People who've been through foster care systems, like the Oregon Department of Human Services, are more likely to suffer from chronic health conditions later in life.
Bradley W. Parks / OPB
Children and youth in foster care suffer from a variety of different trauma, aside from being taken out of their families of origin. One factor that contributes to mental health issues and negative outcomes is how many placements they have while in the system. Freelance journalist Libby Dowsett wrote a five-part series for “Street Roots” looking at programs in other states that are improving placement stability and reducing disruptions. We talk with Dowsett about the specifics of these programs, what the data shows about their effectiveness and whether they might work in Oregon.
This transcript was created by a computer and edited by a volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. We start today with foster care and one particular challenge many young people in the system face. It’s common for foster youth in Oregon and around the country to be shuffled from one placement to another. These can be difficult disruptions that add an extra layer of uncertainty to already traumatized lives. The freelance writer Libby Dowsett wanted to find out what some states are doing to try to prevent these kinds of disruptions. She talked to officials in Georgia and Iowa who are working on placement stability for kids in foster care. She just finished a five part series about this for Street Roots, and she joins us now to talk about what she found. Libby Dowsett, welcome to Think Out Loud.
Libby Dowsett: Hi, thanks for having me.
Miller: Thanks for joining us. I gave sort of a one sentence version of this. But why did you decide to focus specifically on placement stability? There are a lot of issues in Oregon and nationwide that you could focus on for foster care, but why focus on placement stability in particular?
Dowsett: I do a lot of foster care stories, for Street Roots, and this particular topic, it is not a stereotype that kids are throwing their belongings and garbage bags or having them gathered up in a bag and thrown in the back of a car. That’s actually happening. They are going from home to home, home to group home, group home to group home, all these different scenarios, so we wanted to zero in on that, because that seemed to be almost how kids were introducing themselves to me: ‘Hi, my name is so and so I’ve had 14 placement changes”
Miller: They would lead with that?
Dowsett: Yeah. To have them identify themselves that way was sad to me, and to others at Street Roots, in fact, Street Roots came up with this idea and asked me would I want to be involved. So they were thinking the same thing even though I was doing the stories and the reporting. So, it’s a big issue.
Miller: You found that in Oregon, which you note is about average, in terms of this kind of instability, in Oregon, 41% of children in foster care have had at least three placements during their time in care, 15% have had six or more. What are the effects of that kind of instability?
Dowsett: They define placement stability in child welfare as two or fewer placements. To talk to these young people that we talked to in this series, about having, like I said, 14 placements, she was one person in particular, Chai, that I talked to, she had been so many places she couldn’t put the order right away. When I was saying, oh, were you in a group home? It’s all jumbled up, because there were so many, and she said after I believe two or three, she just felt unloved and this is how it’s going to be, and just deal with it, because you know, life as you knew it... she preferred to be not in a home, but life as you think it’s going to be, is over and you’re just in a constant state of flux, basically.
Miller: What is being moved by the people, or in this case the state, that’s in charge of you, what does that do for your ability to feel ‘at home’ somewhere, or your ability to make human connections with the people around you?
Dowsett: It was really sad what we found out talking to a child psychiatrist, talking to consultants who talk to child welfare groups about the damage. These children are so fragile, and to be moved from different placements, they tend to not form relationships as well in the future. They think ‘I’m not going to put any effort into making relationships because they’re only going to be broken down the road,’ and so it affects their life in so many ways and also their outcomes in life. You know, there’s incarceration, there’s homelessness, there are so many issues they face after foster care and that’s driven by the number of placements they’ve had.
Miller: I imagine there are many different answers to this question, but what are the kinds of reasons that kids would be moved from one place to another?
Dowsett: We had some examples, one young person was telling me they were caught smoking by their foster parents, and their foster parents said, ‘Hey, that was one of our rules. We can just tell this is going downhill. You know, you’re going to have to move.’ And that’s just one example, another was getting in trouble with the cops a lot, and they kept coming back saying, you know, this is just causing problems in town. Could...is there any way this youth, at a group home, could maybe go to another group home, and that person was moved for that reason. And I mean there’s a myriad of reasons and we started going through a few of them. Jacqueline, a 22 year old, she’s now a Portland Warner Pacific student in Portland, and she was moved because her age She hit a certain age, an older foster youth, and so they had to move her for that reason. So, there’s just so many reasons.
Miller: Is it fair to say that each move makes another move more likely, that at least, it could exacerbate the kind of behavior that could lead to somebody being transferred?
Dowsett: The more placements, the longer you are in care, the more behavioral issues you face. Chai was saying that her behavior just got worse and worse as she went on. And so she was ornery, she said, standoffish only because she didn’t want to get attached to anyone. So when she didn’t want to participate in holidays or come downstairs for a birthday party, they saw that perhaps as, ‘this isn’t working out, we’re not bonding,’ but she was trying to protect herself from being hurt so many times. So I could see that…
Miller: You note in your series that despite the fact that there has been a lot of focus on improving Oregon’s foster care system in the last few years, with each new leader saying some version of, ‘We need to do better. We realize there are serious issues, we’ll do better.’ Nevertheless, the percentage of children with three or more placements has only grown in the last three years. How do you explain that? That this issue is actually currently getting worse in Oregon?
Dowsett: It’s remarkable because the Child Welfare Department is greatly reducing the number of kids in foster care. That’s their goal, to keep more kids in homes, not put them in foster care at all, if they can help it. And if they do, put them with relatives or family friends, that’s the big push. So to see placement instability still inching up, it makes you think what isn’t being looked at here? And I found a lot of the numbers were driven by these lateral moves between group homes, in and out of treatment, those are moves, and as the foster youth we talked to mentioned, no move, even going back to your family, is a move, and that’s hard, that’s an adjustment. Even though that’s a positive move, they all affect these youth. So to see them inching up- some of these kids have been in so many- when we talked about Chai having 14, that, I’m finding, is not that high. Some of these people have had moves up in the 40s or more, especially the kids in the treatment foster care program, Treatment Foster Care Oregon, which is our last piece. Some of those kids have seen dozens and dozens of moves.
Miller: That is the model that Oregon developed called treatment foster care for kids with the most severe emotional and behavioral problems. What distinguishes this model?
Dowsett: Treatment Foster Care Oregon was developed with researchers down in Eugene where they looked at all the research well before they ever launched the program. So here the program has 40 years of research behind it. It’s being used in Australia and Sweden and other Scandinavian countries. It’s been used in the U. K. But yet in Oregon, it’s only being used in one area, and that’s Eugene-Springfield. And why it’s different is it has highly skilled and well supported foster parents. So a ton of resources are thrown in to support these foster parents. They only have one foster child at a time and they only do it for about nine months, maybe a year. And so all this attention is put on this one child, with these well-skilled foster parents and they have a whole team behind them. There’s a special therapist for the kid, there’s a special therapist to work with the birth family or the guardians to get them ready and trained so when the child graduates the program they will be ready to keep this structure going. Some of the reasons it may not be in other parts of Oregon is it’s expensive, and it also takes a couple of years to get everyone up and going, trained, certified. And so that is one of the big areas that they’re trying to work on.
Miller: And is it working?
Dowsett: It is working -- the evidence, according to Treatment Foster Care Oregon consultants, It is working, it’s showing great results. And like I said, we looked at Chicago who’s been using it, and they’re expanding their program. They added a team during their pilot project, they added another team in Chicago. So they expanded it within the pilot project, and now they’re looking at another team in the central state area. So it’s working in other places. Now, will it work here, will they have the funding and the support that they need... remains to be seen. And they are doing a pilot project right now in Oregon with Treatment Foster Care Oregon and two other models, treatment foster care models, to see probably, which one works best for Oregon.
Miller: If you’re just tuning in. We’re talking right now about efforts around the country and in Oregon to bring more stability to kids in foster care. We’re talking to Libby Dowsett, a freelance writer who has just concluded a five part series for the newspaper Street Roots. One of the programs of pilots that you looked into is in Iowa. It has the name ‘Four Questions, Seven Judges.’ Can you describe this?
Dowsett: I really like this program but it remains to be seen if it will be tried out in other areas because Iowa started it as a pilot project, expanded across the state since then. So there are these four questions that judges in the juvenile court system are asking the caseworker every single time the caseworker comes to them and says, okay, we have this child, we think we need to remove them from this foster home or this home. And the judge will then go through these four questions, and they’re simple. It’s: What can we do to remove the danger instead of the child? Can someone the child or family knows move into the home? Can the caregiver and the child go live somewhere else? Could the child be moved temporarily to live with a relative? Those are the four basic questions, and it’s remarkable, they say, what comes out of the answers, that they thought they were always asking these questions, but just to have them written down and read through is making a difference in Iowa.
Miller: You heard one story from a judge about a request to remove eight children from a home where a married couple was dealing with drug addiction. Can you tell us what happened?
Dowsett: So the parents were struggling with drug addiction, they had a child that was exposed to drugs and the judge knew that ‘If I remove these children, they’re going to be broken up into lots of different homes’ and all those kids really relied on each other.
Miller: That finding a foster care for these eight kids would mean breaking up these eight kids.
Dowsett: Right.
Miller: ... wouldn’t be together anymore,...
Dowsett: Correct.
Miller: But keeping them with their biological parents or in that home also in the current state seemed untenable.
Dowsett: Correct. So the judge, Judge Owens and the Social Worker went through these questions one by one, and he said after we went through them we realized that we need someone to come in and stabilize the house while these parents get help, and the person they came up with was the mother’s ex-husband. So the ex-husband who was father to six of the kids, moved into the home while they got treatment and then once they were stable they moved back in and were in the house and then he moved out.
Miller: It’s a kind of creative solution that you need buy in from a lot of people to make something like that work.
Dowsett: Right. He said that we were winging it. We didn’t know if that would work, but he said it did, and he didn’t have any more involvement with that family which he considers a win, he considers the case was resolved.
Miller: You noted that judges in Oregon tried something sort of similar to this ‘Four Questions-Seven Judges’ pilot, some system to reduce the chance that kids would be removed from their original homes. An Oregon judge or judges tried about 10 years ago in a pilot, and it didn’t really lead to a big change in placement decisions. Why not?
Dowsett: It didn’t. They believe, in the studies that have come since then, they believe perhaps, they were called ‘bench cards,’ very similar. Go through some procedures, read them out loud on these bench cards and they saw a lot of positive change, the judges were more involved in asking these questions. They took a little more time. They involved the family a lot more in these discussions and so those were positives, but they didn’t see any big placement change results, and so they believe it could be that the judges did use the bench cards for the initial hearings, but didn’t continue to use the bench cards as the process went on with each case.
Miller: You had another pilot project in Iowa that you looked at, they’ve tried something that is called ‘No Eject-No Reject Policy,’ how does it work?
Dowsett: They started noticing a lot of moves between group homes and so they said, how are we going to stop this shuffle around from group home to group home. So they decided to change their contract with group care providers and say you can’t kick out kids anymore and you have to take them when we send them your way, because they were refusing to take certain kids, because they had become a bit specialized in the state. So if you have a kid with a particular issue, they say, ‘Oh we’re not gonna take that kid, but you should send him or her to the northern part of the state where they really do a good job treating that condition,’ which sounds great, but you’re moving the kid all the way across the state and far from their families. And research shows the farther you are from your families when you’re receiving treatment or care, the lower the chance you have of reunifying with your family, because you’re getting disconnected. And so they wanted to keep kids close at hand. And so they said you can’t kick them out, you can’t refuse them, but in return we will pre-buy beds at your facilities. So it’s good for budgeting. They know exactly how many beds will be filled. And that was a problem before, they would have all these beds and they didn’t know month to month how many would be used by the state.
Miller: There’s one more innovative program that you looked at, this one was in Georgia. It’s called ‘Pause,’ and basically before a child is going to be moved from one placement to another, everybody who is involved in that child’s life and case has to get together. They have a meeting, all of them together to talk about it. This is one more program that seems interesting. It’s not perfect. But you show that there is some real value in it. I’m curious. I mean behind all of this reporting is the idea that there are solutions out there... are at least innovations that could improve a system, whether it’s at a local level or at the state level. As far as you know, are officials in Oregon doing something like what you did- looking around to see what might be working, other places to solve problems that are issues here and saying, let’s try what they’re doing?
Dowsett: They have implemented in Oregon, the KEEP Program, which is part of the Oregon Social Learning Centers Research, follow me here, where Treatment Foster Care Oregon was created. So there’s this great research center down in Eugene and they came up with the KEEP Program as well. So, the cousin of Treatment Foster Care Oregon is being implemented in Oregon. Oregon is also doing a pretty good job at promoting Kinship Family Caregivers. So they have a Kinship Navigator Program now, that helps relatives and family friends who step forward and say, ‘yes I will care for my niece or nephew or grandchild.’ And the Kinship Navigator Program is helping support them, helping them find services and know what the resources are so they can help kids within their home.
Miller: No matter what states do to improve their systems, it seems like there are always going to be some new placements. That seems clear.
Dowsett: Right.
Miller: What did you learn about best practices for how foster care systems can handle those transitions?
Dowsett: You mean the transitions that are going to happen no matter what?
Miller: Exactly. Sometimes a kid is going to be moved from one home to another. Is there something you’ve learned about the best way to handle those?
Dowsett: Yes. And I learned this from the kids. They’re all young adults, but to me, they’re kids, but they say, take the process and really think about where you’re putting these kids. Chai said, she probably wouldn’t have had so many changes and so much combativeness if she had been asked, ‘What would be a type of placement that would really work for you?’ And I know the realities of foster care -- people are overworked, underpaid. There’s a lot of strain in the system, but she said just taking a ‘pause call,’ or just some more intentional placements would have helped her, and she might have not had to move quite so much. We also talked to that child psychiatrist who was saying transitions need to be child centered, they need to be through the eyes of a child. And he had a great quote where he talks about, imagine you come home, someone pulls up, doesn’t speak your language, escorts you out, puts you in the car, takes you somewhere else, you go to another home where they don’t speak your language and drops you off and they’re gone. I think that brought home the message what this must be like for a kid in the foster care system.
Miller: He also, if we’re talking about the same person, said, ‘we can’t think of kids like Fedex packages going from one place to another.’ Libby Dowsett, thanks for joining us today.
Dowsett: Thank you for having me.
Miller: Libby Dowsett is a Freelance Writer. She often contributes to Street Roots. You can read her five part series all about adding more stability to foster care placements in Street Roots.
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