Standards for public agencies

2020 Edition

Child and Family Services (PA-CFS) 18: Supports and Services for Expectant and Parenting Youth in Out-of-Home Care

The agency promotes the safety, permanency, and well-being of youth in out-of-home care who are expectant or parenting, by providing resources and supports that empower youth to make informed decisions about pregnancy, experience healthy births, and develop the skills needed for personal functioning and parenthood.

Interpretation: The needs of expectant and parenting youth can be met through a continuum of care that includes “whole family” placements, specialized foster care, residential treatment, and supported living arrangements. The agency should aim to meet the needs of expectant and parenting youth and their children in the most family-like setting that best meets their needs. Given that youths’ needs often go unmet, it is crucial that caseworkers provide close oversight and play an active role in monitoring the receipt of services. 

Interpretation: The terms “expectant youth” and “parenting youth” refer to both birth mothers and fathers. The term “pregnant youth” refers exclusively to birth mothers.

NA  The agency does not work with children placed in out-of-home care.
2020 Edition




Child and Family Services promote child and family well-being, protect children’s safety, stablilize and strengthen families, and ensure permanency.
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions; exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement. 
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.  
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.  
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  
  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.   
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner. 
  • Service quality or agency functioning may be compromised.   
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.  
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for referring youth and their children to services


  • Policy regarding youths’ parenting rights
  • Table of contents of parenting education curricula
  • Parenting skills assessment tool
  • Procedures for developing parenting plans
  • Community resource and referral list 
  • Contracts or service agreements with community providers for the provision of services to expectant and parenting youth
  • Informational materials provided to youth
  • Parenting education curricula


  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Parents served
    4. Youth served including their children, if appropriate
    5. Resource parents
    6. Residential treatment providers
  • Review case records

Fundamental Practice

PA-CFS 18.01

Pregnant youth receive timely, ongoing, relevant, and accessible services appropriate to their needs that address: 
  1. nonjudgmental and nondirective pregnancy and birth options counseling;
  2. prenatal health care;
  3. diagnosis and treatment of health concerns, including sexually transmitted diseases;
  4. genetic risk identification;
  5. food and nutrition;
  6. mental health care, including information, screening, and treatment for prenatal depression;
  7. substance use conditions;
  8. medication use;
  9. smoking cessation; and
  10. labor and delivery.



Regarding element (h), a qualified mental health professional should re-evaluate pharmacological treatments for safety, risks, and benefits during pregnancy and make appropriate adjustments to the treatment plan, such as tapering or adjusting dosages or increasing monitoring of symptoms.  

Fundamental Practice

PA-CFS 18.02

Following childbirth, the agency promotes child and maternal well-being and prepares youth to recognize and respond to signs of problems in both themselves and their infants, by ensuring youth receive timely postnatal care and support related to: 
  1. postpartum health care;
  2. postpartum depression, including screening for and addressing changes in the new mother’s mood, emotional state, behavior, and coping strategies;
  3. breastfeeding education and assistance;
  4. pediatric care, including well-baby visits and immunizations; and
  5. family planning.

PA-CFS 18.03

Expectant and parenting youth are informed of their legal rights regarding the custody of their children, and agency policy:
  1. prohibits the separation of children from youth parents for reasons other than abuse or neglect; and
  2. clearly asserts that children should not be separated from youth parents due solely to the youth’s age, or involvement with the child welfare system, or as a means of obtaining services or financial support for the children. 

PA-CFS 18.04

Expectant and parenting youth are helped to develop skills and knowledge related to: 
  1. basic caregiving routines;
  2. child growth and development;
  3. meeting children’s social, emotional, and physical health needs;
  4. environmental safety and injury prevention;
  5. parent-child interactions and bonding;
  6. age-appropriate behavioral expectations and appropriate discipline; 
  7. family planning; and 
  8. establishing a functioning support network of family members or caring adults.

Examples: Agencies can tailor how topics are addressed based on service recipients’ needs. For example, when serving expectant parents or parents of young children, education on environmental safety and injury prevention will typically address topics such as safe practices for sleeping and bathing.

PA-CFS 18.05

Workers collaborate with expectant and parenting youth and their caregivers, co-parents, and other family members when appropriate, to develop individualized parenting plans that define: 
  1. the rights and responsibilities of the youth parents; and
  2. each individual’s role and expectations for supporting the youth parents to care for their children.


PA-CFS 18.06

Workers assist expectant and parenting youth to obtain or enroll in assistance that will support them to care for their children and work towards financial independence, including:   
  1. public benefits such as Medicaid, WIC, SNAP, and TANF;
  2. transportation;
  3. maternal and child health programs;
  4. legal advocacy;
  5. affordable and quality child care;
  6. community resources, such as free clinics; and
  7. educational or vocational programs that support and accommodate the circumstances of expectant and parenting youth.

PA-CFS 18.07

The agency promotes responsible fatherhood and paternal engagement by: 
  1.  indicating in the case record when youth in out-of-home care become fathers;
  2. identifying the relationship between expectant youth parents;
  3.  linking youth fathers to services that help them understand their legal rights and responsibilities, establish legal paternity, and adjust to the parenting role; and
  4. assisting pregnant youth to notify birth fathers and engage them in service planning, when appropriate.