Summary
There has been an enormous increase in foster care placements, especially with grandparents and other extended family members, since 1985. This is primarily attributable to problems associated with parental drug use, principally of crack cocaine. Drug. related problems that lead to kinship foster placement include prenatal drug exposure, child maltreatment, incarceration, and early death by violence or AIDS or other illness. Grandparents caring for their children's children have a variety of social, mental health, and medical needs because of this stressful role. Following a literature review, a comprehensive social service and medical program developed through the partnership of a large urban teaching hospital, a foundation involved in funding programs for older adults, and an inner city school district is described.