Foster Care: State Efforts to Improve the Permanency Planning Process Show Some Promise

Published by the Government Accountability Office on 1997-05-07.

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

                 United States General Accounting Office

GAO              Report to the Chairman, Subcommittee
                 on Human Resources, Committee on
                 Ways and Means, House of

May 1997
                 FOSTER CARE
                 State Efforts to
                 Improve the
                 Permanency Planning
                 Process Show Some

      United States
GAO   General Accounting Office
      Washington, D.C. 20548

      Health, Education, and
      Human Services Division


      May 7, 1997

      The Honorable E. Clay Shaw, Jr.
      Chairman, Subcommittee on
        Human Resources
      Committee on Ways and Means
      House of Representatives

      Dear Mr. Chairman:

      The mid-1980s through the mid-1990s witnessed dramatic increases in the
      number of children placed in foster care to protect them from abuse and
      neglect at home. From fiscal year 1984 to 1995, the foster care population
      rose from an estimated 276,000 children to 494,000.1 In 1995, states
      received more than $2.8 billion in federal assistance for approximately half
      of these 494,000 children in foster care.2 The Congressional Budget Office
      estimates that by 2001, federal costs will rise to $4.8 billion with caseloads
      of federally assisted foster care children increasing by almost 26 percent.
      Longer stays in foster care have contributed to these rising costs. Many of
      these children are among the nation’s most at risk for future problems,
      having suffered the effects of both physical and emotional abuse, and

      The continued growth in the foster care caseload and its associated costs,
      as well as the likely adverse effects of long stays in foster care on children,
      increase the importance of quickly finding permanent placements for
      children. These placements can range from reuniting children with their
      parents, to finding adoptive homes and, in increasing numbers, to placing
      foster children with relatives. Yet navigating the child welfare system in
      pursuit of permanent homes for these children can be a daunting task.
      State child welfare agencies—working with many players that include the
      courts and public and private service providers—guide a child through
      temporary or shelter placements, multiple court hearings, and, as often
      happens, more than one foster family placement. This circuitous and
      burdensome route to a permanent placement can often take years, cost

       The American Public Welfare Association estimated these numbers on the basis of data voluntarily
      reported by the states; it designated the 1995 number as preliminary.
       Under title IV-E of the Social Security Act, federal matching funds are provided to states for foster
      care maintenance costs for children from families eligible for Aid to Families With Dependent Children
      (AFDC). Although legislation passed in 1996 eliminated the AFDC program, children who meet the
      1995 eligibility criteria for AFDC will continue to be eligible for title IV-E assistance. The states incur
      all foster care costs for children not eligible for federal support.

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thousands of dollars for each child, and have serious emotional
consequences for the children.

The federal government plays an important role in financing foster care
and establishes minimum procedural requirements for the placement
process. The Adoption Assistance and Child Welfare Act of 1980
(P.L. 96-272) requires that states conduct a permanency hearing within 18
months after a child enters foster care to determine the future status of the
child.3 If a final decision is not made, then additional hearings must be
held at least every 12 months. During this time, to be eligible for federal
foster care funds, states are required to facilitate the reunification of
parent and child or, if those efforts fail, begin the process of terminating
parental rights or finding a long-term foster care placement.

Because of your concerns about the length of the permanency planning
process and your interest in improving foster care, you asked us for
information about state efforts to hasten the process and ultimately reduce
the time a child spends in foster care. More specifically, you asked us to
determine (1) what statutory and policy changes states have made to limit
the time allowed to determine permanent placements for foster children,
(2) what changes states or localities have made in their operations in an
attempt to achieve more timely permanent placements and what the
impact of those changes has been, and (3) what factors officials believe
helped them meet the challenges of achieving more timely permanent

In conducting this work, we collected and summarized state statutory and
policy changes that limited the time allowed for permanent placement
hearings. We also interviewed officials and collected program information
from six states—Arizona, Georgia, Kansas, Kentucky, Ohio, and
Tennessee—on initiatives that had been implemented between 1987 and
1992 and were expected to achieve more timely permanent placements for
foster children. A complete discussion of our scope and methodology
appears in appendix I.

 At the permanency hearing, the choices that can be made regarding the future status of the child can
include reunifying the child with his or her family, continuing the child in foster care for a specified
period, placing the child for adoption, or continuing the child in foster care on a permanent or
long-term basis because of the child’s special needs or circumstances. This hearing must be held in a
family or juvenile court or another court of competent jurisdiction or by an administrative body
appointed or approved by the court. Although the hearing must be held, the law does not require that a
final decision on the status of the child be made.

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                   Signaling the importance of a permanent placement to the well-being of
Results in Brief   children, 23 states have enacted laws establishing requirements regarding
                   the timing of the permanency hearing that are more stringent than those
                   under federal law. Federal law requires a hearing within 18 months after
                   the child’s entry into foster care. An additional three states, while not
                   enacting such statutes, have imposed similar requirements as a matter of

                   Statutory or policy changes alone, however, are not sufficient to resolve
                   the final placement of foster children more quickly. The states we
                   reviewed have made changes in their operations to facilitate reunifying
                   children with their families, expedite terminating parental rights when
                   reunification efforts have failed, or modify the role and operations of the
                   court both to streamline the process and to make well-informed
                   permanent placement decisions. While these initiatives focus on certain
                   stages of the permanency planning process, such as when a child first
                   enters foster care, two states are implementing major changes to their
                   overall foster care systems.

                   Although initiatives are in place, most of these states have not
                   systematically evaluated the impact of them, and data concerning these
                   efforts were limited. However, most states did report that many of these
                   initiatives contributed to reducing the time spent in foster care or
                   decreasing the total number of placement changes while a child is in foster
                   care. For example, Tennessee’s Wraparound Funding Project focused on
                   removing economic barriers to reunification. State officials credited the
                   effort with helping to reunite children with their families more quickly by
                   allowing caseworkers to provide services such as payment for respite
                   care, rent, utility bills, or car repairs, which they were previously unable to
                   provide because of restrictions on the use of foster care funds. In
                   Kentucky, a state report indicated that once the decision to terminate
                   parental rights was made, the Termination of Parental Rights Project
                   reduced the time it takes to complete the termination procedure by about
                   1 year, making it possible for adoption proceedings to begin earlier.

                   State officials identified a number of factors that helped them meet the
                   challenges involved in making changes. In some cases, child welfare
                   officials and staff had to undergo significant culture change, modifying
                   long-held views about the merits of pursuing termination of parental rights
                   versus family reunification. They found that changing the way they
                   approached making decisions about the well-being of children and their
                   families was a lengthy process. To implement these initiatives

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             successfully, program officials believed that it was necessary to have the
             long-term and active involvement of key officials at all levels, including the
             governor, legislators, and agency officials as well as caseworkers, service
             providers, attorneys, and judges. This participation was essential to define
             the problem and reach consensus. Doing so required considerable
             coordination efforts and an extended commitment of resources.

             State child welfare systems consist of a complicated network of policies
Background   and programs designed to protect children. Today, these systems must
             respond to growing numbers of children from families with serious and
             multiple problems. Many of these families also need intensive and
             long-term interventions to address these problems. With growing
             caseloads over the past decade, the systems’ ability to keep pace with the
             needs of troubled children and their families has been greatly taxed. In
             addition, the continued growth in caseloads expected over the next few
             years will give child welfare agencies little relief.

             When parents or guardians are unable to care for their children, state child
             welfare agencies face the difficult task of providing temporary placements
             for children while simultaneously working with a wide array of public and
             private service providers, as well as the courts, to determine the best
             long-term placement option. The permanency planning process is guided
             by federal statute and typically occurs in stages requiring considerable
             time. Finding an appropriate placement solution is extremely difficult
             because it often involves numerous steps and many different players.

             In each case, states must make reasonable efforts to prevent the
             placement of a child in foster care. If the child must be removed from the
             home, states are required under the Adoption Assistance and Child
             Welfare Act to take appropriate steps to make the child’s safe return home
             possible. Once removed, if reunification with the parents cannot be
             accomplished quickly, a child will be placed in temporary foster care while
             state child welfare agencies and community service providers continue to
             work with the parents in hope of reunification. To be eligible for federal
             funding, the state must demonstrate to the appropriate court that it has
             made reasonable efforts to prevent out-of-home placement and to reunify
             the family. Federal law further requires that placement be as close as
             possible to the parent’s home in the most family-like setting possible.

             To guide the permanency planning process by which a state is to find
             permanent placements for foster care children, the act also requires that

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the state develop a case plan for each child within 60 days of the time the
state agency begins providing services to the child. This plan must
describe services to be provided to aid the family and must outline actions
that will be expected of various agencies and family members to make
reunification possible. States are then required to hold reviews every 6
months before a court or administrative panel to evaluate progress made
toward reaching a permanency goal.4 If progress toward reunification
cannot be made, state agencies often face the arduous task of either
preparing a case for the termination of parental rights or finding a
long-term foster care placement. The federal requirement of conducting a
permanency hearing within 18 months serves to ensure that child welfare
agencies focus on determining a permanent placement, including return to
the family or adoption, in a timely manner rather than continuing a child in
foster care.

For abused and neglected children, living with their parents may be
unsafe. Yet foster care is not an optimal situation, especially not as a
permanent solution. State child welfare agencies and the courts are
confronted with the dilemma of whether to reunite families as quickly as
possible or keep the children in foster care with the expectation of future
reunification. They must also determine at what point to abandon hope of
reunification, terminate the parents’ rights, and initiate a search for an
adoptive home or other permanent placement for the child. If children are
reunited with their families too quickly, they may return to foster care
because the home environment may still be unstable. On the other hand,
when children remain in foster care too long, it is difficult to reestablish
emotional ties with their families. Furthermore, the chances for adoption
can be reduced because the child is older than the most desirable adoption
age or has developed behavioral problems.

Determining an appropriate placement option for children quickly is of
twofold importance. First, finding permanent placements for children
removed from their families is critical to ensure their overall well-being.
Children without permanent homes and stable caregivers may be more
likely to develop emotional, intellectual, and behavioral problems. A
second reason for placing children more quickly is the financial costs of
children remaining in foster care. The federal share of the average monthly
maintenance payment for title IV-E was $574 in 1996. While some options

 During these periodic reviews, states must determine if continued temporary placement is necessary
and appropriate, whether the permanency plan is being adequately followed, and what degree of
progress has been made toward reunifying the family. States must also project a likely date for
achieving a permanency goal. If not reviewed by a court, these periodic reviews may be held before
panels including those formed by a child welfare agency or a panel of area citizens.

Page 5                                      GAO/HEHS-97-73 State Efforts Show Some Promise

                       for permanent placements, such as providing long-term support to a
                       relative to care for a child, may not realize cost savings, other options,
                       such as adoption, will reduce foster care costs. Title IV-E payments,
                       between fiscal years 1984 and 1996, increased from $435.7 million to an
                       estimated $3.1 billion.

                       The prolonged stays of children in foster care have prompted states to
Statutory and Policy   enact laws or policies to shorten to less than the federally allowed 18
Changes Require        months the time between entry into foster care and the first permanency
States to Hold First   hearing at which permanent placement is considered. As shown in figure
                       1, 23 states have enacted such laws, with a majority of these requiring the
Permanency Hearing     hearing to be held within 12 months. In two states, the shorter time frame
Sooner                 applies only to younger children. Colorado requires the permanency
                       hearing be held within 6 months for children under 6, and Washington
                       requires the hearing to be held within 12 months for children 10 years old
                       or younger. An additional three states, while not enacting such statutes,
                       have policies requiring permanency hearings earlier than 18 months. For a
                       description of the 26 state statutes, policies, and time requirements, see
                       appendix II. The remaining 24 states and the District of Columbia have
                       statutes consistent with the federal requirement of 18 months.

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Figure 1: States That Require a Permanency Hearing Earlier Than the Federal Government, as of December 31, 1996

                                         The state laws, like federal law, do not require that a final decision be
                                         made at the first hearing. Ohio and Minnesota, however, do require that a

                                         Page 7                              GAO/HEHS-97-73 State Efforts Show Some Promise

                             permanency decision be determined after a limited extension period. Ohio,
                             for example, requires a permanency hearing to be held within 12 months,
                             with a maximum of two 6-month extensions. At the end of that time, a
                             permanent placement decision must be made. According to officials in
                             Ohio’s Office of Child Care and Family Services, this requirement was
                             included in an effort to expedite the permanency planning process and
                             reduce the time children spend in foster care. However, state officials also
                             believed that this requirement may have had the unintended result of
                             increasing the number of children placed in long-term foster care because
                             other placement options could not be developed. State data, in part,
                             confirmed this observation. While long-term foster care placements for
                             children supported with state-only funds dropped from 1,301 in 1990 to
                             779 in 1995, long-term placements for children supported with federal
                             funds rose from 1,657 to 2,057 for the same period. The reasons for the
                             difference between these two groups are unknown.

                             Although the states we reviewed did not systematically evaluate the
States Make Changes          impact of their initiatives, they implemented a variety of operational and
in Permanency                procedural changes to expedite and improve the permanency process.
Planning Process With        Other efforts made changes to the operation of the courts and the use of
                             resources available to them for making permanency decisions. These
Some Positive Results        states reported that these actions have improved the lives of some
for Foster Care              children by (1) reuniting them with their families more quickly,
                             (2) expediting the termination of parental rights when reunification efforts
Children                     were determined to be unfeasible—thus making it possible for child
                             welfare agencies to begin looking for an adoptive home sooner—or
                             (3) reducing the number of different foster care placements in which they
                             lived. States are also addressing changes in the permanency planning
                             process through larger reform efforts of their child welfare systems.
                             However, because these efforts were only recently implemented or were
                             still in the initial implementation stage, no evaluation information on their
                             effect was available.

New Service Strategies       Two states we reviewed implemented low-cost and creative methods for
Help Reunification Efforts   financing and providing services that address specific barriers to
                             reunification. For example, Arizona’s Housing Assistance Program focused
                             on families where children had been removed and placed in state custody
                             and the major barrier to reunification was inadequate housing for the
                             family. In 1989, the state enacted a bill authorizing the use of state foster
                             care funds to provide special housing assistance. According to state

                             Page 8                            GAO/HEHS-97-73 State Efforts Show Some Promise

                         reports summarizing the program and statistics provided by Arizona
                         Department of Economic Security officials, between 1991 and 1995, 939
                         children were reunited with their families as a result of this program,
                         representing almost 12 percent of those children reunified during this
                         period. This program saved the state over $1 million in foster care-related
                         costs between 1991 and 1995.

                         Also, Tennessee’s Wraparound Funding Program allowed caseworkers to
                         use state funds to provide services that removed economic barriers to
                         reunification. These services were not typically associated with traditional
                         reunification services and prior to this program were not allowable foster
                         care expenditures. Examples include home or car repairs, utilities or rent
                         payments, and respite care. According to a report summarizing the
                         program, during one 6-month period in 1995, the program provided
                         services to 1,279 children. A state Department of Children’s Services
                         official estimated that had these children remained in care as long as the
                         average child in foster care, the state would have incurred an additional
                         $700,000 in state and federal foster care maintenance payments.

States Streamline        Regarding other changes, Arizona and Kentucky placed special emphasis
Termination Procedures   on expediting the process by which parental rights could be terminated.
                         Arizona’s Severance Project focused on cases where termination of
                         parental rights was likely or reunification services were not warranted and
                         for which a backlog of cases had developed. In April 1986, the state
                         enacted a bill providing funds for hiring severance specialists and legal
                         staff to work on termination cases. The following year, in 1987, the state
                         implemented the Arizona State Adoption Project. This project focused on
                         identifying additional adoptive homes, including recruiting adoptive
                         parents for specific children and contracting for adoptive home
                         recruitment activities. State officials reported that the Adoption Project
                         resulted in a 54-percent increase in the number of new homes added to the
                         state registry in late 1987 and 1988. In addition, they noted that the
                         Severance Project contributed to a more than 32-percent reduction in the
                         average length of stay between entry into care and the filing of the
                         termination petition for fiscal years 1991 through 1995.

                         To reduce a backlog of pending cases, Kentucky’s Termination of Parental
                         Rights Project focused on reducing the time required to terminate parental
                         rights once this permanency goal was established. This effort included
                         retraining caseworkers, lawyers, and judges on the consequences of long
                         stays in foster care and streamlining and improving the steps caseworkers

                         Page 9                            GAO/HEHS-97-73 State Efforts Show Some Promise

                             must follow when collecting and documenting the information required for
                             the termination procedures. A report on this effort indicated that between
                             1989 and 1991, the state decreased the average time to terminate parental
                             rights by slightly over 1 year. In addition, between 1988 and 1990, the
                             average length of stay for children in foster care decreased from 2.8 years
                             to 2 years, and the number of different foster care placements for each
                             child decreased from four to three.5 However, as the number of children
                             available for adoption rose, the state was forced to focus its efforts on
                             identifying potential adoptive homes and shifted its emphasis to strategies
                             to better inform the public about the availability of adoptive children.

Concurrent Planning Can      Tennessee’s Concurrent Planning Program allowed caseworkers to work
Lead to Greater Efficiency   toward achieving family reunification while at the same time developing
                             an alternate permanency plan if reunification efforts did not succeed.6 The
                             goal was to obtain permanency for the child by either (1) strengthening
                             the family and reducing the risks in the home so that the child can be
                             reunified with his or her family; or (2) verifying that the family cannot
                             protect the child, meet the child’s needs, or reduce the risks to the child in
                             a timely manner and that termination of parental rights should be pursued.
                             By working on the two plans simultaneously, caseworkers reduced the
                             time required to prepare the necessary paperwork to terminate parental
                             rights if reunification efforts failed.

                             Under a concurrent planning approach, caseworkers emphasize to the
                             parents that if they do not adhere to the requirements set forth in their
                             case plan, parental rights can be terminated. Since this program was
                             initiated in 1991, state officials report that 70 percent of the children in the
                             program obtained permanency, primarily through reunification, within 12
                             months of placement in foster care. Without this program the children
                             would have stayed in foster care longer than 12 months. The officials
                             attributed obtaining quicker permanency in part to parents making more
                             concerted efforts to make the changes needed to have their children
                             return home.

                              Report on Improving Practice: Termination of Parental Rights, Kentucky Department for Social
                             Services (Sept. 1991).
                              The program was used in cases involving children aged 8 and under.

                             Page 10                                     GAO/HEHS-97-73 State Efforts Show Some Promise

Use of Community            All decisions regarding both the temporary and final placement of foster
Resources and Streamlined   care children come through states’ court systems. As a result, some states
Procedures Improve Court    and counties focused attention on the courts’ involvement in achieving
                            permanency more quickly. Georgia’s Citizen Review Panel Program
Functioning                 created local advisory panels of private citizens within the child’s
                            community to assist judges in their review and decisions regarding foster
                            care placements for each child in care. The objective of these panels is
                            (1) to gather additional information regarding the placement options for
                            each foster child—often information that cannot be collected by state
                            agencies because of large caseloads and limited staff resources—and
                            (2) to review compliance with court-ordered case plans to ensure that the
                            state agencies are working toward permanent placements. The program
                            operates in 56 counties and, in 1996, covered over 42 percent of Georgia’s
                            foster care population. The state reported that between 1994 and 1996, the
                            review panels recommended that 5,855 children be placed for adoption,
                            10,845 children be reunified with their families, and 3,048 children remain
                            in foster care.

                            In Hamilton County, Ohio, juvenile court officials focused attention on the
                            court’s involvement in achieving permanency more quickly by developing
                            new procedures to expedite case processing. In 1985, they revised court
                            procedures by (1) designating lawyers specially trained in foster care
                            issues as magistrates to hear cases, (2) assigning one magistrate to each
                            case for the life of that case to achieve continuity and consistent rulings,
                            and (3) agreeing at the end of every hearing—while all participants are
                            present—to the date for the next hearing. According to court officials, the
                            county saved thousands of dollars because it could operate three
                            magistrates’ courtrooms for the cost of one judge’s courtroom. Also, a
                            report on court activities indicated that because of these changes, between
                            1986 and 1990, the number of children placed in four or more different
                            foster care placements decreased by 11 percent and the percentage of
                            children leaving temporary and long-term foster care in 2 years or less
                            increased from 37 percent to 75 percent.

                            Even where improvements have been made, there can still be problems
                            that are beyond the control of officials. According to reports prepared by
                            court officials, between 1986 and 1989 the number of children in care in
                            Hamilton County decreased 15 percent. However, in 1992, the number
                            returned to the 1986 level of about 1,100 children and continued to
                            increase through the first half of 1996 to about 1,500. According to court
                            officials, a dramatic rise in crack cocaine use in the county contributed to

                            Page 11                           GAO/HEHS-97-73 State Efforts Show Some Promise

                               this sharp increase. Child welfare agencies were unable to readily arrange
                               for the increased services that these families needed.

Some Initiatives Attempt       Some states are also addressing the need for quicker permanency as part
Systemwide Changes to          of larger initiatives designed to make major changes in their foster care
Improve the Permanency         programs. One state plans to privatize foster care services. Another state
                               has redesigned its foster care operating policies and procedures to
Process                        improve outcomes for children. Because these efforts are recent, no
                               information on results was available.

Privatization Proposes         In 1996, Kansas began privatizing most child welfare services, including
Incentives for Speedier        foster care. Two events contributed to this decision. First, because of
Placements                     rising state costs, the Governor directed all state agencies to consider
                               privatizing services to reduce the size of the state workforce. Second, the
                               state had settled a suit brought by the Kansas chapter of the American
                               Civil Liberties Union citing unacceptable increases in the number of
                               children in foster care and lengthy stays in care. The goal of privatization
                               is to allow children in out-of-home placements to experience a minimal
                               number of placements or to achieve permanency in their lives in the
                               shortest time possible.

                               Kansas contracted with private social services agencies for family
                               preservation services, foster and residential care, and adoption services.
                               State officials continue to be responsible for determining if the original
                               charges of dependency, neglect, or abuse are substantiated and to monitor
                               contractor performance. The contracted service providers are responsible
                               for providing all services to the families.

                               Under the contracts, providers will be paid a per-child rate, with a
                               payment structure that pays contractors for results. For example, in the
                               foster care contract, 25 percent of costs will be paid at the time of referral,
                               25 percent upon receipt of the first 60-day progress report, and 25 percent
                               upon receipt of the 180-day formal case plan. The final 25 percent will not
                               be paid until reunification or a permanent placement is achieved. If a child
                               reenters care before 12 months have passed, the contractor is responsible
                               for all the foster care maintenance costs for out-of-home placement.

Agency Redesign Intended to    Arizona also is pursuing major changes to its child welfare system.
Expedite Placement Decisions   Arizona’s Project Redesign was prompted by a number of fatalities of
                               young children in foster homes in a very short time. Begun in 1994, this
                               project focused on writing and implementing new child welfare policies

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                            and procedures with a goal of increasing caseworker contact with foster
                            families and reducing caseworkers’ caseloads and the length of time
                            children spend in foster care.

                            The major activities of Project Redesign included rewriting policies and
                            licensing rules, preparing a new supervisors’ handbook, creating a
                            mentoring program for new supervisors, developing and implementing a
                            method to more equitably distribute workload among staff, and creating
                            the Uniform Case Practice Record. This record methodically guides
                            caseworkers through all the steps necessary to make a permanent
                            placement decision. This helps ensure that all the needed information is
                            available to the courts, thus preventing delays in the process.

States Have Not Assessed    Our efforts to assess the overall impact of these initiatives were hampered
the Impact of Initiatives   by the absence of evaluation data. In general, we found that the states did
                            not conduct evaluations of their programs, and outcome information was
                            often limited to state reports and the observations of state officials. While
                            many of these efforts reported improvements, for example, in speeding the
                            termination of parental rights once this permanency goal was established,
                            the lack of comparison groups or quality pre-initiative data made it
                            difficult to reach definitive conclusions about the effectiveness of these

                            Several national efforts are under way that may improve the information
                            available on foster children and facilitate states’ design and
                            implementation of systematic evaluations in the future. Nationwide, most
                            states are currently designing or implementing Statewide Automated Child
                            Welfare Information Systems as required under the title IV-E foster care
                            program. These systems are to include case-specific data on all children in
                            foster care and all adopted children placed or provided adoption
                            assistance by the state or its contractors. From 1994 to 1996, federal funds
                            have provided up to 75 percent of the costs of planning, design,
                            development, and installation of these state systems. The Personal
                            Responsibility and Work Opportunity Reconciliation Act (P.L. 104-193),
                            enacted in August 1996, continues this enhanced federal match through
                            1997, at which time the federal match rate will be reduced to 50 percent. In
                            addition, P.L. 104-193 appropriated funds for a national longitudinal study
                            based on random samples of children at risk of abuse or neglect or

                            Page 13                           GAO/HEHS-97-73 State Efforts Show Some Promise

                          determined by a state to have been abused or neglected. This study is to
                          include state-level data for selected states.7

                          States increased their chances for successfully developing and
Key Factors Essential     implementing new initiatives when certain key factors were a part of the
for Meeting Goals of      process. When contemplating changes, state officials had to take into
New Initiatives           consideration the intricacies of the foster care process; the inherent
                          difficulty that caseworkers and court officials face when deciding if a child
                          should be returned home; and the need in some cases to change the
                          culture of caseworkers and judges to recognize that, in certain cases,
                          termination of parental rights should be pursued. Some experts believe
                          that current child welfare practices often discourage caseworkers from
                          finding permanent placements other than with the biological parents.
                          Officials in the states we reviewed recognized that addressing these
                          challenges required concerted time and effort, coordination, and
                          resources. These officials identified several critical, often interrelated,
                          factors required to meet these challenges. These included (1) long-term
                          involvement of officials in leadership positions; (2) involvement of key
                          stakeholders in developing consensus and obtaining buy-in concerning the
                          nature of the problem and the solution; and (3) the availability of
                          resources to plan, implement, and sustain the project. The following two
                          examples illustrate these concepts.

Statewide Involvement     In the mid-1980s, Ohio officials began a multiyear effort that culminated
Culminates in New Child   with the state enacting a new child welfare law that became effective in
Welfare Legislation       January 1989. Before enacting this law, the legislature created a task force
                          whose members were involved in planning throughout the drafting and
                          passage of legislation. The task force was cochaired by a state senator and
                          a representative. Other members included state and county child welfare
                          agency officials, juvenile court judges, attorneys, and county
                          commissioners. In addition, public hearings were held throughout the
                          state that provided a forum for input from all parties interested in child
                          welfare, including private citizens, service providers, caseworkers, judges,
                          attorneys, and foster care parents.

                          By involving all interested parties and by providing numerous
                          opportunities for input, state officials were able to develop consensus on
                          the problems and solutions and obtain buy-in to the proposed solutions

                           The law states that the study yield data reliable at the state level for as many states as the Secretary of
                          the Department of Health and Human Services (HHS) determines is feasible.

                          Page 14                                         GAO/HEHS-97-73 State Efforts Show Some Promise

                            from program staff. For example, there were numerous discussions about
                            whether a specific time frame for remaining in temporary foster care
                            should be stipulated. They ultimately compromised on 12 months plus two
                            6-month extensions.

Statewide Efforts Shorten   In 1988, to shorten the termination of parental rights process, the
Termination of Parental     Kentucky Department of Social Services collaborated with seven other
Rights Process              agencies to obtain a federal grant to develop new approaches to address
                            this issue. As part of this effort and to ensure buy-in, the Secretary of
                            Human Resources appointed a multidisciplinary advisory committee
                            chaired by a chief Circuit Court judge. Other members of the committee
                            included representatives from social service agencies, court officials,
                            attorneys, the legislature, and child welfare advocacy groups. The
                            committee met quarterly throughout the 2-year project.

                            Committee members recognized they needed to change the way
                            caseworkers and members of the legal system viewed termination of
                            parental rights. Many caseworkers had viewed terminating parental rights
                            as a failure on their part because they were not able to reunify the family.
                            As a result, they were reluctant to pursue termination and instead kept the
                            children in foster care. Also, often judges and lawyers were not sufficiently
                            informed of the negative consequences for children who do not have
                            permanent homes. Thus, as part of this project, newsletters and training
                            were provided about the effects on the child of delaying termination of
                            parental rights.

                            After 2 years, many meetings, and retraining caseworkers, state officials
                            reported that they had reduced the time to complete the termination of
                            parental rights process by 1 year. Among the changes they believed
                            contributed to this reduction were (1) simplifying the process caseworkers
                            follow when providing termination of parental rights information to the
                            attorneys that handle these cases and (2) using an absent parent search
                            handbook, which was developed to assist caseworkers in conducting more
                            timely and complete searches.

                            Many of the children in foster care are among the nation’s most vulnerable
Conclusions                 citizens. The consequences of long spells in foster care and multiple
                            placements, coupled with the effects of poverty, highlight the need for
                            quick resolution of placement questions for these children. With the
                            expected rise in foster care caseloads through the start of the next century

                            Page 15                           GAO/HEHS-97-73 State Efforts Show Some Promise

                  further straining state and federal child welfare budgets, increasing
                  pressure will be placed on states to develop strategies to move children
                  into permanent placements more quickly. Many of these initiatives will
                  need to address the difficult issues of deciding under what circumstances
                  to pursue reunification and what time is appropriate before seeking the
                  termination of parental rights.

                  We found promising initiatives for changing parts of the permanency
                  process so that children can be moved out of foster care into permanent
                  placements more quickly. Developing and successfully implementing these
                  innovative approaches takes time and often challenges long-standing
                  beliefs. To succeed, these initiatives must look to local leadership
                  involvement, consensus building, and sustained resources.

                  As new initiatives become a part of the complex child welfare system,
                  however, they can also create unintended consequences. For example, if
                  states are identifying appropriate cases for the quicker termination of
                  parental rights and processing them more expeditiously—thereby freeing
                  more children for possible adoption—additional problems can occur if
                  efforts to develop more adoptive homes have not been given equal
                  emphasis. Also, if states require more stringent time frames for holding
                  permanency hearings, they must adjust to this shorter time to avoid
                  placements based on expedience rather than careful deliberation about
                  what is best for the child.

                  We also found that a critical feature of these initiatives was often absent:
                  Many of them lacked evaluations designed to assess the impact of the
                  effort. The availability of evaluation information from these initiatives
                  would not only point to the relative success or failure of an effort but also
                  such information could assist in identifying unintended outcomes. The
                  absence of program and evaluation data will continue to hinder the ability
                  of program officials and policymakers to fully understand the overall
                  impact of these initiatives. Efforts are under way, however, to improve the
                  availability of information on foster children.

                  In its written comments on a draft of this report, HHS generally concurred
Agency Comments   with the conclusions in this report. It agreed that efforts to improve the
                  timeliness of permanent placements are important and indicated that they
                  are a priority of the department. HHS also commented that it would be
                  useful to include a definition of permanency planning in the report, and we
                  revised the report in response to this comment. Although federal

                  Page 16                           GAO/HEHS-97-73 State Efforts Show Some Promise

requirements establish some guidelines, variation in state policies and
priorities make the development of a single definition difficult. Finally, the
department recognized the benefits of presenting different approaches to
speeding the permanency planning processes while stressing the need for
systemic changes. Because of the complex nature of the child welfare
system, we agree that states and localities must consider the entire system
when attempting to make reforms.

We have incorporated the department’s technical comments into our
report where appropriate. See appendix III for HHS’ comments.

We are sending copies of this report to the Secretary of HHS, state child
welfare agencies, and other interested parties. Copies also will be made
available to others on request. If you or your staff have any questions
about this report, please call me at (202) 512-7215. Other major
contributors to this report are listed in appendix IV.

Sincerely yours,

Mark V. Nadel
Associate Director,
Income Security Issues

Page 17                            GAO/HEHS-97-73 State Efforts Show Some Promise

Letter                                                                                              1

Appendix I                                                                                         20

Scope and
Appendix II                                                                                        22

States That Require a
Permanency Hearing
Earlier Than the
Federal Requirement
of 18 Months, as of
December 31, 1996
Appendix III                                                                                       24

Comments From the
Department of Health
and Human Services
Appendix IV                                                                                        26

GAO Contacts and
Related GAO Products                                                                               28

Figure                  Figure 1: States That Require a Permanency Hearing Earlier Than             7
                          the Federal Government, as of December 31, 1996


                        AFDC      Aid to Families With Dependent Children
                        HHS       Department of Health and Human Services

                        Page 18                         GAO/HEHS-97-73 State Efforts Show Some Promise
Page 19   GAO/HEHS-97-73 State Efforts Show Some Promise
Appendix I

Scope and Methodology

             To identify states that have enacted laws or implemented policies
             establishing requirements regarding the timing of the first permanency
             hearing that are more stringent than those under federal law, we reviewed
             pertinent state legislation and policies of 50 states and the District of
             Columbia. We also discussed those laws and state policies with state legal
             and child welfare officials. Federal law allows the hearing to be held as
             late as 18 months after the child’s entry into foster care, but state laws
             vary widely in the terms they use for various hearings. In cases where state
             law did not specifically identify a hearing as a permanency hearing, we
             asked for further clarification from state officials. If we determined that
             the state law was consistent with the federal requirement, we treated the
             required hearing as a permanency hearing.

             To determine what changes states and localities have made to achieve
             more timely permanent placements and factors that contributed to their
             success, we first reviewed literature on foster care and permanency
             planning. In addition, we discussed permanency planning and permanent
             placement decisions with experts in the field, including child welfare
             officials in all 50 states and the District of Columbia. In the course of our
             discussions with state officials and experts, we identified specific state
             and local initiatives that were attempting to permanently place foster care
             children in a more timely manner.

             We selected six states that had implemented initiatives that addressed
             making more timely permanent placements for children in foster care. The
             states were Arizona, Georgia, Kansas, Kentucky, Ohio, and Tennessee.
             Each state selected had at least one initiative that was implemented
             between 1989 and 1992, ensuring that we would be able to obtain
             historical information about the planning and implementation of those
             initiatives and that the initiatives had been in place long enough to have
             some impact. We included states that had initiatives that addressed
             different aspects of the permanency process. We also included states with
             statutory requirements for holding the first permanency hearing that were
             stricter than the federal requirement as well as states with requirements
             that were consistent with the federal requirement.

             We conducted site visits in four of the six states—Georgia, Kansas,
             Kentucky, and Tennessee—and obtained information from Arizona and
             Ohio through telephone interviews. We interviewed state and county
             foster care and adoption officials and juvenile court officials and collected
             information on the initiatives, including descriptions of program goals and
             objectives and factors that facilitated change, reports on program results,

             Page 20                           GAO/HEHS-97-73 State Efforts Show Some Promise
Appendix I
Scope and Methodology

and other statistical information on the foster care population. We did not
verify program data from these states.

We did our work between January 1996 and January 1997 in accordance
with generally accepted government auditing standards.

Page 21                          GAO/HEHS-97-73 State Efforts Show Some Promise
Appendix II

States That Require a Permanency Hearing
Earlier Than the Federal Requirement of 18
Months, as of December 31, 1996

                Requirement for
                holding the                  Year law was                                      State policy/ regulation
State           permanency hearinga               enacted   State law citation                 citation
Arizona         12 months                           1995    Ariz. Rev. Stat. Ann., Section
                                                            8-515.C.(West Supp. 1996)
Colorado        6 and 18 monthsb                    1994    Colo. Rev. Stat., Section
                                                            19-3-702(1)(Supp. 1996)
Connecticut     12 months                           1995    Conn. Gen. Stat. Ann., Section
                                                            46b-129(d),(e) (West 1995)
Delaware        17 months                           1987                                       Child Protective Service
                                                                                               Directive Policy #3026
Georgia         12 months                           1996    Ga. Code Ann., Section
                                                            15-11-419 (j),(k)(1996)
Illinois        16 months                           1993    705 Ill. Comp. Stat. Ann.,
                                                            405/2-22(5)(West Supp. 1996)
Indiana         12 months                           1996    Ind. Code Ann., Section
                                                            31-6-4-19(c)(Michie Supp. 1996)
Iowa            12 months                           1987    Iowa Code Ann., Section
                                                            232.104 (West 1994)
Kansas          12 months                           1994    Kan. Stat. Ann., Section
Louisiana       12 months                           1991    La. Ch. Code Ann., Arts.
                                                            702,710(West 1995)
Michigan        15 1/2 monthsc                      1988    Mich. Stat. Ann., Section
                                                            27.3178(598.19a)(Law Co-op
                                                            Supp. 1996)
Minnesota       12 months                           1993    Minn. Stat. Ann., Section
                                                            260.191 Subd. 3b(West Supp.
Mississippi     12 months                           1985    Miss. Code Ann., Section
                                                            43-21-613 (3)(1993)
New Hampshire   12 months                           1987                                       New Hampshire Court
                                                                                               Rules Annotated, Abuse
                                                                                               and Neglect, Guideline
                                                                                               39 (Permanency
                                                                                               Planning Review)d
New Mexico      6 months                            1993                                       State official’s statemente
New York        12 months                           1989    N.Y. Jud. Law, Section
                                                            1055(b)(McKinney Supp. 1997)
Ohio            12 months                           1989    Ohio Rev. Code Ann., Sections
                                                            2151.353(F), 2151.415 (A)
                                                            (Anderson 1994)
Pennsylvania    6 months                            1986    42 Pa. Cons. Stat. Ann., Section
                                                            6351(e-g)(West Supp. 1996)
Rhode Island    12 months                           1985    R.I. Gen. Laws, Section

                                   Page 22                              GAO/HEHS-97-73 State Efforts Show Some Promise
                                     Appendix II
                                     States That Require a Permanency Hearing
                                     Earlier Than the Federal Requirement of 18
                                     Months, as of December 31, 1996

                 Requirement for
                 holding the                   Year law was                                                 State policy/ regulation
State            permanency hearinga                enacted          State law citation                     citation
South Carolina   12 months                              1983         S.C. Code Ann., Section
                                                                     20-7-766(Law. Co-op. Supp.
Utah             16 months                              1995         Utah Code Ann., Sections
Virginia         12 monthsf                             1994         Va. Code Ann., Section
                                                                     16.1-282(Michie 1996)
Washington       12 and 18 monthsg                      1994         Wash. Rev. Code Ann., Section
                                                                     13.34.145(3)(4) (West Supp.
West Virginia    12 months                              1984         W. Va. Code, Sections 49-6-5,
Wisconsin        12 months                              1981         Wis. Stat. Ann., Sections
                                                                     48.355(4); 48.38;
                                                                     48.365(5)(West 1987)
Wyoming          12 months                              1995         Wyo. Stat. Ann., Section
                                                                     14-6-229 (k)(Michie Supp. 1996)

                                       Generally, a permanency hearing must be held within the indicated number of months after the
                                     child enters foster care.
                                      Colorado law requires that for children under age 6, the permanency hearing must be held within
                                     6 months from the time a child enters care. The time frame to hold the permanency hearing was
                                     calculated by adding the days needed to conduct the adjudicatory, dispositional, and
                                     permanency planning hearings. This expedited procedures program will be implemented on a
                                     county-by-county basis and will be fully implemented in the state by June 30, 2004. For children
                                     aged 6 and older, the permanency hearing is held within 18 months of placement.
                                       Michigan’s time frame to hold the permanency hearing was calculated by adding the days
                                     needed to conduct the preliminary hearing, trial, dispositional hearing, and the permanency
                                      New Hampshire law is unclear regarding the time frame for holding the permanency hearing;
                                     therefore, we relied on the New Hampshire Court Rules Annotated—Statutory Requirements
                                     Guidelines for Abuse and Neglect, Guideline 39, which requires that a permanency hearing be
                                     held within 1 year of the child’s placement in foster care.
                                       New Mexico law does not refer to permanency hearings. It does require that a dispositional
                                     hearing be conducted every 6 months to review the permanency plan of the child. During this
                                     review, a permanency decision for the child can be made but is not required.
                                      Virginia’s time frame to hold the permanency hearing was calculated by adding the number of
                                     months required to file the petition to hold the permanency hearing plus the number of days within
                                     which the court is required to schedule the hearing.
                                      Washington’s law requires the permanency hearing to be held no later than 12 months after a
                                     child is placed in foster care for children 10 years old and under. For children over age 10, the
                                     permanency hearing must be held no later than 18 months after a child is placed in foster care.

                                     Page 23                                      GAO/HEHS-97-73 State Efforts Show Some Promise
Appendix III

Comments From the Department of Health
and Human Services

               Page 24    GAO/HEHS-97-73 State Efforts Show Some Promise
Appendix III
Comments From the Department of Health
and Human Services

Page 25                             GAO/HEHS-97-73 State Efforts Show Some Promise
Appendix IV

GAO Contacts and Staff Acknowledgments

                  Gale C. Harris, Assistant Director, (202) 512-7235
GAO Contacts      Shellee S. Soliday, Evaluator-in-Charge, (404) 679-1950

                  In addition to those named above, Diana Eisenstat served as an adviser;
Staff             David D. Bellis, Octavia V. Parks, and Rathi Bose coauthored the report
Acknowledgments   and contributed significantly to all data-gathering and analysis efforts.
                  Also, Julian P. Klazkin provided legal analysis of state statutes.

                  Page 26                           GAO/HEHS-97-73 State Efforts Show Some Promise
Page 27   GAO/HEHS-97-73 State Efforts Show Some Promise
Related GAO Products

              Child Welfare: States’ Progress in Implementing Family Preservation and
              Support Activities (GAO/HEHS-97-34, Feb. 18, 1997).

              Child Welfare: Complex Needs Strain Capacity to Provide Services
              (GAO/HEHS-95-208, Sept. 26, 1995).

              Child Welfare: Opportunities to Further Enhance Family Preservation and
              Support (GAO/HEHS-95-112, June 15, 1995).

              Foster Care: Health Needs of Many Young Children Unknown and Unmet
              (GAO/HEHS-95-114, May 26, 1995).

              Foster Care: Parental Drug Abuse Has Alarming Impact on Young Children
              (GAO/HEHS-94-89, Apr. 4, 1994).

              Residential Care: Some High-Risk Youth Benefit, But More Study Needed
              (GAO/HEHS-94-56, Jan. 28, 1994).

              Foster Care: Services to Prevent Out-of-Home Placements Are Limited by
              Funding Barriers (GAO/HRD-93-76, June 29, 1993).

              Foster Care: State Agencies Other Than Child Welfare Can Access Title
              IV-E Funds (GAO/HRD-93-6, Feb. 9, 1993).

              Foster Care: Children’s Experiences Linked to Various Factors; Better
              Data Need (GAO/HRD-91-64, Sept. 11, 1991).

              Child Welfare: Monitoring Out-of-State Placements (GAO/HRD-91-107BR,
              Sept. 3, 1991).

(106710)      Page 28                          GAO/HEHS-97-73 State Efforts Show Some Promise
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