Effects of Foster Care Factors on Time to Reunification for Children with Substance Removals: A National Longitudinal Study

Background/Purpose: The number and proportion of children in foster care due to parental substance use continues to increase. Little is known regarding the effect of foster care variables on permanency planning for these children. This study sought to understand whether foster care factors, including foster parent age, race, parent-child racial match, family structure, and receipt of federal foster care supports, impacted length in care and likelihood of permanency for children with substance removals.

Method: Adoption and Foster Care Analysis and Reporting System (AFCARS) data identified all U.S. children removed due to substance use whose most recent foster care placement occurred between 2007-2017. Cases were tracked through September 30, 2018. Bivariate analyses described the presence of key foster care variables (age, race, racial match, family structure, and supports) among the study sample. To account for censoring, a cluster robust Cox proportional hazard model estimated likelihood of permanency depending on these foster care variables. Model covariates included child age, sex, number of prior foster care episodes, diagnosed disability status, other removal reasons, and rural/urban continuum code.

Results: Among the children whose most recent foster care removal occurred during the study timeframe, 33.7% of children had a substance removal (n = 964,341) and became the study sample. Foster parent data was missing for about one-third of cases, with racial match information missing for 38% of cases, therefore multivariate analysis was conducted with the remaining n = 550,431 cases with complete data. The majority of foster care providers were married couples between the ages of 35 and 55 hosting children whose race matched their own. Although 71% of children received Medicaid while in care, less than one-third received Title IV-E foster care payments. The average monthly foster care payment was just under $600. Median time in care estimates reveal shortened time to permanency for children residing with older foster parents and with those receiving fewer number of federal benefits. Results of the Cox model revealed that, controlling for covariates, permanency was significantly more likely for children placed with older foster parents, particularly foster parents over age 55, and children placed with white or Asian foster parents. Receiving Title IV-A AFDC payments was associated with increased likelihood of permanency, while receiving Title IV-E foster care payments, child support funds, SSI or Social Security Act Benefits, and higher monthly foster care payments were associated reduced likelihood of permanency.

Implications: Although limited by missing data, this is the first study to report child welfare outcomes from federally collected data on foster care providers. Foster carer factors appear to influence longevity of out-of-home placement and likelihood of permanency. As the number and proportion of children with substance removals continues to increase, knowledge regarding risk and protective factors of foster care placements is critical. Increasing financial supports for foster care providers, particularly younger providers who may not be receiving other sources of federal support, may reduce the observed disparities.