December 1999

The Foster Care Independence Act was approved by the House of Representatives on November 18 and by the Senate on November 19, just minutes before adjourning for the year. The Act allows states to use Medicaid dollars to provide health insurance coverage to former foster children until age 21 and allows youth to have assets worth up to $10,000 without losing benefits. It also doubles the money for Independent Living programs (from $70 million to $140 million) and allows this money to be spent on such activities as life skills training, substance abuse prevention, and preventive health skills. The provisions of the new Foster Care Independence Act will go into effect when the President signs the bill into law.

When young people in foster care turn 18, they face many difficulties. They often lose their housing, their support for daily living, and their health insurance. Although youth formerly in foster care have higher levels of physical and mental health problems than their peers, 51% of them have no insurance coverage and 44% rate "obtaining medical care" as a significant problem. If they try to save money in preparation for these losses, total assets above $1000 make them ineligible for Independent Living programs.

To address these concerns, the Foster Care Independence Act was introduced in the House of Representatives by Reps. Nancy Johnson (R-CT) and Ben Cardin (D-MD), and in the Senate by the late Senator John Chafee (R-RI). After strong advocacy efforts by APA and other organizations, the House passed the bill on June 25 by an overwhelming vote of 380 to 6. A modified version of the bill, H.R. 3443, was approved by the House on November 18 and the Senate on November 19. President Clinton is expected to sign it.

Medicaid expansion. States may extend Medicaid coverage until age 21 to young people who have "graduated" from foster care.

Independent Living. The name of the Independent Living program is changed to the John H. Chafee Foster Care Independence Program as a tribute to Senator Chafee's longstanding commitment to child welfare. In addition, funding for the Independent Living Program is doubled from $70 million to $140 million annually. States may use up to 30 percent of these funds for room and board for youth ages 18 to 21 who have left foster care. The remaining funds can be used for: education, vocational training, preparation for post secondary education, training in daily living skills, substance abuse prevention, pregnancy prevention, and preventive health activities. States must also use federal training funds to help foster parents, adoptive parents, group home workers, and case managers understand and address issues confronting adolescents who are preparing for independent living.

Additional uses of the funds allow states to help children prepare for self-sufficiency when appropriate, not just after their 16^th birthday as in the current law. Furthermore, states can offer different services to children at various stages of achieving independence, or children in different parts of the state. They can also use a variety of providers to deliver independent living services. However, states must devote some portion of their funds for assistance and services for older youths who have left foster care but have not reached age 21. Independent living activities are not to be viewed as an alternative to adoption, and can occur concurrently with efforts to find adoptive families for these young people. To carry out these activities, all states will receive a minimum of $500,000, with each state contributing a 20 percent state match.

Research and evaluation provisions. The Secretary of Health and Human Services (HHS) must, in consultation with youth service providers, researchers, and other entities, develop outcome measures to assess Independent Living programs. Outcomes include educational attainment, employment, avoidance of dependency, homelessness, non-marital childbirth, high-risk behaviors, and incarceration. HHS must also track how many children are receiving services and what services are received and provided. An amount of $2.1 million is set aside for a national evaluation and for technical assistance to states in assisting youths transitioning from foster care.

For additional information, see the APA briefing sheet Maintaining Health Benefits for Children Transitioning from Foster Care. The full text of H.R. 3443 can be viewed on Thomas at http://thomas.loc.gov

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