Method: We use California child welfare administrative data to capture TAY’s placement records, THPP providers, and the supervising county. We first identified about 6,000 TAY who turned 18 between 2014 and 2018, stayed in care after their 18th birthday, and were not missing information on their supervising county. We also identified 69 THPP providers who served TAY in California between 2016 and 2018. Fifty-three of the 58 counties in California had at least one youth who met these criteria and were included in our analysis. We calculated the number of THPP providers operating in each county and the percentage of TAY placed in THPP for each county. We grouped counties by urbanicity, resulting in four groups: rural, urban, large urban, and Los Angeles (LA) county.
Results: The number of providers offering THPP placements varied significantly across county and was correlated with the counties’ TAY population. LA County, which accounts for a third of California’s TAY population, had 31 THPP providers. In the 11 large urban counties, an average of 19 providers offered THPP. The 19 urban and 22 rural counties each had an average of nine and five providers offering THPP, respectively. We also found significant variation (p <.05) between counties in the percentage of TAY placed in THPP. Statewide, 21% of the TAY were placed in THPP. The percentage of TAY in THPP was 12% in LA County. In other counties across the state, the percentage of TAY placed in THPP ranged from 14% and 38% in large urban counties, 1% to 55% in urban counties, and 3% to 83% in rural counties. Further, our analyses found that the variation in the percentage of youth placed in THPPs was not associated with the TAY population or the number of THPP providers.
Conclusion: Our study finds that TAY’s chance to receive specialized care may not be equal across the state, even if the youth may live in a county with more THPP providers. In other words, based on their supervising county, the opportunity for TAY to receive specialized intensive services that support their transition to adulthood can vary. A deeper mixed methods inquiry into county-level THPP referral practices could then inform more consistent and equitable statewide policy and practice.
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