P&P October 2016

Orange County, California With more than 3 million residents, of which 23 percent are under the age of 18, Orange County is California’s third most populous county, and the sixth most populous in the United States. Orange County has California’s sixth highest number of youth in foster care at about 2,200, of which 42 percent are 12 to 21 years of age; and of which 14 percent are 18 to 21 years of age in Extended Foster Care. Two years ago, Orange County joined five other counties in an 18-month learning community to reduce the rate of pregnancy among youth in foster care—the California Foster Youth Pregnancy Prevention Institute, a project of the John Burton Foundation

which clarified child welfare social worker responsibilities and authority to support healthy sexual develop- ment of youth and young adults in foster care. 2. Keep current with up-to- date information Reading about diverse perspectives helps develop a deep understanding of how mistimed pregnancies affect the multigenerational life trajectory; learn about engagement and interven- tion innovations; and keep informed about new data to consider for course adjustments. See Appendix 1 for some of our favorite sources for additional reading. 3. Get the full picture At the beginning, we were so singu- larly focused on reducing pregnancy and sexually transmitted infection that we confused this with our end goal. We then realized that pregnancy pre- vention was a breakthrough strategy to realize improved successful tran- sition to adulthood outcomes (e.g., education, employment, income, and childrearing). See Figure 1, which presents this strategy from a “social determinants of health” lens. We integrated strategies throughout child welfare practice by providing common ground, shared resources, cohesion, and deeper anchoring of the interventions. For example, we strengthened existing strategies that help youth and young adults anchor a future outlook through access to services and normalcy activity consis- tent with the Youth Thrive Framework, including interventions focused on sexual and reproductive health. 4. Complete a readiness assessment Assess the political landscape, key stakeholders (e.g., internal and external leadership, social workers, youth, parents, foster and kinship caregivers), and accessible resources to identify quick wins to galvanize momentum, identify minefields, determine first steps, and develop a malleable

in partnership with the American Public Human Services Association and The National Campaign to Prevent Teen and Unplanned Pregnancy. When we started, we did not know how many youth in foster care were pregnant or parenting and we did not have a written policy to guide social workers. Over the next two years, Orange County obtained increasing clarity and we are pleased to share some key lessons we’ve learned: 1. Contact the experts In addition to the John Burton Foundation’s expertise in California’s transition age youth in foster care, the American Public Human Services Association’s expertise in organiza- tional change and effectiveness, and The National Campaign to Prevent Teen and Unplanned Pregnancy’s expertise in pregnancy prevention, the California Foster Youth Pregnancy Prevention Institute also enlisted teen reproductive health law expertise from the National Center for Youth Law, pregnancy and parenting among foster youth data expertise from the Children’s Data Network, and evidence- based intervention exper- tise. These helped clarify urgency and authority to act and, thereby, facili- tated responsibility to act. These were especially critical during the formative stage to inform policy development and strategic planning, and to solidify local internal and external support. For example, these helped answer questions like… „ „ What is the prevalence of pregnancy and parenting among youth and young adults in care compared to their peers not in care? „ „ How do we compare with other counties? „ „ What is the cost of doing nothing? „ „ What is the cost of doing something? „ „ What are contributing factors? „ „ What are tried-and-true interventions? „ „ What are the rights and responsi- bilities of youth, their parents, and child welfare services, and under what conditions do they exist? In California, we were supported by the passage in 2014 of Senate Bill 528,

Jamie Muñoz is administrative manager II at the Orange County Social Services Agency's Children and Family Services Division.

Rebecca Griesse is senior manager of Programs at The National Campaign

to Prevent Teen and Unplanned Pregnancy.

Phil Basso is the deputy executive director of the American Public Human Services Association.

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