Foster Care Re-Entry: Exploring the role of foster care characteristics,in-home child welfare services and cross-sector services

Background & Purpose: Permanent, safe exit is a primary goal of foster care. While exiting care to home or relatives is considered a positive outcome, some research raises questions as to the ongoing safety and well-being of these children (Jonson-Reid, 2003; Taussing et al., 2001). Relatively few studies have attempted to understand characteristics of cases that return to care after “successful” exits to reunification or relative care. Even fewer studies have viewed this from an ecological perspective, controlling for not only placement characteristics but individual, family, service use and community characteristics. This study seeks to advance our understanding of how service characteristics and timing within and outside the foster care system may impact the likelihood of re-entry into care.

Methods: Data are taken from a larger longitudinal cross-sector services and outcomes study of abused and neglected children born 1982-1994. For this analysis, children with a history of at least one maltreatment report who entered foster care for the first time prior to age 16 were followed for up to ten years after exit to home or relatives (n=686). Analyses included bivariate survival analyses and Cox regression models of risk of re-entry, using a sandwich estimator to correct estimates due to possible clustering by census tract. Children were censored due to death, turning 18 or at the end of the study period.

Results: About 36% of the children returned to foster care with a median time to return of about 28 months. Children from homes in census tracts with high mobility, with parents who did not complete high school, and who had at least one report of physical abuse prior to entry had higher risk of re-entry. If the child's caregiver had a service record of mental health treatment or AFDC prior to initial placement there was higher risk of re-entry. After entry into care, placement instability was associated with increased risk of re-entry, while family receipt of in-home child welfare services during and/or after exit from foster care decreased the risk of re-entry.

Conclusions: Results support findings of prior studies (e.g., placement instability), but also highlight the utility of including cross-sector service data. Services records indicated that those involved in income maintenance or mental health care prior to foster care entry were at greater risk of being unable to provide a permanent safe environment after exit. This highlights the need to attend to the caregiver's well-being beyond attending to parenting issues in order to achieve permanent exits. Our findings suggest that one way to do this may be the use of in-home child welfare services to provide after care support. Finally, most studies of foster care re-entry have limited follow-up to less than three years. Our research suggests that this underestimates the rate of re-entry which has implications for thinking about after care policy and programming.