oversight

Foster Care: HHS Could Better Facilitate the Interjurisdictional Adoption Process

Published by the Government Accountability Office on 1999-11-19.

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

                 United States General Accounting Office

GAO              Report to Congressional Requesters




November 1999
                 FOSTER CARE
                 HHS Could Better
                 Facilitate the
                 Interjurisdictional
                 Adoption Process




GAO/HEHS-00-12
      United States
GAO   General Accounting Office
      Washington, D.C. 20548

      Health, Education, and
      Human Services Division

      B-281621

      November 19, 1999

      The Honorable William V. Roth, Jr.
      Chairman
      The Honorable Daniel Patrick Moynihan
      Ranking Minority Member
      Committee on Finance
      United States Senate

      The Honorable Bill Archer
      Chairman
      The Honorable Charles B. Rangel
      Ranking Minority Member
      Committee on Ways and Means
      House of Representatives

      The Adoption and Safe Families Act of 1997 (ASFA) is the most recent
      federal legislation to emphasize the importance of permanence in the lives
      of the 520,000 children in foster care and, in particular, the importance of
      adoption when foster children cannot safely and quickly return to the care
      of their birth parents. This act includes a provision prohibiting states from
      delaying or denying the adoption of a foster child when an approved
      family is available in a jurisdiction different from the one in which the
      child resides. The Department of Health and Human Services (HHS) is
      responsible for monitoring states’ adherence to this prohibition and to
      other provisions in ASFA. The act also requires us to study and consider
      how to improve procedures and policies to facilitate the timely and
      permanent adoptions of children across state and county
      jurisdictions—referred to as interjurisdictional adoptions.

      As agreed with committee staff, in response to the requirement in ASFA that
      we report to the Congress on interjurisdictional adoption issues, we are
      providing information on (1) the number of foster children who are
      available and waiting for an adoptive home to be identified, (2) the actions
      taken by state and county child welfare agencies1 and nonprofit
      organizations to improve the adoption process when prospective adoptive
      families and foster children live in different jurisdictions, and (3) the
      actions taken by the federal government to improve the adoption process
      when prospective adoptive families and foster children live in different
      jurisdictions. In particular, in ASFA the Congress identified four steps


      1
       In this report, we use the phrase “public child welfare agencies” to refer to both state and county
      child welfare agencies.



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                   related to timely and permanent interjurisdictional adoptions that our
                   study should address. First, states and counties may need to improve
                   procedures to recruit prospective adoptive parents from states or counties
                   different from the one in which adoptable children reside. Second, states
                   and counties may need to improve procedures for the acceptance of
                   homestudies when the studies are done in a different state or county.2
                   Third, states may need to assure their acceptance of termination of
                   parental rights orders and adoption decrees issued by a court in a different
                   state.3 Fourth, states may need to improve procedures for administering
                   and implementing the Interstate Compact on the Placement of Children
                   (ICPC).4 To develop this information, we contacted federal, state, and
                   county child welfare officials and experts affiliated with nonprofit
                   organizations interested in interjurisdictional adoption issues. We also
                   conducted case studies in three states—California, Florida, and Missouri.
                   Appendix I describes our scope and methodology. We conducted our
                   review from November 1998 to August 1999 in accordance with generally
                   accepted government auditing standards.


                   At any given time, about 1.5 percent of foster children—about 8,000—are
Results in Brief   legally available for adoption and waiting for an adoptive home but have
                   no current prospects for adoption. This number is small because, of those
                   foster children who are adopted, about 78 percent are adopted by their
                   foster parents or relatives. Virtually all of the remaining foster children
                   who are waiting for adoptive homes are among the most difficult to place
                   due to their older age, their need to be placed with siblings, or other
                   special considerations. Because these children are hard to place, they are
                   likely to be candidates for adoptive placement across jurisdictions.

                   Public child welfare agencies have directed their efforts toward the initial
                   step in the interjurisdictional adoption process—recruitment of
                   prospective adoptive families—and have done less to improve the other
                   steps in the adoption process because they are largely beyond their legal
                   authority to change. For example, these agencies are using traditional
                   recruiting methods in new ways, as was the case in two of the three states
                   we visited. These states enter into contracts with other states to conduct


                   2
                    A homestudy is a written report used to approve individuals as adoptive parents. See the Background
                   section of this report for a further description of homestudies and their use in the adoption process.
                   3
                    A court order to terminate parental rights severs the legal relationship between parent and child, thus
                   making the child eligible for adoption. An adoption decree finalizes the adoption process and provides
                   full parental rights to the adopting parent.
                   4
                    The ICPC is a uniformly enacted statute that provides the legal framework for placing children in
                   adoptive homes across state lines. The Background section of this report further describes this
                   compact and its process.
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             recruitment activities in geographic areas outside the public child welfare
             agency’s jurisdiction. The agencies also use Internet web sites, which can
             be accessed from anywhere in the nation, to reach beyond their borders to
             recruit prospective adoptive families and publicize waiting children.
             Nonprofit organizations that are working to improve interjurisdictional
             adoption processes have targeted their efforts at those steps in the
             adoption process that correspond to their professional interests. Such
             interests include nationwide recruitment of adoptive homes for
             hard-to-place waiting foster children as well as issues related to
             improvements in the use of homestudies and the ICPC process.

             HHS  leadership could facilitate improvements in the interjurisdictional
             adoption process, much of which is outside the legal authority of
             individual public child welfare agencies. HHS has developed plans to
             address problems in the interjurisdictional adoption process and
             implemented some actions. For example, as part of its technical assistance
             efforts, HHS provided guidelines for state legislation on termination of
             parental rights and assistance to states on ICPC issues. However, because
             the plans were made in response to two presidential directives regarding
             adoption, HHS Office of Inspector General recommendations, and the
             passage of ASFA, they were implemented independently rather than as part
             of an organized strategy. We are recommending that HHS better coordinate
             its efforts to facilitate improvements to the interjurisdictional adoption
             process.


             ASFA established as a federal priority the safe and timely placement of
Background   foster children in permanent homes, even if those homes are located in a
             jurisdiction different from that of the waiting children. Among the many
             provisions in ASFA, three are specific to interjurisdictional adoption issues.
             First, the act requires state plans5 to specify that a state will not deny or
             delay the placement of a child for adoption when an approved family6 is
             available outside of the jurisdiction with responsibility for handling the
             case of the child. Second, state plans7 must contain assurances that the
             state will develop plans for the effective use of cross-jurisdictional


             5
              State plans are required under title IV-E of the Social Security Act in order for states to receive federal
             foster care funds for maintenance of foster children, specific administration costs associated with
             foster care programs, and adoption assistance.
             6
              “Approved family” generally refers to an individual with an approved homestudy. However, HHS has
             not issued regulations to define this term as used in ASFA.
             7
              Other state plans are required under title IV-B of the Social Security Act in order for states to receive
             federal funds for child welfare services.



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resources to facilitate timely adoptive or permanent placements for
waiting children. Third, the act established a penalty against federal foster
care funds for states that are found to deny or delay the placement of a
child for adoption when an approved family is available outside of the
jurisdiction, or that fail to promptly grant a fair hearing to an individual
who alleges such a violation. HHS has a limited role in determining the
policies and procedures used by child welfare programs, including foster
care programs. HHS is responsible for issuing federal foster care
regulations containing minimal procedural requirements, monitoring
states’ compliance with them, and administering federal foster care
funding.

The public child welfare system, which oversees the adoption of foster
children, is composed mainly of state and local child welfare agencies and
state juvenile dependency courts. State laws provide more detail and
specificity regarding the circumstances in which adoptions may occur
than do federal laws and set the parameters, consistent with federal
constitutional and statutory requirements, under which child welfare
systems operate. For example, state laws specify the legal grounds for
terminating parental rights to free a child to be adopted. The child welfare
agencies promulgate the regulations, policies, and procedures for foster
care programs and administer those programs. Thus, state child welfare
agencies have a central role in regulating the activities of foster care
programs, including the adoption of foster children. In 12 states, that
responsibility is delegated to local child welfare agencies. State courts are
responsible for reviewing child welfare agency actions for individual foster
children and their families and taking legal actions as necessary to protect
children. Such actions include ordering the placement of foster children in
temporary homes, presiding over periodic hearings to plan for a child’s
permanent placement, terminating the parental rights of birth parents
when their children cannot be safely returned to their care, and granting
adoption decrees to adoptive parents.

The ICPC provides the legal framework for the placement of children
across state lines by public and private agencies, courts, and—in some
cases—private individuals. It is a statute enacted uniformly by all 50
states, the District of Columbia, and the U.S. Virgin Islands. A nonprofit
organization, the Association of Administrators of the Interstate Compact
on the Placement of Children (AAICPC), provides guidance to states in
interpreting and revising ICPC. Use of ICPC ensures that appropriate state
laws are followed before a placement is made and that children placed
out-of-state receive the protections and services that would be provided if



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they remained in their home states. States provide these services on a
reciprocal basis. Of the adoptive placements made under ICPC, few are
placements of foster children; almost all interstate adoptive placements
involve adoptions either between individuals or through private adoption
agencies. However, all foster care placements across state lines must be
processed through the compact. HHS has no direct role in ICPC
administration. Figure 1 shows the ICPC process for obtaining approval for
an out-of-state placement for a foster child. Figure 2 shows the ICPC
process once the decision has been made to place a child out-of-state.




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Figure 1: ICPC Process to Request Homestudy and Placement of Foster Child Out-of-State




                                         a
                                          In a few states, responsibility for contacting the state where the prospective adoptive parent
                                         resides has been delegated to the local child welfare agency. In those locations, the ICPC state
                                         compact administrator receives copies of the paperwork but may not be responsible for
                                         forwarding it.


                                         Source: GAO analysis.




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Figure 2: ICPC Process After Homestudy Is Obtained and Placement of Foster Child Is Approved




                                         a
                                          In a few states, responsibility for contacting the state where the prospective adoptive parent
                                         resides has been delegated to the local child welfare agency. In those locations, the ICPC state
                                         compact administrator receives copies of the paperwork but may not be responsible for
                                         forwarding it.


                                         Source: GAO analysis.




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Prospective adoptive parents come into the foster child’s life in a variety of
ways and through a long, complex process, particularly when a
hard-to-place child is involved. Public child welfare agencies engage in
outreach and other recruitment efforts to attract individuals to be foster
and adoptive parents and undertake a variety of concurrent activities so
that a waiting foster child can be placed with an appropriate prospective
adoptive parent. Most adoptive parents begin their relationship with the
child as the child’s foster parents. Others are relatives of the foster child. A
small percentage of adoptive parents come into the foster child’s life after
the child’s foster parents and relatives have declined to adopt the child
and another home must be sought for the child. Regardless of the way in
which a prospective adoptive parent enters the process, it can take a
prospective adoptive parent 1 to 3 years from the initial contact with a
child welfare agency to finalization of an adoption. Appendix II shows how
prospective adoptive parents enter the child welfare system, general
activities child welfare agencies undertake to make an appropriate
adoptive placement, and—when an interjurisdictional placement is
involved—when the ICPC is invoked.

The homestudy is a key component in the process of becoming a foster or
adoptive parent. Homestudies are written reports that are generally
prepared by a child welfare caseworker. The studies assess the financial
situation, current and previous relationships, life experiences, and
parenting abilities of a person wishing to become an adoptive parent. The
process also usually includes checks for criminal activity by the
prospective adoptive parent. The homestudy process is generally
combined with mandatory training for prospective foster or adoptive
parents, a combination that typically takes 3 months to complete. An
applicant is approved as a foster or adoptive parent only after the
homestudy process is completed, a written report of its findings is
approved by a child welfare agency, and the home is found to meet safety
standards. Agencies may then consider whether a prospective adoptive
parent would be an appropriate caregiver for a particular foster child.
Homestudies must be updated, in some locations as frequently as annually,
in order for a prospective adoptive parent to retain approved status. In
addition, homestudies may need to be updated at the time a prospective
adoptive parent is considered as a placement for a specific foster child in
order to determine if the person can meet that child’s special needs.
Although no standardized national homestudy format exists, appendix III
contains an example of one state’s recommended homestudy format—an
example that reflects the scope and detail typically found in homestudies.




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Few Foster Children Are              At any given time, an estimated 1.5 percent of foster children—about
Available and Waiting for            8,000—are available for adoption and, as yet, no adoptive family has been
Adoptive Homes but Most              identified for them. About one-third of foster children will never return to
                                     their birth parents, leaving those children in need of permanent homes. Yet
Who Wait Are Difficult to            few of the children in need of new permanent homes are, at any given
Place                                time, legally freed from their birth parents and thus available for adoption.
                                     Furthermore, HHS estimates that of the foster children who are adopted,
                                     78 percent will be adopted by their foster parents or relatives. Figure 3
                                     shows the likely permanency outcomes for foster children in care at any
                                     given time.


Figure 3: Anticipated Outcomes for
Foster Children




                                     a
                                      Other outcomes includes aging out of the foster care system at age 18 and, in some
                                     circumstances, legal guardianship. While in foster care, children who have other outcomes live in
                                     a variety of arrangements including the homes of relatives, foster homes, group homes, and
                                     residential care facilities.
                                     b
                                      For this grouping in the figure, we expanded the information to indicate the likely legal status of
                                     children in that grouping, at any given time, prior to attaining the anticipated outcome.




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                           Source: GAO analysis of HHS data.


                           While estimates of the number of adoptions across state lines vary, the
                           number of interjurisdictional adoptions is likely small. HHS administrative
                           data place the number of finalized adoptions of foster children across state
                           lines at less than 250 in 1998. Furthermore, the Office of Inspector General
                           noted that one-half of states’ ICPC offices do not know how many children
                           they place through ICPC due to poor quality data and ineffective tracking
                           techniques.

                           The foster children who are not adopted by their foster parents or
                           relatives are among the most difficult to place. Almost all of them have
                           special needs. Typically, they are school age, have physical or mental
                           impairments, have siblings who should be placed with them, and are
                           children of color. HHS reported that of the children freed for adoption,
                           more than 35 percent are teenagers and an additional 17 percent are
                           between the ages of 9 and 12 years. In general, within the foster care
                           population, only these hard-to-place and legally freed children are likely to
                           be candidates for adoptive placements across jurisdictions.


                           Public child welfare agencies have directed their efforts toward the initial
Public Child Welfare       step in the interjurisdictional adoption process—recruitment of
Agencies Focus on          prospective adoptive families—and have done less to improve the other
Recruitment While          steps in the adoption process because changing those steps is largely
                           beyond their legal authority. Nonprofit organizations working to improve
Nonprofit                  interjurisdictional adoption processes have targeted their efforts at those
Organizations Address      steps in the adoption process that correspond to the organizations’ areas
                           of interest. Such interests include nationwide recruitment of adoptive
a Range of Issues          homes for hard-to-place waiting foster children as well as issues related to
                           improvements in the use of homestudies and the ICPC process.


Public Child Welfare       In the initial step of the interjurisdictional adoption process—recruitment
Agencies Focus on          of prospective adoptive families—public child welfare agencies are
Improving the Use of       attempting to reach beyond their borders by using traditional recruitment
                           methods. In addition to using TV spots, newspaper stories, and billboards,
Traditional and Internet   two of the three states we visited also contract with other organizations
Recruitment Methods        for recruitment services; the contracts include provisions for recruitment
                           across jurisdictional lines. For example, Missouri contracts with other
                           organizations to recruit prospective foster and adoptive families from
                           several bordering states as well as from within the state. In Florida,



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Broward County contracts with other organizations for recruitment within
its borders and in adjoining counties. Public child welfare agencies also
participate in voluntary networks—referred to as adoption exchanges—to
identify adoptive families for hard-to-place foster children. These
voluntary networks provide child welfare agencies with the opportunity to
share information about children who need adoptive homes and approved
families who want to adopt a foster child.

Public child welfare agencies are also using the Internet to expand their
ability to recruit prospective adoptive families. Almost all state child
welfare agencies have set up their own public Internet web sites, which
can be accessed from anywhere in the nation, to promote adoption of
foster children; 30 states include photolistings of freed and waiting
children.8 Appendix IV lists public Internet web sites set up by state child
welfare agencies and a listing of the types of information that the public
can access. States have taken a variety of approaches in determining
which children to publicize on their child welfare web sites. Some state
web sites have photolistings that picture and describe all foster children in
a state who have been freed and are waiting for an adoptive home; other
states show only the hardest-to-place children; still others show a
representative sample of their available foster children.

In general, states have not evaluated the effectiveness of their sites as a
means of recruiting potential adoptive families nationwide. While many
state web sites welcome inquiries from all prospective adoptive families
nationwide, three state web sites specify that the state will consider only
applicants from within the state. Finally, public child welfare agencies also
use the Internet to participate in privately operated adoption exchanges on
password-protected sites that can be accessed only by caseworkers.

Public child welfare agencies do not have authority to specify the contents
of a homestudy prepared in another jurisdiction, but the three states we
visited have taken limited actions to increase the acceptability of the ones
they receive from other states. For example, if the public child welfare
agency requests a homestudy on a prospective adoptive parent in another
jurisdiction, the requesting agency notifies the agency preparing the
homestudy of its specific requirements so that they can be included in the
study. If the public child welfare agency receives an approved homestudy
from outside the agency’s jurisdiction, it contacts the agency that prepared

8
 Public child welfare agency’s public Internet sites protect the privacy of foster children listed on
them. In general, sites limit information about the children to first name and age of a child and a brief
description of a child’s special needs. As an added safeguard, courts must grant permission for public
distribution of information about the foster children under their jurisdiction.



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and approved the homestudy for additional information that will allow the
homestudy to meet local requirements and allow the agency to assess the
appropriateness of prospective adoptive parents. Additionally, in two of
the states we visited that contract with other agencies to conduct
recruitment activities, the contracts specify the content of the
homestudies done by the contractors. Thus, homestudies done by the
contractor will meet the criteria set for local homestudies.

As is the case with homestudies, public child welfare agencies also have
only limited authority to improve the acceptance of court orders across
jurisdictions. The Constitution sets the framework for states to accept the
court orders of other states but neither the Congress nor case law has
specifically addressed acceptance of termination of parental rights orders
or adoption decrees.9 In addition, the Supreme Court has ruled that states
are not obligated to honor judicial actions of other states in situations
where minimum standards of due process have not been provided to those
affected. HHS officials and experts told us that there is little to suggest that
interjurisdictional adoptions of foster children were delayed or denied
because termination of parental rights orders or adoption decrees were
not accepted across jurisdictions. One of the states we visited (Florida)
specifies in its adoption statutes that the state will accept such orders
from any other state.

Although public child welfare agencies can control only the steps in the
ICPC process that occur within their own state, two of the states we visited,
Florida and Missouri, have taken actions to avoid delays within their ICPC
offices.10 Officials in the three states we visited told us that they process
ICPC requests promptly and Florida has implemented performance goals to
further improve the timeliness of its processes. In Florida, the ICPC office
specified that ICPC requests related to adoption are to be processed
through its office within 3 days. Missouri has also instituted agreements
with two of its neighboring states with the goal of alleviating delays in
beginning homestudies requested through the ICPC office. However, the

9
 The acceptance of court orders of other states—otherwise called the granting of full faith and
credit—is governed by Article IV, Section 1 of the U.S. Constitution. It states, “Full faith and credit
shall be given in each State to the public acts, records, and judicial proceedings of every other State.
And the Congress may by general laws prescribe the manner in which such acts, records and
proceedings shall be proved, and the effect thereof.” In at least five instances since 1948, the Congress
passed laws to clarify the application of this clause. Clarifying legislation usually specifies the
instances in which full faith and credit is to be granted, such as is the case with child support orders.
In one instance, the Defense of Marriage Act, the legislation specifies that full faith and credit need not
be extended to marriages between certain parties.
10
  For placement of children in out-of-state foster or adoptive homes, California delegates responsibility
for the in-state ICPC process to its counties. Only children whose out-of-state placements are in group
homes are handled by the state ICPC office.



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                          agreements—referred to as border agreements—have been used
                          infrequently, even though one of the agreements has been in place for
                          more than a year. State officials were surprised that the 1-year-old
                          agreement was used infrequently. Officials from the two states involved
                          have decided to review the agreement with their respective staff to
                          emphasize the agreement’s value in speeding the start of the homestudy
                          process.


Nonprofit Organizations   Nonprofit organizations have initiated national efforts that cover many of
Also Address Issues in    the steps in the interjurisdictional adoption process. The National
Interjurisdictional       Adoption Center, the American Public Human Services Association
                          (APHSA), and its affiliate, AAICPC, are among the nonprofit organizations
Adoption Process          leading such efforts. The National Adoption Center operates two
                          recruitment-related Internet sites. APHSA initiated efforts to address issues
                          related to homestudies, and its affiliate provides recommendations to
                          member states to improve the ICPC process.

                          The National Adoption Center established and maintains11 two
                          recruitment-related Internet sites—a public national photolisting service
                          to publicize foster children who are currently available and waiting for
                          adoption, and a secure web site with additional resources for use by child
                          welfare agencies.12 The public Internet web site, called FACES OF
                          ADOPTION: America’s Waiting Children,13 listed about 1,800 waiting
                          children from about 38 states as of August 1999. The center anticipates
                          that additional states will soon become members, resulting in some
                          increase in the number of children listed on its site in the coming months.
                          Prospective adoptive parents can request information about a specific
                          child from the center. The center’s private Internet web site, called
                          NAE-Online, contains additional information about the children and also
                          contains information about families with approved homestudies. The site
                          is accessible only to child welfare agencies that pay a membership fee to
                          the center. The center estimated that during a 2-month period in summer
                          1999, about 30 foster children were placed for adoption as a result of their
                          listings being seen on FACES OF ADOPTION.



                          11
                            The Children Awaiting Parents, Inc., cosponsors the public web site.
                          12
                            Similar to web sites set up by state child welfare agencies, the center’s web site protects the privacy
                          of foster children in the photolisting service by providing only general descriptive information about
                          the children listed.
                          13
                            The site can be found on the Internet at http://www.adopt.org.



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                            In February 1999, APHSA convened a task force called the Geographic
                            Barriers Task Force of APHSA to Identify Barriers to Placements across
                            State Lines to explore issues related to the use of homestudies across
                            jurisdictions. The membership of the task force is still evolving, although it
                            is expected to include representatives of state child welfare agencies, child
                            welfare advocacy organizations, the AAICPC, and the Association of
                            Administrators of the Interstate Compact on Adoption and Medical
                            Assistance.14 As of August 1999, the task force had not set a time frame for
                            completion of its work or identified the scope of the work.

                            AAICPC provides guidance to states in interpreting ICPC and
                            recommendations on procedures. This group consists of representatives of
                            ICPC administrators from each state. AAICPC members implement
                            procedures that they believe will increase the timeliness of the ICPC
                            process. For example, ICPC Regulation 7 allows agencies to request an
                            expedited homestudy when a child is likely to be placed with a relative
                            residing in another state.


                            In response to presidential, legislative, and departmental actions, HHS
HHS Has Identified          identified problems that ranged across the interjurisdictional adoption
Problems That Affect        process, but its plans were not part of an organized strategy. HHS identified
Interjurisdictional         problems ranging from a shortage of adoptive families for special needs
                            foster children to placements by the courts that violate ICPC. HHS’ action
Adoptions but Lacks         plans did not address all identified problems and other actions are behind
an Organized Strategy       schedule. As the federal government’s primary agency for foster care and
                            adoption issues, HHS has a key role in providing leadership to assist states
                            in resolving interjurisdictional issues.

                            Since1996, the following presidential, legislative, and departmental actions
                            have directed HHS’ attention to issues related to interjurisdictional
                            adoption:

                        •   On December 14, 1996, the President issued a Presidential Executive
                            Memorandum directing HHS to increase by 100 percent the number of
                            foster children adopted within 5 years.
                        •   On November 19, 1997, ASFA was enacted, giving HHS responsibility for
                            issuing regulations and enforcing penalties for, among other provisions,

                            14
                              The Interstate Compact on Adoption and Medical Assistance provides the legal framework to ensure
                            that foster children who are eligible for federal adoption assistance continue to receive medical and
                            other services after adoption. The compact is a statute uniformly enacted by 30 states. The Association
                            of Administrators of the Interstate Compact on Adoption and Medical Assistance administers this
                            compact under a cooperative agreement with HHS.



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    delaying or denying adoptive placements across jurisdictions when an
    approved family is available.
•   On November 24, 1998, the President issued a Presidential Executive
    Memorandum directing HHS to establish a national registry for freed foster
    children who need adoptive homes.
•   In November 1998, the HHS Office of Inspector General issued a report,
    “The Interstate Compact on the Placement of Children: State Structure
    and Process,” describing states’ implementation of ICPC and the number of
    children affected by ICPC.
•   In March 1999, the Office of Inspector General issued a companion report,
    “Interstate Compact on the Placement of Children: Implementation,”
    describing how well states have implemented ICPC and recommending HHS
    actions for improvement.

    HHS  characterized its role in foster care adoptions in its response to the
    President’s memorandum on increasing adoptions: “The federal role in
    this initiative [Adoption 2002] is largely one of supporting states and
    communities by providing financial incentives, technical assistance, policy
    and programmatic leadership, and recognition of successful efforts.”15 For
    interjurisdictional adoption issues, HHS’ efforts to identify problems and
    develop action plans largely reflect these areas.

    For recruitment, HHS determined that the pool of prospective adoptive
    families who can care for children with special needs remained
    insufficient.16 To improve recruitment, and in response to the presidential
    directive to establish a national registry, HHS developed a plan to
    implement an Internet site publicizing freed and waiting foster children.17
    HHS estimated the first-year cost of the site at $1.5 million with annual
    operating costs of $1.25 million. The service is slated to begin operation on
    September 1, 2001. Although preliminary implementation actions were to
    be completed by August 1999, HHS had not completed any of the steps
    outlined in its plan by that date. For example, it has not conducted focus
    groups to identify concerns or established a standing work group to
    recommend photolisting service policy. However, HHS acknowledges that
    this effort appears to duplicate much of the existing national photolisting
    service maintained by the National Adoption Center and now plans to
    reassess its approach to this effort.

    15
     Adoption 2002: A Response to the Presidential Executive Memorandum on Adoption, U.S.
    Department of Health and Human Services (Washington, D.C.: Dec. 14, 1996), p. 9.
    16
      Adoption 2002, p. 6.
    17
     Plan to Implement a National Internet Adoption Photolisting Service, U.S. Department of Health and
    Human Services (Washington, D.C.: n.d.), www.acf.dhhs.gov/programs/cb/special/photolts/toc.htm.



    Page 15                                           GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621




For homestudies, HHS found that differing state laws and requirements for
the content of homestudies hamper acceptance of homestudies across
jurisdictions.18 HHS has not published plans to address this issue. However,
officials told us that they are supportive of APHSA’s efforts to provide
leadership on interjurisdictional homestudy issues.

Although HHS did not identify a specific need to improve the acceptance of
termination of parental rights orders and adoption decrees, it planned, as
part of its technical assistance efforts to states, to develop and disseminate
guidelines for state legislation relating to terminating parental rights.19
While not prepared in response to a concern about parental rights orders,
HHS’ recently released guidelines help states review their laws and develop
statutes and policies that reflect the best practices in child welfare,
including guidance on the termination of parental rights.20

For ICPC, HHS identified several problems. According to HHS, some child
welfare agency staff as well as judges and attorneys do not understand
ICPC and lack training on its purpose and function.21 Delays may occur in
the placement process, including adoptive placements, thus lengthening
the multistep process, when key people do not comply with ICPC.22
Furthermore, when placements in violation of ICPC23 occur, states are
sometimes unaware that children are placed in their jurisdiction.24 For
example, judges sometimes disregard the ICPC process and order
out-of-state placements without ICPC. To improve the administration of
ICPC, HHS planned to work with its National Resource Centers25 to
determine how to promote awareness of ICPC, provide training to state


18
  Plan to Implement a National Internet Photolisting Service, p. 8.
19
  Adoption 2002, p. 11.
20
 Adoption 2002: The President’s Initiative on Adoption and Foster Care, Guidelines for Public Policy
and State Legislation Governing Permanence for Children, U.S. Department of Health and Human
Services (Washington, D.C.: June 1999).
21
 Photolisting Service, p. 9; and Interstate Compact on the Placement of Children: Implementation, U.S.
Department of Health and Human Services Office of Inspector General, OEI-02-95-00044 (Washington,
D.C.: Mar. 1999), p. 7.
22
  Interstate Compact Implementation, pp. 2 and 8.
23
  Interstate Compact Implementation, p. 8.
24
 The Interstate Compact on the Placement of Children: State Structure and Process, U.S. Department
of Health and Human Services Office of Inspector General, OEI-02-95-00041 (Washington, D.C.:
Nov. 1998), p. 9.
25
 National Resource Centers are operated by contractors who are responsible for providing technical
assistance on child welfare issues to states.



Page 16                                              GAO/HEHS-00-12 Interjurisdictional Adoption
              B-281621




              agency staff who operate ICPC, and support development of model
              procedures to help ICPC operate more effectively.26 To promote awareness
              of ICPC and provide training, HHS invited other organizations, such as
              AAICPC, to make presentations about ICPC at HHS-sponsored workshops and
              meetings. To support development of model procedures, HHS included
              improvement of ICPC as an example of an interjurisdictional adoption issue
              that could receive funding under the Adoption Opportunities grant
              program.27 Although HHS received proposals for fiscal year 1998, HHS
              determined that none of the proposals had sufficient merit to be
              recommended for funding. HHS revised its request for proposals on
              interjurisdictional adoption issues and listed both collaborative planning
              to increase interjurisdictional adoptions and support for improving
              implementation of ICPC as areas of special interest for fiscal year 1999
              grants. HHS awarded five grants in those areas of special interest.


              The 8,000 foster children who, at any given time, are freed and waiting for
Conclusions   an adoptive home are not readily adoptable because of their special needs.
              Searching across jurisdictional lines for an adoptive family for these
              hard-to-place children may increase the likelihood that a foster child can
              be matched with an appropriate family. However, the interjurisdictional
              adoption process is longer and more complex than the adoption process
              within a jurisdiction. Thus, opportunities for successful outcomes from
              interjurisdictional searches for adoptive families depend, in large measure,
              on the soundness of the process itself. While states have the primary
              responsibility to regulate adoptions, nonprofit organizations are also
              actively involved in developing needed improvements. However, states’
              authority does not extend beyond their own borders and nonprofit
              organizations cannot directly change the process. As a result, the states
              and organizations cannot effect change in all steps of the
              interjurisdictional adoption process. While HHS has made some efforts to
              assist states in improving this process in areas such as provision of
              technical assistance, a more organized strategy and a widely available plan
              could facilitate dialogue and collaboration among all who have an interest
              in improvements to the interjurisdictional adoption process. For example,
              such a plan could present strategies to promote the standardization of
              homestudies and assist states in their use of web sites.




              26
                Interstate Compact Implementation, pp. 11-12.
              27
                The Adoption Opportunities grant program is designed to provide support for demonstration projects
              that facilitate the elimination of barriers to adoption and provide permanent loving homes for children
              who would benefit from adoption, particularly children with special needs.


              Page 17                                            GAO/HEHS-00-12 Interjurisdictional Adoption
                         B-281621




                         We recommend that the Secretary of HHS develop and make widely
Recommendation           available an action plan to address areas that would facilitate the
                         interjurisdictional adoption of foster children. The plan should critically
                         assess planned and ongoing activities by HHS and others and, at a
                         minimum, should include strategies to

                     •   Encourage collaborative partnerships among governments and others to
                         promote standardization of homestudies and additional training on ICPC
                         and its process, and
                     •   Provide technical assistance to states on the effective use of adoption web
                         sites to recruit adoptive families for hard-to-place foster children.


                         We provided HHS and state child welfare officials in the three states we
Agency Comments          visited with the opportunity to comment on a draft of this report; we
and Our Evaluation       received comments from HHS and the state of California. In its comments
                         on a draft of the report, HHS acknowledged that the interjurisdictional
                         adoption process is not functioning optimally. It expanded on two topics
                         addressed in the report—HHS’ discretionary grantmaking activities and
                         Internet activities—and discussed why HHS does not believe that our
                         recommended action is necessary. In discussing the use of discretionary
                         grants, such as Adoption Opportunities grants, to improve the
                         interjurisdictional adoption process, HHS reiterated its position on its
                         discretionary grantmaking activities and provided additional information
                         about the grants that were awarded for fiscal year 1999. In addition, HHS
                         noted that it considers the grantmaking process to be its mechanism for
                         coordinating with others to improve the interjurisdictional adoption
                         process. In discussing Internet activities, HHS noted that interest in Internet
                         activity regarding adoption is high, the interest comes from a variety of
                         sources, and adoption agencies have struggled to keep up with the rapidly
                         growing Internet technology. Furthermore, HHS seeks to support
                         Internet-based efforts that do not exceed states’ capacities to respond and
                         that do not duplicate efforts by the private sector.

                         In responding to our recommendation that HHS develop and make widely
                         available an action plan to facilitate the interjurisdictional adoption of
                         foster children, HHS stated that it has not had a need to create such a plan
                         given the changing nature of technology and the continuous efforts it is
                         making to facilitate the interjurisdictional adoption process. We believe
                         that the value of a more organized strategy and a widely available action
                         plan lies in the increased dialogue, and resulting collaboration, such a plan
                         can generate between HHS and the many public agencies and private



                         Page 18                                GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621




organizations that have an interest in improving the interjurisdictional
adoption process. Particularly in light of HHS’ stated desire to avoid
duplicating the efforts of others and its recent decision to reassess the
value of its plan for a national photolisting service, a mechanism that
would keep interested parties abreast of HHS’ plans is warranted. HHS also
made technical comments, which we incorporated where appropriate. The
full text of HHS’ comments is contained in appendix V.

The state of California agreed with our report and noted its interest in
being involved in future efforts to improve the interjurisdictional adoption
process.


We will send copies of this report to the Secretary of Health and Human
Services and program officials in California, Florida, and Missouri. We will
also make copies available to others on request.

If you have any questions regarding this letter, please contact me at
(202) 512-7215. Key contributors to this report are listed in appendix VI.

Sincerely yours,




Cynthia M. Fagnoni
Director, Education, Workforce,
  and Income Security Issues




Page 19                               GAO/HEHS-00-12 Interjurisdictional Adoption
Contents



Letter                                                                                              1


Appendix I                                                                                         22

Scope and
Methodology
Appendix II                                                                                        24

The Adoption Process
for Foster Children
Appendix III                                                                                       26

Sample Homestudy
Format
Appendix IV                                                                                        34

Child Welfare-Related
State Web Sites as of
August 1999
Appendix V                                                                                         36

Comments From the
Department of Health
and Human Services
Appendix VI                                                                                        39

GAO Contacts and
Staff
Acknowledgments
Figures                 Figure 1: ICPC Process to Request Homestudy and Placement of                6
                          Foster Child Out-of-State
                        Figure 2: ICPC Process After Homestudy Is Obtained and                      7
                          Placement of Foster Child Is Approved




                        Page 20                            GAO/HEHS-00-12 Interjurisdictional Adoption
Contents




Figure 3: Anticipated Outcomes for Foster Children                           9




Abbreviations

AAICPC     Association of Administrators of the Interstate Compact on
                the Placement of Children
APHSA      American Public Human Services Association
ASFA       Adoption and Safe Families Act of 1997
HHS        Department of Health and Human Services
ICPC       Interstate Compact on the Placement of Children


Page 21                             GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix I

Scope and Methodology


             To obtain a national perspective on interjurisdictional issues, we
             interviewed officials at the Department of Health and Human Services
             (HHS) about the department’s role and actions relevant to
             interjurisdictional adoption issues. We also interviewed experts and
             advocates affiliated with nonprofit organizations interested in
             interjurisdictional adoption issues about their organizations’ related
             activities. These organizations included the American Public Human
             Services Association, the Association of Administrators of the Interstate
             Compact on the Placement of Children, the Association of Administrators
             of the Interstate Compact on Adoption and Medical Assistance, the
             National Adoption Center, and the American Bar Association. In addition,
             we reviewed the public Internet web sites maintained by the National
             Adoption Center and state child welfare agencies to determine the types of
             information available to prospective adoptive parents regardless of their
             geographic location.

             To obtain a state and county child welfare perspective on
             interjurisdictional issues, we conducted case studies in three
             states—California, Florida, and Missouri. We chose those states because
             they are among the 10 states with the largest foster care populations and
             they have varying levels of experience with the placement of foster
             children across state lines. In each state, we met with state foster care and
             adoption officials and their local counterparts in one county with a large
             foster care population. Those counties were Contra Costa County,
             California; Broward County, Florida; and Jackson County, Missouri.

             We conducted our review from November 1998 to August 1999 in
             accordance with generally accepted government auditing standards.




             Page 22                                GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix I
Scope and Methodology




Page 23                 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix II

The Adoption Process for Foster Children




               Page 24       GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix II
The Adoption Process for Foster Children




Page 25                                    GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III

Sample Homestudy Format


               The specific content and format of homestudies vary by agency. This
               suggested format, developed by Florida, reflects the scope and detail
               typically found in homestudies.




               Page 26                              GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 27                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 28                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 29                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 30                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 31                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 32                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III
Sample Homestudy Format




Page 33                   GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix IV

Child Welfare-Related State Web Sites as of
August 1999




               Page 34         GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix IV
Child Welfare-Related State Web Sites as of
August 1999




Page 35                                       GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix V

Comments From the Department of Health
and Human Services




             Page 36       GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix V
Comments From the Department of Health
and Human Services




Page 37                                  GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix V
Comments From the Department of Health
and Human Services




Page 38                                  GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix VI

GAO Contacts and Staff Acknowledgments


                  David D. Bellis, (202) 512-7278
GAO Contacts      Kerry Gail Dunn, (415) 904-2234


                  In addition to the individuals named above, Ann T. Walker, Karen E.
Acknowledgments   Lyons, and Elizabeth Jarvis-Shean made key contributions to this report.




(116026)          Page 39                              GAO/HEHS-00-12 Interjurisdictional Adoption
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