Extending care: Supporting young people’s transition from out-of-home care to adulthood

Extending care: Supporting young people’s transition from out-of-home care to adulthood

Paul McDonald and Philip Mendes
15 May 2019

This webinar discussed recent research on the social and economic benefits of extending care to young people transitioning to adulthood.

Audio transcript: Extending care: Supporting young people’s transition from out-of-home care to adulthood

Audio transcript (edited)

DR MUIR

Good afternoon everyone, and welcome to today's webinar; Extending Care: Supporting young people's transition from out-of-home care to adulthood. My name is Stewart Muir, a senior research fellow here at the Australian Institute of Family Studies.
Before we start today, I'd like to acknowledge the traditional custodians of the lands on which we're meeting. In Melbourne, the traditional custodians are the Wurundjeri and the Boonwurrung peoples of the Kulin Nation. I pay my respects to their elders past and present, and to elders from other communities who may be participating today.

Today's webinar will discuss recent research on the social and economic benefits of extending care to young people who are transitioning from out-of-home care into adulthood, and we're very privileged to have two eminent speakers to discuss this topic. We have Philip Mendes, director of the Social Inclusion and Social Policy research unit in the Department of Social Work at Monash University, and Paul McDonald, CEO of Anglicare Victoria.

Philip has been researching State care and transitions from care for over 20 years. He is the Australian representative on the Transitions to Adulthood for Young People Leaving Public Care International Research Group, and has undertaken research on youth justice, employment and mentoring programs, disability in Indigenous care leavers, and is also currently leading a national study of Indigenous young people leaving care, which is funded by the Sidney Myer foundation. Please head to our website for information about the range of publications that Philip has authored on this subject.

Joining Philip is Paul McDonald. Paul will be drawing on his extensive experience leading numerous government and non-government social welfare initiatives to improve outcomes for young people. In addition to his role for Anglicare Victoria, Paul is president of the Centre for Excellence in Child and Family Welfare, was recently appointed State Chair of the Reform of the Out-of-Home-Care System for the Victorian Government, and is Chair of the Home Stretch Campaign.

During the webinar today, we encourage you to send your questions throughout for Philip and Paul to answer during our Q&A session at the end of today's presentation. Any questions we can't get to during the session will be posted and answered in the online forum following this presentation. Please let us know if you don't want your question published on the online forum. As always, our webinars are recorded, the slides are available in the handout section of the go to webinar, and the audio, slides, transcript and recording of the webinar will also be available on our website in the coming week. So I'd now like to hand over to Philip Mendes and please everyone give him a warm, virtual welcome.

DR MENDES

So young people transitioning from out-of-home care, often called care leavers or care experienced young people, are a universally vulnerable group who have generally not received the ongoing and holistic support that they require to transition successfully into adult life.

Now leaving care is formally defined as the end of legal responsibility by the state for young people living in out-of-home care, which generally occurs no later than 18 years of age. And care leavers generally experience accelerated and compressed transitions to adulthood, and as a consequence they often face significant barriers to accessing education, employment, housing health and other developmental and transitional pathways and opportunities that are readily available to their non-care peers in the general community.

Now historically, most countries are provided only limited leaving care or post-care support services, but over the last two decades there has been growing international awareness of the needs of care leavers and an expectation of ongoing care beyond 18 years of age. Consequently, most of the countries in the OECD and many other jurisdictions, have introduced new legislation or expanded existing laws, policies or programs to assist this group of young people.

Now, that upgraded assistance seems to reflect an increasing recognition that if the invasive state intervention into families by child protection systems is to be justified, then governments have both the moral and the legal obligation to devote sufficient resources to ensure that the outcomes for these rescue children are better than if they had remained with their family of origin. So in this webinar, we're specifically going to look at some of the extended care reforms in both England and the USA.

England introduced the Children Leaving Care Act 2000in October 2001, which was followed by similar legislation in Northern Ireland and Scotland. That Act was intended, 'to improve the life chances of young people living in and leaving care', and to replicate the supports that responsible parents would be expected to provide for their children. It extended the expected age of leaving care from 16 to 18 years, and obliged local authorities to continue to provide advice and support for care leavers up to the age of 21, and even to 24 years for those still in education and training. In short, the intention was to delay the transition from care until young people were both prepared and ready to leave. So the Act introduced an expectation of corporate parenting responsibility to provide ongoing support to care leavers in order to promote better outcomes.

So overall, the Act significantly extended the duties and powers of the earlier Children Act in England. And local authorities throughout England were then obliged to assess the needs of all young people in care, and required to develop a pathway plan at the age of 16 years to meet those needs and provide a clear road to independence. Furthermore, the authorities had to arrange for care leavers to have a personal advisor until they were 21 years of age, who would coordinate the services required to meet the pathway plan.

Now that new act in England produced a mixture of positive and negative results. So on the one hand, there appeared to be an increased number of young people in further education and a reduction in the numbers of those care leavers not in education, training or employment. In addition, there seemed to be gains in accommodation, financial support, improvements in life skills, and development of social networks and staffing for leaving care services.

On the other hand, there were still problems in areas like resources, planning, availability and provision of health services. There arguably remained too many young people still not in education, employment or training, a lack of specialist support for young people with a disability and those with mental health or emotional or behavioural difficulties, and a lack of suitable accommodation.

So one key policy response to those concerns was the introduction of a form of extended care in England known as the Staying Put program which was introduced as a pilot from 2008 to 11 in eleven local authorities and then legislated as an ongoing duty on all local authorities in England from May 2014 in the Children and Families Act 2014. So that act required local authorities in England to facilitate, monitor, and support Staying Put arrangements for fostered young people until they reach the age of 21 where this is what they and their foster carers want unless the local authorities consider that the Staying Put arrangement is not consistent with the welfare of the young person.

Now Emily Munro, who is now at the University of Bedfordshire and her colleagues completed an evaluation of the Staying Put trial in 2012 and they used a range of mixed methods in their evaluation. What they found were systemic benefits of the Staying Put extended foster care program including the following: stable and supportive relationships providing ongoing emotional support to young people who are not developing or ready for adulthood at 18 years and housing and associated stability which facilitates engagement in education, employment and training and enabling young people to undertake a gradual transition that mirrors the pathways of their peers in the general population. Specific positive outcomes included greater housing stability and higher engagement in education and training and employment, including greater access to higher education which should leave to higher future earnings and less reliance on public benefits.

Now, to date there has been no formal evaluation of the ongoing Staying Put program but informal reports from researchers and policy advocates in England emphasise the importance of the duties being backed up by adequate resources to ensure sufficient information is available to young people and foster carers plus consistency of service delivery across all regions to facilitate the option of Staying Put.

And then there is the USA. So the USA introduced the Foster Care Independence Act in December 1999 which expanded room and board for young care leavers aged 18 to 20 years, expanded access to Medicaid for care leavers, provided additional funds for education and training and increased state accountability for care leaver outcomes. The Act was a significant improvement at that time, in terms of offering greater support to meet care leavers' needs around access to housing, health services, in particular mental health services and education and training. However, research revealed that funding remained inadequate to meet the needs of most care leavers. Take up by states in regard to health care was discretionary and optimal implementation of that Act depending on their willingness in states to match federal funds with required levels of individual state funding.

Consequently, the USA enacted the Fostering Connections Act in 2008 as a form of extended care which aimed to extend the Foster Care Independence Act by giving states the option of maintaining young people in foster care until 21 years of age. There is a requirement to be eligible, that young people are completing secondary school or equivalent, or enrolled in post-secondary or vocational school, or participating in a program or activity that promotes or removes barriers to employment, or are employed 80 hours a month, or alternatively are incapable of school and/or work requirements due to a documented medical condition or disability. By early 2017, nearly half of all American states have taken up this option of extending care till 21 with federal financial support.

Now Professor Mark Courtney, a leading researcher in America, and his colleagues in California used a number of mixed methods in their evaluation of extended care in California, and they were able to report specific benefits of extended care such as the following: enhanced educational outcomes, improved earnings and less economic hardship, fewer earlier pregnancies, lower levels of homelessness, reduced mental health difficulties or involvement in the criminal justice system, and greater involvement of non-custodial fathers with their children.

Additionally, the New Zealand based researcher Ian Matheson, completed a mapping exercise of the international evidence base for extended care last year. He used a number of methods, and was able to cite evidence of consistent positive outcomes in education, reduced criminal justice involvement, housing stability and more positive transitioning overall. However, he concluded that the results concerning earnings, delayed pregnancies, and engagement with training and employment seemed to be more varied.

Now Ian Matheson argues that extended care works for a number of clear reasons: because it offers continuity and stability to young people, a nurturing environment, it helps engagement in education, employment and training, it empowers young people, and it gives them greater choice and control over the timing and the process of their transition. He notes that outcomes can be fluid depending on a range of factors, including whether extended care is offered universally to all care leavers or not, whether it includes residential care or not, whether it allows those who left earlier than 18 years to return before they turn 21 and whether or not it includes strict conditions like full time involvement in education, employment and training. Effectiveness may also vary across different political regimes and cultures in different countries. So he recommends a strong co-design or coproduction approach and an evaluative approach for optimal outcomes.

So to conclude briefly with lessons for Australia, remembering that both England and USA have very different health and welfare systems to Australia, but nevertheless the evidence does suggest that extended care in Australia should lead to improvements in the key areas like education and employment, housing, health, and reduced involvement in offending and criminal justice. But we need to remember that effective implementation requires (1), detailed planning; (2), sufficient funding, and; (3), ongoing monitoring and evaluation.

MR MCDONALD

Okay. So hello everyone, great to be with you on this AIFS webinar. I'm Paul McDonald, Chair of the Home Stretch movement and also CEO of Anglicare Victoria. I'm gonna talk to you about the extended care reform progress and debate that's been going on in Australia, and how jurisdictions are faring in each of those on their activities and consideration for implementing care, as very much what we've seen internationally, here in Australia.

The way that maybe I thought I'd kick off is show you a short video just for two minutes, and it's just to summarise the issues around extended care, how young people suffer – I'd have to say, in such sort of direct terms – when care is terminated at 18 as is evident in all jurisdictions around Australia. Now just on the video folks, if the video doesn't play I request you to stay with us. It only goes for a couple of minutes, and then we'll resume the webinar. Your internet or systems may struggle though, and we apologise for any inconvenience if that is the case. What AIFS will also do though, is that'll put the video up on the Child Family Community Australia website, or CFCA, so you can access it there as well. So I might turn to my team of technical colleagues, and they're gonna press the button and let's see how we go.

Okay, well hopefully a number of you or many of you just got a sense of that video. If you didn't get a sense, I'm gonna walk you through the case anyway so you haven't missed anything. And you can also find that video up on YouTube. Where I thought I'd go first, is what is out-of-home care, and basically out-of-home care refers to statutory care of children, young people, who are unable to live with their parents; so children in out-of-home care are in most cases also on a care and protection order. They may have been removed due to abuse, neglect, or relinquishment reasons.

There are around 40, well, you know, depending on the latest stats, and I'm certainly here in the building of AIFS, so I'd think there'd be upgraded stats here, but let's say there's around 50,000 young people who are in out-of-home care. Most of those are in foster care and kinship care with around 5 to 6 per cent who are in residential care, and about a third of those, a bit over a third, are children of Aboriginal or Torres Strait Islander descent.

So in a sense, when we're thinking about this target group, and I'm really talking to you about the target group between 15 and 17 years when the state normally sets about the process of exiting or terminating care. When you look across Australia there's around, in jurisdictional terms, nationally there's 3000 young people who will be exiting between 15 and 17 every year from state care, and hopefully you can see the slide of the breakdown of the different states in relation to how many from each state that are exited, but every year, around 3000 are exited.

Now what we do know about this target group, and there's been many centimetres of research, I'd have to say here in Australia, that talk about the outcomes for children and young people when they do leave care. What we do know, and you might've noticed Swinburne University of Technology back in 2015 who did their national survey of homeless youth, found that 63 per cent of them were actually in state care historically and were now homeless. When you have a look at some of the other outcomes: 35 per cent had five or more places of stay in their first 12 months from leaving care; just under 30 per cent were unemployed; many of them were new parents; and also many, particularly the young men, around forty-odd per cent had been involved in the juvenile justice system, again, within the first 12 months of the care being terminated.

And what we do know, and what's great to do this webinar with you in AIFS, is yesterday the Australian Institute of Family Studies, you might've seen it, released a report about how young people are remaining in the family home for longer. Now there's some, I think it's 43 per cent the AIFS report announced yesterday of 20 to 24 year olds, up from 36 per cent, are still in the family home. Goodness me. 17 per cent of 25 to 29 year olds are still in the family home. Yet in every state in Australia, legislatively speaking, care is to be terminated, ended, without discretion, without any discussion, at 18.

Now what does this in fact mean? Well, their workers removed, all legal, physical, domestic support is then terminated, and they're required to fend for themselves. There may be, in different states that you may be occupied, some leaving care programs, but the important point here is that the care is terminated. It is not disrupted, terminated; so it finishes - has to continue in some other guise. So what we've seen is West Australia, South Australia, Tasmania, Victoria, ACT, New South Wales, Queensland, and Northern Territory, all universally have their legislation that care is to be finished at 18 and all universally have their care planning requirements are required to begin with the child at 15. Now can you imagine going up to your own child at 15 and saying, 'Oh by the way, Johnny, we've got to get you a leaving care plan.' This is what the state does to children in state care; it requires them to have a care leaving plan at 15.

Now really as we know as parents, as we know in raising children ourselves or even corporately, what I mean by that of raising children in the care system, we know they're not ready to go at 18. So Home Stretch argues why don't we provide the option for the care placement to continue past 18 through to 21 to guarantee that? And in fact actually, build that in when they're doing their leave care plan at 15 to ensure that there's certainty and continuity.

We know, and Phil's just very eloquently described the international progress where care is extended, 46 states in the United States, so it's virtually across the country there, of England also permitted to 21 years. So it's interesting when you go to the States, folks. You go to the States and say, "Oh, how's this foster care system going to be extended through to 21', and they say, 'Oh what do you mean? Foster care is through to 21. Foster care is 21.' So it's actually very much in their DNA, that care does not finish up until 21. Yet we continue, in Australia, to have an artificial, dated, backward thinking, non-contemporary parent way of looking at children at state care, and what we're saying, is it's time for Australia to catch up with the rest of the world.

So the next slide that I'm showing you on your screen at the moment, are the evaluations that Phil mentioned and referred to, but just specifically on number terms, the reports have shown that it's halved the homeless rate for this cohort. Halved it by 50 per cent. Doubled the participation rate of this cohort. 38 per cent of reduction in youth pregnancies. Have a look at the – I encourage you to have a look at the CalYOUTH Study which is the Courtney study on extended care in California; reduced arrests by 54 per cent. So compelling stats.

So what we went on and looking at in relation to child and family welfare reform, was considered in the UK by Amanda Cumberland, who was the parliamentary advisor at the time, was the most significant child welfare reform in the United Kingdom. Well, we want to get a piece of that here in Australia, don't we folks? So what we decided to do, was that we went to Deloitte Access Economics and we asked them could they do a similar cost benefit study, state by state, and imagine if care was extended to 21, what would be the benefits? What would be the outcomes? What would be the costs to the state? Are there in fact actually economic as well as social outcomes that can be delivered?

What's interesting here on the next slide, which I'm talking about the current financial impact, it's not only the state and territory that have to do some fairly significant costs when we terminate care at 18, and I'll show you those in a tick – well, it's 600 million, but it's interestingly the Commonwealth, who does not have jurisdiction over child welfare here in this country. They're paying 1.8 billion over the next 10 years if we continue to have care terminated at 18, that being cost in Centrelink payments, costs due to early pregnancies, cost in hospitalisation, you name it. So Deloitte Access Economics has found that if we do not extend care through to 21, the costs to the country will be 2.4 billion. 1.8 billion, the Commonwealth are picking up the check, and 0.6 billion or 600 million for the states and territories.

So Deloitte Access Economics said, on a cost benefit ratio, if we did implement the extended care, that is, if we allow the placement to continue through to 21, then on current figures – and this is on current figures if around 30 per cent of children who were in care took up the option. Now remember, and I'll just detour here a little bit, we're not arguing or suggesting that every child in state care should continue on to 21. Many will choose their own path. Many will say, 'Great, I can't wait to get out of here', and bang, off they go.

But for those who aren't ready, or for those, you know, seven months pregnant, those who've got court next week, those hopelessly unemployed, those on the spectrum order, those who are very well adjusted but aren't very independently ready, for all of those could we allow that option for them to remain? Deloitte Access Economics on the economic argument said that, in fact, there's a cost benefit return. There's a return on every one dollar; if the government invested one dollar into extending care, their return would be: New South Wales, $3.40; Queensland, $2.69; Tasmania, $2.69 – as the list goes on. It's all there in front of you. So there's a return on investment for governments. So not only is this producing good social return, but it's producing good economic return for state governments.

And on the social return, Deloitte Access Economics said if we did what the States, what the UK, what New Zealand are planning to do, then measured against homelessness rates, we'll see reductions in teen pregnancy from 16 per cent to 10.2, homelessness reduction for this cohort from 39 per cent to 19.5 per cent. I mean, hospitalisation reduced from 29 per cent to 19 – so there's about a third there. Interaction with the criminal justice reduced again by around a third. Mental illness reduced; interestingly, such a focus of this election campaign, mental illness reduced very significantly. And so on, and so forth. So it's a simple reform with social outcomes and proof and evidence of social returns that are really giants in the social policy area for outcomes.

Now how could this work? How would we do this? Well just briefly, how we'd do it, a likely pathway is that if a child is in foster or kinship placement, in the current placement, and if the carer and the child said, 'Yes, let's remain together', then their placement would continue. Or if the child and foster and kinship said, 'Look, I've really enjoyed being with my foster and kinship placement, but I'd like to go out on my own in some sort of supervised sort of arrangement', or if one was in residential or lead tenant placement, they'd also move into a guaranteed supervised independent living arrangement. And I can talk a little bit about how some states are thinking about doing that in a tick.

And those who have left care, that is those who have gone and said, 'No, stuff it, I'm out of here, I can't wait', and then have fallen, as many as I've seen and as many as you have seen, fallen into homeless shelters within three to four months of ill thought through plans, we'd bring them back too, just like our own kids who have gone out, had a go, and then said, 'Mum, Dad, can I come back?' Just like that, we'd have a care system saying, 'Yes, we cared for you for 17 years. I know you tried it, it didn't work out, okay, come back into this model and we'll get you up and started.'

Now in relation to the reimbursements or costs, we estimate it'll be about 22,000, 23,000 per head. That would cover the ongoing carer reimbursements through to 21, that would continue to be paid to the foster kinship placement. Of course, we'd have a case manager pro rata, that is, a casework three, it's one of these young people. And of course some financial brokerage to help point them into education and employment. So how has the Home Stretch call for reform gone so far? Well, I'd have to say pretty well. Just around three years ago we implemented this campaign and not one policy gonk, not one government department, not one political party had written in, 'extended care will be our policy.'

And here, three years down the track, we have Tasmania committing to extending care to 21. South Australian government committing to paying reimbursements to foster or kinship care, you know straight down the freeway through to 21. Every foster and kinship care placement will be reimbursed to 21, if that child and carer wishes to just stay in South Australia. West Australia is doing a trial for 20 young people, and Victoria have announced 250 young people will be offered extended care through to 21.

And what's interesting about the Victorian context, if you're looking at how governments are thinking about it, if a young person says at 19, 20, 'You know, okay, I'm ready to try out on my own, I'm 20', that cost that's going to the carers reimbursement then travels to the young person to their new independent placement through to 21. So the resources continue through until the age comes off at 21.

And where's the Home Stretch campaign up to? Well we still seek for every jurisdiction not only the option to be offered as a policy, but legislative change; that we write it in for generations to come, that the option of being able to remain in 21 exists in every state and territory. We're also interested in the Federal Government getting into the game. Look, what are they doing? Well, in fact, they're writing the biggest cheque. If we don't extend care to 21, they're writing, as I pointed out to the federal minister, 'You're writing cheques every day of the week, Minister. Even though you don't think you're in the child welfare game, you are.' 1.8 billion they'll be writing worth of cheques for a group that could've actually avoided having those cheques written if we stayed their care through to 21. And we're looking for good progress in the southern states of Western Australia, South Australia, and Victoria.

We're also looking for New South Wales and Queensland to get on board and actually announce this. We feel that part of our campaign is turning our minds to New South Wales and Queensland, so all you New South Wales and Queensland listeners, start sort of writing off to your local member or your minister about this, would be a helpful way of also encouraging them to consider that.

We've got a planned symposium. Phil's mentioned the likes of Munro, Courtney, those sort of luminaries of extended care; we'll be bringing them out to Australia to further help governments and jurisdictions around the country to talk about how to implement best practice and policy in relation to extended care. And folks, I might leave it to there. Thanks very much.

DR MUIR

Okay. Thank you very much Philip and Paul. We have, well, quite a bit of time for questions and we've had some questions coming in. So this first question is one for Philip, and we have a question asking if the international evidence, and they mention Matheson, mentions the strict approach to training and employment, and the question was whether that focus improves results for young people or exacerbates the issues that they face. And I guess the broader question is what do you see as the pros and cons of that kind of focus on extra care being conditional on remaining in education or employment?

DR MENDES

Look, I think there are pros and cons. And the pro obviously would be that it does give some young people an incentive to progress education, training, or employment that they might be ambivalent about, which will enhance their career pathways. But on the other hand, we've got to remember that a lot of the young people leaving care, not unlike young people in the general community, are just maturing between the ages of 18 to 21, and many of them at 18 or 19 are not ready to go into full time education, training, or employment. But with good support, particularly relationship support, may move on from certain issues, and by the time they're 21 or 22 may be ready to do that. And there is a lot of evidence from the international literature that many of the care leavers who end up not only completing higher education but, in many cases, completing post-graduate higher education, do so more often when they're 25 or 30, not when they're 20 or 21. So we need to take that into account, and we need to be careful that when 46- we're setting up extended care criteria - - -

(Loss of audio - 10 seconds).

MR MCDONALD

Just on the employment and education, nationally only 30 per cent of those in out-of-home care make it past year 10, okay? So it's very likely that the 15 to 17 year old group will either not be at school or may be likely to be unemployed. So what we want this program to do – it's very helpful. We've seen the evidence internationally that it doubles education employment rates, but we don't want to make it conditional of entry into it. We want to ensure this is the helping hand to get into it, rather than the threshold you must be in.

And what's interesting in Tasmania is that, in fact, they're putting a - on-top of offering in their policy extended care, they're saying if during the care placement at 18 to 21, a child actually ends up getting into tertiary education, they'll pay a carer bonus. So rather than it's a conditional of entry, they're paying a bonus to the caring family if the child – so in a sense, it's important that we see this as an aim. We do want to get children coming out of care into education and employment, but not a condition in relation to the extended care policy entry.

DR MUIR

Okay, thank you. We've heard today from both our speakers that many young people who are not in out-of-home care are staying at home until they're 25 or older, and Philip, you also talked about peoples' age of education, times of entering sort of employment or education are in their middle twenties. So we had a question from a listening who was wondering why we're talking about 21 instead of 25 in terms of extending care?

MR MCDONALD

Well, it's a good question, and really as policy reform, we think governments improve their policy in this area in an incremental step by step base. And we take the view that if we just went in and said, 'It must be 25, from 18 to 25', then I think governments will go, 'Well gee, that's a big leap', and then move into the thinking of, 'Well, I pulled myself up by my bootstraps at 22, so what's wrong?' But they do, and I think the policy reform debate does hold itself well when we're talking to 21. And people do understand; many politicians have their own children there at 21.

The second thing is, internationally when they've got to 21, then you've seen as we're seeing in the United States now, a commentary about, 'Oh, could we extend that through to 23 or to 25?' And what New Zealand have done, and actually they're coming from a lower base slightly - one year isn't it, Phil, from 17 through to 21, rather than 18 to 21. They've said, 'We will provide support through to 21, but we'll provide non-financial assistance through to 25.' So that's why. So we want this a reachable, achievable, digestible reform for governments, and we think that by saying 21, that sort of fits that mould, rather than drifting into, you know, the deserving and undeserving debates you can get into if you go past that, for the initial step in this reform.

DR MENDES

I'd agree with Paul, and I think it's noticeable that the Youth Allowance federally moves into the higher rate of Newstart Allowance at 22 years of age. So probably 21 is a bit of an accepted age at which people can and should move into adulthood, but I certainly wouldn't rule out the possibility that over time it will become evident, once extended care is applied in every state and territory and is evaluated, that the evaluations will probably demonstrate that it should extend beyond 21 to possibly 25.

DR MUIR

Okay, thank you. In some of the examples you gave of international experience, the focus has often been on young people exiting foster care or having extended foster care. And we've had a couple of listeners mention that, of course, not all young people are in foster care, and young people from residential care are often particularly vulnerable when they're exiting care. Paul, you mentioned some other options for extending care for those who are not from foster care; could you maybe expand on that a little?

MR MCDONALD

Yeah, no, it's a good question. They may only be about 5 to 6 per cent of our out-of-home care population, but they occupy much of our thinking and also really costs to government. They're probably, you know, sort of the higher – I don't know, or the more active, the more expensive in the costs to government. So just quickly dipping into it internationally, Scotland have said theoretically in their policy they will offer extended care to residential care; where the UK, England had said foster and kinship, but Scotland said that. And they came up with four theoretical options. They said they'll either place a unit on the same physical side of the residential care, you know, a little studio apartment that sometimes you see things like Kids Under Cover and those sort of things offer here in Australia. And the home base will be the star for the residential care; will offer something down the road, but still the home base being the residential care that they exited, and so on and so forth.

What's interesting here in Australia, and I mentioned South Australia went foster and kinship and Tasmania is still forming its policy, but here in Victoria the government were specific, 'We want this also for residential care.' And rather than this phased approach, 'Let's do foster kinship' – ' We want resi as well.' So that's why you see this interesting policy characteristic of the money following the young person, rather than foster kinship reimbursements. But in fact, if that breaks down or alternatively if the kids coming out of resi, that reimbursement, around $10,000, will contribute yearly to his or her rent or his or her board because it's not going to a carer. So we're enabling a better financial – these kids have got a better financial chance of accessing the housing market because of this. Still they get their worker, and still they get their brokerage in relation to employment and education.

So the Victorian government has said, 'Nope, all in. We're not going to have this phased entry or not going to have this separate entry', and they're some of the ideas that the Victoria Government are wrestling with about how we bring it home for our residential care kids too.

DR MUIR

Okay, thank you. This is a question for Philip, which is whether there's been much research on outcomes for young people who informally remain with their carers after they turn 18. Because we know that that does happen, although it's not always formally recorded; but is there much research on how these young people fare?

DR MENDES

I'm not sure there is a lot of research in Australia. It has been difficult historically to complete research on the post 18-group in Australia because governments have not supported that group, and it has been difficult to access that particular cohort for research. We have heard anecdotally in a number of research projects that many foster or kin carers do continue support beyond 18 often from their own resources. And certainly feedback from some of the young people in that situation has been that that support has been fantastic and an absolutely key attribute in enabling them to have good outcomes in areas like education, training and employment. So I guess the value of extended care is that for many young people who've been growing up in foster care or kinship care, it is now formalising arrangements that were already being made, but mainly through the generosity of foster carers and kin carers.

MR MCDONALD

And just briefly on that, and I've had a couple of grandparents sit in my office, you know, and they say, 'It's expensive raising teenagers on the pension, Paul.' And so they're still committed to running the care, but really they're being asked to finance this themselves And I was asked the question recently on a radio interview, and they said, 'Well, really Paul, doesn’t the system really, you know, look after them anyway? Don't foster carers and kinship carers [as Phil's explained] step up to the mark and just take on the care?' And I said, 'Yes, they do, but why should we have a system of care that's reliant on the good heart of the volunteer to finish off the job?' To, you know, finish up the development of the - why are we reliant on that, rather than that is a formal part of that?

I mean, I'm sorry folks, I'm from Melbourne, but it's sort of like building the West Gate Bridge and stopping three-quarters of the way and saying, 'Hmm, that's a job well done, I think we can all go home now.' Or the Sydney Harbour, or the Story Bridge in Brisbane. I mean, we're stopping prematurely our execution of care at 18. It is premature as a parent. We may not be a natural parent, but government is the parent it is, and we have to finish off the job. And that's why I think formally, rather than relying on the good heart of the volunteer, being the foster and kinship, to do it, is the right thing for Australia to do.

DR MUIR

Thank you. We've also had a question about the number of young people and care leavers in particular who have complex needs and how extending care might work for this particular group, what considerations might there be for extending care to those with particularly complex needs? And we know that, amongst care leavers, there are very high rates of say, mental illness, physical or emotional difficulties; so what kind of considerations would go into that kind of extended care?

MR MCDONALD

Well look, I think it's a good question, because many of them will be overrepresented with mental health issues and with other complex issues, or even how the care system's looked after them, and whether, you know, history of trauma in families or even trauma in the care system. I mean, many of these kids are going to have some issue one way or the other. I think what we're looking for is at least a platform of care to, first of all, hold the base, you know, and see if they can offer them a base between 18 and 21. Secondly, I think we've got to become more – I think government give them – become more sensitised to the experience of the 18, 19, 20 year old coming out of care.

You know, really, though I issued some sort of statistic about what we do know about young people coming out of the care, the care system is very aloof – no, government services, even though government has grown up these children, are very aloof. We don't give them gold passes into services, yet we know they'll be overrepresented in hospital and in mental health services. So I think where we'd like to go is, as we build the base, we start specialising or bringing in, whether it's in fact actually resources, not only for employment and engagement exercise, but resources to bring some sort of modern mental health of a young adult nature to these young people, is a very good question and it's very relevant for this target group.

So in a sense, we're looking for a population base reform, and then within that, understanding who needs those special needs and can government actually finance it. And I think if government saw that, in fact, like a parent sees their responsibilities raising their children continues past after they've moved out of home, we could see a government see that their responsibilities for the children they've raised, continue at least through to 21. And look at the government services on hand that they have to actually leverage those services to saying 'This should be a priority group between 18 to 21.'

DR MENDES

I think there is a strong economic and social argument for particularly supporting that group of young people, whether we call them complex needs or vulnerable young people. And we can go two ways as a community. We can say that we're going to be like any other parent in the community that have young people living at home who have difficulties and we hope between the age of 18 and 21, or it might be 18 to 25, those difficulties will in some way resolve themselves, or at least we can get them under control. Or we can say, let it rip, let them into the crisis intervention systems, whether it be mental health system or income support or criminal justice, which are very, very expensive for government, very expensive and harmful for the community, and harmful for the young people themselves.

So I certainly think there is a strong argument economically as well as socially for extended care. It's a system that actually does, ideally, prioritise that group that do have complex needs.

DR MUIR

Thank you very much. We've had, I suppose, further questions about specific groups of care leavers, and in particular about Aboriginal and Torres Strait Islander young people, and both whether there are special considerations that might need to be taken account for these young people. In particular, whether there's a consideration of, I suppose helping them to connect to culture or maintain a connection to culture if they're remaining with a kinship or foster carer beyond the age of 18?

DR MENDES

We're currently undertaking a national study of Aboriginal and Torres Strait Islander care leavers in Australia. It's the first ever study, and one of the reasons for the study is really to find out the basic data and basic statistics. So although we know that there are a very high disproportionate number of Indigenous young people in the out-of-home care system, we actually know very little about how many or what percentage leave care in every state and territory. We know very little about the services that support them; whether they're run by aboriginal community controlled organisations or not. And we know very little about the particular cultural and community supports provided to this group of young people, including particularly whether they have access to cultural plans or not.

So I think we really need to ensure that we have the key knowledge about what is happening to this group of young people currently. How many are leaving care in every state and territory, from how many are leaving from resi-care, from kinship care, from foster care. We have heard anecdotally that many of them are leaving care very young, often before 15 years and 9 months, which is the cut off for leaving care support in Victoria and I think in most states and territories. So, you know, I think that really the first key aim here is to identify what is happening to that cohort and what are their different experiences compared to non-indigenous care leavers, so that we can then identify the particular service supports needed to meet their needs.

DR MUIR

Okay, thank you Philip and Paul. That's all we have time for today, and thank you everyone for attending today. Please follow the link on your screen to our website so that you can continue the conversation. And as you leave the webinar, a short survey will open in a new window, and we greatly appreciate your feedback. Please note too, any unanswered questions may be published along with your first name on the CFCA website for a response from the presenters after the webinar; so please let us know if you don't want your question or first name to be published on our website. And hopefully we'll see you again next time.

WEBINAR CONCLUDED

IMPORTANT INFORMATION - PLEASE READ

The transcript is provided for information purposes only and is provided on the basis that all persons accessing the transcript undertake responsibility for assessing the relevance and accuracy of its content. Before using the material contained in the transcript, the permission of the relevant presenter should be obtained.

The Commonwealth of Australia, represented by the Australian Institute of Family Studies (AIFS), is not responsible for, and makes no representations in relation to, the accuracy of this transcript. AIFS does not accept any liability to any person for the content (or the use of such content) included in the transcript. The transcript may include or summarise views, standards or recommendations of third parties. The inclusion of such material is not an endorsement by AIFS of that material; nor does it indicate a commitment by AIFS to any particular course of action.

Slide outline: Extending care: Supporting young people’s transition from out-of-home care to adulthood

Slide outline

1. Extending care: Supporting young people’s transition from out-of-home care to adulthood

Paul McDonald and Philip Mendes
CFCA Webinar
15 May 2019 

2. Asking questions

  • Send through your questions via the chat box at any time during the webinar.
  • Let us know if you don’t want your question published on the online forum following the presentation.

3. Webinar resources

  • All our webinars are recorded. 
  • The slides are available in the handout section of Gotowebinar. 
  • The video will be shared during the webinar and a Youtube link to the video will be included in the resources for this webinar 
  • The audio and transcript will be posted on our website and YouTube channel in the coming week.

4. Care leavers

  • Young people transitioning from out-of-home care (often called care leavers) are universally a vulnerable group who have generally not received the ongoing and holistic support that they require to transition successfully into adult life.
  • Care leavers generally experience accelerated and compressed transitions to adulthood, and consequently often face significant barriers to accessing educational, employment, housing, health and other development and transitional pathways and opportunities that are readily available to their non-care peers.
  • Historically, most countries have provided only limited leaving care or post-care support services. However, over the last two decades there has been growing international awareness of the needs of care leavers, and an expectation of ongoing care beyond 18 years. In this webinar, we specifically examine reforms in England and the USA.

5. Children leaving Care Act 2000

  • England introduced the Children (Leaving Care) Act 2000 in October 2001.
  • The Act was intended ‘to improve the life chances of young people living in and leaving care’, and to replicate the supports that responsible parents would be expected to provide for their children. It extended the expected age of leaving care from 16 to 18, and obliged local authorities to continue to provide advice and support for young care leavers up to the age of 21, and even to 24 years for those still in education and training.
  • In short, the intention was to delay the transition from care until young people are prepared and ready to leave. The Act introduced an expectation of corporate parenting responsibility to provide ongoing support to care leavers in order to promote better outcomes. Both positive and negative outcomes.

6. Staying Put

England introduced a form of extended care: the Staying Put program which ran as a pilot from 2008-11 in 11 local authorities, and was later legislated as an ongoing duty on all local authorities in England on 13 May 2014, in part 5 Welfare of Children (98) of the Children and Families Act 2014.

This requires local authorities in England to facilitate, monitor and support staying put arrangements for fostered young people until they reach the age of 21, where this is what they and their foster carers want unless the local authority considers that the staying put arrangement is not consistent with the welfare of the young person. 

7. Staying Put evaluation

  • Emily Munro and colleagues completed an evaluation of the Staying Put trial in 2012. They cited systemic benefits of the Staying Put extended foster care program such as: stable and supportive relationships providing ongoing emotional support to young people who are not developmentally ready for adulthood at 18 years; and housing and associated stability which facilitates engagement in EET, and enables young people to undertake a gradual transition that mirrors the pathways of their peers in the general population.
  • Specific positive outcomes included: greater housing stability, and higher engagement in education or training and employment which should lead to higher future earnings and less reliance on public benefits.
  • To date, there has been no formal evaluation of the ongoing program. But informal reports by researchers and policy advocates emphasize the importance of duties being backed up by adequate resources to ensure sufficient information is available to young people and foster carers, plus consistency of service delivery across regions to facilitate access to the option of Staying Put.

8. Foster Care Independence Act

  • The USA introduced the Foster Care Independence Act in December 1999 which expanded assistance including room and board for young care leavers aged 18-21 years, expanded access to Medicaid for care leavers, provided additional funds for education and training, and increased state accountability for care leavers outcomes.
  • The Act was a significant improvement in terms of offering greater support to meet care leavers’ needs around access to housing, health services in particular mental health services, and education and training.
  • However, funding remained inadequate to meet the needs of most care leavers, take-up by states in regards to health care was discretionary, and optimal implementation of the Act depended on their willingness to match federal funds with required levels of state funding.

9. Fostering Connections Act in 2008

  • Consequently, the US enacted the Fostering Connections Act in 2008 as a form of extended care which aimed to extend the Foster Care Independence Act by giving states the option of maintaining young people in foster care until 21 years.
  • There is a requirement that young people are completing secondary school or equivalent,  or enrolled in postsecondary or vocational school, or participating in a program or activity that promotes or removes barriers to employment, or employed 80 hours a month, or incapable of school and/or work requirements due to a documented medical condition.
  • Mark Courtney and colleagues in California cite specific benefits of extended care such as: enhanced educational outcomes, improved earnings and less economic hardship, fewer early pregnancies, lower levels of homelessness, reduced mental health difficulties or involvement in the criminal justice system, and greater involvement of noncustodial fathers with their children.

10. International evidence

  • Additionally, the New Zealand-based researcher Iain Matheson (2018) completed a mapping exercise of the international evidence base for extending care. He cites evidence of consistent positive outcomes in education, reduced criminal justice involvement, housing stability, and more positive transitioning overall. However, the results concerning earnings, delayed pregnancies, and engagement with training/employment seem to be more varied.
  • Matheson argues that extended care works because it offers: continuity and stability, a nurturing environment, helps engagement in education, employment and training, and empowers young people and gives them greater choice and control over the timing and process of their transition. He notes that outcomes may be fluid depending on a range of factors such as whether extended care is offered universally or not, includes residential care, allows those who left earlier than 18 years to return before 21 years, and includes strict conditions such as full-time involvement in EET.

11. Lessons for Australia

  • Extended care should lead to improvements in key areas such as education and employment, housing, health, and reduced involvement in offending and criminal justice system.
  • Effective implementation requires detailed planning, sufficient funding, and ongoing monitoring and evaluation.

12. References

Courtney, Mark & Okpych, Nathanael (2017) Memo from CalYouth: Early findings on the relationship between extended foster care and youths’ outcomes at age 19. Chapin Hall, University of Chicago.

Courtney, M. et al (2016) Findings from the California Youth Transitions to Adulthood Study (CalYOUTH): Conditions of youth at Age 19. Chapin Hall, University of Chicago.

Matheson, Iain (2018) ‘Extending care from 18 to 21: Towards an international evidence base’, Paper presented to EUSARF Conference, Porto, October.

Munro, E., Lushey, C., Maskell-Graham, D. & Ward, H. (2012) Evaluation of the Staying Put: 18 Plus Family Placement Programme: Final Report. Centre for Child and Family Research, Loughborough University.

Munro, E.R., Molholt, A., & Hollingworth, K. (2016). ‘Leaving care in the UK and Scandinavia: Is it all that different in contrasting welfare regimes’. In P. Mendes and P. Snow (Eds.), Young people transitioning from out-of-home care (pp. 199-219). London: Palgrave Macmillan.

National Care Advisory Service (2012) Staying Put Peer Research Report. Department for Education, London.

13. Paul McDonald
AIFS Webinar
15 May 2019

14. What is ‘Out of Home’ care?

Out of Home care refers to statutory care of children and young people who are unable to live with their parents. Children in Out of Home care are, in most cases, also on a care and protection order.

There were 46,450 (17% increase since June 2012) children and young people in Out of Home care across Australia as at June 2016.

Alt text: This slide shows two pie graphs. The first shows the difference in percentage between children in residential care or group homes (6.4%) compared to children living in foster or kinship care (93.6%). The second graph highlights the high percentage of Aboriginal and Torres Strait Islander children in care (36.2% or 16,846) of all children in care in Australia at June 2016.

15. 3,000 young people between the ages of 15-17 years are exited from state care each year in Australia

Bar graph showing the number of 15-17 years that leave state care each year by state

NSW - 1,159

Vic. - 806

Qld - 566

WA - 207

SA - 205

Tas. and NT - 61 each

ACT - 59

16. What happens to young people leaving care in the first 12 months?

Five pie charts that show what happens to young people leaving care in the first 12 months.

Pie chart 1: indicates that, according Swinburne University of Technology report published in 2015, 63% of homeless youth have a state care history.

Pie chart 2: 35% of care leavers lived in 5 or more location in the first 12 months.

Pie chart 3: 22% females and 46% males leaving care were involved with the justice system in the first 12 months.

Pie chart 4: 29% were unemployed, compared to the national average of 9.7%

Pie chart 5: 28% were already parents.

17. Whilst 85% of 18–21 year olds in Australia are still at home (HILDA)

A pie chart shows that 85% of young people aged 18–21 years are still living at home with one or both parents.

18. All states and territories terminate care to the young person before they turn 18

Map of Australia showing the states and territories' arrangements for ending care for young people

NT, WA, SA, Tas., NSW, ACT, Vic., - Exit care at 18. Planning exit begins at 15.

Qld - Exit care at 18. Planning exit begins at 14 years 11 months.

19. What do governments do internationally for ‘care leavers’?

  • United States – Extended care to 21 years in 46 states.
  • England – ‘Staying Put’, extended care to 21 years for foster and kinship placements.
  • Scotland – has extended the age of leaving care (from April 2015) until 21 for both foster and residential care.
  • Canada – Ontario has extended care to 21 years.
  • New Zealand – extending care to 21 years, with non-financial transition support and advice available up to 25.

Alt text: Map of the world with the US, UK, Scotland, Canada and New Zealand marked as locations where extended care policies have been implemented.

20. International evidence of Continued Care to 21 years: (Evaluations from United States and United Kingdom)

  • Halved homelessness
  • Doubled education participation
  • Doubled odds of employment
  • 38% reduction in youth pregnancies
  • 54% reduction in arrests
  • Federal and state tax savings estimates at US $320 million

21. Quote from Amanda Cumberland, Policy and Parliamentary Adviser at The Adolescent and Children's Trust

... the most significant child welfare reform in the United Kingdom in a generation.

22. What are the costs and benefits state by state, if care were extended to age 21 in Australia:

Alt text: Slide shows three front covers of cost benefit analysis reports by Deloitte Access Economics that have been published over recent years.

23. Deloitte Access Economics: Current Financial Impact

The financial impact of the current cohort of care leavers aged 18 to 21 years due to higher usage of government services is estimated to be $1.8 billion for the Commonwealth Government and $0.6 billion for the state and territory governments over the next 10 years, giving a total impact of $2.4 billion.

Alt text: Pie chart showing the difference in cost to the states and commonwealth of care leavers: state and territory costs are depicted as a little less than a quarter of the pie chart, compared to the cost to the Commonwealth that is depicted as more than three quarters of the pie chart.

24: Deloitte Access Economics: National Cost Benefit Ratio

This is a table of cost benefit ratio by state and territory.

The following shows the cost benefit ratio return on $1 invested by jurisdiction:

NSW - 3.40

QLD and Tas. - 2.69

WA - 2.17

NT - 1.94

Vic. - 1.84

ACT - 1.77

SA - 1.40

Federal - 2.00

25. Deloitte Access Economics: Social outcomes if care was extended to 21 years in Australia

Homelessness halved 39% to 19.5%

Rate of teen pregnancy reduced 16.6% to 10.2%

Educational engagement increased 4.5% to 10.4%

Interaction with the criminal justice system reduced 16.3% to 10.4%

Mental illness reduced 54.4% to 30.8%

Smoking reduced 56.8% to 24.5%

Hospitalisation reduced 29.2% to 19.2%

26. Likely pathway if care was extended past 18 years

Descriptive text: Boxes indicating what would change moving from the current placement situation to a continued care arrangement.

Current placement

  • Foster/Kinship placement
  • Residential/Lead Tenant placement
  • Those that have left care and need support again

Continued care arrangement

  • Remain in foster/kinship placement if young person and carer agree
  • A guaranteed supervised independent iiving arrangement

Continued care support past 18 years would include:

  • Ongoing carer reimbursements or housing subsidy
  • Case management worker
  • Financial brokerage available for education and employment

27. Recent commitments to extending care to 21 years in Australia

Alt text: Table detailing the recent commitments made by states and territories regarding extending young people’s time in care.

In February 2018, Tasmania commited to extend care to 21 years.

For South Australia, in June 2018, foster care and kinship care reimbursements continued until young person in care reaches the age of 21.

In September 2018, Victoria committed to extend care to 21 years for 250 young people over five years.

In October 2018, Western Australia committed to trial extended care to 21 years for 20 young people.

28. Further Home Stretch work

The Home Stretch Campaign recommends:

  • legislative change to ensure young people in care have the option of extended care to 21 years in each state and territory
  • a federally co-ordinated approach for extended care to 21 years to bring all states and territories up to the same starting line and to realise the full social and economic benefits for young people leaving care
  • an increase in numbers of eligible young people to have the option of extended care to 21 years in Victoria.
  • Planned Symposium August 2019, on extended care: informing Australian policy development, program implementation and evaluation to extend care to 21 years.

29. For more information about the Home Stretch campaign, visit our website:

thehomestretch.org.au

30. Continue the conversation…

Please submit questions or comments on the online forum following today’s webinar: aifs.gov.au/cfca/news-discussion.

This webinar was held on 15 May 2019. 

Young people leaving out-of-home care (OOHC) are a vulnerable population. They are at increased risk of poor mental health and developmental delays, and may experience a lack of affordable housing and poor pathways to employment.

The transition to adulthood without family support can be challenging for young people leaving OOHC after they turn 18 years of age. Some have argued that young people can be better supported during their transition to adulthood by extending care until 21 years of age or later.

This webinar looked at how extending care could improve a range of critical outcomes for these young people. The presenters reviewed how policy has developed over recent decades, and outlined the potential economic benefits of extending care to young people transitioning from OOHC to adulthood. They also discussed the emerging evidence on extended care implemented internationally and considered its implications for policy and practice in Australia.

This webinar is of interest to practitioners working with young people, particularly in OOHC and related social support services.

Related resources


Featured image: © GettyImages/Daisy-Daisy

About the presenters

Paul McDonald

Paul is currently the Chief Executive Officer of Anglicare Victoria, a leading agency in delivering OOHC and family support to vulnerable children, young people and families. Paul has extensive experience leading various government and non-government social welfare initiatives to improve outcomes for young people. His previous positions have included Deputy Secretary in the Department of Human Services responsible for the leadership and management of Victoria’s Child Protection Services and Youth Justice Program.

Paul is Chair of the Home Stretch Campaign, a national campaign that seeks to stop young people in state care becoming homeless, unemployed or imprisoned when their care ends at 18 years. He was recently appointed State Chair of the Reform of the Out-of-Home-Care System for the Victorian Government, and is current President of the Centre for Excellence in Child and Family Welfare.

Paul was also recently the recipient of the Robin Clark leadership award at the 2017 Victorian Protecting Children Awards. This award recognises a leader who inspires others about achieving the best outcomes for Aboriginal and non-Aboriginal children, young people and their families.

Philip Mendes

Associate Professor Philip Mendes is the Director of the Social Inclusion and Social Policy Research Unit (SISPRU) in the Department of Social Work at Monash University. Philip has been researching young people leaving state care for 20 years. He is the Australian representative on the Transitions to Adulthood for Young People Leaving Public Care International Research Group and has completed major studies pertaining to youth justice, employment and mentoring programs, disability and Indigenous care leavers. He is currently leading a national study of Indigenous young people leaving care funded by the Sidney Myer Foundation.

Philip has authored/co-authored 12 books including, most recently, Young People Transitioning from Out-Of-Home Care: International Research, Policy and Practice, co-edited with Pamela Snow (2016), the third edition of Australia’s Welfare Wars (2017) and Empowerment and Control in the Australian Welfare State: A Critical Analysis of Australian Social Policy Since 1972 (2018). Prior to entering academia, Philip was a child protection worker in Victoria in 1987–88 and again from 1992–95.

Comments

Excellent webinar thanks: great to get the international stats A no brainer really that after child services are heavily involved in ones childhood that some young people might feel abandoned. One situation will and must differ from another and humans are not necessarily alike.
Susan Westcott