Nelly Medina was 9 when her mother, who was addicted to drugs, left her and her two siblings and did not come home.

By the time Medina turned 18, she had lived in 14 foster homes and attended 10 public schools. She asked to be emancipated at 16 so she could abort a pregnancy. She ultimately miscarried.

There was no consistency in her education, social life or support system.

“The biggest problem with the system was they keep moving us around like that,” Medina said. “We didn’t have a place we could stay where we felt welcome.”

Children who age out of foster care without family have increased rates of incarceration, unwanted pregnancy and homelessness. According to the National Foster Youth Institute, 23,000 young people age out of foster care alone each year in the U.S.

“They’re the next generation of poor and homeless Americans,” said Judy Cockerton, founder and executive director of Treehouse Foundation in Easthampton, an intergenerational community where families adopting children from the state’s Department of Children and Families live alongside older adults. “Our child welfare system is not a good parent.”

Medina, 33, is working hard to become a success story. She got her GED and is working toward an associate’s degree and certificate in law enforcement from Quinsigamond Community College. She interns for the Worcester chapter of the Massachusetts Women’s Political Caucus and won an award for her work connecting community college students with mentors. She has a 3-year old son. She wants to work in education, join the Worcester School Committee and advocate for foster kids.

But the traumatic experience of being bounced between homes remains with her.

Medina said few foster families understood her Puerto Rican culture, food and ways of interacting. She was accused of stealing, which she attributes to being the only Latina in an all-white school.

Her attention deficit disorder went undiagnosed for years — and when it was diagnosed, she was not given medication because her mother was addicted to drugs.

She tried to run away from foster homes to be with her siblings. She tried to kill herself twice.

Medina said she carried her things in her pockets until she was 20 because no one taught her she should carry a purse.

“There’s no advocacy, no way for us to learn how to live,” Medina said.

According to DCF, there were around 9,200 children in out-of-home placements — like foster care or group homes — at the end of 2018. Around 3,100 were between the ages of 12 and 17.

Under federal and state law, DCF must make reasonable efforts to reunify the child with their parents after a child is removed from their home.

Within nine months, DCF convenes a “permanency planning conference,” then determines whether to set a goal of family reunification or adoption, guardianship or placement with a relative. Within a year of a child being taken, the court holds a permanency hearing, which could lead to a trial to terminate parental rights.

But according to DCF statistics, more than 1,000 children had been in foster care for more than four years as of December 2018.

Around 3,300 children had the goal of reunifying with their birth families, and an equivalent number had the goal of adoption.

According to DCF, the department is focused on incorporating permanency planning in its processes. Reviews of foster care placements must now include permanency planning, particularly for teenagers. The department has hired 18 new foster care recruiters, who are recruiting new pre-adoptive parents and tracking down relatives to care for children.

Between fiscal 2017 and 2018, adoptions increased by 22 percent.

But many children never find a permanent family.

Quinsigamond Community College student Christina Rodriguez, April 3, 2019, is set to graduate in May.Hoang 'Leon' Nguyen / The Republican

Christina Rodriguez was one of seven siblings. She bounced for a decade between foster homes and juvenile detention centers.

“I was bumped around to different homes, never given the opportunity to feel like I was part of a family,” Rodriguez said.

Many homes were short-term placements. In one, Rodriguez said she was almost sexually assaulted by a foster parent — and when she reported it, no one believed her. In another house, nine girls shared a bedbug-infested bedroom. When the woman who ran the house went on vacation, she put the girls in respite care. One foster mother had her foster kids dig a hole for her new house, so she wouldn’t have to pay for labor.

Until today, Rodriguez can’t wash her body with certain types of soap because it brings back memories of being treated badly.

Rodriguez ran away from homes to meet her siblings. Like Medina, she was bullied for being the only Latina in all-white schools. She moved between Lunenburg, Grafton, Gardner, Fitchburg and elsewhere.

Rodriguez is now a criminal justice major at Quinsigamond Community College and plans to graduate in May. Her goal is to become a lawyer and advocate for children.

But Rodriguez said foster care delayed her education. She dropped out of school at 16 and returned at 22. She is finishing college at 30. She only learned once it was too late that she should have been eligible for financial aid.

The problem of children in the foster care system who are unable to find a permanent family is “huge,” said Lesli Suggs, president and CEO of the Home for Little Wanderers, which provides services to children in state care from birth through age 22. Suggs estimates that 600 to 700 kids age out of the foster care system without a permanent family, although DCF pegs the number at closer to 400.

“You invest all this time, then don’t seal the deal to find permanency or support until they successfully launch into adulthood. Talk about a lousy return on investment — and it’s morally not the right thing to do,” Suggs said.

A 2008 study by a task force formed to look at children aging out of care surveyed 800 young adults who turned 18 in 2005 in the care of Massachusetts’ youth services agency. The study found that 37 percent had experienced homelessness since turning 18, 11 percent reported sexual contact against their will, 34 percent used illegal drugs in the last 30 days, and 25 percent were arrested in the last year.

A 2015 look at Massachusetts data by the national group Child Trends surveyed nearly 200 21-year-olds who aged out of foster care. It found that 51 percent were employed, 42 percent were attending school, 34 percent had experienced homelessness, 22 percent were receiving public assistance and 14 percent had been incarcerated in the past two years.

Although the statistics are old, advocates for children say the problems have persisted.

“When we fail to find permanent families, the outcomes are not good,” Suggs said.

Suggs said “permanency” may not always mean a biological parent or adoptive family, but someone like a coach or godmother who can provide stability.

Lesli Suggs, president and CEO of the Home for Little Wanderers, speaks at a Statehouse briefing on permanence on April 9, 2019. (Shira Schoenberg / The Republican)

Around two years ago, Suggs and James Lister, executive director of Plummer Youth Promise, teamed up with three other social service agencies to start the Massachusetts Permanency Practice Alliance. The groups work to implement new strategies to provide children in state care with someone who can guide them as they transition into adulthood.

Plummer Youth Promise offers residential care and other services to youth involved with the foster system. At a briefing the Massachusetts Permanency Practice Alliance held at the Statehouse, Lister said he was too often preparing teenagers to live on their own, then dropping them off at a homeless shelter.

Lister said he began to take the approach that these children need permanency. He called permanency a concept that is “a difficult thing to explain, but it’s real easy to define it when you know a kid who doesn’t have it.”

He said a lack of permanency is the teenager who has no baby pictures for a high school yearbook, the teen who carries their life belongings in a trash bag or spends all of Thanksgiving at a youth program.

Lister recalled one 16-year-old who spent his life in four foster homes and a residential program. Plummer staff tracked down his birth mother in another state and found her parenting five children. She gave the teen away as a newborn because she had gotten pregnant when she was raped. As the years went by, she assumed he was happily adopted and did not want to disturb him. Staff worked with the teen and his mother to move him into her family.

There are many reasons a child may have to move between homes, such as struggles in a school system, behavioral problems that make families unwilling to adopt them, or biological parents who take kids back before becoming unstable again. There has also been a shortage of foster families.

Rep. Jack Lewis, D-Framingham, an adoptive parent, said he worries the process gives biological parents so many chances for reunification that children are never free for adoption. Sometimes, by the time they are free, they are almost 18 and cannot find an adoptive family.

“A reason kids spend years in foster care is the hope that’s held out that reunification is going to happen,” Lewis said.

Jessica, 32, an elementary school teacher who lives in northern Massachusetts, was removed from her mother’s house at age 5 when her mother was hospitalized for a drug overdose.

She was placed with a relative, then moved to another home and adopted at age 9. Jessica didn’t go to school consistently until fourth grade, when she joined the family that adopted her.

Jessica said her biological mother consumed drugs and alcohol and worked as a prostitute, putting her children in harm’s way. Her younger brother was born drug addicted and had serious health problems due to abuse and neglect by their mother. But adoptions of her and her siblings were held up because their birth mother still had parental rights.

Jessica said the system gave their biological mother rights, but left the children in “limbo." She asked: “What rights did (my brother) have? Did he have any?”

Correction: A detail of Rodriguez’s story was deleted after conflicting information was provided after publication.