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Analysis of State Actions on Important Issues

Supporting and Retaining Foster Parents

April 2002
Volume 27, Number 11

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Most states are experiencing a serious shortage of qualified foster parents. Between 1984 and 1995, the number of children in foster care increased 68 percent, while the number of foster parents decreased by 4 percent.1 The principal cause of this shortage is the inability of child welfare agencies to retain the foster parents they have recruited. Turnover among foster parents is extremely high; some agencies lose from 30 percent to 50 percent of their caregivers every year. This trend increases the risk that children will be inappropriately placed in expensive institutions or with families that are unprepared to meet their complex needs. It also puts pressure on child welfare agencies to license marginal homes and to place children away from their families and communities.2

Why Do Foster Parents Quit?

Although some foster parents quit because of normal life changes such as a return to work or the birth of a child, many leave because of a lack of support from the child welfare agency and a feeling of being undervalued and unappreciated (table 1). These problems are, in large measure, attributable to high turnover among foster care caseworkers. Lack of continuity in relationships with caseworkers makes it difficult for foster parents to maintain the trust, respect and support they need from the child welfare system. In addition, foster parents frequently are asked to care for children with serious physical, emotional and behavioral problems but often are poorly trained, not given adequate information about the children in their care, and are left on their own to negotiate a fragmented and confusing service delivery system. They usually are not consulted when decisions are made on behalf of the child. The monthly payments they receive are, in many cases, insufficient to cover their expenses. They often are confused about their roles, rights and responsibilities but may be labeled as troublemakers if they ask questions or seek help from caseworkers.

Table 1: Five Top Reasons Foster Families Decide to Quite Fostering3

Source U.S. Department of Health and Human Services, National Survey of Current and Former Foster Parents, 1993.

What Do Foster Parents Need?

Foster parents have a difficult job and need a variety of supports and services. These include:

• Adequate pre-service and in-service training;
• Information about the child, including the child's current case plan, educational and medical status, and placement and treatment history;
• Respect as a member of the child's case planning team and as a partner in the policy development process;
• Support from the child welfare agency, including adequate supervision, monitoring and consultation, as well as support from a network of other foster parents who can serve as mentors;
• An opportunity to provide feedback to the agency without fear of reprisal;
• Clarity about foster parents' roles, rights and responsibilities;
• Services such as child care, respite care, liability insurance, and health care.

What Are State Legislatures Doing to Support Foster Parents?

States and localities are experimenting with a variety of approaches to support foster parents and improve retention rates. Although some of these approaches have shown promise, most have not been rigorously evaluated, and the few studies that have been published are too small to yield results that can be generalized to all foster parents.4 Nevertheless, state lawmakers are beginning to pay more attention to the challenge of foster parent retention and to enact laws designed to address the problems underlying high caregiver turnover. Although legislation is unlikely to improve retention unless it is accompanied by changes in agency values, culture and practice, it can be an important step in the right direction.

What Foster Parents Need:

• Respect
• Training
• Information
• Support
• Services

Foster Parents' Rights

Six states-Illinois, Maryland, Mississippi, Oklahoma, Tennessee and Washington-have enacted statements of foster parents' rights. Other states have incorporated a list of foster parents' rights in agency policy. These lists of rights are intended to address many of the concerns raised by foster parents, including the right to be treated with respect and the right to voice grievances without fear of retaliation or harassment.

Foster Parents' Rights Statutes

Participation in Case Planning

In response to foster parents' concerns that they have no say over their foster children's future, five statutes on foster parents' rights include some provision for participation in case planning and decision-making on behalf of the child. Other states, including Virginia and Washington, also have enacted provisions requiring that child welfare agencies consult with foster parents regarding children's case plans.5 In addition to participation in case planning, the statements of rights enacted by Illinois, Oklahoma and Tennessee give foster parents the right to be considered as a placement option if a child who formerly was placed with the foster parent subsequently re-enters care.

Five of the statutes on foster parents' rights also include the right to information relevant to care of the child. Tennessee's law, for example, requires foster parents to be informed if a child has committed certain serious delinquent acts and to receive information about a child's medical, behavioral or psychological needs. 6 Oklahoma's statute gives foster parents the right to communicate with other foster parents who have cared for the child and with professionals such as the child's therapist, physician and teachers.7 Other states have enacted laws requiring the sharing of information with foster parents. Washington, for example, enacted a provision in 1997 that requires the preparation of a passport containing information on the health and educational status of any child who has been in foster care for 90 days or more.8 In response to the legislative mandate, the state Division of Children and Family Services created an automated, interdisciplinary record keeping and tracking system. The program has an operating budget of approximately $4 million, which is funded in part by federal funds under the statewide automated child welfare information system (SACWIS) program in Title IV-E of the Social Security Act. Other states also have enacted passport laws.9

Current and former foster parents surveyed in 1991 reported a lack of needed services, including, child care, respite care, family counseling, transportation, health insurance, liability insurance and recreational opportunities for foster children.10 Some states have laws that are intended to address these service needs.

Respite Care. Respite care provides temporary relief from the stresses associated with caring for a foster child. At least seven states have laws addressing respite care for foster parents. Most of these programs are subject to the availability of funds.

• California: Authorized pilot projects to provide respite care to caregivers of seriously emotionally disturbed children and mentally ill adults. Respite care under the program may be provided to foster parents if funding is not available through the county foster care program.11
• Florida: Established a pilot program in one rural and one urban county to provide intensive services to foster children and their caregivers, including regularly scheduled respite care by trained homemakers.12
• Missouri: Requires the division of family services to establish reasonably accessible respite care facilities at which licensed foster parents may leave foster children for predetermined periods of time.13
• Montana: Mandated the provision of respite care for foster children who have developmental disabilities, who are medically demanding or who are suffering from severe emotional problems.14
• Nevada: Requires the establishment of respite care programs in counties with a population of 100,000 or more.15
• Tennessee: Includes in its list of foster parents' rights a requirement that the state offer respite care to foster parents.16
• Washington: Requires the establishment of a respite care program for foster children with emotional, mental or physical handicaps.17

Health Insurance. Many foster parents do not have access to affordable health insurance. Some states allow foster parents to enroll in state-sponsored group health insurance programs.

• Connecticut: State law allows foster parents who have been licensed for six months or more, and their dependents, to purchase coverage under a group health insurance plan arranged by the state comptroller.18
• Oregon: State law allows foster parents to participate in the health plan available to state employees. Foster parents are considered eligible state employees for such purpose.19

Kentucky enacted legislation in 2001 to require recommendations regarding foster parents purchasing health insurance through the public employee health insurance group. 20 In its report to the legislature, the state did not recommend this approach because of an opinion of the state Revenue Cabinet that inclusion of foster parents in the state employee health plan might jeopardize the non-taxable status of plan benefits under section 125 of the Internal Revenue Code.21

Protection Against Liability: Foster parents are subject to civil liability for acts or omissions resulting in injury or death to foster children and also to liability for the acts of foster children that result in injury, death or property damage to third parties. States have enacted various types of laws to protect foster parents from such liability in appropriate cases. Wisconsin law, for example, provides foster parents with immunity from civil liability for their own acts or omissions, unless they were not performed in good faith or were not in compliance with written instructions regarding care of the child.22 Colorado enacted legislation in 2000 to limit the civil liability of foster care providers for the actions of their foster children.23 Some states provide liability coverage for foster parents, either through establishment of a risk pool or through the purchase of private insurance.24

Foster parent associations in a number of states-including Connecticut, Iowa, Nebraska and Washington-sponsor mentoring programs in which experienced foster parents provide support and advice to other foster caregivers and act as liaisons with the public child welfare agency.25 The statute mandating the Washington program requires the foster parent liaison to "enhance the working relationship between department caseworkers and foster parents" and to "substantially reduce the turnover rate of foster parents."26 Kentucky also has a statewide mentor program run jointly by the Cabinet for Families and Children and Murray State University.

Child welfare experts agree that adequate training is critical to foster parent retention. The number of hours of pre-service and in-service training required of foster parents, governed in some states by statute, varies significantly from state to state. Most states require from 12 to 30 hours of pre-service training and from six to 20 hours of annual in-service training.27 Although most state laws on foster parent training do not prescribe curricula in detail, legislation can specify required elements to guide agencies in planning training programs. Recent federal law requires that states use federal training funds to help foster parents, among others, address the issues confronting adolescents who are preparing for independent living.28 A report by Casey Family Programs recommends that foster parent training include certain other elements:

• Behavior management;
• An emphasis on specific skills;
• Dealing with attachment, grief and loss;
• Involvement of both birth and foster families in training;
• The importance of teamwork and shared decision-making; and
• Cross-training of foster parents and agency staff.29

Oklahoma's statute on foster parent training, for example, emphasizes the importance of training in behavior management, parent-child conflict resolution and stress management, in addition to other required elements.30 Washington law requires that training cover, among other things, "attachment, separation, and loss issues faced by birth parents, foster children, and foster parents."31

One approach to the problem of foster parent retention that is receiving more attention from policymakers is the "professionalization" of foster parenting, also referred to as "paid parenting." Professional foster parents are trained employees of a public or private child welfare agency and receive a salary and benefits in addition to a monthly subsidy. Advocates of this approach claim that professional foster parents are more likely to stay on the job, are better prepared to handle children with serious behavioral problems, are less likely to be confused about their roles and responsibilities, and are accorded greater respect by caseworkers. In addition, advocates claim that professional foster caregivers are a cost-effective alternative to expensive institutional placements and that they have more time to work directly with foster children and their birth parents, thereby speeding up permanent placements through reunification or adoption. Finally, it is argued that professionalization removes economic disincentives to fostering, improves the supply of caregivers in low-income neighborhoods, and lessens the need to place children away from their communities.32

Critics of this approach argue that professionalization is fundamentally inconsistent with the idea of family and that professional concerns will interfere with the intimacy and spontaneity of the parent/child relationship. They worry, for example, that a professional foster parent will be less likely than an unpaid foster parent to adopt a foster child because of the resulting loss of salary, benefits and professional status.33

Professional foster parenting is being tested in Chicago, Florida and, most recently, Boston. The Florida pilot program was authorized by legislation in 1998;34 is funded with a mix of public and private funds by The Ounce of Prevention Fund of Florida, a non-profit public/private partnership; and is operated by Neighbor to Family, Inc. Foster parents are employees of Neighbor to Family and receive an annual salary of between $10,000 and $14,000, as well as intensive training, child care, respite care and other support services. The goals of the pilot project are to keep sibling groups together in foster care, to reduce foster parent turnover, and to expedite permanent placements of children. The program has not yet been fully evaluated, but preliminary results are promising, including a 95 percent foster parent retention rate.35

The Florida project is based on a program in Chicago called Neighbor to Neighbor, which is funded by the Illinois Department of Children and Family Services and administered by the Jane Addams Hull House Association, a private child welfare agency. A 1999 study found that the program outperformed regular foster care in the areas of placement stability (number of placement changes), keeping sibling groups intact, placement proximity to birth family and reunification with birth family, but performed poorly in terms of placing children in adoptive families or in permanent guardianships.36 The majority of foster parents interviewed for the study rated their treatment by Hull House as excellent (14 percent), very good (38 percent) or good (38 percent).37 The study, however, did not examine foster parent retention rates.

Conclusion

Foster parents are a valuable but often neglected resource, both for child welfare agencies and the children they serve. They are increasingly being asked to fill a variety of roles-including nurturer, disciplinarian, therapist, case manager, recruiter, mentor to birth parents, member of the permanency planning team and potential adoptive parent-and to care for children with increasingly complex and deep-seated emotional, behavioral and medical problems. Policymakers are beginning to appreciate the key role played by foster parents in keeping sibling groups together, facilitating the permanent placement of children and preparing foster youth for independent living. Support for foster parents, however, has not kept pace with these additional demands. In an era of state budget shortfalls, it may be unrealistic to expect significant increases in the resources provided to public child welfare agencies for support of foster caregivers. There are, however, a number of low-cost options that legislators can consider, including provisions for participation in case planning, adequate information sharing, better training, peer mentoring, and recognition of foster parents for the important work that they do.

Notes

1. Kathy Barbell and Madelyn Freundlich, Foster Care Today (Washington, D.C.: Casey Family Programs, 2001).

2. Annie E. Casey Foundation, Recruitment, Training and Support: The Essential Tools of Foster Care (Baltimore, Md.: AECF, n.d.)

3. Table reprinted from Casey Family Programs, Lighting the Way: Attracting and Supporting Foster Families (Seattle: Casey Family Programs, 2000), 18 (hereinafter Lighting the Way).

4. Lighting the Way, 18.

5. 2001 Va. Acts, Chap. 437, codified at Va. Code _ 2.1-754; 1997 Wash. Laws, Chap. 272, codified at Wash. Rev. Code _74.13.280.

6. Tenn. Code Ann. _37-2-415(c)(1).

7. Okla. Stat. Ann. tit. 10, _7206.1 A.10, 11.

8. 1997 Wash. Laws, Chap. 272, codified at Wash. Rev. Code _74.13.285.

9. See, e.g., Ky. Rev. Stat. _605.160 and Mich. Comp. Laws _722.954c.

10. U.S. Department of Health and Human Services, The National Survey of Current and Former Foster Parents (Washington, D.C.: DHHS, 1993).

11. Cal. Welfare and Institutions Code _5832-5837.

12. Fla. Stat. _409.803.

13. Mo. Rev. Stat. _210.545.

14. Mont. Code Ann. _52-2-627.

15. Nev. Rev. Stat. _424.077.

16. Tenn. Code Ann. _37-2-415(a)(22).

17. Wash. Rev. Code _74.13.270.

18. Conn. Gen. Stat. _5-259(f). See also Policy 41-25-6, Connecticut Department of Children and Families.

19. Or. Rev. Stat. _243.140.

20. H.B. 145, Chap. 142 (2001).

21. Kentucky Revenue Cabinet, Administrative Response to Secretary Carol Palmore, May 18, 2001.

22. Wis. Stat. _895.485.

23. Colo. Rev. Stat. _13-21-117.7.

24. See, e.g., Cal. Health and Safety Code _1527; Ga. Code _45-9-4 (d); Iowa Code _237.13; Kan. Stat. Ann. _75-5328a; Md. Family Law Code _5-529; Minn. Stat. _245.814; Neb. Rev. Stat. _43-1320 and Wash. Rev. Code _74.14B.080.

25. Casey Family Programs, "Resource Family Mentoring," April 18, 2001. Available on Casey Family Programs Web site: www.casey.org.

26. Wash. Rev. Code _74.13.340.

27. National Foster Parent Association, Inc., "State Foster Parent Training Requirements," available on NFPA's Web site: www.nfpainc.org.

28. Foster Care Independence Act of 1999, P.L. 106-169.

29. Lighting the Way, 26.

30. Okla. Stat. Ann. tit. 10, _7212.

31. Wash. Rev. Code _74.13.250.

32. Mark Testa and Nancy Rolock, "Professional Foster Care: A Future Worth Pursuing?," Child Welfare LXXVIII, no. 1, 108-124. See also, Thomas Waldock, "Professionalizing Foster Care: The Welfare of Children," The Social Worker 64, no. 3, available on the web at http://home.ica.net/~sharyn/article2.htm; Casey Family Programs, "Resources on Professional Foster Parenting," available on their Web site, www.casey.org.

33. R. Lemay, "Against the Professionalization of Foster Care: An Essay," The Social Worker 59, no. 101-104.

34. 1998 Fla. Laws, Chap. 98-403, codified at Fla. Stat. _39.817.

35. Casey Family Programs, "Resources on Professional Foster Parenting."

36. Mark Testa and Nancy Rolock, "Professional Foster Care: A Future Worth Pursuing?," Child Welfare LXXVIII, No. 1, 108-124.

37. Mark Testa, Jane Addams Hull House Association Neighbor to Neighbor Program Evaluation (Chicago: University of Chicago, 1997).

STATE LEGISLATIVE REPORT is published 12 to 18 times a year. It is distributed without charge to legislative leaders, council and research directors, legislative librarians, and selected groups for each issue. For further information on STATE LEGISLATIVE REPORT or to obtain copies, contact the NCSL Book Order Department in Denver at (303) 830-2054.

© 2002 by the National Conference of State Legislatures

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