The British Journal of Social Work

Mendes,, Philip;Rogers,, Justin

doi: 10.1093/bjsw/bcaa028pmid: N/A

Abstract Young people transitioning from out-of-home care (generally called care leavers) are recognised globally as a vulnerable group. In the last eighteen months, four Australian jurisdictions have extended state care till twenty-one years in an attempt to advance the life opportunities of this cohort. These initiatives are strongly influenced by extended care programmes in the USA and England, which have reported improved outcomes for care leavers. This article interrogates formal public evaluations of these extended care programmes with a particular focus on their eligibility criteria that have determined which groups of care leavers are included or alternatively excluded and the identified strengths and limitations of the programmes. Additionally, we consider cross-cultural differences in leaving care populations and variations within the broader social policy context of these jurisdictions, which may also impact on the effectiveness of policy transfer. Some conclusions are drawn about key factors that may enhance the success of extended care programmes. care leavers, eligibility criteria, extended care, policy transfer, transitioning from out-of-home care Introduction Young people transitioning from out-of-home care (OOHC), often called care leavers or care experienced young people, are recognised universally as a disadvantaged group who have generally not received the ongoing support from responsible carers and other adults that they require to transition successfully into adulthood. Numerous research studies have reported adverse outcomes in relation to core life domains such as stable and affordable housing, health care, supportive social relationships and engagement in education, training and employment (Jones, 2019; Mann-Feder and Goyette, 2019; Stein and Munro, 2008; Stott, 2013; Woodgate et al., 2017). Their challenges reflect a combination of three factors. First, many if not most enter OOHC due to significant childhood maltreatment and trauma. Second, many experience inadequate care within the OOHC system, including major instability of placements and carers (Cocker and Allain, 2019). Third, most leave care at eighteen years old or even younger and do not receive the ongoing relationship-based and practical assistance offered by most families in the community up to and even well beyond twenty-five years of age. In fact, many abruptly lose their limited existing supports from carers and other community connections whilst being expected to move rapidly to independent living (Jones, 2019). These ‘accelerated and compressed transitions’ to adulthood make it difficult for them to access mainstream educational, employment, housing, health and other development and transitional ‘pathways to adulthood’ (Stein, 2016, p. v). This is not to argue that care leavers are all the same, and destined to fail. In fact, their backgrounds, experiences and outcomes vary considerably according to their family background, the nature of maltreatment experienced pre-care, the context of their entry into care, their cultural and ethnic backgrounds (taking into account that Indigenous children are represented in disproportionate numbers in at least Australia, New Zealand, Canada and the USA), their OOHC experiences, their individual capabilities when leaving care, the presence of special needs such as physical or intellectual disability or poor mental health and the level of formal professional and informal family or community supports available to them as they transition from care. The prominent UK scholar Stein (2012) developed a widely applied framework that broadly classified care leavers into three groups. The first he calls the ‘moving-on group’ (p. 170) who probably comprise about 20 per cent of care leavers. Youth in this group are likely to have had positive OOHC experiences involving stable and supportive relationships with carers, and a gradual preparation for leaving care. They welcome the assistance provided during their transition to independence and actively participate in further or higher education. Young people in this group are likely to have experienced secure and stable placements, be highly resilient, welcome independence and able to make effective use of leaving and aftercare supports. Those who have ‘moved on’ in Australia include leading academics, media personalities, journalists, sports stars, such as Australian Rules footballer Josh Jenkins, and politicians, such as former Tasmanian Premier David Bartlett. The second group Stein terms ‘survivors’ (p. 171) who probably comprise about 60 per cent of care leavers. They are likely to have experienced placement instability, and to have left care at a younger age with limited planning and few support networks. However, they are still able to benefit over time from professional and community assistance. The ‘strugglers’ (p. 172) are the third group who appear to comprise about 20 per cent of care leavers. They are likely to have had traumatic pre-care experiences and may experience major social and emotional deficits. A significant number in this group experience homelessness, involvement in youth and adult criminal justice systems, poor mental health, substance abuse, long-term reliance on income support payments and social isolation. Nevertheless, specialist after-care services remain an important form of assistance in the absence of other supportive relationships. Stein (2012) also notes that these categories are fluid, and some youth may have difficult initial transitions but later be able to take advantage of growing maturity and effective support services to ‘move on’ into the mainstream. They need to have the same opportunity as their non-care peers to test limits and make mistakes without losing ongoing support from the key adult figures in their lives (Mendes and Snow, 2016). Historically, most countries have provided only limited leaving care or post-care support services, which often only include short-term provisions to meet basic needs such as financial support and assistance with finding accommodation. However, over the last two decades, there has been increasing global awareness of the needs of care leavers, and an expectation that care will continue beyond eighteen years. Consequently, most Western countries and many other jurisdictions have introduced new bills or expanded existing policies and services to assist care leavers (Mendes and Snow, 2016). One particular form of upgraded assistance has been the introduction of extended care programmes in some jurisdictions which allow young people to remain in OOHC until twenty-one years of age or older. These programmes are viewed as providing young people with a more normative transition process based on developmental capacity, rather than chronological age, that is likely to facilitate improved outcomes (Burley and Lee, 2010; Collins, 2015; Jones, 2019; McGhee, 2017; Stein, 2012). They seem to reflect the influence of social investment ideas (Morel et al., 2012), whereby greater resources are invested in these young people in an attempt to facilitate their inclusion into the social and economic mainstream, rather than allowing them to fall into entrenched long-term disadvantage. A summary of existing extended care programmes in a number of jurisdictions is presented in Supplementary Table One. In the analysis that follows, we discuss the recent introduction of extended care programmes in Australia and the strong influence on these programmes via what is called ‘policy transfer’ (Alcock, 2001) from existing extended care programmes in England and the USA. Traditionally, Australia, England and the USA have been identified as belonging to the same group of ‘liberal’ welfare states. These states are typified by selective, residual public benefits and market provision of welfare services, with minimal social citizenship rights guaranteed outside participation in the labour market (Esping-Andersen, 1990). However, in practice, it is arguable that Australia and England maintain stronger social safety nets for disadvantaged young people (however, limited) than the USA (Castles, 2010). For example, both Australia and England have mandatory universal health insurance schemes, whereas Medicaid in the USA is limited to designated low-income groups and varies across states. Similarly, young people aged eighteen to twenty-five years who are either studying or unemployed in Australia and England have access to income support payments, but this is not the case in the USA, see Supplementary Table two. These distinctions may have significant policy implications in that care leavers in Australia and England should at least in principle be able to draw on broader social welfare supports in addition to extended care services, whereas youth leaving care in the USA may be more reliant on specific entitlements linked to extended care programmes. Australian leaving care policy Australia has a federal model whereby OOHC is managed by child protection services in each state and territory that have their own legislation, policies and programmes. As of June 2018, there were over 47,000 children in OOHC nationally, of whom the majority (90 per cent in total) were either in relative/kinship care or foster care. Only about 6 per cent lived in residential care homes supervised by rostered staff. Indigenous children were vastly over-represented in OOHC, comprising over one-third of the total population or eleven times the proportion of non-Indigenous children (AIHW, 2019). It is estimated that approximately 3,130 youth nationally aged fifteen to seventeen years transition from care each year (AIHW, 2017). The Commonwealth Government recommends, but does not enforce, minimum benchmarks such as the expectation for all youth to have a leaving care plan commencing at fifteen years of age. They are currently funding a three-year Independent Adulthood Trial in the state of Western Australia which is intended to enhance the social and economic well-being of care leavers. Currently, all jurisdictions provide post-care support beyond eighteen years on only a discretionary, rather than mandatory, basis (Baidawi, 2016). Numerous Australian studies have reported that youth leaving care experience poor outcomes because they lack sufficient maturity and living skills at eighteen years to live independently; often have limited engagement in education; leave care directly into the homeless persons system; or are involved in offending and the criminal justice system (see summary of concerns in Mendes, 2019; Mendes and McCurdy, 2019). Additionally, Indigenous care leavers may experience disconnection from their culture and identity (Krakouer et al., 2018; Mendes et al., 2019). However, four states are now trialling forms of extended care until twenty-one years for selected groups of care leavers. Both Tasmania and South Australia are funding foster care placements till twenty-one  years. Western Australia commenced a trial programme supporting twenty young people in May 2019, and Victoria introduced a pilot programme in September 2018 providing extended support to 250 young people over five years, whether transitioning from foster care, residential care or kinship care (Mendes, 2019). The Victorian programme includes three components: an accommodation allowance; caseworker assistance based on regular relationship-based contact; and a funding package that assists youth to acquire key education, employment and training and health supports (Department of Health and Human Services, 2019). The other four jurisdictions—New South Wales, Queensland, the Northern Territory and the Australian Capital Territory—have not established extended care programmes at this stage. The four extended care programmes were introduced in response to the Home Stretch campaign, led by Anglicare Victoria, to urge all Australian jurisdictions to offer extended care programmes till at least twenty-one years. They have used a range of advocacy strategies including public forums and launches, media interviews, presentations to numerous conferences, meetings with State and Commonwealth politicians, and publications of research reports presenting a cost–benefit analysis (Mendes, 2018). Home Stretch have highlighted positive findings from extended care programmes in the USA, the UK and Canada to support their social and economic case for extended care. For example, a 2016 report referred to beneficial outcomes from England and California as a rationale for introducing similar programmes in the State of Victoria. To be sure, Home Stretch added that these programmes varied in terms of whether extended care was offered to those leaving residential care as well as foster care, and also whether restrictive eligibility conditions were imposed such as participation in education or training. Hence, they emphasised that the model introduced in Victoria would need to address the specific needs of the local OOHC cohort. According to Home Stretch, extended care would provide major economic benefits including reduced homelessness, less hospitalisation, fewer care leavers arrested and general improvements in physical and mental health and social connections (Anglicare Victoria, 2016). An associated Home Stretch report examined the details of extended care programmes in all the countries of the UK (England, Wales, Scotland and Northern Ireland), the USA and Canada. This report also noted variation around eligibility conditions and placement types, but added that most schemes allowed young people to move into independent living but still retain an option for later returning to OOHC before their 21st birthday. This flexibility was identified as important for protecting the rights of care leavers (Baidawi 2016). Given the major focus within the Australian leaving care policy debate on ‘policy transfer’ (Alcock, 2001) from England and the USA, we have chosen to examine in depth the extended care programmes and outcomes in those jurisdictions. A number of databases were used to locate relevant scholarly studies, public reports and broader grey literature on extended care using search terms such as ‘extending out-of-home care’, ‘extending foster care’ and ‘Staying Put’. In the next section, we explore why a trial of Staying Put was introduced in England, the results of that trial as reported by the formal evaluation and the subsequent outcomes of the ongoing programme. We then duplicate this process for extended care programmes in the USA. Leaving care policy in England As of March 2018, there were just over 75,000 children in OOHC in England. Seventy-three per cent were in ‘foster placements’, 11 per cent were in ‘secure units, children’s homes or semi-independent living arrangements’ and 6 per cent were living with parents. About 3 per cent were placed for adoption. Nearly 11,000 young people aged seventeen and eighteen years left care in 2018 (Department for Education, 2018, p. 7). England introduced the 2000 Children (Leaving Care) Act 2000 in October 2001. The Act was intended ‘to improve the life chances of young people living in and leaving care’ and to replicate the supports that responsible parents would be expected to provide for their children (Department of Health, 2001, p. 6). It extended the expected age of leaving care from sixteen to eighteen, and obliged local authorities to continue to provide advice and support for young care leavers up to the age of twenty-one, and even to twenty-four years for those still in education and training. In short, the intention was to delay the transition from care until young people were prepared and ready to leave. The Act introduced an expectation of corporate parenting responsibility to provide ongoing support to care leavers to promote better outcomes (Department of Health, 2001). Overall, the Act significantly extended the duties and powers of the earlier Children Act 1989 which had imposed new responsibilities on local authorities to advise and support youth leaving care (Department of Health, 1991), but left the implementation of that support open to discretion (Stein, 2012). In contrast, local authorities were now obliged by the Act 2000 to assess the needs of all young people in care and introduce a Pathway Plan at the age of sixteen years to identify the services required to meet those needs and provide a clear pathway to independence. Furthermore, the authority was required to appoint a Personal Adviser who would work with the young person until they are twenty-one years old and coordinate the resources and services required to meet the Pathway Plan (Wade and Munro, 2008). The new Act influenced the introduction of service reforms that produced a mixture of positive and negative results. There appeared to be an increased number of young people in further education, and a reduction in the numbers of ‘those not in education, training or employment’ (Stein, 2012, p. 23). In addition, there seemed to be gains in accommodation, financial support, improvements in life skills and development of social networks, and staffing for leaving care services. However, there were still inconsistencies in the ‘funding, range and quality of services’ (Stein, 2012, p. 23). There remained too many young people not engaged in education or employment-related activities; a lack of specialist supports for young people with complex needs such as those with a disability or mental health concerns and a lack of suitable accommodation (Wade and Munro, 2008). One of the key responses to these concerns was the introduction of a form of extended care: the Staying Put programme which commenced as a pilot from 2008 to 2011 in eleven local authorities, and was later legislated as an ongoing duty on all local authorities in England on 13 May 2014, in part 5 Welfare of Children (98) of the Children and Families Act 2014. This ‘requires local authorities to facilitate, monitor and support arrangements’ for fostered young people until they reach the age of twenty-one, ‘where this is what they and their foster carers want’, unless the local authority considers that the Staying Put arrangement is not consistent with the welfare of the young person (House of Commons Education Committee, 2017, p. 18). The three stated objectives of the Staying Put pilot were to facilitate a more gradual and normative pathway to adulthood; to enable young people to optimise achievements in ‘education, training and employment’; and to give ‘weight’ to the views of young people on the timing of their move from care to independence (Munro et al., 2012, p. 6). The Staying Put model presented two conditions for inclusion. One was an established family-type relationship with a former foster carer. Eight out of the eleven local authorities formally required this model, whereas three local authorities implemented a hybrid model that did not demand this pre-existing relationship. Additionally, four of the six local authorities that were reviewed in-depth required a formal commitment to participate in education, employment or training, and one specified education or training but not employment. Albeit three of those five authorities allowed exemptions on the grounds of poor health, participation in voluntary work, or cessation of a course or job. The other authority did not impose this condition due to a concern that it may exclude more vulnerable groups of young people with complex needs (i.e. those with emotional and behavioural difficulties who have experienced considerable placement instability), that were the most likely to require ongoing assistance (Munro et al., 2012). A research team led by Munro completed an evaluation of the Staying Put trial in 2012. They used mixed methods in their evaluation such as interviews with managers; interviews with young people both in and not Staying Put; interviews with ‘current or former foster carers’ and ‘leaving care personal advisers’; focus groups and verification surveys with social care practitioners; and analysis of quarterly data submitted to the Department for Education (Munro et al., 2012, p. 6). Two methodological limitations were acknowledged. One was the relatively small number of interviews with young people not Staying Put (only eleven) as opposed to twenty-one interviews with the Staying Put group. The other was that most of the Staying Put samples had not yet moved into independent living, so it was not possible to judge whether extended care had better prepared them for that transition (Munro et al., 2012). The researchers reported systemic benefits of the Staying Put programme such as stable and supportive relationships providing ongoing emotional support to young people who are not developmentally ready for adulthood at eighteen years (National Care Advisory Service, 2012); and greater housing stability which facilitates engagement in education or training and employment including improved access to higher education, and enables young people to undertake a gradual transition not dissimilar to their peers in the broader community. These positive outcomes should result in both individual and societal benefits, including higher future earnings and less reliance on income support payments by the young people, and associated savings in government expenditure (Munro et al., 2012; NCAS, 2012). Following a vigorous ‘Don’t Move Me’ campaign coordinated by the Fostering Network, the national government allocated 42.4 million pounds to fund the first three years of Staying Put from 2014 to 2017 across every local authority in England (Cann, 2014). The annual funding for Staying Put in 2019–2020 is nearly 24 million pounds (Department for Education, 2019). Significant numbers of care leavers (more than 1,500) have utilised the Staying Put Scheme each year. In 2016–2017, 51 per cent of young people were ‘still living with their former foster carers three months after their 18th birthday’, plus 25 per cent of nineteen year olds, and 18 per cent of twenty year olds (HCEC, 2017, p. 18). However, by March 2018, the number of eighteen year olds remaining with their foster carers had declined to 46 per cent which was the lowest proportion since the programme was introduced (Donovan, 2018; Ofsted, 2018). The latest figures indicate slight increases. About 1,800 care leavers or 55 per cent of eligible youth were still residing with their former carers three months after they turned eighteen. This figure reduced to 31 per cent for nineteen year olds, and 21 per cent for twenty year olds (Department for Education, 2018; Roberts, 2018). There is currently no formal evaluation of the ongoing Staying Put programme, but informal analysis by researchers and policy advocates has raised a number of concerns around the policy implementation including the following: Inadequate resources allocated by the national government to organise and support Staying Put placements. This has produced unreasonable financial pressure on local governments to make up the shortfall (Fostering Network, 2016; House of Commons Education Committee, 2017; Lepper, 2015; Stevenson, 2015). Foster carers not receiving an adequate minimum allowance, compared to that paid for fostering younger children, which gives them an incentive to participate. For example, some carers have experienced a major drop in weekly income which is particularly challenging for those who work full-time in that role. There has been an associated pressure on young people to contribute financially by claiming housing benefits or via other means (Cumberland, 2014; HCEC, 2017; Roberts, 2018; Stevenson, 2015; Williams, 2017). The variability of implementation at local level including senior managers and social workers in some authorities failing to provide satisfactory planning and support (Donovan, 2018; Lepper, 2015; Roberts, 2018; Stevenson, 2015; Williams, 2017). Some ambiguity about whether or not placements would be retained for young people who move to attend university, or accept training or employment offers, but still need to return during the long holidays or at other times (Fostering Network, 2016; Williams, 2017). An additional limitation is that approximately 9 per cent of youth leaving residential care (called children’s homes in England) cannot access the Staying Put programme (Stevenson, 2015). These youth are often the most disadvantaged group in the OOHC system, having experienced large numbers of placements and presenting with deep-seated emotional and behavioural challenges (Munro, 2019; Rogers, 2015). However, the government rejected an extended version of Staying Put on the grounds that it would be inappropriate for young adults to inhabit the same residence as younger children, and also that it would be enormously expensive costing about 142 million pounds over three years (Narey, 2016). This economic argument has been challenged by activists and groups of care experienced people. For example, Every Child Leaving Care Matters (ECLCM) are a campaign group who have lobbied the government to extend Staying Put for residential care leavers, on the grounds that the current approach promotes a two-tier system that disadvantages vulnerable care leavers from residential settings (ECLCM, 2018). By way of compromise, the government announced a plan to introduce a Staying Close scheme whereby youth transitioning from residential care (Narey, 2016) would live nearby their former homes to maintain existing positive relationships with their former carers (Department for Education, 2016; Lepper, 2016). A two-year Staying Close pilot started in 2018 supporting 120 care leavers, and this has been recently extended to 2019–2020 to reach eight sites across England. The Staying Close programme is currently being evaluated and the report is due for publication in March 2020. At present, there does not seem to be any information available on a planned date for an ongoing version of Staying Close. Leaving care policy in the USA As of August 2018, there were nearly 443,000 children living in ‘foster care’ in the USA, which is used as the general term for OOHC. Seventy-seven per cent resided in ‘foster family homes’ with either relatives or non-relatives and thirteen per cent in ‘group homes’ or ‘institutions’. The remaining 10 per cent lived in ‘pre-adoptive homes’, ‘supervised independent living’ or were on ‘trial home visits’ or classified as ‘runaways’. Only 2 per cent were of American Indian/Alaska Native background. Just over 17,000 young people transitioned from OOHC at eighteen years of age (United States Department of Health and Human Services, 2018, p. 1). There are no specific studies of the transition from care experiences of Native Americans, although one national study of independent living services utilised by care leavers found that Native American young people generally access more supports than other groups (Okpych, 2015). The USA introduced the Foster Care Independence Act in December 1999 which expanded assistance including room and board for young care leavers aged eighteen to twenty-one years, bolstered access to Medicaid (the health insurance programme for low-income Americans) for care leavers, provided additional funds for education and training, and increased state accountability for care leavers’ outcomes. The Act was a significant improvement in terms of offering greater support to meet care leavers’ needs around access to housing, health services in particular mental health services, and education and training (Courtney and Hughes Heuring, 2005; Courtney, 2019; Jones, 2019). However, Courtney (2019) has emphasised two major limitations of the Act: its failure to fund the core material needs of care leavers transitioning to independence and the absence of any federal funding commitment to state parental responsibility beyond the age of eighteen years. Consequently, the USA enacted the Fostering Connections Act in 2008 as a form of extended care, which aimed to extend the Foster Care Independence Act by ‘giving states and nationally recognized Native American Tribal Nations the option of maintaining young people in foster care until 21 years’ (Courtney 2019, p. 134). The programme has strict eligibility criteria in that participating youth are required to be completing secondary school or an equivalent programme, or enrolled in post-secondary or vocational education, or participating in a programme or activity that promotes or removes barriers to employment, or employed eighty hours a month, or incapable of school and/or work requirements due to a documented medical condition (Courtney, 2019). However, there seems to be little information available as to whether or not vulnerable young people involved in substance abuse or experiencing poor mental health are able to qualify for this exemption (Stott, 2013). Nevertheless, by July 2017, half the states (twenty-five in total) and the District of Columbia had adopted this option of extending care till twenty-one with federal financial assistance (Children’s Bureau, 2017; Jones, 2019). Mark Courtney and colleagues completed two separate evaluations of the benefits of extended study in the USA. The first study, known as the Midwest evaluation of the adult functioning of former foster youth, compared the outcomes for care leavers in Illinois where extended care till twenty-one years was already available, to outcomes for a similar cohort in Iowa and Wisconsin where OOHC ended at eighteen years of age. That study collected five waves of data from 2002 to 2011 based mostly on detailed personal interviews with young people at seventeen or eighteen, nineteen, twenty-one, twenty-three or twenty-four and twenty-six years of age. Researchers found evidence of improved educational outcomes, higher employment and wage outcomes, reduced risk of homelessness between seventeen and nineteen years, lower rates of early pregnancy and parenting, greater engagement of male parents with their children and reduced rates of criminal offending for young women (Courtney, 2015, 2019; Dworsky et al., 2013 ). Their more recent study, known as the California youth transitions to adulthood study or CalYOUTH, used mixed methods to examine the impact of extended care in California, which has the biggest population of youth in care post-eighteen years in the USA (Courtney, 2019). The researchers completed three waves of interviews with young people at ages sixteen to seventeen, nineteen and twenty-one; conducted online surveys of child welfare workers; collected administrative records from California’s child welfare services/case management system covering areas such as employment, education, receipt of government aid, health care and criminal justice; and accessed college enrolment records from the National Student Clearinghouse (Courtney et al., 2016; Courtney and Okpych, 2017). They identified specific benefits of extended care such as enhanced educational outcomes, improved earnings and less economic hardship, fewer early pregnancies, lower levels of homelessness, reduced involvement in the criminal justice system, and greater involvement of non-custodial fathers with their children (Courtney, 2019; Courtney and Okpych, 2017; Courtney et al., 2016; Courtney et al., 2018; Okpych and Courtney, 2019). Nevertheless, there were no statistically significant associations between extended care and outcomes for general physical health, mental illness, drug and alcohol abuse, food insecurity, early parenting for males or females, experience of physical victimisation or formal completion of college semesters or degrees (Courtney, 2019; Courtney and Okpych, 2017; Courtney et al., 2018). This finding has led researchers to recommend that more regular caseworker support may be required to assist young adults in extended care, given that they are no longer able to access daily support from adult caregivers (Courtney, 2019; Courtney et al., 2018). There may also be a need to extend care well beyond twenty-one years of age to enable young people to complete degrees and/or other forms of training and personal development (Okpych and Courtney, 2019). The researchers above suggest that the utility of extended care programmes may relate closely to their provision of basic support services pertaining to food, housing, health care, education and income support generally that are not guaranteed by the US safety net (Courtney, 2019). They also acknowledge some limitations in their respective studies. First, the findings concerning Illinois and California may not be transferrable to other states, which implemented extended care programmes in different ways that resulted in differences between the capacity of the care leaver populations entering extended care, and/or offer varied social safety nets (i.e. concerning access to Medicaid, employment and housing) that differ from those two states (Courtney, 2019; see also Jones, 2019; Miller, 2018). Second, it is probable that the relatively strict eligibility criteria for inclusion in extended care programmes means that the young people selected for those programmes were already more likely to fit into Mike Stein’s ‘moving-on’ category, whereas those excluded from the extended care option in Illinois, California and other participating states may fall into the more vulnerable ‘struggling’ and ‘survivor’ categories (Courtney et al., 2016). That second limitation seems to be substantiated by an evaluation of the extended care programme in Washington which reports that participants were more likely than young people who transitioned from care at eighteen years of age in that state to have strong educational outcomes, stable placement experiences and minimal involvement in offending (Burley and Lee, 2010). A further qualification is raised by Jones (2019), whose review of research studies on extended care in the USA suggests a ‘self-selection process’, whereby ‘high-functioning youth’ are more likely to engage with extended care programmes and ‘high-risk youth’ involved in substance abuse or offending are less likely to do so (p. 17). In short, the findings concerning benefits may reflect the influence of varied pre-care or OOHC experiences as well as the specific impact of extended care. In contrast to England, our search for grey literature did not identify any informal or unofficial reviews which may have provided further detail on the effectiveness of the application of extended care programmes in the USA and/or reflection on the differences between the various states. Discussion and conclusion The limited but growing feedback from existing extended care programmes seems to be mostly positive. Those young people willing and eligible to participate are provided with an opportunity for stability and continuity via existing relationships with supportive adults, which optimise their chances for successful transitions including positive engagement with education and/or employment, and lower the prospects of negative outcomes such as homelessness. To be sure, the impact of extended care programmes may vary considerably according to the social and cultural characteristics of the care leaver population in that jurisdiction, the eligibility conditions imposed for participation and the wider social safety net supports available within the jurisdiction. Inclusive criteria and effective resourcing are essential to ensure that all groups of care leavers, rather than only Stein’s ‘moving-on’ group, can access the benefits of extended care. Conversely, the strict eligibility conditions currently applied in a number of jurisdictions can mean that the most vulnerable care leavers with the worst OOHC experiences and highest support needs, including limited opportunity to participate in education or employment, are directly excluded from extended care (Munro et al., 2016; Munro, 2019; Stott, 2013). In planning implementation, authorities need to identify and fund real costs to carers, taking into account cost–benefit analysis which shows that the financial cost of not providing extended care may be far higher in the longer term (McGhee, 2017). It is also important to maximise opportunities for participatory co-design with young people so that their lived experience of key needs and priorities can inform the development of extended care programmes (Matheson, 2018). An ongoing monitoring and review of the effectiveness of policy and practice implementation is also vital. This includes prioritising the development of a skilled workforce to support care leavers backed by senior management leading and driving programme improvement (McGhee, 2017). Additionally, young people who move away in the short term to attend university, join the army or accept employment offers, should be enabled to return to the carer’s residence during holiday or other breaks no differently to their non-care peers (Welsh Government, 2016). The major policy implication for Australia is that extended care needs to be applied universally to include youth leaving all forms of care: foster, kinship and residential care. And given that many vulnerable care leavers may choose not to engage with extended care programmes at eighteen years of age, it seems important for extended care to offer the flexibility for young people to return to care at nineteen or even twenty years old at the point when they have matured and are ready to engage. Policy makers should actively examine and learn from the experiences of all other jurisdictions offering extended care programmes, including not only England and the USA as discussed above but also Scotland which is the only country currently offering extended residential care. Ideally, a national Australian extended care programme would be introduced by the Commonwealth to ensure that it was available in all States and Territories, and that youth who moved from one location to another were still eligible to participate. Additionally, Australian extended care programmes will need to develop strategies that meet the specific needs of the large number of Indigenous care leavers seeking to reconnect with culture and identity, and draw on the knowledge base from other countries such as Canada and New Zealand which also have large numbers of Indigenous youth leaving care (Atwool, 2016; Fast et al., 2019). 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