oversight

Children's Issues: A Decade of GAO Reports and Recent Activities

Published by the Government Accountability Office on 1990-09-21.

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

            i
                           United   States   General   Accounting    Office
                           Report to the Select Committee on
GAO’                   4   Children, Youth, and Families,
                           House of Representatives


September       I990
                           CHILDREN’S ISSUES
                           A Decade of GAO
                           Reports and Recent
                           Activities




                                                                    -..
GAO/HRD90-162                                                                 ..
                                                                               .*

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

      Human Resources    Division

      I3-240552

      September 21, 1990

      The Honorable George Miller
      Chairman, Select Committee on
        Children, Youth, and Families
      House of Representatives

      The Honorable Thomas .J. Bliley, Jr.
      Ranking Minority Member
      Select Committee on Children,
        Youth, and Families
      House of Representatives

      This report responds to your May 8, 1990, request for a comprehensive
      report of GAO'S activities since 1980 on children’s issues.

      We have defined children’s issues to include a wide range of federal pro-
      grams and policy areas affecting children (from birth to age 18) and
      their families. Our work has addressed a broad spectrum of domestic
      issues that affect children, such as infant mortality, access to health
      care, poverty, homelessness, early childhood education and child care,
      and foster care. For this report, we have categorized the results of our
      work into the following issues: child day care, child welfare and social
      services, education, health, housing, income security, nutrition, youth
      employment and training, and other child and family issues.

      Table I categorizes, by issue, over 250 GAO reports, testimonies, ongoing
      assignments, and other activities on issues affecting children. The table
      further reflects an increase in GAO'S work on children’s issues: 58 reports
      were issued in the 18-month period from October 1, 1988, through
      March 31, 1990, compared with 119 reports issued in the g-year period
      of fiscal years 1980-88. In the 18-month period, our work most fre-
      quently addressed health and education issues.




       Page 1                       GAO/HRIXlO-162   Children’s   Issues: Reports   and Activities
5240552




its issue date. At that time, we will send copies to interested parties and
make copies available to others upon request.

Should you have any questions concerning this report, please call me on
(202) 275-1655. Other major contributors are listed in appendix VI.




Linda G. Morra
Director, Intergovernmental
   and Management Issues




Page 3                        GAO/HRBB&162   Children’s   Issues: Reports   and Activities
    Early Childhood Education: Information on Costs and                                 17
         Services at High-Quality Centers (GAO/HRD-
         89-130FS, July 21, 1989)
    Early Childhood Education: What Are the Costs of                                    18
         High-Quality Programs? (GAO/HRD-90-43BR,
         Jan. 24,199O)
    Education Reform: Initial Effects in Four School                                     18
         Districts (GAO/PEMD-89-28, Sept. 26, 1989)
    Effective Schools Programs: Their Extent and                                         19
         Characteristics (GAO/HRD-89-132BR,
         Sept. 13, 1989)
    Special Education: Congressional Action Needed to                                    19
         Improve Chapter 1 Handicapped Program (GAO/
         HRD-89-54, May 23, 1989)
    Special Education: Estimates of Handicapped Indian                                   19
         Preschoolers and Sufficiency of Services (GAO/
         HRD-90-61BR, Mar. 5, 1990)
    Special Education: The Attorney Fees Provision of                                    20
         Public Law 99-372 (GAO/HRD-90-22BR,
         Nov. 24,1989)
    Transition Series: Education Issues (GAO/OCG-                                        20
         89-18TR, Nov. 1988)
    Vocational Education: Opportunity to Prepare for the                                 21
         Future (GAO/HRD-89-55, May 10, 1989)
Health                                                                                   21
    Health Care: Availability in the Texas-Mexico Border                                 21
        Area (GAO/HRD-89-12, Oct. 26, 1988)
    Health Care: Children’s Medical Services Programs in                                 22
         10 States (GAO/HRD-89-81, July 14, 1989)
    Health Care: Home Care Experiences of Families                                       22
         With Chronically Ill Children (GAO/HRD-89-73,
         June 20,1989)
    Health Care: Nine States’ Experiences With Home                                      22
         Care Waivers (GAO/HRD-89-95, July 14, 1989)
    Health Care Financing: Unreimbursed Charges of                                       23
         Selected Children’s Hospitals (GAO/HRD-89-76,
         July 11, 1989)
    Human Embryo Laboratories: Standards Favored to                                      23
         Ensure Quality (GAO/HRD-90-24, Dec. 19, 1989)
    Medicaid: States Expand Coverage for Pregnant                                        23
         Women, Infants, and Children (GAO/HRD-89-90,
         Aug. 16,1989)



Page 5                     GAO/IIRD-SO-162   Children’s   Issues: Reports   and Activities
contents




Nutrition                                                                                30
     Food Assistance: The National WIC Evaluation:                                       30
         Reporting and Follow-Up Issues (GAO/RCED-
         90-3, Dec. 14, 1989)
     Food Assistance Programs: Nutritional Adequacy of                                   30
         Primary Food Programs on Four Indian
         Reservations (GAO/RCED-89-177,
         Sept. 29,1989)
     Food Stamp Program: A Demographic Analysis of                                       31
         Participation and Nonparticipation (GAO/PEMD-
         90-8, Jan. 19, 1990)
     Food Stamp Program: Administrative Hindrances to                                    31
         Participation (GAO/RCED-89-4, Oct. 21, 1988)
     Food Stamp Program: Participants Temporarily                                        32
         Terminated for Procedural Noncompliance
         (GAO/RCED-89-81, June 22,1989)
     Food Stamps: Reasons for Nonparticipation (GAO/                                      32
         PEMD-89-5BR, Dec. 8, 1988)
     School Lunch Program: Buy American Procedures at                                     32
         Commodity Schools (GAO/RCED-89-218,
         Sept. 26, 1989)
     School Lunch Program: Buy American Procedures at                                     33
         Schools With Cash or Credit in Lieu of Food
         (GAO/RCED-89-183, Aug. 9,1989)
     Transition Series: Agriculture Issues (GAO/OCG-                                      33
         89-12TR, Nov. 1988)
Youth Employment      and Training                                                        33
      Job Training Partnership Act: Information on                                        33
          Training, Placements, and Wages of Male and
          Female Participants (GAO/HRD-89-152FS,
          Sept. 12, 1989)
      Job Training Partnership Act: Youth Participant                                     33
          Characteristics, Services, and Outcomes (GAO/
          HRD-90-46BR, Jan. 24, 1990)
Other Child and Family     Issues                                                         34
      Legislative Branch: Parental Leave Practices and                                    34
           Child Care Services (GAO/HRD-90-12,
           Nov. 14, 1989)
      Parental Leave: Revised Cost Estimate Reflecting the                                34
           Impact of Spousal Leave (GAO/HRD-89-68,
           Apr. 6,1989)
      United Nations: 1J.S.Participation in the Children’s                                35
           Fund (GAO/NSIAD-89-204, Sept. 27, 1989)


 Page 7                      GAO/‘HRb90-162   Children’s   Iesues: Reporta   and Actltitlea
                        Contents




Appendix VI                                                                                                     57
Major Contributors to
This Report
Tables                  Table I: GAO Products and Activities on Children’s Issues                                    2
                            (Fiscal Year 1980-Mar. 1990)
                        Table IV.l: Key GAO Contacts for Work on Children’s                                     50
                            Issues

Figures                 Figure I. 1: GAO Reports on Children’s Issues                                            12
                             (Oct. 1988-Mar. 1990)
                        Figure 11.1:GAO Testimony on Children’s Issues                                          36
                             (Oct. 1988-Mar. 1990)
                        Figure III. 1: GAO Reports on Children’s Issues                                          39
                             (Fiscal Years 1980-88)
                        Figure IV. 1: Ongoing GAO Assignments on Children’s                                      49
                             Issues (as of Mar. 3 1, 1990)
                        Figure V.l: Published Articles and Papers by GAO Staff                                   54
                             on Children’s Issues (Oct. 1988-Mar. 1990)




                        Page 9                      GAO/HRD-90-162   Children’s   Issues: Reports   and Activities
Page 11   GAO/HRDB@162   Children’s   Issues: Reports   and Activities
                             Appendix I
                             An Annotated   Bibliography of GAO Reports
                             on Children, October 1983 Through
                             March 1990




                             11 years, the federal government has increased its support for child care
                             by about $2 billion in constant 1988 dollars. At the same time, however,
                             support to low-income families declined as a proportion of the total fed-
                             eral child care budget. This decline in the share of dollars spent for low-
                             income families was mainly due to higher-income families expanding
                             their use of the child care tax credit. No federal agency is responsible
                             for coordinating all federal child care efforts, although there has been
                             some child care coordination at the state level. While the supply of child
                             care is difficult to measure because so much is privately provided and
                             unregulated, information indicates that some types of child care, such as
                             care for infants and toddlers, school-age children, and sick children, are
                             in short supply.


Child Care: Selected         GAO  developed from various data bases a selected bibliography on child
Bibliography (GAO/HRD-       care. This bibliography contains 386 citations, most accompanied by
                             abstracts taken from the data bases. The cited literature includes
89-98FS, July 11, 1989)      journal articles, books, research reports, studies, and conference papers
                             published during the period 1978 to mid-1988.


Marine Corps Child Care:     In the spring of 1988, weekly fees for one child at the Marine Corps
                             Recruit Depot, Parris Island, South Carolina, and the Marine Corps Air
User Fee Increases at        Station, Beaufort, South Carolina, child care centers ranged from $22 to
Parris Island and Beaufort   $24 and from $24 to $29, respectively, depending on the parent’s mili-
Installations (GAO/HRD-      tary rank. During 1988, both centers experienced significant pressures
89-74, Mar. 24, 1989)        to increase user fees. These pressures resulted primarily from a combi-
                             nation of factors, including: (1) directives from Marine Corps headquar-
                             ters to cover more nonappropriated costs with user fees; (2) cuts in
                             fiscal year 1988 morale, welfare, and recreation appropriations; and (3)
                             increased manpower and operations expenses partly due to an overall
                             Marine Corps initiative to improve the quality of child care. In 1988,
                             both installations found it necessary to raise fees. The increased weekly
                             child care fees at Parris Island ranged from $26 to $45 and in Beaufort
                             from $36 to $40.


Military Child Care:         The demand for child care services has exceeded the supply at most mil-
Extensive, Diverse, and      itary bases. Military child care is provided on installations primarily
                             through child development centers and family day care homes. Care in a
Growing (GAO/HRD-89-3,       center is given by trained caregivers on a fee-for-service basis. Care in
Mar. 8, 1989)                family day care homes is given in government housing, usually by a
                             trained military spouse, at a rate agreed upon by the caregiver and the


                              Page 13                             GAO/HRIWO-162   Children’s   Issues: Reports   and Activities
                             Appendix I
                             An Annotated Bibliography  of GAO Reports
                             on Children, October 1988 Tbmugh
                             March 1990




Foster Care: Incomplete      In response to reports of widespread abuses of the foster care system,
                             the Adoption Assistance and Child Welfare Act of 1980 revised several
Implementation of the        child welfare programs. Evidence suggests, however, that the revised
Reforms and Unknown          requirements have not been completely carried out. Although 94 percent
Effectiveness (GAO/          of the states had met ACYF’S minimum requirements for the case review
PEMD-89-17, Aug. 14,         system by 1987, ACYF compliance reviews revealed problems in com-
1989)                        pleting case reviews within the required time periods. In the absence of
                             a national evaluation or comprehensive information system, GAO could
                             not determine if the reforms carried out have reduced the number of
                             unnecessary and inappropriate placements of children into foster care.
                             Although procedural protections have generally been instituted, present
                             conditions suggest a continuing need for incentives to fully implement
                             these reforms and, perhaps, additional efforts by ACYF and the states to
                             strengthen them.


Foster Care: Preliminary     During the 197Os, widespread abuses of the foster care system were
Report on Reform Effects     reported. In light of these reports, the Adoption Assistance and Child
                             Welfare Act of 1980 amended several child welfare programs under the
(GAO/PEMD-8923BR,            Social Security Act. In particular, the act made funds available for the
June 1,1989)                 federal Foster Care program and large funding increases for the Child
                             Welfare Services grant, contingent on the states’ implementation of cer-
                             tain procedural protections for children in foster care. This briefing
                             report presents, primarily in tabular form, the preliminary results of
                             GAO’S review. Final results were reported in GAO/PEMD-89-17.




Foster Parents: Recruiting   Foster care professionals report that recruiting and retaining foster par-
and Preservice Training      ents are becoming increasingly difficult. Preservice training, which is
                             provided before social services agencies approve parents and place
Practices Need Evaluation    foster children with them, is seen by foster care professionals as a con-
(GAO/HRD-89-86, Aug. 3,      tinuation of recruiting that can help prepare foster parents for the chal-
1989)                        lenges of caring for foster children. Reliable data on state recruitment
                             and retention of foster parents, however, are not generally available.
                             Few formal evaluations of states’ foster parent recruiting and preservice
                             training strategies have been done. As a result, HHS should comprehen-
                             sively evaluate the effectiveness of various foster parent recruiting
                             strategies.




                             Page 15                             GAO/HRD90-162   Children’s   Issues: Reports   and Activities
                                                          --
                              Appendix I
                              An Annotated Bibliography  of GAO Reports
                              on Children, October 1988 Through
                              March 1990




                                                        --
                              did not adequately monitor and administer the grant agreements, as pre-
                              scribed by federal regulation and Office of Management and Budget
                              (OMB) circulars.




DOD Overseas Schools:         DOD  spent about $755 million in 1988 to run 271 overseas schools
Additional Assurances of      attended by over 150,000 students, who are dependents of military and
                              DOD civilian personnel stationed abroad. GAO found that while DOD
Educational Quality           schools are accredited and their students tend to score well on standard-
Needed (GAO/HRD-90-13,        ized tests, DOD school management and parents should have additional
Mar. 15, 1990)                assurances that the schools are providing students with a high-quality
                              education. Scores provide but one measure of education quality and
                              should be supplemented with other indicators-like      promotion rates
                              and measures of the variety of course offerings. DOD also needs better
                              procedures for documenting that the schools have quality teachers and
                              that students meet graduation standards. School advisory committees
                              have been established to give parents and teachers a forum for express-
                              ing their views on school operations; however, these committees seldom
                              exercise their specific authority to advise school principals on budgets
                              and course curricula. DODhas implemented widely used drug and alcohol
                              abuse programs in its schools and has generally corrected facilities’
                              shortcomings, such as inadequate space and leaky roofs, that were iden-
                              tified by its accrediting organization.


Early Childhood               Preliminary results of a GAO survey of 265 high-quality early childhood
Education: Information on     education programs showed that, on average, they spent $4,070 per
                              child in fiscal year 1988; after adjusting for in-kind donations, the cost
Costs and Services at High-   per child was $4,660. The average child-to-teacher ratio for 4-year-old
Quality Centers (GAO/         children was about 9 to 1; at many of these centers, the ratios for
HRD-89-130FS, July 21,        infants and toddlers were closer to 4 to 1. More than three-fourths of
1989)                         center expenses were for salaries and benefits and rent or mortgage.
                              Other costs were for additional operating expenses-such as educa-
                              tional materials and equipment, food, office supplies, repairs and main-
                              tenances, insurance, and utilities-and    supplementary services, such as
                              health screening and parent education. Final results were reported in
                              GAO/FIRD-90.43BR.




                              Page 17                             GAO/HIUW@162   Children’s   Issues: Reports   and Activities
                           Appendix I
                           An Annotated Bibliography  of GAO Reports
                           on children, October 1988 Through
                           March 1990




Effective Schools          This briefing report discusses (1) the number of school districts with
Programs: Their Extent     effective schools programs, (2) common program characteristics and
                           practices, (3) how school districts evaluate the effect of their programs
and Characteristics        on students’ academic achievement, and (4) federal requirements for
(GAO/HRD-89-132BR,         evaluating these programs.
Sept. 13,1989)

Special Education:         In 1965, the Congress established the Title I (now Chapter 1) Handi-
                           capped Program. Primarily, the program was to help states finance the
Congressional Action       education of handicapped children, most of whom were severely handi-
Needed to Improve          capped, in state-operated or supported institutions. In 1975, the Con-
Chapter 1 Handicapped      gress enacted a much larger program through the Education of the
Program (GAO/HRD-89-54,    Handicapped Act (EHA). This act required that states assure an adequate
May 23,1989)               education for all handicapped children and provided additional federal
                           financial assistance. Handicapped children covered by Chapter 1 are
                           generally educated separately from nonhandicapped children. Although
                           the services these handicapped children receive are similar in nature to
                           those provided under EHA, they often are more frequent or more inten-
                           sive, reflecting their more serious handicapping conditions. Chapter 1 is
                           administratively similar to EHA, and the procedural safeguards guaran-
                           teed to EHA program participants are also provided to Chapter 1 pro-
                           gram students. However, a number of problems in Chapter 1
                           administration may indicate a need for legislative changes. For example,
                           four states that count children with handicaps generally not considered
                           to be severe have received nearly half of all program funds. The Con-
                           gress should restructure the Chapter 1 program to eliminate funding
                           imbalances and to better assure that all states focus on severely handi-
                           capped children. Also, the Congress should enact legislation to merge the
                           Chapter 1 and EHA programs. If the programs are merged, the Congress
                           should consider a separate funding set aside for states to use to serve
                           only severely handicapped children.


Special Education:         GAO  is required by Public Law loo-297 to review the Bureau of Indian
Estimates of Handicapped   Affairs’s (BIA) programs for educating handicapped Indian preschoolers.
                           This briefing report discusses GAO’S estimates of (1) the number of hand-
Indian Preschoolers and    icapped Indian preschoolers on the 63 reservations with schools admin-
Sufficiency of Services    istered by BIA and (2) the sufficiency of services they receive. GAO
(GAO/HRD-90-61BR,          estimates that while nearly 3,000 handicapped Indian preschoolers aged
Mar. 5, 1990)              3 and 4 live on the 63 reservations with BIA schools, only 838 of these
                           children were receiving special education services in school year 1988-
                           89. At least 24 percent of 791 handicapped children with Individual


                           Page 19                            GAO/HBD-90162   Children’s   Issues: Reports   and Activities
                             Appendix I
                             An Annotated  Bibliography of GAO Reports
                             on Childreq  October 1986 Through
                             March 1990




                              financial management systems to address accounting and internal con-
                              trol weaknesses.


Vocational Education:         Providing quality vocational education to underserved groups in all
                              areas of each state and encouraging modernization and improvement of
Opportunity to Prepare for    vocational education programs are two major objectives of the Carl D.
the Future (GAO/HRD-          Perkins Vocational Education Act. In the six states and 20 localities GAO
89-55, May 10,1989)           visited, vocational education programs and services consistent with the
                              Perkins Act were provided. But vocational education students in eco-
                              nomically depressed areas may be less likely to receive Perkins funding
                              for improved or modernized program activities than students outside
                              such areas. All six states visited allocated more than half of their basic
                              state grants to economically depressed areas, as the act requires. But
                              some states designated relatively wealthy areas as “economically
                              depressed” and gave them greater per capita funding than some poorer
                              communities. Further, the disadvantaged population allocation formula
                              includes students who are academically disadvantaged but not poor.
                              Thus, some relatively wealthy school districts can receive more money
                              per low-income student than districts with high concentrations of low-
                              income students. Should the Congress want to target additional Perkins
                               Act funds to poor communities, it could amend the act to (1) require
                              states to allocate at least as much Perkins funding for each vocational
                              student in economically depressed areas as in other areas of the state,
                              (2) remove “academically disadvantaged” students who are not poor
                               from the fund allocation formula for the disadvantaged, and (3) require
                               that any Perkins funds redistributions for the disadvantaged and handi-
                               capped populations be made in approximately the same proportions
                               between poorer and wealthier areas as the original allocations.



Health

Health Care: Availability    -Concern haa been expressed about the health problems and availability
in the Texas-Mexico            of health care in the Texas-Mexico border area counties. Some of the
                               findings were that the general birth rate was higher, the death rate was
Border Area (GAO/HRD-          lower, and the communicable disease rate was relatively higher than
89-12, Oct. 26, 1988)          elsewhere in the United States. A majority of the border counties have
                               physician shortages; areas with populations of under 9,000 do not have
                               hospital or clinic facilities and emergency care equipment. Four catego-
                               ries of federal, state. and local health-related programs could benefit


                               Page 21                           GAO/IIRDSO-162   Children’s   Issues: Reports   and Activities
                            Appendix I
                            An Annotated Bibliography  of GAO Reports
                            on Children, October 1988 Through
                            March 1990




                            of 32 home and community-based waivers. Children were eligible for
                            services under 24 of them and represented about 10 percent of the indi-
                            viduals served under these arrangements. Officials in eight of the nine
                            states told us they were satisfied with the results achieved with their
                            waivers; that is, they were able to provide less costly home and
                            community-based care. On the other hand, most states reported difficul-
                            ties with their initial attempts to obtain waivers. Some officials believed
                            that the initial waiver application and approval process was a long,
                            stretched out, and uncertain process.


Health Care Financing:      Unreimbursed charges at the 13 children’s hospitals that GAO visited
Unreimbursed Charges of     averaged about 20 percent of their total charges for patient care during
                            fiscal year 1986, the latest year for which they had complete data at the
Selected Children’s         time. Such charges are attributable to charity care, bad debts, and
Hospitals (GAO/HRD-         allowances and discounts available under contractual arrangements
89-76, July 11, 1989)       with certain public and private payers. The contractual arrangements
                            accounted for 59 percent of the unreimbursed charges, followed by
                            charity care and bad debts. Hospitals attempted to mitigate the impact
                            of unreimbursed charges by (1) considering them in setting patient
                            charges and (2) generating income from other sources.


Human Embryo                The successful application of advanced reproductive technologies has
Laboratories: Standards     raised the hopes of many infertile couples. Because human embryo labo-
                            ratories play an important role in the treatment of such patients, GAO
Favored to Ensure Quality   surveyed laboratory personnel qualifications, quality control measures,
(GAO/HRD-90-24,             and techniques. GAO found that these factors varied, and most of the
Dec. 19, 1989)              technology practitioners responding to GAO'S survey generally agreed
                            that some oversight of human embryo laboratories would improve the
                            quality of care people receive. Most respondents favored more uniform
                            personnel qualifications and quality control requirements. Many repro-
                            ductive technology program directors, however, opposed mandating
                            standardized techniques, noting that similar results may be obtained
                            when different methods, materials, and techniques are used.


Medicaid: States Expand     In recent years, most states have expanded Medicaid eligibility for preg-
Coverage for Pregnant       nant women, infants, and young children. Eighty-six percent of states
                            have raised their income limits for Medicaid eligibility for pregnant
Women, Infants, and         women and infants. In addition to raising income levels, 36 states have
Children (GAO/HRD-          adopted at least two other options-dropping    assets tests (guaranteeing
89-90, Aug. 16, 1989)       continuous eligibility) and offering temporary (presumptive) eligibility


                            Page 23                             GAO/~99-162   Children’s   Issues: Reports   and Activities
                                Appendix I
                                An Annotated   Bibliography of GAO Reports
                                on Children, October 1988 Thruugh
                                March 1990




Youth Camps: Nationwide         No federal legislation currently exists to regulate youth camp safety and
                                health. Instead, states develop and implement their own youth camp
and State Data on Safety        health and safety standards. Nationally, and in five of the six states GAC)
and Health Lacking              visited, little information was available on accidents, illnesses, and fatal-
(GAO/HRD-89-140,                ities that occur at youth camps. Youth camp safety and health stan-
Sept. 20, 1989)                 dards in the 50 states vary widely, and GAO found no source of
                                nationwide data on the states’ enforcement activities whether conducted
                                by the state centrally or delegated to local jurisdictions.



Housing

Children and Youths:            On a given night, about 68,000 children and youths aged 16 or younger
About 68,000 Homeless           may be members of families that are literally homeless. Of these chil-
                                dren and youths, about 25,500 are likely to be in urban shelters and
and 186,000 in Shared           hotels; about 21,800 are likely to be in suburban and rural areas; about
Housing at Any Given            4,000 are housed by churches; about 9,000 may be sleeping in aban-
Time (GAO/PEMD-89- 14,          doned buildings, cars! or public places; and about 7,700 may be in
June 15,1989)                   various other settings. In addition to those who are literally homeless,
                                nearly 186,000 children and youths may be precariously housed,
                                spending the night in doubled-up circumstances.


Homelessness: Homeless          This report analyzes the characteristics of youths who were served by
and Runaway Youth               shelters funded under the Runaway and Homeless Youth Act. GAO found
                                that while there have been reports of a growing population of homeless
Receiving Services at           youths, little information is available on the size or characteristics of
Federally Funded Shelters       either the total homeless youth population or the subgroup seeking
(GAO/HRD-90-45,                 assistance from runaway and homeless shelters. As the result of its
Dec. 19, 1989)                  analysis, however, GAOmade the following observations:

                            . Homeless youths seem to be a diverse group of people facing many
                              problems.
                            . The shelter network may not be able to meet some needs of homeless
                              and runaway youths.
                            l Many youths may not be receiving needed services after they leave the
                              shelters.
                            . Many homeless youths who do not return to their families after leaving
                              a shelter move on to unstable living arrangements.
                            l Very few of the homeless youths appear to leave shelters for indepen-
                              dent living programs.


                                Page 26                              GAO/IIRD40-162   Children’s   Issues: Reports   and Activities
                             Appendix I
                             AnAmotawdBibliographyof        GAOReports
                             on Children, October 1988 Through
                             March 1990




Housing Conference:          For many years, the federal government has played an important role in
                             ensuring and providing an adequate and affordable supply of decent,
National Housing Policy      safe, and sanitary housing for many citizens. Since 1980, however, fed-
Issues (GAO/RCED-89-l -74,   eral funding for housing programs has been reduced substantially for
Aug. 1989)                   some programs and others have been targeted for further reduction or
                             even elimination. The Congress and the administration have again begun
                             to emphasize the need for immediate attention to programs that would
                             provide an adequate and affordable supply of housing, including
                             housing for the homeless. This staff study presents the proceedings of a
                             September 1988 conference sponsored by GAO to help it plan its future
                             work on the problems of availability and affordability of housing for
                             low-income households, homeless individuals and families, and first-
                             time home buyers. In view of the recently disclosed problems of mis-
                             management at HUD, GAO also plans to undertake studies of internal con-
                             trols in various HUD programs.


Rental Housing: Housing      EILJD is
                                    currently operating two similar rental assistance subsidy pro-
                             grams-certificates    and vouchers-whose     identical goals are to provide
Vouchers Cost More Than      low-income families with decent, safe, and affordable rental housing.
Certificates but Offer       The administration has proposed that the certificate program be
Added Benefits               replaced with the voucher program, claiming that vouchers are less
(GAO/RCED-89-20,             costly and are more efficient. The latest data available, however, indi-
Feb. 16, 1989)               cate that voucher costs are likely to be higher than certificate costs.
                             Using data from HIJD'S first-year report on the housing voucher program,
                             GAO calculated that with HUD'S 1989 budget request, about 9,500 fewer
                             families can be assisted with vouchers than with certificates. GAO
                             believes that operating one rental assistance program is advantageous; it
                             would provide consistent benefits to program recipients and a unified
                             approach to delivering housing assistance. The merits and drawbacks of
                             features presently distinguishing vouchers from certificates need to be
                             evaluated.


Transition Series: Housing    GAO  found that the new administration, which came into office January
                              1989, will need to: (1) encourage continued private investment in low-
and Urban Development         income housing, focusing on individual markets to determine the amount
Issues (GALO/OCG-89-          of federal incentives needed; (2) consider the cost effectiveness of pre-
22TR, NovI. 1988)             serving public, low-income housing; (3) continually monitor tax policies;
                              (4) discontinue the separate housing voucher and certificate programs
                              to assist low-income families, and consolidate the best features of both
                              programs into one program aimed at providing equitable, cost-effective



                              Page 27                              GAO/IIRD-96.162   Children’s   Issues: Reports   and Activities
                            Appendix 1
                            An Annotated Bibliography   of GAO Reports
                            on Children, October 1968 Through
                            March 1996




Interstate Child Support:   OCSEand state caseload and collection data are of questionable reliability
                            and provide limited information about interstate child support. OCSE
Case Data Limitations,      data cannot be used to determine the relative size of states’ interstate
Enforcement Problems,       versus total caseloads because CASE collects different types of informa-
Views on Improvements       tion on interstate and total cases. Some of the barriers states identified
Needed (GAO/HRD-89-25,      that affect collections are insufficient staff, lack of automation, dif-
Jan. 27, 1989)              fering policies and procedures among states, and lack of communica-
                            tion/cooperation between states. Some ongoing improvements at the
                            state level include: (1) strengthening state legislation, policies, and pro-
                            cedures; (2) increasing attention and priority to interstate cases; (3)
                            improving absent parent location services; and (4) increasing staffing
                            and training. Some suggested actions at the federal level should include:
                            standardizing laws, procedures, and forms that bear on interstate cases;
                            establishing child support office performance standards for handling
                            interstate cases; and establishing an interstate computer network with
                            uniform processing requirements for each state.


Transition Series: Health   Among other things, GAO reported that HHS needs to provide strong lead-
and Human Services Issues   ership to establish performance standards, encourage states to use
                            proven collection techniques, and promote automated child support
(GAO/OCG-89-lOTR,           enforcement systems.
Nov. 1988)
                                                     --.
Welfare Reform:             This briefing report focuses on Alabama’s proposed welfare reform
Alabama’s Demonstration     demonstration project called Avenues to Self-Sufficiency through
                            Employment and Training Services. Specifically, the report (1) analyzes
Project (GAO/HRD-89-        the procedures used to process the demonstration project proposal,
129BR, Aug. 17,1989)        including whether the project complied with current law, and (2) pro-
                            vides information about the project’s characteristics, such as benefits
                            and changes associated with the project, the project’s effects on future
                            beneficiaries, and Alabama’s early cost and savings estimates if the pro-
                            gram is implemented in three counties and statewide.




                            Page 29                              GAO/HRD99-162   Children’s   Issues: Reports   and Activities
                            Appendix I
                            An Annotated Bibliography  of GAO Reports
                            on Children, October 1988 Through
                            March 1990




                                determine the nutritional adequacy of program benefits for specific indi-
                                viduals. Four major diet-related health conditions exist on the four res-
                                ervations: obesity, diabetes, heart disease, and hypertension. Although
                                proper nutrition may not cure these conditions, it can reduce their com-
                                plications or help prevent their occurrence. These programs do not spe-
                                cifically address the special dietary needs of Indian recipients; however,
                                GAO believes that ensuring that recipients receive and apply adequate
                                nutrition education can help meet these needs.


Food Stamp Program: A           Why do some households that are eligible for food stamps not receive
Demographic Analysis of         them? GAO found that in 1987, over 56 percent of eligible households did
                                not participate in the Food Stamp Program. Households receiving other
Participation and               welfare benefits were more likely to participate in the Food Stamp Pro-
Nonparticipation (GAO/          gram. On the other hand, households receiving social security, those
PEMD-90-8, Jan. 19, 1990)       headed by the elderly, and those headed by both white and nonwhite
                                single men were less likely to receive food stamps. The main reasons
                                given for not participating in the program were (1) lack of interest in the
                                benefits, (2) a lack of program information, and (3) problems with the
                                program or lack of access to it. Given that outreach efforts may be
                                resumed under the Hunger Prevention Act, GAO believes states should be
                                encouraged to target those groups that would most benefit from the
                                program.

                            -
Food Stamp Program:             States have adopted a number of procedures to assure eligibility for
Administrative Hindrances       Food Stamp Program benefits and ensure that needy persons receive the
                                appropriate amount of assistance in the most economical and efficient
to Participation (GAO/          way possible. However, under certain circumstances, procedures
RCED-89-4, Oct. 21, 1988)       adopted by states (California, Illinois, Maryland, Oklahoma, and Texas)
                                GAO visited have prevented or delayed eligible households from applying
                                for food stamps and participating in the program. For example, GAO
                                found that two offices conducted normal business only 4 days each
                                week, which limited access to food stamp services, all local offices in one
                                state and one local office in each of two other states did not consider
                                applicants for expedited benefits or provide expedited benefits on time,
                                and three local offices in one state did not always help applicants obtain
                                the documents they needed to complete their applications.




                                Page 31                         GAO/IIRBSO-162   Children’s   Issues: Reports   and Activities
                             Appendix I
                             An Annotated Bibliography  of GAO Reports
                             on Children, October 1988 Through
                             March 1996




School Lunch Program:        School districts receiving federal funds are required, whenever possible,
                             to purchase only food products that are produced in the United States.
Buy American Procedures      GAO found that the Food and Nutrition Service and two of the three
at Schools With Cash or      states visited have implemented the Buy American provisions, but had
Credit in Lieu of Food       done only limited monitoring to determine compliance. Officials at three
(GAO/RCED-89-183,            of the four school districts GAO visited were aware of the Buy American
Aug. 9, 1989)                requirement and had instructed suppliers to deliver domestic products
                             only. Officials in two of the districts periodically inspected product
                             labels to ensure that the Buy American requirement was being met.
                             Monitoring by the Food and Nutrition Service was limited.


Transition Series:           As part of the transition series of reports, GAO found that, among other
Agriculture Issues (GAO/     things, USDA needs to improve the effectiveness and accuracy of the food
                             stamp sanction system and resolve unpaid sanctions owed to the federal
OCG-89-1ZTR, Nov. 1988)      government.



Youth Employment
and Training

Job Training Partnership     This fact sheet discusses the occupations in which male and female par-
Act: Information on          ticipants in the Job Training Partnership Act program were trained and
                             subsequently placed. It provides (1) a summary of the skill level of occu-
Training, Placements, and    pations for which men and women were trained and placed; (2) a com-
Wages of Male and Female     parison of the number and percentage of men and women trained in
Participants (GAO/HRD-       specific occupations, categorized as higher, moderate, and lower skill
89-152FS, Sept. 12, 1989)    level positions; and (3) a similar comparison for those placed in specific
                             occupations.


Job Training Partnership     The Job Training Partnership Act offers training to economically disad-
Act: Youth Participant       vantaged youth, many of whom lack basic work skills and remain unem-
                             ployed despite economic expansion and a shortage of qualified workers.
Characteristics, Services,   This briefing report provides information on the characteristics of
and Outcomes (GAO/HRD-       youths (aged 14 to 21) enrolled under Title IIA of the act, the services
90-46BR, Jan. 24, 1990)      they received, and the outcomes they attained.




                             Page 33                             GAO/HRD96-162   Children’s   Issues: Reports   and Activities
                       Appendix I
                       An Annotated Bibliography   of GAO Reports
                       on Children, October 1988 Through
                       March 1990




United Nations: U.S.   GAOfound that officials and representatives of other major donor coun-
Participation in the   tries believe that United Nations Children’s Fund (UNICEF)programs are
                       managed in a generally effective manner. They do, however, have cer-
Children’s Fund        tain concerns about UNICEFpolicies and programs. GAOobserved condi-
(GAO/NSIAD-89-204,     tions at some UNICEF-assistedproject sites that suggested increased
Sept. 27, 1989)        monitoring and oversight might be helpful. United Nations audits of
                       UNICEF’S1985 and 1986 financial statements were critical of several
                       accounting and financial management practices. UNICEFmanagement has
                       responded affirmatively to the auditor’s recommendations. While the
                       United States remains a major contributor to and participant in UNICEF,
                       it is no longer the predominant donor, and its level of influence may be
                       declining.




                        Page 36                             GAO/HRD9O-162   Children’s   Issues: Reports   and Activities
            Appendix11
            GAO Testimony on Children’s Issues,
            October 1988 Through March 1990




            GAO'S Study of Overseas Department of Defense Dependents’ Schools, by
            William J. Gainer, Human Resources Division, before the Subcommittee
            on Military Personnel and Compensation, House Committee on Armed
            Services (GAO/T-HKD-89-1 , Oct. 5, 1988).

            Impacts of Education Reform, by Eleanor Chelimsky, Program Evalua-
            tion and Methodology Division, before the Subcommittee on Elementary,
            Secondary and Vocational Education, House Committee on Education
            and Labor (GAO/T-PEMD-XW,  Mar. 7, 1989).

            Implementation of the Carl D. Perkins Vocational Education Act, by
            William J. Gainer, Human Resources Division, before the House Com-
            mittee on Education and Labor (GAO/T-HKD-89-08, Mar. 7, 1989).

            Observations on Ohio’s Implementation of the Drug-Free Schools and
            Communities Act, by .John H. Luke, Detroit Regional Office, before the
            Senate Committee on Governmental Affairs (GAO/T-HRD-90-18,    Feb. 13,
            1990).

            Vocational Education: Opportunity to Prepare for the Future, by
            William J. Gainer, Human Resources Division, before the Subcommittee
            on Education, Arts, and Humanities, Senate Committee on Labor and
            Human Resources ((;.~o/T~rrr~D-89-Dr, .June 22, 1989).

            _________-
            Meeting the Needs of Children in a Home-Based Setting, by J. William
Health      Gadsby, Human Resources Division, before the Senate Committee on
            Finance (GAO/T-HRD-89-30, June 20, 1989).

            Nationwide and State Data on Youth Camp Safety and Health Not Col-
            lected, by Linda G. Morra, Human Resources Division, before the Sub-
            committee on Health and Safety, House Committee on Education and
            Labor (GAO/T-HRD-8%'27, Sept. 20, 1989).


            Adequacy of Nutrition Programs on Indian Reservations, by Flora H.
Nutrition   Milans, Resources, Community, and Economic Development Division,
            before the Senate Committee on Agriculture, Nutrition and Forestry and
            the Senate Select Committee on Indian Affairs (GAO/T-RCED-90-30, Feb. 20,
            1990).




            Page37                                GAO/HRD-90162   Children’s   Issues: Reports   and Activities
Appendix III                                                        -

GAO Reports on Children, FiscallYears 1980-88


                                         GAO  issued 119 reports on issues affecting children and their families
                                         from fiscal years 1980 through 1988. Figure III.1 shows the distribution
                                         of these reports among nine different issues. From 1980 through 1984,
                                         GAO issued more reports on child welfare and social services issues than
                                         any other issue. From 1985 through 1988, however, the emphasis
                                         shifted to income security and nutrition issues.


Figure 111.1:GAO Reports on Children’s
Issues (Fiscal Years 1980-88)
                                         30    Number   of Rqwxls


                                         25
                                                        r




                                          Child Care: Availability for Civilian Dependents at Selected                    Installa-
Child Day Care                            tions (GAOIHRD-88-115,  Sept. 15, 1988)
                                                                                                                   WD



                                          Child Care: Employer Assistance for Private Sector and Federal
                                          Employees (GAO/GGD-86-38, Feb. 11, 1986)

                                          Military Child Care Programs: Progress Made, More Needed                 (GAO/
                                          FED-82-30, June 1, 1982)




                                          Page 39                       GAO/HRD96-162   Children’s   Issues: Reports   and Activities
Appaulix III
GAO Reports on Children,   Fixal   Years 1980.66




Health and Human Services: Documentation of Funding Decisions for
Child Abuse and Neglect Grants Inadequate (GAO/HRD-87-69, May 22,
1987)

Implementation of Public Law 94-142 As It Relates to Handicapped
Delinquents in the District of Columbia (GAO/GGD86-4, Oct. 17, 1985)

Improved Federal Efforts Needed to Change Juvenile Detention Prac-
tices (GAO/GGD%23, Mar. 22, 1983)

Increased Federal Efforts Needed to Better Identify, Treat, and Prevent
Child Abuse and Neglect (GAO/HRD-80-66, Apr. 29, 1980)

Inter-title Transfers-A    Way for States to Increase Federal Funding for
Social Services (GAO/HRD-81.116, July 10, 1981)

Juvenile Justice: Grant to the National Partnership to Prevent Drug and
Alcohol Abuse (GAO/GGD-88-5BR, Apr. 6, 1988)

Legislative Changes Are Needed to Handle Certain Cases Under the Fed-
eral Youth Corrections Act (GAO/GGD-83-40, Mar. 9, 1983)

Missing Children: Missing Children Data Collected by the National Crime
Information Center (GAO,XKXWS~IFS,  Jan. 28, 1986)

Propriety of Non-Federal Cash Matching Requirements for Juvenile Jus-
tice Grants (GAO/GGD-X4-28, Dec. 9, 1983)

Residential Care: Patterns of Child Placement in Three States                          (GAO/
PEMD-85-02,June 28, 1985 )

Review of Certain Aspects of Group Home Care for Children in Cali-
fornia (GAO/HRD-85-62, ,July 19, 1985)

Sexual Exploitation of Children-A                  Problem of Unknown Magnitude
(GAOIHRD-82-64, Apr. 20, 1982)

 States Are Funding Juvenile Justice Projects That Conform to Legisla-
 tive Objectives (GAO/GGI)-x0-40, Mar. 7, 1980)

 States Use Several Strategies to Cope with Funding Reductions Under
 Social Services Block Grant (GAO/HAD-84.68, Aug. 9, 1984)



 Page 41                               GAO/HRD-90.162   Children’s   Issues: Reports   and Activities
         Appendix III
         GAO Reports on Children,   Fiscal Years 1980-98




         Greater Use of Exemplary Education Programs Could Improve Educa-
         tion for Disadvantaged Children (GAOIHRD-81~65, Sept. 15, 1981)

         Impact Aid: San Antonio Military School Districts Can Adjust to
         Reduced Federal Assistance (GAO/HRD-88.63BR,  May 19, 1988)


         School Dropouts: Survey of Local Programs               (GAOIHRD-87-108,          July      20,
         1987)

         School Dropouts: The Extent and Nature of the Problem                        (GAO/HRD-86-
         106BR, June 23, 1986)


         Should the Bureau of Indian Affairs Continue to Provide Educational
         Services to Indian Children? (GAO/CED-80-72, Apr. 23, 1980)

         Special Education: Financing Health and Educational Services for Handi-
         capped Children (GAO/HRD-X6-GZBR, July 31, 1986)

         Unanswered Questions on Educating Handicapped Children in Local
         Public Schools (GAO/HRDm81-43, Feb. 5, 1981)


         Better Management and More Resources Needed to Strengthen Federal
Health   Efforts to Improve Pregnancy Outcome (GAO~HRD-80-24, Jan. 21, 1980)

         Block Grants: Federal Set-Asides for Substance Abuse and Mental
         Health Services (GAO!HRD-88-17, Oct. 14, 1987)

         DOD   Health Care: Pediatric and Other Emergency Room Care                             (GAO/
         ~~~-88-113, Sept. 28, 1988)

         Early Observations on States’ Plans to Provide Children’s Mental Health
         Services Under the ADAMH Block Grant (GAO/HRD-85-84, July 10, 1985)

         Immunization: Safety and Use of Polio Vaccines                     (GAO/HRD-87.83BR,
         May 11,1987)

         Maternal and Child Health Block Grant: Program Changes Emerging
         Under State Administration (GAO/HRD+W35,  May 7, 1984)

          Medicaid: Interstate Variations in Benefits and Expenditures                          (GAO/
          HRD-87.67BR, May 4, 1987)



          Page 43                              GAO/HRB99-162   Children’s     Issues: Reports     and Activities
Appmdix  III
GAO Reports on Children,   Fiscal Years 1980-38




Child Support: Need to Improve Efforts to Identify Fathers and Obtain
Support Orders (GAOiHRD-87-37, Apr. 30, 1987)

Child Support: States’ Implementation of the 1984 Child Support
Enforcement Amendments (GAO/HRD-86-4OBR, Dec. 24, 1985)

Child Support: States’ Progress in Implementing the 1984 Amendments
(GAO/HRD-87.11,OCt. 3, 1986)

Federal Personnel: Garnishments of Wages for Commercial and
Domestic Debts (GAOjGGD-88-49FS, Feb. 17, 1988)

Tax Policy: Evaluation of IRS’ Refund Offset Study                  (GAO/GGD-88-117,
Sept. 1, 1988)

I~J.S.Child Support: Needed Efforts Underway to Increase Collections for
Absent Parents (GAO,%RD-85-5, Oct. 30, 1984)

Welfare: Expert Panels’ Insights on Major Reform Proposals                       (GAO/
HRD-88-59, Feb. 3, 1988)


Welfare: Income and Relative Poverty Status of AFDC Families                           (GAO/
HRD-88-9, NOV. 4, 1987)


Welfare: Relationships and Incomes in Households with AFDC Recipi-
ents and Others (GAOjHRD-88-78, May 11, 1988)

Welfare Eligibility: Programs Treat Indian Tribal Trust Fund Payments
Inconsistently (GAO/HI(I)-88-38, May 20, 1988)

Welfare Reform: Projected Effects of Requiring AFDC for Unemployed
Parents Nationwide ((;AO@IRD-8&88BR, May 23, 1988)

 Welfare Simplification: States’ Views on Coordinating Services for Low-
 Income Families (GAO ~1~1~-87-110~s, July 29, 1987)

 Welfare Simplification: Thirty-Two States’ Views on Coordinating Ser-
 vices for Low-Income Families (GAO/HRD-87.GFS, Oct. 30, 1986)

 Welfare and Taxes: Extending Benefits and Taxes to Puerto Rico, Virgin
 Islands, Guam, and American Samoa (GAO/HRD87-60,  Sept. 15. 1987)




 Page 45                              GAO/HRD90-162   Children’s   Issues: Reports   and Activities
                   GAO Reporta   on Children,   Fkd   Years 19SO-96




                   Participation in the National School Lunch Program                       (GAO/RCED-84-132,
                   Mar. 30, 1984)

                   School Lunch Program: Evaluation of Alternatives to Commodity Dona-
                   tions (GAOIRCED-~~-~ 13, June 11, 1987)

                   School Meal Programs: Options for Improving the Verification of Stu-
                   dent Eligibility (GAO/RCED-~~-~ZZBR, Mar. 17, 1986)

                   Supplemental Food Program: Savings From Food Purchases Could
                   Increase WE Participation (GAO/RCED-88-183BR, July 25, 1988)

                   Supplemental Food Program: Using Cost Saving Methods Could Increase
                   Participation (GAOIRCED-~~-%BR,~C~. 9, 1987)

                   Surplus Commodities: Temporary Emergency Food                           Assistance        Pro-
                   gram’s Operations and Continuance (GAOIRCED88-11,                        Oct.   19,   1987)


                   WIC Evaluations Provide Some Favorable But No Conclusive Evidence on
                   the Effects Expected for the Special Supplemental Program for Women,
                   Infants, and Children (GAO/PEMD84-4, Jan. 30,1984)


                   CETA Demonstration Provides Lessons on Implementing Youth Pro-
Youth Employment   grams (GAO/HRD-~~-~,I%X. 8,198O)
and Training
                   Job Corps: Its Costs, Employment Outcomes, and Service to the Public
                   (GAO/HRD86-121BR, July 30, 1986)

                   Job Training Partnership Act: Data Collection Efforts and Needs (GAO/
                   HRD-86-69BR, Mar. 31, 1986)

                   Job Training Partnership Act: Initial Implementation of Program for
                   Disadvantaged Youth and Adults (GAOIHRD-~~-~, Mar. 4, 1985)

                   Job Training Partnership Act: Summer Youth Programs Increase
                   EmphasisonEducation     (GAO/HRD87-lOlBR,June 30, 1987)


                   Labor Market Problems of Teenagers Result Largely From Doing Poorly
                   in School (GAOIPAD82-06, Mar. 29, 1982)

                   Summer Youth Jobs Program: Congressional Action Has Increased
                   Emphasis on Remedial Education (GAO/HRD88-118, Sept. 30, 1988)




                   page47                                 GAO/HRDg0162Children'sIssues:ReportsandActi~ties
Appendix IV

Ongoing GAO Assignments on Children’s Issues,
as of March 31,199O

                                            As of March 31, 1990, GAO had 44 assignments in process on issues
                                            affecting children. Figure IV.1 shows the distribution of these assign-
                                            ments among nine different issues.


Figure IV.l: Ongoing GAO Assignments
on Children’s Issues (as of Mar 31, 1990)
                                            14   Number   of Aesignmmts


                                            12


                                            10


                                             a


                                            6


                                            4


                                            2




                                            Table IV. 1 provides contact points for ongoing       GAO    assignments.




                                            Page 49                       GAO/HRD-9@162   Children’s    Issues: Reports   and Activities
            Appendix N
            Ongoing GAO Assignments on Children’s
            Issues, aa of March 31,199O




            Civil Rights Enforcement in Schools
Education
            Current and Proposed Methods Used to Allocate Chapter 1 Funds Infor-
            mation on Drug-Free Schools Program

            Innovative Urban Schools Programs

            Learning-Disabled Students in the Education of the Handicapped Act
            Program

            Supplemental Education Services Provided to Immigrant Children IJnder
            the Emergency Immigrant Education Act of 1984

            The Need for Financial Assistance for School Construction as Autho-
            rized by Public Law 8 l-8 15


                 Federal Efforts to Prevent               Infection in Out-of-School
Health      AIDS:
            Adolescents
                                                    HIV



            AIDS:   School-Based Efforts to Prevent Adolescent                HIV   Infection

            Analysis of the Cost of Health, Social, and Related Services for Infants
            of Substance-Abusing Women

            Characteristics of the Uninsured in Michigan and Other Selected States

            Characteristics of the Ininsured         in Selected States

            Home Visiting as a Means to Improve Maternal and Child Health and
            Well-Being

            Drug Abuse Among School Drop-Outs and Pregnant Teens +

            Drug Abuse Prevention/Education               Projects for Preteens: Effectiveness
            and Promising Practices +

            Effects of Expanded Eligibility for Medicaid-Financed Prenatal Care on
            Participation +

            State Responses to Federal Efforts to Expand Medicaid Program
            Coverage



             Page 61                            GAO/HRD90162     Children’s    Issues: Reports   and Activities
                   Appendix N
                   Ongoing GAO Assignments on Children’s
                   Issues, aa of March 31,199O




                   Child Labor Violations and Workplace Fatalities and Injuries Suffered
Youth Employment   by Minors in the U.S.
and Training
                   Child Labor Violations and Sweatshops in the U.S.

                   Youth Employment Policies: A Review of Policies and Practices of the
                   U.S. and Several Competitor Nations




                   Page 63                            GAO/HRD90162   Children’s   Issues: Reports   and Activities
                        Appendix V
                        Other Publications   and Papers by GAO Staff
                        on ChiIdren’s Issues, October 1988 Through
                        March 1990




                        Frederick Mulhauser,
Education                                            PEMD,


            l           presented a paper on GAO'S evaluations of education programs, before a
                        symposium on evaluation for education policy and practice, sponsored
                        by the University of Warwick, in Coventry, England, September 22-24,
                        1989.
            l           authored “Reviewing Bilingual Education for Congress,” in the March
                        1990 issue of The Annals of the American Academy of Political and
                        Social Science.


                        Jeffrey Mayer,       PEMD,


                .       authored “Evaluation of Maternal and Child Health Community Nursing
                        Services: Application of Two Quasi-Experimental Designs,” Health
                        Action Papers, fall 1988.
                l       co-authored:

                        “Pregnant Women Eligible for Medicaid Expansion of Maternity Ser-
                        vices: Implications for Outreach,” Evaluation and The Health Profes-
                        sions, December 1989.

                        “A Randomized Evaluation of Smoking Cessation Interventions for Preg-
                        nant Women at a WIG Clinic,” The American Journal of Public Health,
                        January 1990.

                         “The Dissemination of Therapeutic Foster Care,” in R.P. Hawkins and J.
                         Breiling (Editors) Therapeutic Foster Care: Critical Issues, Washington,
                         D.C.: Child Welfare League of America, 1989.

                    l    presented papers on:

                         Application of an evaluation framework to expanded maternity services
                         at the Annual Meeting of the American Evaluation Association, San
                         Francisco, October 1989.

                         Community-based approaches to maternal and infant health at the
                         Second Biennial Conference on Community Research and Action, East
                         Lansing, Michigan, June 1989.




                         Page 56                              GAO/HRMO46Z   Chhken’s Issues: Reports and Activities
Appeqdix VI

Major Contributors to This Report


IHuman Resources
                    David D. Bellis, Project Manager
 Division,          Janice S. Raynor, Evaluator
 Washington, D.C.




 (llt%362)          Page 57                      GAO/IiRD-9@162   Children’s   Issues: Reports   and Activities
a
                   Appendix V
                   Other Publleations   and Papers by GAO Staff
                   on Children’s Issues, October 1988 Through
                   March 1990




                   Sheila Smythe, HRD, authored “Safeguarding Our Children’s Health,”
                   The GAO Journal, fall 1988.


                   Mark Rom,
Income Security                   PEMD,


                   authored “The Family Support Act of 1988: Federalism, Developmental
                   Policy, and Welfare Reform,” Publius, summer 1989, and
                   co-authored “Federalism, Welfare Reform, and Residential Choice,”
                   American Political Science Review, fall 1989.


                   Joanne Frankel and Tom Medvetz, HRD, and Harriet Ganson, Boston
Youth Employment   Regional Office, presented a paper, “Using the CPS to Evaluate the Job
and Training       Training Partnership Act,” at the annual meeting of the American Eval-
                   uation Association, New Orleans, Louisiana, November 1988.

                   Kalman Rupp, HKD, co-authored “Participation                   in JTPA,” published in
                   Evaluation Forum, February 1989.

                   Carlotta Young, HKD, presented a paper, ‘Sweatshops Threaten the
                   Health of Workers Throughout the U.S. in Multiple Industries,” at the
                   117th Annual Meeting of the American Public Health Association in Chi-
                   cago, Illinois, October 25, 1989.


                   Stephanie Shipman, PEMD, authored “General Criteria for Evaluating
Other Child and    Social Programs,” describing GAO'S framework for evaluating and com-
Family Issues      paring children’s programs, Evaluation Practice, spring 1989.




                    Page 56                              GAO/IIRE-90162   Children’s   Issues: Reports   and Activities
Other Publications and Papers by GAO Staff on
Children’s Issues,October 1988 Through
March 1990
                                     In addition to the issued reports and testimonies given, GAO staff inde-
                                     pendently published 10 articles in professional journals and presented 7
                                     papers to professional meetings on child-related topics from October
                                     1988 through March 1990.’ Figure V.l shows the distribution of these
                                     articles and papers among nine different issues.


Figure V.l: Published Articles and
Papers by GAO Staff on Children’s
Issues (Ott 1988-Mar 1990)           10    Number   of Publications




                                      s




                                     William Laurie, Detroit Regional Office, presented a paper, “Child Care:
Child Day Care                       Diversity in Infancy,” at the Ohio Academy of Science 98th Annual
                                     Meeting, in Cleveland, Ohio, April 12, 1989.


                                     Lisa Cassady, GGD, presented a paper, “The Family Response to Conflict
Child Welfare and                    Scale: Development of a Measure of Marital Conflict and Children’s
Social Services                      Exposure and Reactions,” at the fall meeting of the Capitol Area Social
                                     Psychological Association, Bethesda, Maryland, October 21, 1989.

                                      ‘These   articles and papers do not necessarily reflect the vmvs and opinions of GAO.




                                     Page 54                                  GAO/HRD9O-162      Children’s   Issues: Reports   and Activities
                  Appendix IV
                  Ongoing GAO Assl@ments      on Children’s
                  Issues, 8s of March 31,1996




                  The Crack Epidemic


                  Effectiveness of               Supportive Housing Demonstration Program
Housing                                  HUD'S


                  Use of Surplus and Underutilized Federal Property for the Homeless


                  America’s Underclass: Size, Causes, and Cures
Income Security
                  Characteristics of Low-Income Single-Parent Families

                  Credit Bureau Reporting to Encourage Child Support Payments

                  Interstate Child Support Enforcement: Interstate Access to Absent
                  Parent Information Can Be Improved

                  Job Opportunities and Basic Skills (JOBS) Training Program of the
                  Family Support Act of 1988

                  Measuring Effects of the AFDC Unemployed Parent Program +

                  Methods for Assessing the Full Costs and Benefits of Innovative Child
                  Support Enforcement Programs +

                  Trends in the Size and Composition of the Poverty Population +


                  An Analysis of Alternative Methods for Defining a Household Within
Nutrition         the Food Stamp Program

                  Food and Nutrition Problems on Indian Reservations

                  Implementation of the New Temporary Emergency Food Assistance Pro-
                  gram Provisions of the Hunger Prevention Act of 1988

                  States’ Experiences in Containing Infant Formula Costs in the WIG
                  Program

                  Verification of Washington Family Independence Program Payments




                  Page 52                                GAO/HRIN6-162   Children’s   Issues: Reports   and Activities
                                          Appendix   lv




Table IV.l: Key GAO Contacts   for Work
on Children’s Issues                      Issues                                        Contact
                                          Chrld Welfare and Socral Services (Juvenile   Lowell Dodge, Drrector, Administratron of
                                          Justice Issues)                               Justice Issues, GGD, (202) 275-8389
                                          Child Welfare and Socral Servrces, Income     Joseph Delfico, Drrector, Income Secunty
                                          Security                                      Issues, HRD, (202) 275-6193
                                          Educatron; Youth Employment and Training      Franklrn Frazier, Director, Education and
                                                                                        Employment Issues, HRD, (202) 275-1793
                                          -___
                                          Health                                        Janet Shikles, Director, Health Financrng and
                                                                                        Polrcy Issues, HRD, (202) 275-5451

                                                                                        Mark Nadel, Assocrate Director, Natronal and
                                                                                        Publrc Health Issues, HRD. (202) 275-6195
                                          Housing                                       John Ols, Drrector, Housing and Communrty
                                                                      -~    _~__.       Development Issues, RCED, (202) 275-5525
                                          Nutntion                                      John Harman, Drrector, Food and Agriculture
                                                                                        Issues. RCED, (202) 275-5138             --~
                                          Other Child and Family Issues                 Linda Morra, Director, Intergovernmental and
                                                                                        Management Issues, HRD. (202) 275-1655


                                          For assignments followed by a ‘I+“, contact Carl E. Wisler, Director,
                                          Planning and Reporting, Program Evaluation and Methodology Division,
                                          (202) 275-1854.


                                          Analysis of Juvenile Detention
Child Welfare and
Social Services                            Child Abuse Prevention Challenge Grant Program

                                           Foster Care Children’s Duration in Care and Rate of Reentry

                                           Foster Care Reform Implementation, Length of Stay, and Recidivism

                                           Out-of-State Placement of Children in Group Residential Care

                                           Respite Care for Families With Children at Risk of Abuse

                                           Selected Aspects of the Department of Health and Human Services’
                                           Office of Human Development Services’ Management of Foster Care and
                                           Child Welfare Services

                                           Unintentional     Firearms Injuries +




                                           Page 60                             GAO/HRB3@162    Children’s   Issues: Reports   and Activities
                  Appendix III
                  GAO Reports on ChlIdren,   FiscnI Years 1986.88




                  The Job Training Partnership Act: An Analysis of Support Cost Limits
                  and Participant Characteristics (GAOIHRD-86-16, Nov. 6, 1985)

                  Youth Job Training: Problems Measuring Attainment of Employment
                  Competencies (GAO/HRD-87-33, Feb. 11, 1987)


                  Children’s Programs: A Comparative Evaluation Framework and Five
Other Child and   Illustrations (GAO/PEMD&-ZBBR, Aug. 31, 1988)
Family Issues
                  Needs-Based Programs: Eligibility and Benefit Factors                      (GAO/HRD-86-
                  107x3, July 9,1986)

                  Parental Leave: Estimated Cost of Revised Parental and Medical Leave
                  Act (GAO/HRD-88-103, May 26, 1988)


                  Parental Leave: Estimated Cost of Revised Parental and Medical Leave
                  Act Proposal (GAO/HRD-88-132, Sept. 27, 1988)

                  Parental Leave: Estimated Costs of H.R. 925, the Family and Medical
                  Leave Act of 1987 (GAO/HRD-88-34, Nov. 10, 1987)




                   Page 48                              GAO/IIRD-96-162   Children’s   Issues: Reports   and Activities
            Appendix IIl
            GAO Reports on Children,   Fiscal Years 198088




            Work and Welfare: Analysis of AFDC Employment Programs in Four
            States (GAO/HRD-88-33FS, Jan. 5, 1988)

            Work and Welfare: Current AFDC Work Programs and Implications for
            Federal Policy (GAOIHRD-87.34, Jan. 29, 1987)


            Benefit Overpayments: Recoveries Could Be Increased in the Food
Nutrition   Stamp and AFDC Programs (GAO/RCED-86-17, Mar. 14, 1986)

            Child Care Food Program: Better Management Will Yield Better Nutri-
            tion and Fiscal Integrity (GAO/CED-80-91, June 6, 1980)

            Food Stamp Program: Evaluation of Improper Denial or Termination
            Error Rates (GAO/RCED-88.12, Oct. 22, 1987)

            Food Stamp Program: Participation by AFDC Households                           (GAO/RCEE+88-
            85~R, Feb. 11,1988)

            Food Stamp Program: Refinements Needed to Improve Accuracy of
            Quality Control Error Rates (GAO/RCED-86-195, Sept. 19, 1986)


             Food Stamp Program: Reporting of Application Activities Could Be
             Improved (GAO/RCED-88.156, July 14, 1988)

             Food Stamp Program: Restoration of Improperly Denied or Terminated
             Benefits (GAOIRCED-87-51, Oct. 30, 1986)


             Food Stamp Program: Results of the Simplified Application Demonstra-
             tion Project (GAO/RCED-87.102, June 11, 1987)

             Food Stamp Program: Trends in Program Applications, Participation,
             and Denials (GAO/RCED-87.80BR, Apr. 2, 1987)

             Food Stamps: Examination of Program Data and Analysis of Nonpartici-
             pation (GAO/PEMD-88-21, July 5, 1988)

             Need to Foster Optimal Use of Resources in the Special Supplemental
             Food Program for Women, Infants, and Children (GAO/RCED-86-106,
             Sept. 27,1985)

             Overview  and Perspectives           On TheFoodStamp              Program(GAO/RCED-85-
             109, Apr. 17,1985)


             Page 46                              GAO/HRtWO-162   Children’s     Issues: Reports   and Activities
                  Appendix III
                  GAO Reports on Children,   Fiscal Years 1986-66




                  Prenatal Care: Medicaid Recipients and Uninsured Women Obtain Insuf-
                  ficient &T(GAO/HRD87-137,  sept.30,  1987)

                  Teenage Pregnancy: 500,000 Births a Year but Few Tested Programs
                  (GAO/PEMD&lGBR,  July 21,1986)

                  The Sudden Infant Death Syndrome Program Helps Families but Needs
                  Improvement (GAO,'HRI)-81.25, Feb. 6, 1981)


                  Changes in Rent Burdens and Housing Conditions of Lower Income
Housing           Households (GAO/KCE~)-~~-~I~~, Apr. 23, 1985)

                  Federal Rental Housing Production Incentives: Effect on Rents and
                  Investor Returns (GA~!KCED-85-1 14, May 10, 1985)

                  Federally Supported Centers Provide Needed Services for Runaways
                  and Homeless Youth (GAO/IPE-83-7, Sept. 26, 1983)

                  Homelessness: A Complex Problem and the Federal Response                               (GAO/
                  HRD-85-40, Apr. 9, 1985 )


                  Homelessness: Implementation of Food and Shelter Programs Under the
                  McKinney Act (GAO~RCED-88-63, Dec. 8, 1987)

                   Housing Allowances: An Assessment of Program Participation and
                   Effects (GAOIPEMD-86-8, Feb. 10, 1986)

                   HUD Not Fulfilling Responsibility to Eliminate Lead-Baaed Paint Hazard
                   in Federal Housing (GAO/CED-81-31, Dec. 16, 1980)

                   Public Housing Vacancies and the Related Impact of HUD'S Proposal to
                   Reduce Operating Subsidies (GAO/RCED85-93, Mar. 29, 1985)

                   Rural Rental Housing: Cost Information on FMHA’s Section 515 Program
                   and Other Housing Options (GAOIRCED87.SG, Aug. 18, 1987)


                   Child and Family Welfare: Selected HHS Discretionary Funding in Fiscal
Income Security    Year 1985 (GAO/HRI)-8fi-87FS, Apr. 10, 1986)

                   Child Support Collection Efforts for Non-AFDC Families                       (GAO/HRD~~-3,
                   Oct. 30, 1984)


                   page44                               GAO/HRD-!?I3162   Children’s   Issues: Reports    and Activities
                                                                                             -
            Appendix Ill
            GAO Reports    on Children,   Piscal Years 1966.66




            The Office of Juvenile Justice and Delinquency Prevention’s Special
            Emphasis Program Has Not Realized Its Full Potential (GAO/GGD8242,
            Apr. 16,1982)

            The Proposed Missing Children and Serial Murder Tracking Program Is
            Not Eligible for Juvenile Justice and Delinquency Prevention Act Special
            Emphasis Funds (GAOIGGD-847, Nov. 16,1983)


            Bilingual Education: A New Look at the Research Evidence
Education   PEMD-~~-~~BR,Mar. 10, 1987)
                                                                                                 (GAO/



            Bilingual Education: Information on Limited English Proficient Students
            (GAO/HRD87-85BR,  Apr. 30, 1987)

            Bureau of Indian Affairs Plans to Consolidate Off-Reservation Indian
            Boarding Schools (GAOjRCED83-204, Sept. 12, 1983)

            Compensatory Education: Chapter l’s Comparability of Services Provi-
            sion (GAO/HRD87-102, Aug. 27, 1987)

            Compensatory Education: Chapter 1 Participants Generally Meet Selec-
            tion Criteria (GAO/HRD-87-26, Jan. 30, 1987)

            Compensatory Education: Chapter 1 Services Provided to Private Secta-
            rian School Students (GAO/HRD-87-128BR, Sept. 21, 1987)

            Deaf Education: Costs and Student Characteristics at Federally Assisted
            Schools (GA~/HRD~~-~~BR, Feb. 14, 1986)

            Deaf Education: The National Mission of Gallaudet’s Elementary and
            Secondary Schools (GAO/HRDS~-133, Sept. 30, 1987)

            Disparities Still Exist in Who Gets Special Education                    (GAO/IPE-81-1,
            Sept. 30,198l)

            DODSchools: Funding and Operating Alternatives for Education of
            Dependents (GAO/HRD-87-16, Dec. 10, 1986)

            Education Block Grant Alters State Role and Provides Greater Local Dis-
            cretion (GAO/HRD~~-18,Nov. 19, 1984)




             Page 42                                 GAO/HlD9lX162   Children’s   Issues: Reports   and Activities
                    Appendix III
                    GAO Reports on Children,   Fiscal Years 198088




Child Welfare and   Care   (GAO/HRD-81-73,     Apr. 20, 1981)
Social Services
                    Appointments to and Operations of the National Advisory Committee
                    for Juvenile Justice and Delinquency Prevention (GAO/GGD-84-8, Nov. 30,
                    1983)

                    Better Federal Program Administration                 Can Contribute to Improving
                    State Foster Care Program (GAO/HRD84-2,                Aug. 10, 1984)

                    Better Monitoring and Recordkeeping Systems Needed to Accurately
                    Account for Juvenile Justice Practices (GAO/GGD-84-85, July 9, 1984)

                    Circumstances That Resulted in New York Receiving About Half of the
                    Federal Foster Care Reimbursement to States in Fiscal Year 1978 (GAO/
                    ~~~-81-156, Sept. 24, 1981)

                    Competitive and Noncompetitive Grant Awards Made by the Office of
                    .Juvenile Justice and Delinquency Prevention (GAO/GGD-85-6, Oct. 26,
                     1984)

                     Drug Suppression/Habitual Offender Program Awards Were Proper
                     (GAO~GGD-84-44, Apr. 3. 1984)

                     Federal and State Actions Needed to Overcome Problems in Adminis-
                     tering the Title XX Program (GAOIHRD-81-8, Oct. 29, 1980)

                     Follow-up Review to Report on Increased Federal Efforts Needed to
                     Better Identify, Treat, and Prevent Child Abuse and Neglect (GAO/
                     HRDW153,Sept.    18, 1981)

                     Foster Care: Use of Funds for Youths Placed in the Rite of Passage Pro-
                     gram(GAO/HRD87-23RK,   Dec. 9, 1986)

                     Guyana Tragedy Points to a Need for Better Care and Protection of
                     Guardianship Children (GAO/HRD-81-7, Dec. 30, 1980)

                     Head Start: An Effective Program but the Fund Distribution Formula
                     Needs Revision and Management Controls Need Improvement (GAO/
                     HRD-81-83, July 23, 1981)




                     Page 40                              GAO/HRB96-162     Children’s   Issues: Reports   and Activities
                   Appendixll
                   GAOTestimonyonChildren's      Issues,
                   October1988ThroughMarch1990




                   GAO'S  Review of USDA'S National WIG Evaluation Report and Follow-up
                   Issues, bv Keith 0. Fultz. Resources, Communitv. and Economic Devel-
                   opment Division, before the House Select Committee on Hunger, the
                   Senate Committee on Agriculture, Nutrition, and Forestry, and the Sub-
                   committee on Nutrition and Investigations, Senate Committee on Agri-
                   culture, Nutrition, and Forestry (GAO/T-RCED-90-21, Jan. 24, 1990).

                   Use of Surplus Dairy Products in the National School Lunch Program, by
                   William E. Gahr, Resources, Community, and Economic Development
                   Division, before the Subcommittee on Nutrition and Investigations,
                   Senate Committee on Agriculture, Nutrition, and Forestry (GAO/T-
                   RCEDW49,   June 14, 1989).


                   Child Labor Violations and Sweatshops in the US., by Franklin Frazier,
Youth Employment   Human Resources Division, before the Subcommittee on Employment
and Training       and Housing, House Committee on Government Operations (GAO/T-
                   HRD-90-18, Mar. 16, 1999).


                   Job Training Partnership Act: Comments on H.R. 2039, The JTPA
                   Amendments of 1989, by William J. Gainer, Human Resources Division,
                   before the House Committee on Education and Labor (GAO/T-HRD-89-32,
                   June 29,1989).

                   Senate Bill 543: The Job Training Partnership Act Youth Employment
                   Amendments of 1989, by William J. Gainer, Human Resources Division,
                   before the Subcommittee on Employment and Productivity, Senate Com-
                   mittee on Labor and Human Resources (GAO/T-HRD-89-18,  May 11, 1989).


                         Cost Estimate of the Family and Medical Leave Act of 1989 (H.R.
Other Child and    GAO'S
                   770) by William J. Gainer, Human Resources Division, before the Sub-
Family Issues      committee on Labor-Management Relations, House Committee on Educa-
                   tion and Labor (GAO/T-HRD-89-4, Feb. 7, 1989)

                   GAO'S Cost Estimate of the Family and Medical Leave Act Proposal, by
                   William J. Gainer, Human Resources Division, before the Subcommittee
                   on Children, Families, Drugs, and Alcoholism, Senate Committee on
                   Labor and Human Resources (GAO/T-HRD-89-3,   Feb. 2, 1989).




                   Page38                                  GAO/HRD90-162Children.s   1ssues:ReportsmdActivities
Annendix II

GAO Testimony on Children’s Issues,
October 1988 Through March 1990

                                          From October 1988 through March 1990, GAO testified 17 times before
                                          congressional committees on issues affecting children. Figure II. 1 shows
                                          the distribution of testimony among nine different child-related issues.


Figure 11.1:GAO Testimony on Children’s
Issues (Ott 1988.Mar. 1990)
                                          10   Number of Testlmonlsc




                                          Respite Care: Insights on Federal, State, and Private Sector Involvement,
Child Welfare and                         by Franklin Frazier, Human Resources Division, before the Subcom-
Social Services                           mittee on Select Education, House Committee on Education and Labor
                                          (GAO/T-HRD-89-12, Apr. 6, 1989).


                                          Education Information: Production and Quality Deserve Increased
Education                                 Attention, by Lois-ellin Datta, Program Evaluation and Methodology
                                          Division, before the Subcommittee on Government Information and Reg-
                                          ulation, Senate Committee on Government Affairs (GAO/T-PEMD-90-7,  Nov.
                                          1, 1989).




                                          Page 36                      GAO/HRD-90162   Children’s   Issues: Reports   and Activities
                           Appendix I
                           An Annotated Bibliography    of GAO Repoti
                           on ChiIdren, October 19.96 Through
                           March 1396




Other Child and
Family Issues

Legislative Branch:        This report provides information on parental leave policies and child
                           care services in the legislative branch. Eighty-one Senators’ offices
Parental Leave Practices   responded to GAO’S questionnaire. The 16 standing committees of the
and Child Care Services    Senate, the Office of the Secretary of the Senate, and the Senate Ser-
(GAO/HRD-90-12,            geant at Arms also responded to GAO’S telephone survey. Most of the 81
Nov. 14, 1989)             Senators’ offices, the 16 Senate committees, and Senate offices had
                           maternity and parental leave policies, although they varied greatly.
                           Both the Senate and the House of Representatives run child care centers
                           with a combined enrollment of about 115 children. Among the legislative
                           branch agencies, only GAO and the Government Printing Office plan to
                           open child care centers.’ Lack of management support, along with
                           funding and space problems, tends to impede the opening of child care
                           centers.


Parental Leave: Revised    GAO   was asked to estimate the cost of adding a provision allowing 10
Cost Estimate Reflecting   weeks of unpaid leave to care for a seriously ill spouse to the proposed
                           Family and Medical Leave Act of 1989 (H.R. 770). The act would permit
the Impact of Spousal      an employee to take up to 10 weeks of unpaid leave over a Z-year period
Leave (GAO/HRD-89-68,      upon the birth or adoption or placement for foster care of child, or the
Apr. 6, 1989)              serious health condition of a child or parent, and up to 15 weeks every
                           year for personal illness. Upon returning to work, the employee is guar-
                           anteed the same or equivalent job. The proposed legislation would
                           require employers to continue health benefits for workers while on
                           unpaid leave on the same basis as if the employee were still working, but
                           does not require the continuation of other employee benefits. The pro-
                           posed provision would provide the same job protection and health bene-
                           fits. The estimated cost of H.R. 770 to employers who have 50 or more
                           workers would be $188 million annually. If the legislation is expanded
                           the cost increases by $142 million to about $330 million annually. When
                           firms employing between 35 and 49 people are included, the cost of
                           H.R. 770 is estimated to be $212 million annually, which increases to
                           $368 million annually when the provision to care of seriously ill spouses
                           is included.



                            ‘GAO’s on-site child day care center qxned   in June 1990.




                            Page 34                                GAO/HRIN@162          Children’s   Issues: Reports   and Activities
                            Appendix I
                            An Annotated Bibliography  of GAO Reports
                            on Children, October 1938 Through
                            March 1990




Food Stamp Program:         The Food Stamp Program is designed to provide low-income household
                            members additional food purchasing power to help them acquire an ade-
Participants Temporarily    quate low-cost diet. However, eligible participants can be temporarily
Terminated for Procedural   terminated from the program if they do not comply with procedural
Noncompliance               requirements. GAO, on the basis of its sample, estimated that about 49
(GAOIRCED-89-81,            percent of the households in Georgia and about 68 percent of the house-
June 22,1989)               holds in Wisconsin experienced breaks in service. Participant-caused
                            breaks resulting in benefit losses were caused by participants not (1)
                            submitting timely monthly reports, (2) providing requested verification
                            documents, (3) notifying their local office regarding the nonreceipt of
                            stamps, (4) meeting work requirements, and (5) filing timely or complete
                            new applications for recertification.


Food Stamps: Reasons for    Based on an analysis of nationally representative data, GAO found that,
Nonparticipation            in 1979 and 1986, slightly more than one-half of the households eligible
                            for food stamps did not participate in the program because they did not
(GAO/PEMD-89-5BR,           think they were eligible. Approximately one-third of those who thought
Dec. 8, 1988)               they were ineligible also thought their assets or income were too high for
                            the Food Stamp Program. About two-thirds of the eligible nonpartici-
                            pants who thought they were eligible for benefits did not try to get food
                            stamps. The reasons this group gave for not participating in the pro-
                            gram were they (1) did not need the benefits and (2) were concerned
                            about the likely administrative “hassles.”


School Lunch Program:       The over 15,000 school districts participating in USDA’S National School
Buy American Procedures     Lunch Program are required, whenever possible, to use federal funds to
                            purchase food products that are produced only in the United States.
at Commodity Schools        Generally, GAO found that the Food and Nutrition Service and two of the
(GAO/RCED-89-2 18,          four states that it visited had implemented the Buy American require-
Sept. 26,1989)              ment, but monitoring of compliance has been limited. The Service and
                            the states have not done any monitoring, although some of the school
                            districts have inspected delivered food items. Neither the Service nor
                            the states GAO visited monitor commodity school district purchases to
                            ensure that the Buy American requirement is met. Although waivers
                            from the Buy American requirement are permitted, neither the Service
                            nor the states had received waiver requests from any of the districts.




                            Page 32                             GAO/HRD-W-162   Children’s   Issues: Reports   and Activities
                            Appendix I
                            An Annotated     Bibliography of GAO Reports
                            onChildren,October1988Through
                            Man-h 1990




Nutrition

Food Assistance: The        At an annual cost of about $1.93 billion, the Special Supplemental Food
                            Program for Women, Infants, and Children (WE) provides nutritional
National WIC Evaluation:    supplements and education to needy pregnant women, breast-feeding
Reporting and Follow-Up     mothers, and children up to age 5. In 1986, the U.S. Department of Agri-
Issues (GAO/RCED-90-3,      culture (USDA) published a study entitled The National WIGEvaluation,
Dec. 14, 1989)              which discussed the effects of the program on participants’ nutrition
                            and health. Almost immediately questions surfaced about how the study
                            was reviewed and reported. USDA said it deleted the original chapter and
                            executive summaries and replaced them with a compendium of results
                            because the data did not justify the research team’s favorable conclu-
                            sions about WIG.GAO found, however, that USDA'S compendium of results
                            (1) contained errors and misleading statements about some of the data
                            and (2) deleted the study team’s overall conclusions about WIG'S effect
                            on participants. In contrast, the original executive summary used appro-
                            priate methodology, was accurately presented, and reported the study’s
                            main conclusions: that WIG improves the diet of pregnant women and
                            children, adds to maternal weight gain, increases the use of prenatal
                            care, and reduces preterm deliveries. In 1984, arguing that the response
                            rate would be too low, I:SDA withdrew a proposal to assess WIG'S effect
                            on the physical and mental development of children born to mothers
                            who had participated in the evaluation. Since the response rate prob-
                            ably would have been higher than USDA reported, GAO believes USDA
                            acted prematurely in canceling this follow-up study. USDA is now
                            deciding whether to pursue a study of WIG'S effect on a different group
                            of children.


Food Assistance Programs:   GAO   looked at whether food assistance programs met the nutritional
Nutritional Adequacy of      needs of Indians living on four reservations: Fort Berthold in North
                             Dakota; Pine Ridge in South Dakota; White Earth in Minnesota; and
Primary Food Programs on     Navajo in Arizona, New Mexico, and Utah. GAO found that several food
Four Indian Reservations     assistance programs serve the four Indian reservations, the two largest
(GAO/RCED-89-177,            being USDA'S Food Stamp Program and Food Distribution Program on
Sept. 29,1989)               Indian Reservations. These two programs are designed to provide recipi-
                             ents with benefits consistent with national dietary guidelines. However,
                             because many factors affect the nutritional value of the food people
                             consume, such as the quantity of food eaten, food preparation methods,
                             and the variable nutritional needs of individuals, GAO was unable to



                             Page30                                GAO/HRD-90162   Children’s   Issues: Reports   and Activities
                          Appendix I
                          An Annotated Bibliography   of GAO Reports
                          on Children, October 1088 Tbrou8h
                          March 1990




                          support to those with housing needs; and (5) implement long-term solu-
                          tions that take into account the diversity of the homeless population and
                          the array of contributory causes.


Welfare Hotels: Uses,     GAO  examined the use of “welfare hotels” as primary housing for needy
                          families. Welfare hotels are regarded as commercially owned, one-story
Costs, and Alternatives   or multistory hotels or motels providing shelter to a clientele composed
(GAO/HRD-89-26BR,         exclusively or primarily of homeless families receiving some type of
Jan. 31,1989)             public assistance. Basic services provided to hotel residents usually
                          include a room with a private bath, linen changes, room cleaning, and
                          general facility maintenance. However, services can vary; in some
                          instances families have difficulty receiving even basic hotel service.
                          Ilotel costs vary widely, from an average of $65 to $100 per night in
                          New York City. Average daily rates paid in other localities include: $49
                          in Washington, D.C.; $50 in the state of New Jersey; $75 to $89 in West-
                          chester County, New York; and $35 and below in other localities. Alter-
                          natives, such as congregate family shelters and transitional apartments,
                          can be more expensive than hotels. Various government and private
                          sector initiatives are underway to address the need for low-income
                          housing.



Income Security

Child Support: State      The IIIIS Office of Child Support Enforcement (OCSE) administers the pro-
Progress in Developing    gram to strengthen state and local efforts to find absent parents, estab-
                          lish paternity, obtain child support orders, and collect support
Automated Enforcement     payments. The Congress recognized that the use of automation could
Systems (GAO/HRD-89-      result in more efficient, cost-effective child support enforcement; thus, it
IOFS, Feb. 10,1989)       authorized enhanced federal funding for planning, developing, and
                          installing comprehensive, statewide automated systems. GAO inter-
                          viewed officials in all 50 states, the District of Columbia, Guam, Puerto
                          Rico, and the Virgin Islands to find out states’ progress in the develop-
                          ment of automated systems for these programs. Of the 54 state systems,
                          ‘as of May 1988, CKXEhad certified 2 as fully operating. The rest of the
                          states’ systems were as follows: 14 were mostly operating, 15 were in
                          the developing or installing phase, and 21 were in the preplanning or
                          planning phase. The other two states had no plans to establish compre-
                          hensive systems.



                           Page 28                             GAO/IIRLW@162   Children’s   Issues: Reports   and Activities
                           Appendix I
                           An Annotated Bibliography   of GAO Reports
                           on Children, October 1988 Tlwough
                           March 1990




                           Because troubled youths and those who are younger than age 16 may
                           not be suitable for independent living programs, more information is
                           needed on alternative programs.

                                                        -
Homelessness: HUD’s and    The McKinney Act authorized additional funding for three existing pro-
                           grams-the Federal Emergency Management Agency’s (FEMA) Food and
FEMA’s Progress in         Shelter Program, the Department of Housing and Urban Development’s
Implementing the           (HUD) Emergency Shelter Grants Program, and its Supportive Housing
McKinney Act               Demonstration Program. The act also established two new HUD pro-
(GAO/RCED-89-50,           grams-Supplemental       Assistance for Facilities to Assist the Homeless
May 11,1989)               and the Single Room Occupancy Program. HUD and FEMA program funds
                           enable many organizations to provide an increased amount of shelter,
                           meals, and other services that may not otherwise be provided and that
                           are often crucial to keeping facilities operational. The impact of the
                           FEMA program, however, was lessened because it provided little or no
                            funds during the crucial winter months of 1987-88. FEMA had disbursed
                            $97 million of its $124 million McKinney Act funds by May 31, 1988;
                            however, only $8.3 million was disbursed by January 31, 1988, and
                            $31.5 million by February 28. Actions were taken to alleviate this situa-
                            tion during the winter of 1988-89. The impact of the HIJD program has
                            been limited because these are long-term programs and grantees have
                            made few disbursements. As of May 31, 1988, HUD had disbursed only
                            5 percent of the $253 million provided for its programs. FEMA and HIJD
                            disbursements reached 100 percent and 24 percent, respectively, by
                            February 17,1989.


Homelessness: McKinney     GAO   is required to report annually on the status of programs authorized
Act Programs and Funding    under the McKinney Act. The act, which seeks to establish a comprehen-
                            sive program to help homeless people, now funds 18 programs that pro-
for Fiscal Year 1989        vide direct services for the homeless. This report outlines the act’s
(GAO/RCED-90-52,            legislative history, describes each McKinney Act program, and details
Feb. 16, 1990)              moneys provided under each program, by state, for fiscal year 1989. Of
                            the $1.1 billion that the Congress appropriated for McKinney Act pro-
                            grams during fiscal years 1987-89, the largest portion-around
                            $365 million-went     to FEMA'S Emergency Food and Shelter Program,
                            which gives emergency food and shelter to needy people.




                            Page 26                             GAO/HRIHJO-162   Children’s   Issues: Reports   and Activities
                                 Appendix I
                                 An Annotated Bibliography  of GAO Reports
                                 on Children, October 1998 Through
                                 March 1990




                             -
                                 to pregnant women. GAO also observed, however, that while a lack of
                                 money is the most important obstacle to obtaining care, other barriers-
                                 such as the overall inadequacy of the prenatal care system, administra-
                                 tive and institutional obstacles presented by the health care system, and
                                 personal and cultural factors-must     also be eliminated if access to care
                                 for pregnant women, infants, and children is to be further improved.

                             -
Pediatric AIDS: Health and       Acquired immunodeficiency syndrome (AIDS) is rapidly becoming a
                                 major health threat to children. It is now the ninth leading cause of
Social Service Needs of          death among children I- to 4-years old; within the next 3 to 4 years it
Infants and Children             could be among the top five leading causes of childhood death. Most
(GAO/HRD-89-96,                  children infected with the human immunodeficiency virus (HIV) are from
May 5,1989)                      low-income and disadvantaged families who have limited access to ade-
                                 quate health care services. As a result, these children and their families
                                 rely on public health and social services systems. In some communities,
                                 these systems are already overburdened. Consequently, these children
                                 are at risk of long and costly hospital stays that tend to reduce the
                                 overall quality of life compared to a home environment. In the communi-
                                 ties that were reviewed, foster care, home health care, and support ser-
                                 vices have been developed or expanded to help reduce the time HIV-
                                 infected children spend in the hospital and the resultant health care
                                 costs. All communities reported, however, inadequate current capacity
                                 to meet the demand for such services as day care, group homes that
                                 provide intermediate-level care, respite care, mental health counseling,
                                 and transportation. Some federal support is available to fund these
                                  services.


Teenage Smoking: Higher          The 1970s saw a decline in the teenage smoking participation rate,
Excise Tax Should                which appears to have been largely caused by anti-smoking campaigns
                                 and related public health measures. By the 1980s the decline appar-
Significantly Reduce the         ently had stalled. To trigger a further decline, health experts and others
Number of Smokers                have called for increases in the cigarette excise tax. Raising the federal
(GAO/HRD-89-119,                 excise tax on cigarettes will reduce teenage smoking to the extent that
June 30,1989)                    they will respond to higher cigarette prices.




                                  Page24                             GAO/HRD4K%162   Children’s   Jssues: Reports   and Activities
                            Appendix I
                            An Annotated   Bibliography of GAO Reports
                            on Children, October 1988 Through
                            March 1990




                            various segments of this population, depending on whether program eli-
                            gibility requirements are met.


Health Care: Children’s     GAO  reviewed how 10 states (Arizona, California, Florida, Georgia,
                            Maine, Maryland, Minnesota, Mississippi, Ohio, and Texas) use federal
Medical Services Programs   Maternal and Child Health (MCH) Services block grant funds to support
in 10 States (GAO/HRD-      their children’s medical services (CMS) programs. All 10 states allocated
89-81, July 14, 1989)       federal MCH funds to their CMSprograms, but 8 states did not designate,
                            or earmark, MCH funds for specific CMS activities. Arizona designated
                            federal funds almost exclusively for CMS personnel and administrative
                            costs, and Ohio, for CMS administration and medical case management.
                            Most CMS programs (1) provided many medical services, such as physi-
                            cian office visits, medications, medical equipment and supplies, and
                            therapies; (2) provided some support services, such as case manage-
                            ment, counseling, and transportation; and (3) covered a wide range of
                            medical conditions.


Health Care: Home Care      From 10 to 15 percent of all U.S. children have a chronic health condi-
Experiences of Families     tion, health researchers estimate, and about 1 million of these have a
                            severe form of the condition. In general terms, a chronic illness is a con-
With Chronically Ill        dition that lasts for a substantial period of time and has continuing and
Children (GAO/HRD-          often debilitating effects. While some changes in service delivery and
89-73, June 20, 1989)       financing have supported the home care concept, families still reported
                            difficulties in obtaining needed services. Parents say three factors com-
                            monly accounted for their difficulties--lack    of (1) financing because of
                            health insurance coverage limitations, (2) information on services avail-
                            able, and (3) a focal point to contact when help was needed with home
                            care. Among possible improvements are (1) consolidating information on
                            existing services and making it available to all organizations serving
                            chronically ill children, (2) providing this information to parents during
                            the hospital discharge planning process, and (3) referring parents who
                            need help in the home-care setting to organizations providing case man-
                             agement services.


Health Care: Nine States’    Medicaid normally does not pay for long-term medical care provided
Experiences With Home        outside of institutions. GAO visited nine states (California, Florida,
                             Georgia, Maine, Maryland, Minnesota, Mississippi, Ohio, and Texas) to
Care Waivers (GAO/HRD-       get information on states’ experiences in applying for, renewing, and
89-95, July 14, 1989)        administering Medicaid waivers to permit payment for home care pro-
                             vided to chronically ill children. These nine states administered a total


                             Page 22                             GAO/HRMlO-162   Children’s   Issues: Reports   and Activities
                                 Appendix I
                                 An Annotated Bibliography   of GAO Reports
                                 on Children, October 1999 Through
                                 March 1990




                                 Education Programs were receiving fewer services than their program
                                 prescribed. BIA officials attributed the insufficient services to a shortage
                                 of qualified personnel and inadequate funding. GAO recommends that
                                 each BIA field office annually identify and locate every preschooler
                                 thought to be handicapped and in need of special education services.


Special Education: The           Under the Handicapped Children’s Protection Act of 1986, courts are
Attorney Fees Provision of       authorized to award reasonable attorney fees to parents who prevail in
                                 cases brought against state and local education agencies, regarding the
Public Law 99-372                education of their handicapped children. GAO did a national study of the
(GAO/HRD-90-22BR,                impact of the law’s attorney fees provision. Increases in the number of
Nov. 24, 1989)                   administrative hearings between fiscal years 1984 and 1988 and the
                                 small number of civil action decisions during this same period suggest a
                                 trend toward informal resolution of disputes between parents and
                                 school districts. Educational placement issues were the most frequent
                                 type of complaint considered in both administrative hearings and in civil
                                 action cases. Overall, parents prevailed in 43 percent of the administra-
                                 tive decisions prepared by administrative hearing officers and in 43 per-
                                 cent of the civil action cases during the 5-year period. Parents who were
                                 represented by attorneys in administrative hearings accounted for
                                 almost 60 percent of the cases in which parents prevailed. Since the
                                 act’s passage, parents have increased their use of attorneys in adminis-
                                 trative hearings; however, GAO could not conclude that the increase
                                  resulted from the act. Attorney fees awarded under the act, while not
                                 large, have more than doubled from fiscal years 1987 to 1988-from
                                  about $157,000 to $387,000. However, about three-fourths of the state
                                  agencies had no statewide information on the amount of attorney fees
                                  awarded. GAO believes the financial data it obtained significantly under-
                                  state state and local education agencies’ actual annual expenditures for
                                  attorney fees awarded to parents.


Transition Series:               This report is one of a series of 26 special reports issued in November
Education Issues (G.AO/          1988 during the executive branch’s transition to a new administration.
                                 Among other things, GAO noted that the Department of Education could
OCG-89-18TR, Nov. 1988)
                             . enhance its role in elementary and secondary education programs by
                               (1) providing better guidance for federal program implementation and
                               (2) collecting and analyzing education related data from states and
                             l strengthen departmental management by (1) developing an operational
                               management system with realistic program priorities and (2) improving



                                  Page 20                             GAO/HRB99-162   Children’s   Issues: Reports   and Activities
                            Appendix I
                            An Annotated Bibliography   of GAO Reports
                            on Children, October 1988 Through
                            March 1990




Early Childhood             To assist the Congress in its consideration of legislation that would fund
                            education programs for children too young for kindergarten (mainly 4-
Education: What Are the     year-olds), GAO looked at the costs of high-quality early childhood edu-
Costs of High-Quality       cation programs. In this briefing report, GAO (1) estimated the average
Programs? (GAO/HRD-         annual cost per child, (2) compared the average annual salaries of early
90-43BR, Jan. 24, 1990)     childhood education teachers with those of public elementary school
                            teachers, and (3) determined the extent to which the costs of a typical
                            early childhood education center change when factors like the teacher-
                            to-student ratio change.


Education Reform: Initial   GAO  examined student data from four large school districts in four states
Effects in Four School      where comprehensive state-level reforms have been in effect long
                            enough for a class of students to experience at least 3 years of high
Districts (GAO/PEMD-        school under the new requirements. These reforms have included such
89-28, Sept. 26, 1989)      changes as more academic course requirements for graduation and a
                            passing score on an exit test. With respect to the performance of educa-
                            tionally disadvantaged students, GAO found that education reform was
                            neither a disaster nor a boon in the four districts examined. While disad-
                            vantaged students appear to have improved performance in some cases,
                            these improvements were modest. The effects of reform on dropout
                            rates were mixed. Only two districts had sound data to identify drop-
                            outs. In one, the rate increased modestly; in the other, it decreased mod-
                            estly. Increased enrollment in academic courses after reform was
                            associated with a slight decline in vocational enrollment for disadvan-
                            taged students. This raised two possible concerns: (1) the decline
                            occurred entirely among the type of vocational education courses that
                            prepare students for the labor market rather than among consumer or
                            homemaking courses and (2) disadvantaged postreform students were
                            somewhat less likely than disadvantaged prereform students to have
                            scheduled five or more vocational courses over 3 years of high school.
                            These findings suggest that at-risk students may be receiving less occu-
                            pational training than do their prereform counterparts. Concerns were
                            also raised about the effect of education reforms on the availability of
                            some vocational education courses and on the number of vocational edu-
                            cational teachers employed.




                            Page 18                             GAO/HlUHW162   Children’s   Issues: Reports   and Activities
                             Appendix I
                             An Annotated Bibliography  of GAO Reports
                             on Children, October 1989 Through
                             March 1990




Head Start: Information on   HHS'S  Head Start program annually provides more than $1.2 billion in
                             child development services to about 450,000 children, aged 3 to 5 years.
Sponsoring Organizations     Participating children attend Head Start centers in their communities,
and Center Facilities        where they receive nutrition, medical, social, mental health, and educa-
(GAO/HRD-89-123FS,           tional services. This fact sheet provides information on public and pri-
July 12, 1989)               vate organizations that operate local Head Start programs and the kinds
                             of facilities these programs use.



Education

Compensatory Education:      For more than 2 decades, public school teachers in the Chapter 1 pro-
Aguilar v. Felton            gram, the federal program of compensatory education for the disadvan-
                             taged, provided remedial services to sectarian (religious) private school
Decision’s Continuing        students on private school premises. However, in its Aguilar v. Felton
Impact on Chapter 1          decision, the Supreme Court ruled that this practice was unconstitu-
Program (GAO/HRD-89-         tional. In this report, GAO identifies (1) how much school districts had
131BR, Sept. 27,1989)        spent or planned to spend for new methods of providing remedial ser-
                             vices and (2) how states plan to distribute to school districts federal
                             funds authorized to help pay for these methods. GAO also determined
                             (1) the changes in sectarian private school participation since the ruling
                             and (2) the satisfaction of public and private school officials with the
                             new methods and the resulting quality of instructional services in
                             selected school districts.


Desegregation Activities:    From 1978 through 1987, the Cleveland School District received $385.9
Administration of            million in federal funds for desegregation activities. No federal funds
                             were provided specifically for desegregation activities after June 1987.
Education Grant Funds at     GAO found that federal funds were appropriately     spent on desegregation
the Cleveland School         activities; however, the school district did not comply with all the speci-
District (GAO/HRD-89-83,     fications of a 1978 court-ordered desegregation plan and subsequent
Aug. 29,1989)                federal grant agreements. The school district (1) requested and received
                             excessive advances of federal grant funds; (2) accrued interest on these
                             advances, but did not report or remit this income to the Department of
                             Education; (3) without required Education approval, obligated and
                             spent first-year grant funds in the second year; and (4) did not comply
                             with some federal procurement requirements. The deficiencies GAO
                             found in the school district went undetected because Education officials




                              Page16                             GAO/JJRB9@162   Children’s   Issues: Reports   and Activities
                          Appendix I
                          An Annotated Bibliogaphy    of GAO Reports
                          on Children, October 1966 Through
                          March 1990




                          families needing care. The military provides most of its child care at
                          child development centers, which are designed to (1) offer care at a
                          lower cost than private sector care and at more convenient locations and
                          (2) provide services that may not be available in the private sector. As
                          of February 9, 1988, child development centers and family day care
                          homes had the combined capacity to care for about 62,000 children at
                          the same time, an 82-percent increase over the end of fiscal year 1984.
                          In spite of the growth, centers cannot currently meet demand. Of the
                          installations GAO surveyed, 185 maintained waiting lists of interested
                          parents. These lists contained the names of about 24,700 children.



Child Welfare and
Social Services

Adoption: Assistance      The conference report on the National Defense Authorization Act for
Provided by Selected      Fiscal Years 1988 and 1989 directed GAO to obtain information on the
                          assistance private employers give employees who are adopting children.
Employers to Adopting     The conference report indicated that this information was needed to
Parents (GAO/HRD-90-      evaluate the Department of Defense (DOD) test adoption expense reim-
47FS, Dec. 19,1989)       bursement program. This fact sheet presents information on selected
                          employers’ financial assistance for comparison with DOD’S test program
                          and information on leave available from the selected employers to
                          adopting parents.


Foster Care: Delayed      In reviewing foster care reforms required for states’ receipt of addi-
Follow-Up of              tional funds under the Child Welfare Services grants program, GAO
                          found that the Department of Health and Human Services’(HHs) Admin-
Noncomplying States May   istration for Children, Youth, and Families (ACYF) has been diligent
Reduce Incentive for      about recouping Child Welfare Services incentive funds once a state has
Reform (GAO/PEMD-89-      been determined to be ineligible for such funds. ACYF, however, has been
16, Sept. 13, 1989)       slow to review the performance of some states that have failed compli-
                          ance reviews in previous years, resulting in payments of about $24.7
                          million since 1984 to six states that may not have been eligible for those
                          funds. To ensure that incentive funds are expended in compliance with
                          the law, ACYF should promptly rereview those six states that failed a
                          review between 1983 and 1985. ACYF should also do periodic reviews
                          promptly in the future.




                          Page 14                              GAO/HRD9@162   Children’s   Issues: Reports   and Activities
Appendix I

An Annotated Bibliography of GAO Reports on
Children, October 1988 Through March 1990

                                        From October 1988 through March 1990, GAO issued 58 reports on chil-
                                        dren and their families. Figure I.1 shows the distribution of these
                                        reports among nine different issues.


Figure 1.1: GAO Reports on Children’s
Issues (013 1988.Mar. 1990)
                                        14   Number   of Reporfs


                                        12


                                        10                         -

                                         6




Child Day Care

Child Care: Government                  This briefing report identifies child care funding, describes coordination
Funding Sources,                        of child care programs and services, and summarizes current informa-
                                        tion on the availability of child care. It also includes information on how
Coordination, and Service               programs affect low-income families seeking child care. GAO estimated
Availability (GAO/HRD-                  that in fiscal year 1988, federal funding for child care would exceed
90-26BR, Oct. 13, 1989)                 $6.6 billion. These services were provided through 46 programs,
                                        although almost 90 percent of the funding was for four major pro-
                                        grams-the Child and Dependent Care Tax Credit, the Social Services
                                        Block Grant, Head Start, and the Child Care Food Program. In the past



                                        Page 12                        GAO/HRDW-162   Children’s   Issues: Reports and Activities
c4lntents




Abbreviations

ACYF        Administration for Children, Youth and Families
AIDS        acquired immunodeficiency syndrome
13IA        Bureau of Indian Affairs
CMS         children’s medical services
DOD         Department of Defense
 EHA        Education of the Handicapped Act
 FEMA       Federal Emergency Management Agency
 GAO        General Accounting Office
 HHS        Department of Health and Human Services
 HIV        human immunodeficiency virus
 HUD        Department of Housing and Urban Development
 MCH        maternal and child health
 OCSE       Office of Child Support Enforcement
 OMB        Office of Management and Budget
 USDA       U.S. Department of Agriculture
 UNICEF     United Nations Children’s Fund (formerly United Nations
                 International Children’s Emergency Fund)
 WIG        Special Supplemental Food Program for Women, Infants, and
                Children


 Page 10                     GAO/HBD-96-162   Children’s   Issues: Reports   and Activities
                             contents




Appendix II                                                                                                          36
GAO Testimony on             Child Welfare and Social Services
                             Education
                                                                                                                     36
                                                                                                                     36
Children’s Issues,           Health                                                                                  37
October 1988 Through         Nutrition                                                                               37
                             Youth Employment and Training                                                           38
March 1990         -         Other Child and Family Issues                                                           38

Appendix III                                                                                                         39
GAO Reports on         Child Day Care
                       Child Welfare and Social Services
                                                                                                                     39
                                                                                                                     40
Children, Fiscal Years Education                                                                                     42
1980-88                Health                                                                                        43
                             Housing                                                                                 44
                             Income Security                                                                         44
                             Nutrition                                                                               46
                             Youth Employment and Training                                                           47
                             Other Child and Family Issues                                                           48

Appendix IV                                                                                                           49
Ongoing GAO                  Child Welfare and Social Services
                             Education
                                                                                                                      50
                                                                                                                      51
Assignments on               Health                                                                                   51
Children’s Issues, as of     Housing                                                                                  52
March 31, 1990               Income Security                                                                          52
                             Nutrition                                                                                52
                             Youth Employment and Training                                                            53

Appendix V                                                                                                            54
Other Publications and childDaycare                                                                                   54
                       Child Welfare and Social Services                                                              54
Papers by GAO Staff    Education                                                                                      55
on Children’s Issues, Health                                                                                          55
October 1988 Through income    Security
                       Youth Employment and Training
                                                                                                                      56
                                                                                                                      56
March 1990             Other Child and Family Issues                                                                  56




                              Page 8                     GAO/HRD-90-162   Children’s   Issues: Reports   and Activities
    Pediatric AIDS: Health and Social Service Needs of                                 24
         Infants and Children (GAO/HRD-89-96,
         May 5,1989)
    Teenage Smoking: Higher Excise Tax Should                                           24
         Significantly Reduce the Number of Smokers
         (GAO/HRD-89-119, June 30,1989)
    Youth Camps: Nationwide and State Data on Safety                                    25
         and Health Lacking (GAO/HRD-89-140,
         Sept. 20, 1989)
Housing                                                                                 25
    Children and Youths: About 68,000 Homeless and                                      25
          186,000 in Shared Housing at Any Given Time
         (GAO/PEMD-89-14, June 15,1989)
    Homelessness: Homeless and Runaway Youth                                            25
         Receiving Services at Federally Funded Shelters
         (GAO/HRD-90-45, Dec. 19,1989)
    Homelessness: HUD’s and FEMA’s Progress in                                          26
         Implementing the McKinney Act (GAO/RCED-
         89-50, May 11,1989)
    Homelessness: McKinney Act Programs and Funding                                     26
          for Fiscal Year 1989 (GAO/RCED-90-52,
          Feb. 16,199O)
    Housing Conference: National Housing Policy Issues                                  27
          (GAO/RCED-89-174, Aug. 1989)
    Rental Housing: Housing Vouchers Cost More Than                                     27
          Certificates but Offer Added Benefits (GAO/
          RCED-89-20, Feb. 16, 1989)
    Transition Series: Housing and Urban Development                                    27
          Issues (GAO/OCG-89-22TR, Nov. 1988)
    Welfare Hotels: Uses, Costs, and Alternatives (GAO/                                 28
          HRD-89-26BR, Jan. 31, 1989)
Income Security                                                                         28
        Child Support: State Progress in Developing                                     28
             Automated Enforcement Systems (GAO/HRD-89-
             lOFS, Feb. 10,1989)
        Interstate Child Support: Case Data Limitations,                                29
             Enforcement Problems, Views on Improvements
             Needed (GAO/HRD-89-25, Jan. 27,1989)
        Transition Series: Health and Human Services Issues                             29
             (GAO/OCG-89-lOTR, Nov. 1988)
        Welfare Reform: Alabama’s Demonstration Project                                 29
             (GAO/HRD-89-129BR, Aug. 17,1989)



Page6                          GAO/‘HRD9O-162   Children’s   lssuee: Reporta and ActMties
Contents


                                                                                                               -

Letter                                                                                                               1

Appendix I                                                                                                         12
An-Annotated           Child Day Care
                           Child Care: Government Funding Sources,
                                                                                                                   12
                                                                                                                   12
Bibliography of GAO              Coordination, and Service Availability (GAO/
Reports on Children,             HRD-90-26BR, Oct. 13, 1989)
                           Child Care: Selected Bibliography (GAO/HRD-                                             13
October 1988 Through             89-98FS. July 11, 1989)
March 1990                 Marine Corps Child Care: User Fee Increases at                                          13
                                 Parris Island and Beaufort Installations (GAO/
                                 HRD-89-74, Mar. 24, 1989)
                           Military Child Care: Extensive, Diverse, and Growing                                    13
                                 (GAO/IIRD-89-3, Mar. 8, 1989)
                       Child Welfare    and Social Services                                                        14
                           Adoption: Assistance Provided by Selected                                               14
                               Employers to Adopting Parents (GAO/HRD-
                               90-47FS. Dec. 19, 1989)
                           Foster Care: Delayed Follow-Up of Noncomplying                                          14
                               States May Reduce Incentive for Reform (GAO/
                               PEMD-89-16, Sept. 13, 1989)
                           Foster Care: Incomplete Implementation of the                                           15
                               Reforms and LJnknown Effectiveness (GAO/
                                PEMD-89-17, Aug. 14, 1989)
                           Foster Care: Preliminary Report on Reform Effects                                       15
                                (GAO/PEMD-89-23BR, June 1,1989)
                           Foster Parents: Recruiting and Preservice Training                                      15
                                Practices Need Evaluation (GAO/HRD-89-86,
                                Aug. 3, 1989)
                           Head Start: Information on Sponsoring Organizations                                     16
                                and Center Facilities (GAO/HRD-89-123FS,
                                July 12. 1989)
                       Education                                                                                   16
                            Compensatory Education: Aguilar v. Felton                                              16
                                Decision’s Continuing Impact on Chapter 1
                                Program (GAO/HRD-89-131BR, Sept. 27, 1989)
                            Desegregation Activities: Administration of                                            16
                                Education Grant Funds at the Cleveland School
                                District (GAO/HRD-89-83, Aug. 29, 1989)
                            DOD Overseas Schools: Additional Assurances of                                         17
                                Educational Quality Needed (GAO/HRD-90-13,
                                Mar. 15. 1990)


                       Page 4                        GAO/HRD9@162   Children’s   Isawe:   Reports   and Activities
                                                  B-240552




Table I: GAO Products   and Activities   on Children’s   Issues (Fiscal Year 1980-Mar 1990)
                                                                                    Type of activity
                                                 Reports           Reporls     Testimonies    Ongoing jobs                 Other
                                                  issued             issued                              (as of      activities=
Issue                                      (FYs 1980-88) (10/88- 03/90) (IO/S&O?;;                   03/31/90)   (10/W 03/90)               Total
Child day care                                            3                 4               0                  0                 1               a
Child welfare and social serwes                          28                 6               1                  8                 1             44
Education                                                18                12               6                  7                 2             45
Health                                                   10                10               2                11                  7             40
Housing                                                   9                 8               0                  2                 0             19
Income secuntv                                           18                 4               0                  8                 2             32
Nutrition                                                19                 9               3                  5                 0             36
Youth employment and training                             9                 2               3                  3                 3             20
Other child and family issues                              5                3               2                  0                 1             11
Total                                                  119                 58              17                44                 17           255
                                                  ‘Includes other external   publIshed   articles   and papers   delivered   by GAO staff


                                                  Most GAO reports and activities included in this report focus primarily
                                                  on children. However, some focus on federal programs serving children
                                                  more indirectly, such as food stamps or housing assistance. We have not
                                                  included all GAO reports on such federal programs. Instead, we have
                                                  included only those that deal primarily with improving access to or the
                                                  quality or effectiveness of services for children,

                                                  The results of our work are organized in five appendixes as follows:

                                              . An annotated bibliography of reports on federal programs and policy
                                                areas affecting children and their families, from October 1988 through
                                                March 1990. (See app. I.)
                                              l Testimony of GAO officials before congressional committees on federal
                                                programs and policy areas relating to children and their families, for the
                                                same period. (See app. II.)
                                              . All relevant GAO reports issued from fiscal years 1980 through 1988.
                                                (See app. III.)
                                              . Ongoing assignments relating to children and families, as of March 31,
                                                1990. (See app. IV’.)
                                              . Published articles and papers independently prepared by GAO staff on
                                                child-related issues, from October 1988 through March 1990.
                                                (See app. V.)

                                                  As agreed with your office, unless you publicly announce its contents
                                                  earlier, we plan no further distribution of this report until 10 days from


                                                  Page 2