Child Welfare
Federal Oversight of State IV-B Activities Could Inform Action Needed to Improve Services to Families and Statutory Compliance Gao ID: GAO-06-787T May 23, 2006For federal fiscal year 2004, state and local child protective services staff determined that an estimated 872,000 children have been victims of abuse or neglect. Title IV-B subparts 1 and 2 authorize a wide array of child welfare services with some restrictions on states' use of funds. This testimony discusses: (1) how states used Title IV-B dollars to serve families under subparts 1 and 2; (2) the extent that federal oversight ensured state compliance with spending requirements under subpart 1; and (3) what the research said about the effectiveness of service states have provided to families using Title IV-B funds. This testimony was primarily based on a 2003 report (GAO-03-956).
States used Title IV-B funds to provide a broad range of services to prevent the occurrence of abuse, neglect, and foster care placements in addition to other child welfare services. While there was some overlap, states reported using Title IV-B subpart 1 funds primarily to operate child welfare programs and serve families in the foster care system, while states reported using subpart 2 funds primarily for family services targeted to families at risk of child removal due to abuse or neglect. For example, nearly half of subpart 1 staff costs paid salaries for social worker positions in child protective services. Family services under subpart 2 included those to support, preserve, and reunify families by providing mentoring programs, financial assistance to help with rent and utilities, parenting classes, child care, and support groups. HHS provided relatively little oversight specific to state spending under subpart 1. HHS did not collect data on subpart 1 expenditures and regional officials paid little attention to statutory limits in states' planned use of funds. In response to GAO's survey, 10 states reported actual 2002 subpart 1 expenditures that exceeded the sending limits by over $15 million in total. Research is limited assessing the effectiveness of services provided under Title IV-B. In GAO's survey, 22 states reported providing services other than foster care and adoption assistance payments, staff salaries, or administration under subpart 1; however, none of these states had sufficiently evaluated the outcomes of these services. Similarly, GAO's literature review showed that few evaluations had been conducted, and evaluations that had been conducted showed mixed results. HHS evaluations of subpart 2 services also have shown no or little effect in reducing out-of-home placement, maltreatment recurrence, or improved family functioning beyond what normal casework services achieved.
GAO-06-787T, Child Welfare: Federal Oversight of State IV-B Activities Could Inform Action Needed to Improve Services to Families and Statutory Compliance
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Testimony:
Before the Subcommittee on Human Resources, Committee on Ways and
Means, House of Representatives:
United States Government Accountability Office:
GAO:
For Release on Delivery Expected at 2:00 p.m. EDT:
Tuesday, May 23, 2006:
Child Welfare:
Federal Oversight of State IV-B Activities Could Inform Action Needed
to Improve Services to Families and Statutory Compliance:
Statement of Cornelia M. Ashby, Director Education, Workforce, and
Income Security Issues:
Child Welfare:
GAO-06-787T:
GAO Highlights:
Highlights of GAO-06-787T, a testimony to Chairman, Subcommittee on
Human Resources, Committee on Ways and Means, House of Representatives.
Why GAO Did This Study:
For federal fiscal year 2004, state and local child protective services
staff determined that an estimated 872,000 children had been victims of
abuse or neglect. Title IV-B subparts 1 and 2 authorize a wide array of
child welfare services, with some restrictions on states‘ use of funds.
This testimony discusses: (1) how states used Title IV-B dollars to
serve families under subparts 1 and 2; (2) the extent that federal
oversight ensured state compliance with spending requirements under
subpart 1; and (3) what the research said about the effectiveness of
services states have provided to families using Title IV-B funds. This
testimony was primarily based on a 2003 report (GAO-03-956).
What GAO Found:
States used Title IV-B funds to provide a broad range of services to
prevent the occurrence of abuse, neglect, and foster care placements in
addition to other child welfare services. While there was some overlap,
states reported using Title IV-B subpart 1 funds primarily to operate
child welfare programs and serve families in the foster care system,
while states reported using subpart 2 funds primarily for family
services targeted to families at risk of child removal due to abuse and
neglect. Some costs to operate programs included direct services to
children and families. For example, nearly half of subpart 1 staff
costs paid salaries for social worker positions in child protective
services. Family services under subpart 2 included those to support,
preserve, and reunify families by providing mentoring programs,
financial assistance to help with rent and utilities, parenting
classes, child care, and support groups.
Table: States Reported Use of Federal Funds under Title IV-B, Fiscal
Year 2002:
Service Category: Program Operation; Subpart 1: Amount: $114,108,675;
Subpart 1: Percent: 44.4%;
Subpart 2: Amount: $17,843,725;
Subpart 2: Percent: 6.9%;
Service Category: Child protective services; Subpart 1: Amount:
$40,543,000;
Subpart 1: Percent: 15.8%;
Subpart 2: Amount: $2,248,690;
Subpart 2: Percent: 0.9%;
Service Category: Family Services; Subpart 1: Amount: $36,624,068;
Subpart 1: Percent: 14.2%;
Subpart 2: Amount: $182,720,128;
Subpart 2: Percent: 71.3%;
Service Category: Foster care and adoption; Subpart 1: Amount:
$35,255,267;
Subpart 1: Percent: 13.7%;
Subpart 2: Amount: $36,695,036;
Subpart 2: Percent: 14.4%;
Service Category: Miscellaneous;
Subpart 1: Amount: $30,623,527;
Subpart 1: Percent: 11.9%;
Subpart 2: Amount: $16,299,500;
Subpart 2: Percent: 6.4%;
Service Category: Total;
Subpart 1: Amount: $257,154,537;
Subpart 1: Percent: 100.0%;
Subpart 2: Amount: $255,807,079;
Subpart 2: Percent: 100.0%;
Source: GAO Survey.
Note: Percentages do not always total to 100 due to rounding.
[End of Table]
HHS provided relatively little oversight specific to state spending
under subpart 1. HHS did not collect data on subpart 1 expenditures and
regional officials paid little attention to statutory limits in states‘
planned use of funds. In response to GAO‘s survey, 10 states reported
actual 2002 subpart 1 expenditures that exceeded the spending limits by
over $15 million in total.
Research is limited assessing the effectiveness of services provided
under Title IV-B. In GAO‘s survey, 22 states reported providing
services other than foster care and adoption assistance payments, staff
salaries, or administration under subpart 1; however, none of these
states had sufficiently evaluated the outcomes of these services.
Similarly, GAO‘s literature review showed that few evaluations had been
conducted, and evaluations that had been conducted showed mixed
results. HHS evaluations of subpart 2 services also have shown no or
little effect in reducing out-of-home placement, maltreatment
recurrence, or improved family functioning beyond what normal casework
services achieved.
What GAO Recommends:
The 2003 report recommended that the Secretary of Health and Human
Services (HHS) consider collecting data on states‘ use of Title IV-B
subpart 1 funds, use these data in its design of alternative financing
options, and provide the necessary guidance to ensure state compliance
with statutory restrictions on the use of subpart 1 funds. HHS‘s
Administration for Children and Families (ACF) agreed with the report‘s
findings and implemented the recommendation to provide guidance to
states. ACF disagreed with the recommendation to collect data from
states and did not comment on using these data for its financing
option.
[Hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-787T].
To view the full product, including the scope and methodology, click on
the link above. For more information, contact Cornelia Ashby at (202)
512-8403 or ashbyc@gao.gov.
[End of Section]
United States Government Accountability Office:
Washington, DC 20548:
Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today to present information from our 2003
report on how states used funds authorized under Title IV-B of the
Social Security Act to help families address problems that lead to
child abuse and neglect and subsequent separation of children from
their families.[Footnote 1] For federal fiscal year 2004, child
protective services (CPS) staff in state and local child welfare
agencies reported investigating or assessing an estimated 3 million
allegations of child maltreatment and determined that approximately
872,000 children had been the victims of child abuse or neglect by
their parents or other caregivers. Established in 1935, Title IV-B
first authorized funds to states that could be used to provide a wide
array of child welfare services including those necessary to
investigate reports of child maltreatment, remove children from their
home and place them with a temporary foster family, help preserve or
reunify families, and place children who cannot be safely reunified
with their families in an adoptive home.
The Congress has passed various laws over the years emphasizing the
need for states to use Title IV-B funding to provide supportive
services to preserve and reunify families. In 1980, for example, the
Adoption Assistance and Child Welfare Act established a dollar cap on
the amount of child welfare funds that states could use under Title IV-
B for foster care and certain other activities to encourage states to
use additional funding for services to families. In 1993, the Congress
established the family preservation and family support services program
under Title IV-B subpart 2, authorizing funding to states for family
preservation and community-based family support services. The Adoption
and Safe Families Act of 1997 further encouraged spending on family
support services by reauthorizing subpart 2, renaming it Promoting Safe
and Stable Families, and expanding the types of programs on which
states were authorized to spend Title IV-B funds to include adoption
promotion and support services and time-limited family reunification
services. In fiscal year 2006, the Congress appropriated $287 million
for child welfare services under subpart 1 and $394 million for family
support services under subpart 2.[Footnote 2] These funds are
administered to states by the Department of Health and Human Services'
(HHS) Administration for Children and Families (ACF).
My testimony today is primarily based on information included in our
2003 report. Specifically, I will be discussing: (1) how states used
Title IV-B dollars to serve families under subparts 1 and 2; (2) the
extent that federal oversight ensured state compliance with spending
requirements under subpart 1; and (3) what the research said about the
effectiveness of services states have provided to families using Title
IV-B funds.
In summary, while overlap exists, states reported using Title IV-B
subpart 1 funds primarily to staff and administer child welfare
programs and serve families in the foster care system, while states
reported using subpart 2 funds primarily for prevention and support
services for families at risk of child abuse and neglect. It is
difficult, however, to clearly differentiate among the various service
categories and populations served. HHS provided relatively little
oversight in how states spent federal funds under subpart 1, and at
least 10 states spent a total of over $15 million over the legislated
cap for foster care and adoption assistance payments. Although the
predominance of federal funding spent for foster care and adoption
assistance has long been cited as providing a disincentive to preserve
and reunify families, little research is available on the effectiveness
of the services subpart 1 funds provide and HHS evaluations of services
funded under subpart 2 have generally shown no or little effect.
Similarly, the extent that differences in how states spent funds to
support children and families resulted in better or worse outcomes for
children is unknown.
To help address this information gap, our 2003 report recommended that
the Secretary of HHS consider the feasibility of collecting and using
data on states' use of Title IV-B subpart 1 funds. We made this
recommendation not only to facilitate federal oversight and analysis of
how states' spending patterns correlate to child outcomes, but also so
that HHS could use this data to inform the design of alternative
funding proposals that would give states more flexibility in spending
federal child welfare funds. We also recommended that the Secretary
provide the necessary guidance to ensure compliance with statutory
restrictions on the use of Title IV-B subpart 1funds. ACF agreed with
our findings and implemented guidance to states reminding them of the
statutory requirements for subpart 1 spending. However, ACF disagreed
with our recommendation to consider collecting data on subpart 1
expenditures. ACF believed that its level of oversight was commensurate
with the scope and intent of subpart 1, noting that its oversight
efforts were more appropriately focused on reviews of the states'
overall child welfare systems. ACF did not comment on our
recommendation to use such data to inform the design of an alternative
financing option.
Our review was based on two surveys to child welfare directors to
obtain information on how they use Title IV-B funds. We also visited
four states--California, New Jersey, Ohio, and Washington--where we
interviewed state and local officials and service providers. We also
held discussions with HHS headquarters and regional office officials
and child welfare experts. We reviewed results from HHS's assessments
of state child welfare agencies as well as the literature assessing the
effectiveness of various child welfare services.
Background:
Title IV-B of the Social Security Act authorizes funds to states to
provide an array of child welfare services to prevent the occurrence of
abuse, neglect, and need to place children in foster care. The
Administration for Children and Families within HHS is responsible for
the administration and oversight of federal funding to states for child
welfare services under Title IV-B. HHS headquarters staff are
responsible for developing appropriate policies and procedures for
states to follow in obtaining and using federal child welfare funds,
while staff in HHS's 10 regional offices are responsible for providing
direct oversight of state child welfare systems. No federal eligibility
criteria apply to the children and families receiving services funded
under Title IV-B. The amount of subpart 1 funds a state receives is
based on its population under the age of 21 and the state per capita
income, while subpart 2 funding is determined by the percentage of
children in a state whose families receive food stamps.
Subpart 1 provides grants to states for child welfare services, that
are broadly defined. Subpart 1 funds are intended for services that are
directed toward the accomplishment of the following purposes:
* protect and promote the welfare of all children;
* prevent or remedy problems that may result in the abuse or neglect of
children;
* prevent the unnecessary separation of children from their families by
helping families address problems that can lead to out-of-home
placements;
* reunite children with their families;
* place children in appropriate adoptive homes when reunification is
not possible; and:
* ensure adequate care to children away from their homes in cases in
which the child cannot be returned home or cannot be placed for
adoption.
Subpart 2 services are similar to those allowed under subpart 1,
although the range of services allowed under subpart 2 is more limited
in some cases. For example, time-limited family reunification services
can only be provided during a child's first 15 months in foster care,
while no such restriction is placed on the use of subpart 1 funds. In
addition, states must spend a "significant portion" of their subpart 2
funds on each of four service categories:[Footnote 3]
* Family preservation service. Services designed to help families at
risk or in crisis, including services to (1) help reunify children with
their families when safe and appropriate; (2) place children in
permanent homes through adoption, guardianship, or some other permanent
living arrangement; (3) help children at risk of foster care placement
remain safely with their families; (4) provide follow-up assistance to
families when a child has been returned after a foster care placement;
(5) provide temporary respite care; and (6) improve parenting skills.
* Family support services. Community-based services to promote the
safety and well-being of children and families designed to increase the
strength and stability of families, to increase parental competence, to
provide children a safe and supportive family environment, to
strengthen parental relationships, and to enhance child development.
Examples of such services include parenting skills training and home
visiting programs for first time parents of newborns.
* Time-limited family reunification services. Services provided to a
child placed in foster care and to the parents of the child in order to
facilitate the safe reunification of the child within 15 months of
placement. These services include counseling, substance abuse treatment
services, mental health services, and assistance to address domestic
violence.
* Adoption promotion and support services: Services designed to
encourage more adoptions of children in foster care when adoption is in
the best interest of the child, including services to expedite the
adoption process and support adoptive families.
Federal child welfare funding has long been criticized for entitling
states to reimbursement for foster care placements, while providing
little funding for services to prevent such placements. When the
Congress enacted the Adoption Assistance and Child Welfare Act of 1980,
it created a new funding source for foster care and adoption assistance
under Title IV-E of the Social Security Act. Title IV-E provides an
open-ended entitlement for foster care maintenance payments to cover a
portion of the food, housing, and incidental expenses for all foster
children whose parents meet certain federal eligibility
criteria.[Footnote 4] Title IV-E also provides payments to adoptive
parents of eligible foster children with special needs.[Footnote 5]
While states could still use Title IV-B funding for foster care and
adoption assistance for children ineligible under Title IV-E, the law
established a dollar cap on the amount of Title IV-B funds that states
could use for three categories of service: foster care maintenance
payments, adoption assistance payments, and child care related to a
parent's employment or training. The law requires that the total of
subpart 1 funds used for these categories cannot exceed a state's total
1979 subpart 1 expenditures for all types of services. The intent of
this restriction, according to a congressional document, was to
encourage states to devote increases in subpart 1 funding as much as
possible to supportive services that could prevent the need for out-of-
home placements.[Footnote 6] However, this restriction applies only to
the federal portion of subpart 1 expenditures, as the law provides that
states may use any or all of their state matching funds for foster care
maintenance payments.
For the fourth consecutive year, the President's budget proposes a
Child Welfare Program Option. HHS developed the proposal to give states
more flexibility in using Title IV-E foster care funds for preventive
services such as those under Title IV-B. Under this proposal, states
could voluntarily choose to receive a fixed IV-E foster care allocation
(based on historic expenditure rates) over a 5-year period, rather than
receiving a per child allocation. States could use this allocation for
any services provided under Titles IV-B and IV-E, but would also have
to fund any foster care maintenance payments and associated
administrative costs from this fixed grant or use state funds. No
legislation to enact this option has been introduced.
States Used Subparts 1 and 2 to Support Similar Services and
Populations, but Funding Emphasis Differed:
While overlap exists, states reported using subpart 1 funding primarily
for costs to staff and administer child welfare programs and serve
families in the foster care system, while states reported using subpart
2 funding for family support services and to serve families at risk for
child abuse and neglect. Officials in almost all of HHS's regional
offices supported retaining the current balance between allowing states
some flexibility in use of funds and targeting some resources toward
prevention. States reported in our survey that flexibility was
important to meet the needs of their child welfare systems, and thus
generally preferred the financing structure of subpart 1 over subpart
2:
States Emphasized Different Services under Subparts 1 and 2:
While states funded similar services under subparts 1 and 2, most
states reported using subpart 1 funds primarily to pay for costs
associated with operating child welfare programs, while most states
reported using subpart 2 funds for family services as shown in table 1.
For example, states used over 44 percent of subpart 1 funds to pay for
staff salaries and costs to administer and manage programs. In
contrast, states spent over 71 percent of subpart 2 funds for services
to support, preserve, and reunify families.
Table 1: States' Reported Use of Federal Funds Under Title IV-B, fiscal
year 2002:
Service Category: Child Protective Services;
Subpart 1: Number of states: 17;
Subpart 1: Amount: $40,543,000;
Subpart 1: Percent: 15.8;
Subpart 2: Number of states: 5;
Subpart 2: Amount[A]: $2,248,690;
Subpart 2: Percent[B]: 0.9.
Service Category: Program Operation: Service Category: Staff positions;
Subpart 1: Number of states: 25;
Subpart 1: Amount: $70,965,578;
Subpart 1: Percent: 27.6;
Subpart 2: Number of states: 17;
Subpart 2: Amount[A]: $6,229,058;
Subpart 2: Percent[B]: 2.4.
Service Category: Program Operation: Service Category: Administration
and management;
Subpart 1: Number of states: 16;
Subpart 1: Amount: 43,143,097;
Subpart 1: Percent: 16.8;
Subpart 2: Number of states: 18;
Subpart 2: Amount[A]: 11,614,667;
Subpart 2: Percent[B]: 4.5.
Service Category: Program Operation: Service Category: Subtotal;
Subpart 1: Number of states: n/a;
Subpart 1: Amount: $114,108,675;
Subpart 1: Percent: 44.4;
Subpart 2: Number of states: n/a;
Subpart 2: Amount[A]: $17,843,725;
Subpart 2: Percent[B]: 6.9.
Service Category: Family Services: Service Category: Family
support/prevention;
Subpart 1: Number of states: 17;
Subpart 1: Amount: 19,840,891;
Subpart 1: Percent: 7.7;
Subpart 2: Number of states: 28;
Subpart 2: Amount[A]: 127,430,496;
Subpart 2: Percent[B]: 49.8.
Service Category: Family Services: Service Category: Counseling and
mental health services;
Subpart 1: Number of states: 2;
Subpart 1: Amount: 8,350,562;
Subpart 1: Percent: 3.2;
Subpart 2: Number of states: 5;
Subpart 2: Amount[A]: 1,354,763;
Subpart 2: Percent[B]: 0.5.
Service Category: Family Services: Service Category: Family
preservation;
Subpart 1: Number of states: 7;
Subpart 1: Amount: 5,986,045;
Subpart 1: Percent: 2.3;
Subpart 2: Number of states: 23;
Subpart 2: Amount[A]: 30,308,896;
Subpart 2: Percent[B]: 11.8.
Service Category: Family Services: Service Category: Family
reunification;
Subpart 1: Number of states: 4;
Subpart 1: Amount: 2,446,570;
Subpart 1: Percent: 1.0;
Subpart 2: Number of states: 26;
Subpart 2: Amount[A]: 23,625,973;
Subpart 2: Percent[B]: 9.2.
Service Category: Family Services: Service Category: Subtotal;
Subpart 1: Number of states: n/a;
Subpart 1: Amount: $36,624,068;
Subpart 1: Percent: 14.2;
Subpart 2: Number of states: n/a;
Subpart 2: Amount[A]: 182,720,128;
Subpart 2: Percent[B]: 71.3.
Service Category: Foster care and adoption: Service Category: Foster
care maintenance payments;
Subpart 1: Number of states: 17;
Subpart 1: Amount: 27,890,783;
Subpart 1: Percent: 10.8;
Subpart 2: Number of states: 2;
Subpart 2: Amount[A]: 647,154;
Subpart 2: Percent[B]: 0.3.
Service Category: Foster care and adoption: Service Category: Adoption
subsidy payments;
Subpart 1: Number of states: 7;
Subpart 1: Amount: 4,657,546;
Subpart 1: Percent: 1.8;
Subpart 2: Number of states: 2;
Subpart 2: Amount[A]: 737,412;
Subpart 2: Percent[B]: 0.3.
Service Category: Foster care and adoption: Service Category:
Recruitment and training for foster/adoptive parents;
Subpart 1: Number of states: 9;
Subpart 1: Amount: 2,260,061;
Subpart 1: Percent: 0.9;
Subpart 2: Number of states: 16;
Subpart 2: Amount[A]: 6,828,885;
Subpart 2: Percent[B]: 2.7.
Service Category: Foster care and adoption: Service Category: Adoption
support and preservation services;
Subpart 1: Number of states: 2;
Subpart 1: Amount: 446,877;
Subpart 1: Percent: 0.2;
Subpart 2: Number of states: 27;
Subpart 2: Amount[A]: 28,481,585;
Subpart 2: Percent[B]: 11.1.
Service Category: Foster care and adoption: Service Category: Subtotal;
Subpart 1: Number of states: n/a;
Subpart 1: Amount: $35,255,267;
Subpart 1: Percent: 13.7;
Subpart 2: Number of states: n/a;
Subpart 2: Amount[A]: $36,695,036;
Subpart 2: Percent[B]: 14.4.
Service Category: Miscellaneous: Service Category: Multiple
responses[C];
Subpart 1: Number of states: 8;
Subpart 1: Amount: 25,806,347;
Subpart 1: Percent: 10.0;
Subpart 2: Number of states: 4;
Subpart 2: Amount[A]: 3,503,585;
Subpart 2: Percent[B]: 1.4.
Service Category: Miscellaneous: Service Category: Other;
Subpart 1: Number of states: 11;
Subpart 1: Amount: 4,817,180;
Subpart 1: Percent: 1.9;
Subpart 2: Number of states: 15;
Subpart 2: Amount[A]: 12,795,915;
Subpart 2: Percent[B]: 5.0.
Service Category: Miscellaneous: Service Category: Subtotal;
Subpart 1: Number of states: n/a;
Subpart 1: Amount: $30,623,527;
Subpart 1: Percent: 11.9;
Subpart 2: Number of states: n/a;
Subpart 2: Amount[A]: $16,299,500;
Subpart 2: Percent[B]: 6.4.
Service Category: Total[D];
Subpart 1: Number of states: n/a;
Subpart 1: Amount: $257,154,537;
Subpart 1: Percent: 100.0;
Subpart 2: Number of states: [Empty];
Subpart 2: Amount[A]: $255,807,079;
Subpart 2: Percent[B]: 100.0.
Source: GAO survey.
Notes: Percentages do not always total to 100 due to rounding.
Data on subpart 1 expenditures are based on survey responses from 46
states and data on subpart 2 expenditures are based on survey responses
from 44 states. While Pennsylvania responded to our survey, it did not
provide expenditure data for subparts 1 or 2.
[A] When providing data for our survey, states were asked to indicate
the single service category that best described the type of program
funded by subparts 1 and 2. States may not have been consistent in
categorizing services. For example, several HHS officials told us that
the delineation between family support and family preservation services
is not clear, thus two states providing the same services to the same
types of families may report them in different categories.
Inconsistencies such as these could have an effect on any measured
differences among service categories.
[B] States may spend less than 20 percent of their subpart 2 funds on
any of the required service categories if they have a strong rationale.
Some HHS regional officials said that they approve exceptions to the 20
percent requirement if a state is spending a significant amount of
nonfederal funds on a subpart 2 service category.
[C] Although states were asked to indicate the single service category
that best described the type of program funded by subparts 1 and 2,
several states selected multiple program categories when responding to
our survey. For example, Rhode Island reported that it funded a home
visitation program and indicated that this program includes family
support, health, and family reunification services. Thus, the responses
from states that reported multiple categories for a program are
represented by this category.
[D] The aggregate dollars reported in the service categories do not
match the total allocations for subparts 1 and 2 in fiscal year 2002.
States have 2 years to spend their Title IV-B allocations. As a result,
expenditures in fiscal year 2002 may include dollars from a state's
fiscal year 2001 Title IV-B allocation, as well as its fiscal year 2002
Title IV-B allocation. Similarly, some fiscal year 2002 allocations may
not have been spent until fiscal year 2003.
[End of table]
Subpart 1 Services:
The majority of subpart 1 funds were spent on staff salaries, and
Washington officials said that in their state, over half of these costs
paid for staff providing direct services to children and families.
Overall, states reported that nearly half of Title IV-B funds used for
staff salaries supported social worker positions in child protective
services. Another 20 percent of funds supported positions for other
social workers. The remaining costs supported other staff including
those providing supervision of caseworkers and legal services. (See
fig. 1.)
Figure 1: Proportion of Title IV-B Funds States Reported Using to
Support Staff Salaries under Subpart 1 by Position, Fiscal Year 2002:
[See PDF for image]
Notes: Some states spent subpart 1 funds on salaries, but could not
provide information on the types of staff positions included.
Percentages do not total to 100 due to rounding.
[End of figure]
The remaining subpart 1 funds were split fairly evenly among
administration and management, child protective services, and foster
care maintenance payments:
* Administration and management comprised the second largest category
of subpart 1 expenditures, accounting for almost 17 percent of subpart
1 dollars. These services included rent and utilities for office space,
travel expenses for agency staff, and staff training.[Footnote 7]
* Child protective services represent the third largest category of
subpart 1 expenditures. States reported using about 16 percent of their
subpart 1 funds to provide a variety of CPS services, such as telephone
hotlines for the public to report instances of child abuse and neglect,
emergency shelters for children who needed to be removed from their
homes, and investigative services.
* States reported using nearly 11 percent of their subpart 1 funds to
make recurring payments for the room and board of foster children who
were not otherwise eligible for federal reimbursement. For example, New
Jersey officials reported spending over half of the state's subpart 1
funds on foster care maintenance payments.
Subpart 2 Services:
States reported using over 70 percent of their subpart 2 dollars on
serving families, with nearly half of these funds used to fund family
support and prevention services. These services included mentoring
programs to help pregnant adolescents learn to be self-sufficient,
financial assistance to low-income families to help with rent and
utilities, parenting classes, child care, and support groups provided
by community-based resource centers.
The remaining subpart 2 funds were split fairly evenly among family
preservation, family reunification, and services to support and
preserve adoptive families.
* Family preservation services accounted for nearly 12 percent of
subpart 2 dollars. Services provided by Washington state in this
category included counseling and parent training services for up to 6
months for families with children who were at risk of being placed in
foster care.
* Adoption support and preservation services accounted for over 11
percent of subpart 2 dollars. With these funds, states provided
services such as counseling for children who were going to be adopted,
family preservation services to adoptive families, and respite care for
adoptive families. Officials in Ohio reported using almost half of its
subpart 2 dollars for adoption services, including post adoption
services and services to recruit families for children in need of
homes.
* Family reunification services accounted for over 9 percent of subpart
2 funds. These services included supervised visitation centers for
parents to visit with their children who were in foster care and
coordinators for alcohol and drug treatment services for families whose
primary barrier to reunification was substance abuse. New Jersey funded
a supervised visitation program that offered parenting education,
counseling, transportation, and support groups and was located in a
private home, allowing families to visit together in a homelike setting
and engage in more natural interactions.
States Emphasized Different Populations Served Under Subparts 1 and 2:
States served similar populations under subparts 1 and 2; however,
states reported using most subpart 1 funds primarily to serve families
whose children had been removed from the home, while most subpart 2
funds were reported to serve families with children at risk of removal
due to child abuse or neglect, as shown in table 2. For example, states
used 42 percent of subpart 1 funds to serve children in foster care
and/or their parents. In contrast, states used 44 percent of subpart 2
funds for children at risk of child abuse and neglect and/or their
parents.
Table 2: Populations Served under Subparts 1 and 2 of Title IV-B as
Reported by States, Fiscal Year 2002:
Population served: Children in foster care and/or their parents;
Subpart 1: Number of services: 33;
Subpart 1: Amount of funding: $34,732,673;
Subpart 1: Percent of funding: 42;
Subpart 2: Number of services: 46;
Subpart 2: Amount of funding: $15,218,065;
Subpart 2: Percent of funding: 9.
Population served: Children at risk of child abuse and neglect and/or
their parents;
Subpart 1: Number of services: 28;
Subpart 1: Amount of funding: 13,751,328;
Subpart 1: Percent of funding: 17;
Subpart 2: Number of services: 133;
Subpart 2: Amount of funding: 73,996,404;
Subpart 2: Percent of funding: 44.
Population served: Multiple populations;
Subpart 1: Number of services: 21;
Subpart 1: Amount of funding: 11,949,444;
Subpart 1: Percent of funding: 14;
Subpart 2: Number of services: 43;
Subpart 2: Amount of funding: 18,119,756;
Subpart 2: Percent of funding: 11.
Population served: Children at risk of child abuse or neglect and/or
their parents and children living in foster care and/or their parents;
Subpart 1: Number of services: 12;
Subpart 1: Amount of funding: 7,077,448;
Subpart 1: Percent of funding: 9;
Subpart 2: Number of services: 39;
Subpart 2: Amount of funding: 17,606,172;
Subpart 2: Percent of funding: 11.
Population served: All populations;
Subpart 1: Number of services: 5;
Subpart 1: Amount of funding: 7,513,368;
Subpart 1: Percent of funding: 9;
Subpart 2: Number of services: 7;
Subpart 2: Amount of funding: 11,028,464;
Subpart 2: Percent of funding: 7.
Population served: Children waiting for adoption, adopted children, and
adoptive parents;
Subpart 1: Number of services: 9;
Subpart 1: Amount of funding: 4,153,271;
Subpart 1: Percent of funding: 5;
Subpart 2: Number of services: 54;
Subpart 2: Amount of funding: 27,340,372;
Subpart 2: Percent of funding: 16.
Population served: Other populations, such as delinquent teens and
foster parents;
Subpart 1: Number of services: 10;
Subpart 1: Amount of funding: 3,492,142;
Subpart 1: Percent of funding: 4;
Subpart 2: Number of services: 16;
Subpart 2: Amount of funding: 3,336,070;
Subpart 2: Percent of funding: 2.
Population served: Total[A];
Subpart 1: Number of services: 118;
Subpart 1: Amount of funding: $82,669,674;
Subpart 1: Percent of funding: 100;
Subpart 2: Number of services: 338;
Subpart 2: Amount of funding: $166,645,301;
Subpart 2: Percent of funding: 100.
Source: GAO survey.
Note: This analysis is based on survey responses from 35 states with
state-administered child welfare systems that provided population data
for their subpart 1 services and 39 states with state-administered
child welfare systems that provided population data for their subpart 2
services. Therefore, these data can only be generalized to states with
state-administered child welfare systems.
[A] The dollar totals in this table do not match those in table 1
because we do not have population data from states that completed the
county-administered survey. Due to the differences in information
available from states with county-administered child welfare systems,
we did not request data from these states on the types of children and
families who received services funded by Title IV-B. In addition, we
did not collect data on the populations served for the category of
staff salaries, and we excluded population data for the category of
administration and management expenses since these expenses are not
targeted to a particular population of children and families.
[End of table]
In our survey, we asked states for more detailed information about the
populations served by programs under subparts 1 and 2, such as
demographic and socioeconomic characteristics. However, few states were
able to provide this data. For selected subpart 1 services, 10 states
were able to estimate the extent to which the same children and
families also received services under subpart 2:
* four states reported that generally none or almost none of the
recipients also received a service funded by subpart 2,
* three states reported that generally less than half of the recipients
received subpart 2 services,
* one state reported that all or almost all recipients received subpart
2 services, and:
* two states provided varying estimates for different subpart 1
services.
HHS Officials and States Supported Flexibility of Title IV-B Funding:
Officials in almost all of HHS's regional offices supported retaining
the current balance between allowing states some flexibility in use of
funds and targeting some resources toward prevention, regardless of
whether federal funding sources are combined under alternative
financing options. One regional official noted that the current
financing structure of subpart 1 gives states the flexibility to
address unexpected circumstances affecting the child welfare system--
for example, the need to develop substance abuse treatment programs for
parents affected by the cocaine epidemic of the 1980s.[Footnote 8]
Other regional officials noted that the spending requirements under
subpart 2 helped ensure that states used some funds on family support
services and prevention activities to help preserve families and keep
children from entering foster care.
States reported in our survey that flexibility was important to meet
the needs of their child welfare systems, and thus generally preferred
the financing structure of subpart 1 over subpart 2, as shown in figure
2.
Figure 2: State Reported Preferences for Financing Structure of
Subparts 1 and 2 of Title IV-B:
[See PDF for image]
Note: Data on state preferences are based on responses from 46 states,
although they did not all respond to each item.
[End of figure]
Federal Oversight Insufficient to Ensure State Compliance with Title IV-
B Spending Requirements under Subpart 1:
HHS provided relatively little oversight specific to state spending
under subpart 1. HHS does not collect data on subpart 1 expenditures,
relying instead on cursory reviews of plans submitted by states that
discuss how they intend to use their subpart 1 funds in the coming
year. HHS regional officials reported that they review these plans for
relatively limited purposes because there are few restrictions on how
states can spend subpart 1 dollars. We also found that HHS regional
offices had paid little attention to statutory limits in states'
planned use of subpart 1 funds. In response to our survey, 10 states
reported actual 2002 subpart 1 expenditures that exceeded the spending
limits by over $15 million in total.
HHS Had Little Information about States' Use of Subpart 1 Funds:
HHS received forms from states each year that showed how they planned
to spend subpart 1 funds, but had little information on how states
actually spent these funds. Officials from four HHS regional offices
said that they generally reviewed the forms to ensure that states were
requesting the total amount of subpart 1 funds to which they were
entitled, and that they complied with the requirement to match 25
percent of subpart 1 funds with state funds. Most regional offices
indicated that their review of the state submitted forms focused more
on subpart 2 than subpart 1. For example, they reported reviewing
planned subpart 2 spending to ensure that states complied with the
requirement to spend at least 20 percent of funds on each of the
service categories and spend no more than 10 percent of funds for
administrative purposes. Several HHS officials said that they did not
monitor subpart 1 funds as closely as other federal child welfare funds
due to the relatively small funding amount and the lack of detailed
requirements about how these funds could be spent.
Oversight of subpart 1 was further limited because spending plans
states provided on the annual forms may not reliably show how states
actually spent Title IV-B funds. HHS officials explained that states'
actual expenditures may vary from planned expenditures as states
address unforeseen circumstances. The timing for submitting the annual
forms also affected how well states could plan Title IV-B spending. HHS
required states to submit their initial spending plans for the upcoming
year by June 30, prior to states receiving information on program
appropriations for the upcoming year. While we did not conduct a review
comparing state submitted planned expenditures to actual expenditures
for previous years, we did identify instances that suggested
differences in planned and actual expenditures as well as data on
actual expenditures that were not always accurate. For example, two
states with county-administered child welfare systems said they could
not reliably estimate planned spending by service category because the
states did not collect expenditure data from county child welfare
agencies that administer Title IV-B funds.[Footnote 9]
One regional official explained that the only way to determine how a
state actually used its Title IV-B funds was to review its financial
accounts. At the time of our review, three regional offices had
indicated that they had begun asking states to provide Title IV-B
expenditure data.
HHS Regional Offices Were Unaware of Spending Limits or Did Not Enforce
Them:
HHS regional offices paid little attention to the statutory limits on
the use of subpart 1 funds for foster care maintenance and adoption
assistance. Officials in only 1 of HHS's 10 regional offices said that
they ensured state plans complied with statutory spending limits for
subpart 1. In contrast, 5 regional offices were unaware that any limits
on the use of subpart 1 funds existed. Four other regional offices were
aware that some limitations existed, but did not ensure state
compliance with them.
Two regional offices said they did not monitor planned expenditures for
subpart 1 because they had no data to calculate the spending limit for
each state, and HHS had not provided guidance on how to enforce the
limits. Officials in another region said that their office discontinued
subpart 1 compliance reviews because they considered the limits to be
meaningless because state and federal funds are fungible and state
funds spent on child welfare services greatly exceeded subpart 1federal
funds. In other words, any attempt to enforce the limits, according to
these officials, would only lead to changes in how states accounted for
state and federal funds.
Some states reported in our survey that they spent 2002 subpart 1 funds
in excess of the statutory authority for foster care maintenance and
adoption assistance payments. (See fig. 4.) While spending excesses
were small in some states, they were large in others, ranging from a
low of $27,000 in New Hampshire to nearly $4 million in Michigan. In
total, reported actual spending by the 10 states exceeded the statutory
limit by over $15 million.
Figure 3: States Reporting Actual Expenditures in Excess of Statutory
Authority for Foster Care Maintenance and Adoption Assistance Payments
under Title IV-B, Subpart 1, Fiscal Year 2002:
[See PDF for image]
[End of figure]
Subsequent to our review, ACF issued guidance to states reminding them
of the statutory spending limits for Title IV-B subpart 1 funds in
November 2003. This guidance included information needed by each state
to calculate its spending limit for foster care and adoption assistance
payments, and day care related to employment or training.
Little Research Existed on the Effectiveness of Title IV-B Services:
Research on the effectiveness of services provided under subpart 1of
Title IV-B was limited, and HHS evaluations of subpart 2 services
showed no or little effect on children's outcomes. In our survey, 22
states reported providing services other than maintenance payments,
staff salaries, or administration under subpart 1; however, none of
these states had evaluated the outcomes of these services. One state
official said that few states could afford to divert resources away
from direct services to families in order to conduct formal program
evaluations, given the tremendous service needs of families involved in
the child welfare system.
Similarly, our literature review showed that few evaluations had been
conducted, and evaluations that had been conducted produced mixed
results. For example, one study evaluating a program[Footnote 10] in
Texas to increase family literacy and prevent child abuse by enhancing
parent-child interactions cited results showing positive effects on
children's measured competence and classroom behavior. However,
evaluation of the same program in New York did not consistently show
differences in outcomes for children and parents in the program
compared to those in a control group.
HHS evaluations of subpart 2 services also have shown no or little
effect, as reported by the Congressional Research Service.[Footnote 11]
The Congress required HHS to evaluate the effectiveness of programs
funded under subpart 2 as part of its initial approval of funding for
family preservation and family support services. HHS focused on the use
of subpart 2 funds in three large-scale evaluations. One looked at
overall implementation issues for the program, the second looked at the
effectiveness of two models of family preservation services (both
providing relatively intensive casework), and the third looked at the
effectiveness of a wide range of family support services. Overall, the
findings were similar across all evaluation sites showing subpart 2
services provided no or little effect in reducing out-of-home
placement, maltreatment recurrence, or improved family functioning
beyond what normal casework services achieved.[Footnote 12] No similar
large scale evaluations of time-limited reunification services or of
adoption promotion and support services have been made.
Prior Recommendations:
Our 2003 report recommended that the Secretary of HHS provide the
necessary guidance to ensure that HHS regional offices are providing
appropriate oversight of subpart 1, consider the feasibility of
collecting data on states' use of these funds to facilitate program
oversight and guidance to states, and use the information gained
through enhanced oversight of subpart 1 to inform its design of
alternative child welfare financing options. ACF agreed with our
findings and implemented guidance to states reminding them of the
statutory requirements for subpart 1 spending. ACF disagreed with our
recommendation to consider collecting data on subpart 1 expenditures.
ACF believed that its level of oversight was commensurate with the
scope and intent of subpart 1, noting that its oversight efforts are
more appropriately focused on reviews of the states' overall child
welfare systems. ACF did not comment on our recommendation to use such
data to inform the design of an alternative financing option.
Mr. Chairman, this completes my prepared statement. I would be happy to
respond to any questions you or other Members of the Subcommittee may
have.
[End of section]
Appendix I: GAO Contact and Acknowledgments:
For further information regarding this testimony, please contact me at
(202) 512-8403. Individuals making key contributions to this testimony
include Lacinda Ayers, Diana Pietrowiak, and Michelle St. Pierre.
[End of section]
Appendix II: Related GAO Products:
Lessons Learned for Protecting and Educating Children after the Gulf
Coast Hurricanes. GAO-06-680R. Washington, D.C.: May 11, 2006.
District of Columbia: Federal Funds for Foster Care Improvements Used
to Implement New Programs, but Challenges Remain. GAO-05-787.
Washington, D.C.: July 22, 2005.
Child Welfare: Better Data and Evaluations Could Improve Processes and
Programs for Adopting Children with Special Needs. GAO-05-292.
Washington, D.C.: June 13, 2005.
Indian Child Welfare Act: Existing Information on Implementation Issues
Could Be Used to Target Guidance and Assistance to States. GAO-05-290.
Washington, D.C.: April 4, 2005.
Foster Youth: HHS Actions Could Improve Coordination of Services and
Monitoring of States' Independent Living Programs. GAO-05-25.
Washington, D.C.: November 18, 2004.
D.C. Child And Family Services Agency: More Focus Needed on Human
Capital Management Issues for Caseworkers and Foster Parent Recruitment
and Retention. GAO-04-1017. Washington, D.C.: September 24, 2004.
Child And Family Services Reviews: States and HHS Face Challenges in
Assessing and Improving State Performance. GAO-04-781T. Washington,
D.C.: May 13, 2004.
D.C. Family Court: Operations and Case Management Have Improved, but
Critical Issues Remain. GAO-04-685T. Washington, D.C.: April 23, 2004.
Child and Family Services Reviews: Better Use of Data and Improved
Guidance Could Enhance HHS's Oversight of State Performance. GAO-04-
333. Washington, D.C.: April 20, 2004.
Child Welfare: Improved Federal Oversight Could Assist States in
Overcoming Key Challenges. GAO-04-418T. Washington, D.C.: January 28,
2004.
D.C. Family Court: Progress Has Been Made in Implementing Its
Transition. GAO-04-234. Washington, D.C.: January 6, 2004.
Child Welfare: States Face Challenges in Developing Information Systems
and Reporting Reliable Child Welfare Data. GAO-04-267T. Washington,
D.C.: November 19, 2003.
Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide
States Additional Information to Improve Services. GAO-03-956.
Washington, D.C.: September 12, 2003.
Child Welfare: Most States Are Developing Statewide Information
Systems, but the Reliability of Child Welfare Data Could be Improved.
GAO-03-809. Washington, D.C.: July 31, 2003.
D.C. Child and Family Services: Key Issues Affecting the Management of
Its Foster Care Cases. GAO-03-758T. Washington, D.C.: May 16, 2003.
Child Welfare and Juvenile Justice: Federal Agencies Could Play a
Stronger Role in Helping States Reduce the Number of Children Placed
Solely to Obtain Mental Health Services. GAO-03-397. Washington, D.C.:
April 21, 2003.
Foster Care: States Focusing on Finding Permanent Homes for Children,
but Long-Standing Barriers Remain. GAO-03-626T. Washington, D.C.: April
8, 2003.
Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare
Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March
31, 2003.
Foster Care: Recent Legislation Helps States Focus on Finding Permanent
Homes for Children, but Long-Standing Barriers Remain. GAO-02-585.
Washington, D.C.: June 28, 2002.
District of Columbia Child Welfare: Long-Term Challenges to Ensuring
Children's Well-Being. GAO-01-191. Washington, D.C.: December 29, 2000.
Foster Care: HHS Should Ensure That Juvenile Justice Placements Are
Reviewed. GAO/HEHS-00-42. Washington, D.C.: June 9, 2000.
Juvenile Courts: Reforms Aim to Better Serve Maltreated Children. GAO/
HEHS-99-13. Washington, D.C.: January 11, 2000.
Foster Care: States' Early Experiences Implementing the Adoption and
Safe Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999.
Foster Care: HHS Could Better Facilitate the Interjurisdictional
Adoption Process. GAO/HEHS-00-12. Washington, D.C.: November 19, 1999.
Foster Care: Effectiveness of Independent Living Services Unknown. GAO/
HEHS-00-13. Washington, D.C.: November 5, 1999.
Child Welfare: States' Progress in Implementing Family Preservation and
Support Services. GAO/HEHS-97-34. Washington, D.C.: February 18, 1997.
Child Welfare: Opportunities to Further Enhance Family Preservation and
Support Activities. GAO/HEHS-95-112. Washington, D.C.: June 15, 1995.
FOOTNOTES
[1] GAO, Child Welfare:Enhanced Federal Oversight of Title IV-B Could
Provide States Additional Information to Improve Services, GAO-03-956
(Washington, D.C.: Sept. 12, 2003).
[2] States are required to provide matching funds in order to receive
federal Title IV-B funding.
[3] HHS program instructions require states to spend at least 20
percent of their subpart 2 funds on each of the four service
categories, unless a state has a strong rationale for some other
spending patterns. By statute, states can spend no more than 10 percent
of subpart 2 funds on administrative costs.
[4] States are entitled to Title IV-E reimbursement on behalf of
children who would have been eligible for Aid to Families with
Dependent Children (AFDC) (as AFDC existed on July 16, 1996), but for
the fact that they were removed from the home of certain specified
relatives. While the AFDC program was replaced by the Temporary
Assistance for Needy Families program in 1996, eligibility for Title IV-
E payments remains tied to the income eligibility requirements of the
now defunct AFDC program. In addition, certain judicial findings must
be present for the child, and all other requirements included in
section 472 (a) and (b) of the Social Security Act must be met, in
order for the child to be eligible for Title IV-E foster care
maintenance payments.
[5] Special needs are characteristics that can make it difficult for a
child to be adopted and may include emotional, physical, or mental
disabilities, emotional disturbance, age, or being a member of a
minority race. To qualify for an adoption subsidy under Title IV-E, a
state must determine that the child cannot or should not return home; a
state must make a reasonable, but unsuccessful effort to place the
child without the subsidy; and a specific factor or condition must
exist that makes it difficult to place the child without a subsidy.
[6] Staff of the House Committee on Ways and Means, 106th Congress,
Background Material and Data on Programs Within the Jurisdiction of the
Committee on Ways and Means (Comm. Print 2000).
[7] This amount may be understated since some states may not have
separately reported administrative expenses associated with a specific
program. For example, officials in one state reported that the total
spending for a family support program included salaries for agency
staff, overhead expenses, and related staff travel.
[8] States face similar challenges addressing the service needs of
families caused by the current epidemic of methamphetamine use.
[9] Most states administer their child welfare systems at the state
level; however a few states delegate administrative responsibility and
control to counties or other local entities. Several large states, such
as California, New York, Ohio, and Pennsylvania, are county-
administered.
[10] The Home Instruction for Parents of Preschool Youngsters (HIPPY)
program has a goal to prevent academic underachievement of children
when they enter school. HIPPY works with parents in their homes or in
parent groups to increase the degree of literacy in the home. The
program also seeks to prevent child abuse by enhancing child-parent
interactions and focuses on economically disadvantaged parents who may
not be involved in parenting programs.
[11] Congressional Research Service, The Promoting Safe and Stable
Families Program: Reauthorization in the 109th Congress, April 7,
2006., pp. 10-18.
[12] U.S. Department of Health and Human Services, Evaluation of Family
Preservation and Reunification Programs, Final Report (Volumes 1 and
2), Dec. 2002.
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