When children are removed from their homes, state or local child welfare agencies are typically responsible for coordinating their placement and provision of services. State or local child welfare agencies may also contract with private child welfare agencies to help them administer child welfare services. Child welfare agencies often place children in a foster home or in group care settings, depending on the child’s needs. Children placed in foster families may live with unrelated foster parents, relatives, or fictive kin (e.g., close family friends who are not relatives). Group care settings— also known as congregate care—typically include group homes and child care facilities that provide 24-hour care and/or treatment for groups of children. For example, these settings may include child care institutions, residential treatment facilities, or maternity homes, according to HHS. Child welfare agencies may provide foster caregivers with a monthly payment (referred to as a foster care maintenance payment) to help cover the costs of a child’s care, as determined by each state. Children generally remain in foster care until a permanent suitable living arrangement can be made, either by addressing the issues that led to the child’s removal and returning the child to his or her family; or through adoption, guardianship, placement with a relative, or another planned permanent living arrangement. In some cases, the child reaches adulthood before leaving foster care, commonly referred to as “aging out” of foster care. Historically, aging out typically occurred at age 18, but some state-funded programs implemented prior to the enactment of the Fostering Connections Act in 2008 allowed youth to remain in care beyond their 18th birthday. Title IV-E of the Social Security Act authorizes federal funding to state child welfare agencies to help cover the costs of operating their foster care programs. ACF administers title IV-E and oversees states’ foster care programs for compliance with IV-E requirements. Title IV-E is the largest single federal source of funding for child welfare programs, comprising about 89 percent of federal child welfare appropriations in fiscal year 2017 (approximately $7 billion of nearly $7.9 billion), according to ACF. Under title IV-E, states can access funding for their foster care programs in a few ways. Title IV-E reimbursements: Title IV-E funds may be used to reimburse states for a portion of expenses to support the daily care and supervision of eligible youth in foster care (such as for food, clothing, and shelter). The eligibility requirements generally limit reimbursements under title IV-E to youth that were removed from homes with very low incomes, among other criteria. However, some states have received waivers from certain title IV-E funding requirements to carry out HHS-approved demonstration projects. According to HHS, under these waivers states receive a capped allocation of title IV-E funds for youth in foster care, and these funds are generally reserved for youth under age 18. Chafee Program funds: The Chafee Program provides funding to states, under title IV-E, for support services that are intended to assist eligible youth in the transition to adulthood. Chafee Program funds are allocated to each state based on the state’s proportion of the nation’s foster care caseload. Through the Chafee Program, states can offer services to youth who have experienced foster care at ages 14 or older, youth who are likely to age out of foster care, and certain older youth who have aged out or left the foster care system. States generally have flexibility in determining the goals, strategies, and other features of their Chafee programs, as long as states design and conduct their programs based on the key purposes outlined in the law. Chafee Program services may include help with education, employment, financial management, housing, and emotional support through mentoring. State and county child welfare agencies may contract with private entities to provide these services. Up to 30 percent of a state’s Chafee Program allotment may also be used for room and board costs for certain eligible youth. According to HHS data, services provided under the Chafee Program may vary by state, including the extent to which states provide room and board financial assistance services. While title IV-E is the primary source of federal funding available to states for child welfare programs and services, states may also use other federal funds, such as title IV-B of the Social Security Act, Temporary Assistance for Needy Families (TANF) and Social Services Block Grant funds, as well as Medicaid. State child welfare agencies also generally combine state and local funds with federal funds to support their programs. According to a state survey funded by the Annie E. Casey Foundation and Casey Family Programs, in state fiscal year 2014, 43 percent of all child welfare expenditures were from federal sources, and 57 percent were from state and local funds. Since the Fostering Connections Act was enacted in 2008, HHS has as of February 2018 approved 26 states and six federally recognized tribes to claim title IV-E funding to extend foster care to youth ages 18 to 21. According to ACF, most of these states (19 of 26) began offering federally funded extended care between 2010 and 2012, with one state beginning to provide extended care as recently as 2018. States have several different options for implementing their extended care programs. For example, in order to be eligible for extended care, title IV- E requires a youth to meet at least one of five employment or education conditions specified in the statute. States can choose to use all or some of these conditions to determine which youth are eligible for their extended care program (referred to in this report as “eligibility criteria”). In addition, states can utilize supervised independent living settings for youth in extended foster care—a placement setting not typically available for federal reimbursement for youth under age 18. (See table 1 and fig. 1). The amendments made by the Fostering Connections Act permit states to use title IV-E funds to place eligible youth age 18 or older in supervised settings in which the youth live independently. According to a research brief sponsored by ACF, supervised independent living settings are unlike other foster care placement options (such as foster homes and group homes) because they are primarily intended for youth in extended care. States may place youth under age 18 in supervised independent living settings, but, as previously noted, they generally may not seek federal reimbursement for foster care maintenance payments for youth under 18 in such settings. According to ACF’s program instructions for implementing the Fostering Connections Act, state child welfare agencies have the discretion to develop a range of supervised independent living settings which can be reasonably interpreted as consistent with the law, including whether such settings need to be licensed and any safety protocols that may be needed. These instructions state that child welfare agencies may determine that—when paired with a supervising agency or supervising caseworker—host homes, college dormitories, shared housing, semi- supervised apartments, or other housing arrangements meet the supervised setting requirement. Youth in such settings may not have onsite caregivers and often have increased responsibilities, such as paying bills, assuming leases, and working with a landlord, according to ACF documentation. However, youth may receive foster care services, such as financial support and case management, to help them become successful adults. Additionally, ACF encouraged child welfare agencies to continue to work with youth who are in supervised independent living settings to ensure that youth form permanent connections with caring adults. This could include exploring options for guardianship, adoption, or living with other caring adults, and helping youth work towards those outcomes. In response to our survey, all 26 extended-care states reported offering a variety of supervised independent living arrangements as a placement option for older youth in care, with most of the options falling largely in two broad categories—transitional living programs and private residences—in addition to a range of other types of supervised independent living settings (see fig. 2). Overall, across 21 of the 26 extended-care states for which we analyzed placement data, about 34 percent of youth in foster care who were ages 18 to 21 were placed in supervised independent living settings in state fiscal year 2017 (see appendix I for additional information). Twenty-three of the 26 extended-care states reported that they offer transitional living programs as a type of supervised independent living arrangement. Generally, officials said these programs provide youth with the opportunity to practice daily independence and may include on-site case management and high levels of support built into regular programming. Supports may include experiential learning activities to build independent living skills, such as grocery shopping and budgeting. Local officials in California told us that transitional living programs are a stepping stone to independence, and they encourage older youth to start in one of these programs before living on their own. In our discussion groups with youth in extended care, youth told us transitional living programs helped them gradually move towards more independence and learn how to pay bills on their own. Officials we spoke with in the five selected states—California, Illinois, Maryland, New York, and Tennessee—described transitional living programs that use single-site or scattered-site models, or both, ranging from a group of youth living in a single family home to youth living in apartments dispersed across a geographical area (see table 2). Local caseworkers may continue to check in with youth in both single-site and scattered-site transitional living programs, but private agencies operating these programs are typically responsible for providing more frequent case management and supervision, according to officials in the selected states (see text box). One youth in a scattered-site program in California told us that he meets with his county case worker every couple of months, but he meets with program staff on a weekly basis and sometimes several times a week. Examples of Single-Site and Scattered-Site Transitional Living Programs in Selected States Single-site program: Officials from a single-site, all-male program in Tennessee described it as a family-like environment. Youth in the program live in cottages and house managers live in private quarters attached to the cottages. Program participants have their own bedrooms, and share bathrooms and common areas such as the kitchen. Youth over age 18 do not require 24-hour supervision, but have 24-hour access and daily interaction with the house managers. Youth typically receive an allowance of $150 per month (reduced to $100 if they are employed) to purchase personal items such as hygiene products. Scattered-site program: Officials from a private agency in California explained that their agency holds master leases on one- and two-bedroom apartments across Los Angeles and Alameda counties for youth who have demonstrated their readiness for more independence. An education and employment specialist or youth advisor meets with youth living in these apartments once a week, but youth can access program staff via phone anytime and are encouraged to attend activities at the agency’s main site. Youth receive a monthly stipend for personal expenses and their rent is paid by the program, but they are encouraged to work to manage additional living expenses. Those who stay in the program until they age out of foster care may remain in the apartment and take over the lease. Officials and representatives of private agencies we spoke with in four of the selected states said that they have transitional living programs specifically for certain populations that need specialized support. For example, Illinois officials described programs in their state that specialize in serving youth with mental illnesses, youth who are developmentally delayed, pregnant or parenting youth, youth who are dually involved with child welfare and justice systems, and youth with problematic sexual behaviors, such as sexual offenders. (See sidebar.) State and local officials we spoke with in the selected states said that youth who are ready to practice living more independently, in many instances with no on-site supervision, may live in private residences. Youth in these settings may choose where they would like to live, in comparison to youth in transitional living programs whose options may be limited to the apartments and facilities offered by the programs. Officials said that youth may live in apartments or private homes that are integrated in the community, and they are often responsible for signing their own lease or rental agreement. According to officials in the selected states, the level of supervision provided to youth living in private residences varies, but is generally less than youth in transitional living programs. Officials we spoke with in all five selected states confirmed that, at a minimum, case workers are expected to have monthly, in-person contact with youth. These visits are typically to confirm if youth are still in their living arrangement, and to determine if youth are experiencing any challenges, such as limited access to resources in their community. However, officials said that some youth may receive more frequent case management and supervision, such as youth who have behavioral or mental health conditions. For example, officials at one private agency in Illinois told us their staff have weekly check-ins with youth who require legal assistance or have mental health needs. State and local officials in two states mentioned that in addition to monthly in-person contact, case workers typically have more frequent communication with youth via phone calls, texting, or video conferencing. If youth are located far away to attend college or pursue other opportunities, caseworkers may use these alternative modes of communication to maintain contact and provide support. For example, a case worker for a private agency in Illinois told us that she video chats with her client twice a week, and communicates via text messaging and email several times a week, to provide support for this college student living in a private residence while studying abroad. Generally, states vary in the types of settings they allow for private residences, according to our survey results. Among the 26 extended-care states, the most common types of settings states reported offering include living in a shared apartment or home with a friend or roommate (25) or living in a private apartment or home (24). Most states reported that they also allow supervised independent living arrangements where a young person lives in a foster family home (20) (see text box). Living Arrangements with Current or Former Foster Parents In response to our survey, most states reported that they allow youth in supervised independent living arrangements to live with a foster parent. Officials in two states mentioned that because these placements are considered supervised independent living settings, youth are eligible to receive a stipend directly from the child welfare agency for rent and living expenses. The youth and their foster parent(s) may establish a rental agreement so the youth can practice paying rent. In three states, officials also said that they provide foster families with information and resources to teach and demonstrate independent living skills, such as cooking and cleaning a home. State and local officials said this arrangement allows youth to remain connected to a supportive adult, while also learning to live independently. In our discussion groups with youth in extended care, one youth told us that living with a foster family can be a good choice when a youth has a good bond with the foster parents, and when the foster parents allow the youth to have more independence. Youth in private residences typically receive a stipend to pay for their rent and other costs, according to our survey results. States reported that stipend amounts ranged from $421.80 to $1,715 per month. However, states reported having different expectations for youths’ responsibilities in covering their living expenses. Officials in some states said they require youth to supplement their stipend with income from their employment to cover living expenses. Officials in other states said they may encourage youth to work because the stipend may not be enough to cover most of their housing and other costs. Officials in one county said that youth may receive up to $850 per month but that amount may be adjusted based on the income they earn while attending school. In another state, officials reported that youth are expected to pay at least $50 towards their rent and, depending on the young person’s budget and financial obligations, the child welfare agency typically pays the difference directly to the landlord. One youth we spoke with in Illinois said that while working and going to school part-time, he built up his savings with help from the stipend that he received from the child welfare agency. States also reported allowing youth to live in a variety of other types of supervised independent living arrangements. According to our survey, other types of supervised independent living arrangements include college dorm rooms (22 states), Job Corps or employment training programs (21), single room occupancies (19), or mental health or substance use treatment facilities (15). Officials we spoke with said that they continue to provide case management and supervision to youth in these placements, and may also support youth with a stipend to assist with living expenses. Additionally, they said that when colleges go on break during the winter or summer, case workers work with youth to find a temporary placement if needed to ensure there is no lapse in housing. Temporary placements may include living with former foster parents, friends, or renting their own apartment. Supervised independent living settings are primarily intended for youth age 18 and older in extended care; however, some states also reported allowing these arrangements for youth under 18. In response to our survey, 19 of 26 states reported allowing youth under age 18 to live in supervised independent living arrangements. State and local officials said that in instances when youth under 18 are placed in supervised independent living arrangements, they are generally placed in college dorms or transitional living programs. In one state we visited, a transitional living program official said that the program accepts youth as young as 15 years old in a very few instances. (See table 3.) Local officials and case workers said that they place youth under age 18 in supervised independent living settings on a case-by-case basis if their case worker determines that the young person is mature and capable enough to manage living with less supervision (see text box). In response to our survey, 17 states reported that when youth under age 18 are placed in supervised independent living settings, they generally receive additional supervision or supportive services compared to youth 18 and older. Two states reported that no additional supervision or supportive services are provided for youth under 18 in independent living arrangements beyond those provided to youth ages 18 to 21. Officials we spoke with in three of the five selected states provided examples of the additional supports they offer to younger youth in these settings. Officials at one private agency in Tennessee told us that if youth under 18 in their transitional living program are unable to ride the bus to high school, program staff will transport them to school. State officials in California said that generally, youth under 18 living in transitional living programs receive more hands-on support. Officials at one private agency in California said the supports provided to youth under 18 in their transitional living program include 24 hour access to on-site program staff and weekly meetings with their case manager. Officials in Maryland told us youth under 18 living on their own receive additional case management support to evaluate how the youth is adjusting to living on their own, and to provide additional guidance on budgeting and household management. While many states allow youth under age 18 to live in supervised independent living settings in certain circumstances, over half of all extended-care states (15 of 26) reported that the typical age that youth enter this placement type is 18. Officials in three of the selected states said that even when the state allows it, these arrangements are not often used for youth under 18. Additionally, officials we spoke with reported that highly independent settings, such as their own apartment, are typically reserved for youth age 18 or older. Most states we surveyed reported considering youths’ readiness, such as life skills, education, and employment status, when placing youth in supervised independent living arrangements. Officials we spoke with in four of the five selected states similarly noted that supervised independent living is most appropriate for youth who have demonstrated their readiness. These officials also noted that they consider the availability of housing options, including for youth with complex needs, which can affect youths’ placement in supervised independent living arrangements. Life skills. In response to our survey, most states reported considering youths’ life skills when placing youth in supervised independent living. Specifically, 19 states reported requiring or recommending that youth participate in an assessment to gauge their mastery of certain life skills, such as the ability to budget finances or schedule medical appointments. For example, state officials in California said they developed an assessment form with questions such as whether youth understand the risks associated with using credit cards, can shop for food and prepare meals, and know how to do laundry. Caseworkers in one California county said that they consider youths’ ability to manage their living costs and their rental responsibilities prior to approving a supervised independent living placement. Education and employment. Most states also reported considering education and employment when placing youth in supervised independent living. Specifically, 16 states reported requiring or recommending that youth have a high school diploma or General Education Development certificate, or be enrolled in secondary or post- secondary school, in order to be placed in supervised independent living. Additionally, 17 states reported requiring or recommending that youth be employed or enrolled in a job training program. For example, in Illinois, youth who want to live in private residences must have a job for at least 45 days prior to being referred for placement, and continue working for at least 15 hours per week while in the private residence. Five states reported considering other indicators of readiness beyond life skills, education, and employment when placing youth in supervised independent living settings. For example, the District of Columbia reported requiring that youth (1) have no pending or unresolved criminal proceedings at the time they apply for supervised independent living, and (2) have a checking account with a minimum balance of $100 and actively participate in the child welfare agency’s financial literacy program. Availability of housing options, including for youth with complex needs. State and local officials in two of the five selected states said that they may place youth in private residences as a default or short-term option when no other living arrangements are available for youth age 18 or older. For example, officials in Tennessee said that transitional living programs and other housing options for youth outside of metropolitan areas are more limited. To ensure that youth in these areas do not experience homelessness, the officials said they may rely on other living arrangements, such as providing youth with stipends to live in private residences. Additionally, officials in New York and California said in certain localities, there may be constraints offering certain supervised independent living settings due to a lack of affordable housing. For example, officials in one San Francisco area county said some youth who want to live independently choose to move to a different part of the state, or even out of state, because their stipend for a private residence is insufficient to afford an apartment there. Officials in all selected states also said that there are shortages of foster parents willing to provide care for youth ages 18 to 21, which can generally affect their options for living arrangements. State and local officials from all five selected states also cited challenges finding housing options that are equipped to serve certain subpopulations of youth with complex needs, such as youth with acute mental health needs, youth that are also involved in the juvenile justice system, and pregnant and parenting youth. For example, local and private agency officials said state child welfare agencies may require parenting youth in supervised independent living settings to be in larger apartments, which may be too costly to afford. In addition, officials in four selected states said private agencies may be less likely to accept youth with acute mental health conditions or youth involved in the juvenile justice system if the agencies do not have the resources to address their needs. In addition to these considerations, officials we spoke with in all five selected states and other stakeholders said they consider the importance of giving youth in extended care greater involvement in decision making as they become adults. Local officials in California said they believe in allowing youth to take risks and experience the challenges of living independently while they have support from the child welfare system. Similarly, local officials in Tennessee said that giving youth choices in their living arrangements and considering their needs and goals is important for keeping them engaged in extended care. Most (24 of 26) extended-care states we surveyed reported using title IV- E funds to support youth in supervised independent living arrangements. Most (19 of 26) states also reported using Chafee Program funds, which primarily support independent living services, to fund supervised independent living arrangements. For example, state officials in Tennessee said that in certain situations when youth need to secure an apartment quickly, officials may use Chafee Program funds to help with the deposit. Officials in Illinois told us that they also use some Chafee Program funds for room and board, particularly for youth who are not title IV-E eligible. In addition to title IV-E and Chafee Program funds, most states reported using a combination of sources, including other federal funds such as those available under title IV-B of the Social Security Act, as well as state and local funds, to pay for supervised independent living arrangements. All states reported using state funds for supervised independent living (see fig. 3). Although most states reported using title IV-E funds to support supervised independent arrangements, in several states, few youth in extended care (regardless of their living arrangement) were eligible for title IV-E funding. In 14 of the 17 extended-care states for which we calculated eligibility rates, we found that the majority of youth ages 18 to 21 in care were not eligible for title IV-E reimbursement in state fiscal year 2017, meaning that the state was responsible for most or all of the cost of their care. We found that six of the states had title IV-E eligibility rates of 30 percent or lower. Two states, Virginia and Hawaii, had eligibility rates of over 70 percent (see fig. 4). State officials we spoke with in three of the five selected states said that ineligibility frequently stems from family income exceeding the income limit for title IV-E funding. Specifically, title IV-E is limited to youth removed from homes that would have qualified for cash assistance under the Aid to Families with Dependent Children (AFDC) program as of July 16, 1996. To receive title IV-E funding, youth must have met eligibility requirements at the time they were initially removed from their home, or at the time of their voluntary placement agreement. ACF has reported that fewer families meet the AFDC income standards over time, thereby reducing the number of all youth who are eligible for title IV-E funding, regardless of their age. In 2018, we reported on declining title IV-E eligibility rates for the entire population of youth in foster care. Officials we spoke with in Illinois and Tennessee said they reconsider a youth’s title IV-E eligibility once the youth turns 18, using the youth’s income at that point in time. Officials from these two states told us they close the original foster care case when a young person turns 18 and then reopen the case when the young person re-enters extended care. Using this approach, officials said they can base the title IV-E eligibility determination on the youth’s income at the time of re-entry into the foster care system, rather than the income of the home from which the youth was removed upon initially entering foster care. Illinois officials said this process helped increase the eligibility of their extended-care population by more than 30 percent since 2012. Officials we spoke with in the remaining three selected states said they do not use this approach. ACF officials said that states can choose to close and re-open cases for youth in extended care, which would allow new eligibility determinations based on a youth’s income. However, ACF officials said they do not monitor states’ choices in this area, or how states’ choices affect their title IV-E eligibility rate. Officials said they focus on helping states identify options and provide examples in ACF program instructions so states can determine what works best with their own policies and procedures. Four states (Arkansas, Indiana, Maryland, and Massachusetts) reported in our survey not claiming title IV-E reimbursements for any youth in extended care in state fiscal year 2017. Officials in two states, Indiana and Maryland, reported not claiming title IV-E funds for youth in extended care at least in part because they use a title IV-E waiver. However, according to ACF, states can claim title IV-E reimbursements for youth over 18 in addition to their waiver funds, so these two states may be able to claim additional title IV-E funds for their extended care population. State officials in Arkansas told us they have not yet established the proper procedures, internal controls, and monitoring mechanisms to allow them to claim title IV-E funds for youth in extended care. Officials said they do not have systems to track when youth may have lost their jobs or dropped out of school, which could affect the youth’s eligibility for extended care. To help youth develop independent living skills and successfully transition out of care, state and local officials in four of the five selected states reported offering targeted training and support for youth ages 18 to 21. For example: Officials in one Maryland county said they offer youth nearing age 21 a 3-week intensive training focused on employment and housing called “Keys to Success.” According to officials, Keys to Success offers experiential learning through cooking demonstrations, budgeting and financial literacy training, group trips to stores to look at furniture or interview-appropriate clothing, and housing fairs. (See fig. 5.) Officials from Youth Villages, a national nonprofit organization, said they offer the organization’s intensive YVLifeSet program to youth in extended care in Tennessee. The program generally lasts six to nine months and pairs youth with a specialist to meet with weekly to help them achieve their goals for independent adulthood. For example, to help youth maintain employment, officials said specialists can help youth build skills such as how to handle conflict with supervisors or coworkers, provide customer service, and understand job expectations, among others. In Illinois, the state’s “Countdown to 21” program is intended to encourage youth to plan for long-term education and vocational goals, and promote their financial stability through financial literacy training. All youth, at age 19, are referred to the financial literacy training, which covers topics such as credit and investing, and officials said most youth complete the training prior to exiting extended care. Officials in one California county said they offer youth ages 18 to 21 an annual public transportation pass through the Youth on the Move program, to ensure they can get to work or school. According to ACF, some extended care states also have a specialized case management system for youth over 18. For example, officials from one county in Maryland told us that all youth in foster care are automatically enrolled in a supervised independent living case management track when they turn 18. This case management system is intended to identify a youth’s areas of need and design a plan to prepare them for living independently, regardless of their current living arrangement. Youth in extended care can also participate in independent living services that are offered more broadly to all older youth in foster care. Officials in all five selected states reported offering services that support youth in extended care in their housing, education, financial literacy, and employment goals, as well as offering health education, mentoring, and training on daily living skills (e.g., grocery shopping and budgeting). Examples of types of services the selected states reported offering to all older youth include: Housing. Officials from Youth Villages described how their organization assists youth in Tennessee to learn to find and maintain stable housing. For example, Youth Villages specialists work with youth to search for affordable housing options, develop a housing budget, complete applications, and address background check issues. Specialists also help youth build and maintain relationships with roommates and landlords. Education. County officials in New York described how a local community college helps youth complete financial aid forms, and conducts college day simulations and resume-building workshops. Financial literacy. County officials in Maryland told us they offer classroom instruction on financial literacy which includes how to understand financial aid, good banking practices, and how to asses loans and grants. Employment. In California, county officials told us about several programs they offer to help youth meet their employment goals, such as a youth worker program in which 16- to 21-year-olds are hired to rotate through different county departments for 18 months. Health. County officials in Maryland told us they offer yoga classes and other stress reduction techniques, as well as outings to local clinics for youth to learn about family planning resources. Mentoring. County officials in California told us they host weekly social events to establish community connections between youth in care, and youth have regular meetings with supportive adults focused on building connections with family and friends. Daily living. Officials at a private agency in Illinois told us the youth in their housing programs have a set schedule to participate in different life skills activities, such as cooking, doing laundry, and other chores. Although officials in all five selected states said they offer a variety of training and supports to help youth in extended care develop independent living skills, officials in these states also said that youth may experience challenges using these skills. For example, officials said youth in private residences may have difficulty covering their living expenses, which can lead to evictions. A New York county official said some youth living on their own may struggle with the lack of structure and the amount of independence in making their own decisions and setting their schedule. For these youth, officials said the child welfare agency will increase the level of case management, and offer additional support or services. To best support the development of independent living skills in youth in extended care, officials we spoke with in all five selected states said they use assessments such as the Casey Life Skills assessment, transition planning, or regular check-ins to determine youth goals, direct youth to services to meet their needs, and to measure their progress. A county official in New York described how private child welfare agencies use the Casey Life Skills assessment every 6 months for youth in care to target services to areas in which the youth needs to build skills. Through its Ready by 21 program, Maryland has yearly independent living benchmarks for youth, starting at age 14. Officials we spoke with said that caseworkers can use these benchmarks to assess a youth’s progress towards living independently, create an individual service plan based on their progress, and direct youth to additional resources as needed (see fig. 6). In addition, title IV-E requires that caseworkers assist youth with developing a transition planning document. According to state and local officials, youth periodically meet with their caseworkers to discuss their progress on their goals, and caseworkers may provide additional guidance and support as needed during these meetings. For example, a caseworker in Tennessee described providing youth funds for driver’s education classes and licenses, prom expenses, and extracurricular activities, based on conversations with youth about their needs. Officials we spoke with in all five states also discussed providing financial incentives to encourage youth to participate in independent living services. For example, according to officials in Illinois, if youth complete the financial literacy course offered by the state child welfare agency, they receive $1,200 when they exit care. County officials in Maryland described participating in the Jim Casey Opportunity Passport program. In this program, officials said, youth who complete financial literacy training are eligible for a matched savings program of up to $3,000 to purchase an asset, such as a car. In our discussion groups with youth in extended care, youth told us that they are responsible for taking the initiative to participate in services, but financial incentives are helpful. Youth told us that as a result of these incentives, as well as other supportive savings programs, some are able to exit care with substantial savings. We provided a draft of this report to HHS for review and comment. In response, HHS provided technical comments, which we incorporated as appropriate, but did not provide general comments on the draft report. As agreed with your offices, unless you publicly announce its contents earlier, we plan no further distribution until 30 days from its issue date. At that time, we will send copies of this report to interested congressional committees and to the Department of Health and Human Services. In addition, the report will be available at no charge on the GAO website at http://www.gao.gov. If you or your staff have any questions about this report, please contact me at (202) 512-7215 or larink@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. GAO staff who made key contributions to this report are listed in appendix II. Figure 7 below presents the total number and percentage of youth in extended care by living arrangement (referred to as placement type) during states’ fiscal year 2017. Table 4 and Figure 8 present the number and percentage of youth in extended care by state and placement type during each state’s fiscal year 2017, respectively. Placement types include foster family homes with relatives or non-relatives, group homes or institutions, supervised independent living arrangements, and other types of arrangements. Figure 7, Table 4, and Figure 8 present information for 21 extended-care states. We excluded five of the 26 extended-care states we surveyed because they reported point in time data that did not reflect their entire state fiscal year 2017, or they reported data that were not reliable for the purposes of our analysis. To develop Figure 7, Table 4, and Figure 8, we assessed the information we collected in our survey of extended-care states on youth ages 18 to 21 for whom the state child welfare agency had responsibility for placement, care, or supervision during states’ fiscal year 2017. We administered the survey to state child welfare agencies in the 26 states approved by the Department of Health and Human Services (HHS) to offer federally funded extended care as of February 2018. The survey was conducted between August and October 2018 and we obtained a 100 percent response rate. Specifically, we asked states to provide data on the number of these youth in care by placement type. In addition, we asked states to provide data on the number of youth under age 18 that were placed in supervised independent living or other independent living arrangements. To ensure the quality and reliability of the survey, we pretested the questionnaire with three extended-care states to check (1) the clarity and flow of the questions, (2) the appropriateness of the terminology used, (3) if the information could be easily obtained and whether there were concerns about the reliability of data that would be collected, and (4) if the survey was comprehensive and unbiased. We revised the questionnaire based on the pretests. We reviewed responses to assess if they were consistent and contained all relevant information, and followed up as necessary to determine that states’ responses were complete, reasonable, and sufficiently reliable for the purposes of this report; we excluded data where we had concerns about their reliability. In addition to the contact named above, Sara Schibanoff Kelly (Assistant Director), Aimee Elivert (Analyst-in-Charge), Ada Nwadugbo, and Alexandra Squitieri made key contributions to this report. Also contributing to this report were Lucas Alvarez, Sarah Cornetto, Erik Gartland, Jean McSween, Mimi Nguyen, Jessica Orr, Jerry Sandau, and Almeta Spencer. Foster Care: Additional Actions Could Help HHS Better Support States’ Use of Private Providers to Recruit and Retain Foster Families. GAO-18-376. Washington, D.C.: May 30, 2018. Foster Care: Most Tribes Do Not Anticipate Challenges with Case Goal Changes but HHS Could Further Promote Guardianship Assistance. GAO-16-625. Washington, D.C.: August 8, 2016. Higher Education: Actions Needed to Improve Financial Access to Federal Financial Assistance for Homeless and Foster Youth. GAO-16-343. Washington, D.C.: May 19, 2016. Foster Care: HHS Could Do More to Support States’ Efforts to Keep Children in Family-Based Care. GAO-16-85. Washington, D.C.: October 9, 2015. Foster Care: HHS Needs to Improve Oversight of Fostering Connections Act Implementation. GAO-14-347. Washington, D.C.: May 29, 2014. Child Welfare: States Use Flexible Funds, but Struggle to Meet Service Needs. GAO-13-170. Washington, D.C.: January 30, 2013. Foster Youth: HHS Actions Could Improve Coordination of Services and Monitoring of States Independent Living Programs. GAO-05-25. Washington, D.C.: November 18, 2004.

Summary: Youth who leave the foster care system at age 18 are often ill-prepared to live on their own and may face challenges as they transition to adulthood, such as difficulties finding stable housing. The Fostering Connections to Success and Increasing Adoptions Act of 2008 allowed states to receive federal reimbursement through title IV-E of the Social Security Act for a portion of the cost of extending care to certain eligible youth up to age 21. The Act also allows youth ages 18 up to 21 to live in a supervised setting in which the individual is living independently. One such setting may be an apartment, with monthly check-ins with a case worker (referred to as supervised independent living arrangements). GAO was asked to review supervised independent living arrangements and services for older youth. Among other things, this report examines (1) the types of supervised independent living arrangements available; (2) factors states reported considering when placing youth in these living arrangements; and (3) how selected states prepare youth to live independently. GAO surveyed state child welfare agencies in the 26 states approved by the Department of Health and Human Services (HHS) to receive federal funding to support their extended foster care programs; interviewed state and local child welfare officials and stakeholders in five states selected for factors such as variation in child welfare administration systems; reviewed relevant federal laws, regulations, and guidance; and interviewed HHS officials. The 26 states that have approval to receive federal funding to support their extended foster care programs for youth ages 18 up to 21 reported providing a range of supervised independent living arrangements. These arrangements include transitional living programs, private residences, and other settings (see figure). Officials we spoke with in five selected states said transitional living programs typically involve private child welfare agencies that lease apartments or facilities for youth, either at a single site or scattered across a geographic area, and offer on-site case management and supports to help youth build independent living skills. For private residences, youth may choose where to live, such as a private or shared apartment. In these cases, youth are typically responsible for their own lease, and may receive minimal supervision compared to youth in transitional living programs. For other settings, states reported options such as college dorms and residential employment training programs. Nineteen states also reported allowing youth under 18 to live in supervised independent living settings in certain instances, such as when they are pregnant, parents, or attending college, although such placements are generally not eligible for federal funding. Factors that most states reported considering when placing youth in supervised independent living arrangements include the youth's life skills—for example, their ability to budget finances and schedule medical appointments—as well as their education and employment status. Officials in selected states also said they consider the availability of housing, which may be limited in certain localities due to a lack of affordable housing options or other factors, and the options available to youth with complex needs, such as those who are pregnant and parents. Officials in four selected states said they help prepare youth in extended foster care to live independently by providing targeted trainings and other supports, such as financial literacy training. In all five selected states, youth can also learn independent living skills through services offered more broadly to all older youth in foster care, officials said, including assistance with housing, education, employment, and daily living skills, such as grocery shopping and budgeting.