Assessing risk of foster care re-entry for children with short-stays in child welfare systems

• In Event: Understanding trauma in vulnerable children and families: addressing the intersection of multiple systems' level risk factors

Abstract

Background
Children placed in out-of-home (OOH) care by child welfare systems face myriad deleterious developmental outcomes. These risks are compounded when children reunite with caregivers and subsequently re-enter OOH care. One risk factor associated with re-entry risk is length of stay in OOH care. Research shows that children with stays of less than 90-days are at greater risk of re-entry than those with longer-stays, but scant research focuses on re-entries among “short-stayers” (i.e., children in OOH care for 30-days or less), who may be particularly vulnerable to poor outcomes given the abrupt and traumatic removal and reunification window. This project examined the risk of re-entry into OOH care for short-stayers compared to children with greater lengths of removal periods in OOH care.

Methods. This research used the Adoption and Foster Care Analysis and Reporting System (AFCARS), administrative data on children in foster-care in the U.S. from October 1, 2015 to March 31, 2021 (11 six-month reporting periods). Data were restricted to children who entered foster care for the first time after the first period and experienced at least one discharge (N=713,932). Children were classified by length of stay: short-stays (30-or-fewer days), moderate-stays (31-90 days), and longer-stays (90-or-more days). A logistic regression model tested the odds of children re-entering foster care based on length of stay, controlling for demographic and child welfare-related variables.

Results. The descriptive statistics showed that approximately 81% of children’s first OOH removal was a longer-stay, about 11% short-stay, and 8% moderate-stay. About 13% of short-stayers, 12% of moderate-stayers, and 7% of longer-stayers re-entered OOH care after first discharge. The logistic regression results showed that children who experienced a short- or moderate-stay at their first discharge had increased odds of re-entry into foster care (short: OR=1.58, z=36.29, p<.001; moderate: OR=1.43, z=25.00, p<.001) compared to longer-stayers, controlling for child and case characteristics. Many child and case characteristics (e.g., discharge reasons and child race-ethnicity) were also independently associated with odds of re-entry.

Discussion. The results suggest that children with short-stays are at elevated risk of repeated disruptions by child welfare authorities, which may have severe consequences for children’s psychological, emotional, and social development. Re-entries into OOH care suggest inadequate support was provided to families to prevent further involvement with child welfare systems, and short-stayers may be at heightened disadvantage. Because short-stayers have the greatest odds of re-entry compared to moderate- and longer-stayers, this reinforces calls from emergent research to focus specifically on outcomes for short-stayers. The plight of short-stayers in child welfare highlights the impact of even brief encounters with child welfare services. These brief removals are likely harmful, and recent research asserts that a standing concern for short-stayers is whether such brief removals are even necessary or if they cause unwarranted trauma for children (Getz et al., 2022). Even though this study suggests children who experienced short-stays may be at increased risk of re-entry into OOH care, only 13% of short-stayers re-entered in the analytic period, suggesting the concern about removal necessity is still prescient, particularly in light of re-entry risk.

Authors

• Brett Greenfield, Rutgers University - New Brunswick
  Presenting Author

• Liwei Zhang, Washington University in St. Louis

• Cassandra A Simmel, Rutgers University - New Brunswick