Examining the Impact of Termination of Parental Rights on Foster Care Permanency Outcomes: A Propensity Score Weighted Longitudinal Analysis

Background: The Adoption and Safe Families Act (1997) aimed to expedite the discharge process for children in foster care, prioritizing their best interests and attempting to set time parameters for termination of parental rights (TPR) when this is deemed necessary. Despite this goal, many children experience prolonged waits in care, exposing them to potential deprivation of stability and family connectedness. Achieving permanency may include adoption, which typically involves TPR. Yet, there is limited focus on the role of TPR in expediting a permanent exit from foster care. This study addresses this gap by exploring the association between TPR and the subsequent permanency outcomes for children, examining both TPR and non-TPR cases as well as permanency among TPR cases according to the time to TPR.

Methods: This study drew on longitudinal data from the Adoption and Foster Care Analysis and Reporting System on 166,998 children who entered or re-entered foster care in 2013 under the age of 12 years. A total of 52,154 cases had TPR proceedings. Children were followed for up to seven years. Two Cox proportional hazards models were constructed to examine the risks associated with exiting care (coded as 1) versus those of aging out or remaining in care (coded as 0). Model 1 accounts for time from entry to exit to home, adoption, or relative/guardianship care for TPR versus non-TPR cases. Model 2 accounts for time from TPR to adoption or relative/guardianship care for children whose TPR was completed in rapid (within 6 months), medium (6-18 months), or long time (>18 months). Propensity score weighting methods were applied to balance group differences in both models. Covariates include child and case characteristics, family size, urbanicity, and removal reasons noted in the data. For covariates violating the proportional hazards assumption, the interactions between their hazard ratios (HR) and the function of time were kept in the models to account for the time-varying effect. All analyses were adjusted for the clustering effect at the State level.

Results: After balancing the TPR and non-TPR groups and controlling for covariates, TPR decisions presented a strong negative impact on the speed of achieving permanency (HR= 0.068, 95% CI: 0.055-0.083, p<0.001). However, this negative impact decreased over time, as indicated by the interaction between TPR and time (HR= 1.075, 95% CI: 1.066-1.085, p<0.001). After balancing the rapid, medium, and long TPR groups and controlling for all the covariates, there was no statistically significant impact of time to TPR on risks of exiting care at a given time.

Conclusions and Implications: Children who had their parental rights terminated were significantly slower to exit foster care, suggesting that the AFSA goals for accelerating TPR do not guarantee faster exits. This was further reinforced by the lack of difference in speed of obtaining the TPR in model two. This study underscores the complexity of achieving timely permanency for children in foster care and may suggest the need for services to address the barriers to exit may be more important than trying to limit timelines for case outcomes.