Ch.7 Evolving IssuesCh.7 Evolving Issues web_admin Thu, 12/23/2021 - 16:12
Author: Charles J. Kehoe, ACSW, CCE
Internationally known futurist Edward Barlow, Jr. always began his presentations with this statement: “Eighty percent of what you need to know to be successful in your career is happening outside of your chosen field.” Mr. Barlow reminds us that it is not enough to know about trends only in our own profession, but we must also understand the global trends that are changing the world. Events outside the field are changing the way juvenile detention centers, juvenile correctional facilities, adult local detention centers (jails), and adult correctional facilities (prisons) do their work.
For instance, since the 1980s, many of the poorest areas on the planet, including Sudan, South Sudan, and Somalia have suffered brutal civil wars and genocide. Thousands of men, women, and children have been murdered, died from the resulting famine and disease, or fled their homeland as refugees. Juvenile detention and corrections professionals might have had little awareness of the impact these distant events would have on their work lives.
Many churches and faith-based organizations reached out as humanitarians to the starving and disenfranchised refugees of this conflict and brought them to the U.S. In cities like Columbus, Ohio, Omaha, Nebraska, and Sioux Falls, South Dakota, the victims of these wars and rebellions were given an opportunity to start life over.
Over time, some of the children of the refugees became caught up in the juvenile justice system. Some had very limited English speaking ability. Communication between residents and staff became a challenge. In most juvenile detention and correctional facilities, resident handbooks are in English and Spanish, but in these communities, juvenile detention and juvenile correctional administrators published their handbooks in several different languages. Staff in these facilities received training on the different ethnic and cultural groups they were now exposed to in their jobs, but learning several languages was clearly beyond their reach. In addition, the Post Traumatic Stress Disorder (PTSD) these young people experienced challenged even the most experienced mental health professionals. The unintended consequences of bringing refugees out of a deadly environment into a much different world and culture had a significant impact on juvenile detention centers and juvenile correctional facilities.
In addition, documented and undocumented families from Central American nations and others continue to be swept up in enhanced immigration law enforcement. The crackdown on illegal immigration has resulted in more young people being held in the child welfare and juvenile justice systems, including with some private providers. There is a small fraction of youth held in juvenile detention facilities if they have been taken into custody for a delinquent or criminal act. In some cases, foreign-born youth who commit serious crimes may be tried as adults and serve their sentences in adult correctional facilities.
Prior to 2000, juvenile detention directors, juvenile correctional administrators, and wardens and superintendents of adult facilities would not have predicted that their facilities would serve a multi-national resident population, but less than 15 years later, it is more common than not to have them doing just that.
Today, the administrators of confinement facilities for youth are fully engaged in strategic planning, which means they are regularly defining and redefining their facility’s purpose, mission, vision, and goals and identifying the best strategies to accomplish these goals and realize their mission. Strategic planning involves identifying and allocating precious resources.
Planning cannot be done in a vacuum. Administrators must understand that their facilities are a microcosm of the larger society; this applies to both the employee culture and the resident culture.
One approach administrators should use is “environmental scanning.” Brown and Weiner define environmental scanning as “a kind of radar to scan the world systematically and signal the new, the unexpected, and the major and the minor.” Management consultant, Ray Gagnon said, “There’s no doubt that defining the future for an enterprise is one of the most important obligations of leadership. There’s also little doubt that actually conducting the strategic planning process by which this takes place is one of leadership’s most challenging activities.” According to James L. Morrison, the goal of environmental scanning is to alert decision makers to potentially significant external changes in time to formulate a response. Consequently, the scope of environmental scanning is necessarily broad.
Environmental scanning requires an analysis of the organization’s mission, vision, strengths, weaknesses, customers, organizational wellness, employee turnover, and financial performance. The next level of analysis should be the larger profession or business to which the organization belongs. Understanding public attitudes about the profession, analyzing recent passed and failed legislation at the local, state, and federal levels, monitoring trade associations and what vendors are planning for the future all contribute to an a better understanding of the environment. It is also useful to identify key competitors, their performance, and competitive advantages. Juvenile detention and correctional facilities and adult facilities that serve youth should be aware of developments in the public and private sectors; creative ideas happen in both. An analysis of the external environment considers direct and indirect influences from the social, technological, economic, environmental, and political arenas (STEEP).
Scanning can take many forms. Some employees do a very passive or informal environmental scan as they read newspapers and magazines, listen to programs on the radio or television, or surf the internet. Unfortunately, the information learned from this passive approach is seldom incorporated into the strategic planning process, which means that events and trends that signal changes are often ignored or completely missed.
Active environmental scanning focuses on data, trends, and information from not just the immediate business or industry, but the larger global environment. For some organizations, scanning is more ad hoc and may focus on a specific issue that is a priority for the organization. As part of more regular planning process, some organizations periodically refresh their regularly scheduled environmental scanning process. Other organizations, however, are continuously scanning the environment to share with the administration and management information can be incorporated into the ongoing strategic planning process. Obviously, most juvenile detention and juvenile correctional facilities do not have the resources to conduct continuous environmental scans. Morrison states, “The rationale undergirding active scanning is that potentially relevant ‘data’ are limited only by your conception of the environment. These data are inherently scattered, vague, and imprecise and come from a host of sources. Since early signals often show up in unexpected places, your scanning must be ongoing, fully integrated within your institution, and sufficiently comprehensive to cover the environments important to your decision makers.”
The National Institute of Corrections (NIC) Information Center assists correctional policy makers, practitioners, elected officials, and others interested in corrections issues. Information Specialists who have professional experience in corrections provide expert research assistance with full access to materials in the NIC library collection.
The NIC Information Center began environmental scanning of social, technological, economic, and corrections issues in the late 1990s. The purpose of the scanning was to provide information and data to aid in the development of NIC programs. The related report—Environmental Scan 2012: 7th Edition—has become a valuable resource for juvenile and adult correctional administrators. Staff from the Information Center review corrections publications, as well as more popular newspapers, magazines, and websites and regularly monitor publications and reports from local, state, national, international, and independent sources. Some of the report’s findings are described later in this chapter.
Another very valuable resource is the Annie E. Casey Foundation’s KIDS COUNT Data Book. This annual report tracks trends along four domain levels based on what children need to survive. Those domains are economic well-being, education, health, and family and community. The findings from the Data Book will also be described in greater detail later in this chapter.
The number of scanning resources available on the Internet is virtually limitless, but the following are some that may be of value when considering a more global view of the future:
Arlington Institute https://www.arlingtoninstitute.org/
Brain Reserve https://www.faithpopcorn.com/
Now and Next https://www.nowandnext.com/
Pew Research Center https://www.pewresearch.org/
Shaping Tomorrow http://www.shapingtomorrow.com/
Strategic Business Insights http://www.strategicbusinessinsights.com/
The Tomorrow Project http://tomorrow-projects.com/
The World Future Society https://www.worldfuture.org/
Trend Watching https://www.trendwatching.com
As previously stated, the evolving issues in confinement facilities for youth relate to those issues that are happening outside those facilities. Although there may be some issues that are evolving within the confinement facilities for youth, in the majority of cases, the forces that are creating and shaping significant changes are coming from the outside. The remainder of this chapter will review some of the issues that will directly impact confinement facilities for youth.
Tracking birth rates is an important way to identify early trends for many different fields. Baby food companies, children’s clothing companies, pediatric healthcare organizations, toy manufactures, and theme parks are among the enterprises that closely monitor changes in birth rates. Most school districts, cities, counties, and states use this information in their strategic planning efforts. Juvenile detention and correctional facilities can easily find current trends for their state and locality by consulting the local health department and national websites. The birth rate forecasts dynamic aspects of the population as it matures, such as the future demand for the workforce in various sectors of the economy.
The U.S. birth rate hit an all-time low in 2012, with 63.0 births per 1,000 women ages 15–44. In 2011, the birth rate was 63.2. This represents the fifth consecutive year when the birth rate has declined and the lowest year since the government started keeping records in 1909.
Falling birth rates create challenges for the economy and future labor pools, as there will be fewer young workers in about 20 years. Since 2007, U.S. birth rates have been below the level required to maintain a constant population. In 2013, the Wall Street Journal reported that “low fertility means less growth in a country’s population, barring a pickup in immigration. Fewer people can mean fewer workers to propel the economy and a smaller tax base to draw from to pay the benefits due retired Americans.”
Peter Drucker, regarded as one of the foremost management leaders in the world, wrote about declining birth rates, saying that “politically, this means that immigration will become an important—and highly divisive—issue in all rich countries. It will cut across all traditional political alignments. Economically, the decline in the youth population will change markets in fundamental ways. Growth in family formation has been the driving force of all domestic markets in the developed world, but the rate of family formation is certain to fall steadily unless bolstered by large-scale immigration of younger people. The homogeneous mass market that emerged in all rich countries after the Second World War has been youth-determined from the start. It will now become middle-age-determined, or perhaps more likely it will split into two: a middle-age-determined mass market and a much smaller youth-determined one. And because the supply of young people will shrink, creating new employment patterns to attract and hold the growing number of older people (especially older educated people) will become increasingly important.”
The Wall Street Journal went on to report, “Birth rates for women in their early 20s declined to a new record low between 2011 and 2012. The average age of a U.S. mother at first birth rose, again, to 25.8 years old, from 25.6 years in 2011.”
The decline in the U.S. and global economies is causing many young people to delay getting married, to postpone having children, or to have fewer children. Many young couples simply cannot afford the cost of a family. In addition, there are also more young women in the workforce.
Teen births have shown significant declines over the last several decades. The decline began after 1991, falling by nearly half (61.8 births per 1,000 youth ages 15–19 in 1991 to 31.3 in 2011). There were over 329,772 births to teen mothers ages 15–19 in 2011, the lowest number since 1946, when 322,381 births to teens were recorded. For younger girls ages 10–14, the rate declined from 1.2 in 1970 to 0.4 in 2011.
The Annie E. Casey Foundation’s KIDS COUNT Data Book for 2013 reported that, “at 56 births per 1,000 teenage girls, the teen birth rate for Latinos was the highest across major racial and ethnic groups. Although it remained high, the 2010 rate for births to Latino teens was the lowest on record.”
According to the National Vital Statistics Reports from the Centers for Disease Control and Prevention, birth rates for teens ages 15–19 declined from 68.3 in 1970 to 31.3 in 2011. Between 2010 and 2011, the teen birth rate declined 8%. The 2012 birth rate for this group is estimated to be even lower. If 1991 teen births had prevailed from 1992 through 2011, there would have been an additional 3.6 million births to females ages 15–19.
Implications for Youth Confinement Facilities
As previously stated, a declining birth rate can mean fewer future workers. With people living longer, the costs for entitlement programs such as Social Security and Medicare will also increase. With fewer people in the workforce, competition for talented workers will increase. Work in a correctional setting is not always seen as a desirable job, which means that juvenile and adult correctional programs will have to improve their recruiting strategies and find ways to keep older employees in the agency.
The KIDS COUNT Data Book for 2013 states, “Teenage childbearing can have long-term negative effects for both the mother and newborn. Teens are at higher risk of bearing low-birthweight and preterm babies. And, their babies are far more likely to be born into families with limited educational and economic resources.” Because of all of the associated problems of teen pregnancy, the declining rate is encouraging and is evidence that prevention programs and contraceptive approaches are working, but more can be done.
Confinement facilities for youth are well positioned to do more to provide sex education programs for residents. The regular programming for youth should incorporate sex education for young men and young women. Often, idleness is a serious problem in confinement facilities. Programs that inform youth of the importance of pregnancy prevention are a constructive use of time that is not scheduled for other programs.
Programs that teach youth who are already parents about positive parenting skills are of critical importance. Several facilities have adopted programs at work in hundreds of high schools that use animated dolls to teach teens about childcare. Teaching young fathers about their responsibilities to their children can be very beneficial for both parent and child.
According to the American Community Survey conducted by the U.S. Census Bureau, between 2000 and 2012, the percentage of people in poverty increased from 12.2% of the population to 15.9%. The number of people living in poverty increased from 33.3 million to 48.8 million.
The poverty rate in 2012 for children under age 18 was 21.8%, the highest of any age group and the highest for children since the survey began in 2001. The poverty rate for people ages 18–64 was 13.7%, while the rate for people ages 65 and older was 9.1%. These poverty rates were unchanged from 2011.
The Census Bureau’s Report, Child Poverty in the United States 2009 – 2010: Selected Race Groups and Hispanic Origin, found that the poverty rates for White children and Asian children were lower than the national average of 22%, while those for African American children (38.2%), Hispanic children (32.3%), and children of two or more races (22.7%), were all higher than the national average.
The KIDS COUNT Data Book 2013 reported that the 2011 child poverty rate was 23%, and for those under age 3, it was 26%. From 2005 to 2011, the Casey Foundation reported that the child poverty rate rose from 19% to 23%, which represents an increase of three million children. The poverty rate for children age 5 and younger is 26%.
Children growing up in poverty have the odds stacked against them. Poverty has an adverse impact on a child’s cognitive development and his or her ability to learn. A recent study from the University of Wisconsin at Madison found that “the research using brain scans suggests children in low-income families have a slower rate of growth in two key brain structures: the parietal lobe that serves as the network hub of the brain, and the frontal lobe, one of the last parts of the brain to develop. By age 4, children in families living with incomes under 200% of the federal poverty line have less gray matter—brain tissue critical for processing of information and execution of actions—than kids growing up in families with higher incomes, according to the research…One of the things that is important here is that the infants' brains look very similar at birth," professor and researcher Seth Pollack said. "You start seeing the separation in brain growth between the children living in poverty and the more affluent children increase over time, which really implicates the postnatal environment."
Children growing up in poverty experience deprivation on several levels. Their nutrition does not meet minimum daily requirements. Healthcare is often unavailable or unaffordable. Sleep deprivation is not uncommon. Children who live in poverty may also live in violent or unsafe communities or neighborhoods. Educational materials that stimulate the brain are lacking. Even when parents are working, employment may not be secure or temporary. Many parents are forced to work several part-time jobs that still fall short of providing a stable income with benefits. Parents may themselves be lacking an education, which makes finding gainful employment even more challenging. The recession of recent years has exacerbated unemployment and poverty. The KIDS COUNT Data Book 2013 reported that, in 2011, nearly one-third of all children in the U.S. (23.8 million) lived in families where no parent had full-time, year-round employment. Half of all Native American children (51%) and African American children (49%) had no parent with full-time, year-round employment in 2011, compared with 25% of White children and 39% of Latino children.
Implications for Youth Confinement Facilities
Administrators and staff in confinement facilities for youth see the adverse and destructive impact of poverty on youth every day. Low educational achievement scores, healthcare issues, a lack of social skills, and family stress are a few of the challenges residents will need to overcome to avoid relapsing into delinquent behavior after their release.
Confinement facilities can play a pivotal role in helping to inform youth of the importance of an education, life skills, and how to find and keep a job. Providing youth with high-quality healthcare—including dental care—can be of great value to a young person. Ensuring that youth understand where help is available in their communities and how to access it can be of considerable value to youth and their families.
Facility staff should understand the environment to which the youth will return. Working closely with the reentry or aftercare worker, facility staff can focus on program strategies that will build on community strengths and address community weaknesses. In some cases, the community or neighborhood may be so poverty stricken or unsafe that the youth would need other housing arrangements. Facilities that do not have reentry or aftercare workers may need to design a system that collects pertinent information and improves coordination and collaboration among juvenile probation officers, social services caseworkers, mental health professionals, and others to help young people through this difficult transition.
Peter Drucker has said the “Next Society” will be a knowledge society. “Knowledge will be its key resource and knowledge workers will be the dominant group in its workforce. What is different this time is the need for the continuing education of already well-trained and highly knowledgeable adults. Schooling traditionally stopped when work began. In the knowledge society it never stops…Conversely, knowledge rapidly becomes obsolete, and knowledge workers regularly have to go back to school. Continuing education of already highly educated adults will therefore become a big growth area in the Next Society.”
In the 21st century, formal education begins in preschool programs, where children can receive a strong start that will help them in their later education. Yet, the Casey Foundation found that, “from 2009 to 2011, more than 4.3 million 3- and 4-year-olds were not enrolled in preschool, representing more than half (54 percent) of all children in that age group.”
High-performing preschool programs for children ages 3–4 prepare these children for the challenges and opportunities they will experience in elementary and secondary education. Probably the most famous of preschool programs is Head Start, which began in the mid-1960s with President Lyndon Johnson’s War on Poverty. Head Start is intended to help children of low-income families by providing a comprehensive program to meet children’s educational, emotional, social, health, nutritional, and psychological needs. Nearly 50 years later, Head Start is respected as one of the most successful government-initiated programs for children. But, as the Casey Foundation pointed out, many children—especially 3-year-olds—continue to be left out of preschool opportunities, which worsens their likelihood of future socioeconomic success. The rate of children not enrolled in preschool programs is considerably higher for Latinos (63%) and Native American children (58%), compared to White and African American children (54%) and for Pacific Island and Asian children (48%).
As children move through their education, certain milestones can forecast a child’s academic future. “Proficiency in reading by the end of third grade is a crucial marker in a child’s educational development. In the early years, learning to read is a critical component of education. But beginning in fourth grade, children use reading to learn other subjects, and therefore, mastery of reading becomes a critical component in their ability to keep up academically. Children who reach fourth grade without being able to read proficiently are more likely to drop out of high school, reducing their earning potential and chances for success.”
In the 21st century, competency in mathematics is critical to success in every career. In many respects, automation has made math skills even more important. How proficient a young person is in math has a direct bearing on his or her earning power. The Casey Foundation reported that, “among public school students, math proficiency levels in eighth grade and reading proficiency levels in fourth grade were quite similar in 2011, but there was greater improvement in eighth grade math achievement. Nationwide, two-thirds (66 percent) of public school eighth graders scored below proficient math levels in 2011, compared with 72 percent in 2005.”
When race was factored in to the data for eighth graders, 87% of African Americans, 83% of Native Americans, 80% of Latinos, and 57% of Whites were below proficiency levels for math. All groups did show improvements between 2005 and 2011. There was a 7% improvement for Latino eighth graders.
Poverty impacts math proficiency as well. While 53% of eighth graders from higher-income families were below proficiency in math, 83% of children in the eighth grade from low-income families were below proficiency.
Not finishing high school on time or dropping out has a huge fiscal impact on the individual over the course of his or her life. “In 2011, median annual earnings for someone without a high school diploma ($18,800) were 70 percent of those of a high school graduate ($26,700), and 39 percent of the median earnings of someone with a bachelor’s degree ($48,300).” Nationally, twice as many African American students do not graduate compared to non-Hispanic White students.
Adolescents who dropout or leave school and do not have a job are at great risk of living in poverty as adults and being challenged by other socioeconomic and behavioral problems. These youth are often referred to as “disenfranchised” or “disconnected.” There are approximately 1.5 million such youth (8% of the juvenile population). Native American, African American, and Latino youth had the highest rates of not finishing high school and being unemployed.
The educational levels of parents also directly impact their children; parents who have more education are better able to provide for their sons and daughters. Conversely, children in homes where parents have not completed high school are at greater risk of not being ready for school, which compromises their future educational achievement. “In 2011, 15 percent of children lived in households headed by an adult without a high school diploma. This represents 11.1 million children, compared with 12 million in 2005…More than one-third (37 percent) of Latino children lived in households headed by someone without a high school diploma. That’s more than two and a half times the rate for African American children (14 percent) and more than six times the rate for non-Hispanic white children (6 percent).”
Implications for Youth Confinement Facilities
Implications for staff. Day care and preschool programs are important for all children. A facility administrator needs to be aware of the impact of work schedules on facility staff. A change from 8- or 10-hour shifts to 12-hour shifts will have an effect on an employee’s children. Single parents find it extremely difficult to find day care and preschool programs that will provide services on an extended schedule.
Implications for youth. Education programs for youth in confinement facilities need to have the very best teachers if the youth are to overcome their academic challenges. In some states, juvenile justice departments and local juvenile detention facilities are required to use local public education districts; in other states, state and local agencies may outsource the educational program. Regardless of the approach, confinement facilities for youth are in a position to make up for academic lost ground. Preparing youth for reentry is of critical importance, and preparing youth to return to school is an important part of reentry. The facility administrator and school principal must work as partners with a shared vision and commitment to provide unconditional support to a youth’s academic growth.
Providing parenting skills training for youth in confinement facilities, as previously mentioned, must include discussion groups on the importance of preschool programs for 3- and 4-year-olds and the benefits to them of having a parent with at least a high school diploma.
Healthcare for Children and Youth
Children living in poverty or low-income families often have no health insurance coverage, are less likely to have a regular healthcare provider, and are less likely to receive care when it is needed, according to the Annie E. Casey Foundation. Delayed treatment often results in hospitalization. Without health insurance, these families are exposed to treatment costs they cannot afford. There is the hope and expectation that the federal Affordable Care Act will reduce the number of uninsured by providing coverage for many families and children who are currently unprotected. In 2011, 7% of the nation’s children lacked health insurance; 17% of Native American children and 13% of Latino children were more likely to be uninsured than non-Hispanic White children (5%), African American children (6%), and Asian/Pacific Islander children (8%).
A seldom-discussed area of children’s health is dental care. The PEW Charitable Trusts conducted a study of dental care for the nation’s children and found that “each year in the United States, tens of millions of children, disproportionately low-income, go without seeing a dentist. This lack of access to dental care is a complex problem fueled by a number of factors, with two different dentist shortages compounding the issue:
- An uneven distribution of dentists nationwide means many parts of the country do not have an adequate number of these practitioners. As a result, access to care is constrained for people in these communities regardless of income or insurance coverage.
- The relatively small number of dentists who participate in Medicaid means that many low-income people are not receiving dental care.”
Even children who are receiving Medicaid are not getting dental care as required. Most dentists believe children should be seen every six months; however, PEW reported that 14 million children enrolled in Medicaid did not receive any dental service in 2011. According to the most recent comparison, in 2010, privately insured children were almost 30% more likely to receive dental care than those who were publicly insured through Medicaid or other government programs, even though low-income children are almost twice as likely as their wealthier peers to develop cavities.
Many dentists do not accept patients who are covered by government-funded programs like Medicaid, citing low payment rates and the burden of bureaucracy. However, as the PEW Trust learned, the low reimbursement rates and the bureaucracy are just a small part of a complex issue. The actual shortage of dentists—especially in rural areas and poverty stricken areas—is the crux of the problem. There are simply not enough dentists to meet the demands of the country. Dental schools, dental associations, and other advocacy groups are requesting that state legislatures expand the role of midlevel dental assistants. It is believed that this is a more practical approach and has been shown to be very effective in the practice of medicine with the creation of physician’s assistants and nurse practitioners.
Teen mortality rates report that automobile and other accidents are the leading cause of death for children and youth ages 1–14. Accidents account for 32% of all childhood deaths. Recent research on the human brain has shown that the adolescent brain is underdeveloped until the early 20s. Because the brain is not “fully wired,” teens are especially likely to be involved in risk-taking behaviors. Mortality numbers confirm this. The Casey Foundation found that “in 2010, accidents, homicides, and suicides accounted for 73 percent of deaths to teens ages 15 to 19.” Mortality rates for African American and Native American children and teens were considerably higher than for children and youth in other racial groups. The good news is that death rates for children and adolescents have declined. (See Ch. 6: Adolescent Development)
Substance Abuse and Other Risks
Alcohol and substance abuse take a heavy toll on today’s adolescents. Seven percent of the youth ages 12–17 have abused drugs or reported they were dependent on drugs or alcohol during the previous year. It should be noted that this is a 1% decline from 2005 and 2006. Asian/Pacific Islander and African American teens were the least likely to be dependent on or abuse alcohol or drugs.
Lastly, providing healthcare to such an at-risk population is a matter of public health. Fifty years ago, this would not have been mentioned, but in the 21st century, the facts are clear—the people who find themselves caught up in the juvenile and criminal justice systems have histories of risky behaviors, which often results in sexually transmitted diseases and other blood-borne diseases, such as hepatitis B and hepatitis C. These can be transmitted inside the facility and can spread to the community if youth are not treated. Public safety includes protection from contagious disease, as well as protection from crime.
Implications for Youth Confinement Facilities
The U.S. Supreme Court case, Estelle v. Gamble, found that the failure of correctional administrators to provide for the healthcare needs of inmates constitutes cruel and unusual punishment and that deliberate indifference to serious medical needs of prisoners constitutes unnecessary and wanton infliction of pain, all of which is prohibited by the 8th Amendment.
Some administrators of confinement facilities for youth may challenge the idea of providing comprehensive healthcare to its residents. This may be especially true of youth in juvenile detention facilities and in jails where comprehensive healthcare may be scarce and very expensive. However, the jurisdiction involved has the responsibility to provide healthcare, even when those in custody are children and youth, regardless of the type of facility in which they are being held. Confinement facilities have the unique ability to provide comprehensive services, because they have a “captive audience.”
Even in mid-sized urban areas, where medical schools are located, partnerships between universities and juvenile detention and correctional facilities or local jails have been created to provide pediatric healthcare to confined adolescents. Interns and resident doctors can gain considerable experience working with youth in confinement, while the facility gains well-supervised and affordable healthcare.
Teams in mobile dental units meet the needs of patients by traveling through low-income and poverty-stricken neighborhoods providing dental care. These fully equipped mobile dental offices are often available to correctional facilities, saving the time and expense of transporting youth and adults to an outside office.
It is highly likely that confinement facilities for youth will need to provide more medical and healthcare services in the future.
The juvenile justice system in the U.S. has always been a changing landscape. Juvenile justice is not always high on the priority list of legislators, governors, or the public. The first juvenile court was established in Cook County (Chicago). More than a century later, that same juvenile justice system continues to reinvent itself with help from outside organizations, advocacy groups, and concerned legislators. Scandals, abuses, deaths, and official misconduct have resulted in litigation, legislative changes, and reforms. Since 2000, encouraging signs point to the dawn of a new day for juvenile justice services. Will these changes shape the juvenile justice system of the 21st century? Will the changes become the new normal for children who come in contact with the juvenile justice system? Only time will tell, but given the magnitude of recent changes, the chances are that many of them will be permanent.
In the mid-1900s, there was a public outcry that the juvenile justice system was soft on crime and young "super predators” would be roaming the streets preying on the innocent, the elderly, and the vulnerable. These fears were driven by headlines of tragic crimes and increases in juvenile arrests. Governors campaigned on platforms that promised juvenile reforms and overhauls of the juvenile justice system. Those who claimed the juvenile justice system was a failed experiment demanded that the age of jurisdiction in the juvenile court be lowered at the top end and that more juveniles be treated as adults. Legislators passed laws that established automatic waivers for certain crimes, regardless of the juvenile’s age at the time of the offense. In several states, prosecuting attorneys demanded and got the authority to prosecute youth as adults. The authority of the juvenile court judge to decide on waiver to adult court was greatly minimized through statutory exclusions (e.g., automatic waivers or offenses that have been excluded from juvenile court jurisdiction) and prosecutorial waivers (e.g., the prosecutor alone decides in which court he or she will file certain cases).
The super predators did not arrive as forecast, and recent trends give reason for hope that the juvenile justice system has weathered yet another “get tough” storm.
The FBI Uniform Crime Reports (UCR) is regarded as one of the leading indicators of crime and arrest trends in the nation. In Crime in the United States 2012, 10-year arrest trends for all ages declined by 9.1% between 2003 and 2012. For people over age 18, arrests dropped 3.9% in the same period. Arrests for youth under age18 plunged 37.2%.
Source: FBI, “Crime in the United States, 2012.”
When comparing arrests for specific crimes, the differences are even more dramatic. According to UCR 2012 report, murder and non-negligent manslaughter decreased 3.9% for those ages 18 and over, and 37% for those younger than 18. Aggravated assaults decreased 9.4% for those 18 and over, but dove 42.7% for juveniles. Arrests for burglary for those under 18 dove 36.5%, but increased 11.3% for those 18 and over. Arrests for all violent crimes was down 8.6% for those 18 and over, but dropped 36.0 % for those younger than 18. Property crime arrests increased 18.9% over the ten-year period for people 18 and over, but declined 36.0% for those under 18.
The overall decline in juvenile crime of 37.2% meant that from 2003 through 2012, there were 521,969 fewer juvenile arrests.
The 2012 UCR also found that juvenile arrests also declined between 2011 and 2012. There was a 10.4% drop in arrests of those under 18, while arrests for those 18 and over only declined by 0.9%. Only arrests for embezzlement suspicion increased for those under 18.
Declining Institution Populations in Juvenile Facilities: Is Dependence on Juvenile Institutions Declining?
Population trends and rates since 1997 are encouraging. In 1997, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) initiated a system to capture information regarding children and youth in custody. This survey, referred to as The Census of Juveniles in Residential Placement (CJRP), collects information from secure and nonsecure juvenile facilities every two years. The CJRP defines a juvenile as a person who is younger than 21 years of age and in a residential facility as a result of his or her involvement with the juvenile justice system. It includes delinquent offenders and status offenders, both pre- and post-adjudicated. The CJRP does not count youth who may be in an adult jail awaiting a trial in adult criminal court or those who have been sentenced as adults and are in jail or prison. The survey also excludes federal facilities, mental health and substance abuse treatment facilities, and facilities for children and youth who have been abused. Jurisdictional age and the management of youth in state-run facilities varies significantly, making comparisons among the states very difficult.
The most recent one-day census was taken on February 24, 2010, and recorded 79,165 youth in 2,259 facilities. Since 1997, the number of juvenile offenders in juvenile detention and juvenile correctional facilities fell by 33%. The number incarcerated for status offenses plunged 52% in the same period, according to OJJDP.
Young people ages 16 and 17 represented about 26% of the total number of youth ages 10–17 in 2010. However, youth ages 16 and 17 accounted for more than 50% of all arrests for youth under age 18, 40% of the juvenile court cases, and more than 50% of the juveniles in residential placements.
Delinquent offenders represented 86% of all residents in juvenile placement. Status offenders represented approximately 4% and all other residents (youth who were 21 and older, and those uncharged and not adjudicated for an offense) equaled about 11% (because of rounding, the total is more than 100%).
In actual numbers, the number of youth in residential placement declined by 37,536 between 1997 and 2010. This is a 33% decrease in the actual number of youth in residential facilities. The number of juvenile offenders dropped by 31,037 (31.4%), and there were 3,226 fewer youth in residential care for status offenses—a decrease of 52%. Other residents declined by 3,273 (28%).
In 2010, the custody rate for youth was 225 for every 100,000 youth in the U.S. population. OJJDP defines the custody rate as the count of youth in custody per 100,000 youth in the population ages 10 years through the upper age of a state’s juvenile court jurisdiction. The overall custody rate varies among the states. In 2011, it ranged from a high of 575 in South Dakota to a low of 53 in Vermont. Nationally, the detention rate is 65 for juvenile detention facilities and 154 in commitment programs (e.g., group homes, juvenile correctional centers, ranches)—2.4 times the detention rate.
By comparison, the population of youth ages 10–19 increased between 2000 and 2010 by 1,969,575 (4.8%). This makes the decrease in juvenile arrests and youth confinement facility placements all the more encouraging.
Public vs. Private Facilities
Although there are more private than public facilities, public facilities hold a greater number of youth. Public and private facilities differ slightly in the populations they serve. Public facilities hold more youth who are being detained. Over 75% of those youth held for violent offenses are held in public facilities, as are 70% of the delinquent youth. Public facilities, on the other hand, hold fewer than 30% of the status offenders. Drug offenders are nearly evenly divided between private and public facilities.
Technical Violations and Status Offenders
Between 1997 and 2000, the number of detained youth decreased by 26% for person offenses, 47% for property offenses, and 45% for drug offenses. The declines were not as low, however, for youth in residential facilities for public order offenses and technical violations. Pubic order offenses declined 21%, but technical violations only declined 6%. Private facilities held 26% more youth for technical violations in 2010 than in 1997. The Annie E. Casey Foundation found that 40% of the detentions and commitments are “due to technical violations of probation, drug possession, low-level property offenses, public order offenses and status offenses." In other words, a significant number of youth are incarcerated for offenses that do not constitute a clear risk to public safety.
Technical violations are more often a function of the juvenile probation department and juvenile court. Because fewer youth have been arrested and processed through the juvenile court system, one might expect a commensurate drop in technical violations. The National Juvenile Justice Coalition’s campaign, Act 4 Juvenile Justice, has pointed out that the Juvenile Justice and Delinquency Prevention Act (JJDPA) has not been significantly updated in over 20 years, despite the impressive gains in juvenile justice research and evaluation. In particular, the Valid Court Order Amendment allows for the continued incarceration of children and youth for status offenses. A major review by Congress of the JJDPA would find that much has changed in juvenile justice in two decades. It is critical that these changes and advances be incorporated into the JJDPA to sustain a decreased reliance on youth incarceration.
The dramatic decline in the number of status offenders in juvenile residential care is an encouraging sign. After four decades of pushing to remove status offenders from juvenile detention and correctional facilities, it appears that there has been a genuine change in the belief that incarceration is good for status offenders. The number of youth in residential facilities for status offenses reached its lowest level in 2010. The number of status offenders in public facilities declined 46% between 2001 and 2010. In private facilities, the number increased in 2006, but then declined almost 38% by 2010. More work still needs to be done before the mission is truly accomplished, but there is no denying that the juvenile justice system is making progress in the removal of status offenses from facilities that serve youth.
Girls and Young Women in Residential Placement
Girls and young women make up 13% of the youth in residential facilities. Although the number of females in residential placement declined, young women maintained the same percentage overall. One-third of the females who are in residential placements are in private facilities. The vast majority (72%) of young women in placement for status offenses are in private facilities. Of those young women held for non-trafficking drug offenses, 55% were in private residential placements. Young women with less serious offenses were more likely to be placed in a private residential facility. Eleven percent of the females in residential care were status offenders in 2010, which was a decline from 21% in 1997. In spite of this progress, technical violations and status offenses were more common among females in placement than males.
The Challenge of DMC: Disproportionate Minority Care
Although there have been substantial gains made in reducing the number of youth in residential care, the overrepresentation of minorities—especially African American youth—remains a major challenge for the juvenile justice system in the U.S. In 2010, there were more than 47,000 minority offenders in residential placements in juvenile facilities across the country, which is 68% of the custody population nationwide. African American youth accounted for 41% of all youth in custody.
The number of youth in residential placement dropped 33% between 1997 and 2010. The number of White youth declined 42% compared to a decrease of only 27% for minority youth. For African American youth, the decline was 31%, for Hispanic youth it was 19%, for Native American youth it was 23%, and for Asian youth it was 67%. The rate of incarceration (youth in confinement per 100,000 in the population) also declined.
In 1997 the incarceration rate was 356. In 2010 it dropped to 225. For African American youth, the rate changed from 968 to 605. The rate for Non-Hispanic White youth shifted from 201 to 127, and for Hispanic youth it declined from 468 to 229. For Native American youth, the rate declined from 490 to 367. Lastly, one of the largest declines was in the Asian and Pacific Islander population where the rate dropped from 195 to 47.
Although the decline in all these rates is very welcome news, the fact remains that African American youth are still five times as likely to be confined as their White peers. Latino and Native American youth are between two and three times as likely to be confined. To address the DMC issue, researchers and policymakers must look beyond incarceration rates and examine the entire juvenile and criminal justice system, from prevention through arrest and disposition. To study only one piece of the juvenile justice system—the incarceration factor—and not delve into the decision-making around arrests, trial, adjudication, and disposition is irresponsible. Very few juvenile detention superintendents, juvenile correctional facility directors, jail administrators, or wardens have “gate keeping authority.” DMC will be addressed when police agencies, prosecutors, and judges embrace the fact that this is a systemic issue and not an institutional issue.
Implications for Youth Confinement Facilities
Many elected officials, adult and juvenile detention and corrections professionals, and youth advocates are surprised and encouraged by the declining numbers of youth in juvenile detention and correctional facilities. However, some in the juvenile justice system warn that the data are inconclusive; all of the trend information needs to be complete before a final analysis is possible. Still, the evidence is compelling; public policy on the incarceration of youth is changing in most states. Juvenile justice research is now better than it has ever been. Discoveries about the adolescent brain have played a significant role in shaping some decisions of the U.S. Supreme Court. Evidence-based practices are imprinted on nearly every new program and federal grant for youth and adult offenders. Technology provides new pathways for understanding what works and why. However, challenges remain. Over a third of America’s incarcerated youth are in custody for offenses that pose little risk to public safety. There are considerable differences in the handling of juvenile offenders between states, which means that “justice by geography” is still a reality. Minority children and youth continue to be overrepresented in institutions compared to their proportion of the general population. All interested stakeholders must continue to closely monitor national and state incarceration trends in the quest to remove youth from confinement when it is not required for public protection.
After many years of get-tough legislation intended to make the juvenile justice system more like the adult criminal justice system, there is evidence that some legislative bodies are beginning to rethink some of the laws that were enacted in the past 20–30 years.
The National Conference of State Legislatures (NCSL) report, Trends in Juvenile Justice State Legislation: 2001-2011, states:
Today, more and better information is available to policymakers on the causes of juvenile crime and what can be done to prevent it. This includes important information about neurobiological and psychosocial factors and the effect on development and competency of adolescents. The research has contributed to recent legislative trends to distinguish juvenile from adult offenders, restore the jurisdiction of the juvenile court, and adopt scientific screening and assessment tools to structure decision-making and identify needs of juvenile offenders. Competency statutes and policies have become more research-based, and youth interventions are evidence-based across a range of programs and services. Other legislative actions have increased due process protections for juveniles, reformed detention and addressed racial disparities in juvenile justice systems.
The NCSL making such a statement signals a tipping point.
The report pointed out that recent U.S. Supreme Court cases such as Roper v. Simmons, Miller v. Alabama, and Graham v. Florida were greatly influenced by the research on the adolescent brain. This has resulted in 12 states and the District of Columbia changing laws related to a sentence of life without parole for juvenile offenders.
The NCSL reported another major trend as 38 states have now raised the maximum age of juvenile court jurisdiction to 17, with 10 additional states setting the upper limit at 16. States are moving away from lowering jurisdictional ages.
Reforms have also been taking place in the waiver of youth to adult courts and direct file laws. In the last ten years, many legislative bodies changed the law related to treating youth as adult criminals, leaving only the most serious offenders to the adult courts. Still other states returned authority to juvenile court judges to determine what is in the best interest of the youth and public safety. Some states have implemented “blended sentences,” meaning that a youth tried and convicted in adult court can begin serving the sentence in the juvenile system. In many cases, credit is earned for time served while the youth is incarcerated in the juvenile facility. In other states, legislation has changed the direct file authority of prosecuting attorneys for less serious felonies. There is no doubt that the changes that are being made regarding the transfer of youth to the adult courts reflect a trend toward keeping youth in the juvenile justice system.
Other reforms are also addressing youth competency, due process and procedural issues, legal counsel, indigent defense, and confidentiality and expungement of juvenile records. Several states have taken aggressive steps to implement evidence-based programs that are clearly based on sound research and evaluations. Alternatives to incarceration and community-based services are being revitalized and funded with money saved as juvenile institutions are being downsized.
Juvenile Justice: The De Facto Mental Health Agency
The majority of children and youth who get caught in the web of the juvenile justice system have some type of mental health disorder. In the past ten years, more emphasis has been placed on the mental health needs of juvenile offenders by providing proper assessment and screenings and treatment services. State legislative bodies are making the connection between mental health disorders and juvenile offenders. The next step is for elected officials to adequately fund community-based mental health services for young people with serious mental health issues before their behavior brings them into the juvenile justice system. Juvenile detention and correctional facilities must not be the de facto community mental health program. It is simply not the mission of these facilities, nor is it that of adult facilities. Adult jails and prisons have a hard enough time providing mental health services for the adults in these facilities, much less youth—who often have greater needs and challenges. (See Ch. 9: Admission and Intake, Ch. 10: Effective Programs and Services, and Ch. 15: Service and Treatment Plans)
DMC Demands Effective Legislative Oversight
Some states have taken steps to require “minority impact statements” for proposed legislation related to crimes, sentencing, probation, and parole. The impact statements will help legislators understand the effect the legislation may have on minorities.
A number of states have taken steps in the past decade to redefine the juvenile detention mission and reduce the number of youth who are transferred to adult jails and prisons. The nationally recognized Juvenile Detention Alternatives Initiative (JDAI), created by the Annie E. Casey Foundation, has demonstrated that the use of juvenile detention can be safely reduced with proper intake screening and risk assessment. Many legislative bodies have recognized this as one aspect of a viable approach to managing the state’s juvenile detention population and to controlling costs.
Simply looking at the numbers and demographics of incarcerated youth will not have a lasting impact on reducing minority contact and confinements. Communities, neighborhoods, schools, and community-based agencies must collaborate with the juvenile justice system to create significant and durable changes. Attempting to reduce DMC without addressing poverty, unemployment, school suspensions, dropping out of school, and other challenges is not a systemic approach.
Aftercare and Reentry
State legislators have focused on aftercare and reentry legislation that creates community-based services to help youth successfully return to the community. Many younger legislators and younger judges were in college when some of today’s reforms were in their infancy. They are open to new ideas and understand the importance of research-driven decision-making. By investing in community-based reentry programs and alternatives to incarceration, legislators in the majority of states are now seeing the fiscal impact of their decisions as juvenile residential facilities are closed or returned to the state for other purposes. By encouraging multi-agency collaboration and coordination, legislators can witness the transformation of a juvenile justice system that is better able to serve youth while preventing juvenile crime. (See Ch. 18: Transition Planning and Reentry)
Implications for Youth Confinement Facilities
Legislative bodies are better informed on the issues of youth now than in the past. Given credible, evidence-based data, many state legislatures understand what works and what does not work in juvenile justice, leading to better legislation. The laws passed in many states in the last decade indicate a movement toward better programs and services and away from harsh laws and programs that have not proven effective. Only time will tell if current trends will continue. Keeping legislators informed of the changing trends with regard to youth in confinement facilities is a proactive step to ensure the pendulum does not swing in the wrong direction.
Social Media and Juvenile Justice in the Age of Technology
Government agencies—especially those in the human services fields—have not kept up with technological advances of the last 25 years. Kathleen Feely, Vice President of Innovation, Annie E. Casey Foundation, and CEO of Case Commons, Inc. wrote, “While the private sector has been transformed by the web-based technology revolution of the 1990s, government human services have not. Instead, human services technology—and child welfare technology, in particular—is mired woefully in the past, to the detriment of caseworkers and administrators struggling with out-of-date systems and at great cost to vulnerable children and families.” Employees who are serving youth in confinement facilities at all levels can easily be included in this group. Feely refers to this as the “chasm between human services policy and technology.”
This technology discussion needs to go beyond the hardware, software, and latest device. Products change overnight. How the technology is blended with the policies that drive the facilities that hold youth is more important than the hardware and software that actually do the work. How technology can support effective and supportive services for youth and families is of critical importance to those who work in confinement facilities for youth.
Mobile devices that will have virtually unlimited access to vast amounts of information, in real time, will expedite the communication of data within an organization and to approved recipients. But the government lags behind the business world. This can only serve to frustrate and turn away highly talented younger workers. The technology field is changing so rapidly that governmental agencies—with their complicated procurement rules and limited budgets—cannot begin to compete with the private sector or maintain state-of-the-art equipment.
In April of 2011, the Annie E. Casey Foundation launched a new initiative called Case Commons, which uses a web-based application to link children in foster care with services that they need. The program’s main vehicle, called Casebook: A 21st Century Tool for Family-Centered Practice, uses social networking to help child welfare workers document, organize, and convey wide-ranging information vital to the child. If this system can be used in child welfare settings, it could be helpful in youth confinement settings as well. Mobility will be the key to the system’s success.
The technology discussion must also include the ethical questions that will be asked of professionals in the field. How ethical is it to monitor the social networking sites and pages of clients? With fingertip controls, how can agencies protect confidential data, including HIPAA protected information? Breaches of confidential data have occurred and are cause for concern. What is the potential damage that could result from an employee making a video of a fight in a youth facility that is then posted to a domain or sent to a television network?
Implication for Youth Confinement Facilities
Administrators of facilities that confine youth must be prepared to answer these questions and to partner with information and technology professionals to insure that the rights of youth and victims are protected while also protecting an agency from costly litigation.
Technology that lacks safeguards for privacy protection can be a very serious problem. Achieving balance between the best tools to help youth and to protect confidential information is critical to successfully managing an organization. It is critical that all facilities that serve youth have plans for managing cyber-attacks or breaches of confidentiality. Through thoughtful planning and discussion, an administrator can better protect information and manage critical events.
Act 4 Juvenile Justice. “Importance of Reauthorization.” https://www.act4jj.org/resources.
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Brown, A., and E. Weiner. 1985. Supermanaging: How to Harness Change for PersonaI and Organizational Success. New York: Mentor.
Brown, Sarah Alice. 2012. Trends in Juvenile Justice State Legislation: 2001-2011. Washington, DC: National Conference of State Legislatures. https://www.ncsl.org/documents/cj/trendsinjuvenilejustice.pdf.
Case Commons. “Casebook: A 21st Century Tool for Family-Centered Practice.” https://casecommons.org/.
Drucker, Peter. 2002. Managing in the Next Society. New York: St. Martin’s Press.
Estelle v. Gamble, 429 U.S. 97, 104 (1976).
Federal Bureau of Investigation. “Crime in the United States, 2012.” https://ucr.fbi.gov/crime-in-the-u.s/2012/crime-in-the-u.s.-2012.
Feely, Kathleen. “Meeting the Human Services Technology Challenge: A Vision for the Future.” .
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Herzog, Karen. 2013. "Poverty Conditions May Hinder Early Brain Development." Milwaukee Wisconsin Journal Sentinel (blog), December 12, 2013. https://archive.jsonline.com/blogs/news/235473321.html.
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Howden, Lindsay M., and Julie A. Meyer. 2011. “Age & Sex Composition 2010: 2010 Census Briefs.” Washington, DC: U.S. Census Bureau. https://www.census.gov/library/publications/2011/dec/c2010br-03.html.
KIDS COUNT Data Center, Annie E. Casey Foundation. 2103. KIDS COUNT Data Book 2013: State Trends in Child Well-Being. https://datacenter.kidscount.org/files/2013kidscountdatabook.pdf.
Macartney, Suzanne. 2011. Child Poverty in the United States 2009 – 2010: Selected Race Groups and Hispanic Origin. Washington, DC: U.S. Census Bureau. https://www.census.gov/library/publications/2011/acs/acsbr10-05.html.
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PEW Charitable Trusts. June, 2013. "In Search of Dental Care, Two Types of Dentist Shortages Limit Children's Access to Care." https://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2013/insearchofdentalcarepdf.pdf.
Shah, Neil. 2013. "Four Years into Economic Recovery, American Fertility Rate Remains Depressed." Wall Street Journal, December 31, 2013. .
 A. Brown and E. Weiner, quoted in James L. Morrison, “Environmental Scanning,” in A Primer for New Institutional Researchers, eds. M.A. Whitley and J. D. Porter,(Tallahassee, FL: Association for Institutional Research, 1992).
 Ray Gagnon, "Strategic Planning: Laying the Foundation with a Solid Environmental Scan," The Huffington Post, September 28, 2012.
 James L. Morrison, “Environmental Scanning,” in A Primer for New Institutional Researchers, eds. M.A. Whitley, and J. D. Porter (Tallahassee, FL: Association for Institutional Research, 1992),86–99.
 For more information, see https://nicic.gov/im-looking-information-assistance-library.
 Neil Shah, "Four Years into Economic Recovery, American Fertility Rate Remains Depressed," Wall Street Journal, December 31, 2013.
 Peter Drucker, Managing in the Next Society, (New York: St. Martin’s Press, 2002), 236.
 Shah, "Four Years into Economic Recovery.”
 KIDS COUNT Data Center, Annie E. Casey Foundation, 2103. KIDS COUNT Data Book 2013: State Trends in Child Well-Being.
 Joyce A. Martin, Brady E. Hamilton, Michelle J.K. Osterman, Sally C. Curtin, and T.J. Matthews, “Births: Final Data for 2012,” National Vital Statistics Reports 62, no. 9, (Hyattsville, MD: National Center for Health Statistics, 2013).
 Bahar Gholipour, “Teen Birth Rate Hits New Low,” (Live Science, August 20, 2014).
 KIDS COUNT Data Center, Annie E. Casey Foundation, KIDS COUNT Data Book 2013, 35.
 Lindsay M. Howden and Julie A. Meyer, “Age & Sex Composition 2010: 2010 Census Briefs,” (Washington, DC: U.S. Census Bureau, 2011).
 Suzanne Macartney, Child Poverty in the United States 2009–2010: Selected Race Groups and Hispanic Origin, (Washington, DC: U.S. Census Bureau, 2011).
 KIDS COUNT Data Center, Annie E. Casey Foundation, KIDS COUNT Data Book 2013.
 Karen Herzog, "Poverty Conditions May Hinder Early Brain Development," Milwaukee Wisconsin Journal Sentinel, (blog), December 12, 2013.
 KIDS COUNT Data Center, Annie E. Casey Foundation, KIDS COUNT Data Book 2013.
 Drucker, Managing in the Next Society, 237, 258.
 KIDS COUNT Data Center, Annie E. Casey Foundation, KIDS COUNT Data Book 2013, 26.
 Ibid., 26.
 Ibid., 27.
 Ibid., 27.
 Ibid., 34.
 The PEW Charitable Trusts, "In Search of Dental Care, Two Types of Dentist Shortages Limit Children's Access to Care," 1.
 KIDS COUNT Data Center, Annie E. Casey Foundation, KIDS COUNT Data Book 2013, 31.
 Estelle v. Gamble, 429 U.S. 97 (1976).
 FBI, “Crime in the United States, 2012.”
 Sarah Hockenberry, Juveniles in Residential Placement 2010, (Washington, DC: Office of Juvenile Justice and Delinquency Prevention, 2013).
 Hockenberry, Juveniles in Residential Placement 2010.
 Suzanne Macartney, Child Poverty in the United States 2009 – 2010.
 Hockenberry, Juveniles in Residential Placement 2010.
 Annie E. Casey Foundation, “Youth Incarceration in the United States,” Infographic.
 Act 4 Juvenile Justice. “Importance of Reauthorization.”
 Hockenberry, Juveniles in Residential Placement.
 KIDS COUNT Data Center, Annie E. Casey Foundation, KIDS COUNT Data Book 2013.
 Sarah Alice Brown, Trends in Juvenile Justice State Legislation: 2001-2011, (Washington, DC: National Conference of State Legislatures, 2011), 3.
 Kathleen Feely, “Meeting the Human Services Technology Challenge: A Vision for the Future.”
 Case Commons, “Casebook: A 21st Century Tool for Family-Centered Practice.”