oversight

Foster Care: States Focusing on Finding Permanent Homes for Children, but Long-Standing Barriers Remain

Published by the Government Accountability Office on 2003-04-08.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                            United States General Accounting Office

GAO                         Testimony

                            Before the Subcommittee on Human Resources
                            Committee on Ways and Means
                            House of Representatives
For Release on Delivery
Expected at 3:00 p.m. EST
Tuesday, April 8, 2003      FOSTER CARE
                            States Focusing on Finding
                            Permanent Homes for
                            Children, but Long-Standing
                            Barriers Remain
                            Statement of Cornelia M. Ashby, Director
                            Education, Workforce, and Income Security Issues




GAO-03-626T
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                                            April 8, 2003


                                            FOSTER CARE

                                            States Focusing on Finding Permanent
Highlights of GAO-03-626T, a testimony      Homes for Children, but Long-Standing
for the Subcommittee on Human
Resources, Committee on Ways and            Barriers Remain
Means, House of Representatives




In response to concerns that some           ASFA’s goal was to increase permanent placements, such as adoption, for
children were languishing in                children in foster care, but determining ASFA’s impact is difficult. The
temporary foster care, Congress             annual number of adoptions have increased by 57 percent from the time
enacted the Adoption and Safe               ASFA was enacted through fiscal year 2000; however, the lack of comparable
Families Act of 1997 (ASFA) to              pre- and post-ASFA data make it difficult to determine ASFA’s role in this
help states move children in foster
care more quickly to safe and
                                            increase. In addition, states have improved their foster care data since
permanent homes. ASFA                       ASFA, making it difficult to determine whether observed changes in
contained two key provisions: (1)           outcomes are due to changes in data quality or changes in state
the “fast track” provision allows           performance. States have also pursued other child welfare reform efforts
states to bypass efforts to reunify         that may be contributing to outcome changes. HHS data on children who
families in certain egregious               left foster care between 1998 and 2000 indicate that most were reunified
situations and (2) the“15 of 22”            with their families after spending a median of 1 year in care (although about
provision requires states, with a           33 percent returned to foster care within 2 years). Children who were
few exceptions, to file a petition to       adopted spent a median of 39 months in care.
terminate parental rights (TPR)
when a child has been in foster             In response to a GAO survey, very few states were able to provide data on
care for 15 of the most recent 22
months. Representative Wally
                                            the number of children affected by ASFA’s fast track and 15 of 22 provisions.
Herger, Chairman of the House               Survey data, as well as information gathered from the six states GAO visited,
Ways and Means Subcommittee on              suggest that states use the fast track provision infrequently and exempt a
Human Resources asked GAO to                number of children from the 15 of 22 provision. During GAO’s site visits,
review (1) changes in outcomes for          state and local officials described circumstances, such as the reluctance on
children in foster care since ASFA          the part of some judges to allow a state to bypass reunification efforts,
was enacted, (2) states’                    which made it difficult for these states to use fast track for more cases. In
implementation of ASFA’s fast               addition, these officials said that difficulties finding adoptive homes for
track and 15 of 22 provisions, (3)          certain children, such as adolescents, discouraged states from using the 15
states’ use of two new adoption-            of 22 provision for these children. States reported exempting children
related funds provided by ASFA,             placed with relatives and children who were expected to reunify shortly with
and (4) states’ initiatives to address
barriers to achieving permanency.
                                            their families.

                                            States are most frequently using ASFA’s two new adoption-related funds to
                                            recruit adoptive parents and provide post adoption services. Examples
                                            include purchasing advertisements on Spanish language television to recruit
                                            adoptive families for older Hispanic children and creating a statewide
                                            adoption resource center to provide support to adoptive families.

                                            The states GAO visited have implemented a variety of practices to address
                                            long-standing barriers—such as court delays and difficulties in recruiting
                                            adoptive families for children with special needs—to achieving permanency
                                            for foster children. To help address court delays, for example, Massachusetts
                                            has developed a mediation program to help birth families and potential
                                            adoptive parents agree on the permanent plan for a child. However, limited
                                            data are available on the effectiveness of these practices.
www.gao.gov/cgi-bin/getrpt?GAO-03-626T.

To view this testimony, click on the link   In a related report, GAO recommended that the Secretary of Health and
above.                                      Human Services review the feasibility of collecting data on states’ use of
For more information, contact Cornelia M.
Ashby at (202) 512-8403 or
                                            ASFA’s fast track and 15 of 22 provisions.
ashbyc@gao.gov.
Mr. Chairman and Members of the Subcommittee:

Thank you for inviting me here today to discuss the implementation of the
Adoption and Safe Families Act of 1997 (ASFA). As you are aware, this
legislation was enacted in response to concerns that some children were
languishing in temporary foster care while prolonged attempts were made
to reunify them with their birth families. ASFA contained two key
provisions that were intended to help states move children in foster care
more quickly to safe and permanent homes. One of these provisions,
referred to as “fast track,” allows states to bypass efforts to reunify
families in certain egregious situations. The other provision, informally
called “15 of 22,” requires states, with a few exceptions, to file a petition to
terminate parental rights (TPR) when a child has been in foster care for 15
of the most recent 22 months. In addition, ASFA emphasized the
importance of adoption when foster children cannot safely and quickly
return to the care of their birth parents. Toward that end, ASFA
established incentive payments for states that increase their adoptions. In
addition, the law provided a new source of funds for states to use to
promote and support adoptions through the Promoting Safe and Stable
Families (PSSF) Program.

My testimony today will focus on four key issues: (1) changes in the
outcomes and characteristics of children in foster care from the time
ASFA was enacted through fiscal year 2000, (2) states’ implementation of
ASFA’s fast track and 15 of 22 provisions, (3) states’ use of adoption-
related funds provided by ASFA, and (4) practices states are using to
address barriers to achieving permanency for children in foster care. My
comments are based on the findings from our June 2002 report, Foster
Care: Recent Legislation Helps States Focus on Finding Permanent Homes
for Children, but Long-Standing Barriers Remain (GAO-02-585, June 28,
2002). Those findings were based on our analyses of national foster care
and adoption data from the U.S. Department of Health and Human
Services (HHS) for fiscal years 1998 through 2000;1 site visits to Illinois,
Maryland, Massachusetts, North Carolina, Oregon, and Texas; and
interviews with federal officials and child welfare experts. In addition, we
conducted a survey of child welfare directors in the 50 states and the




1
 Throughout this testimony, fiscal year refers to federal fiscal year, unless noted otherwise.
In addition, we selectively updated information contained in this testimony.


Page 1                                                                         GAO-03-626T
District of Columbia.2 We received responses from 46 states, although they
did not all respond to every question.3

In summary, while the annual number of adoptions has increased by 57
percent from the time ASFA was enacted through fiscal year 2000, the lack
of comparable pre- and post-ASFA data makes it difficult to determine
ASFA’s role in this increase or changes in other foster care outcomes.
However, HHS data on children who left foster care between 1998 and
2000 provide some insight into the experiences of children in foster care.
For example, children who left foster care during this time spent a median
of nearly 1 year in care. Of these children, those who were adopted spent a
median of approximately 3-½ years in foster care. Recent improvements in
the quality of HHS data, however, make it difficult to determine if changes
observed after 1998 are the result of changes in data quality or actual
changes in the outcomes and characteristics of foster children. Similarly,
data on states’ use of ASFA’s two key permanency provisions—fast track
and 15 of 22—are limited, although some states described circumstances
that hindered the broader use of these provisions. For example, state
officials described several court-related issues, such as reluctance on the
part of some judges to allow a state to bypass reunification efforts, which
made it difficult for these states to use the fast track provision for more
cases.

In general, states are most frequently using the new adoption-related funds
provided by ASFA to recruit adoptive parents and provide post adoption
services. For example, Connecticut used its adoption incentive funds to
buy advertisements on Spanish language television to recruit adoptive
families for older Hispanic children and sibling groups to address a
shortage of families for these children. Oregon used its PSSF funds to
create a new, statewide resource center to provide information and
referral services, support groups, and educational workshops to adoptive
families. The states we visited have implemented a variety of practices to
address long-standing barriers—such as court delays and difficulties in
recruiting adoptive families for children with special needs—to achieving
permanency for foster children. To help address court delays, for example,



2
Throughout this testimony, references to state survey responses include the District of
Columbia.
3
  In addition, we requested survey data by federal fiscal year for 1999 and 2000. However, of
the 46 states responding to our survey, 22 provided data for time periods other than federal
fiscal years 1999 and 2000, such as calendar year or state fiscal year.



Page 2                                                                        GAO-03-626T
             Massachusetts has developed a mediation program to help birth families
             and potential adoptive parents agree on the permanent plan for a child,
             thereby avoiding the time associated with a court trial and an appeal of the
             court’s decision. States are testing different approaches to address these
             barriers; however, limited data are available on the effectiveness of these
             practices.


             The foster care system has grown dramatically in the past two decades,
Background   with the number of children in foster care nearly doubling since the mid-
             1980s. Concerns about children’s long stays in foster care culminated in
             the passage of ASFA in 1997, which emphasized the child welfare system’s
             goals of safety, permanency, and child and family well-being. HHS’s
             Administration for Children and Families (ACF) is responsible for the
             administration and oversight of federal funding to states for child welfare
             services under Titles IV-B and IV-E of the Social Security Act.

             These two titles of the Social Security Act provide federal funding targeted
             specifically to foster care and related child welfare services.4 Title IV-E
             provides an open-ended individual entitlement for foster care maintenance
             payments to cover a portion of the food, housing, and incidental expenses
             for all foster children whose parents meet certain federal eligibility
             criteria.5 Title IV-E also provides payments to adoptive parents of eligible
             foster children with special needs.6 Special needs are characteristics that
             can make it more difficult for a child to be adopted and may include
             emotional, physical, or mental disabilities; age; or being a member of a
             sibling group or a member of a minority race. Title IV-B provides limited
             funding for child welfare services to foster children, as well as children
             remaining in their homes. In fiscal year 2002, total Title IV-E spending was



             4
              In addition, Title XX provides funds under the social services block grant that may be used
             for many purposes, including child welfare.
             5
              Certain judicial findings must be present for the child in order for the child to be eligible
             for Title IV-E foster care maintenance payments.
             6
              Special needs are defined as a specific factor or condition that make it difficult to place a
             child with adoptive parents without providing adoption assistance. States have the
             discretion to define the specifics of the special needs category. The existence of special
             needs is used to determine a child’s eligibility for adoption assistance under Title IV-E. To
             qualify for an adoption subsidy under Title IV-E, the state must determine that the child
             cannot or should not return home; the state must make a reasonable, but unsuccessful
             effort to place the child without the subsidy; and a specific factor or condition must exist
             that makes it difficult to place the child without a subsidy.



             Page 3                                                                           GAO-03-626T
approximately $6.1 billion and total Title IV-B spending was approximately
$674 million.

HHS compiles data on children in foster care and children who have been
adopted from state child welfare agencies in the Adoption and Foster Care
Analysis and Reporting System (AFCARS). HHS is responsible for
collecting and reporting data and verifying their quality. States began
submitting AFCARS data to HHS in 1995. Twice a year, states are required
to submit data on the characteristics of children in foster care, foster
parents, adopted children, and adoptive parents. Prior to AFCARS, child
welfare data were collected in the Voluntary Cooperative Information
System (VCIS), operated by what was then called the American Public
Welfare Association.7 Since reporting to VCIS was not mandatory, the data
in the system were incomplete. In addition, the data submitted were
inconsistent because states used different reporting periods and different
definitions for various data elements.

ASFA included two key provisions intended to help states move into safe,
permanent placements those foster children who are unable to safely
return home in a reasonable amount of time. Under the fast track
provision, states are not required to pursue efforts to prevent removal
from home or to return a child home if a parent has (1) lost parental rights
to that child’s sibling; (2) committed specific types of felonies, including
murder or voluntary manslaughter of the child’s sibling; or (3) subjected
the child to aggravated circumstances, such as abandonment, torture,
chronic abuse, or sexual abuse. In these egregious situations, the courts
may determine that services to preserve or reunite the family are not
required. Once the court makes such a determination, the state must begin
within 30 days to find the child an alternative permanent family or other
permanent arrangement.8

The second provision requires states to file a TPR with the courts if (1) an
infant has been abandoned; (2) the parent committed any of the felonies
listed in the fast track provision; or (3) the child has been in foster care for
15 of the most recent 22 months. ASFA allows for some exemptions from



7
 In 1998, the American Public Welfare Association became the American Public Human
Services Association.
8
  In addition, the Abandoned Infants Assistance Act of 1988, as amended in 1996, requires
states to expedite the termination of parental rights for abandoned infants in order to
receive priority to obtain certain federal funds.



Page 4                                                                       GAO-03-626T
the 15 of 22 provision. Under ASFA, states are not required to file a TPR if
the child is placed with a relative; the state has not provided services
needed to make the home safe for the child’s return; or the state
documents a compelling reason that filing a TPR is not in the child’s best
interest.

ASFA also created two new adoption-related funding sources. First, ASFA
reauthorized the family preservation and family support program under
subpart 2 of Title IV-B of the Social Security Act, renaming it Promoting
Safe and Stable Families (PSSF) and adding two new funding categories:
adoption promotion and support services and time-limited family
reunification services. The original family preservation program included
only family preservation and community-based family support services. In
January 2002, the PSSF program was reauthorized, authorizing $305
million for each of fiscal years 2002 through 2006, along with an additional
$200 million in discretionary grant funds for each of those years.

Second, ASFA created the adoption incentive payment program, which
awards states $4,000 for each foster child who is adopted over a previously
established baseline and an extra $2,000 for each adopted child
characterized by the state as having a special need. States have earned a
total of approximately $145 million in incentive payments for adoptions
finalized in fiscal years 1998 through 2001.

ASFA also expanded the use of federal child welfare demonstration
waivers that allow states to test innovative foster care and adoption
practices. In 1994, the Congress gave HHS the authority to establish up to
10 child welfare demonstrations that waive certain restrictions in Titles IV-
B and IV-E of the Social Security Act and allow broader use of federal
foster care funds. ASFA authorized 10 additional waivers in each year
between fiscal years 1998 and 2002 to ensure more states had the
opportunity to test innovations. States with an approved waiver must
conduct a formal evaluation of the project’s effectiveness and must
demonstrate the waiver’s cost neutrality—that is, a state cannot spend
more in Titles IV-B and IV-E funds than it would have without the waiver.
Projects generally are to last no more than 5 years.




Page 5                                                           GAO-03-626T
                           The number of annual adoptions has increased since the implementation
Limited Data are           of ASFA; however, data limitations restrict comparative analysis of other
Available to Measure       outcomes and characteristics of children in foster care.9 Foster care
                           adoptions grew from 31,004 in fiscal year 1997 to 48,680 in fiscal year 2000,
Changes in the             representing a 57 percent increase.10 However, current data constraints
Outcomes and               make it difficult to determine what role ASFA played in this increase. The
                           lack of reliable and comparable pre- and post-ASFA data limits our ability
Characteristics of         to analyze how other foster care outcomes or children’s characteristics
Children Since ASFA        have changed. Current data do, however, provide some information about
                           the characteristics and experiences of foster children after ASFA. For
                           example, children leaving foster care between 1998 and 2000 spent a
                           median of approximately 1 year in care. Of these children, those who were
                           adopted spent more time in care—a median of approximately 3-½ years.


Adoptions Have Increased   Adoptions from state foster care programs have increased nationwide by
Since ASFA, but Changes    57 percent from the time ASFA was enacted through fiscal year 2000, but
in Other Outcomes          changes in other outcomes are less clearly discernable. According to data
                           available from HHS, the increase in adoptions began prior to the
Unclear                    enactment of federal child welfare reforms (see fig. 1). For example,
                           adoptions generally increased between 8 percent and 12 percent each year
                           between 1995 and 2000, except in 1999 when they increased by 29 percent
                           over 1998 adoptions. The increase in overall adoptions of children in foster
                           care is accompanied by a parallel increase in the adoptions of children
                           with special needs.




                           9
                            HHS officials believe that the adoption data available as early as 1995 are more reliable
                           than early data on other outcomes because of the incentive payments that states can earn
                           for increasing adoptions. They noted that states made great efforts to improve the accuracy
                           of their adoption data when the incentive payment baselines were established. For
                           example, HHS initially estimated about 20,000 adoptions for fiscal year 1997, but after
                           states reviewed and submitted their adoption data, as required for participation in the
                           adoption incentive program, they reported about 31,000 adoptions.
                           10
                                All HHS data are presented in terms of federal fiscal year.



                           Page 6                                                                      GAO-03-626T
Figure 1: Number of Children Adopted from Foster Care between Fiscal Years 1995
and 2000


60,000

                                                                                                         48,680
50,000                                                                                       44,952       (8%)
                                                                                             (29%)

                                                                      34,736
40,000
                                                                      (12%)
                                                  31,004
                         27,718                   (12%)                                                  36,947
30,000                    (8%)                                                               33,721      (10%)
         25,644
                                                                                             (35%)

                                                                      24,960
20,000                                            22,760              (10%)
                         20,532                   (11%)
         18,796           (9%)
10,000



    0

     1995                  1996                  1997                   1998                  1999           2000

              Total adoptions
              Adoptions of children with special needs


  Source: Data from HHS's Children's Bureau used to determine adoption incentive payments.

Note: The percentages in parentheses represent the increase in finalized adoptions over the previous
year.


The role ASFA played in the increase in adoptions after 1997, however, is
unclear. Similarly, whether the number of foster children being adopted
will continue to rise in the future is unknown. For example, since our
report was issued last June, HHS reported that 48,741 adoptions were
finalized in 2001, which represents only a slight increase over adoptions
finalized in 2000. While ASFA may have contributed to the adoptions of
these children, other factors may have also played a role. For example,
HHS officials told us that state child welfare reform efforts that occurred
before ASFA might be linked to the observed increase in adoptions. Since
it can take several years for foster children to be adopted, and ASFA has
only been in existence for a few years, evidence of ASFA’s effect may not
be available for some time.

ASFA’s effect on other foster care outcomes, such as birth family
reunifications, is also difficult to determine. Lack of comparable and
reliable data on foster care children, before and after ASFA, make it


Page 7                                                                                                GAO-03-626T
                          difficult to know how ASFA has affected the child welfare system. While
                          HHS officials report that some data are reliable to provide a picture of
                          children in foster care after ASFA, they state that the child welfare data
                          covering pre-ASFA periods are not reliable due to problems such as low
                          response rates and data inconsistencies. Since 1998, however, HHS data
                          specialists have observed improvements in the data submitted to HHS by
                          states and attribute the changes to several factors, including the provisions
                          of federal technical assistance to the states on data processing issues, the
                          use of federal financial penalties and rewards, and the use of outcome
                          measures to evaluate states’ performance. According to HHS, these data
                          improvements make it impossible to determine whether observed changes
                          in outcomes from one year to the next are the result of changes in data
                          quality or changes in state performance. HHS expects that the data will
                          stabilize over time and can eventually be used as a reliable measure of
                          state performance.


Current Data Describe     Although pre-ASFA data are limited, current data do shed some light on
Characteristics and       the characteristics and experiences of the more than 741,000 children who
Experiences of Children   exited foster care between 1998 and 2000.11 According to HHS data for this
                          time period and results from our survey, the following outcomes and
Who Exited Care between   characteristics describe the experiences children had while in foster care:
1998 and 2000
                          •   Children left foster care after a median length of stay of approximately
                              1 year, although the amount of time spent in care differed depending on
                              where the children were permanently placed. For example, in 2000, the
                              median length of stay for children exiting care was 12 months. In
                              contrast, the median length of stay for adopted children was 39 months
                              in 2000.
                          •   Many children have only one placement during their foster care stay,
                              but a few experience five or more placements. Adopted children tend
                              to have more foster care placements than other children, in part,
                              because of their longer foster care stays.
                          •   Upon leaving foster care, most children returned home to the families
                              they had been living with prior to entering foster care. However,
                              approximately 33 percent of the children who went home to their birth



                          11
                             According to HHS’s AFCARS data, 223,255 children exited foster care in fiscal year 1998
                          from 44 states (including the District of Columbia and Puerto Rico); 250,950 exited foster
                          care in fiscal year 1999 from 51 states (including the District of Columbia and Puerto Rico);
                          and 267,344 exited foster care in fiscal year 2000 from 51 states (including the District of
                          Columbia).



                          Page 8                                                                        GAO-03-626T
     families in 1998 subsequently returned to foster care by 2000, for
     reasons such as additional abuse and neglect at home.
•    Our survey results indicated that the median percentage of children
     abused or neglected while in foster care during 1999 and 2000 was 0.60
     percent and 0.49 percent, respectively.12 Maltreatment rates in foster
     care ranged from a high of 2.74 percent in the District of Columbia to a
     low of 0.02 percent in Nebraska.13

Children exit foster care in a number of ways, including reunifying with
their families,14 being adopted, emancipation,15 or entering a guardianship
arrangement.16 Although most children reunify with their families, the
second most common way of exiting foster care is through adoption. The
children adopted from foster care have a wide variety of characteristics,
yet the data indicate some general themes.

•    On average, 85 percent of the children adopted in 1998, 1999, and 2000
     were classified as having at least one special need that would qualify
     them for adoption subsidies under Title IV-E.17 According to results



12
  Of the 46 states that responded to our survey, 16 provided data on the percentage of
foster children who had a substantiated report of abuse or neglect in fiscal year 1999, 2
provided data for calendar year 1999, 1 provided data for state fiscal year 1999, 18 provided
data for fiscal year 2000, 1 provided data for calendar year 2000, and 2 provided data for
state fiscal year 2000.
13
  According to HHS’s Child Welfare Outcomes 1999: Annual Report, the median
percentage of foster children abused and neglected while in care was 0.5 percent for the 20
states reporting. Maltreatment rates in foster care range from a high of 2.3 percent in
Rhode Island to a low of 0.1 percent in Arizona, Delaware, and Wyoming.
14
 In AFCARS, reunification is defined as the child returning to the family with whom the
child had been living prior to entering foster care.
15
  A child is emancipated from foster care when the child reaches majority age according to
state law.
16
  Guardianship arrangements occur when permanent legal custody is awarded to an
individual, such as a relative.
17
   While current AFCARS data indicate that 85 percent of children adopted in fiscal years
1998 through 2000 have at least one special need, the adoption incentive data presented
earlier in figure 1 indicate a lower proportion of children with special needs adopted from
foster care. An HHS official explained that this discrepancy is due to the timing of the
measurement of the data. The data in figure 1 were measured at an earlier point in time and
the numbers are not updated since adoption incentive payments are awarded to states
based on the number of finalized adoptions reported at the end of each fiscal year. The data
presented here reflect changes to AFCARS based on states resubmitting previous data after
the initial reporting periods and are as recent as April 2002.



Page 9                                                                        GAO-03-626T
     from our survey, 18 states reported that, on average, 32 percent of the
     children adopted from foster care in 2000 had three or more special
     needs.18
•    Children adopted from foster care are equally likely to be male or
     female, slightly more likely to be black, and much more likely to be
     under age 12. The gender and race/ethnicity distributions of children
     adopted from foster care are similar to those of the general population
     of children in foster care. However, children adopted from foster care
     tend to be younger than the general population of children in foster
     care.
•    Our survey results indicate that in fiscal year 2000 adopted children
     spent an average of 18 months living with the family that eventually
     adopted them prior to their adoption being finalized.19

As noted for other outcomes, the lack of reliable and national pre-ASFA
data make it difficult to determine whether the rate at which adoptions
encountered problems has changed since ASFA was enacted.20 However,
limited data suggest that problems occur in a small percentage of foster
care adoptions. According to our survey,21 about 5 percent of adoptions
planned in fiscal years 1999 and 2000 disrupted prior to being finalized.22
States also reported that approximately 1 percent of adoptions finalized in
these years legally dissolved at a later date and that about 1 percent of the
children who were adopted in these years subsequently re-entered foster




18
 One of the 18 states reporting on the number of children adopted with three or more
special needs provided data based on calendar year 2000.
19
   Of the 46 states responding to our survey, 22 provided fiscal year data on the length of
time children lived with the family that eventually adopted them and 1 provided data for
calendar year 2000.
20
 Studies on adoption problems prior to ASFA’s enactment have several limitations, such as
small samples sizes, coverage of a few locations, and a focus on narrowly defined groups of
children.
21
  Of the 46 states that responded to our survey, 17 provided data on adoption disruptions
for fiscal year 1999, 2 provided data for calendar year 1999, 18 provided data on adoption
disruptions for fiscal year 2000, and 2 provided data for calendar year 2000.
22
  For example, Illinois reported a 12.4 percent disruption rate for fiscal year 1999 on our
survey. In comparison, one study (Robert Goerge and others, Adoption, Disruption, and
Displacement in the Child Welfare System, 1976-1995 (Chicago: Chapin Hall Center for
Children at the University of Chicago, 1995)) reviewed all planned and finalized adoptions
in Illinois between 1981 and 1987. During that time, an average of 9.9 percent of adoption
plans for Illinois foster children disrupted.



Page 10                                                                        GAO-03-626T
                              care.23 However, little time has elapsed since these adoptions were
                              finalized, and some of these adoptions may fail at a later date.


                              While few states were able to provide data on the numbers of children
While Little Data are         affected by ASFA’s fast track and 15 of 22 provisions, some reported on
Available on Key              circumstances that make it difficult to use these provisions for more
                              children. In addition, HHS collects very little data on the use of these
ASFA Permanency               provisions. Data from four states that provided fast track data in response
Provisions, Some              to our survey indicate that they do not use this provision frequently.
                              However, they described several court-related issues that make it difficult
States Describe               to fast track more children, including court delays and a reluctance on the
Circumstances That            part of some judges to relieve the state from reunification efforts. Survey
Limit Their Broader           responses from the few states that provided data on the 15 of 22 provision
                              indicate that these states do not file TPRs for many children who are in
Use                           care for 15 months. Officials in the six states we visited reported that they
                              determine that filing a TPR under this provision for many children is not in
                              the children’s best interests. The determination is based on a variety of
                              factors, such as difficulties in finding adoptive parents.


While Data on Fast Track      Few states were able to provide data on their use of the fast track
Are Limited, Some States      provision in response to our survey and HHS does not collect these data
Report Court-Related          from the states. As a result, we do not have sufficient information to
                              discuss the extent to which states are using this provision. Survey data
Issues That Hinder the Use    reported by four states suggest the infrequent use of fast track. In fiscal
of the Fast Track Provision   year 2000, for example, about 4,000 children entered the child welfare
for More Children             system in Maryland, but only 36 were fast-tracked. Child welfare officials
                              in the six states we visited told us that they used ASFA’s fast track
                              provision for a relatively small number of cases. Three states indicated
                              that they fast-tracked abandoned infants, while four states reported using
                              fast track for cases involving serious abuse, such as when a parent has
                              murdered a sibling; however, some state officials also noted that few child
                              welfare cases involve these circumstances. In addition, five states reported


                              23
                                Of the 46 states that responded to our survey, 18 provided data on dissolutions for fiscal
                              year 1999, 19 provided data on dissolutions for fiscal year 2000 and 1 provided data for
                              calendar year 2000. In addition, 21 states provided survey data on foster care re-entries by
                              children adopted in fiscal year 1999, 22 provided data for children adopted in fiscal year
                              2000, and 1 provided data for children adopted in calendar year 2000. Our survey results
                              indicate that of all the children with finalized adoptions in fiscal year 1999, 0.55 percent
                              returned to foster care in fiscal year 1999 or 2000. Of all the children with finalized
                              adoptions in fiscal year 2000, 1.43 percent returned to foster care in fiscal year 2000.



                              Page 11                                                                        GAO-03-626T
that they would fast track certain children whose parents had involuntarily
lost parental rights to previous children if no indication exists that the
parents have addressed the problem that led to the removal of the
children.

Officials in five of the states we visited described several court-related
issues that they believe hindered the greater use of the fast track
provision. However, because of the lack of data on states’ use of fast track,
we were unable to determine the extent of these problems. Officials in
these states told us that some judges or other legal officials are at times
reluctant to approve a state’s fast track request. For example, child
welfare staff for a county in North Carolina described a case in which a
judge approved a fast track request involving a child who had suffered
from shaken baby syndrome, but refused a similar request on a sibling
who was born a few months after the shaking episode. County staff said
that the judge’s decision was based on the fact that the parents had not
hurt the newborn and should be given an opportunity to demonstrate their
ability to care for this child. State officials in North Carolina also told us
that delays in scheduling TPR trials in the state undermine the intent of
fast tracking. They noted that the agency may save time by not providing
services to a family, but the child may not be adopted more quickly if it
takes 12 months to schedule the TPR trial. Officials in Massachusetts
expressed similar concerns about court delays experienced in the state
when parents appeal a court decision to terminate their parental rights.

Other difficulties in using fast track to move children out of foster care
more quickly are related to the specific categories of cases that are eligible
to be fast-tracked. Officials in five states told us that they look at several
factors when considering the use of fast track for a parent who has lost
parental rights for other children. If a different birth father is involved,
child welfare officials told us that they are obligated to work with him to
determine if he is willing and able to care for the child. According to
Maryland officials, if the agency is providing services to the father to
facilitate reunification, pursuing a fast track case for the mother will not
help the child leave foster care more quickly. In addition, child welfare
officials in Massachusetts and Illinois emphasized that a parent who has
addressed the problems that led to a previous TPR should have an
opportunity to demonstrate the ability to care for a subsequent child.

Regarding the fast track category involving parents who have been
convicted of certain felonies, child welfare officials in Massachusetts and
Texas described this provision as impractical due to the time it takes to
obtain a conviction. Massachusetts officials told us that, in most cases, the

Page 12                                                          GAO-03-626T
                             children are removed at the time the crime is committed, and judges will
                             not approve the fast track in these cases until the parent is actually
                             convicted, which is usually at least a year after the actual crime. Finally, in
                             Massachusetts, Texas, and Maryland, officials reported that it can be
                             difficult to prove that a parent subjected a child to aggravated
                             circumstances, such as torture or sexual abuse. According to these
                             officials, the time and effort to go through additional court hearings to
                             demonstrate the aggravated circumstances is not worthwhile; instead, the
                             child welfare agency chooses to provide services to the family.


Although Little Data Exist   Most states do not collect data on their use of ASFA’s 15 of 22 provision. In
on 15 of 22, Some States     response to our survey, only nine states were able to provide information
Report That They Do Not      on the number of children for whom the state filed a TPR due to the 15 of
                             22 provision or the number of children who were in care for 15 of the most
File TPRs on Many            recent 22 months and for whom a TPR was not filed. In addition, HHS
Children                     does not systematically track these data, although it does collect some
                             limited information on the 15 of 22 provision as part of its review of state
                             child welfare agencies. The survey responses from 9 states indicated that
                             they did not file a TPR on a number of children—between 31 and 2,919 in
                             2000—who met the requirements of the 15 of 22 provision. For most of
                             these nine states, the number of children for whom a TPR was not filed
                             greatly exceeded the number of children for whom a TPR was filed. For
                             example, while Oklahoma filed over 1,000 TPRs primarily because the
                             child had been in foster care for 15 of the most recent 22 months, it did not
                             file a TPR for an additional 2,900 children.

                             Officials in all six states we visited told us that establishing specific
                             timeframes for making permanency decisions about children in foster care
                             has helped their child welfare agencies focus their priorities on finding
                             permanent homes for children more quickly. Two of the states we
                             visited—Texas and Massachusetts—created procedures prior to ASFA to
                             review children who had been in care for a certain length of time and
                             decide whether continued efforts to reunify a family were warranted.
                             Other states had not established such timeframes for making permanency
                             decisions before the 15 of 22 provision was enacted. The director of one
                             state child welfare agency told us that, prior to ASFA, the agency would
                             work with families for years before it would pursue adoption for a child in
                             foster care. Officials in Maryland, North Carolina, and Oregon said that the
                             pressure of these new timeframes has helped child welfare staff work
                             more effectively with parents, informing them up front about what actions
                             they have to take in the next 12 to 15 months in order to reunify with their
                             children. Private agency staff in three states, however, expressed concern

                             Page 13                                                            GAO-03-626T
that pressure from these timeframes could push the child welfare agency
and the courts to make decisions too quickly for some children.

Child welfare officials in the six states we visited described several
circumstances under which they would not file a TPR on a child who was
in care for 15 of the most recent 22 months. In five of the six states, these
officials told us that the provision is difficult to apply to children with
special needs for whom adoption may not be a realistic option, such as
adolescents and children with serious emotional or behavioral problems.
Officials from Maryland and North Carolina reported that, in many cases,
the child welfare agency does not file a TPR for children who have been in
care for 15 of the most recent 22 months because neither the agency nor
the courts consider it to be in the children’s best interest to be legal
orphans—that is, to have their relationship to their parents legally
terminated, but have no identified family ready to adopt them.24 State
officials in Oregon told us that state law requires that parental rights be
terminated solely for the purposes of adoption, so as to avoid creating
legal orphans.

Officials in four states noted that many adolescents remain in long-term
foster care. In some cases, they have strong ties to their families, even if
they cannot live with them, and will not consent to an adoption.25 In other
cases, the teenager is functioning well in a stable situation with a relative
or foster family that is committed to the child but unwilling to adopt.26 For
example, officials in a child welfare agency for a county in North Carolina
told us about a potentially violent 16-year old foster child who had been in
a therapeutic foster home for 10 years. The family was committed to
fostering the child, but did not want to adopt him because they did not
have the financial resources to provide for his medical needs and because
they did not want to be responsible for the results of his actions.




24
 In North Carolina, child welfare agency staff may recommend to the court that a TPR not
be filed on a child who has been in care for 15 of the most recent 22 months; however,
according to state officials, North Carolina requires that a judge determine that one of the
ASFA exceptions exists.
25
 All the states we visited require that children over a certain age consent to their adoption.
For example, Maryland requires that children 10 years or older consent to their adoption.
26
 ASFA specifically allows states to exempt children placed with relatives from the 15 of 22
provision.



Page 14                                                                        GAO-03-626T
                       Child welfare staff from two states told us that some parents need a little
                       more than 15 months to address the problems that led to the removal of
                       their children. If the child welfare agency is reasonably confident that the
                       parents will be able to reunify with their children in a few months, the
                       agency will not file a TPR for a child who has been in foster care for 15
                       months. In addition, child welfare officials in four states observed that
                       parents must have access to needed services, particularly substance abuse
                       treatment, soon after a child enters care in order for the child welfare
                       system to determine if reunification is a realistic goal by the time a child
                       has been in care for 15 months. Officials in Maryland, Oregon, and Texas
                       reported that the lack of appropriate substance abuse treatment programs
                       that address the needs of parents makes it difficult to get parents in
                       treatment and stable by the 15th month.


                       States reported in our survey that they most commonly used their
New ASFA Adoption-     adoption incentive payments and PSSF adoption promotion and support
Related Funds Most     services funds to recruit adoptive families and to provide post adoption
                       services (see table 1). Child welfare officials in all of the states we visited
Commonly Used to       reported that they are struggling to recruit adoptive families for older
Recruit Adoptive       children and those with severe behavioral or medical problems. To meet
                       this challenge, states are investing in activities designed to match specific
Families and Provide   foster care children with adoptive families, as well as general campaigns to
Post Adoption          recruit adoptive families. Child-specific recruitment efforts include:
Services               featuring children available for adoption on television, hosting matching
                       parties for prospective adoptive parents to meet children available for
                       adoption, and taking pictures and videos of foster children to show to
                       prospective families. For example, Massachusetts used its incentive
                       payments to fund recruitment videos to feature the 20 children who had
                       been waiting the longest for adoptive families. General recruitment efforts
                       being funded by states include promoting adoption through National
                       Adoption Month events, hiring additional recruiters, and partnering with
                       religious groups.




                       Page 15                                                           GAO-03-626T
Table 1: Main Uses of Adoption Incentive Payments and PSSF Adoption Promotion
and Support Funds

                                              Number of states using                  Number of states
                                                  adoption incentive              using PSSF adoption
                                                           payments             promotion and support
    Activity                                   (FY 1999 and FY 2000)                   funds (FY 2000)
    Recruitment of adoptive families                             19a                               16b
    Post adoption servicesc                                      17a                               21b
                                                                            d
    Preadoptive counseling                                                                          15
                                                                       13e                                d
    Hiring/Contracting additional
    social work staff
    Training                                                            11                            4
Source: GAO survey.

Note: Of the 46 states that responded to our survey, 34 provided data on the use of FY 1999 and FY
2000 incentive payments and 26 provided information on the use of FY 2000 PSSF funds.
a
    One state provided data for calendar year 1999.
b
    One state provided data for calendar year 2000.
c
 Post adoption services include: counseling, respite care (short-term specialized child care to provide
families with temporary relief from the challenges of caring for adoptive children), support groups,
adoption subsidies, and adoption preservation services.
d
    This activity was not included as a response for this funding source.
e
    One state provided data for state fiscal years 1999 and 2000.


States are also investing adoption incentive payments and PSSF funds in
services to help adoptive parents meet the challenges of caring for
children who have experienced abuse and neglect. During our site visits,
officials in Massachusetts and Illinois pointed out that the population of
adopted children had increased significantly in recent years and that the
availability of post adoption services was essential to ensure that these
placements remain stable. Approximately 60 percent of the states
responding to our survey used their adoption incentive payments or their
PSSF funds or both for post adoption services, such as post adoption
counseling, respite services, support groups, and recreational activities.
For example, California has used some of its adoption incentive funds to
pay for therapeutic camps and tutoring sessions for adopted children. In
addition, Minnesota has used PSSF funds to teach adoptive parents how to
care for children with fetal alcohol syndrome and children who find it
difficult to become emotionally attached to caregivers.

Although the 46 states responding to our survey reported that they are
most frequently using the money for the activities described above, about
two-thirds of them also reported that they are investing some of these


Page 16                                                                                  GAO-03-626T
                          funds in a variety of other services. Many states are using PSSF funds to
                          provide pre-adoptive counseling to help children and parents prepare for
                          the emotional challenges of forming a new family. Similarly, some states
                          are using incentive payments and PSSF funds to train foster families,
                          adoptive families, and service providers. For example, Arkansas used its
                          incentive payments to help families attend an adoptive parent conference,
                          while Kentucky used its incentive funds to train judges and attorneys on
                          adoption matters. Finally, some states are using their adoption incentive
                          payments to hire or contract additional child welfare and legal staff.


                          States have been developing a range of practices to address long-standing
States Develop            barriers to achieving permanency for children in a timely manner—many
Practices in Response     of which have been the subject of our previous reports. Both
                          independently and through demonstration waivers approved by HHS,
to Long-Standing          states are using a variety of practices to address barriers relating to the
Barriers That             courts, recruiting adoptive families for children with special needs, placing
                          children in permanent homes in other jurisdictions, and the availability of
Continue to Hamper        needed services. Because few of these practices have been rigorously
Efforts to Promote        evaluated, however, limited information is available on their effectiveness.
Permanency for
Foster Children


Systemic Court Problems   Our previous work, officials in all the states we visited, and over half of
Continue to Delay Child   our survey respondents identified problems with the court system as a
Welfare Cases             barrier to moving children from foster care into safe and permanent
                          homes.27 In 1999, we reported on systemic problems that hinder the ability
                          of courts to produce decisions on child welfare cases in a timely manner




                          27
                             Of the 29 states that reported an insufficient number of judges or court staff, 18 reported
                          that the problem represented either a moderate, great, or very great hindrance to finding
                          permanent homes for children. Of the 28 states that reported insufficient training for court
                          staff, 20 reported that the problem represented a moderate or great hindrance. Of the 23
                          states that reported that judges were not supportive of ASFA’s goals, 10 reported that the
                          problem represented either a moderate, great, or very great hindrance. Of the 46 states that
                          responded to our survey, 40 reported on the insufficient number of judges and court staff,
                          41 reported on the lack of training for judges and court staff, and 39 reported on judges not
                          being supportive of ASFA’s goals.



                          Page 17                                                                        GAO-03-626T
that meet the needs of children.28 The barriers included inadequate
numbers of judges and attorneys to handle large caseloads, the lack of
cooperation between the courts and child welfare agencies, and
insufficient training of judges and attorneys involved in child welfare
cases.

During our visit to Massachusetts, state officials told us that the courts
experienced significant delays in court hearings and appeals due to a lack
of court resources. As an alternative to court proceedings, Massachusetts
implemented a permanency mediation program—a formal dispute
resolution process in which an independent third party facilitates
permanency planning between family members and potential adoptive
parents in a nonadversarial setting. By avoiding trials to terminate parental
rights, Massachusetts officials reported that permanency mediation helps
reduce court workloads, eliminate appeals, and more effectively uses
limited court resources. A preliminary evaluation of the Massachusetts
program suggested that cases involved in the mediation program needed
less time and fewer court resources to reach an agreement than cases that
go to trial. However, the evaluation did not directly compare outcomes,
such as the length of time a child spent in foster care, for mediation and
nonmediation cases.

Texas officials identified court barriers in rural areas that negatively affect
both the timeliness and quality of child welfare proceedings—specifically,
the lack of court time for child welfare cases and the lack of judges with
training and experience in child welfare issues. In response to these
barriers, Texas developed the visiting judge cluster court system, an
approach in which a judge trained in child welfare issues is assigned to a
cluster of rural counties. The judge travels from county to county
presiding over all child welfare cases. This approach may create more
court time in rural areas and allows knowledgeable and experienced
judges to make the best possible decisions for children in foster care.
While Texas officials believe this approach has been helpful in moving
children to permanency, no formal evaluation of the approach has been
conducted.




28
 U.S. General Accounting Office, Juvenile Courts: Reforms Aim to Better Serve
Maltreated Children, GAO/HEHS-99-13 (Washington, D.C.: Jan. 11, 1999).



Page 18                                                                   GAO-03-626T
Permanency for Children   Officials in five states we visited, along with the majority of the
with Special Needs        respondents to our state survey, reported that difficulties in recruiting
Hindered by Lack of       families to adopt children with special needs is a major barrier to
                          achieving permanent placements for these children.29 Our survey revealed
Adoptive Families         that states relied on three main activities to recruit adoptive families for
                          children who are waiting to be adopted: listing a child’s profile on state
                          and local Web sites, exploring adoption by adults significantly involved in
                          the child’s life, and featuring the child on local television news shows.30

                          Several states we visited are using recruitment campaigns targeted to
                          particular individuals who may be more likely to adopt children with
                          special needs. For example, the child welfare agencies in Illinois,
                          Maryland, North Carolina, and Texas are collaborating with local churches
                          to recruit adoptive families specifically for minority children. However, an
                          Illinois recruitment report noted that little information exists on what
                          kinds of families are likely to adopt children with specific characteristics.
                          While the states we visited used a variety of recruitment efforts to find
                          families for special needs children, they generally did not collect data on
                          the effectiveness of their recruiting efforts.

                          In addition to the activities described above, some demonstration waivers
                          are testing a different approach to finding permanent homes for children
                          in foster care.31 Seven states are using demonstration waivers to pay
                          subsidies to relatives and foster parents who become legal guardians to
                          foster children in their care. These states hope to reduce the number of
                          children in long-term foster care by formalizing existing relationships in
                          which relatives or foster parents are committed to caring for a child but
                          adoption is not a viable option. Evaluation results from Illinois’s waiver
                          suggest that offering subsidized guardianship can increase the percentage



                          29
                           Of the 46 states responding to our survey, 43 states reported on the sufficiency of
                          adoptive homes for children with special needs. All 43 states reported that they did not
                          have enough adoptive homes for children with special needs, with 39 reporting that the
                          problem represented a moderate, great, or very great hindrance to finding permanent
                          homes for children.
                          30
                           Of the 46 states responding to our survey, 44 answered the question about recruitment
                          activities used in their states.
                          31
                           HHS is authorized to approve child welfare demonstration projects in up to 10 states for
                          each of the 5 fiscal years 1998 through 2002. Under these projects, HHS waives certain
                          restrictions in title IV-E and allows broader use of federal foster care funds.



                          Page 19                                                                       GAO-03-626T
                          of children placed in a permanent and safe home. Results from most of the
                          other guardianship waiver projects are not yet available.

Placing Children Across   Many states encounter long-standing barriers in placing children with
Jurisdictions Remains     adoptive families in other states. As we reported previously, these
Problematic for States    interjurisdictional adoptions take longer and are more complex than
                          adoptions within the same child welfare jurisdiction.32 Interjurisdictional
                          adoptions involve recruiting adoptive families from other states or other
                          counties within a state, conducting comprehensive home studies of
                          adoptive families in one jurisdiction, sending the resulting home study
                          reports to another jurisdiction, and ensuring that all required legal,
                          financial, and administrative processes for interjurisdictional adoptions
                          are completed. Five states we visited reported frequent delays in obtaining
                          from other states the home study reports necessary to place a child with a
                          potential adoptive family in another state. According to recent HHS data,
                          children adopted by out-of-state families typically spend about 1 year
                          longer in foster care than children adopted by in-state families.

                          Child welfare agencies have implemented a range of practices to facilitate
                          adoptions across state and county lines. In our survey, the most common
                          practices for recruiting adoptive families in other jurisdictions included
                          publicizing profiles of foster care children on websites, presenting profiles
                          of children in out-of-state media, and contracting with private agencies to
                          recruit adoptive parents in other states.33 States have also developed
                          practices to expedite the completion of home studies and shorten the
                          approval processes for interstate adoptions. The two primary practices
                          cited by states on our survey were working with neighboring states to
                          facilitate interstate placements and contracting with private agencies to
                          conduct home studies in other states.34

                          States we visited have implemented several of these practices to overcome
                          barriers to interjurisdictional adoptions. In Oregon, the state child welfare


                          32
                           U.S. General Accounting Office, Foster Care: HHS Could Better Facilitate the
                          Interjurisdictional Adoption Process, GAO/HEHS-00-12 (Washington, D.C.: Nov. 19, 1999).
                          33
                            Of the 46 states that responded to our survey, 22 reported that they publicized profiles of
                          foster children in media in other states, 41 reported that they publicized profiles of foster
                          children on web sites, and 15 reported that they contracted with private agencies to recruit
                          adoptive parents in other states.
                          34
                             Of the 46 states responding to our survey, 35 reported that they worked with neighboring
                          states to facilitate interstate placements and 19 reported that they contracted with private
                          agencies in other states to conduct home studies.



                          Page 20                                                                        GAO-03-626T
                          agency works with neighboring states in the Northwest Adoption
                          Exchange to recruit adoptive parents for children with special needs. In
                          Texas, the state contracts with private agencies to place foster care
                          children with out-of-state adoptive families. In Illinois, the state works
                          with a private agency in Mississippi to conduct home studies because
                          families in Mississippi adopt many Illinois children.


Poor Access to Services   Officials in four states told us that making decisions about a child’s
Can Impede Permanency     permanent home within a year is difficult if the parent has not had access
Decisions                 to the services necessary to address their problems, particularly substance
                          abuse treatment. We have previously reported on barriers to working with
                          parents who have a substance abuse problem, including inadequate
                          treatment resources and a lack of collaboration among substance abuse
                          treatment providers and child welfare agencies.35 Similarly, 33 states
                          reported in our survey that the lack of substance abuse treatment
                          programs is a barrier to achieving permanency for children.36

                          To address this issue, four states have developed waiver projects to
                          address the needs of parents with substance abuse problems. By testing
                          ways to engage parents in treatment and to provide more supportive
                          services, these states hope to increase the number of substance abusing
                          parents who engage in treatment, increase the percentage of children who
                          reunify with parents who are recovering from a substance abuse problem,
                          and reduce the time these children spend in foster care. For example,
                          Delaware’s waiver funds substance abuse counselors to help social
                          workers assess potential substance abuse problems and engage parents in
                          treatment. Final evaluation results were published in March 2002 and
                          concluded that the project successfully engaged many parents in
                          substance abuse treatment and resulted in foster care cost savings,
                          although it did not achieve many of its intended outcomes. For example,
                          children participating in the waiver project spent 31 percent less time in
                          foster care than similar children who were not part of the waiver project,



                          35
                           U.S. General Accounting Office, Foster Care: Agencies Face Challenges Securing Stable
                          Homes for Children of Substance Abusers, GAO/HEHS-98-182 (Washington, D.C.: Sept. 30,
                          1998).
                          36
                            Of the 46 states that responded to our survey, 39 reported on the lack of substance abuse
                          treatment programs. Of the 33 states that reported that not enough drug treatment
                          programs were available, 26 reported that the problem represented either a moderate,
                          great, or very great hindrance to finding permanent homes for children.



                          Page 21                                                                      GAO-03-626T
               although the project’s goal was a 50 percent reduction. Evaluation results
               for the other states are not yet available.


               Most of the states we visited reported that ASFA has played an important
Concluding     role in helping them focus on achieving permanency for children within
Observations   the first year that they enter foster care. However, numerous problems
               with existing data make it difficult to assess at this time how outcomes for
               children in foster care have changed since ASFA was enacted. While an
               increasing number of children have been placed in permanent homes
               through adoption during the last several years, we know little about the
               role ASFA played in the adoption increases or other important outcomes,
               such as whether children who reunify with their families are more or less
               likely to return to foster care or whether these adoptions are more or less
               stable than adoptions from previous years.

               The availability of reliable data, both on foster care outcomes and the
               effectiveness of child welfare practices, is essential to efforts to improve
               the child welfare system. In the past few years, HHS and the states have
               taken important steps to improve the data available to assess child welfare
               operations. In addition, evaluation data from the demonstration waivers
               should be available in the next few years, providing key information on
               child welfare practices that are effective and replicable. However,
               important information about ASFA’s impact on children in foster care is
               still unavailable. For example, the lack of comprehensive and consistent
               data regarding the fast track and 15 of 22 provisions make it difficult to
               understand the role of these new provisions in reforming the child welfare
               system and moving children into permanent placements. To obtain a
               clearer understanding of how ASFA’s two key permanency provisions are
               working, we recommended in our June 2002 report that the Secretary of
               HHS review the feasibility of collecting data on states’ use of ASFA’s fast
               track and 15 of 22 provisions. In commenting on that report, ACF generally
               agreed with our findings and recommendation. ACF officials report that
               they are currently in the process of reviewing child welfare data issues,
               which includes an internal review of AFCARS and obtaining input from the
               states through focus groups. In addition, GAO is currently conducting an
               engagement for the Senate Finance Committee and the House Majority
               Leader on states’ implementation of automated information systems and
               reporting of child welfare data to HHS. I expect this report to be released
               in July.




               Page 22                                                         GAO-03-626T
                  Mr. Chairman, this concludes my prepared statement. I would be pleased
                  to respond to any questions that you or other members of the
                  Subcommittee may have.


                  For further contacts regarding this testimony, please call Cornelia M.
GAO Contact and   Ashby at (202) 512-8403. Individuals making key contributions to this
Acknowledgments   testimony include Diana Pietrowiak, Sara L. Schibanoff, and Michelle St.
                  Pierre.




                  Page 23                                                       GAO-03-626T
Related GAO Products


             Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare
             Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March
             31, 2003.

             Foster Care: Recent Legislation Helps States Focus on Finding
             Permanent Homes for Children, but Long-Standing Barriers Remain.
             GAO-02-585. Washington, D.C.: June 28, 2002.

             Child Welfare: New Financing and Service Strategies Hold Promise, but
             Effects Unknown. GAO/T-HEHS-00-158. Washington, D.C.: July 20, 2000.

             Foster Care: HHS Should Ensure That Juvenile Justice Placements Are
             Reviewed. GAO/HEHS-00-42. Washington, D.C.: June 9, 2000.

             Foster Care: States’ Early Experiences Implementing the Adoption and
             Safe Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999.

             Foster Care: HHS Could Better Facilitate the Interjurisdictional
             Adoption Process. GAO/HEHS-00-12. Washington, D.C.: November 19,
             1999.

             Foster Care: Effectiveness of Independent Living Services Unknown.
             GAO/HEHS-00-13. Washington, D.C.: November 5, 1999.

             Foster Care: Kinship Care Quality and Permanency Issues. GAO/HEHS-
             99-32. Washington, D.C.: May 6, 1999.

             Foster Care: Increases in Adoption Rates. GAO/HEHS-99-114R.
             Washington, D.C.: April 20, 1999.

             Juvenile Courts: Reforms Aim to Better Serve Maltreated Children.
             GAO/HEHS-99-13. Washington, D.C.: January 11, 2000.

             Foster Care: Agencies Face Challenges Securing Stable Homes for
             Children of Substance Abusers. GAO/HEHS-98-182. Washington, D.C.:
             September 30, 1998.

             Foster Care: State Efforts to Improve the Permanency Planning Process
             Show Some Promise. GAO/HEHS-97-73. Washington, D.C.: May 7, 1997.

             Child Welfare: States’ Progress in Implementing Family Preservation
             and Support Activities. GAO/HEHS-97-34. Washington, D.C.: February 18,
             1997.

             Page 24                                                     GAO-03-626T
           Permanency Hearings for Foster Children. GAO/HEHS-97-55R.
           Washington, D.C.: January 30, 1997.

           Child Welfare: Complex Needs Strain Capacity to Provide Services.
           GAO/HEHS-95-208. Washington, D.C.: September 26, 1995.

           Child Welfare: HHS Begins to Assume Leadership to Implement National
           and State Systems. GAO/AIMD-94-37. Washington, D.C.: June 8, 1994.




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