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Foster Care

A SYSTEM OVERLOADED: THE FOSTER CARE CRISIS

"The children are now buffeted by countless rejections and severe stress. They often become angry, depressed, and violent. Few of them understand that they are the littlest victims of a system that, by all accounts, has been overwhelmed" (The New York Times, March 15, 1987).

Seemingly on a daily basis, especially in our larger cities, newspapers report the crisis in foster care. State departments of social services are being sued for neglecting children in their care, caseworkers are being accused of malfeasance, and children placed in foster care for their own best interests are reported to have experienced further abuse and some have died. Pediatricians who care for foster children, and who need as well to be their advocates, should understand the foster care system—its origins, mandates, objectives, and how well it has fared.

Although its roots are in the English Elizabethan Poor Law of 1601, foster care as we know it today in the United States grew out of the federal initiative Aid to Dependent Children which was enacted as title IV-A of the Social Security Act of 1935. The objective of this entitlement program was to provide financial assistance to widows and widowers with children to avoid the breakup of families because of economic hardship.

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