May 16, 2018

Stephanie Rubin, CEO

Texans Care
1106 Clayton Lane, #111W
Austin, TX 78723

Dear Ms. Rubin:

Your organization’s recent report, “Fostering Healthy Lives – Strategies to Prevent Teen
Pregnancy in Foster Care and Support Teen Parents in Foster Care,” attempted to highlight the
important issue of foster youth who are pregnant or parenting while in foster care. I believe you
missed that opportunity by producing a report that is more sensational than factual. I am also
personally disappointed at how Texans Care portrays youth in care through this report.

The report is based on misleading conclusions and flawed methodology; it implies that some
unique circumstance in Texas foster care allows for teenagers to become pregnant at a higher
rate than teens in the general population, and worse, that DFPS and State Leadership is aware
and ignores this circumstance. Let me be clear: foster care does not cause teen pregnancy.

We are aware of no reliable data that indicates 50 percent of youth in Texas foster care will
“likely” be pregnant by age 19, as you claim. While this number is certainly sensational, it is
deceptive. In fact, the only way to prove this assumption is follow a specific cohort of children
throughout their time in the foster care system. That was not done for this report, so the
conclusion is unreliable.

It is misleading to compare youth in Texas foster care to youth in the general population. A
better and more accurate comparison would be to compare them to other teens on Medicaid, a
comparable population with similar risk factors such as socioeconomic status and family
circumstances.

Your comparison further misleads the reader by ignoring that the pregnancy rate in the general
population is likely underreported. Many youth in Texas are uninsured and therefore may be less
likely to go to the doctor. Teens in foster care, however, are all covered by STAR Health and are
required to go to the doctor for a full medical examination every year. As a result, their
pregnancies are much more likely to be identified and recorded.

701 W. 51st Street • P. O. Box 149030 • Austin, Texas 78714-9030 • 512-438-4800 • www.dfps.state.tx.us
An Equal Opportunity Employer and Provider
May 16, 2018
Rubin Letter
Page Two

The report includes a mischaracterization of data that implies Texas denies access to proper
prenatal care for children in foster care, leading to more babies born with low birth weight. In
order to draw this conclusion, the report compares pregnant Texas foster teens to the complete
Texas female teen and adult population. Again, teens in foster care have guaranteed access to
medical and prenatal care through the STAR Health program, while teenagers outside of foster
care do not always enjoy the same medical benefits. To imply that pregnant teenagers in foster
care are purposefully prevented from seeking proper care which results in children with low
birthweight is irresponsible.

Your report is counterproductive; it provides no actionable data that could be used to influence
policy or improve the lives and health of youth in foster care. It uses flawed methodology and
misleading comparisons to sensationalize an issue that is well-known in child welfare. Like all
teenagers, teenagers in foster care sometimes get pregnant, but the vast majority do not.

Finally, I would be remiss to not point out the potential damage of this report to the very children
you purport to care for. By exaggerating and misusing data, you may have made it more difficult
for our older teens to be placed by labeling them and implying that they are somehow more
likely to become pregnant than another similarly situated teen.

Regardless of all of the above, DFPS continues to work to improve outcomes for all children in
our care, including those who are pregnant and those who are parenting. Although we are far
apart on this issue, we do appreciate your continued interest in our programs and our children.
They are precious and deserve our best efforts to protect them, nurture them, and arm them with
the tools they will need to succeed.

Sincerely,

H.L. WHITMAN, JR.

cc: Governor Greg Abbott

Lieutenant Governor Dan Patrick
Speaker Joe Straus
Chairman Charles Schwertner
Chairman Richard Raymond
Executive Commissioner Charles Smith
Commissioner John Hellerstedt