P0091 - Housing Instability Among Families and Caregivers of Children in Foster Care

Background: Housing instability is defined by experiencing at least one of four circumstances in the past 12 months: two or more moves, inability to pay rent/mortgage/utilities, needing to stay with others due to difficulty paying bills, or a history of homelessness. Children subjected to housing instability are more likely to have poorer physical health, exacerbated chronic conditions, behavioral problems, and increased hospitalizations. Children entering foster care also tend to have poorer mental and physical health in comparison to children who have never been in foster care. A study of housing needs of grandparent caregivers concluded that, “poverty and financial strain was found to be the overarching threat to securing and maintaining safe, affordable housing that is suitable for raising grandchildren.”

Hypothesis: We hypothesized that kinship caregivers of youth enrolled in the Care4Kids (C4K) program were more likely to acknowledge having circumstances associated with housing instability and were more likely to accept housing resources.

Aims: Assess the rate of housing instability of families/caregivers of foster children enrolled in Care4Kids Foster Care Medical Home Program. Offer community resources (directed toward addressing housing needs) to caregivers identified as having housing instability. Compare rates of housing instability for different categories of caregivers.

Methods: Triweekly review of the Care4Kids database to identify children enrolled in the C4K program who met criteria for study inclusion (removed from and placed in Milwaukee County). The study included children that entered foster care, changed placement, or re-enrolled in C4K between July and December 2019. Caregivers of identified children were interviewed regarding move frequency, inability to pay rent/mortgage/utilities, needing to stay with others due to difficulty paying bills, and history of homelessness in the past 12 months, as a part of the introduction to Care4Kids. Survey data was entered and stored into a RedCap database. Caregivers who screened positively for housing instability were offered a referral to the Children’s Community Health Plan housing navigator. Caregivers who did not screen positively were also able to request and receive a housing referral.

Results: From July-December 2019, 161 caregivers were surveyed (86% consented to participation). There were 47 homes where multiple eligible children resided. 68/138 (49%) consenting caregivers were kinship caregivers, 63 (46%) were non-relative caregivers, and 7 (5%) were reunified caregivers. 15 kinship, 1 non-relative and 3 reunified caregivers screened positively for housing instability; 4 kinship and 3 reunified caregivers desired referrals to housing resources. 13 caregivers (7 kinship and 6 non-relative) did not screen positively for housing instability but desired a housing referral.

Conclusion: Housing instability was most common for kinship caregivers. Since more caregivers requesting housing referral had a negative screen for housing instability, the screening tool may not be the optimal for identifying those families truly needing support.