Placement Transitions in out-of-Home Care: Associations with Permanency Timing and Foster Care Re-Entry

Background:

The primary goal of out-of-home care is to ensure the safety and well-being of children, potentially requiring placement in out-of-home care (OOHC), but moving them to permanent and stable homes (reunification, guardianship, or adoption) without unnecessary delay. Previous research identified four distinct placement transition types between kinship and non-kinship family home settings (kinship to non-kinship, non-kinship to kinship, and then those who do not change type.) Findings indicate that children placed in kinship settings during their first or second placements generally achieve permanency more quickly than those who remain continuously in non-kin foster care. However, it remains unclear whether these transition types are associated with specific types of permanency outcomes, the rate these youth achieve these permanency outcomes, or the rate of re-entry. This study aims to address this gap.

Methods:

We analyzed child welfare administrative data from a Mid-Atlantic state, including 4,869 children who entered out-of-home care for at least seven days between January 2008 and April 2023, with their first two placements in family-based settings. Competing risks models and logistic regressions were conducted in SAS. The competing risks models assessed time in weeks to each type of permanency. Two logistic regressions examined re-entry—defined as a foster care episode following permanency—using transition types and first-episode permanency outcomes as independent variables (separately). Children who were adopted or emancipated were excluded from the latter model.

Results:

Among the sampled children, 17.9% achieved permanency after their second placement ended, comprising 10.2% reunification, 6.1% guardianship, and 1.6% adoption. Overall, children exposed to kinship care at any point had higher permanency rates compared to those continuously in non-kin foster care. Specifically, children who experienced transitions between kinship and non-kinship placements had increased rates of reunification compared to children consistently placed in non-kin foster care. Additionally, children whose second placement was in kinship care were significantly more likely to achieve guardianship. Conversely, children initially placed in kinship care had lower adoption rates compared to those continuously in non-kin foster care. Re-entry rates did not significantly differ across the four transition groups, but previous permanency outcomes did. Children reunified during their second placement had three times higher odds of reentry, and those achieving guardianship had 53% higher odds of re-entry compared to children who did not attain permanency until after their second placement.

Discussion:

The findings indicate that the second placement strongly aligns with specific permanency outcomes. For children who exited to kinship care, the likelihood of achieving guardianship did not differ by whether their first placement was with kin or non-kin. Although placement transition type alone did not significantly predict re-entry, the specific permanency outcomes achieved at the second placement were strongly associated with re-entry risk. Children reunified or placed under guardianship showed significantly higher odds of re-entry, suggesting that these permanency arrangements may require additional post-permanency support and monitoring to sustain stability. These results underscore the importance of considering placement transitions in permanency planning, highlighting the need to tailor interventions and support strategies that align closely with targeted permanency goals.