house with only a small brown paper sack of clothes; that is all she had. Well, when we did the dishes, my wife said, ``What do you think?'' And I said, ``Let her stay.'' She is now our daughter, fortunately, and has a beautiful granddaughter for us. We put every dollar back that came to us as foster parents into a college fund, so she knew that she had a way of getting a college education. As the daddy, so to speak, I thought she should have majored in home economics. Right? Most girls should, right? [Laughter.] Old-fashioned dad. When she came home from the first month of college and said, ``Daddy, if you don't let me major in agriculture, I am going to quit.'' So, I said, ``You go get your degree in agriculture; I want you to get a degree.'' She now is a very professional person in farm finance work. How do we get more successful families involved in doing foster care and all? Many of our parents--and this is not all bad, I understand--but many of them are really low-income people that unfortunately have not ever been able to accomplish with education and they are needing to use what money comes in of dollars to exist. So, the day comes when they have to let them go, because it becomes a burden. They come in your home and in 6 more weeks on down the road you are going to do it, because you have to bridge the gap, and it is the best thing for that child. And I think we were trying to say what is the best thing for the child even if we had to keep her another year or 2 years. It doesn't matter, because we put every dollar back into a college fund for this young lady that we adopted then as our daughter. We had one heck of a time trying to adopt her, because of the complications from foster care to being able to adopt. It was a terrible experience going through that, but I think if we could give them--and that is why I was interested in the measurement of success--how do we allow them to bridge the gap, so they can become successful young people? There are a lot of them that have got tremendous ability. Mr. DeLay. Well, Mr. Watkins, first of all, I want to hire your wife for the Whip organization; maybe that is how I can get your vote. [Laughter.] I now know how to get to you. [Laughter.] Mr. Watkins. You usually get results, too. Mr. DeLay. Very quickly, I have the same concern. I have a lot of criticism of the foster care system, not of the individual people, but the system itself is about to fail, because I have seen in associating with foster parents, a lot of foster parents--in fact, it was exhibited in the foster home that our boy came from--they are doing it for the money, and they are warehousing the kids; they are sticking them in rooms; not allowing them to come out; not teaching them a thing, and just collecting a check, and we have to address that someday, but the other side, too, is--and it is the reason that I have started becoming very vocal--my wife and I decided early on when we got involved with abused children many years ago that we wouldn't tell anybody, because we didn't want people to think that we were doing it for politics---- Mr. Watkins. Right, right. Mr. DeLay [continuing]. And the more we got into it and the worse we saw, we felt like that I was put here for a purpose and maybe this is the purpose to raise the visibility of what is going on with our abused children, and the more and more that I speak out and have spoken out just in the last few months, the more people have come to me, people of means that have come to me and said, ``You know, I have got a big, empty house, and I could do this. If you can do it, I can do it.'' And they start checking into it, and it helps the local organizations--in our case, Child Advocates of Fort Wayne County and others in our foster care system, Houston Achievement Place--to recruit, because we are giving them names and those kinds of things, and it is like the old starfish story--you know that story, right? Where the father and the son were walking on the beach, and the beach was littered with starfish, and the father picked up one and threw it back in the sea, and the son said, ``Well, daddy, what are you doing that for? You will never be able to pick up all these starfish and throw them out to sea; it doesn't matter?'' And the daddy looked down at the son and said, ``It matters to them.'' And if we do it one kid at a time, one foster home at a time, we can make a huge impact. Mr. Watkins. The same reason, though. I didn't go public a lot earlier, because I thought people would think I was doing this politically. I probably talked more about it right here on this Subcommittee the last 2 years than I have any other time. In fact, I kind of fell in this thing. I didn't really know this was going to be part of that Subcommittee, and maybe there is a reason for it. I think there is a lot of additional things that we all can do to help elevate that and make it--notch it up a lot more in success, and I appreciate what you and your family are doing, and maybe we can---- Mr. DeLay. Well, I appreciate that. I will just close with saying, Madam Chairman, that I feel very, very strongly that you cannot disconnect the community involvement. There is a role for government to play in dealing with abused and neglected children, but the most effective success with these children come from organizations that raise their own money from their own communities and connects people to people by doing that, and people are interested in a young person as that person and that name and not a number, and we can never ever discourage that. We should focus on community-based programs, certainly overseen by government programs, but we should never ever discourage communities from raising their own money, getting involved, and running their programs. Chairman Johnson of Connecticut. Well, I thank you for your testimony and for your experience and consider it a great asset to our Subcommittee that Wes has had direct experience and you have direct experience. Passage of the Adoption and Safe Families Act 2 years ago is making an enormous difference---- Mr. DeLay. Yes, it is. Chairman Johnson of Connecticut [continuing]. In breaking down the barriers for foster parents to adopt children, and actually that is where the growth is in adoptions, and that is one of the big centers of growth in adoptions. And, also, that business of the bill requiring a 15-month plan and getting kids out of homes that are never going to come around for them and into permanent homes, so we hope that we will reduce the flow of kids into foster care, and we hope we will deal better through this bill with older kids who have been in foster care for a long time, and then there is a way to begin looking at how we do fund the States so that being a foster parent could be more like being a day care provider; something that requires you to provide a certain level of education and actually pays you more than just the mere stipend that we currently pay and carries a lot more responsibility with it. I don't know what the answer is, but I think your point about community is very important. This business of placing kids in a community 25 miles or 50 miles from where all their friends are and ripping them out of one high school where they are being successful because now they have to move to a home that is in a different community. It is the most disheartening thing to talk to kids who have finally stabilized themselves, and then have the worker appear 1 day to completely throw the pieces of their lives up in the air again. So, there is a lot of work to be done on the system itself, but part of the problem is the rigidity of how we fund it, and we do have to approach that. As to your comments on this bill, we certainly will pay for it, but we are about $130 million short of being able to make sure that the kids can participate in Medicaid, and I think we do have to find a way to make sure that when they turn 18 they don't lose access to health care, because adolescence is such a very, very important time to learn to take care of yourself physically and also a critical time to deal with certain mental health and substance tendencies that really are the difference between making it as an adult and not making it. So, thanks for your interest and support. We appreciate it. Mr. DeLay. Thanks very much. Chairman Johnson of Connecticut. The final panel, let me bring forward Eileen McCaffrey, executive director of the Orphan Foundation of America; Kelli Sutton Block of the People Places of Charlottesville, Charlottesville, Virginia; Sonja Matheny, student at North Carolina Central University, Center of Keys for Life Program, Maryland, and Montrey Bowie, a high school student from Ellicott City, Maryland, Our House program: and my colleague, Mr. Cardin, is due to return any minute. We are going to start with Eileen McCaffrey from the Orphan Foundation. STATEMENT OF EILEEN MCCAFFREY, EXECUTIVE DIRECTOR, ORPHAN FOUNDATION OF AMERICA, VIENNA, VIRGINIA Ms. McCaffrey. Madam Chair, thank you for having me, Members of the Subcommittee. I am very, very pleased to be here today. At this point, nearly every one of my buttons have been pushed. You have raised issues that I think about, I breathe, I sleep---- Chairman Johnson of Connecticut. Not exactly the buttons you would expect of the Ways and Means Committee unless it is to set tax policy. [Laughter.] Ms. McCaffrey. Right. So many of the things that have been raised here today have answers. They are not easy, but there are things we can do that will make a difference. In reference to this bill, you have done a really good job. It is quite obvious that you have listened to the kids. We hear them throughout this bill. The fact that you put in specific language about independent living programs and things they should cover--hard skills--that is important. You touched on the issue housing, money, support services for kids till 21, thank you. The framework flexibility you have defined with these issues and goals must be addressed with independent living programs. The couple of things you asked about as far as reporting and what is reasonable to expect. We need to involve the kids. We need to get them to understand that them answering these surveys, them participating in the program is a way that they can give back. I have personally known over 1,000 foster children, and 999 of them want to improve the system. If we build them into the system, if we ask them to participate as equals, as stakeholders, they will absolutely help define outcome, and they will answer those surveys. One of the other issues brought up was how to make these programs more effective? Again, involve the children. Involve community groups, involve adoptive parents. Right now, programs are defined by people, by program experts, and they don't necessarily meet the needs of the kids. A number of years ago, I was at a conference, and a woman from California was saying they would use their State independent living money to hire a doctor--it was a girl's program with gynecologists--to see the girls. So, I politely asked her, ``Where are you?'' assuming they were in rural California. And she said, ``We are in L.A.'' I couldn't believe it. I couldn't believe it. And I said to her, ``Well, what about the clinics? Those girls will have to use these clinics in a couple of months.'' ``Well, it would be easier,'' and she just kept telling me it would easier, and I kept saying, ``Easier for who?'' And that is the point. Programs have to be designed with the kids in mind. Much of what was said today was about the different groups of kids, and, yes, there are absolutely a number of low functioning foster youth, and there are high functioning foster youth. One of the concerns I have is that independent living programs will start creaming the crop. Those kids want to stay in care, because they have reached a level of understanding what they can get from the system, and I don't mean that in a negative sense. They realize they need more support; they will stay in care. It is the kids who have been let down so often, who are so angry, and they have not connected with anyone in the system that will leave. So, I think States--I think the reporting mechanism is critical; can't stress it enough. I think they have to be held accountable similar to the ways we are looking at schools and doing scorecards on those, the American public deserves to know the billions of dollars are spent in foster care, and that will only be told with outcome. So, please--and that is one of the things that has to stay in this bill. We would also like to see more innovative programs being highlighted and used as models; programs that absolutely stress work and career training. There is a program called Our House in Maryland that you will hear from. It is built around work, and by giving the kids an idea of what employment they will go into, they can effectively do independent living skills; they can effectively do school, GED work. I think unless we start talking to these kids about apprentice programs, about all the different options, we are going to lose too many. Last, I would like independent living programs to better train--I think the whole system has to gear everyone involved in a foster kid's life in the independent living concept. Foster parents need to be trained as group home workers who are often very low paid and underskilled. You have to understand the concept of independent living, and they themselves many need some training. They may not have made some good choices along the way or fulfilled their process. It is not reasonable to expect them to help the kids do it unless we train them. Additionally, there are--this country is founded on volunteerism. People call my organization every day saying, ``How can I help?'' There really needs to be mechanisms for volunteers and mentoring. More than anything, that is what these kids need. They need relationships with people, and then they will come back to the system, and they will tell them their outcome. As we talked about--as Mr. Watkins talked about recruiting foster parents, I have some strong ideas on that. We can do that; we can do better, but the system has to be opened up. We have to take it away from child welfare experts and make it more community based. Let those experts share their expertise, but let us learn from parents who have successfully raised children. Let us take from existing resources--nonprofits that are in the community, church groups, business associations. There are so many resources in this rich country that to think our foster children are going without is a tragedy. Most of what needs to be said has been said already, and I do just want to reiterate that these children are assets, but they are falling through the cracks, and we all lose, and I think we could work together. I think that States need the flexibility, but they need to be held accountable, and they need to better incorporate existing resources into their programs rather than constantly creating new. Thank you. [The prepared statement follows:] Statement of Eileen McCaffrey, Executive Director, Orphan Foundation of America, Vienna, Virginia I would like to begin by thanking you Madam Chairman and Rep. Cardin for your work on this bill and say it will increase much needed services for a nearly forgotten group of American teenagers. We as a country must begin to value the potential of foster youth and see them as an asset. This will require increased monetary investment and emotionally supporting their dreams by nurturing and guiding them through the array of choices they face as young adults. As Members of this esteemed committee each of you are well aware that too many of our nation's former wards of the state end up as grim statistics. When these kids lose, we all lose. Whether you are look at the bottom line and see annual loss of productivity or believe there is a moral obligation to provide quality services, the fact is we have a vested interest in the 25,000 children that annually age out of foster care. The $140,000,000 expenditure proposed in this bill will support states' initiatives to better serve foster youth ages 16 to 21. You have wisely provided concrete guidelines after hearing foster youth's frustration at being ill prepared for the work world and post secondary education and training. Additionally, you realize foster teens have not been given enough emotional and financial support as they take those first steps toward independence and adulthood. The bill gives states the flexibility they need to design and implement successful and innovative programs. Yet, within the framework of flexibility you have clearly defined the issues and goals that must be addressed by independent living programs nationwide. The Orphan Foundation of America supports the specific language included in section 477. We applaud the emphasis on hard skills such as budgeting, substance abuse prevention, career and goal planning, and post secondary preparation for youth ages 16 -18. Moreover, thank you for recognizing the need to provide financial, housing, counseling and other support services to youth until they turn 21. This bill directs social services to develop programs that meet the needs of the whole child, including emotional and social needs. Every foster youth should have the opportunity to develop relationships within their community that will provide them with personal and emotional support. Children aging out of foster care desperately need friendship that will not end when their case is closed. Successful Independent Living Programs are have a multitude of community partners and devote resources to recruiting and training mentors, life skills trainers, employment and internship sponsors. I also believe this bill does due diligence with the American tax payers money by allocating $1,500,000 for review and reporting. The detailed data you request is not cumbersome or overwhelming. Complete data collection will help all interested parties identify trends, spot weaknesses and deficiencies that can be corrected, and recognize efficacy. Given the total expenditures on the foster care system it is incumbent upon social service agencies to make this information public record. This is a good bill that provides a much-needed infusion of money into programs that are critical to the success of our nation's foster teens. The three recommendations I would make to the committee are: 1) Do not lessen the reporting requirements. Consider it an annual health care checkup, some states will leave with a clean bill of health while others work with the Department of Human Services to find treatment and remedies for their shortcomings. The U.S. taxpayer deserves to know the outcome of foster youth. 2) Allocate pilot project funding for innovative training, work and intern programs that address the needs of lower functioning foster youth. States could use this money to support partnerships with businesses and existing nonprofits that train youth for careers before discharge. The Maryland based OUR HOUSE Youth program trains young men to be carpenters; this model could be replicated. Programs should help youth begin apprenticeships in culinary arts, welding, etc. 3) Direct states to incorporate independent living education into training for foster parents, group home workers and case managers. Everyone involved in foster care must begin to realize they are a youth resource in this ongoing process that begins the day the youth enters care. Members of this Subcommittee, I appreciate the opportunity to share my opinions with you. On behalf of the many foster teens and volunteers who work with these youth through the Orphan Foundation of America thank you for developing and supporting this bill. Chairman Johnson of Connecticut. Thank you very much. Ms. Block, from the People Places of Charlottesville-- beautiful city, beautiful town. STATEMENT OF KELLI SUTTON BLOCK, PEOPLE PLACES OF CHARLOTTESVILLE, CHARLOTTESVILLE, VIRGINIA Ms. Sutton Block. Yes, thank you. Jenny was gang raped at 12 and never told anyone, and her mother kicked her out of the house, because she was failing school and acting out sexually. She is now 19; was in independent living for a year, and her case was closed a year ago when she couldn't stay in school. Lance was home schooled by his father until he was 11 and beaten when he didn't know the right answer, while his blind mother sat in the next room. He just turned 18 and lives in an independent living program. John's mother has been in and out of jail for drugs his whole life. He has never met his father, and he saw his sister murdered in his home when he was 10 years old. He is now 15 and will begin independent living services next year. My name is Kelli Sutton Block, and these are some of the children with whom I have met on a weekly basis. I work for People Places which is one of the oldest therapeutic foster care programs in the Nation. Today, I will tell you what we at People Places see as the essentials to any successful independent living program, and I will tell you briefly about the program we have developed to meet these needs. The primary goal of an independent living program is to prepare adolescents in foster care to lead healthy, productive lives. In order to do this, we have identified three critical elements of successful independent living programs. Those elements are that the program must be individualized to the foster adolescent; they must be based in reality, and they must be therapeutic. To be successful, an independent living program must be individualized. Adolescents in foster care span a vast range of skills and abilities. What works for one child will not necessarily work for another. Jenny, for example, with an IQ of 80 and a fear of open spaces will have very different needs from Lance, with an IQ of 120 and a history of aggression. These children need to be worked with individually. Each adolescent should have a customized, independent living plan with specific treatment goals to emphasize the child's skills and account for his or her deficits. This, of course, calls for small caseloads for independent living workers. Second, if we are truly expecting to improve the lives of these adolescents, we must develop programs that are based in reality and are not just built to ease our collective conscience. Three aspects of independent living programs require practical and realistic solutions. First, monthly stipends must be sufficient. Jenny, living on a stipend from the State, had $160 a month after paying her rent and utilities; that is $5.30 a day to pay for all of her food, transportation, and personal items. To create an expectation that a child should become independent and to not give him or her enough money to do so, is to create disdain and distrust for the system and for the people who work within it. Second, independent living programs must support older adolescents as they learn to get and keep a job. As noted, children from foster care come from a variety of backgrounds. There are many children for whom postsecondary education is completely unrealistic. For these children to simply hold a decent job for the rest of their lives would be an unprecedented victory in their families. We must support them as they learn to do this. Third, all independent living adolescents must have health care coverage. Learning to take responsibility for oneself is a critical part of becoming independent as you mentioned. We must give these children the means to do so. Two weeks ago, John broke his ankle. If he were not covered by Medicaid, something as simple as this would have quickly put him into debt adding to his already considerable stresses. Independent living programs must be therapeutic. They must address the social and psychological needs of adolescents in foster care as well as their practical needs. As we all know, many foster children come from tragic childhoods of abuse and neglect. Teaching a child budgeting skills is a total waste of time if he cannot effectively express himself; cannot endure stressful situations, or cannot summon the courage to get out of bed in the morning. Jenny stopped by the other day and intimated that she is finally ready to talk to someone about when she was raped 7 years ago. Her case was closed last year, however, and she no longer receives Medicaid or any health care services. She makes 6 dollars an hour as a chambermaid in a hotel. If these children are ever expected to participate in society, they must have access to mental health services until they are at least 21. As young adults not even old enough to drink alcohol, these children cannot be expected to pay for psychotherapy. Indeed, they won't be able to afford it, and society will pay the price one way or the other. At People Places, we have developed a transitional independent living program called the Guide Program for foster adolescents who are not quite ready to live on their own. In the Guide Program, a teenager in foster care rents a spare room from a responsible, trained adult. This adult functions as a mentor, a friend, a sounding board, and safety net for the teen. The 18 months they spend together is a way for the teen to learn experientially what it takes to live on one's own. In addition, each teen has a case manager who helps them set weekly goals in the domains of home, education or work, self, and community. Their weekly allowance is determined by their progress on these stated goals. Over time, these teens take on increased responsibility and meet with their case manager less frequently. They also meet in peer, skill-building groups to learn practical independent living skills and to process their learning experiences. The long-term goals are for the teen to gain competence, personal accountability, integration into the community, and a strong confidence in themselves. In conclusion, to prepare foster adolescents to make their way in our society is a complex task. These are children who come into care with many different needs, many painful histories, and many different ideas of what they want from life. Independent living programs operate within the small but critical, stressful stage of late adolescence. To best serve these children, programs need to be individualized, based in reality, and to be therapeutic. In order to build such programs sufficient funds and services are desperately needed. This legislation is certainly a step in the right direction. Thank you. [The prepared statement follows:] Statement of Kelli Sutton Block, People Places of Charlottesville, Charlottesville, Virginia Introduction Jenny was gang-raped at twelve, never told anyone, and her mother kicked her out of the house because she was failing school and acting out sexually. She is now 19, and her case was closed a year ago. Lance was home-schooled by his father until he was eleven, and beaten when he didn't know the right answer, while his blind mother sat in the next room. He just turned 18, and is in an independent living program. John's mother has been in and out of jail for drugs his whole life, he has never met his father, and he saw his sister murdered in his home when he was ten years old. He is now 15, and will begin independent living services next year. My name is Kelli Sutton Block, and these are some of the children with whom I have met on a weekly basis. I work for People Places, which is one of the oldest therapeutic foster care programs in the nation. Today I will tell you what we, at People Places, see as the essentials to any successful independent living program, and I will tell you briefly about the program we have developed to meet these needs. The primary goal of an independent living program is to prepare adolescents in foster care to lead healthy, productive lives. In order to do this, we have identified three critical elements of successful independent living programs. These elements are that the programs must be individualized to the foster adolescent, they must be based in reality, and they must be therapeutic. Individualized To be successful, an independent living program must be individualized. Adolescents in foster care span a vast range of skills and abilities. What works for one child will not necessarily work for another. Jenny, for example, with an I.Q. of 80 and a fear of open spaces will have very different needs from Lance, with an I.Q. of 120 and a history of aggression. These children need to be worked with individually. Each adolescent should have a customized independent living plan with specific treatment goals that emphasize that child's skills and account for his/her deficits. Practical and Realistic If we are truly expecting to improve the lives of these adolescents, we must develop programs that are based in reality, and are not just built to ease our collective conscience. Three aspects of independent living programs require practical and realistic solutions. First, monthly stipends must be sufficient. Jenny, living on a stipend from the state, had $160. a month after paying her rent and utilities. That's $5.30 a day to pay for all of her food, transportation, and personal items. To create the expectation that a child should become independent, and to not give him/her enough money to do so, is to create disdain and distrust for the system and for the people who work within it. Second, independent living programs must support older adolescents as they learn to get and keep a job. As noted, children in foster care come from a variety of backgrounds. There are many children for whom post-secondary education is completely unrealistic. For these children, to simply hold a decent job for the rest of their lives would be an unprecedented victory in their families. We must support them as they learn to do this. Third, all independent living adolescents must have health care coverage. Learning to take responsibility for oneself is a critical part of becoming independent. We must give these children the means to do so. Two weeks ago, John broke his ankle. If he were not covered by Medicaid, these unexpected medical bills would have quickly put him into debt, adding to his already considerable stresses. Therapeutic Independent living programs must address the social and psychological needs of adolescents in foster care, as well as their practical needs. As we all know, many foster children come from tragic childhoods of abuse and neglect. Teaching a child budgeting skills is a total waste of time if he cannot effectively express himself, cannot endure stressful situations, or cannot summon the courage to get out of bed in the morning. Jenny stopped by the other day, and intimated that she is finally ready to talk to someone about when she was raped seven years ago. Her case was closed last year, however, and she no longer receives Medicaid, or any health care services. She makes $6.00 an hour as a chambermaid in a hotel. If these children are ever expected to participate in society, they must have access to mental health services until they are at least 21. As young adults, not even old enough to drink alcohol, these children cannot be expected to pay for psychotherapy. Indeed, they won't be able to afford it, and society will pay the price, one way or the other. One Example At People Places, we have developed an transitional independent living program called the Guide Program for foster adolescents who are not quite ready to live on their own. In the Guide Program, a teenager in foster care lives with a responsible, trained adult. This adult functions as a mentor, a sounding board, and a safety net for the teen. The 18 months they spend together is a way for the teen to learn, experientially, what it takes to live on one's own. In addition, each teen has a case manager who helps them set weekly goals in the domains of home, education/work, self, and community. Their weekly allowance is determined by their progress on these stated goals. Over time, the teens take on increased responsibility and meet with their case manager less frequently. The long-term goals are for the teen to gain competence, personal accountability, integration into the community, and a strong confidence in themselves. Conclusion In conclusion, to prepare foster adolescents to make their way in our society is a complex task. These are children who come into care with many different needs, many painful histories, and many different ideas of what they want from life. Independent living programs operate within the small but critical, stressful stage of late adolescence. To best serve these children, programs should be individualized, based in reality, and therapeutic. In order to build such programs, sufficient funds and services are desperately needed. This legislation is a step in the right direction. Thank you. Chairman Johnson of Connecticut. Thank you very much. Ms. Matheny. STATEMENT OF SONJA MATHENY, STUDENT, NORTH CAROLINA CENTRAL UNIVERSITY, KEYS FOR LIFE Ms. Matheny. Good morning. My name is Sonja Matheny. It is a great honor to speak on behalf of older foster youth. I am 19 years old. I attend North Carolina Central University where I am a third-year business administration major. I have been a ward of the court since I was 2 years old--the DC court, District of Columbia. Being in foster care in the foster care system is difficult for most children. At a young age, we will know that we will come--the day will come when we will lose our financial and emotional support. We have to work twice as hard and quickly to be prepared to take care of ourselves at a young age. When we turn 18, most of us are terminated from the child care system. A few lucky ones, like me, receive support until they turn 21. In my case I have been luckier than many of my peers. At 16, I became part of the Keys for Life Independent Living Program located here in Washington, DC. This program has encouraged me to strive for success. While I was in high school, it offered me tutoring, life skills training, SAT preparation, college preparation, and internship opportunities. In preparation for college, the program sent me to local and out-of-state college tours; paid for some of my college application fees, and helped me find financial aid. Keys for Life was there to assist me with each step of the college enrollment process. I do not know if I could have done all the necessary things to prepare for college without them. It is difficult for a 17- or an 18-year-old to keep track of all the details and deadlines especially when your life may be chaotic. Many foster teens live in group homes that are noisy and have lots of people coming in and out. They have no private space to keep their important papers, and the adults in the home may not encourage them or support their goals. Keys would like to help guide me through the financial aid process, and they introduced me to the Orphan Foundation of America. The Orphan Foundation provides scholarships to young people in foster care. Their staff consists of volunteers, and their funding comes from the direct contributions of people concerned about young people in foster care. This year, I will receive $5,000 from the Orphan Foundation, but they cannot afford to help everyone who wants to go to college. I will be using the money to pay for my room and board. When a foster youth has goals, they need to be helped by many different groups of people like the Orphan Foundation. Unfortunately, my brother who is also on foster care has not benefited from the independent living program. It is important that people understand when the system lets kids down too many times, they will stop having faith in it. This happens too often. Kids just want out of the system, and they realize too late that the time they had with the independent living program could have helped them. Although my brother has worked hard pursuing his college degree, he has to pay for everything by himself. He was terminated from the system without any transition and had to move from the foster home before he had the opportunity to finish school. Overnight, became fully responsible for all of his expenses. He is now 24 years old and still striving to fulfill his dream of finishing college. I would like to recommend three improvements that need to be made within the independent living program. The first one, the program should be available for any foster teen who is 14 or a freshman in high school. If students became part of the program in ninth grade, they will have--if they become part of the program in ninth grade, they will have a better chance of realizing that staying in school and getting good grades is the key to having the opportunities as an adult. I hear many people in the program say that they could have done much better in school had they started the independent living program sooner. From age 16 to 21 is not enough time to fully prepare someone for a successful life. Second, there should be a transitioning support plan for every foster youth before they age out. This transitional plan would help young adults put in place the stable living conditions necessary to finish college and training school or get a job. And, last, for the youth who are in college, independent living money should be available to pay for room and board. Living on campus provides students with a stable environment so the students can focus more on their studies. Thank you. [The prepared statement follows:] Statement of Sonja Matheny, Student, North Carolina Central University, Keys for Life Good Morning, my name is Sonja Matheny and it is a great honor to speak on behalf of older foster youth. I am nineteen years old and I attend North Carolina Central University, where I am a third year Business Administration major. I have been a ward of the District of Columbia since I was two years old. Being in the foster care system is difficult for most children. At a young age, we know the day will come when we lose all of our financial and emotional support. We have to work twice as hard and quickly to be prepared to take care of ourselves at a very young age. When we turn eighteen most of us are terminated from the foster care system; a few lucky ones like me receive some support until they turn twenty-one. Most of us are terminated before we are ready. Throughout our years in care, there has been inadequate support from foster families, group homes, social workers, and people around us do not understand how hard it is not having a family and home of your own. Many of my peers lose confidence in the system and do not believe that programs like independent living can help them get ready to be on their own. Growing up is a daily process and short term programs like Independent Living can't make up for the years of not having any guidance towards adulthood. In my case, I have been luckier than many of my peers. At sixteen I became part of the Keys for Life Independent Living Program located here in Washington D.C. This program has encouraged me to strive for success. While I was in high school, it offered me tutoring, life skills training, S.A.T preparation, college preparation, and internship opportunities. In preparation for college, the program sent me on local and out-of-state college tours, paid for some of my college application fees, and helped me find financial aid. Keys for Life was there to assist me with each step of the college enrollment process. I do not know if I could have done all the things necessary to go to college without them. It is difficult for a 17 or 18 year old to keep track of all the details and deadlines, especially when your life might chaotic. Many foster teens live in group homes that are noisy and have lots of people coming and going, they have no private space to keep important papers and the adults in the home may not encourage or support their goals. Keys for Life helped guide me through the federal financial aid process and they introduced me to the Orphan Foundation of America. The Orphan Foundation provides scholarships to young people in foster-care. Their staff consists of volunteers and their funding comes from the direct contributions of people concerned about young people in foster care. This year I will receive a $5,000 from the Orphan Foundation but they can not afford to help everyone who wants to go to college. I will be using their money to pay for room and board. When a foster youth has goals they need to be helped by many different groups of people like the Orphan Foundation. Unfortunately, my brother who was also in foster care has not benefited from an Independent Living Program. It is important people understand that when the system lets kids down too many times they stop having faith in it. This happen often, kids just want out of the system and some realize too late that they do need the help of a independent living program. But unlike my friends at college who have families that take them back--foster kids can=t return. Although my brother has worked hard pursing his college degree, he has to pay for everything himself. He was terminated from the system without any transition plan and had to move from the foster home before he had the opportunity to finish school. Overnight he became fully responsible for all of his expenses. He is now twenty-four years old and still trying to fulfill his dream of finishing college. Although Independent Living Programs definitely provide many benefits, I would like to recommend five improvements that need to be made. 1) The programs should be available to any foster teen who is 14 or a freshman in high school. If students become part of the program in ninth grade, they will have a better chance of realizing that staying in school and getting good grades is the key to having options as an adult. I hear a lot of people in the program say they could have done much better in school if they had started the independent living program sooner. From age sixteen to twenty-one, is not enough time to fully prepare someone for a successful life. 2) There should be a transitional support plan for every foster youth before they age out. This transitional plan would help young adults put in place the stable living conditions necessary to finish college or training school or get a job. 3) For the foster youth who are in college, independent living money should be available to pay room and board at school. Living on campus provides students with a stable environment so the student can focus more on their studies. 4) All foster youth should have health care coverage until they complete school or job training. Part of the transitional plan should include being able to join a health insurance plan when Medicaid expires. 5) Lastly, more civic organizations and businesses should be encouraged to become involved with foster youth. All children should have relationships with people outside of the foster care system that help them feel like they belong to society. In conclusion, I want to thank you for increasing the funding for independent living programs to $140,000,000 and ask you to make sure that states spend the money in ways that will truly help more foster youth gain independence and live prosperous lives. Thank you. Chairman Johnson of Connecticut. Excellent. Thank you very much. Mr. Bowie. STATEMENT OF MONTREY BOWIE, HIGH SCHOOL STUDENT, OUR HOUSE, INC., ELLICOTT CITY, MARYLAND Mr. Bowie. Hi. My name is Montrey Bowie, and I am 17 years old. I was born in Frederick, Maryland. I completed the ninth grade when I was in school. I had a tough time when I was young. I had grown-ups who did not care about me, did not spend much time with me. I began to get in trouble when I was 9 years old and still growing up so my life could not take care of me. When I was 13, the State pulled me out of my home, and I went from group home to group home 4 times total until I was 15 years old. I did not learn anything about how to live or how to take care of myself. Then the State put me in a foster home with six other foster kids. The seven of us had to share two bedrooms, and the lady was not kind to me. Again, I was very much alone and had no growing up support. Finally, after a year in this home, I ran away. I survived by getting into trouble, but soon I was caught and placed in another foster home, and this home also did not address my needs. I took a job at McDonald's, but I realized that I was not going to have much of a future there. I wanted to be a carpenter and own my own construction business. I heard about Our House Youth Home, and I went for an interview. It is located between Washington and Baltimore. I got accepted there a year ago, and I am still currently enrolled there. At Our House, we do three things. We learn carpentry during the day; we have our high school classes at night, and we do community service work every Saturday. We won the top county award in 1997 and the top State award in 1998 for all of the hours of volunteer work that we do to help other people. I will be taking the high school diploma next month. I will be graduating from Our House this summer. I will turn 18 at the end of the summer. I do not have a home to go to, and I will be on my own soon. I have to find a place to live and start paying a security deposit to even have a phone installed. This is very scary for me. For the first time in my life, I will be completely on my own. I will have a job with a carpentry union in Frederick, Maryland, because Our House Youth Home taught me carpentry and guaranteed all of its graduates a job in construction field, but I must have transportation to belong to a union, because there are carpenter's jobs all over the different construction sites. I might get a car that has been donated to Our House, but auto insurance costs a lot of money, and insurance companies won't donate even 1 month's premium. Despite the uncertainty of my whole life in front of me, I still feel lucky. At Our House, I have gained self-respect, a work ethic, and a carpentry trade, and a high school degree. I have social workers to give me weekly counseling sessions and to talk with me if I ever need someone to listen to me. They have been preparing me for adult life. I have weekly life skills training, group counseling, CPR certification, and even a 2-month public speaking course. I have had volunteer GED students who have taught me how to study. I feel Our House has given me a lot of tools that will help me, but they need help. They need an after-care program. They need a place for guys like me who are just 18. You see, at 18, most kids have to leave their programs, because 18-year-olds are considered adults. I am still going to need an adult to talk with me who cares about me. I am still going to need a grown-up who I can trust to help me make decisions. I might even need some counseling before I go out completely on my own. However, many of my friends from foster care have only a high school degree and no job skills. They will have to work at minimum wage, but when we are on our own, we all will have to purchase sheets, towels, dishes and pans, food, and clothes as well as worrying about our transportation to and from our job. I don't understand why there can't be more Our House homes to help them get ready. I have five following recommendations: first, kids who have no parents to help them or to give them guidance need a jumpstart on life to make them successful and taxpaying citizens; second, we need mentors who we can call on when things get us down; third, we need help in putting a security deposit on our first month apartment, on our phone, our auto insurance, our first month's rent, our linen, cookware, our furniture, and transportation; fourth, we need more youth homes like Our House--every kid needs this kind of training; fifth, we need Congress to look over the State spending of funds for us, because I don't believe the State of Maryland did such a good job with me. They never seem to have enough money to take care of us properly. And the last I want to say is I am going to be a good citizen, and I am going to give back to this country. Thank you. [The prepared statement follows:] Statement of Montrey Bowie, High School Student, Our House, Inc., Ellicott City, Maryland My name is Montrey Bowie, and I'm 17 years old. I was born in Frederick, MD. I completed the 9th grade when I was in school. I had a tough time when I was young. I had adults who did not care about me, who did not spend much time with me. I began to get in trouble when I was 9 years old, and still the adults in my life could not take care of me. When I was 13, the state pulled me out of my home, and I bounced from group home to group home--4 in all until I was 15. I did not learn anything about how to live, or how to take care of myself. Then the state put me in a foster home with 6 other foster kids. The 7 of us had to share two bedrooms, and the lady was not kind to me. Again, I was very much alone and had no adult support. Finally, after a year in this home, I ran away. And I survived by getting in trouble. But soon I was caught, placed in another foster home, and this home also did not address my needs. I took a job at McDonalds, but I realized that I was not going to have much of a future there. I wanted to be a carpenter, and own my own construction business. I heard about Our House Youth Home, and I went for an interview. It is located between Washington & Baltimore. I got accepted there about a year ago, and I am still currently enrolled there. At Our House, we do 3 things: we learn carpentry during the day, have our high school classes at night, and do community service work every Saturday. We won the top county award in '97 & the top state award in '98 for all the hours of volunteering that we do to help other people. I will be taking the high school diploma exam next month, and I will be graduating from Our House this summer. I will turn 18 at the end of the summer. I do not have a home to go to, and I will be on my own. I have to find a place to live, and start paying security deposits to even have a phone installed. This is very scary for me. For the 1st time in my life, I will be completely on my own. I will have a job with the carpenter's union in Frederick, MD, because Our House Youth Home taught me carpentry, and guarantees all its graduates a job in the construction field. But I must have transportation to belong to the union, because its carpenters drive all over to different construction sites. I might get a car that's been donated to Our House, but auto insurance costs a lot of money, and insurance companies won't donate even one months's premium. Despite the uncertainty of my whole life in front of me, I still feel lucky. At Our House, I have gained self-respect, a work ethic, a carpentry trade, & a high school degree. I had social workers to give me weekly counseling sessions, and to talk with me if I ever needed someone to listen to. They have been preparing me for adult life. I have weekly life skills training, group counseling, CPR certification, and even a two month public speaking course: Toastmasters. I have had volunteer GED tutors who have taught me how to study. I feel Our House is giving me a lot of tools that will help me. But they need help: they need an aftercare program. They need a place for guys like me who are just 18. You see, at 18, most kids have to leave their programs because 18 year olds are considered adults. I am still going to need an adult to talk to who cares about me. I am still going to need an adult who I can trust to help me make decisions. I might even need some counseling, before I go out completely on my own. However, many of my friends from foster care have only a high school degree, and no job skills. They will have to work at minimum wage. But when we are on our own, we all will have to purchase sheets, towels, dishes & pans, food, and clothes, as well as worrying about our transportation to and from our jobs. I don't understand why there can't be more Our House Youth Homes to help them get ready. I have the following 5 recommendations: 1st--Kids who have no parents to help them or to give them guidance, need a jump start on life to make them successful & tax paying citizens. 2nd--We need mentors who we can call on when things get us down. 3rd--We need help in putting a security deposit on our 1st apartment, on our phone, our auto insurance, our 1st month's rent, our linens & cookware, our furniture, and transportation. 4th--We need more youth homes like Our House. Every kid needs this kind of training. 5th--We need congress to look over the state's spending of funds for us, because I don't believe the state of Maryland did such a good job with me. They never seemed to have enough money to take care of us properly. And the last thing I want to say is, I am going to be a good citizen, and I am going to give back. Chairman Johnson of Connecticut. I thank the panel for their testimony, and I particularly congratulate the two of you on the extraordinary intelligence of your testimony and the professionalism with which you delivered it. It is really a testament that you have been able to use the resources that did come to you, though late on, with such very good effect, and it is very encouraging to hear that clearly your friends in those programs also have been able to benefit. But you are absolutely right, it is really scandalous that we should be telling children--one of the earlier people-- maybe, perhaps, it was you, Ms. McCaffrey, who testified about the fear--or Tom DeLay--and we do hope to make very significant change in this program. It is frustrating, because we hear all the people testify and say what good programs, and so you want to say, ``Listen, State, you are going to have to do this program.'' But every child is different, and every community is different, and so communities do have to tailor and develop their programs. We can do a much better job of sharing successful programs throughout the States. We don't do a good job of that. In many ways, the whole foster care system has been a sort of little secret off to the side that we don't talk about, and the more-- you may have heard the earlier panels talk about how once you have the data everybody says ``Wow.'' We had testimony about 2 weeks ago on the Adoption and Safe Families Act, and person after person said, ``Once we had to focus on this issue, we did a much better job.'' So, we are hoping through this legislation to get States to focus; to give them more resources; to have them look at what actually happens as a result of the efforts they make. I mean, look at all the money that was, frankly, wasted on you when you were young, because it was not helping you do the right thing, but it was costly. So, as we get each piece moving along a little better, we hope to figure out how to get the whole system to be, frankly, more child-centered but also more realistic and more practical. One of the things that--as you write this legislation, you want to say, ``These kids should be number one on the work study programs in the high schools.'' Well, you can't necessarily mandate that, but we certainly will in the report language try to cite that kind of issue. First of all, if you do that here, it gets referred to another Committee, and you might never get it back. So, you do have to be careful telling people how you think they can do it best, because you are the results of really caring people thinking about how can we do this best, and, clearly, there is a way to do this best. So, we hope that we will put some money out there and create a different framework within which people cannot only think about these things and can use the money more flexibly but will be held more accountable, and it will be more visible of what did happen and why did it happen? The testimony that we had both at our initial hearing and along the way as to the lack of any support for kids in getting education--both of you got education. Montrey, you got a trade that pays well, and you, Sonja, are in college, and those things open up opportunity, and so much of the money that we spend in the system doesn't open up opportunity. So, we do hope that we will make big change, and I thank you for your very specific recommendations. I appreciate that. I appreciate the thoughtfulness and straightforwardness of your testimony. I very much appreciate the fact that you have been able to put aside feeling sorry for yourselves and ``how come I haven't got a better break in life?'' and make the breaks for yourself now; I admire that. Thank you all for your testimony. The hearing is adjourned. [Whereupon, at 12:05 p.m., the hearing was adjourned.] [Submissions for the record follow:] Kathi L. Grasso, Esq. Baltimore, Maryland 21218 May 26, 1999 The Honorable Nancy L. Johnson, Chair & Subcommittee Members Subcommittee on Human Resources Committee on Ways and Means U.S. House of Representatives Rayburn House Office Building, Room B-317 Washington, DC 20515-6216 RE: Statement of Kathi L. Grasso, Esq., on H.R. 1802 Dear Chairwoman Johnson and Subcommittee Members: I am submitting these comments on the ``Foster Care Independence Act of 1999,'' H.R. 1802, as a private citizen, not on behalf of my current employer. Having been court-appointed counsel for hundreds of youth in child abuse cases while employed at Maryland's Legal Aid Bureau and the Maryland Disability Law Center, I was moved to write because many of my former clients would have greatly benefited from the provision of services envisioned by H.R. 1802. As you are aware, too many adults who have been in foster care as children experience homelessness, imprisonment, violence, poor health outcomes, and the devastating effects of poverty. I commend the Chairwoman's sponsorship of this bill that has the potential to enhance opportunities for foster care youth to participate in much needed independent living programs, as well as facilitate their access to appropriate health care. I support increased funding for these services and Medicaid expansion, but wish to address issues, including the juvenile court's role in monitoring the provision of services, that if addressed could further enable youth transitioning from foster care to receive meaningful independent living services. From my work as an attorney for youth and now with the American Bar Association Center on Children and the Law, I have come to learn that too many teens in foster care, especially those with developmental and mental disabilities, are denied access to services necessary to enable them to make the transition to young adulthood and self-sufficiency. Reasons include: Limits on the jurisdiction of some state courts to preside over cases of youth over eighteen years of age; Lack of or inadequate independent living programs and services; Limited financial resources for these programs; Some states not opting to pay for foster care and/or independent living programs/services for youth older than 18; Rigid standards for admittance into existing programs; Variance in case worker competence (e.g., some may be ignorant of adolescent development and needs; lack rapport or ability to communicate with teens); and Lack of uniformity in how programs are administered or operated. The Court's Role in Monitoring the Provision of Independent Living Services In accordance with federal law, this nation's juvenile and family courts play an instrumental role in monitoring the provision of permanency planning services to abused and neglected children, including independent living services. I know from personal experience that many of my older clients aged eighteen to twenty-one would have been denied transitional living services if the court had not maintained jurisdiction over their cases after their eighteenth birthdays, and if they had not had access to their own legal counsel to advocate for services. In some states, such as Maryland, courts have the authority to review cases of youth in foster care until the person turns twenty-one years of age and can ensure that these young people are not inappropriately denied foster care and transitional living services. In other states, court jurisdiction is terminated once the youth turns age eighteen and as such, there may be no independent judicial oversight. For example, in L.Y. and Melody v. Department of Health and Rehabilitation Services, 696 So.2d 430 (Fla. App. 1997), Judge Pariente, in a concurring special opinion, voiced frustration with Florida's statute terminating court jurisdiction over children in foster care at age eighteen stating that juvenile court jurisdiction should be co-extensive with the obligation of the Department to provide services to individuals who have been previously placed in foster care. Id., at 432. He acknowledged the trial judge's concern that there will be no effective oversight to ensure that the Department provides the services that it is obligated to provide. Id., at 433. Concerned about diminished funding for children's services, he adds: With these budgetary cuts in mind, are the children over eighteen, regardless of how well they may or may not be doing, the next targets? This Court fears that they are, and that a large number of children are going to be cut loose with no resources other than to resort to public assistance, crime, prostitution, and other degrading acts in order to survive. Did the people who may be cutting them loose adequately fulfill their responsibility to prepare these people for independence? Id., at 434. The court goes on to encourage ``HRS in Tallahassee, the Guardian [Ad Litem] program and all responsible child advocates [to] band together to advocate amending the law in order to allow some independent oversight of the manner in which there is review for children who choose to remain in extended foster care beyond their eighteenth birthdays.'' Id., at 435. To ensure that courts are involved in the implementation of the proposed legislation, I recommend that the bill incorporate additional provisions under Section 477(b)(2) and (b)(3), respectively, to require that states in their state plans and certification process detail how they will coordinate with their courts to promote judicial involvement in supporting youth who are transitioning from the child welfare system through their twenty-first birthdays. This coordination could include educating judges and lawyers on transitional living issues and encouraging states, when necessary, to extend their courts' child welfare jurisdiction to allow juvenile judges to preside over the cases of dependent youth eighteen to twenty-one years of age. Ensuring That All Dependent Youth 18-21 Have Access to Foster Care and Independent Living Services In addition to the court's role in monitoring services, I am concerned that the proposed legislation may have the unintentional effect of pushing youth upon their eighteenth birthdays out of stable foster care placements. The bill's purpose section, as well as other language, appears to indicate that the bill is only addressing the needs of youth who are former foster care recipients. Some examples include the following: Sec. 477 (a)(1), ``to identify children who are likely to remain in foster care until 18 years of age....''; Sec. 477 (a)(2), (a)(3), ``to help children who are likely to remain in foster care until 18 years of age....''; Sec. 477 (a)(5), ``to provide...services to former foster care recipients....''; Sec. 477 (b)(3)(A), ``that the State will provide assistance and services to children who have left foster care....''; and Sec. 477 (b)(4)(C), ``all children in the State who have left foster care....'' Would this legislation allow independent living funds to be appropriated for transitional living services to youth who still reside in foster care placements after age eighteen and until age twenty-one? Many youth will benefit from the stability of being in a family foster home after age eighteen and at the same time will be in need of services to enable them to transition to self-sufficient adulthood. For instance, what about the nineteen or twenty year old youth who lives with a foster family and attends a local college? If states wanted to take advantage of increased independent living funding, would some youth be unnecessarily removed from their stable foster home environments and forced to live on their own? We should work to ensure that youth in foster care are afforded the same opportunities for family life as non-foster care youth. I would therefore recommend that the bill be amended to extend foster care maintenance payments to dependent youth up to age twenty-one and ensure that youth, aged eighteen to twenty-one, in foster care can also be recipients of independent or transitional living services. Ensuring That All Dependent Youth 18-21 Have Access to Appropriate Health Care Studies indicate that a significant number of children and youth coming under the auspices of juvenile, dependency and family courts have disabling, chronic, and life threatening conditions that are not always identified and treated.\1\ Expanding Medicaid coverage to youth transitioning from foster care aged eighteen through twenty-one is essential if we are to increase the chances of this at-risk population of youth being physically and mentally healthy as adults. --------------------------------------------------------------------------- \1\ United States General Accounting Office, Report to the Ranking Minority Member, Subcommittee on Human Resources, Committee on Ways and Means, House of Representatives, Foster Care: Health Needs of Many Young Children Are Unknown and Unmet, GAO/HEHS-95-114 (May 1995); Chernoff, R, Combs-Orme, T, Risley-Curtiss, C, Heisler, A, Assessing the health status of children entering foster care, Pediatrics, 93(4): 594-601 (April 1994); Horwitz, SM, Simms, MD, Farrington, R, Impact of developmental problems on young children's exits from foster care, Developmental and Behavioral Pediatrics, 15(2):105-110 (April 1994); Halfon, N, Berkowitz, G, Klee, L, Mental health service utilization by children in foster care in California, Pediatrics, 89(6): 1238-1244 (June 1992); and McIntyre, A, Keesler, T, Psychological disorders among foster children, Journal of Clinical Child Psychology, 15(4), 297-303 (1986). --------------------------------------------------------------------------- I appreciate the opportunity to comment. Thank you for your consideration. Sincerely, Kathi L. Grasso, Esq. Statement of National Independent Living Association, Jacksonville, Florida The National Independent Living Association(NILA) submits this document as testimony to the distinguished members of the House Ways and Means' Subcommittee on Human Resources. The National Independent Living Association is an association connected to hundreds of public and private agencies, state agencies, foster care parents, individuals and foster care youth who represent 50 states across the nation. These member agencies and individuals represent foster care youth and services, youth at risk and young people in out of home placements in need of extending, quality care in order to make the transition from care to independence successful. Many of our members are state coordinators, provide specialized services and focus their programs specifically on independent living services and transitional living skills. On behalf of our members and on behalf of over 500,000 young people in care, we thank you for the opportunity to submit our recommendations and comments for your review. In 1989, the founders of NILA were instrumental in shaping the legislation for foster care youth. They made positive change in policy and began a movement across the nation that connected foster care services, providers, and youth together. Over the years, the networking and advocacy that has taken place for young people in out of home care has sparked concerns for the constant changes and problems young people face, in society and programming. These issues have become NILA's focus as many of the young people leaving care become homeless, incarcerated, pregnant and in greater need of mental health and medical services. As Bill Pinto, Program Director for Connecticut's Department of Human Services, stated in his March 9th testimony to the Subcommittee on Health and Human Resources, ``To me, the story of Independent Living in the United States is one of 'tragedy and triumph'. The tragedy is that, far too often, graduates of the American child welfare system become America's homeless, prisoners, public assistant recipients and psychiatric patients.'' NILA feels very strongly about it's commitment and responsibility to the older youth in America who are in alternative care. Entering into adulthood can take many forms, and particular experiences or events may be viewed as turning points for individuals during which new directions are taken. Research has shown that positive youth development is fostered when adolescents have a sense of industry and competency, a feeling of being connected to others and to society, a belief that they have control over their lives and a stable identity. Many of the children placed in out of home placements are victims of abuse, abandonment, parents with addictions and many other hardships. These youth require security and support that will aide them in their growth as young adults to feel connected, in control and with a sense of identity. We have a responsibility to do more for the young people aging out of the system than we have been. The challenges young people face at age 18 are tremendous and it may be that the absence of support from families, societal institutions, communities and friends, rather than any given problem behavior, explains the failure or inabilities of some adolescents to achieve successful adulthood. We must support their desire to complete their education, find gainful employment, and their will to become independent, healthy members of society. It is critical that we begin recognizing the transition from childhood to adolescence to self-sufficiency or adulthood, is a process, not an event. The bipartisan bill being introduced will play an important role in promoting the successes of young people in out of home placements transitioning to independent living. Unfortunately there is no single ``cure all'' solution, but NILA supports all efforts made for better policy and programming for these youth. In 1997, Congress passed the bipartisan Adoption and Safe Families Act which ensures that more young people in foster care will have safe and permanent living arrangements. While this was monumental for many children and youth, adoption is not possible for every child in alternative placements. The ``Transition to Adulthood Program Act of 1999,'' being introduced by U.S Representative Ben Cardin (D-MD) and U.S. Representative Nancy Johnson (R-CT) addresses many of the issues for Independent Living Services programs and the young people they serve. NILA is pleased that Congress and the Clinton Administration are addressing the needs of our young people. In fact, a study contracted by the U.S. Department of Health and Human Services concluded that emancipated youth are a troubled population.\1\ --------------------------------------------------------------------------- \1\ Alliance For Children & Families, Into the Newsroom, public relations staff, February 28-March 2, 1999. Study contracted by the U.S Department of Health and Human Services. --------------------------------------------------------------------------- Two thirds of the 18 year olds in the study did not complete high school or a GED Sixty-one percent had no job experience. Thirty-eight percent had been diagnosed as emotionally disturbed Seventeen percent had a drug abuse problem Nine percent had a health problem. Seventeen percent of the females were pregnant Of the total 34, 600 youths emancipated from foster care during the study period, 40 percent received no independent living services to help them prepare for responsible adult life. For those who had received services, the study found that many of the skills encouraged by the Independent Living Programs were positively related to good outcomes once the adolescents left foster care. A good example of this is the story about a young man in foster care who just reached his 18th birthday. He is forced to leave his current placement and is exited out on his own. For much of his life he has become significantly familiar with the word ``survival.'' He has survived a childhood of abuse, neglect and domestic violence, multiple placements in foster homes, group homes and alternative care. He knows how to survive street life, sleepless nights under bridges, in cars and at various friends homes and lonely holidays without family. But he doesn't know how to fill out a job application or how to interview for a job, let alone maintain one. He doesn't know how important completing his education will be to his future or how to find permanent, safe housing. He is arrested for stealing food, and while jail isn't ideal, it is three square meals, a bed to sleep on and a roof over his head. Meanwhile, the young lady he got pregnant is having the baby. She is familiar with the welfare system and knows how to survive on it and manipulate it. But she doesn't know how important pre-natal care is nor does she have strong parenting skills because she has never known a positive parent role model. As dramatic as this sounds, these two young people represent a large number of youth being emancipated from care every year. NILA believes the issues that youth in out-of-home placements are faced with are among the most integral, important issues facing Congress. If the well being of our children is a priority, then we must act with vigor. NILA's Board of Directors, members and its legislative committee have reviewed the highlights of the bipartisan bill being introduced and have outlined additional recommendations and other improvements that we believe will better address the needs of young people making the transition to adulthood. An increase in the Independent Living budget from $70 million to $140 million. Current allocations to states remains based on the 1984 census and overall dollars have not been increased since 1992. A substantial increase is pertinent to the delivery of services to youth who are suppose to receive them. National policy for states flexible funding that provides measurable outcomes for design and implementation of programming specific to older youth in out-of-home care. While there are many responsible programs that are providing quality, extended care to youth aging out of the system, there are many, unfortunately, that continuously fail our older adolescents. Policy that promotes accountability and outcome measures will also promote proper and safer exits from care for youth. Reallocation of funds based on the average of the last two years' foster care census (both IV-E and non IV-E eligible). This number should be re-calculated regularly to allow for the shifts in the population. The distribution formula for the Independent Living IV-E initiative funds has not been updated since 1984. For many states the current formula does not meet their needs for the increased number of youth they are serving. Employment tax credit for hiring current or former foster care youth. Less than half of the youth emancipated from care without support or aftercare, are unemployed. Only 38% maintain a job for over a year. Incentive to employers to work with and train these youth could prove to be very affordable. When adolescents perceive their futures in terms of work that will allow them to have positive work experiences and become economically self- sufficient, they are more likely to feel a sense of responsibility and capability to manage their future. An increase in allowable savings for youth up to $5,000. NILA strongly recommends that young people graduating from foster care not be penalized by becoming ineligible for Title XX or other social services for maintaining a personal savings plan. Lowering the age for IV-E eligibility to 14 years. The younger an adolescent begins to get involved in skills training, self-preparation and specialized programming, the more likely the results will be positive. Studies have shown that if in early adolescents (ages 11-14) and through mid- adolescence (ages 15-17) characteristics of competency, connectedness, self control and identity are nurtured, it is more likely that these youth will engage in pro-social behaviors, exhibit positive school performances and be members of nondeviant peer groups.\1\ --------------------------------------------------------------------------- \1\ U.S. Department of Health and Human Services, Administration for Children and Families, Understanding Youth Development: Promoting Positive Pathways of Growth; January 1997. --------------------------------------------------------------------------- No more than 40% of allocations to be spent on room and board and at least 60% of the funds to be spent on training and services to prepare youth for self-sufficiency. Allocations for room and board are very important to assisting programs in transitioning youth to self-sufficiency and long term independent living. It is apparently evident that skills training and support services and after care are the back bone to the success of ``long-term.'' Therefore a greater percentage of the funding needs to go to training and programming that promotes preparedness. NILA supports the Data Reporting Requirements proposed in the bipartisan bill being introduced. NILA recommends additions to the data requirements be; the number of youth who are in college, post secondary education and other trade/training educational institutes. A stronger emphasis on educational assistance and preparation for employment. The Westat study, conducted in 1989-1990, showed that youth who received continued services and support to attend continuing educational programs, were more likely to obtain employment that provided a comfortable wage for living. They were also more likely to abstain from re-entering the system as criminals, welfare recipients or homeless members of society. Requirements that states will provide some assistance to youth, who are not otherwise covered by medical insurance, to obtain and pay for their medical services until age 21. There are 20,000 youth who age out of foster care every year. Not one of them should be without health coverage of some type. The security of these youths medical and mental health is critical to the success of their futures. Allow youth in out of home placement to remain in care until age 21 if they are completing their education and preparing for their transition to adulthood. Many youth are forced to leave care upon reaching the age of 18. Many have not completed their education by this time and are forced to drop-out for various reasons. Continued emotional and tangible support for these young people, coupled with programs designed to promote education and life skills training, will most likely encourage youth to reach for higher education accomplishments. Continuation of services to youth who have left care, such as housing and financial assistance, up until age 21. Between the ages of 18-21 the process of transitioning from adolescence to adulthood needs continued services. Transitional housing is essential to those youth who require some structure and supervision. Supervised group homes and apartments, subsidized housing and community based training should all be part of the process for continuum of care to youth. Allow youth to re-enter foster care after age 18. Often times youth who have been part of multiple placements, traumatic, abusive histories and no family network or support, have a great desire to venture out of care and try ``freedom'' on their own. Statistics show that many of these young people often flounder and falter at their first attempt to independence. However, trial and error can be a clever teacher. Many youth realize ``freedom'' is more than just 'being on your own' without adult supervision. It is knowlege and a good sense of direction. Many wnt and need to return to a sense of connectedness and security while they maneuver themselves comfortably into self-sufficiency. States should be given incentives to allow youth who leave voluntarily at age 18, to re-enter voluntarily at any time prior to age 21. Provide one year of after care services up to age 21. After care has proven itself to be a significant factor in a young person's ability to adjust to the transition into independent living. Many programs across the nation already have built-in after care programs. These programs should be the models that other after care programs are designed after. They are strong examples of how essential it is to the success of these youth exhibiting responsible actions and lifestyles. 4Research and evaluation to determine best practices in preparing youth for adult life. In order for the transition from childhood to adolescence to adulthood to progress efficiently, it is crtical that we evaluate effective programming, successful training approaches, and the emotional and physical well-being of these youth. It is just as important the we continue to research the trends and effects of societal change and assess the challenges in their home environments to begin implementing preventative programming as well. NILA strongly implores the honorable members of the Subcommittee for Health and Human Services to act right now on behalf of all the young people in alternative care by passing a bill that will enhance the quality of care, build a strong sense of community and continue the development of good programming. The challenges our young people face are getting bigger and tougher everyday. The opportunity to create policy that is in their best interests and will contribute to their transition into adulthood, is now. In closing, John F. Kennedy said it best; ``All this will not be finished in the first one hundred days. Nor will it be finished in the first one thousand days, nor in the life of this Administration, nor even perhaps in our lifetime on this planet... But let us begin.'' NILA Designated Representatives Sheet NILA Management Staff James D. Clark, Executive Director NILA Headquarters 4203 Southpoint Blvd, Jacksonville, FL 32216 904-296-1055 ext 1025 Robert E. Arnold, Assistant Executive Director NILA Headquarters 4203 Southpoint Blvd, Jacksonville, FL 32216 904-296-1055 ext 1018 Shelly R. Davalos, NILA Coordinator NILA Headquarters 4203 Southpoint Blvd, Jacksonville, FL 32216 904-296-1038, fax 904-296-1953 NILA Board of Directors Executive Committee: Cathy Welsh, Chair South Bronx Human Development org One Fordham Plaza, Suite 900 Bronx, NY 10458 Kathi Crowe (Vice Chair) Rhode Island Department of Children & Families 610 Mt. Pleasant Ave, Bldg 2 Providence, RI 02908 Lee White, Treasurer Northwest Media 326 West 12th Ave., Eugene, OR 97401 541-343-6636 fax 541-343-0177 Diann Stevens, Secretary Ohio Department of Social Services 1951 Gantz Rd. Grove City, OH 43123 614-278-5974 fax 614-278-5988 Youth Board Members: Geisha Grice--California Youth Connections San Francisco, CA 94104 Srv510-351-4401 Shanequa AndersonLeakke & Watts Bronx, NY 10451 714-293-1194 Amanda Knight--Missourti Division of Family Srv 573-751-4319 Board of Directors By Region Region I: Kathi Crowe (Vice Chair) Region II: Karen Lendon Leake & Watts Yonkers, NY 10704 718-617-5100 fax 718-893-1268 Region III: Patrick Patrong Maryland Ind. Living Program DHR Baltimore, MD 21201-3521 410-767-7634 fax 410-333-0127 Region IV: Don Adams South Carolina Dept. of Social Services Columbia, SC 29202-1520 803-898-7715 fax 803-898-7652 Region IV: Lori Day Fort Lauderdale, FL 33325 954-916-9403 fax 954-524-4451 Region V: Diann Stevens (Secretary) Regiion VI: Rhonda Dyer Pathways Youth Home San Antonio, TX 78250-63009 210-521-8288 fax 210-543-9553 Region VII: Dotti Banks Missouri Division of Family Services Jefferson City, MO 65103 573-751-4319 fax 573-526-3971 Region VIII: Sharon Collins Catholic Charities Arch of New Orleans Marrero, LA 70072 504-340-5100 fax 504-347-0095 Regiion IX: Beverlee Kroll Arizona Dept Economic Security--ACYF Phoenix, AZ 85007 602-542-3981 fax 602-542-3330 Region X: Lee White (Treasurer) State Seat: Janet Luft Texas Dept. Protection & Regulatory Austin, TX 78714-9030 512-438-5442 fax 512-438-3782 Private Seat: Cathy Welsh (Chair)