Iowa youth aging out of foster care: How are they doing?

Youth in foster care can be at risk for challenges that impact their health and well-being, especially as they age out of the system at age 18. The most successful youth achieve educational goals, have stable housing, build financial stability, and have social connections.

The National Youth in Transition Database (NYTD) is a federal initiative that requires state child welfare agencies to collect outcomes information on youth in foster care and alumni. The Iowa Department of Human Services contracts with the Iowa Department of Human Rights to collect much of the data. Cohorts of youth in foster care are surveyed at age 17 every three years and a percentage are surveyed again at ages 19 and 21. The survey focuses on outcomes in these areas: financial self-sufficiency, education, positive connections with adults, homelessness, high-risk behaviors, and access to health insurance. Young people receive compensation for taking the survey.

Mid-Iowa Health Foundation provided a grant to support youth engagement efforts to ensure young people are providing their experiences and expertise in discussions on systems that impact their well-being. Young people with experience in foster care, called NYTD youth ambassadors, were invited to engage their peers and analyze the feedback data received. The process expanded existing efforts to capture the perspectives of those in the system on what could be improved and where supports are needed.

The NYTD report, published by the Department of Human Rights in January 2022, shares results from survey data collected from October 2020-September 2021 (FFY 2021). Survey participants included 350 17-year-olds, 124 19-year-olds, and 130 21-year-olds. Here is a picture of how young people involved in foster care are doing:

5 positive outcomes from the survey:

1. Fewer youth are in foster care overall.

In FFY2021, 350 youth were eligible to take the NYTD survey. This is up slightly from the previous year, but down significantly from 2011, when 534 youth were eligible to participate. This decrease in foster care population suggests that the Family First Prevention Services Act, which prioritizes keeping children safely with families instead of in foster care, is working.

2. Many youth have increased financial security.

About 60% of young people ages 19 and 21 are working, which is above the national cohort of 55% and has increased 10 percentage points over the past six years. The percentage of those receiving any public assistance has also decreased to the lowest level recorded on Iowa’s NYTD survey, which began in 2010. These data points suggest that more young people are gaining increased financial stability.

3. Biological family connections are high.

Supportive adult connections are a critical component of well-being. Nearly all youth aged 17 in foster care reported having at least one adult to go to for support and more than half knew their most supportive adult before entering foster care. Having supportive adult connections is higher for youth in Iowa than the national cohort. Of the 21-year-olds surveyed, 83% have a close relationship with one or more family members, including birth parents, spouse or partner, and/or grandparent. Youth of color were more likely to report connections with biological family members.

4. Access to health insurance has increased.

Access to health insurance enables young people to receive preventative care and to access physical and mental health care when needed. The Iowa NYTD report showed that 75% of 17-year-olds and 79% of 21-year-olds are receiving Medicaid, which is the highest in the history of data collection and is 10 percentage points higher than the national average. While Medicaid is provided to any youth in licensed foster care, those not receiving Medicaid are likely to have access to a different type of insurance.

5. Parenting rates have decreased over time.

Waiting to have children often enables youth to focus on establishing a strong foundation in adulthood, including greater financial stability and educational attainment. The percentage of foster youth (men and women) having parented a child has decreased over the past several years, even though it remains slightly higher than the national average. The survey found that 7% of those aged 17 have had a child and 25% of those aged 21 have had a child in the past two years.

5 areas to improve youth well-being:

1. Fewer youth are receiving education and skills training.

Educational attainment is a key factor in long-term financial stability and well-being. The survey showed that youth in foster care enrolled in school or receiving postsecondary training was at the lowest level since the survey began. Just 17% of 21-year-olds reported receiving employment-related skills training, which was half of the national average. Latino/Hispanic youth were least likely to receive training. Still, more 21-year-olds have their high school diploma or GED compared with the national average. Black and African American youth were more likely to be enrolled in education than White and Hispanic youth.

2. Males are more likely to be disconnected.

35% of NYTD participants were not currently employed or enrolled in school. Males were more likely than females and White youth were more likely than youth of color to be disconnected from work and education. 93% of all males taking the NYTD survey were not enrolled in education.

3. Homelessness has increased.

Thirty percent (30%) of 21-year-olds reported being homeless within the past two years, the highest in Iowa NYTD history. This can include being at shelters, as well as sleeping at other people’s homes. Youth who were formerly in foster care are more likely to experience homelessness at age 21 than youth in other states. A disproportionate number of American Indian or Alaska Native and Black youth reported experiencing homelessness.

4. Iowa is above the national average for high-risk behavior outcomes.

While Iowa has seen improvements in youth experiencing risky behaviors, such as substance use and criminal activity, Iowa is still above the national average in these measures. In particular, one in four youth have been incarcerated by age 21, with youth of color more likely than white youth to experience incarceration. American Indian and Alaska Native youth were over-represented in all high-risk behavior outcome areas, except for receiving mental health counseling services. Asking youth if they’d ever received mental health counseling was a new question this year, with 45% of youth aged 21 reporting that they have received these services.

5. Youth in foster care are not getting connected to services when they age out.

The Iowa Aftercare Services Program, a DHS contracted statewide program for youth ages 18-23, provides youth transitioning out of foster care with support, including access to a self-sufficiency advocate and funds to help with rent and other expenses. When asked if they are being served by the Iowa Aftercare Services Program, just 41% of all 21-year-olds reported receiving these services. Youth of color and males were less likely to report participating in these services. Those who did not access transitional services cited not being aware of the services (39%) as the top reason for not accessing them.

Additional feedback on the foster care system:

The NYTD report also highlighted Iowa Aftercare’s data on how the COVID-19 pandemic has impacted youth aging out of foster care. Among youth in its programs: 63% reported increased stress; 52% lost a job, had hours reduced, or were unable to find work; 27% were unable to stay in touch with family/friends; and 22% lost housing, got behind on rent/utilities, or were forced to move.

NYTD youth ambassadors also worked with the Criminal and Juvenile Justice Planning Team to provide what they call a “talking wall” where young people at shelters, detention centers, group homes, and other child welfare places could share what improvements they would like to see. This year, the wall captured feedback of 383 youth in 40 locations through 1,828 post-it notes. The feedback included the comments shown in the image, including: 

• People of all ages should be able to attend their own court and be able to speak up for themself.
• Be able to do a name change after a failed adoption so you aren't constantly reminded about an adoption that didn't work out every time they write or say their name.
• Give us the attention we need.
• We should be able to request new workers and not have to battle adults.
• Better food and beds.
• Look at us for what we can be. Stop looking at us as a danger.

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View the NYTD report by clicking the button below.