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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
Phil Basso
is the
deputy executive
director of the
American Public
Human Services
Association.
Rebecca Griesse
is senior manager
of Programs at The
National Campaign
to Prevent Teen
and Unplanned
Pregnancy.
Jamie Muñoz
is administrative
manager II at the
Orange County
Social Services
Agency's Children
and Family Services
Division.
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,
Policy&Practice
October 2016
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