39

Cross-over Youth as Adults• Cross-over Youth

– 50% experienced period of extreme poverty

– 66% had jail stay compared to 25% child welfare only

– 18% with adult probation– Highest rate of inpatient

and outpatient health services care

• Juvenile Justice Youth– 25% experienced

period of extreme poverty

– 50% had jail stay– 18% with adult

probation

Cross-over Youth

• Cross-over Youth• 40% enrolled in

community college• 10% utilized

outpatient mental health services

• Juvenile Justice Youth• 2% received AA

degree• 3% met transfer

requirements to 4 year college

• Less than 1% enrolled in 4 year school

40

Table Talk

• What should we consider in light of this information?

41

Impact of Foster Care

• View of youth as a separate member of family

• Attachment, grief and family privilege

• Constant themes of loss

42

Foster Care Survivalist• Former foster youth

demonstrate PTSD rates up to twice as high as U.S. war veterans

• Foster youth compared with others with maltreatment background but not placed report more severe/frequent mental health and behavioral problems

43

Foster Care Survivalist

• Premature conferral of adult status and independence

• Growing up without parents: learning to take care of oneself

• Disavowal of dependence: making meaning of loss and hardship

44

Youth perceive themselves as their most valuable advocate and source of hope while

also viewing themselves as greatest enemy and threat to survival.

45

Resilience in Transitioning Youth

• Resilience: developmental course characteristic of healthy adjustment despite the circumstance of considerable hardship

• Majority demonstrated resilience across multiple domains with female gender, older age at exit, less global stress and higher support significant for higher degrees of resilience

46

Complex Trauma• Combination of early and late-onset, multiple,

and sometimes highly invasive traumatic events, usually of an ongoing interpersonal nature.

• Often includes exposure to repetitive childhood sexual, physical and/or psychological abuse which may occur within the context of emotional neglect and

• Harmful social environments, including poverty, racism, sexism, violence ridden neighborhoods, as an example

47

Impact of Complex Trauma

• Attachment• Biology• Affect regulation• Dissociation• Behavioral regulation• Cognition

48

Adolescent Behaviors and Complex Trauma

• Tension reducing behaviors– Suicidal behavior– Intentional but

nonsuicidal self-injury

– Major substance abuse

– Eating disorders

49

Adolescent Behaviors and Complex Trauma

– Dysfunctional sexual behavior

– Excessive risk-taking

– Physical altercations

– PTSD– Revictimization

50

Placement Stability• Nearly 1 in 3 failed to

achieve any placement stability

• Placement stability strongly associated with behavioral outcomes

• Unstable placements had twice the odds of having behavior problems

51

Trauma Informed Practice Foci

• Safety• Self regulation• Self-reflective

information processing• Traumatic experiences

integration• Relational engagement • Positive affect

enhancement52

Developing Decision Making

53

Non-minor Dependent Rights

• Non-minor dependents retain all of his or her legal decision making authority as an adult (WIC 303(d)

• The decision about remaining in extended foster care is one of the first that they will make

54

Talking About Extended Foster Care

• Utilize the practice principles you have developed throughout the day

• Use the flyer on extended foster care

• Practice a brief conversation about extended foster care

• What will you emphasize?

55

Jurisdictional Status• May remain under

delinquency jurisdiction• If have met rehabilitative

goal, may move to Transition Jurisdiction

• May move to non-minor dependent status under dependency jurisdiction through 241.1 amended county protocol

56

Last hearing Before Age 18• Report must include:

– Plan to remain non-minor dependent

– ICWA participation– SSI and SIJS info– Transition Jurisdiction

recommendation– DPO efforts– Documents and information

provided to youth– TILP outlining planned

participation 57

Transition Jurisdiction

• Age and placement

• Ward or dependent status

• Rehabilitative status

• Reunification status

• Intent to participate

58

Opt Out

• Youth elects to exit foster care

• Must create the 90 day transition plan

• Youth must be informed about right to re-entry

59

Transitional Independent Living Case Plan and Transitional Independent Living Plan

• Submitted with court report 10 calendar days before hearing

• Must include:– Plan to meet criteria & placement– Alternative plan

• Housing• Education• Employment• Support system

60

Findings• Specific criteria to be satisfied• TILCP includes alternative plan• For ICWA eligible:

– Youth intends or does NOT intend to be considered Indian child

• Status of Supplemental Security application• Legal residency status• Information, documents and services required

391(e)• Understands rights• Continuance

61

Orders• If the youth is entering

extended foster care:– court must set a review

hearing within six months of current hearing

• If opting out:– Set hearing for date within

1 month after turns 18– Set 366.21, 366.22,

366.25 or 366.3 as dependent

62

Effects of Legal Adult Status

• Hearings can be attended only by those invited by youth WIC 295

• No protective custody warrants WIC 303(d)

• Court cannot order psychotropic medication WIC 303 (d)

• No caregiver consent for medical/education decisions WIC 303 (d)

63

Effects of Legal Adult Status

• NMD has privacy rights about medical information

• No discussion of educational limits on parents

• Personal rights of foster children DO apply (WIC 16001.9)

64

What Next?

• Mutual agreement

• Placement

• Eligibility documentation

65

Mutual Agreements

• Non-minor dependents must sign a mutual agreement within 6 months of turning 18 if they intend to remain in care

• Signed agreement is not a prerequisite to payment for placement

66

Placement Considerations

• Non-minor dependent youth are adults• Placements should be least restrictive• Encourage independence• Developmental needs and readiness for

independence• Decisions are made in conversation with

youth

67

Group Homes• Youth in extended foster care can remain in

group homes for a brief period if:– The placement is voluntary; and– Staying in the group home will help the youth complete

high school or obtain a GED; and– The youth plans to leave the group home care after

completing high school, obtaining a GED or turning age 19 whichever comes first.

OR– The group home provides treatment for a medical or

mental health condition that interferes the youth’s ability to meet any of the other participation conditions.

68

After Adolescence: Now What?

• Less than 50% of young adults graduate from college in 4 years

• Antidepressant use is highest among 21-32 years

• 40% of young adults 18-35 years are overly dependent on parents for financial, emotional, physical support

• 58% of 21-24 year olds live at home or have returned home in the last 2 years

69

A New Stage of Development

• Age range from 18 to 25 years

• Reflects changes prevalent in industrialized nations

• Time that is least structured and more heterogeneous

70

Emerging Adults

• A phase rather than a stage that overlaps with adolescence and early adulthood

• Five features are more common but not exclusively required

71

Emerging Adults

• Age of identity exploration

• Age of Instability• Self-focused age• Age of feeling in-

between• Age of possibilities

72

Emerging Adulthood

• Peak age period of behaviors that most try to discourage–Binge drinking– Illegal drug use–Risky sexual

behavior

73

Missouri Longitudinal Study• Majority of youth left by

age 19• Those who left earlier

tended to return to family and then to independent living situation

• Those who remained in care transitioned rapidly from group care to independent living situation

74

Why Youth Chose to Leave• 39% disliked or were

frustrated with the “system”

• 28% desire for independence

• 21% failure of Children’s Division to provide services

• 22% desired change in circumstances

• 3% other reasons75

Who Decided

• 45.8% youth’s idea• 35.4% social worker’s

idea• 9.9% judge’s idea• 4/2% family’s idea• 1.4% didn’t know• 3.3% someone else’s

idea

76

77

Table Talk

What does Missouri’s experience suggest to us?