Most lay persons equate child welfare with foster care, although only a small minority of families with substantiated or indicated child abuse or neglect complaints have children placed in foster care -- 16 percent in 1996 (HHS/CB, 1998d). The remainder either are served while remaining at home, or child welfare workers have determined that no services are necessary to keep the child safe (for instance if the perpetrator has left the home). Because foster care is provided to the most troubled families and provides the most intensive (and therefore most expensive) services to children, it is often the focus of public attention. Foster care is also the focus of Federal child welfare policy. There were approximately 520,000 children in foster care on March 31, 1998, a figure that has been rising steadily for a decade (Adoption and Foster Care Analysis and Reporting System, 1998).
The U.S. General Accounting Office (USGAO) in a recent report (USGAO, 1998) found that approximately two-thirds of foster care cases reviewed in urban counties in two States involved parental substance abuse (Figure 4-8).
Substance abuse was noted in 65 percent of cases in California and 74 percent of cases in Illinois. The problem was usually abuse of cocaine or methamphetamine (Figure 4-9), was usually noted in the mother or in both parents of the child, and was in most cases a longstanding problem of at least 5 years duration.
In 80 percent of substance abuse related cases, the child's entry into foster care was the result of severe neglect. In a related study conducted several years ago, the USGAO had found 78 percent of children in foster care had parents with substance abuse problems (USGAO, 1994). These figures have remained remarkably consistent, particularly in studies that look at cases in urban locations.
The Child Welfare League of America's 1998 survey on alcohol and drug issues found that only 8 States could provide information regarding the proportion of foster care cases involving alcohol or other drugs. Even if not able to report specific numbers of cases, States were asked to report whether the proportion of child welfare cases involving substance abuse was up or down in recent years. Thirteen of 47 States reported that more cases than in the past involved substance abuse (CWLA, 1998). The remaining states lacked information on trends in substance abuse in their caseloads.
In preparing this report, we reviewed data reported by States under the Adoption and Foster Care Analysis and Reporting System (AFCARS), a new reporting system under which States provide semi-annual information about all children in foster care or who have been adopted from the public child welfare system. While reporting under AFCARS is mandatory, these requirements are still in the implementation stage and not all States are yet reporting complete data. For the purposes of this report we analyzed data regarding children in care on March 31, 1998. Regarding substance abuse, AFCARS contains the following data elements for each child: yes/no fields indicating whether the parent had an alcohol problem that contributed to the child's placement; whether the parent had a drug problem that contributed to the child's placement; whether the child had an alcohol problem; and whether the child had a drug problem. Child alcohol and drug problems could represent either their own use of substances (primarily in adolescents) or a prenatal exposure to substances (seen in infants).
In the reporting period examined, only 32 States plus the District of Columbia reported any data in the four alcohol and drug fields, and many of these data are incomplete and under-reported. Reports of caretaker alcohol and/or drug problems ranged from less than 1 percent to 62 percent in the States reporting data for these elements (Figure 4-10).
Most of the large States, including New York and Illinois, were not yet reporting these data. We expect reporting for AFCARS to improve considerably over the next several reporting periods. As compared with many of the other required data elements, however, we expect information about substance abuse to be problematic for some time. Whereas elements such as the child's placement setting, case goal, or characteristics have long been part of States' own administrative data systems and transfer reasonably well to AFCARS, documentation of the problems that led to the child's foster care placement has not traditionally been included in automated child welfare information systems. Because reporting these items is not familiar to State and local agencies, it will take them longer to report these data reliably. In addition, it will be difficult to make cross-state comparisons because States may use varying thresholds to decide when substance abuse "contributes" to the foster care placement. Some States may be reporting only drug exposed infants under these data elements, while others report any case in which substance abuse is either part of the allegation or is documented. In States where at least some alcohol and drug data are being reported in AFCARS, there was no consistent pattern regarding either child and family characteristics or the child's experiences in the child welfare system. In most States, substance abuse-related cases looked quite similar to other cases, although under-reporting of substance abuse could have diluted any differences which might exist.
A few smaller studies in particular localities have also examined parental substance abuse as a factor in families with children in foster care. Walker and her colleagues in a study of children in foster care in 1986 found that substance abuse was noted in the case files for 18 - 52 percent of African American children in foster care, varying by city. In general, just over one-third of the children in foster care in New York, Miami, Seattle, Detroit and Houston had a parent with a substance abuse problem that was mentioned in the case file (Walker, et al, 1991; Walker et al, 1994).
While most analyses of data regarding children in foster care look at individual children rather than sibling groups, we must also recognize that many children in foster care are from larger families. Recent analyses of data from California find that of 1,600 newborns entering foster care in that State because of neglect or abandonment, nearly 60 percent had siblings already in care, totaling over 2,500 siblings (Barth, 1997).