SECTION 11. CHILD PROTECTION, FOSTER CARE, AND ADOPTION ASSISTANCE CONTENTS Introduction Federal Child Welfare Programs Today The Title IV-B Child Welfare Services Programs The Title IV-E Foster Care Program The Title IV-E Adoption Assistance Program The Title IV-E Adoption Incentives Payment Program The Title IV-E Foster Care Independence Program State Accountability and Federal Oversight History of Federal Review Efforts Federal Conformity Review System Interethnic and Interjurisdictional Adoption Provisions State Performance Reports Federal Waivers of Title IV-B and IV-E Provisions Recent Trends Affecting Child Welfare Populations and Programs Child Abuse and Neglect Substance Abuse ``Kinship'' Care Welfare Reform National Foster Care and Adoption Information Data Collection Systems Trends in Foster Care Caseloads National Data on Foster Care and Adoption Trends in Child Welfare and Foster Care Costs Legislative History References INTRODUCTION Child welfare services aim to improve the conditions of children and their families and to improve or provide substitutes for functions that parents have difficulty performing. Child welfare services encompass a broad range of activities, including protection of abused or neglected children, support and preservation of families, care of the homeless and neglected, support for family development, and provision of out-of-home care, including adoption. Services may help the family cope with problems or they may protect children while the family learns to perform appropriate parenting roles. It is generally agreed that it is in the best interests of children to live with their families. To this end, experts emphasize both the value of preventive and rehabilitative services and the need to limit the duration of foster care placements. However, if children must be removed, a major principle of professional social work is the provision of permanent living arrangements, either by returning children to their homes in a timely fashion or by moving children into adoption or other permanent arrangements. Many private, nonprofit and government entities work to provide child welfare services to families in need. The primary responsibility for child welfare services in the government, however, rests with the States. Each State has its own legal and administrative structures and programs that address the needs of children. The Federal Government has also been involved in efforts to improve the welfare of children in specific areas of national concern since the early 1900s. About 30 Federal programs were authorized to provide support for such services as of 2000, administered by four different Cabinet agencies and overseen by five House committees. The largest of these programs are authorized under titles IV-B and IV-E of the Social Security Act and are under the jurisdiction of the House Committee on Ways and Means. Additional programs include grants to States, local governments and nongovernmental agencies for prevention and treatment of child abuse and neglect, advocacy centers for victims of sexual abuse, services for abandoned infants and children with AIDS, promotion of adoption, child abuse-related training for judicial personnel, federally administered research and demonstration, Indian child welfare programs, family violence programs, and a number of other small programs. Of these non-Social Security Act programs, most had funding of less than $25 million in 2000. In addition, services related to child welfare may be provided at State discretion under the Social Services Block Grant (title XX of the Social Security Act), described in section 10. Finally, a $5,000 Federal adoption tax credit is available to adoptive parents to offset some of the initial expenses associated with adoption (a $6,000 credit is available for parents who adopt children with special needs; section 13). This section will focus specifically on Child Welfare, Foster Care and Adoption Assistance Programs authorized under titles IV-B and IV-E of the Social Security Act. FEDERAL CHILD WELFARE PROGRAMS TODAY The Social Security Act contains the primary sources of Federal funds available to States for child welfare, foster care, and adoption activities. These funds include both nonentitlement authorizations (for which the amount of funding available is determined through the annual appropriations process) and authorized entitlements (under which the Federal Government has a binding obligation to make payments to any person or unit of government that meets the eligibility criteria established by law). The programs include the Title IV-B Child Welfare Services and Promoting Safe and Stable Families (formerly known as Family Preservation) Programs, the Title IV-E Foster Care Program, the Title IV-E Adoption Assistance Program, the Title IV-E Foster Care Independence Program, and the Title XX Social Services Block Grant (SSBG) Program. Table 11-1 lists these programs, and describes their funding. Table 11-2 provides data on the level of Federal funds provided to States under titles IV-B and IV-E for fiscal years 1989-99, and the U.S. Department of Health and Human Services (DHHS) projections for fiscal years 2000-2005. Under SSBG States have discretion over what portion of their allocation they spend on child welfare activities, as well as a range of other activities not directly focused on children. TABLE 11-1.--FUNDING ENVIRONMENT OF THE FEDERAL PROGRAMS WHICH SUPPORT FOSTER CARE, CHILD WELFARE, AND ADOPTION SERVICES ---------------------------------------------------------------------------------------------------------------- Program Budgetary classification Federal support of total ---------------------------------------------------------------------------------------------------------------- Title IV-E Foster Care Program: Foster care assistance payments...... Authorized entitlement................. Open-ended Federal match at Medicaid rate. Placement services and administrative Authorized entitlement................. Open-ended Federal match of costs. 50 percent.\1\ Training expenses.................... Authorized entitlement................. Open-ended Federal match of 75 percent. Title IV-E Adoption Assistance Program: Adoption assistance payments......... Authorized entitlement................. Open-ended Federal match at Medicaid rate. Nonrecurring adoption expenses....... Authorized entitlement................. Open-ended Federal match of 50 percent.\2\ Placement services and administrative Authorized entitlement................. Open-ended Federal match of costs. 50 percent. Training expenses.................... Authorized entitlement................. Open-ended Federal match of 75 percent. Title IV-E Foster Care Independence Authorized entitlement................. 80 percent Federal funding, Program with a funding ceiling.\3\ Title IV-B Child Welfare Services Program: Child welfare services (subpart 1)... Nonentitlement authorization........... Federal match of 75 percent, total capped at State allotment. Promoting Safe and Stable Families Authorized entitlement................. Federal match of 75 percent, \4\ (subpart 2). with a funding ceiling.\5\ Title XX Social Services Block Grant Authorized entitlement................. 100 percent Federal funding, Program. with a funding ceiling. ---------------------------------------------------------------------------------------------------------------- \1\ Seventy-five percent matching was available from fiscal year 1994 through fiscal year 1997 for certain costs related to data collection. \2\ The Federal Government reimburses 50 percent of up to $2,000 of expenditures for any one placement. \3\ During fiscal years 1991-99, States were required to provide 50 percent matching for any Federal funding claimed that exceeded $45 million. Beginning in fiscal year 2000, the Federal share of expenditures is 80 percent. \4\ The name of this program was changed from Family Preservation and Family Support in 1997, by Public Law 105- 89. \5\ Program authorized through fiscal year 2001. Source: Compiled by House Committee on Ways and Means staff. Funds available to States from the title IV-B programs may be used for services to families and children without regard to family income. Federal matching funds for foster care maintenance payments under title IV-E are provided only in those cases in which the child would have been eligible for Aid to Families with Dependent Children (AFDC) if still in the home. All children determined to have ``special needs'' related to their being adopted, as defined under title IV-E, are eligible for reimbursement of certain non- TABLE 11-2.--FEDERAL FUNDING FOR CHILD WELFARE, FOSTER CARE, AND ADOPTION ACTIVITIES UNDER TITLES IV-B AND IV-E OF THE SOCIAL SECURITY ACT, UNDER CURRENT LAW, 1989-2005 [In millions of dollars] ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Title IV-B-1 Title IV-B-2 Title IV-E foster care State claims Title IV-E adoption assistance State Child Promoting Safe ----------------------------------------- Title IV-E claims Fiscal year Welfare and Stable Independent ---------------------------------------- Total Services Families \1\ Total \2\ Maintenance Administration/ Living Assistance Administration/ Program Program payments training \3\ Program Total \4\ payments training ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ 1989..................................................... $247 (\5\) $1,153 $646 $507 $45 $111 $86 $24 $1,555 1990..................................................... 253 (\5\) 1,473 835 638 50 136 105 31 1,912 1991..................................................... 274 (\5\) 1,819 1,030 789 60 175 130 45 2,328 1992..................................................... 274 (\5\) 2,233 1,204 1,029 70 220 161 58 2,796 1993..................................................... 295 (\5\) 2,534 1,312 1,222 70 272 198 74 3,171 1994..................................................... 295 $60 2,750 1,371 1,375 70 347 249 98 3,522 1995..................................................... 292 150 3,066 1,599 1,467 70 411 306 105 3,989 1996..................................................... 277 225 3,098 1,503 1,595 70 483 361 122 4,153 1997..................................................... 292 240 3,692 1,725 1,967 70 590 429 161 4,884 1998..................................................... 292 255 3,714 1,932 1,782 70 697 512 185 5,027 1999 \6\................................................. 292 275 4,011 1,963 2,048 70 843 621 222 5,491 2000 (estimate).......................................... 292 295 4,398 2,120 2,278 \7\ 105 991 730 261 6,081 2001 (estimate).......................................... 292 305 5,013 2,384 2,629 140 1,161 856 305 6,911 2002 (estimate)......................................... 292 (\8\) 5,426 2,580 2,846 140 1,358 1,000 358 7,216 2003 (estimate)......................................... 292 (\8\) 5,759 2,781 2,978 140 1,575 1,160 415 7,766 2004 (estimate)......................................... 292 (\8\) 6,214 2,998 3,216 140 1,810 1,333 477 8,456 2005 (estimate)......................................... 292 (\8\) 6,702 3,231 3,471 140 2,079 1,531 548 9,213 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ \1\ In fiscal years 1998 and 1999, $16 and $18 million, respectively, lapsed. \2\ Total includes administration, Statewide Automated Child Welfare Information System (SACWIS), and training expenditures, as well as maintenance payments. \3\ Includes regular administration, SACWIS costs, child placement costs, and training. \4\ Total includes administration and training expenditures and assistance payments. Differences in total due to rounding. \5\ The IV-B-2 program did not begin operation until 1994. \6\ Beginning in fiscal year 1999, title IV-E foster care and adoption assistance State claims data include Puerto Rico. \7\ Does not include additional $35 million requested through a supplemental budget request. \8\ Not authorized. Note.--Totals may differ from sum of amounts because of rounding. Source: U.S. Department of Health and Human Services. recurring costs of adoption under the Title IV-E Adoption Assistance Program. However, only AFDC- or Supplemental Security Income (SSI)-eligible ``special-needs'' children qualify for federally matched adoption assistance payments available under title IV-E. Funds available to States for the Title IV-E Foster Care Independence Program may be used for services which facilitate the transition of children from foster care to independent living, regardless of whether they are eligible for AFDC foster care assistance. In addition to the programs described above, title IV-B authorizes funds for research and demonstration activities and for direct Federal grants to public and private entities for child welfare staff training. Under title IV-E, incentive payments are authorized for States that increase their number of adoptions of foster children, including children with special needs, above specified baselines. Table 11-3 provides data on participation under the title IV-B and IV-E programs. Table 11-4 shows the Congressional Budget Office (CBO) projections for Federal foster care and adoption assist- TABLE 11-3.--PARTICIPATION IN CHILD WELFARE, FOSTER CARE, AND ADOPTION ACTIVITIES UNDER TITLES IV-B AND IV-E OF THE SOCIAL SECURITY ACT, UNDER CURRENT LAW, 1988-2004 ---------------------------------------------------------------------------------------------------------------- Title IV- Title IV-B- B-2 1 Child Promoting Title IV-E Title IV-E Title IV-E Fiscal year Welfare Safe and foster care Independent adoption Services Stable assistance Living assistance Program Families payments \1\ Program \2\ payments \1\ Program ---------------------------------------------------------------------------------------------------------------- 1988............................................ NA (\3\) 132,757 18,931 34,698 1989............................................ NA (\3\) 156,871 44,191 40,666 1990............................................ NA (\3\) 167,981 44,365 44,024 1991............................................ NA (\3\) 202,687 45,284 54,818 1992............................................ NA (\3\) 222,315 57,360 66,197 1993............................................ NA (\3\) 231,100 57,918 78,000 1994............................................ NA NA 245,000 71,081 91,200 1995............................................ NA NA 260,800 73,137 106,200 1996............................................ NA NA 273,600 85,261 124,700 1997............................................ NA NA 289,400 84,309 146,900 1998............................................ NA NA 306,500 87,446 168,400 1999 \4\........................................ NA NA 302,422 NA 195,243 2000 (estimated)................................ NA NA 319,300 NA 223,900 2001 (estimated)................................ NA NA 341,700 NA 256,400 2002 (estimated)................................ NA (\5\) 357,100 NA 292,200 2003 (estimated)................................ NA (\5\) 371,400 NA 330,200 2004 (estimated)................................ NA (\5\) 386,300 NA 369,900 ---------------------------------------------------------------------------------------------------------------- \1\ Average monthly number of recipients. \2\ Estimated. \3\ The IV-B-2 program did not begin operation until 1994. \4\ Beginning in fiscal year 1999, data for average monthly number of recipients include Puerto Rico. \5\ The IV-B-2 program is only authorized through 2001. NA--Not available. Source: U.S. Department of Health and Human Services. ance for 2000-2005. According to CBO, between 2000 and 2005, the federally funded foster care caseload is projected to increase from 314,000 to 356,000 (13 percent). Total IV-E foster care outlays are expected to increase 34 percent, from $4,139,000 in 2000 to $5,546,000 in 2005. Over the same time period, the adoption assistance caseload is projected to increase from 218,000 to 345,000 (58 percent), while total adoption assistance outlays are estimated to increase from $953 million to $1,750 million (84 percent). TABLE 11-4.--CBO BASELINE PROJECTIONS FOR THE FEDERAL FOSTER CARE AND ADOPTION ASSISTANCE PROGRAMS, FISCAL YEARS 2000-2005 [In millions of dollars] ---------------------------------------------------------------------------------------------------------------- Program 2000 2001 2002 2003 2004 2005 ---------------------------------------------------------------------------------------------------------------- Foster Care: Title IV-E caseload (in thousands)............................ 314 325 334 342 349 356 Average monthly maintenance payments (Federal share).......... $545 $564 $584 $605 $626 $648 Federal outlays (in millions of dollars): Maintenance payments........................................ 2,034 2,174 2,318 2,459 2,599 2,744 Administrative and child placement services................. 1,899 2,025 2,154 2,282 2,407 2,538 Training.................................................... 206 218 230 241 253 264 ----------------------------------------------- Total outlays............................................. 4,139 4,417 4,702 4,983 5,259 5,546 =============================================== Adoption Assistance: Title IV-E caseload (in thousands)............................ 218 242 267 292 318 345 Average monthly payments (Federal share)...................... 273 283 293 303 314 325 Federal outlays (in millions of dollars): Assistance payments......................................... 705 807 920 1,044 1,178 1,325 Administrative and child placement services................. 210 235 263 292 323 356 Training.................................................... 39 44 49 55 62 69 ----------------------------------------------- Total outlays............................................. 953 1,086 1,232 1,391 1,564 1,750 =============================================== Independent Living: Total outlays............................................. 70 123 140 140 140 140 =============================================== Total outlays........................................... 5,171 5,625 6,074 6,514 6,962 7,436 ---------------------------------------------------------------------------------------------------------------- Note.--Numbers may not add to totals due to rounding. Source: Congressional Budget Office, March 2000 baseline. The Title IV-B Child Welfare Services Programs Grants to States for child welfare services The Child Welfare Services Program under subpart 1 of title IV-B permanently authorizes 75 percent Federal matching grants to States for services that protect the welfare of children. These services: address problems that may result in neglect, abuse, exploitation or delinquency of children; prevent the unnecessary separation of children from their families and restore children to their families, when possible; place children in adoptive families when appropriate; and assure adequate foster care when children cannot return home or be placed for adoption. There are no Federal income eligibility requirements for the receipt of child welfare services. Under legislation originally enacted in 1980 (Public Law 96-272), States are limited in the amount of their title IV-B allotments that may be used for child day care, foster care maintenance payments, and adoption assistance payments. Specifically, States may use no more than their portion of the first $56.6 million in Federal title IV-B appropriations for these three activities. The intent of this restriction is to devote as much title IV-B funding as possible to supportive services that could prevent the need for out-of-home placement. In addition, the 1980 legislation required States to implement certain foster care protections for all children in foster care to be eligible to receive their full allotment of Federal title IV-B appropriations. (The foster care protections are described below.) Between 1977 and 1990, the annual authorization level for the Child Welfare Services Program remained flat at $266 million. The authorization level was increased to $325 million under Public Law 101-239 beginning for fiscal year 1990. Appropriations for the program--the amount of money Congress actually made available for spending each year--increased from $163.6 million in fiscal year 1981 to $294.6 million in fiscal year 1994. Appropriations have since decreased, to $292 million in fiscal year 1995, $277.4 million in fiscal year 1996, and have remained at $292 million since fiscal year 1997 (see table 11-2). Table 11-5 details the State-by-State distribution of child welfare service funds for selected fiscal years. Child welfare service funds are distributed to States on the basis of their under 21 population and per capita income. Because of minimal reporting requirements, no reliable data are available on the exact number of children or families served, their characteristics, or the services provided with child welfare service funds. However, a 1997 study funded by DHHS provides some information on the number and characteristics of children and families served by the child welfare system in 1994, and examines changes in this population since a similar study was conducted of children and families served in 1977 (U.S. Department, 1997). This study looks at children served by all components of the child welfare system, regardless of funding source. The study found a significant decline in the number of children receiving services from the child welfare system, from an estimated 1.8 million children in 1977 to an estimated 1 million in 1994. Of these totals, about the same number of children in each of the 2 years were in foster care (543,000 in 1977 and 502,000 in 1994). TABLE 11-5.--STATE-BY-STATE ALLOCATIONS FOR TITLE IV-B (SUBPART 1) CHILD WELFARE SERVICES, SELECTED YEARS 1989-2000 [In thousands of dollars] -------------------------------------------------------------------------------------------------------------------------------------------------------- 1989 1991 1994 1996 1997 1998 1999 2000 State actual actual actual actual actual actual actual allotments -------------------------------------------------------------------------------------------------------------------------------------------------------- Alabama........................................................ $5,136 $5,634 $5,623 $5,106 $5,327 $5,244 $5,198 $5,250 Alaska......................................................... 294 561 754 725 749 776 787 817 American Samoa................................................. 163 175 193 183 188 187 186 185 Arizona........................................................ 3,797 4,307 5,034 5,015 5,466 5,291 5,752 5,764 Arkansas....................................................... 3,095 3,369 3,424 3,178 3,359 3,349 3,213 3,301 California..................................................... 23,100 26,521 31,732 31,049 32,760 33,893 34,075 34,160 Colorado....................................................... 3,091 3,482 3,866 3,719 3,935 3,959 4,009 3,857 Connecticut.................................................... 2,143 2,123 2,120 2,052 2,154 2,075 2,050 1,885 Delaware....................................................... 654 716 726 713 756 688 689 701 District of Columbia........................................... 432 469 447 345 346 333 327 319 Florida........................................................ 10,361 11,771 13,146 12,781 13,708 13,806 13,930 14,210 Georgia........................................................ 7,301 8,002 8,426 8,032 8,502 8,479 8,584 8,679 Guam........................................................... 342 375 351 329 340 338 336 335 Hawaii......................................................... 1,119 1,247 1,204 1,117 1,179 1,207 1,189 1,196 Idaho.......................................................... 1,388 1,576 1,703 1,622 1,736 1,753 1,760 1,766 Illinois....................................................... 10,773 11,488 11,773 11,067 11,684 11,633 11,663 11,556 Indiana........................................................ 6,064 6,677 6,952 6,367 6,697 6,613 6,575 6,604 Iowa........................................................... 3,074 3,223 3,475 3,223 3,358 3,310 3,318 3,290 Kansas......................................................... 2,461 2,779 3,068 2,873 3,011 3,001 2,996 3,055 Kentucky....................................................... 4,556 4,934 5,030 4,624 4,842 4,806 4,752 4,647 Louisiana...................................................... 5,657 6,368 6,527 5,910 6,195 6,015 5,824 5,842 Maine.......................................................... 1,391 1,477 1,482 1,378 1,432 1,443 1,428 1, 406 Maryland....................................................... 3,798 4,074 4,343 4,156 4,358 4,453 4,386 4,457 Massachusetts.................................................. 4,418 4,498 4,708 4,579 4,792 4,624 4,681 4,627 Michigan....................................................... 9,551 10,047 10,885 10,075 10,487 10,118 10,130 10,178 Minnesota...................................................... 4,206 4,537 5,092 4,785 5,022 4,913 4,915 4,704 Mississippi.................................................... 3,923 4,244 4,293 3,949 4,146 4,051 4,019 4,016 Missouri....................................................... 5,235 5,654 6,146 5,727 5,998 6,055 6,078 6,066 Montana........................................................ 1,049 1,125 1,207 1,158 1,203 1,201 1,183 1,176 Nebraska....................................................... 1,744 2,087 2,071 1,879 1,968 1,991 1,995 2,002 Nevada......................................................... 964 1,123 1,401 1,379 1,516 1,625 1,711 1,786 New Hampshire.................................................. 1,024 498 1,087 1,096 1,152 1,137 1,135 1,134 New Jersey..................................................... 5,465 5,412 5,224 5,368 5,669 5,679 5,542 5,718 New Mexico..................................................... 2,072 2,282 2,510 2,418 2,541 2,530 2,511 2,535 New York....................................................... 14,373 15,245 15,452 14,148 14,808 14,817 14,767 14,539 North Carolina................................................. 7,189 7,916 8,112 7,728 8,229 8,179 8,291 8,440 North Dakota................................................... 849 908 945 858 891 893 874 862 Northern Marianas.............................................. 118 124 142 136 139 138 138 137 Ohio........................................................... 10,429 12,195 12,878 11,853 12,386 11,996 11,901 11,397 Oklahoma....................................................... 3,735 4,114 4,406 4,133 4,310 4,325 4,295 4,316 Oregon......................................................... 2,850 3,162 3,556 3,321 3,531 3,582 3,580 3,594 Pennsylvania................................................... 11,236 12,011 12,148 11,076 11,583 11,515 11,350 11,347 Puerto Rico.................................................... 3,674 7,100 8,105 7,480 7,787 7,722 7,662 7,631 Rhode Island................................................... 953 1,032 1,054 984 1,012 993 986 1,007 South Carolina................................................. 4,468 4,876 4,948 4,544 4,696 4,613 4,670 4,682 South Dakota................................................... 938 1,015 1,075 991 1,029 1,028 1,001 1,023 Tennessee...................................................... 5,598 6,137 6,210 5,792 6,100 5,959 5,946 5,937 Texas.......................................................... 18,958 21,476 23,795 22,401 23,783 23,889 24,264 24,511 Utah........................................................... 2,891 3,192 3,474 3,284 3,469 3,475 3,519 3,561 Vermont........................................................ 583 717 715 674 703 710 701 685 Virginia....................................................... 5,463 5,905 6,373 6,114 6,408 6,444 6,459 6,458 Virgin Islands................................................. 295 310 280 263 271 269 268 267 Washington..................................................... 4,382 4,968 5,699 5,231 5,512 5,679 5,725 5,804 West Virginia.................................................. 2,397 2,519 2,486 2,189 2,251 2,243 2,183 2,157 Wisconsin...................................................... 5,077 5,442 6,022 5,574 5,854 5,742 5,729 5,748 Wyoming........................................................ 382 689 724 638 661 671 662 659 ---------------------------------------------------------------------------------------- Total.................................................... 246,679 273,907 294,624 277,389 291,989 291,458 291,896 291,986 -------------------------------------------------------------------------------------------------------------------------------------------------------- Note.--Totals may differ from sum of State amounts due to rounding. Source: U.S. Department of Health and Human Services. However, DHHS found a sharp drop in the number of children receiving services while still living at home, and a substantial increase in the percent of children who were receiving services as a result of abuse or neglect (45 percent in 1977 compared with 80 percent in 1994). The report suggests that child welfare agencies today are dealing with more difficult cases that require more extensive services and therefore have been forced to set priorities and narrow their focus from a broader population of children and families to those in more immediate crisis. The report found that, despite the goals of Public Law 96-272, the same number of children were in foster care in 1994, as compared with 1977, and foster care ``drift'' remained a problem. The report also found a major shift in the racial composition of children in the system, with minority children increasing from 40 percent of those served in 1977 to 54 percent in 1994. Moreover, the report found that minority children, especially African- American children, were more likely to be placed in foster care than to receive in-home services, even when they presented the same problems and characteristics as white children. Finally, the report examined the longer lengths of stay in foster care experienced by African-American and Hispanic children in 1994 and concluded that higher rates of kinship care did not necessarily explain this phenomenon, since minority children remained in out-of-home care longer than white children, regardless of the type of placement. Grants to States for promoting safe and stable families Grants to States for family preservation and family support services were originally authorized as a capped entitlement under subpart 2 of title IV-B, beginning in fiscal year 1994. States already had the flexibility to expend their child welfare services funds available under subpart 1 of title IV-B for family support and preservation activities, but few States used a significant share of such funds for these two categories of services. Entitlement funding was authorized for 5 years at the following ceiling levels: $60 million in fiscal year 1994; $150 million in 1995; $225 million in 1996; $240 million in 1997; and either $255 million in 1998 or the 1997 level adjusted for inflation, whichever is greater. The Adoption and Safe Families Act (Public Law 105-89), enacted in November 1997, reauthorized and changed the name of this program to Promoting Safe and Stable Families. Entitlement ceilings are now set at the following levels: $275 million for 1999, $295 million for 2000, and $305 million for 2001. From these ceiling amounts, $2 million in fiscal year 1994 and $6 million in each subsequent fiscal year are reserved for use by the Secretary of DHHS to fund research, training, technical assistance and evaluation of family preservation and support activities. In addition, $5 million in fiscal year 1995 and $10 million in each subsequent fiscal year are reserved for a grant program for State courts (described below). Finally, 1 percent of the entitlement is reserved for allotment to Indian tribes. After these set-asides are made, remaining entitlement funds are allocated among States according to their relative shares of children receiving food stamps, subject to a 25- percent non-Federal match. Table 11-6 shows State allotments of promoting safe and stable families entitlement funds in fiscal years 1997-2000. TABLE 11-6.--TITLE IV-B PROMOTING SAFE AND STABLE FAMILIES \1\ PROGRAM: STATE-BY-STATE ALLOCATIONS ---------------------------------------------------------------------------------------------------------------- Fiscal year State Fiscal year Fiscal year Fiscal year 2000 1997 actual 1998 actual 1999 actual allotments ---------------------------------------------------------------------------------------------------------------- Alabama............................................... $4,298,428 $4,587,680 $4,998,474 $5,467,218 Alaska................................................ 343,874 389,953 447,625 529,555 American Samoa........................................ 159,031 164,480 171,567 179,043 Arizona............................................... 4,126,491 4,495,927 4,774,662 5,070,424 Arkansas.............................................. 2,106,230 2,202,087 2,412,199 2,716,339 California............................................ 29,852,578 33,398,317 37,749,671 40,544,805 Colorado.............................................. 2,256,675 2,247,963 2,362,463 2,496,711 Connecticut........................................... 1,805,340 1,995,641 2,138,651 2,349,394 Delaware.............................................. 451,335 481,706 522,229 586,057 District of Columbia.................................. 752,225 825,782 920,117 1,031,541 Florida............................................... 11,691,723 12,203,230 13,105,452 14,020,393 Georgia............................................... 6,297,197 6,766,829 7,559,881 8,335,896 Guam.................................................. 274,029 286,517 302,757 319,890 Hawaii................................................ 773,717 894,598 1,019,589 1,222,967 Idaho................................................. 623,272 688,152 746,041 812,739 Illinois.............................................. 8,682,824 9,404,745 10,046,684 11,393,553 Indiana............................................... 3,890,077 3,945,405 3,978,885 3,909,002 Iowa.................................................. 1,504,450 1,536,873 1,641,290 1,760,182 Kansas................................................ 1,396,989 1,513,935 1,666,158 1,811,435 Kentucky.............................................. 3,696,648 3,738,960 4,003,753 4,411,229 Louisiana............................................. 6,447,642 6,468,629 6,888,444 7,195,319 Maine................................................. 924,162 940,474 969,853 1,066,598 Maryland.............................................. 3,030,392 3,303,130 3,680,469 4,079,010 Massachusetts......................................... 3,632,171 3,784,836 3,978,885 4,149,338 Michigan.............................................. 7,995,076 8,349,578 8,952,491 9,485,814 Minnesota............................................. 2,600,549 2,752,608 2,934,428 2,998,745 Mississippi........................................... 4,019,030 4,197,728 4,327,037 4,532,892 Missouri.............................................. 4,470,365 4,748,249 5,172,550 5,577,218 Montana............................................... 515,811 550,522 646,569 714,863 Nebraska.............................................. 924,162 963,413 1,019,589 1,078,461 Nevada................................................ 752,225 848,721 920,117 1,049,293 New Hampshire......................................... 429,843 481,706 497,361 523,548 New Jersey............................................ 4,212,459 4,541,804 5,147,682 5,616,230 New Mexico............................................ 1,934,292 2,064,456 2,262,991 2,485,020 New York.............................................. 15,237,926 (\2\) (\2\) (\2\) North Carolina........................................ 4,814,239 5,069,387 5,520,703 6,068,954 North Dakota.......................................... 343,874 344,076 348,152 379,765 Northern Marianas..................................... 121,935 125,114 129,247 133,608 Ohio.................................................. 9,499,525 9,634,129 9,972,080 10,110,000 Oklahoma.............................................. 2,750,994 3,004,931 3,232,844 3,490,646 Oregon................................................ 2,041,753 2,225,025 2,437,067 2,631,579 Pennsylvania.......................................... 8,489,395 8,854,223 9,574,192 10,468,059 Puerto Rico........................................... 5,901,525 6,258,461 6,722,614 7,212,312 Rhode Island.......................................... 752,225 825,782 895,249 989,602 South Carolina........................................ 3,116,360 3,349,007 3,556,128 3,927,057 South Dakota.......................................... 429,843 458,768 472,493 533,640 Tennessee............................................. 5,287,066 5,551,093 5,669,911 5,999,983 Texas................................................. 21,169,757 22,892,526 24,793,426 26,985,190 Utah.................................................. 1,096,099 1,123,982 1,143,929 1,225,329 Vermont............................................... 429,843 458,768 522,229 536,382 Virginia.............................................. 3,933,061 4,404,173 4,874,134 5,300,937 Virgin Islands........................................ 222,094 231,404 243,510 256,282 Washington............................................ 3,481,726 3,830,713 4,351,905 4,833,043 West Virginia......................................... 2,493,088 2,523,224 2,287,859 2,486,708 Wisconsin............................................. 2,836,962 2,959,054 3,158,240 3,270,921 Wyoming............................................... 279,398 298,199 323,284 349,572 --------------------------------------------------------- Subtotal........................................ 221,600,000 220,186,673 238,195,810 276,050,000 ========================================================= Set-asides: Indians (1 percent)............................... 2,400,000 2,550,000 2,750,000 2,950,000 Research and evaluation........................... 6,000,000 6,000,000 5,953,061 6,000,000 Courts............................................ 10,000,000 10,000,000 10,000,000 10,000,000 --------------------------------------------------------- Subtotal........................................ 18,400,000 18,550,000 18,703,061 18,950,000 ========================================================= Lapsed funds 0 16,263,327 18,057,129 19,339,709 ========================================================= Total......................................... 240,000,000 255,000,000 274,956,000 295,000,000 ---------------------------------------------------------------------------------------------------------------- \1\ The name of this program was changed from Family Preservation and Family Support in 1997 by Public Law 105- 89. \2\ New York did not apply for its allotment for these years; as a result, their funds lapsed. Note.--Totals may differ from sum of State amounts because of rounding Source: U.S. Department of Health and Human Services. States must submit a plan to the U.S. Department of Health and Human Services (DHHS) that provides a detailed account of how the money will be used. Prior to the enactment of Public Law 105-89, at least 90 percent of the funds had to be used for two categories of services: family preservation services and community-based family support services. Public Law 105-89 added two additional categories: time-limited family reunification services, and adoption promotion and support services. No more than 10 percent of funds can be used for administration. The Federal statute does not specify a percentage or minimum amount of funds that must be spent on any particular category of service, but says that States must devote ``significant portions'' of their expenditures to each of the four categories. DHHS issued program instructions on March 5, 1998, and March 25, 1999, specifying that States must have a ``strong rationale'' for spending less than 20 percent of their allotments on each of the four categories of services. Family preservation services are intended for children and families, including extended and adoptive families, that are at risk or in crisis. Services include: programs to help reunite children with their biological families, if appropriate, or to place them for adoption or another permanent arrangement; programs to prevent placement of children in foster care, including intensive family preservation services; programs to provide followup services to families after a child has been returned from foster care; respite care to provide temporary relief for parents and other care givers (including foster parents); and services to improve parenting skills. Family support services are intended to reach families which are not yet in crisis and to prevent child abuse or neglect from occurring. Family support services are generally community-based activities designed to promote the well-being of children and families, to increase the strength and stability of families (including adoptive, foster and extended families), to increase parents' confidence and competence, to provide children with a stable and supportive family environment, and to enhance child development. Examples include parenting skills training, respite care to relieve parents and other care givers, structured activities involving parents and children to strengthen their relationships, drop-in centers for families, information and referral services, and early developmental screening for children. As added by Public Law 105-89, time-limited reunification services are services and activities intended to facilitate the safe and appropriate reunification of children who have been removed from home and placed in foster care with their parents in a timely fashion; i.e., within 15 months of having entered foster care. Reunification services for children and their families include counseling, substance abuse treatment services, mental health services, assistance to address domestic violence, temporary child care and therapeutic services such as crisis nurseries, and transportation to and from these activities. Adoption promotion and support services, also added to the law by Public Law 105-89, are services and activities designed to encourage more adoptions out of the foster care system, including pre- and postadoptive services and activities designed to expedite adoptions and support adoptive families. In regulations proposed on October 4, 1994, and made final on November 18, 1996, DHHS set forth a series of child and family services ``principles'' that were intended to guide State implementation of the program. According to DHHS, these principles emphasize the paramount importance of safety for all family members, including victims of child abuse and neglect and victims of domestic violence and their dependents. In the preamble to its regulations, DHHS stated that family preservation ``does NOT mean that the family must stay together or `be preserved' under all circumstances.'' The principles also were intended to support a family-focused approach while allowing for individual needs, and a service delivery approach that stresses flexibility, accessibility, coordination, and respect for cultural and community strengths. The Secretary of DHHS is required to evaluate activities under subpart 2 of title IV-B. In September 1994, the Secretary funded three evaluation projects: a study of the implementation of family preservation and family support; a national evaluation of family preservation and reunification programs; and a national evaluation of family support programs. These projects are still underway and no final reports on the national evaluations have yet been published. However, as part of this evaluation, contractors (Westat, James Bell Associates, Chapin Hall Center for Children) submitted two products in May 1995, including a literature review of existing research on family preservation and family reunification and a description of the range of program models then in existence (U.S. Department, 1995a, 1995b). Although numerous studies had been conducted of individual programs, leading to initial enthusiasm for the family preservation approach, the 1995 literature review found ``little solid evidence'' that demonstrated that programs designed to prevent foster care placement or to reunify families had achieved their intended goals. According to the literature review summary, nonexperimental studies had produced misleading results, and the few controlled studies that had been conducted had produced mixed findings. The research suggested that family preservation programs had only modest effects on family and child functioning, although the contractors suggested that it would be unrealistic to expect dramatic results in this area, given the scope of problems facing child welfare clients and the short-term nature of family preservation services. Regarding family reunification, the contractors noted that evaluations of such programs were still very preliminary but that a few studies had reported encouraging results. In 1998, the contractors submitted a final report on one specific family reunification project, known as HomeRebuilders in New York City (Westat et al., 1998). This project began in 1993 and tested an alternative payment method for foster care in which six local agencies received a flat rate for serving an identified group of children in foster care for a 3-year period. These funds could be used for foster care or any service the agencies believed would achieve permanency. Funding was ``front-loaded'' in the first year to encourage early discharge, and agencies could retain any savings they realized if the children left foster care before the end of the 3 years (see below). The impact of HomeRebuilders varied across the six participating agencies. Earlier discharge from foster care and fewer days in care was achieved in one of the three agencies using random assignment, with a 13 percent difference between the experimental and control groups. This outcome did not occur at the other two random assignment sites, however, although one of the nonrandom assignment agencies did show fewer days in foster care. The contractors concluded that changes in fiscal incentives alone are not likely to result in major child welfare reform, but that other factors are needed for reform to occur, such as clear decisionmaking protocols, triage strategies, and data systems that can be used for case and program management. Most recently, James Bell Associates released an interim report (1999a) on the family preservation and family support services implementation study, reporting on State and local planning efforts, the relationship of planning to service delivery, and the design of programs. The contractor found that services did not fall neatly into the categories of family preservation and family support as defined in the legislation, although the majority of services were in general more characteristic of family support programs. This is also consistent with the findings of the U.S. General Accounting Office (GAO), which reported in 1997 that States were using more than half their funds for family support services, which are designed for a broader population than family preservation activities. Court Improvement Program A portion of the promoting safe and stable families entitlement funds is reserved for a grant program to the highest State courts to assess and improve certain child welfare proceedings. The court set-aside equals $5 million in fiscal year 1995 and $10 million in each of fiscal years 1996- 2001. A 25-percent non-Federal match is required in each of the last 6 fiscal years. Courts use their grant funds to assess their procedures and effectiveness in determinations regarding foster care placement, termination of parental rights (TPR), and recognition of adoptions. Courts also can use these grant funds to implement changes found necessary as a result of the assessments. According to DHHS, 49 States and the District of Columbia were participating in this program, as of fiscal year 1999. South Carolina was no longer participating in the program. According to a review conducted for DHHS on court improvement activities during 1995-98, States conducted thorough assessments of their judicial systems and came up with various recommendations (James Bell Associates, 1999b). Categories where improvement was most commonly recommended were: representation of parties, timeliness of decisions, management information systems, quality of court hearings, judicial expertise, multidisciplinary training for court participants, coordination between the courts and child welfare agency or service providers, treatment and participation of parties, and resources for courts and social services. The activities most commonly implemented included: development of training and educational materials; pilot programs; revision of legislation, court rules and judicial directives; development of automated case tracking systems, public relations campaigns and local work groups; supplemental assessments or studies; increased number of attorneys, judges and other court personnel; hiring of court improvement coordinating staff; and improved treatment of parties. The report found that court improvement changes were still at an early stage, partially because initial assessments took longer to complete than expected and also because reforms requiring new legislation or staff require time to implement. However, the report concluded that the Court Improvement Program had raised the visibility of courts within the child welfare system and provided States with flexibility and resources to address court-related challenges. Child welfare research, training, studies In addition to providing funds to the States for services, title IV-B authorizes the Secretary of DHHS to make direct grants for research and demonstration, training, and studies. Specifically, section 426 authorizes direct grants from DHHS to public and private organizations and institutions of higher education for research and demonstration projects related to child welfare, and for training projects for personnel in the child welfare field. For fiscal year 2000, $7 million was appropriated for child welfare training, but no funding was provided for research and demonstration under section 426. Section 429A was added to title IV-B by the welfare reform legislation enacted in 1996 (Public Law 104-193). This provision authorized and appropriated funds for DHHS to conduct a national longitudinal study of children at risk for abuse or neglect, and of children who have been identified as victims of abuse or neglect. For this study, the welfare reform law appropriated $6 million for each of fiscal years 1996-2002; however, Congress subsequently rescinded the appropriations for fiscal years 1996-2000, with the understanding that adequate funding was available for the study in the broader appropriation for social services and income maintenance research. In response to the section 429A provision, DHHS has undertaken the National Survey of Child and Adolescent Well- Being through a contract with Research Triangle Institute and subcontracts with the University of California at Berkeley, the University of North Carolina at Chapel Hill, and Caliber Associates. DHHS anticipates that this study will provide nationally representative data on children and families that come into contact with the child welfare system, which will enable analysis of child and family well-being outcomes in relation to the experience of children and families with the child welfare system, as well as characteristics of the families, the community environment, and other factors. The study is being conducted over a 6-year period (1997-2003) and will include a sample of more than 6,000 children, ages 0-14, from 100 child welfare agencies nationwide. The Title IV-E Foster Care Program Eligibility criteria The Foster Care Program under title IV-E is a permanently authorized entitlement that provides open-ended matching payments to States for the costs of maintaining certain children in foster care, and associated administrative, child placement, and training costs. Several eligibility criteria apply to the foster children on whose behalf Federal reimbursement is available to States. First, children must have been removed from families that would have been eligible for Aid to Families with Dependent Children (AFDC), as the program existed in their State on July 16, 1996. Although welfare reform legislation enacted in 1996 (Public Law 106-193) repealed the AFDC Program, its eligibility criteria continue to be used for determining children's eligibility under title IV- E. Under Public Law 106-193 as originally enacted, foster children would be eligible under title IV-E if their families met the AFDC criteria of June 1, 1995; however, technical corrections enacted in 1997 changed this date to July 16, 1996 (Public Law 105-33). The welfare reform legislation replaced AFDC with a block grant to States called Temporary Assistance for Needy Families (TANF), and requires all States participating in TANF to certify that they will operate a Foster Care and Adoption Assistance Program under title IV-E. States are required to provide foster care maintenance payments to AFDC-eligible children removed from the home of a relative if the child received or would have received AFDC prior to removal from the home and if the following also apply: (1) the removal and foster care placement were based on a voluntary placement agreement signed by the child's parents or guardians or a judicial determination that remaining in the home would be contrary to the child's welfare; (2) reasonable efforts were made to eliminate the need for removal or to return the child home (unless certain exceptions apply, which are described later in the section); and (3) care and placement of the child are the responsibility of the State. Children whose expenses are eligible for reimbursement under title IV-E also are deemed eligible for Medicaid. Finally, States may claim reimbursement on behalf of eligible children who have been placed in licensed or approved foster family homes or child care institutions, which can be public or private, including both for-profit and nonprofit. Public child care institutions can accommodate no more than 25 children, although no limitation applies to the size of private institutions. Detention facilities for children determined to be delinquent are not eligible for Federal reimbursement under title IV-E. Financing structure The Federal matching rate for foster care maintenance payments for a given State is that State's Medicaid matching rate, which is inversely related to State per capita income and can range from 50 to 83 percent. States may claim open-ended Federal matching at a rate of 50 percent for their child placement services and administrative costs, including costs of data collection. States may claim open-ended Federal matching at a rate of 75 percent for costs of training personnel employed (or preparing for employment) by State or local agencies administering the program and for training current and prospective foster and adoptive parents. During fiscal years 1994-97, States also were able to receive Federal matching at the 75 percent rate for certain costs related to the development of Statewide Automated Child Welfare Information Systems (SACWIS); currently, these costs are matched at the 50 percent rate. Foster care expenditures and participation rates The average estimated monthly number of children in title IV-E foster care more than tripled between 1983 and 1999, from 97,370 in fiscal year 1983 to 302,422 in fiscal year 1999 (table 11-3). During those same years, Federal spending on title IV-E foster care increased more than tenfold, from $395 million in fiscal year 1983 to $4 billion in fiscal year 1999. Table 11-7 provides a State breakdown of foster care expenditures in fiscal year 1999, showing maintenance payments, child placement services and administration, information systems, and training expenditures. Note that California, New York, Pennsylvania and Illinois accounted for 49 percent of total Federal foster care expenditures in fiscal year 1999. TABLE 11-7.--FEDERAL FOSTER CARE EXPENDITURES UNDER TITLE IV-E, FISCAL YEAR 1999 [In thousands of dollars] ---------------------------------------------------------------------------------------------------------------- Child Maintenance placement State payments services and SACWIS Training Total administration ---------------------------------------------------------------------------------------------------------------- Alabama............................................ $2,533 $5,801 $3,769 $1,137 $13,240 Alaska............................................. 2,338 6,209 361 511 9,418 Arizona............................................ 25,625 26,738 -660 2,612 54,316 Arkansas........................................... 8,172 16,610 787 6,488 32,057 California......................................... 437,765 427,894 12,192 33,950 911,802 Colorado........................................... 7,993 25,584 6,902 2,070 42,548 Connecticut........................................ 33,044 54,934 0 3,799 91,777 Delaware........................................... 1,650 5,723 347 586 8,306 District of Columbia............................... 22,377 17,011 3,557 0 42,946 Florida............................................ 39,090 67,183 3,886 10,609 120,768 Georgia............................................ 19,975 18,003 1,258 3,657 42,893 Hawaii............................................. 4,916 8,640 0 2,258 15,813 Idaho.............................................. 1,293 6,338 334 -43 7,922 Illinois........................................... 100,774 152,903 10,580 9,011 273,267 Indiana............................................ 30,425 16,592 5,613 688 53,319 Iowa............................................... 19,553 8,809 0 1,260 29,623 Kansas............................................. 20,203 10,269 0 419 30,892 Kentucky........................................... 22,464 12,647 1,928 9,070 46,108 Louisiana.......................................... 29,734 17,344 0 3,058 50,136 Maine.............................................. 27,835 1,842 1,249 1,257 32,183 Maryland........................................... 42,415 47,779 606 5,928 96,728 Massachusetts \1\.................................. 28,415 45,735 1,039 41 75,229 Michigan........................................... 67,906 65,983 0 2,067 135,956 Minnesota.......................................... 30,445 30,393 3,828 7,929 72,595 Mississippi........................................ 2,769 8,058 -2,123 787 9,491 Missouri........................................... 33,757 30,138 749 8,975 73,619 Montana............................................ 4,031 2,764 826 173 7,794 Nebraska........................................... 13,219 6,839 0 5,829 25,887 Nevada............................................. 4,407 4,460 5,380 509 14,756 New Hampshire...................................... 5,756 3,693 1,855 543 11,847 New Jersey......................................... 32,529 12,100 13 998 45,641 New Mexico......................................... 4,145 6,063 15 4,144 14,367 New York........................................... 302,376 160,352 11,278 8,031 482,037 North Carolina..................................... 33,494 25,340 832 4,871 64,537 North Dakota....................................... 4,144 5,862 330 873 11,209 Ohio............................................... 116,128 80,983 838 9,940 207,889 Oklahoma........................................... 14,714 12,450 0 5,254 32,418 Oregon............................................. 12,628 16,981 79 1,812 31,499 Pennsylvania....................................... 169,269 125,280 5,908 15,946 316,403 Puerto Rico........................................ 7,281 0 0 0 7,281 Rhode Island....................................... 4,541 7,385 -9 671 12,588 South Carolina..................................... 8,066 4,774 2,125 2,269 17,234 South Dakota....................................... 2,264 1,828 446 61 4,598 Tennessee.......................................... 13,902 7,953 447 2,887 25,189 Texas.............................................. 63,755 17,549 0 5,660 86,964 Utah............................................... 3,519 13,726 2,093 1,612 20,950 Vermont............................................ 8,705 2,644 0 650 11,999 Virginia........................................... 16,756 23,867 0 3,699 44,322 Washington......................................... 11,271 15,694 976 1, 358 29,299 West Virginia...................................... 11,474 2,526 2,971 758 17,729 Wisconsin.......................................... 29,565 55,130 3,722 3,238 91,654 Wyoming............................................ 1,206 551 435 0 2,192 ------------------------------------------------------------ Total........................................ 1,962,611 1,751,955 96,759 199,910 4,011,236 ---------------------------------------------------------------------------------------------------------------- \1\ Fiscal year 1999 data include estimates for the third and fourth quarters. Note.--Totals may differ from sum of State amounts due to rounding. Source: U.S. Department of Health and Human Services. Federal expenditures for child placement services, administrative costs, and training have grown more rapidly than expenditures for foster care maintenance payments. For example, expenditures for child placement services, administration, and training in fiscal year 1983 equaled $118 million, or 30 percent of total Federal foster care expenditures. In fiscal year 1999, Federal expenditures for child placement services, administration, and training totaled almost $2 billion, or 49 percent of total Federal expenditures for foster care. DHHS regulations give the following examples of allowable child placement services and administrative costs for foster care under title IV-E: referral to services, preparation for and participation in judicial determinations, placement of the child, development of the case plan, case reviews, case management and supervision, recruitment and licensing of foster homes and institutions, rate setting, and a proportionate share of agency overhead. In addition, Federal matching is available for certain expenses related to data collection and automation of child welfare information systems (see below). Expenditures for child placement services and administration also include expenditures made on behalf of children before and during the time a title IV-E eligibility determination is made; as a result, Federal reimbursement is provided for expenditures made for some children who, ultimately, are determined not eligible for title IV-E maintenance payments. In 1987, the DHHS Inspector General reported that administrative costs associated with the Foster Care Program were much higher than those associated with similar programs, such as the former AFDC Program, Medicaid, and the Food Stamp Program (Office, 1987). However, the additional spending was attributed to the fact that regulations implementing Public Law 96-272 expressly defined many activities as allowable administrative costs that had not been reimbursed by the Federal Government prior to 1980, when foster care was part of AFDC. The Inspector General subsequently reported in 1990 that the term ``administrative costs'' is a misnomer (Office, 1990). Most of the activities being funded are not traditional administrative costs, but are child placement services required by the law. The Inspector General determined that the significant increases in Federal reimbursement for so-called ``administrative'' costs occurred for two primary reasons: the expanded definition of administrative costs provided in Public Law 96-272, and a broad interpretation of that definition by the DHHS Departmental Appeals Board. Other factors, according to the Inspector General's 1990 report, included States' use of consultants, an increase in the number of title IV-E children, increases in the number of caseworkers, and cost-of-living increases for State employees. In response to concerns about the rapid growth in administrative costs, the 101st Congress enacted legislation as part of the Omnibus Budget Reconciliation Act of 1990 (Public Law 101-508) that was intended to provide better information on State reimbursement for administrative costs. Under Public Law 101-508, ``child placement services'' was added as a separate category for which States may claim reimbursement, in addition to administrative costs. Prior to this provision, child placement services were included among administrative costs and not identified separately. DHHS reports that of claims filed for child placement and administrative costs in fiscal year 1999, 49 percent were for case planning and management activities, 18 percent were for preplacement activities, 4 percent were for eligibility determinations, and the remaining 28 percent were for other activities including traditional administrative and overhead costs. Foster care payment rates Table 11-8 shows each State's ``basic'' monthly foster care payment rates in 1987, 1991, 1994, and 1998 for children ages 2, 9, and 16, as reported in surveys conducted by the American Public Human Services Association (APHSA) and the Child Welfare League of America. States are allowed to set the payments at any level; thus, the rates vary widely. The basic monthly foster care rates shown in the table are those paid for family foster care, and differ from rates paid for group or congregate care. The family foster care rates shown in the table are only generally comparable due to variations among States regarding the items that are covered under the basic rate, additional services that are provided by supplements, and the States' administrative structures. Table 11-8 indicates whether the basic rate includes each of the following three items: room and board (r); supervision (s); and clothing (c). States include other items in their basic rates, such as child care, respite care, transportation, personal allowance, school supplies, recreational and community activities, and incidentals. In addition, many States and counties supplement their basic rates, for items such as education, child care, respite care, level of need, clothing, transportation, health and medical care (other than Medicaid or State-funded medical assistance), and special emotional, behavioral, medical, or psychological needs. TABLE 11-8.--FOSTER CARE BASIC MONTHLY MAINTENANCE RATES FOR CHILDREN AGES 2, 9, AND 16, SELECTED YEARS 1987-98 -------------------------------------------------------------------------------------------------------------------------------------------------------- Age 2 Age 9 Age 16 State ----------------------------------------------------------------------------------------------- 1987 1991 1994 1998 1987 1991 1994 1998 1987 1991 1994 1998 -------------------------------------------------------------------------------------------------------------------------------------------------------- Alabama................................................. $168 $181 $205 $230rsc $188 $202 $229 $254rsc $198 $213 $241 $266rsc Alaska \1\.............................................. 428 561 588 652rsc 478 499 523 580rsc 565 592 621 689rsc Arizona................................................. 223 247 297 \2\ 403rs 223 247 286 \2\ 392rs 282 305 365 \2\ 471rs c c c Arkansas................................................ 175 195 300 400rc 190 210 325 425rc 220 240 375 475rc California.............................................. 294 345 345 375rsc 340 400 400 436rsc 412 484 484 528rsc Colorado................................................ 235 296 319 \2\ 361rc 266 296 319 \2\ 361rc 318 352 379 \2\ 430rc Connecticut \1\......................................... 268 386 567 622rsc 302 424 586 642rsc 350 478 637 708rsc Delaware \3\............................................ 264 301 342 410rsc 266 304 342 410rsc 342 1 440 511rsc District of Columbia.................................... 304 304 431 445rsc 304 304 431 445rsc 317 317 519 536rsc Florida................................................. 233 296 296 345rsc 233 296 296 355rsc 293 372 372 425rsc Georgia \1\............................................. 300 300 300 338rsc 300 300 300 338rsc 300 300 300 338rsc Hawaii.................................................. 194 529 529 \2\ 529rs 233 529 529 \2\ 529rs 301 529 529 \2\ 529rs Idaho................................................... 138 198 228 228rs 165 205 250 250rs 204 278 338 358rs Illinois................................................ 233 268 322 343rsc 259 299 358 382rsc 282 325 390 415rsc Indiana \4\............................................. 226 281 405 486rsc 245 330 462 536rsc 280 398 518 603rsc Iowa.................................................... 159 198 328 387rsc 201 243 342 409rsc 285 300 405 474rsc Kansas.................................................. 187 304 205 \2\ 305rs 245 304 277 \2\ 305rs 280 386 351 \2\ 386rs c c c Kentucky................................................ 248 265 263 375rsc 263 288 285 350rsc 300 333 330 398rsc Louisiana............................................... 199 283 298 \2\ 348rc 232 316 331 \2\ 331rc 265 349 364 \2\ 364rc Maine................................................... 244 296 296 \2\ 325r 250 304 304 \2\ 334r 291 353 353 \2\ 389r Maryland................................................ 285 535 535 535rsc 285 535 535 535rsc 303 550 550 535rsc Massachusetts........................................... 362 410 410 448rs 362 410 410 464rs 433 486 486 515rs Michigan \5\............................................ 315 332 383 398rsc 315 332 383 398rsc 395 416 454 493rsc Minnesota \1\........................................... 285 341 377 458rsc 285 341 377 458rsc 375 442 487 561rsc Mississippi............................................. 130 145 175 \2\ 225rc 150 165 205 \2\ 255rc 160 175 250 \2\ 300rc Missouri................................................ 174 209 212 316rs 212 255 259 364rs 232 281 286 392rs Montana................................................. 283 307 330 \2\ 345rs 283 307 330 \2\ 345rs 354 384 416 \2\ 435rs Nebraska................................................ 210 222 326 \2\ 326rs 210 291 394 \2\ 393rs 210 351 461 \2\ 463rs c c c Nevada.................................................. 275 281 281 \2\ 304rs 275 281 281 \2\ 304rs 330 337 337 \2\ 365rs New Hampshire........................................... 200 200 314 \2\ 314rs 251 251 342 \2\ 342rs 354 354 404 \2\ 404rs New Jersey.............................................. 203 244 272 294rs 215 259 288 312rs 253 305 340 368rs New Mexico.............................................. 236 258 308 \2\ 308rs 247 270 341 \2\ 341rs 259 281 367 \2\ 367rs c c c New York................................................ 312 353 367 \2\ 367rs 375 424 441 \2\ 441rs 434 490 510 \2\ 510rs New York City........................................... 342 386 401 \2\ 401rs 403 455 473 \2\ 473rs 465 526 547 \2\ 547rs North Carolina.......................................... 215 265 315 315rs 215 265 365 365rs 215 265 415 415rs North Dakota............................................ 240 260 265 317rsc 287 312 318 359rsc 345 416 424 469rsc Ohio \6\................................................ 240 289 413 603rsc 270 328 413 603rsc 300 366 413 603rsc Oklahoma................................................ 300 300 300 300rsc 360 360 360 360rsc 420 420 420 420rsc Oregon.................................................. 200 285 315 356rsc 234 295 327 370rsc 316 363 404 457rsc Pennsylvania............................................ 558 303 315 \2\ 312rc 558 319 368 \2\ 375rc 558 377 473 \2\ 482rc Rhode Island \7\........................................ 223 274 279 308rs 223 274 279 285rs 275 335 341 348rs South Carolina.......................................... 138 182 212 212rsc 158 209 239 239rsc 208 275 305 305rsc South Dakota............................................ 188 237 259 353rsc 230 291 317 353rsc 276 349 382 424rsc Tennessee............................................... 139 255 336 336rs 190 226 262 262rs 224 267 385 385rs Texas................................................... 243 420 476 \2\ 482rs 243 420 476 \2\ 482rs 274 420 476 \2\ 482rs c c c Utah \1\................................................ 198 300 300 326rsc 198 300 300 326rsc 225 300 300 326rsc Vermont................................................. 210 371 416 360rsc 249 371 416 360rsc 268 447 504 440rsc Virginia................................................ 193 246 256 270rs 244 288 300 316rs 309 365 379 400rs Washington.............................................. 184 270 292 338rsc 227 332 359 410rsc 268 392 425 481rsc West Virginia........................................... 161 161 161 400rsc 202 202 202 400rsc 242 242 242 400rsc Wisconsin............................................... 163 231 276 289rsc 224 257 301 315rsc 284 324 361 374rsc Wyoming................................................. 300 400 400 400rsc 300 400 400 400rsc 330 400 400 400rsc ----------------------------------------------------------------------------------------------- Average monthly rates............................... 239 294 329 NA 263 314 350 NA 307 365 407 NA -------------------------------------------------------------------------------------------------------------------------------------------------------- \1\ These States provided daily regular foster care maintenance rates which were converted to monthly rates using the formula: (daily rate) <greek-e> 365 <divide> 12. Alaska's base rate changes for regular family foster care became effective July 1, 1998. \2\ 1998 data were not available. Data shown are for 1996, as reported to the American Public Human Services Association (formerly American Public Welfare Association). \3\ The foster care maintenance rates provided in the table are midpoints. Delaware has a range of payments for each age. Delaware has a standard foster care payment and three levels of care with supplemental payments. \4\ Basic monthly payment rates are State averages of rates set at the county level. They are estimated from daily maintenance payments of $16.20, $17.88, $20.10 and $27.35 respectively. \5\ Michigan has two age ranges for payment rates in family foster care: 0-12 and 13-18. \6\ Ohio's foster care rates range depending on the county: the rates provided in the table are the overall average for 88 counties, converted from Ohio's daily rate to a monthly rate. Rates are determined by the county agency, but must be within the approved uniform statewide standards for per diem foster care maintenance rates. \7\ Regular family foster care basic monthly maintenance rates apply to age ranges. The amount presented for age 2 applies to ages 0-3; the amount for age 9 applies to ages 4-11; the amount for age 16 applies to ages 12 and older. NA--Not available. Note.--Most States and/or counties supplement these basic rates with additional payments. For 1998, figures are coded for major items covered in the basic rate. Key: r = room and board; s = supervision; c = clothing. Source: American Public Human Services Association (formerly American Public Welfare Association) for 1987-96. Child Welfare League of America for 1998. Public Law 96-272 (1980) stipulated that title IV-E foster care payments could be made for children in public institutions, whereas previously under title IV-A (AFDC), payments were limited to children in private nonprofit institutions or foster family homes. To qualify for Federal payments, these public institutions may not accommodate more than 25 children. Facilities operated primarily for the detention of delinquents, including forestry camps and training schools, are ineligible for Federal funds. Legislation enacted in 1996 (Public Law 104-193) also allows participation of for- profit institutions. It is generally agreed that the costs associated with institutional care are substantially higher than the cost of family foster care. However, definitive data are not available. History of Federal protections for children in foster care The 1980 legislation that established the current framework of titles IV-B and IV-E contained several provisions intended to protect foster children and children at risk of foster care placement. Under the 1980 law as originally enacted, States were not eligible for all of their Federal title IV-B funds unless the following protections had been implemented: (1) a one-time inventory of children who had been in foster care more than 6 months to determine the appropriateness of and necessity for their current foster care placement, whether the child should be returned home or freed for adoption, and the services needed to achieve this placement goal; (2) a statewide information system containing the status, demographic characteristics, location, and placement goals of every child in care for the preceding 12 months; (3) a case review system to assure procedural safeguards for each child in foster care, including a 6-month court or administrative review and an 18- month dispositional hearing to assure placement in the least restrictive (most familylike) setting available, in close proximity to the child's original home, and consistent with the child's best interest; and (4) a reunification program to return children to their original homes. These provisions were originally contained in section 427 of the Social Security Act. Effective for fiscal years beginning after April 1, 1996, however, these protections are required of States as a component of their State plans under section 422 of the act. This change was enacted under the Omnibus Budget Reconciliation Act of 1993 (Public Law 103-66). In addition, the Adoption and Safe Families Act (Public Law 105-89) made significant changes in the case review system, including a requirement that dispositional hearings (renamed permanency hearings) be held at 12 months after placement and a requirement that States initiate procedures to terminate parental rights after a child has been in foster care a certain period of time (see below). In addition to the protections specified above, States were required to implement a preplacement preventive service program if the title IV-B appropriation was at least $325 million for 2 consecutive years. The amount appropriated for title IV-B was sufficient to trigger this provision. However, effective April 1, 1996, States are required to implement preplacement preventive services as a component of their State plans. In addition, under Public Law 103-66, States are required to review their policies and procedures related to abandoned children and to implement any changes necessary to enable permanent placement decisions to be made expeditiously for such children. States must comply with certain State plan requirements under title IV-B that are intended to protect all children in foster care. The law reinforces these protections by specifically requiring that they be provided in the case of children for whom Federal reimbursement is claimed under title IV-E. In addition, the law requires States to establish specific goals for title IV-E-eligible children who will remain in foster care more than 24 months, and to describe the steps the State will take to meet these goals. Mandatory procedural safeguards: ``reasonable efforts'' The 1980 legislation required that in every case, ``reasonable efforts'' must be made to prevent placement of a child in foster care and to reunify a foster child with her parents. The Adoption and Safe Families Act (Public Law 105- 89), enacted in November 1997, modified this provision. First, the law now specifies that a child's health and safety must be of ``paramount'' concern in all efforts made by the State to preserve or reunify the child's family. States continue to be required to make reasonable efforts to preserve or reunify the family, but the 1997 law established exceptions to this requirement. Specifically, States are not required to make such efforts if a court finds that a parent had killed another of their children, or committed felony assault against the child or a sibling, or if their parental rights to another child had previously been involuntarily terminated. In addition, the law establishes that efforts to preserve or reunify a family are not required if the court finds that a parent had subjected the child to ``aggravated circumstances.'' Each State may define these circumstances in State law; the act cites abandonment, torture, chronic abuse, and sexual abuse as examples. Moreover, the law does not preclude judges from using their discretion to protect a child's health and safety regardless of whether the specific circumstances are cited in Federal law. If the court determines that reasonable efforts to preserve or reunify a child and family are not required, the law now requires that a permanency hearing be held within 30 days of the child entering foster care, and that reasonable efforts be made to place the child for adoption or in an alternative permanent setting in a timely manner. Notwithstanding the exceptions allowed under the Adoption and Safe Families Act, reasonable efforts to preserve or reunify a family are still required in most cases. The Social Security Act establishes this requirement in two separate provisions. First, in order for a State to be eligible for title IV-E funding, its plan must specify that reasonable efforts will be made prior to a child's placement in foster care to prevent the need for placement or to help the child return home, unless the exceptions described above apply (section 471(a)(15)). Second, for every title IV-E-eligible child placed in foster care, a judicial determination must be made and documented that reasonable efforts were made to prevent placement into foster care in that particular case, unless an exception applies (section 472(a)(1)). The term ``reasonable efforts'' is not defined in law or regulations. Instead, U.S. Department of Health and Human Services (DHHS) regulations have required State plans to include a description of the services provided to prevent removal or to reunify families. The regulations provide an illustrative list of the types of preplacement preventive and reunification services that may be offered. This list includes: 24-hour emergency caretaker and homemaker services; day care; crisis counseling; emergency shelters; access to available emergency financial assistance; respite care; home-based family services; self-help groups; services to unmarried parents; provision of or arrangement for mental health; drug and alcohol abuse counseling; vocational counseling or vocational rehabilitation; and postadoption services. Because ``reasonable efforts'' is not defined, Federal courts have been active in defining reasonable efforts in individual cases. Over the 20 years since enactment of Public Law 96-272, numerous lawsuits have been filed by foster children, parents, and advocacy groups against State and local child welfare systems, challenging their failure to make reasonable efforts to preserve or reunify families. Many of these cases have been broad in scope, and some Federal courts have become involved in the overall child welfare system, although this has traditionally been an area of exclusive State jurisdiction. On March 25, 1992, the U.S. Supreme Court decided in Suter v. Artist M., an Illinois case, that the reasonable efforts requirement does not confer a private right on the child beneficiaries of the act. The plaintiffs, abused and neglected children in State custody, brought suit under the act and under 42 U.S.C. 1983 alleging that the State social services agency failed to: (1) make reasonable efforts to prevent the removal of children from home; (2) make reasonable efforts to reunify children who were removed from home; (3) notify appropriate agencies when a child was mistreated while placed in substitute care; and (4) develop case plans to assure proper services were provided to children while in placement. State officials questioned the appropriateness of involvement by the Federal judiciary in the resolution of child welfare disputes and in the operation of child welfare systems. Both the district court and the Seventh Circuit Court of Appeals held that the ``reasonable efforts'' requirement conferred enforceable rights on the child beneficiaries that were sufficiently specific to be enforceable in an implied cause of action directly under Public Law 96-272 or in an action brought under 42 U.S.C. 1983. The Supreme Court reversed, and construed the reasonable efforts requirement to impose only a generalized duty on the State, to be enforced not by the child beneficiaries, but by the Secretary of DHHS in monitoring and enforcing compliance with State plan requirements. The Court found that Public Law 96-272 does not create any rights, privileges, or immunities within the meaning of section 1983, and fails to provide the ``unambiguous notice'' that is necessary before States receiving Federal grants can be subjected to suit. As a result of the Court's decision in Suter, Congress enacted legislation in 1994 (Public Laws 103-382 and 103-432). These laws added a new section to the Social Security Act, which was inadvertently enacted twice, as section 1123 and section 1130A. The provision establishes that, in any action brought to enforce a provision of the Social Security Act, the provision is not to be deemed unenforceable because of its inclusion in a section of the act requiring a State plan. Congress explicitly stated that it does not intend to limit or expand any grounds for determining the availability of private actions to enforce State plan requirements. The provision also is not intended to alter the Court's decision in Suter that the reasonable efforts requirement is not enforceable in a private right of action. Mandatory procedural safeguards: case planning and case reviews The law specifies case review provisions that apply to all foster children, as required by the title IV-B State plan, and specifically to title IV-E-eligible children in order for States to claim Federal reimbursement for expenditures made on their behalf. The case review process must include a written case plan that: describes the child's placement, including its safety and appropriateness; describes a plan for assuring the child receives safe and proper care and that services are provided to enable the child to return home or to another permanent setting; includes the child's health and education records; describes services to help the child prepare for independent living, if the child is age 16 or older; and for children with permanency plans of adoption or another permanent arrangement, documents the steps taken or planned by the agency to place the child in accordance with that plan. Children must have a case plan that is designed to achieve a safe setting, that is the least restrictive (most familylike) and most appropriate setting available, in close proximity to the child's parent's home, and is consistent with the child's best interest and special needs. The law also requires an administrative or judicial review at least every 6 months for children in foster care to determine the continuing need and appropriateness of the foster care setting, compliance with the case plan, progress made toward improving the conditions that caused the child to be placed in foster care, and projecting a date by which the child can be returned home or placed for adoption or legal guardianship. The mandatory case review process also includes a judicial permanency hearing, to be held no later than 12 months after a child has entered foster care (as amended by the Adoption and Safe Families Act in 1997), and every subsequent 12 months. This hearing determines the child's permanency plan; i.e., whether the child should be returned to the parents, placed for adoption (in which case, the State also will initiate proceedings to terminate parental rights), referred for legal guardianship, or placed in another planned, permanent arrangement (if other options, including placement with a fit and willing relative, are not in the child's best interest). Prior to enactment of Public Law 105-89 in 1997, long-term foster care also was a specified permanency plan. Also as amended in 1997, the law provides that States may make efforts to reunify a child and family concurrently with efforts to place the child for adoption or guardianship. This practice, referred to as ``concurrent planning,'' allows States to develop a backup plan, to save time in case efforts to restore the original family are unsuccessful. The permanency hearing also must ensure safeguards for children placed outside their home State; must determine the independent living services needed for foster children aged 16 and older; and must ensure safeguards for the parental rights pertaining to children in foster care. A child's foster parents, preadoptive parents, or relative caretakers must be given notice and an opportunity to be heard at any review or hearing held with respect to the child. Mandatory procedural safeguards: filing for termination of parental rights (TPR) One of the most significant provisions of the 1997 Adoption and Safe Families Act requires States to initiate proceedings to terminate parental rights for certain foster children. There was no comparable provision in prior law. Specifically, the act requires States to initiate or join TPR proceedings for children who have been in foster care for 15 of the most recent 22 months, or for infants determined under State law to be abandoned, or in any case in which the court has found that a parent has killed another of their children or committed felony assault against the child or a sibling. States can opt not to initiate such proceedings if the child is in a relative's care, or if the State agency has documented in the child's case plan a compelling reason to determine that TPR would not be in the child's best interest, or if the State had not provided necessary services to the family. According to final regulations issued by DHHS on January 25, 2000, exceptions to the TPR requirement must be made on a case-by-case basis; States may not establish blanket exceptions for categories of children. For purposes of the TPR provision and the 12-month permanency hearing, children are considered to have entered foster care on the first date that the court finds they have been subjected to abuse or neglect, or 60 days after their removal from home, whichever occurs first. The Title IV-E Adoption Assistance Program The Title IV-E Adoption Assistance Program is an open-ended entitlement program required of States that participate in TANF. Like the IV-E Foster Care Program, the IV-E Adoption Assistance Program funds three distinct types of activities: assistance payments for qualified children who are adopted, administrative payments for expenses associated with placing children in adoption, and training of professional staff and parents involved in adoptions. Under the Adoption Assistance Program, which is permanently authorized, States develop adoption assistance agreements with parents who adopt eligible children with special needs. Federal matching funds are provided to States that, under these agreements, provide adoption assistance payments to parents who adopt AFDC- or SSI-eligible children with special needs. In addition, the program authorizes Federal matching funds for States that reimburse the nonrecurring adoption expenses of adoptive parents of special-needs children (regardless of Aid to Families with Dependent Children (AFDC) or SSI eligibility). Definition of special needs A special-needs child is defined in the statute as a child with respect to whom the State determines there is a specific condition or situation, such as age, membership in a minority or sibling group, or a mental, emotional, or physical disability, which prevents placement without special assistance. Before a child can be considered to be a child with special needs, the State must determine that the child cannot or should not be returned to the biological family, and that reasonable efforts have been made to place the child without providing adoption assistance. States have discretion in defining special-needs eligibility criteria and individually determining whether a child is eligible. For example, some States add religion or not being able to place the child without subsidy to the definition of special needs. Adoption assistance agreements and payments An adoption assistance agreement is a written agreement between the adoptive parents, the State IV-E agency, and other relevant agencies (such as a private adoption agency) specifying the nature and amount of assistance to be given. Under the adoption assistance agreement, States may make federally subsidized monthly adoption assistance payments for AFDC- and SSI-eligible children with special needs who are adopted. The amount of adoption assistance payments is based on the circumstances of the adopting parents and the needs of the child. No means test can be used to determine eligibility of parents for the program; however, States do consider the adoptive parents' income in determining the payment. Payments may be adjusted periodically if circumstances change, with the concurrence of the adopting parents. However, the payments may not exceed the amount the family would have received on behalf of the child under foster care. Adoption assistance payments may continue until the child is age 18, or, at State option, age 21 if the child is mentally or physically disabled. Payments are discontinued if the State determines that the parents are no longer legally responsible for the support of the child. Federally subsidized payments may start as soon as an agreement is signed and the child has been placed in an adoptive home. Not all families of adopted IV-E eligible children with special needs actually receive adoption assistance payments. The adoptive parents' circumstances may be such that an adoption subsidy is not needed or wanted. Adopted AFDC- or SSI- eligible children with special needs are also eligible for Medicaid if an adoption assistance agreement is in effect, regardless of whether adoption assistance payments are being made. Pursuant to the 1985 budget reconciliation legislation, a child for whom an adoption assistance agreement is in effect is eligible for Medicaid from the State in which the child resides regardless of whether the State is the one with which the adoptive parents have an adoption assistance agreement. States also have the option under the Medicaid Program to provide Medicaid coverage for other special-needs children (those not eligible for AFDC or SSI) who are adopted under a State-funded adoption subsidy program. According to APHSA, all States but four currently take this option, with regard to children for whom they have an adoption assistance agreement in effect. (The four that do not take this option are Connecticut, Illinois, New Mexico, and Michigan.) In addition, APHSA reports that 25 States provide Medicaid to children living in their States who have State-funded adoption assistance agreements from other States, and another 9 States provide Medicaid to children with State-funded adoption assistance agreements from other States, but only if those States are members of the Interstate Compact on Adoption and Medical Assistance. As of April 2000, an additional three States were in the process of developing reciprocity policies. The Adoption and Safe Families Act contains additional requirements regarding health insurance coverage for special- needs adopted children who are not eligible for title IV-E adoption assistance. Specifically, the 1997 law requires States to provide health insurance coverage to non-title IV-E children for whom they have an adoption assistance agreement in effect, if the children have special needs for medical, mental health or rehabilitative care. This health coverage can be through Medicaid or another program, as long as benefits are comparable. In addition, the law prohibits States from receiving adoption incentive payments (described below) in fiscal years 2000 or 2001, or from receiving waivers of title IV-B or IV-E provisions (also described below), unless they provide health coverage for non-title IV-E children who are living in their State, but who are covered by an adoption assistance agreement from another State. The structure of adoption subsidy programs varies across States. Some States offer basic maintenance payments and also allow additional payments for certain activities (such as family counseling) or for certain groups of children (such as children with severe disabilities). Other States offer one level of payment to everyone with no special allowances. Some States allow parents to request changes in payment levels on a regular basis if circumstances change for a child; others allow very little change once the adoption agreement is signed. Some States start payments as soon as placement is made; others not until the adoption is finalized. Not all children who receive adoption subsidies from States are eligible for Federal title IV-E funds. Data from APHSA for 1997 indicate that almost three-fourths of children receiving adoption assistance nationwide were eligible for title IV-E. The non-IV-E children's adoption subsidies are paid solely by the State in which their adoption agreement was signed. Nonrecurring adoption costs The Adoption Assistance Program also authorizes Federal matching funds for States to pay the one-time adoption expenses of parents of special-needs children (regardless of AFDC or SSI eligibility). In order to be eligible, the child must be a child with special needs, as defined in section 473(c) of the Social Security Act and described above. Through the program, parents may receive reimbursement of up to $2,000 per child for these nonrecurring adoption expenses, and States may claim 50 percent Federal matching for these reimbursements. Qualified adoption expenses are defined as reasonable and necessary adoption fees, court costs, attorney fees, and other expenses that are directly related to the adoption of a child with special needs. States may vary in the maximum amount they allow parents to receive under this provision. All States and the District of Columbia have implemented the program; Delaware does not operate a separate program for reimbursing these one-time expenses. Table 11-9 shows State-by- State data on maximum reimbursement rates, based on 1998 data collected by the North American Council on Adoptable Children. These maximum payment rates are the same for most States as the maximum rates reported in a 1996 survey by APHSA; however, APHSA also reported that average reimbursements did not equal the maximum for many States. In 1996, as reported by APHSA, the average maximum reimbursement rate for all States was $1,651, while the average amount actually awarded to adoptive families was $966, based on data for 36 States. Parents adopting children from public child welfare agencies may not necessarily claim these reimbursements because many costs incurred in public agency adoptions are already covered under the States' adoption programs. Adoption assistance expenditures The number of children receiving adoption assistance payments and the Federal expenditures for these payments have increased significantly since the program began. In fiscal year 1981, only six States participated in the program, with payments being made for an average of 165 children per month. In fiscal year 1999, 50 States plus the District of Columbia and Puerto Rico participated, and 195,243 children (table 11- 10) were served. TABLE 11-9.--MAXIMUM STATE REIMBURSEMENT OF NONRECURRING ADOPTION COSTS, 1998 ------------------------------------------------------------------------ Amount States ------------------------------------------------------------------------ $2,000................................. Alaska,\1\ Arizona, District of Columbia (contested), Georgia,\1\ Hawaii, Idaho,\1\ Kansas,\1\ Maine, Maryland,\1\ Michigan, Minnesota, Missouri,\1\ Montana, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio,\1\ Oklahoma,\1\ Oregon, Pennsylvania, Utah,\1\ Vermont,\1\ Virginia, West Virginia, Wisconsin, Wyoming $1,500................................ Arkansas, Illinois, Indiana, Nebraska,\1\ South Carolina, South Dakota, Tennessee, Texas, Washington $1,000................................. Alabama,\1\ District of Columbia (uncontested), Florida, Kentucky,\1\ Louisiana, Mississippi,\1\ Rhode Island $800................................... Colorado $750................................... Connecticut \2\ $400................................... California, Massachusetts $250................................... Nevada ------------------------------------------------------------------------ \1\ States that indicated they will consider reimbursement of nonrecurring adoption costs for international adoptions. \2\ States that indicated they will not consider reimbursement of international adoption nonrecurring expenses. Note.--States without footnotes may have provisions for reimbursing international adoption expenses but did not specify. Iowa participates in the program but did not indicate the maximum amount of reimbursement available to families. Source: North American Council on Adoptable Children. TABLE 11-10.--FEDERAL ADOPTION ASSISTANCE EXPENDITURES, FISCAL YEARS 1994-99, AND AVERAGE NUMBER OF CHILDREN RECEIVING ADOPTION ASSISTANCE, FISCAL YEAR 1999 [In thousands of dollars] ---------------------------------------------------------------------------------------------------------------- 1999 average State 1994 1995 1996 1997 1998 1999 monthly claims claims claims claims claims claims number of children ---------------------------------------------------------------------------------------------------------------- Alabama..................... $1,830 $1,867 $1,786 $2,243 $2,492 $3,525 429 Alaska...................... 1,070 1,286 1,562 1,914 2,232 2,840 731 Arizona..................... 3,960 5,522 6,856 8,365 9,435 11,270 2,161 Arkansas.................... 1,960 1,542 2,387 3,035 4,323 5,181 688 California.................. 43,590 48,234 52,962 76,819 85,093 108,802 24,786 Colorado.................... 3,230 3,316 4,361 5,420 7,888 10,358 2,992 Connecticut................. 6,310 7,122 6,040 4,507 12,369 10,341 1,748 Delaware.................... 430 536 556 592 635 862 267 District of Columbia........ 1,970 1,847 1,987 2,676 3,273 4,434 485 Florida..................... 10,580 16,830 19,613 23,664 29,801 33,428 8,900 Georgia..................... 3,320 4,364 4,864 6,913 11,156 15,193 3,570 Hawaii...................... 480 610 980 1,183 2,026 2,802 675 Idaho....................... 580 753 982 1,063 1,313 1,485 271 Illinois.................... 13,060 16,801 19,362 27,246 35,494 55,526 16,242 Indiana..................... 6,710 7,338 8,692 10,630 12,421 15,106 3,574 Iowa........................ 3,870 4,976 6,591 11,347 12,238 15,792 2,670 Kansas...................... 2,240 2,740 3,180 7,702 4,147 5,809 2,975 Kentucky.................... 3,320 3,540 3,835 3,742 4,436 5,198 1,148 Louisiana................... 9,320 11,044 12,180 13,556 17,342 18,129 1,874 Maine....................... 2,960 2,794 3,669 4,084 4,730 4,811 754 Maryland.................... 2,880 3,633 4,491 5,447 6,271 8,197 2,179 Massachusetts \1\........... 8,380 9,603 11,147 12,585 12,648 17,699 4,552 Michigan.................... 26,840 31,917 37,282 44,032 52,429 58,439 14,213 Minnesota................... 4,620 5,224 5,861 6,653 8,314 10,232 2,246 Mississippi................. 390 667 795 936 1,110 1,346 419 Missouri.................... 5,190 6,743 6,270 7,432 8,775 10,998 3,341 Montana..................... 760 905 1,330 1,258 2,866 2,339 501 Nebraska.................... 1,560 1,771 2,062 2,332 2,881 3,287 877 Nevada...................... 460 668 870 1,504 1,835 1,690 419 New Hampshire \2\........... 740 841 834 803 745 872 313 New Jersey.................. 6,700 8,975 8,522 13,629 9,807 15,614 3,788 New Mexico.................. 1,890 2,443 2,722 3,246 4,413 6,180 1,377 New York.................... 72,590 89,816 100,466 114,405 123,605 134,508 32,759 North Carolina.............. 2,550 4,229 5,258 6,783 8,962 11,035 3,506 North Dakota................ 500 460 544 635 827 1,139 202 Ohio........................ 30,300 34,985 56,331 74,323 69,112 84,502 12,355 Oklahoma.................... 2,240 2,950 4,030 6,431 6,949 8,008 1,671 Oregon...................... 3,300 4,020 4,936 6,178 8,668 10,776 4,081 Pennsylvania................ 4,263 5,440 6,820 8,090 10,273 12,385 2,760 Puerto Rico \3\............. NA NA NA NA NA 54 92 Rhode Island................ 4,610 4,194 3,080 3,042 3,958 4,469 1,053 South Carolina.............. 2,910 3,915 4,454 5,382 6,623 9,169 1,679 South Dakota................ 630 649 666 788 890 1,006 363 Tennessee................... 3,240 3,607 5,814 5,204 4,705 6,605 1,790 Texas....................... 14,520 17,160 17,308 19,815 24,454 28,003 6,969 Utah........................ 1,240 1,158 1,943 2,700 3,782 3,825 951 Vermont..................... 1,860 1,947 2,080 2,664 3,325 3,970 667 Virginia.................... 2,590 2,998 3,671 3,601 5,256 7,705 2,011 Washington.................. 3,940 3,013 4,441 5,085 6,812 9,227 4,563 West Virginia............... 440 492 542 678 4,567 3,189 386 Wisconsin................... 7,730 9,056 10,339 13,122 14,503 17,382 3,211 Wyoming..................... 60 24 51 105 123 172 68 ----------------------------------------------------------------------------------- Total................. 344,540 411,398 482,990 604,371 694,545 842,737 195,243 ---------------------------------------------------------------------------------------------------------------- \1\ Fiscal year 1999 data include estimates for the third and fourth quarters. \2\ Fiscal year 1999 data include estimates for the average monthly number of children. \3\ Did not begin to participate until fiscal year 1999. NA--Not applicable. Note.--Totals may differ from sum of State amounts because of rounding. Source: U.S. Department of Health and Human Services. Federal expenditures for adoption assistance payments have increased from less than $400,000 in fiscal year 1981 to $843 million in fiscal year 1999, and are expected to exceed $2 billion by fiscal year 2005. DHHS data indicate that expenditures for child placement services and administration for the Adoption Assistance Program have also increased significantly in recent years. In fiscal year 1981, claims totaled $100,000; in fiscal year 1999 they totaled $222 million and are expected to be $548 million in fiscal year 2005. The Title IV-E Adoption Incentives Payment Program The Adoption and Safe Families Act of 1997 (Public Law 105- 89) established a new provision intended to promote adoption through incentive payments to States that increase their number of foster child adoptions, with additional incentives for the adoption of special-needs foster children with adoption assistance agreements under title IV-E. Incentive payments equal $4,000 for each foster child whose adoption is finalized (over a certain baseline) and an additional $2,000 for each special-needs child whose adoption is finalized (over the baseline). For adoptions finalized in 1998, the baseline was the average number of adoptions in 1995-97. For adoptions finalized in 1999-2002, the baseline is the highest number of adoptions in any preceding year, beginning with 1997. Table 11- 11 shows the 1998 and 1999 baselines for foster child adoptions in all States. For those States that achieved a sufficient number of adoptions in 1998 to receive an incentive payment in 1999, their 1998 adoptions and incentive awards are also shown. Adoptions shown in this table, which qualified for incentive payments, are those of children who were in foster care before their adoption, and are not necessarily the same as adoptions made with the involvement of public child welfare agencies. The number of incentive-qualifying adoptions in 1998 for States that did not earn incentive payments is not shown in table 11- 11; however, State information on adoptions made with public agency involvement is provided below. TABLE 11-11.--ADOPTION BASELINES, NUMBER OF INCENTIVE-QUALIFYING ADOPTIONS, AND INCENTIVE PAYMENTS, BY STATE ---------------------------------------------------------------------------------------------------------------- Incentive 1998 1998 payments 1999 baseline incentive- for 1998 baseline State (3-year qualifying adoptions (higher of average, adoptions (in 1997 or 1995-97) thousands) 1998) ---------------------------------------------------------------------------------------------------------------- Alabama......................................................... 139 NA 0 136 Alaska.......................................................... 108 NA 0 109 Arizona......................................................... 357 NA 0 474 Arkansas........................................................ 138 251 $596 251 California...................................................... 3,287 3,958 3,916 3,958 Colorado........................................................ 417 560 892 560 Connecticut..................................................... 207 229 88 278 Delaware........................................................ 39 NA 0 33 District of Columbia............................................ 110 NA 0 132 Florida......................................................... 987 1,549 2,744 1,549 Georgia......................................................... 493 672 956 672 Hawaii.......................................................... 85 297 1,102 297 Idaho........................................................... 44 NA 0 47 Illinois........................................................ 2,200 4,656 14,606 4,656 Indiana......................................................... 495 774 1,792 774 Iowa............................................................ 350 517 790 517 Kansas.......................................................... 349 NA 0 421 Kentucky........................................................ 211 NA 0 222 Louisiana....................................................... 220 NA 0 284 Maine........................................................... 108 112 24 112 Maryland........................................................ 342 420 676 420 Massachusetts................................................... 1,116 1,137 84 1,161 Michigan........................................................ 1,905 2,254 2,004 2,254 Minnesota....................................................... 258 427 1,022 427 Mississippi..................................................... 114 169 398 169 Missouri........................................................ 557 616 236 616 Montana......................................................... 115 144 116 144 Nebraska........................................................ 185 NA 0 180 Nevada.......................................................... 149 NA 0 148 New Hampshire................................................... 45 50 20 50 New Jersey...................................................... 621 755 870 755 New Mexico...................................................... 147 197 200 197 New York........................................................ 4,716 4,822 424 4,979 North Carolina.................................................. 467 NA 0 694 North Dakota.................................................... 47 83 144 83 Ohio............................................................ 1,287 NA 0 1,400 Oklahoma........................................................ 338 456 596 456 Oregon.......................................................... 445 665 1,248 665 Pennsylvania.................................................... 1,224 1,494 1,260 1,526 Rhode Island.................................................... 261 NA 0 226 South Carolina.................................................. 256 465 1,064 465 South Dakota.................................................... 56 58 8 58 Tennessee....................................................... 328 NA 0 295 Texas........................................................... 880 1,365 2,872 1,365 Utah............................................................ 225 250 100 268 Vermont......................................................... 75 116 214 116 Washington...................................................... 607 759 620 759 West Virginia................................................... 182 211 128 220 Wisconsin....................................................... 467 589 640 589 Wyoming......................................................... 15 30 0 30 ---------------------------------------------------------------------------------------------------------------- NA--Not available. Source: Compiled by the Congressional Research Service from data available from the U.S. Department of Health and Human Services. Public Law 105-89 originally authorized appropriations of $20 million annually for fiscal years 1999-2003 for adoption incentive payments. In addition, discretionary budget caps were adjusted to help ensure that the funds are actually appropriated for each year. However, the amount of incentive payments that States earned for fiscal year 1999, based on the number of adoptions finalized in 1998, exceeded the $20 million level. Congress subsequently enacted the Foster Care Independence Act (Public Law 106-169), which authorized an additional $23 million for adoption incentive payments in fiscal year 2000. These funds were intended to supplement payments made in fiscal year 1999 for increased adoptions in the previous year. The additional $23 million was appropriated in Public Law 106-113, a consolidated appropriations bill that also called for a governmentwide reduction of 0.38 percent, slightly reducing the amount appropriated in fiscal year 2000 for adoption incentive payments. The total amount awarded for adoptions finalized in fiscal year 1998 was $42.5 million. The Title IV-E Foster Care Independence Program In 1986, title IV-E was amended by Public Law 99-272 (Consolidated Omnibus Budget Reconciliation Act of 1985) to include section 477, which established the Independent Living Program to assist youth who would eventually be emancipated from the foster care system. Several surveys conducted during the mid-80s showed that a significant number of homeless shelter users had been recently discharged from foster care, prompting Congress to establish a program to help youngsters in foster care establish their independence. Initially, an annual entitlement amount of $45 million was established for 1987 and 1988 to provide States with the resources to create and implement independent living services. These services were designed to assist IV-E-eligible children age 16 and over make a successful transition from foster care to independent adult living when they became ineligible for foster care maintenance payments at age 18. In 1988, the program was expanded under Public Law 100-647, which permitted States to provide independent living services to all youth in foster care aged 16 to 18 (not just title IV-E-eligible youth); States could also provide followup services to youth up to 6 months after their emancipation from substitute care. Under Public Law 101-508, States had the option of serving individuals up to age 21 in the Independent Living Program. Funds were allocated on the basis of each State's share of children receiving IV-E foster care in 1984. Public Law 101-239 increased the amount of Federal entitlement funds available to the States for the Independent Living Program to $50 million for fiscal year 1990, $60 million for fiscal year 1991, and $70 million for fiscal year 1992. Beginning in fiscal year 1991, States were required to provide 50 percent matching for any Federal funding claimed that exceeded the original $45 million funding level. In 1993, Congress permanently extended the authority for independent living under Public Law 103-66. In response to continuing concerns about the adjustment problems faced by older children leaving foster care, the 106th Congress enacted the Foster Care Independence Act of 1999 (Public Law 106-169). The law replaced section 477 with new language and renamed the program the John H. Chafee Foster Care Independence Program, in honor of the Rhode Island Senator who was one of the law's sponsors and who died before it was enacted. As amended in 1999, the Foster Care Independence Program is intended to help States provide services to children who are likely to remain in foster care until age 18 (no minimum age is specified for participation in the program), as well as former foster children between the ages of 18 and 21. To participate in the program, States must submit a 5-year plan to DHHS and must certify that, among other things, no more than 30 percent of program funds will be used for room and board for 18-20 year olds and that services will be coordinated with related Federal and State youth programs, including transitional living youth projects funded under the Juvenile Justice and Delinquency Prevention Act, abstinence education, housing programs, programs for disabled youth, and school-to- work activities. The law also allows States to extend Medicaid coverage to former foster children between 18 and 21 years of age. States have flexibility in the use of their Foster Care Independence Program funds within the general purposes outlined in the law. These purposes include helping eligible children make the transition to self-sufficiency through such services as assistance in obtaining a high school diploma, career exploration, vocational training, job placement and retention, training in daily living skills, training in budgeting and financial management skills, substance abuse prevention, and preventive health activities. The program seeks to help eligible children obtain employment and to receive postsecondary education and training. The program also seeks to provide personal and emotional support to eligible children and youth in their efforts to achieve self-sufficiency. The revised Foster Care Independence Program is a capped entitlement with an annual ceiling set at $140 million, which is double the entitlement ceiling level prior to enactment of Public Law 106-169. States are entitled to an amount based on their share of the Nation's foster care population, in the most recent year for which information is available. However, no State may receive less than the greater of $500,000 or the amount received by the State in fiscal year 1998. The law contains a ratable reduction provision to ensure total State allotments do not exceed the national ceiling of $140 million. The law also requires a 20-percent non-Federal match. For fiscal year 2000, Congress appropriated $105 million for the program, notwithstanding the new entitlement ceiling of $140 million. Thus, table 11-12 shows State allocations for fiscal year 2000 under section 477 at the $105 million and $140 million level, under the new formula established by Public Law 106-169. (The law authorizes a set-aside for evaluation activities, equal to 1.5 percent of $140 million, after which State allocations are made.) TABLE 11-12.--TITLE IV-E INDEPENDENT LIVING AWARDS UNDER PUBLIC LAW 106-169, AT FISCAL YEAR 2000 APPROPRIATION AMOUNT OF $105 MILLION AND FULL AUTHORIZATION AMOUNT OF $140 MILLION, BY STATE [In thousands of dollars] ---------------------------------------------------------------------------------------------------------------- Fiscal year 2000 Full State appropriation authorization Funding under amount of $105 amount of $140 prior law million million ---------------------------------------------------------------------------------------------------------------- Alabama......................................................... $1,038 $1,269 $1,038 Alaska.......................................................... 500 500 13 Arizona......................................................... 858 1,248 348 Arkansas........................................................ 500 685 271 California...................................................... 18,804 27,350 12,482 Colorado........................................................ 1,419 2,064 826 Connecticut..................................................... 1,134 1,650 755 Delaware........................................................ 500 500 203 District of Columbia............................................ 1,092 1,092 1,092 Florida......................................................... 4,163 6,055 987 Georgia......................................................... 1,610 2,342 1,099 Hawaii.......................................................... 500 651 18 Idaho........................................................... 500 500 107 Illinois........................................................ 8,524 12,398 2,817 Indiana......................................................... 1,405 2,044 1,020 Iowa............................................................ 593 863 450 Kansas.......................................................... 717 1,030 717 Kentucky........................................................ 984 1,432 792 Louisiana....................................................... 1,358 1,535 1,358 Maine........................................................... 566 713 566 Maryland........................................................ 2,179 3,170 1,238 Massachusetts................................................... 2,353 3,422 636 Michigan........................................................ 4,406 6,408 4,172 Minnesota....................................................... 1,496 2,176 1,142 Mississippi..................................................... 523 761 514 Missouri........................................................ 2,112 3,072 1,295 Montana......................................................... 500 500 244 Nebraska........................................................ 765 1,113 436 Nevada.......................................................... 500 500 154 New Hampshire................................................... 500 500 320 New Jersey...................................................... 2,298 2,298 2,298 New Mexico...................................................... 500 500 207 New York........................................................ 11,586 13,392 11,586 North Carolina.................................................. 1,879 2,733 1,045 North Dakota.................................................... 500 500 192 Ohio............................................................ 2,861 3,072 2,861 Oklahoma........................................................ 1,161 1,688 620 Oregon.......................................................... 1,197 1,741 931 Pennsylvania.................................................... 4,638 5,578 4,638 Puerto Rico..................................................... 1,126 1,637 NA Rhode Island.................................................... 500 500 315 South Carolina.................................................. 810 1,178 580 South Dakota.................................................... 500 500 193 Tennessee....................................................... 1,622 2,359 778 Texas........................................................... 2,900 4,218 1,842 Utah............................................................ 500 500 202 Vermont......................................................... 500 500 296 Virginia........................................................ 1,362 1,393 1,362 Washington...................................................... 1,664 2,421 825 West Virginia................................................... 521 714 521 Wisconsin....................................................... 1,673 2,434 1,554 Wyoming......................................................... 500 500 45 ----------------------------------------------- Total..................................................... 102,900 137,900 70,000 ---------------------------------------------------------------------------------------------------------------- NA--Not available. Note.--The allotments under the fiscal year 2000 appropriation amount of $105 million were provided by the U.S. Department of Health and Human Services. The allotments under the full authorization amount of $140 million are estimates based on the above data provided by the U.S. Department of Health and Human Services. Both allotment columns reflect the evaluation set-aside of 1.5 percent of $140 million ($2.1 million). Source: Table prepared by the Congressional Research Service. As originally enacted in 1986, section 477 instructed the U.S. Department of Health and Human Services (DHHS) to conduct a study of independent living services, which was done in two phases by Westat, Inc. (Cook, 1990, 1992). Looking at youths who emancipated from foster care between January 1987 and July 1988, Westat reported that they were a troubled population. In the study group, two-thirds of 18-year-olds had not completed high school or obtained a GED and 61 percent had no job experience. Also, 38 percent of the youths had been diagnosed as emotionally disturbed, 17 percent had a drug abuse problem, 9 percent had a health problem, and 17 percent of the females were pregnant. During the time they had been in foster care, 58 percent of the study group had experienced at least three placement settings and about 30 percent had been in foster care an average of 9 years. Of the total number of youths who emancipated from foster care during the study period, 31 percent received services from their State's Independent Living Program, 29 percent received informal services, and 40 percent received no independent living services at all. Westat conducted a followup with the study group and reported in 1992 that, 2\1/2\-4 years after leaving foster care, many were still having problems. Only about half had completed high school, a little less than half had jobs, and only about 40 percent had held a job for at least 1 year. Among the females, 60 percent had given birth. One quarter of the youths had been homeless for at least one night, and fewer than 1 in 5 were completely self-supporting. Later research conducted by the University of Wisconsin had similar findings (Courtney & Piliavin, 1998). Looking at Wisconsin youths 12-18 months after they emancipated from foster care in 1995, researchers found 37 percent had still not completed high school and 12 percent had been homeless at least once since their discharge from foster care. While 81 percent had held at least one job since their discharge, only 61 percent reported being employed at the time of their interview, suggesting that job retention was a problem for some. Of females, 40 percent were receiving public assistance, as were 23 percent of the males. Access to medical care was a problem for 44 percent of the youths, usually because of a lack of health insurance. While almost half of the youths had received mental health services when still connected to the child welfare system, 21 percent reported receiving such services after they left foster care. Although they were not reunited with their biological families by the child welfare system, many of the youths had contact with their original families after their discharge from foster care, with about one-third actually living with their families. At the same time, 40 percent reported continued and frequent contact with their foster parents. About 18 percent of the youths had been incarcerated at some point since their discharge. The U.S. General Accounting Office (GAO) reported in 1999 that State and local administrators felt they could not provide youths who were leaving foster care with all the support they needed to make a successful transition to independent adult living. GAO reported that some programs lacked sufficient connections with employers to provide job leads, or opportunities for youths to practice skills in real-life settings, or supervised living arrangements for youths to become experienced at living self-sufficiently. GAO also noted that DHHS lacked sufficient information to evaluate the effectiveness of services. Also in 1999, DHHS released a report reviewing the history of the Independent Living Program over the 10 years from 1987 through 1996 (U.S. Department, 1999b). This report found that many eligible youth did not receive independent living services at all. Specifically, in 30 States that reported data for fiscal year 1996, 37 percent of eligible youth received no services. Of those youth served in fiscal year 1996, 65 percent were either 16 or 17 years old, while 22 percent were 18 and the remainder were 19 or 20. Half the youth were white, and slightly more than half were females. African-American youth comprised 38 percent and Hispanic youth 9 percent. Half of the youth served had been in foster care less than 2 years, while 20 percent had been in care 5 years or longer. Slightly more than a quarter of the youth had special needs, and 9 percent were parents or pregnant. Over the 10 year period reviewed, DHHS found that States shifted from providing primarily tangible skills, such as vocational training, job search, and money management, to also addressing intangible skills, such as decisionmaking, communication, and conflict resolution. To enable assessments of State independent living activities, Public Law 106-169 directed the Secretary of DHHS to develop a series of outcome measures, including the following: educational attainment, high school diploma, employment, avoidance of dependency, homelessness, nonmarital childbirth, incarceration, and high-risk behaviors. The Secretary also must identify data elements that can be used to track the number and characteristics of children receiving independent living services, the type and quantity of services provided, and State performance on the outcome measures. The Secretary must develop a plan to collect this information beginning with the second fiscal year that starts after the date of enactment, and must report to Congress on this plan and timetable within 1 year of the date of enactment. Once this data collection plan is in effect, States must submit the required reports or face financial penalties. In addition, the law requires the Secretary to conduct evaluations of innovative State Independent Living Programs or programs that have potential national significance. The law reserves 1.5 percent of each year's appropriation for such evaluation, technical assistance, performance measurement, and data collection. STATE ACCOUNTABILITY AND FEDERAL OVERSIGHT Federal child welfare law requires States to comply with a series of provisions that are intended to protect children who have been placed in foster care or who are at risk of foster care placement. States are required to comply with these provisions to be eligible to receive Federal funds, but the extent to which the Federal Government actually holds States accountable has been an issue of ongoing concern. On January 25, 2000, DHHS published final regulations establishing a new system, mandated by Congress, for monitoring and enforcing the implementation by States of Federal child welfare laws. The new regulations took effect on March 27, 2000. In addition, the law establishes specific penalties for violations of certain provisions intended to eliminate ethnic or geographic barriers to adoption. Finally, the Adoption and Safe Families Act in 1997 mandated that DHHS establish a series of outcome measures that could be used to rate the performance of State child welfare programs, and to report annually on State performance in meeting these outcome measures. DHHS published the outcome measures on August 20, 1999. The new Federal review system, the specific penalties applicable to violations of ethnic or geographic discrimination provisions, and outcome measures that will be used to assess State performance are described in detail below. History of Federal Review Efforts The history of Federal child welfare review efforts goes back to passage of the Adoption Assistance and Child Welfare Act of 1980 (Public Law 96-272). Many of the original foster child protections were established by that legislation as part of section 427 and were voluntary incentives for States to meet to receive their full allotment of title IV-B funds. In addition, the 1980 law established eligibility requirements that were used to determine which children could qualify for federally subsidized foster care and adoption assistance payments. These eligibility criteria contained provisions that were intended to work together with the ``section 427 requirements'' to protect children in foster care. In the early 1980s, DHHS developed and operated review systems for monitoring State compliance with section 427 protections and with the Federal foster care requirements under title IV-E. However, child welfare advocates, State and Federal officials, and Members of Congress grew dissatisfied with the early review systems for various reasons, both procedural and programmatic, and beginning in 1989, Congress suspended the collection of penalties resulting from these reviews. Procedural concerns included a lack of formal regulations, frequently resulting in confusion about the standards that States were expected to meet. Reviews were conducted retrospectively, sometimes for fiscal years that had long past, so that current practices were not examined. Exacerbating this problem was the late release of final reports by DHHS, so their findings and recommendations were sometimes irrelevant by the time they were issued. State officials had limited ongoing contact with Federal regional office staff, so that formal reviews were seen as adversarial and punitive, rather than collaborative and potentially helpful. The reviews were often seen as time consuming, labor intensive, and burdensome for the States. Of greater concern, however, was the perception that the reviews did not result in improved services for children and families. Both section 427 and title IV-E eligibility reviews focused on paper compliance with legal requirements. Moreover, States were sometimes held accountable for circumstances beyond their control, such as the schedule or actions of the courts. Reviews were criticized for focusing on isolated components of a State's child welfare system, rather than the system as a whole. When problems were identified, penalties were imposed but little technical assistance was provided. The review system contained no mechanism for helping States improve the quality of their child welfare programs, and also were criticized for failing, in some cases, to identify problems in State programs. In 1989, Congress imposed the first in a series of moratoriums, prohibiting DHHS from collecting penalties associated with these reviews. Finally, in 1994, Congress enacted two significant provisions as part of the Social Security Act amendments of that year (Public Law 103-432). First, Congress restructured title IV-B so that the foster child protections previously contained in section 427 were no longer voluntary incentives, but rather mandatory components of the State title IV-B plan. Second, Congress mandated the development of a new system to review State conformity with Federal requirements, including State plan requirements, under titles IV-B and IV-E. The 1994 legislation directed DHHS to develop a review system that would incorporate the concepts of technical assistance and corrective action. Specifically, DHHS was directed to specify the Federal requirements that would be subject to review and the criteria that would be used to determine if a State was substantially meeting those requirements. The law further directed DHHS to specify a method for determining the amount of financial penalties that would be imposed in cases of substantial nonconformity. However, Congress also mandated that before such penalties could be imposed, States must be given an opportunity to implement a corrective action plan, and required that DHHS provide the States with necessary technical assistance. Federal Conformity Review System The 1994 legislation also directed DHHS to promulgate regulations establishing the new review system by July 1, 1995, to take effect on April 1, 1996. After pilot testing the system in several States, DHHS proposed the regulations in the Federal Register of September 18, 1998, and issued them as final on January 25, 2000, with an effective date of March 27, 2000. Two types of reviews are established: child and family services reviews of activities funded by both titles IV-B and IV-E, to determine systemwide State compliance with Federal law; and title IV-E eligibility reviews to determine the eligibility of State expenditures for foster care or related activities for Federal reimbursement under title IV-E. Child and family services reviews The child and family services review primarily measures outcomes and results, and allows States to undertake corrective action if they are not found in substantial conformity with the law. DHHS established three outcomes for children and families and seven specific criteria as indicators of States' conformity with Federal law: 1. Child safety --children are first and foremost protected from abuse and neglect, and --children are safely maintained in their homes whenever possible and appropriate; 2. Permanency for children --children have permanency and stability in their living situations, and --the continuity of family relationships and connections is preserved for children; 3. Child and family well-being --families have enhanced capacity to provide for their children's needs, --children receive appropriate services to meet their educational needs, and --children receive adequate services to meet their physical and mental health needs. In addition, the review system measures State performance on the following seven systemic factors, explained in detail in the regulations, that reflect a State's capacity to deliver services leading to improved outcomes for children and families. These factors are: 1. Statewide information system on children in foster care; 2. Case review system for all children in foster care; 3. Standards to protect the health and safety of children in foster care and an identifiable quality assurance system; 4. Staff development and training program; 5. Service array for children and families; 6. Agency responsiveness to the community; and 7. Foster and adoptive parent licensing, recruitment, and retention. The child and family services review is conducted by a joint Federal-State team, and a full review consists of two steps: first, a statewide assessment conducted by the State members of the team, and second, an onsite review conducted by the joint Federal-State team. The statewide assessment examines each of the seven systemic factors listed above; assesses State performance in each of the three child and family outcomes listed above, using statewide data, and analyzes the State's performance in meeting national standards established for these outcomes; assesses characteristics of the State agency that enable it to deliver services that lead to improved outcomes; and assesses the State's strengths and areas that require further examination during the onsite review. While the national standards mentioned above are not specified in the regulations themselves, DHHS explained in its preamble that standards for some of the criteria, related to two of the three child and family outcomes, were developed based on currently available data. National standards have been established as follows: For the child safety outcome: --percent of children with substantiated or indicated child abuse or neglect reports, for whom a subsequent abuse or neglect report is substantiated or indicated--standard: 7 percent; --percent of foster children who are the subject of substantiated or indicated abuse or neglect by a foster parent or facility staff--standard not specified in the January 25, 2000, publication. For the child permanency outcome: --of children who entered foster care during a review period, the percent who reentered within 12 months of a prior foster care episode--standard: 13 percent; --of foster children who were reunified with their parents, the percent who were reunified in less than 12 months--standard: 80 percent; --of foster children who were adopted, the percent who left foster care in less than 24 months--standard: 26 percent; --of children in foster care less than 12 months, the percent who had no more than two placement settings--standard: 77 percent; and --the median length of stay in foster care prior to discharge, for children entering foster care for the first time--standard: 12 months. DHHS established these national standards at the 75th percentile of all States' performance on the particular outcome, as measured through two data collection systems (see below): the Adoption and Foster Care Analysis and Reporting System (AFCARS), and the National Child Abuse and Neglect Data System (NCANDS). The standards, and the outcomes for which standards are established, may change over time. The onsite component of the child and family services review relies on information from the statewide assessment to determine areas in need of improvement and requiring indepth review. The onsite review may focus on specific geographic areas within the State, as long as the State's largest metropolitan area is included. While the onsite review must be planned and conducted by the joint Federal-State team, DHHS has final approval of the program components and geographic areas that are the focus of the review. Sources of information to determine whether a State is in substantial conformity with Federal law, include at a minimum: specific case records on children and families served by the agency; interviews with the children and families; interviews with caseworkers, foster parents and service providers for the cases selected for review; and interviews with ``key stakeholders,'' including individuals involved in developing the State's child and family services plan, courts, administrative review bodies, guardians ad litem, and other individuals or organizations with responsibility for representing the best interests of children. The onsite review examines a sample of cases (drawn randomly from AFCARS and NCANDS data) that may range in size from 30 to 50. The sample size may be increased to ensure that all program areas (i.e., children in foster care, children and families receiving in-home services) are adequately represented. If discrepancies appear between the statewide assessment and the findings of the onsite review, the State may submit additional data or the State and DHHS may jointly review additional cases, up to a specified maximum. A State is considered in substantial conformity with regard to the three child and family outcomes (and seven associated criteria), if its performance meets the national standards for those outcomes or criteria for which standards are established; and if each of the outcomes is ``substantially achieved'' in 95 percent of cases examined during an onsite review (90 percent for an initial review). Moreover, a State's level of achievement with regard to the child and family outcomes is measured by the extent to which it has implemented a series of statutory and regulatory requirements or assurances. A State is considered in substantial conformity with regard to the seven systemic factors, indicating its service delivery capacity, if all State plan requirements associated with the systemic factor are in place and no more than one of the State plan requirements fails to function. If a State is found not to be in substantial conformity, the regulations require development and implementation of a corrective action plan before financial penalties may be assessed. The plan must be approved by DHHS. States subject to a mandatory program improvement plan must report quarterly to DHHS on their progress, and have a specified time in which to complete the plan, based on the seriousness and complexity of the remedies required to correct program deficiencies. In general, the maximum time allowed to complete the program improvement plan is 2 years, although DHHS may grant 1-year extensions in rare circumstances. Priority goes to correcting deficiencies that affect child safety, which must be addressed in less than 2 years. For States that are not in substantial conformity, DHHS must determine the amount of Federal funds to be withheld from that State as a penalty. DHHS will not actually withhold these funds while an approved program improvement plan is in effect, if the State is actively implementing the plan. DHHS can suspend the withholding of funds for no longer than 3 years, or the amount of time allowed for completing the improvement plan, whichever is shorter. Ultimately, funds are withheld for those States that fail to complete their plan by the specified date, or for States that fail to submit quarterly progress reports, or if reports indicate that the State is not making satisfactory progress toward achieving the steps outlined in the plan. The amount of Federal funds to be withheld from a particular State can vary, depending on the extent of the State's nonconformity. Penalties are calculated as a percentage of the following pool of funds: the State's allotment of title IV-B funds (both subparts 1 and 2) for the year(s) to which the withholding applies; and 10 percent of the State's Federal reimbursement claims for administrative costs related to foster care under title IV-E, for the years to which the withholding applies. In the case of a first finding of substantial nonconformity, the amount to be withheld equals 1 percent of the pooled amount described above, for each of the seven criteria associated with child and family outcomes and for each of the seven systemic factors subject to review. For example, if a State does not substantially achieve two of the seven child and family outcome indicators, then 2 percent of the pooled amount of funds it would otherwise receive would be withheld. Likewise, if a State is not in substantial conformity with one of the systemic factors, then 1 percent of the pooled amount would be withheld. The maximum penalty is 14 percent of the pooled amount (i.e., 1 percent for each of the 14 factors). If a State completes a program improvement plan but is found to be in substantial nonconformity during a second full review, the amount of pooled funds to be withheld increases to 2 percent for each of the child and family outcomes or systemic factors that are not achieved, for a maximum penalty of 28 percent. In the case of a third finding of nonconformity, after completion of a program improvement plan, the penalty increases to 3 percent for each factor, for a maximum of 42 percent. If a State refuses to develop a program improvement plan altogether, it is subject to the maximum 42 percent withholding. Once funds are withheld from a State, the withholding continues until a subsequent full review finds the State in substantial conformity or until the State successfully completes a program improvement plan developed as a result of the subsequent review. All States are required to complete an initial full review under the regulation within the 4-year period that began March 27, 2000. Those States that are found to be in substantial conformity must complete a subsequent full review every 5 years, and submit a completed statewide assessment 3 years after their last onsite review. This assessment must be reviewed by the State and DHHS to determine the State's continuing substantial conformity, but is not subject to formal DHHS approval. If an initial or subsequent full review finds that a State is not in substantial conformity, the State must develop and implement a program improvement plan and must begin a subsequent full review 2 years after the plan is approved. If DHHS has any information suggesting that a State is no longer operating in substantial conformity, it may conduct an inquiry and request data from the State and may, depending on the outcome of the inquiry, require a full or partial review at any time, regardless of when the State was last reviewed. Moreover, if DHHS learns that a State is not complying with a title IV-B or IV-E requirement that is outside the scope of the child and family services review, it may conduct an inquiry and institute a partial review at any time, which could result in a mandatory program improvement plan and potentially a financial penalty. Final determinations of substantial nonconformity, and withholding or reduction of funds, may be appealed to the DHHS Departmental Appeals Board within 60 days of the State receiving notice of the nonconformity. States may seek judicial review of an adverse decision by the Board in Federal district court. Title IV-E eligibility reviews Like the child and family services reviews, title IV-E eligibility reviews are conducted by a Federal-State team and include an onsite review. From AFCARS data, DHHS officials select a random sample of 80 cases, plus a 10 percent ``oversample'' of 8 additional cases, from the pool of children eligible for federally funded foster care maintenance payments. Cases from the oversample are used to replace any cases in the basic sample that are found to be invalid for some reason. The State submits to DHHS the complete payment history for all cases in the sample and the oversample, prior to the onsite review. The Federal-State team reviews the sample to determine whether any cases are ineligible under title IV-E. In an initial review, a State is considered in substantial compliance with the law if no more than 8 cases (from the sample of 80) are determined to be ineligible. In a subsequent review, a State is considered in substantial compliance if no more than 4 cases (again, from a sample of 80) are found ineligible. If a State is found in substantial compliance, it is not subject to another review for 3 years. If a State is not found in substantial compliance, it must develop a program improvement plan followed by a secondary review. The program improvement plan must be developed by the joint Federal-State team, identify weaknesses to be corrected and steps to correct them, and specify a timetable for achieving these steps. However, in contrast to the child and family services review, the program improvement plan for a title IV-E eligibility review can last no longer than 1 year, unless enactment of State legislation is required, in which case an extension of one legislative session may be granted. In the secondary review, DHHS draws a sample of 150 cases (plus a 10 percent oversample) from AFCARS data, for review by the joint Federal-State team. The team calculates for the sample both an ineligibility error rate and a dollar error rate. If neither of these error rates, or only one, is more than 10 percent, a disallowance is assessed for the ineligible cases in the sample. If both error rates exceed 10 percent, an extrapolated disallowance is assessed based on the State's entire foster care population. The following title IV-E State plan requirements, which relate to the eligibility of children and foster care providers, are subject to review: 1. For each child, there must be judicial finding that certain ``reasonable efforts'' were made by the State, and that remaining in the biological home would be ``contrary to the welfare'' of the child; 2. If a child was placed through a voluntary placement agreement, the agreement must meet specified criteria; 3. The State agency must have responsibility for the child's placement and care; 4. The child must be placed in a licensed foster family home or child care institution; and 5. The child must meet Aid to Families with Dependent Children (AFDC) requirements, as in effect on July 16, 1996. Compliance with State plan requirements regarding licensing authorities and criminal background checks are also reviewed. Interethnic and Interjurisdictional Adoption Provisions States are subject to penalties if they violate certain provisions of law that were enacted to eliminate barriers to adoption, in addition to any violations of provisions that are subject to a child and family services review or title IV-E eligibility review. Specifically, States may not discriminate in adoption or foster care placements on the basis of race, color or national origin, and also may not deny or delay a child's adoptive placement when an approved family is available outside of the jurisdiction that has responsibility for handling the child's case. The law establishes specific penalties for violations of these provisions. Regarding discrimination on the basis of race or ethnicity, Congress initially enacted the Multiethnic Placement Act (MEPA) in 1994 (Public Law 103-382), which prohibited any agency or entity that received Federal assistance from discriminating on the basis of the child's or the potential adoptive or foster parents' race, color or national origin. However, as enacted in 1994, MEPA did allow agencies to consider the child's cultural, ethnic, or racial background, and the capacity of the prospective parents to meet the child's needs, as one of the factors used to determine the child's best interest. The 1994 legislation also provided a right of action in U.S. district court for individuals who were aggrieved by a MEPA violation and deemed noncompliance with MEPA to be a violation of title VI of the Civil Rights Act. In addition, the 1994 law amended title IV-B of the Social Security Act to add, as a State plan requirement, that States must provide for the diligent recruitment of potential foster and adoptive families that reflect the ethnic and racial diversity of children who need homes. In 1996, Congress revised the interethnic discrimination provisions, as part of the Small Business Job Protection Act (Public Law 104-188). The 1996 law repealed the prior MEPA provision that allowed consideration of a child's cultural, ethnic, or racial background in making placement decisions. Further, the law amended title IV-E of the Social Security Act to provide that neither the State nor any other entity that receives Federal funds may discriminate in adoption or foster care placements on the basis of race, color or national origin. The law specified a penalty for violations of this State plan requirement, equal to 2 percent of Federal title IV-E funds for a first violation, 3 percent for a second violation, and 5 percent for three or more violations. Private agencies that violate the interethnic provisions are required to pay back any Federal funds received. Under the current law, private individuals may continue to seek relief in U.S. district court. However, Public Law 104-188 provides that no action may be brought more than 2 years after the alleged violation occurs. None of these interethnic provisions affect the application of the Indian Child Welfare Act. The final child welfare review regulations, published by DHHS on January 25, 2000, do not establish a specific monitoring system for the antidiscrimination provisions of MEPA, as amended by the 1996 law. However, the regulations establish a procedure for responding to reports of violations of these provisions, and for enforcing the law in cases where violations are found to have occurred. Specifically, whenever DHHS becomes aware of a possible violation, either through a child and family services review or filing of a complaint or any other mechanism, it refers the case to the Department's Office for Civil Rights (OCR) for investigation. If, on the basis of OCR's investigation, a violation actually has occurred, enforcement action will be taken, based on the nature of the violation. If OCR (or a court) finds that a State has discriminated against an individual, on the basis of race, color or national origin, in the course of a foster or adoptive placement, a penalty is assessed for the quarter in which the State is notified of the violation. The penalty equals 2 percent of the State's total title IV-E funds for the quarter, in the case of a first violation in a given fiscal year, and continues for subsequent quarters in that fiscal year, until the State completes a corrective action plan or comes into compliance. In the case of a second violation in the same fiscal year, the penalty equals 3 percent, and 5 percent for third or subsequent violations in a given fiscal year. Violations that remain uncorrected at the end of the fiscal year may be subject to another review and additional penalties. If a MEPA violation results from a State's statute, regulation, policy, procedure, or practice, and no individual is directly affected, the State has 30 days to develop and submit a corrective action plan for DHHS approval. If the State hasn't completed the plan and come into compliance within 6 months of DHHS approving the plan, penalties are assessed. Findings of MEPA violations, and related financial penalties, may be appealed to the DHHS Departmental Appeals Board, and States may seek judicial review of an adverse decision by the Board in Federal district court. As amended in 1997 by the Adoption and Safe Families Act (Public Law 105-89), title IV-E provides that States may not deny or delay a child's placement for adoption if an approved family is available outside the jurisdiction responsible for the child's case. Further, States must provide an opportunity for a fair hearing to anyone whose allegation of a violation of this provision is denied by the State or not acted upon promptly. The law specifies that the same penalty structure applicable to violations of the interethnic provisions, described above, also applies to violations of this provision (i.e., 2 percent for a first violation, 3 percent for a second violation, and 5 percent for three or more violations). However, DHHS did not address enforcement of this interjurisdictional provision in the January 25, 2000, child welfare monitoring regulations. State Performance Reports The Adoption and Safe Families Act (Public Law 105-89) required the Secretary of DHHS, in consultation with Governors, State legislatures, State and local public officials, and child welfare advocates, to develop a set of outcome measures that could be used to assess State performance in operating programs under titles IV-B and IV-E. The law required that these outcome measures include length of stay in foster care, number of foster care placements, and number of adoptions. The law also required that DHHS develop a system for rating State performance on these outcome measures, and publish an annual report on each State's performance, examining the reasons for high and low performance and making recommendations for how State performance could be improved. The first annual report was issued in early August 2000, too late to be included in this edition of the Green Book. DHHS published preliminary outcomes and measures on February 2, 1999, and published the final list of child welfare outcomes and measures on August 20, 1999. These may be amended or expanded over time, particularly to include outcomes addressing child safety and well-being. According to DHHS, the first annual performance report will be based on NCANDS data for calendar year 1997 and AFCARS data for fiscal year 1998 (these data collection systems are described in detail below). The annual report will include additional information about each State and its child welfare program to provide context necessary to interpret the State's performance on the outcome measures. The final list published by DHHS includes seven child welfare outcomes, each with one or more measures that will be used to assess performance. Table 11-13 identifies the child welfare outcomes and measures. TABLE 11-13.--CHILD WELFARE PERFORMANCE OUTCOMES AND RELATED MEASURES ------------------------------------------------------------------------ Outcome Measure ------------------------------------------------------------------------ Reduce recurrence of Of all children who were victims of child abuse and/or substantiated or indicated child abuse/neglect neglect during the reporting period, what percentage had another substantiated or indicated report within a 12-month period? ------------------------------------------------------------------------ Reduce the incidence Of all children who were in foster care during of child abuse and/or the reporting period, what percentage was the neglect in foster subject of substantiated or indicated care maltreatment by a foster parent or facility staff? ------------------------------------------------------------------------ Increase permanency For all children who exited the child welfare for children in system, what percentage left either to foster care reunification, adoption, or legal guardianship? For children who exited the system and were identified as having a diagnosed disability, what percentage left either to reunification, adoption, or legal guardianship? For children who exited the system and were age 12 or older at the time of their most recent entry into care, what percentage left either to reunification, adoption, or legal guardianship? For all children who exited the system, what percentage by racial/ethnic category left either to reunification, adoption, or legal guardianship? Of all children exiting the system to emancipation, what percentage was age 12 or younger at the time of entry into care? ------------------------------------------------------------------------ Reduce time in foster Of all children who were reunified with their care to reunification parents or caretakers at the time of discharge without increasing from foster care, what percentage was reunified reentry in the following time periods: less than 12 months from the time of the latest removal from home; 12-23 months; 24-35 months; 36-47 months; 48 or more months? Of all children who entered foster care during the reporting period, what percentage reentered care within 12 months of a prior foster care episode? ------------------------------------------------------------------------ Reduce time in foster Of all children who exited care to a finalized care to adoption adoption, what percentage exited care in the following time periods: less than 12 months from the time of latest removal from home; 12- 23 months; 24-35 months; 36-47 months; 48 or more months? Of all children who exited care to a finalized adoption and who were age 3 or older at the time of entry into care, what percentage exited care during the following time periods: less than 12 months from the time of latest removal from home; 12-23 months; 24-35 months; 36-47 months; 48 or more months? ------------------------------------------------------------------------ Increase placement Of all children served who had been in care for stability the time periods listed below, what percentage had no more than two placement settings during that time period: less than 12 months from the time of latest removal from home; 12-23 months; 24-35 months; 36-47 months; 48 or more months? ------------------------------------------------------------------------ Reduce placements of For all children who entered care during the young children in reporting period and were age 12 or younger at group homes or the time of their most recent placement, what institutions percentage was placed in a group home? ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service from information published in the Federal Register (1999). FEDERAL WAIVERS OF TITLE IV-B AND IV-E PROVISIONS To provide States flexibility to design innovative child welfare programs, Congress enacted a provision in 1994 (Public Law 103-432) authorizing the Secretary of the U.S. Department of Health and Human Services (DHHS) to approve up to 10 demonstration projects requiring waivers of provisions under titles IV-B and IV-E. This authority was established by section 1130 of the Social Security Act, and was subsequently amended by the Adoption and Safe Families Act in 1997, allowing DHHS to approve an additional 10 demonstration projects in each of fiscal years 1998-2002. The Secretary may waive any provision of either title IV-B or title IV-E if necessary to enable the State to carry out its demonstration project, with some exceptions. Demonstrations are limited to 5 years and must include an evaluation component and be cost-neutral to the Federal Government. As of April 2000, almost half the States had demonstration projects approved, with some States operating more than one project. For new waivers, DHHS is especially interested in proposals that would examine the following: performance-based systems, integrated systems for behavioral health (substance abuse and mental health), effective prevention and early intervention, adoption and postadoption services, service improvements for children in the placement and care responsibility of tribes, service improvements for adolescent youth, and reunification services for adolescent youth. Table 11-14 summarizes the waiver projects that currently have been approved by DHHS and are in various stages of implementation. Few of these demonstrations operate statewide and few have produced evaluation findings thus far. Almost all are designed as 5-year projects. TABLE 11-14.--SUMMARY OF APPROVED STATE CHILD WELFARE WAIVER DEMONSTRATIONS ------------------------------------------------------------------------ State and date of implementation Project description ------------------------------------------------------------------------ Assisted guardianship/kinship permanence: California Assisted guardianship for relatives caring December 1998 for children, age 13 or older, who have been living with the relative at least 1 year and for whom reunification or adoption are not options. Payments equal the basic foster care rate and children retain Medicaid eligibility. Project goals: promote permanence and stability, reduce court and case management costs, increase client safety, increase client satisfaction. Delaware Assisted guardianship for caretakers July 1996 (related or unrelated) of children, who are older than 12, in a sibling group, or have special needs, and for whom reunification or adoption are not options. Children must have been living with the foster caretaker at least 1 year and have a strong attachment. Payments equal the basic foster care rate, and postadoption- type services are available. Project goals: move children more quickly to permanency, provide an additional permanency option, reduce agency involvement and costs. Illinois Assisted guardianship for relative May 1997 caretakers and licensed foster parents caring for children who have been in foster care at least 2 years and living with the prospective guardian at least 1 year, and for whom reunification or adoption are not options. Payments equal adoption assistance payments, and services may be provided. Project goals: provide more stable placement, reduce agency intrusion in family life, reduce costs. Maryland Assisted guardianship for relative February 1998 caretakers of children ages 0-18 (or up to 21 if in formal education) who have been in stable relative homes at least 6 months, and for whom reunification or adoption are not options. Payments equal $300 per month and priority for support services is given. Project goals: provide more stable placement, reduce agency intrusion in family life, reduce costs. Montana Assisted guardianship for caretakers of January-September 1999 children (including in tribal custody) who are at least age 12, have lived with the prospective guardian at least 1 year, and for whom reunification or adoption are not options. Payments may not exceed foster care rate. Services similar to those for adoptive families, and financial and medical assistance, may be provided at the family's request. Project goals: reduce the number of children in long-term foster care and placement disruptions, without increasing subsequent reports of child abuse or neglect. New Mexico Assisted guardianship for caretakers of January-July, 2000 children for whom reunification or adoption are not options. (Two projects are approved; one for children in State custody and one for children in tribal custody.) Payments are similar to and may not exceed adoption assistance. Project goals: achieve permanency more rapidly, improve child well-being, family functioning and child and caretaker satisfaction, increase number of placements in adoption and guardianship homes, and decrease reentry into foster care. North Carolina Assisted guardianship for related and July 1997 unrelated caretakers of children who have lived with the prospective guardian at least 6 months, and for whom adoption or reunification are not options. Payments and services are similar to those offered adoptive families. (This is part of a larger demonstration of capped allocations and local flexibility, described below.) Project goals (of overall demonstration): reduce rate of initial entry into foster care, reduce length of stay in foster care, reduce rate of reentry into foster care. Oregon Assisted guardianship for related and July 1997 (assisted unrelated caretakers of children who have guardianship option been in foster care at least 1 year, have approved in June 1999) lived with the prospective guardian continuously at least 6 months, are at least 12 years old if the prospective guardian is not a relative (any age for relatives), and for whom termination of parental rights (TPR), adoption or reunification are not options. (This is part of a larger demonstration of capped allocations and local flexibility, described below). Project goals (of overall demonstration): improve outcomes for children and families and increase service efficiency, reduce length of stay in foster care and prevent children's placement in foster care, reduce foster care costs by investing in services, maintain child safety and protection. ------------------------------------------------------------------------ Capped title IV-E allocations and flexibility to local agencies: Florida Capped title IV-E funding allocations that July-December 2000 can be used flexibly are provided to locally controlled, nonprofit, community- based systems of care. A local lead agency is responsible for all children referred to the community-based system from point of referral to exit, and assumes financial risk for service delivery. The State must develop a catastrophic risk plan to ensure that children are not put at risk due to bankruptcy or termination of contracts with private service providers. Target population: children from selected counties with a maltreatment finding who require services beyond investigation. Project goals: improve access to services, reduce length of stay in foster care, reduce reentry into the system, improve satisfaction with services, reduce variability in service delivery across sites. Indiana A fixed number of home-based placement January 1998 slots are allocated to counties, which select children for these slots. Individually-tailored intensive services are designed by community-based teams. Each slot has an allocation of $9,000 and the county bears the risk of costs exceeding this amount. Target population: children with substantiated maltreatment reports who are in or at risk of foster care placement. Project goals: improve child and family well-being, reduce placement in out-of-State facilities, improve youth and caretaker satisfaction, promote permanence. New York Participating local districts use a originally September 1999 prospective payment system with (to be extended) individually negotiated payment arrangements with service providers. Target population: children (chosen by the local district) who can safely remain home or return from foster care with appropriate services, and children who can benefit from adoption services. Project goals: decrease foster care placements, increase quality and flexibility of services, decrease reentry, expedite permanency, increase rate of transfer to less restrictive setting. North Carolina Participating counties receive allocations July 1997 based on historic title IV-E funding levels, which they can use flexibly to achieve goals of permanency, safety, and well-being. Strategies may include internal restructuring and contracting with community-based service providers. Counties may not reduce spending below 1995-96 levels and may enter into risk- sharing agreements with service providers. If necessary, the State will share excess costs with counties at the end of the demonstration. Target population: children at imminent risk of placement. Project goals: reduce rate of initial entry into foster care, reduce length of stay in foster care, reduce rate of reentry into foster care. Ohio Participating counties receive a capped October 1997 allotment based on historic and projected costs, and may negotiate financial and risk-sharing agreements with private providers. Funds may be used flexibly to achieve safety, permanency and well-being outcomes. Target population: children in foster care or at risk of placement. Project goals: reduce time in foster care, reduce placement costs, improve stability for children, promote adoption. Oregon Participating branch offices receive a July 1997 title IV-E allocation based on estimates of projected use for foster care, a portion of which can be used flexibly for alternative services. The branch office retains ``savings'' that result; any additional foster care costs are subsidized by the State. Target population: children in foster care or at risk of placement. Project goals: improve outcomes for children and families and increase service efficiency, reduce length of stay in foster care and prevent children's placement into care, reduce foster care costs by investing in services, maintain child safety and protection. ------------------------------------------------------------------------ Managed care/capitated payment systems: Colorado Participating counties negotiate a July-December 2000 capitated or case rate (rate per child) with service providers, which manage the cases of children assigned to them. Agreements with providers may include risk- sharing formulas, penalties, and performance-based incentives. Providers must accept children assigned by the county, and are responsible for outcomes. Target population: children age 10 or older who are at risk of, or have already experienced, foster care ``drift'' and are at risk of aging out of the system without a permanent family. Project goals: increase child safety (reduce recurrence of maltreatment), achieve permanency more rapidly, improve child and family functioning, decrease adoption. Connecticut Participating lead service agencies receive June 1999 a case rate for each child referred to them for a 15-month period. The lead service agency coordinates the child's care through a network of service providers and places children in the least restrictive setting. Providers may retain savings up to 10 percent of the case rate and are not at risk for excess costs up to 10 percent of the case rate. Target population: children ages 7-15 with significant behavior problems who are authorized for residential placement or group homes. Project goals: reduce average length of stay in foster care, increase safety (i.e., reduce substantiated reports or abuse or neglect), increase stability in the community for the children affected, improve children's behavioral health (based on standardized measures), increase children's and families' satisfaction with department services. Maryland Participating service providers receive a January-July 2000 capitated rate for placement and support services. Providers propose outcome improvements; if improvements are achieved, providers retain savings to be used flexibly while providers that fail to achieve improvements risk financial loss. Providers remain responsible for children who reenter care. Target population: children entering foster care after a dispositional hearing and any siblings already in care, children entering foster care from kinship care and any siblings already in care; foster children age 5 and under and any siblings already in care. Project goals: expedite permanency, reduce time in foster care, decrease reentry into foster care. Michigan Community-based providers receive capped May 1999 allocations ($1,545 per month per child), to be used flexibly to achieve safety and permanency goals. Providers assume full case management responsibility. Some participating providers bear full risk for costs that exceed the capped allocation; others share risk with the State, retaining savings or covering costs within 10 percent of the case rate. Target population: children who have formerly been in foster care, are suitable for reunification, have been judged at risk by a risk assessment process, and for whom the court approves an alternative treatment plan. Project goals: increase availability and flexibility of services, reduce foster care placement, reduce time in foster care, expedite permanency, improve child safety and well-being. Texas A primary contractor receives a per-child September 2000-March 2001 standard monthly payment, based on average historic costs, to cover all services and coordinate service delivery by a provider network. Incentives encourage providers to move children to lower levels of care. Target population: children with therapeutic needs (and their siblings) who have been removed from home due to abuse or neglect. Project goals: improve child functioning, reduce time in foster care, decrease reentry into foster care, increase placement stability, ensure least restrictive placement settings. Washington A fixed payment rate is negotiated for each June-December 1999 demonstration site, which develops local agreements between the child welfare agency and other systems, such as education or mental health. Local agreements specify responsibilities of each participant and local service rate per child. Title IV-E funds may be blended with other (Medicaid or education) funds to provide comprehensive services for children to be served at home or in least restrictive community-based setting. Risk is borne by either contractor or local service providers. Target population: children ages 8-17 in the child welfare system, in need of mental health or special education services, who are in temporary care or likely to enter high- cost care. Project goals: meet safety and individual needs of children in appropriate setting; where therapeutically indicated and appropriate, prevent out-of- community group care settings, decrease length of stay, and ensure placement in least restrictive setting. ------------------------------------------------------------------------ Intensive service options: California In participating counties, title IV-E funds December 1998 are used for individually-targeted services for children and families, in addition to traditional maintenance costs. Intensive services include: family conferencing, ``wraparound'' process for children and adolescents with complex and enduring needs, shared family care in which an entire family is temporarily placed with a host family. Target population: children at risk of removal (for family preservation and placement prevention services), foster children moving toward reunification, adoption or guardianship (for services to expedite permanency goals). Project goals: reduce foster care placement, divert children to less restrictive family-like placements. District of Columbia Social workers are matched with trained January-July 2000 neighborhood-based ``community collaborative'' workers to provide family support services to kinship ``triads''; i.e., kinship care giver, parent, and child. Collaboratives are partnerships intended to produce a community-based service delivery system. Target population: children cared for by kinship care givers, who have been in foster care an average of 3-4 years. Project goals: expedite permanency, increase stability, increase child safety, reduce the incidence of child abuse or neglect, reduce the number of new foster care placements, increase child well-being. Mississippi Using flexible title IV-E funds, originally June-December participating counties provide ``core'' 1999 (to be extended) services (e.g., parent training, family counseling) and additional services to respond to needs (e.g., respite care, temporary financial or inkind assistance, job training, educational services, medical care, transportation, child care, counseling, support services for foster parents, homemaker services). Target population: children in the child welfare system, their parents, foster or potential foster parents, custodial relatives, siblings, adoptive or potential adoptive parents. Project goals: reduce subsequent abuse and neglect, increase number of children remaining with their families, increase relative placements for children placed outside the home, increase placement of children and sibling groups in their home communities, decrease foster care placements, decrease time in foster care, increase child well-being. ------------------------------------------------------------------------ Permanency efforts: California Voluntary placement agreements (without December 1998 court orders) may be extended from 6 to 12 months, while retaining title IV-E eligibility. Target population: children who have been placed voluntarily, would otherwise become dependents of the court, who can likely return home safely during the extended time period. Project goals: reduce long-term foster care costs, achieve permanence more rapidly, increase/ maintain levels of child safety, avoid court processes. Maine Expanded training is provided for social April 1999 workers, mental health and other professionals who work with adoptive families, to provide postadoption support services. Target population: families adopting special-needs children (for services; training provided Statewide). Project goals: increase number of special- needs adoptions, decrease disruptions of special-needs adoptions, decrease length of stay in foster care, strengthen adoptive families. Texas Enhanced adoption services for children September 2000-March 2001 with special needs are provided. Target population: children for whom petition to terminate parental rights has been filed, or for whom parental rights have been terminated, families interested in adopting special-needs children. Project goals: increase pool of adoptive families, increase number of children leaving foster care for adoption, reduce time in care prior to adoption, reduce disruption and dissolution rates. ------------------------------------------------------------------------ Substance abuse services: Delaware Contracted substance abuse counselors are February 1997 colocated with child protection workers; accompany child protection workers on initial visits; with the child protection worker, assess the substance abuse problem and its impact on parenting; conduct or arrange for substance abuse evaluations; and stay connected to families through treatment. Savings are used to pay for the counselors. Target population: children in foster care or likely to enter foster care due to parental substance abuse. Project goals: prevent foster care, reduce number of days in foster care. Illinois Recovery coach services are provided in October 1999-June 2000 addition to traditional child welfare and substance abuse services, assisting families early in the treatment process and providing continuing support during and after treatment to prevent relapse and enable family reunification. Some participants receive enhanced services in addition to the recovery coach. Target population: custodial parents with a child who enters placement. Project goals: increase rate of reunification, reduce length of stay in foster care, reduce reallegations of abuse or neglect, increase successful completion of parental substance abuse treatment. Maryland Family support services teams provide January-July 2000 comprehensive coordinated services. Treatment options include inpatient treatment for parents and their children; intermediate (28-day residential) care, or intensive outpatient treatment. Core services include case management, individual, group and family therapy. Additional services may be provided. Title IV-E funds are used when Medicaid or other sources are not available. Target population: parents who have lost custody or are at risk of losing custody of their children due to substance abuse. Project goals: reduce reallegations of abuse or neglect, reduce time in foster care, increase successful completion of substance abuse treatment, enable mothers to assume a healthy parenting role. New Hampshire A substance abuse specialist trains child November 1999 protection investigators and supervisors on screening and identifying parents with substance abuse problems; evaluates parents identified by child protection investigators; if needed, refers families to counseling and treatment, assists with case planning, collaborates with corrections departments, and provides intensive case management. Target population: families with credible reports of abuse or neglect due to parental substance abuse. Project goals: prevent placement in foster care, reduce time in foster care, reduce subsequent abuse or neglect reports, and reduce foster care costs by improving parents' recovery from substance abuse and use of available services and improving stability and adjustment of children in substance- abusing families. West Virginia Teams of child protection workers and June-December 2000 substance abuse outreach specialists coordinate services for families affected by substance abuse. Parents identify temporary informal care givers for their children (up to 60 days) while the parent receives inpatient and/or residential substance abuse treatment. Child protection workers assess appropriateness of informal care givers and conduct criminal background checks; licensed providers supply temporary care if relatives or friends are not available. Caretakers receive payments no higher than foster care rate. Target population: children likely to enter foster care due to maternal substance abuse. Project goals: expedite family reunification, reduce number of children entering formal foster care, increase number of mothers successfully completing substance abuse treatment. ------------------------------------------------------------------------ Tribal administration of title IV-E funds: New Mexico Administration of foster care maintenance, January-July 2000 adoption and independent living services is fully delegated to the tribal government. Target population: children in the custody of tribes that do not already have agreements with the State as allowed under current law. Project goals: increase capacity of tribes to protect and care for their children without subordination to State oversight, promote and improve permanency. ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service from information available from the U.S. Department of Health and Human Services. RECENT TRENDS AFFECTING CHILD WELFARE POPULATIONS AND PROGRAMS Certain social problems and trends are inextricably linked with the child welfare system and its clients, and data and information on these issues are sometimes used as indicators of the need for child protection and preventive services for families. Most children enter foster care as a result of child abuse or neglect; thus, data on the incidence and trends of maltreatment are of great interest to child welfare practitioners and policymakers. Likewise, substance abuse is cited as a factor in many of the cases coming to the attention of child welfare agencies, so that information on substance abuse among families with children and responses to the problem of substance abuse is also of interest. Kinship care also is a phenomenon that has had a significant impact on the child welfare system. In addition, as a major policy change affecting low-income families with children, the welfare reform law of 1996 has implications for both the child welfare system and its clients. These issues are described briefly below. Child Abuse and Neglect Child Abuse Prevention and Treatment Act Between 1963 and 1967, every State and the District of Columbia enacted some form of child abuse and neglect reporting law. The model reporting law disseminated by the U.S. Children's Bureau facilitated the States' rapid adoption of these laws; after 1974 reporting laws were modified to conform to the standards established by the Child Abuse Prevention and Treatment Act of 1974 (CAPTA). CAPTA provides formula grants to States to help support their child protective service systems ($21 million in fiscal year 2000), in exchange for which States must comply with various requirements related to the reporting, investigation, and treatment of child maltreatment cases. The law also authorizes Federal discretionary research and demonstration projects ($18 million in fiscal year 2000), grants to States for community-based family resource and support services ($33 million in fiscal year 2000), and grants to States to improve investigation and prosecution of child maltreatment cases (funded through a set-aside of the victims of crime fund). As amended most recently in 1996 (Public Law 104-235), CAPTA requires States to have procedures for reporting known or suspected cases of child abuse or neglect, for investigating such reports, and for taking immediate steps to protect children who might be in danger. The law requires States to provide immunity from prosecution for individuals who make good faith reports of suspected abuse or neglect, and to provide confidentiality of records. States also must have procedures for public disclosure of information about cases of abuse or neglect which result in a child's death or near-death. State CAPTA plans must provide for cooperation with law enforcement officials, courts, and human service agencies, and for the expungement of records in cases that are false or unsubstantiated. Further, States must appoint a guardian ad litem, who may be an attorney or court-appointed special advocate, to represent children in judicial proceedings. The 1996 law required States to establish citizen review panels, composed of volunteer community representatives, to evaluate State and local child protection activities. In addition, the law required States (within 2 years of the law's enactment) to have procedures for expedited termination of parental rights (TPR) in any case of an abandoned infant, and to have procedures for individuals to appeal an official finding of abuse or neglect. Also within 2 years of enactment, States were required to provide that family reunification would be not be required for a surviving child with a parent who had committed or aided in the murder or voluntary manslaughter of another of their children, or who had committed a felony assault that resulted in serious bodily injury to any of their children. States were required to provide that conviction of any of these felonies would constitute grounds for TPR. CAPTA also requires States to have procedures for responding to cases of medical neglect. Child abuse and neglect statistics The 1996 CAPTA amendments required States to submit annual aggregate data to DHHS on child maltreatment for inclusion in the National Child Abuse and Neglect Data System (NCANDS). States with the capacity to do so may also submit case-level data. NCANDS was established by the 1988 amendments to CAPTA and has published annual reports each year beginning with 1990, although prior to the 1996 amendments States participated in NCANDS on a voluntary basis. Other sources of national data on child maltreatment have included the American Association for Protecting Children (of the American Humane Association), which collected information from 1976 to 1987, and Prevent Child Abuse America (formerly called the National Committee to Prevent Child Abuse), which has been conducting an annual survey of States since 1986. Finally, DHHS has periodically funded the National Incidence Study of Child Abuse and Neglect (NIS), which collects data on children who have been investigated by child protection agencies, but also includes information from community professionals on children who were either not reported to child welfare agencies or whose cases were not investigated. The NIS has been conducted three times, in 1980, 1986, and 1993. The latest data available from NCANDS are for 1998, and include aggregate data from all States and the District of Columbia and case-level data from 20 States. (It is anticipated that 27 States will submit case-level data for 1999 and that 29 States will submit these data for 2000.) Data for 1998 show that 2.8 million reports of possible maltreatment were made to child welfare agencies in that year (U.S. Department, 2000). Approximately two-thirds of these reports were investigated, and 903,000 children were estimated to have been victims of abuse or neglect, for an incidence rate of 12.9 per 1,000 children. These numbers mark a continuation of a downward trend that began in 1993, when more than 1 million children were substantiated as victims, for an incidence rate of 15.3 per 1,000 children. Table 11-15 shows NCANDS data on the incidence of children alleged to have been victims, and substantiated or indicated victimization, by State, in 1994 and 1998, and the percent change between those years. Chart 11-1 illustrates nationwide changes in these incidence rates between 1990, when NCANDS began, and 1998. TABLE 11-15.--INCIDENCE OF CHILD MALTREATMENT ALLEGATIONS AND VICTIMIZATION, BY STATE, 1994-98 ---------------------------------------------------------------------------------------------------------------- Children Child victims alleged to be Percentage per 1,000 Percentage victims per change in children change in State 1,000 children allegation ----------------- victimization ----------------- rate, 1994- rate, 1994-98 1994 1998 98 1994 1998 ---------------------------------------------------------------------------------------------------------------- Alabama............................................ 37.4 33.1 -11 20.1 15.4 -24 Alaska............................................. 53.5 58.9 10 36.0 37.1 3 Arizona............................................ 43.4 48.0 11 26.3 7.1 -73 Arkansas........................................... 28.7 45.2 58 12.3 13.1 6 California......................................... 51.9 46.4 -11 18.4 17.7 -4 Colorado........................................... \1\ 43. 37.6 -13 \1\ 15. 6.7 -56 3 2 Connecticut........................................ 47.2 51.7 10 35.2 21.4 -39 Delaware........................................... 53.6 54.1 1 14.4 16.2 12 District of Columbia............................... 117.3 95.8 -18 49.4 47.7 -3 Florida............................................ 50.2 52.8 5 23.5 23.2 -1 Georgia............................................ 47.8 36.7 -23 33.9 12.1 -64 Hawaii............................................. 19.6 12.0 -39 7.9 7.3 -7 Idaho.............................................. 100.9 76.0 -25 27.8 22.6 -19 Illinois........................................... 45.6 34.7 -24 17.2 11.2 -35 Indiana............................................ 42.4 67.3 59 17.2 12.5 -27 Iowa............................................... 43.1 38.9 -10 12.7 10.1 -20 Kansas............................................. 49.4 38.4 -22 5.3 7.6 43 Kentucky........................................... 61.4 64.2 4 26.8 23.1 -14 Louisiana.......................................... 36.5 38.0 4 12.2 11.6 -5 Maine.............................................. 29.2 31.0 6 15.6 12.3 -21 Maryland........................................... \1\ 43. 43.5 0 \1\ 15. 11.1 -27 3 2 Massachusetts...................................... 39.7 36.3 -9 16.9 18.9 12 Michigan........................................... 54.5 61.3 12 8.7 8.9 2 Minnesota.......................................... 23.0 19.7 -14 8.5 8.4 -1 Mississippi........................................ 36.0 42.8 19 10.6 8.0 -24 Missouri........................................... 62.9 53.4 -15 11.6 8.9 -23 Montana............................................ 57.8 84.7 47 17.9 14.7 -18 Nebraska........................................... 39.9 32.9 -18 10.3 9.5 -8 Nevada............................................. \1\ 43. 49.7 15 21.3 17.2 -19 3 New Hampshire...................................... \1\ 43. 30.1 -31 3.6 3.9 8 3 New Jersey......................................... 34.0 38.2 12 4.9 4.9 1 New Mexico......................................... 50.9 26.6 -48 15.0 8.4 -44 New York........................................... 46.9 53.4 14 12.2 18.6 52 North Carolina..................................... 54.1 65.6 21 17.1 19.5 14 North Dakota....................................... 45.5 43.7 -4 21.2 0.0 -100 Ohio............................................... 55.1 47.7 -13 21.7 20.4 -6 Oklahoma........................................... 40.1 68.6 71 12.5 18.9 51 Oregon............................................. \1\ 43. 33.5 -23 10.1 12.3 22 3 Pennsylvania....................................... 8.2 7.9 -4 2.4 1.9 -23 Rhode Island....................................... 61.0 41.5 -32 13.7 14.5 6 South Carolina..................................... 42.9 39.9 -7 12.3 8.8 -29 South Dakota....................................... 49.3 26.4 -46 9.3 13.2 41 Tennessee.......................................... 26.9 24.2 -10 9.4 7.5 -21 Texas.............................................. 32.9 30.7 -7 10.5 7.1 -32 Utah............................................... 43.4 38.8 -11 15.6 11.4 -27 Vermont............................................ 20.6 14.0 -32 8.4 6.3 -25 Virginia........................................... 35.3 29.8 -15 6.4 5.9 -8 Washington......................................... 40.8 32.1 -21 \1\ 15. 8.8 -42 2 West Virginia...................................... \1\ 43. 159.5 268 \1\ 15. 19.3 27 3 2 Wisconsin.......................................... 35.5 16.5 -54 13.6 6.0 -55 Wyoming............................................ \1\ 43. 17.1 -61 \1\ 15. 6.2 -59 3 2 ------------------------------------------------------------ Total........................................ 43.3 42.5 -2 15.2 12.9 -15 ---------------------------------------------------------------------------------------------------------------- \1\ Based on estimates. Source: Table prepared by the Congressional Research Service using data provided by the U.S. Department of Health and Human Services. The long-term trend in child abuse reporting has been one of substantial growth, with the number of maltreatment reports more than quadrupling since 1976. However, increased reporting does not necessarily mean an equivalent increase in actual abuse or neglect. It is generally agreed that some part of the dramatic growth in reporting over the last two to three decades is due to greater public awareness and recognition of child abuse and neglect, especially since the 1960s and 1970s when States enacted mandatory CHART 11-1. INCIDENCE RATE OF CHILD MALTREATMENT ALLEGATIONS AND VICTIMIZATION, 1990-98 <GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT> Source: Chart prepared by the Congressional Research Service using data provided by the U.S. Department of Health and Human Services. reporting laws. Moreover, not all reports are substantiated. In fact, the proportion of child maltreatment reports that are substantiated has grown smaller over time. According to NCANDS data, 29 percent of investigations in 1998 resulted in victim determinations, compared to 39 percent in 1990. Looking at data from earlier sources, 65 percent of child abuse or neglect reports were substantiated in 1976. However, researchers and professionals agree that not all children who are victims of abuse or neglect are reported to child welfare agencies. According to the most recent NIS survey, more than 1.5 million children were victims of abuse or neglect in 1993 under the ``harm'' standard (i.e., children who have suffered demonstrable harm by objective measures), for a 67 percent increase from 1986, and a 149 percent increase from 1980 (Sedlak & Broadhurst, 1996). The NIS also found that 2.8 million children could be counted in 1993 under the ``endangerment'' standard (a more subjective measure, including children who were not actually harmed but might be considered at risk), which was almost double the number counted in 1986. The endangerment standard was not used in the 1980 NIS. Of child victims in 1998, almost 54 percent experienced neglect, while 23 percent were physically abused. Almost 12 percent were sexual abuse victims, 6 percent had been psychologically abused, and about 2 percent had suffered from medical neglect. Other forms of maltreatment were found for 25 percent of child victims in 1998, with some children falling into more than one of these categories. According to NCANDS data, the number of children who died in 1998 as a result of substantiated abuse or neglect was about 1,100, which was virtually unchanged from 1997 and 1996, although below the peak of 1,240 in 1994. However, in 1995, the U.S. Advisory Board on Child Abuse and Neglect estimated that 2,000 children under age 18 are actually killed by parents or caretakers each year, and suggested that this might be a low estimate (U.S. Advisory Board, 1995). Substance Abuse Substance abuse has received considerable attention as one of the major challenges facing the child welfare system, especially in the last 10-15 years. It is widely believed that the dramatic increase in foster care placements in the mid to late 1980s resulted, at least in part, from the introduction of crack cocaine. Children born drug exposed often enter substitute care shortly after birth, either because of their own medical problems or because of abuse or neglect by their parents. However, children exposed prenatally to drugs or alcohol are a small portion of the children affected by parental substance abuse. Children of all ages typically enter foster care because of child abuse or neglect, and substance abuse is a factor in the majority of these cases. According to a 1990 publication by the Committee on Ways and Means, New York City officials blamed the introduction of crack for the threefold increase in that city's child abuse and neglect cases involving parental substance abuse between 1986 and 1988. Crack cocaine had an especially significant impact on the number of very young infants entering foster care at birth during the late 1980s. From a survey of women who gave birth during 1992-93, the National Institute on Drug Abuse estimated that 221,000 women who gave birth during that period used illegal drugs while pregnant (5.5 percent of a total of 4 million women). Marijuana and cocaine were the most frequently used illegal drugs (2.9 percent for marijuana; 1.1 percent for cocaine). The survey also estimated that 820,000 women (20.4 percent of all women who gave birth during the period) had smoked cigarettes while pregnant, and 757,000 women (18.8 percent of the total) drank alcohol (National Institute, 1995). Cocaine abuse appears to have declined from 1985, when 5.7 million Americans reported being current users, to the latest available level of 1.7 million Americans in 1997 (National Institute, 1999). However, there has been no significant change in the number of frequent cocaine users (682,000 Americans in 1997) since 1985, and no significant change in the number of current crack users (604,000 in 1997) since 1988. In a report mandated by Congress and released in 1999, the U.S. Department of Health and Human Services (DHHS) looked at data from several sources and concluded that a substantial number of children (8.3 million) live with substance abusing parents (U.S. Department, 1999a). African-American parents have higher rates of illegal drug abuse than white parents, especially for cocaine, and substance abusing parents in general have less education, are less likely to be working full time, are less likely to be married, and more likely to be receiving welfare than other parents. Of all forms of parental substance abuse, alcohol abuse is the most prevalent. Although relatively few of the children in substance abusing families ever come into contact with the child welfare system, substance abuse is a major factor in the child welfare caseload. For children with substantiated reports of abuse or neglect, DHHS found that substance abuse is a factor in between one-third and two-thirds of cases, and is a factor in two-thirds of the cases of children in foster care. While mothers and fathers are equally represented in substance abusing households with children, mothers more typically come to the attention of the child welfare system. The DHHS study identified various barriers to meeting the needs of child welfare clients with substance abuse problems, including the different perspectives and philosophies of the substance abuse treatment and child welfare fields. For example, differences exist with regard to the definition of ``client,'' the establishment of reasonable expectations for outcomes and timetables, and responses to setbacks in treatment. Additional barriers cited by DHHS include certain Federal and State laws, the crisis environment affecting many child welfare agencies, shortages of substance abuse treatment facilities, the particular shortage of services appropriate for women with children, and confidentiality requirements. DHHS identified certain key features as important components of a comprehensive approach to addressing joint substance abuse and child maltreatment problems, including preventive services for children, training for caseworkers, enhanced risk assessment and referral capacity, increased access to substance abuse treatment, client retention, recognition of the importance of permanency for children, and support for ongoing recovery. Kinship Care The number of children living with relatives who are not their parents has increased in recent years, especially among minority populations. In the child welfare system, States increased their use of relatives as foster care providers for 18 percent of foster children in 1986 to 31 percent in 1990, according to data from 25 States submitted to the DHHS Inspector General (Office, 1992). Several recent studies shed light on the characteristics of these children and their families. A study for DHHS in 1997 reported on formal and informal kinship care; in other words, ``formal'' placements of children with relatives by the court or a child welfare agency versus ``informal'' arrangements in which relatives care for children without government intervention (U.S. Department, 1997). Based on Current Population Survey data, the contractors (Chapin Hall and the Urban Institute) found 2.15 million children living with relatives without a parent present in 1994. The report found that among these arrangements generally, two-thirds of care givers were the child's grandparents and about half were married. Of single relative care givers, more than 85 percent were female. Kinship care givers were much older than parents caring for their own children, and more likely to be unmarried, have less education, be unemployed or out of the labor force, be poor, or receive welfare benefits. Based on administrative data from four States (California, Illinois, New York and Missouri), the report found that informal kinship care is more common than formal care, with only about 15 percent of kinship children in these States in a formal foster care placement. Younger children were more likely to be in formal kinship care arrangements than older children. The study also found that formal kinship care was largely an urban phenomenon in these States. New York and Missouri had virtually no formal kinship care outside their major city; in California and Illinois, formal kinship care also was concentrated in their major city and a few other counties. In each State, African-American children were more likely to be in kinship care and were eight times as likely as all other children to be in formal kinship care placements. A 1998 report for DHHS by Macro International examined kinship care in seven States (California, Illinois, Louisiana, Maryland, Minnesota, New York, and Utah). This report found that all seven States had policies that explicitly favored kinship foster care over care by nonrelatives, and most allowed relatives to be licensed or certified and receive title IV-E foster care subsidies (U.S. Department, 1998). At the time of the study in 1995, the seven States combined had an equal number of children placed with relatives and nonrelatives. During the previous 5 years, the total number of foster children in these States had increased, almost entirely within the kinship care component. The report found that case management practices were generally the same for relative and nonrelative foster parents in the seven States, and similar services were provided with some exceptions. For example, nonrelated foster parents were more likely to receive training, respite care, and have support groups available, while relative caretakers were more likely to receive funds to meet emergencies. When family reunification was not possible for the child, caseworkers in the seven States encouraged relatives to seek legal custody, guardianship, or subsidized adoption. The Urban Institute surveyed foster care administrators in 1997 to obtain information on State kinship care policies and found considerable variation among States (Boots & Geen, 1999). Almost all States gave preference to relatives over nonrelative foster care providers, but policies differed with regard to the definition of an eligible ``relative.'' In some States, this category included neighbors, godparents, or other adults with a close but not blood relationship with the child. Licensing policy also varied among States, particularly with regard to the stringency of requirements applied to relative care givers. Ten States required kinship care givers to meet the same licensing standards as nonrelative foster parents; however, the remaining 41 States also offered relatives a more flexible option (e.g., less stringent licensing criteria, waiver of certain licensing criteria, or special licensing criteria established specifically for relatives). In addition, some States offered relatives the option of meeting only minimal requirements (generally safety-related), which meant they could not receive a foster care stipend, but could potentially qualify for a welfare payment. In general, payments made to kinship care givers varied according to the type of licensing they received. Relatives who met the same licensing requirements as nonrelatives were generally eligible to receive the same foster care payment. Of 41 States that offered less stringent licensing options, 21 continued to pay the full foster care rate to relatives covered by these options, while most of the remaining States only offered welfare assistance. Finally, based on their National Survey of America's Families, the Urban Institute estimated about 200,000 children are currently in formal kinship care, or about 10 percent of the total number of children living with relatives without their parents present. The U.S. General Accounting Office (GAO) reported in 1999 on quality and permanency issues raised by kinship care. Looking at open foster care cases in California and Illinois, as of September 1997, GAO found the quality of kinship care and other foster care was good and the experiences of children in both types of settings were comparable. GAO's review confirmed the generally held view that children in kinship care have more stability than children in other forms of foster care, but also found that caseworkers had somewhat less confidence that kinship care givers would enforce court-ordered restrictions on parental visits with their children. In addition, the two States held kinship care givers to somewhat lower standards than other foster parents and provided a lower level of support to these families as well. Kinship care children in California spent about the same length of time in foster care as other foster children, while kinship care children in Illinois spent significantly less time in the system, according to GAO. Most recently, DHHS released a report to Congress on kinship care in response to a mandate in the 1997 Adoption and Safe Families Act (U.S. Department, 2000b). The report included a research review, and also identified the following principles to guide policy discussions on kinship care: the child welfare system should continue to focus on safety, permanency, and well-being of children; kinship placement decisions should be based on the best interests of the child; the child welfare system should not supplant family efforts or income assistance programs; and relatives should be viewed as potential resources but should be assessed on a case-by-case basis. Welfare Reform Congress enacted landmark welfare reform legislation in 1996, the Personal Responsibility and Work Opportunity Reconciliation Act (Public Law 104-193), which has been of great interest to child welfare practitioners, researchers, and policymakers because of its potential implications for the child welfare system and its clients. The 1996 law replaced the 61-year-old program of Aid to Families with Dependent Children (AFDC) with a State-administered block grant of Temporary Assistance for Needy Families (TANF). Receipt of public assistance now is time limited and conditioned on participation in work activities (see section 7). The 1996 legislation had an immediate programmatic impact on child welfare agencies because of the legal connection between AFDC eligibility and title IV-E foster care and adoption assistance. As explained earlier, the law now limits title IV-E funding to those children who would have been eligible for the former AFDC Program as it existed on July 16, 1996. Thus, States must maintain these eligibility criteria, even though AFDC has been repealed, for use in determining title IV-E (and Medicaid) eligibility. Some analysts have observed that over time, these eligibility criteria could erode in value and the number of foster and adoptive children for whom States can claim Federal reimbursement may decrease. The financing of welfare reform also has potential implications for child welfare. The law replaced an open-ended entitlement program with a capped block grant, while allowing foster care and adoption assistance under title IV-E to remain uncapped. There is overlap between the populations served by TANF and title IV-E, raising the possibility that States might have an incentive to shift expenditures from TANF to the open- ended title IV-E program, particularly for kinship care families who might be able to meet Federal title IV-E eligibility criteria. In fact, a significant number of children receiving TANF benefits are ``child-only'' cases (see section 7), which means the adult in the household is not part of the assistance unit. In some cases, the adult may be a parent who is not eligible for TANF benefits because of immigration status or another reason, but some portion of these children are living with relatives who are not their parents. Both welfare and child welfare analysts are particularly interested in the dynamics of this population and the extent to which these children and families resemble those in formal kinship foster care arrangements. Beyond these issues, child welfare professionals are closely watching the implementation of welfare reform to determine its impact on the well-being of children and families, especially as measured through changes in the incidence of child maltreatment or entry into foster care. Although relatively few welfare families ever come into contact with the child welfare system, a disproportionately large share of child welfare clients receive or have received cash assistance. Thus, changes in welfare programs that affect a small percentage of clients may have a significant impact on the size of the child welfare population and the workload of the child welfare system. DHHS recently reported on the interaction between welfare assistance (specifically, receipt of AFDC), Medicaid, and foster care prior to enactment of welfare reform (U.S. Department, 2000a). Using administrative data from California, Illinois, and North Carolina in 1995-96, DHHS found that less than 3 percent of children who entered AFDC during the study period were subsequently placed in foster care. However, about 60 percent of the foster care entries in the three States during the study period were from AFDC families. Infants were more likely to enter foster care from an AFDC family than children ages 15-17 and, if they were placed in foster care, they generally entered care within the first 10 months of receiving welfare. These findings may provide a rough baseline for later research on the transition of welfare recipients to foster care after enactment and implementation of the Federal welfare reform law. Numerous evaluations are currently underway on the impact of welfare reform on various outcomes, including the transition of welfare recipients to work, the family formation patterns of welfare recipients, and the economic status of families receiving or formerly receiving welfare (see appendix L). These evaluations have produced limited findings so far on the impact of welfare reform on child welfare-related outcomes; however, additional findings are expected in the near future. Moreover, as the welfare rolls have declined in recent years, many States are conducting ``leaver'' studies to learn about the circumstances of these families after their TANF benefits end. Some of the leaver studies have examined the extent to which children in former welfare families become involved with the child welfare system after the family's cash assistance ends. As of yet, no significant findings on this outcome have emerged, although these studies will continue and may identify trends in the future. In the interim, some analysts have explored potential impacts by looking at data on previous welfare recipients. For instance, Kristen Shook (1999) at Northwestern University attempted to examine the effect of a reduction in welfare income on the likelihood of a family's involvement with child welfare by studying data on AFDC recipients in the Chicago area during a 16-month period in 1995-96. Shook found that a reduction in welfare income was associated with higher risk of child welfare involvement. This relationship was partially offset by an increase in employment income, but was exacerbated by other stressful life events, such as housing or similar environmental problems, birth of another baby, or health issues. Another recent study, by the National Bureau of Economic Research, examined the relationship between child maltreatment and the economic circumstances of parents using State-level data from several sources on child maltreatment (Paxson & Waldfogel, 1999). In this case, researchers found that States with higher proportions of very poor children, children with absent fathers (especially those with absent fathers and working mothers), or nonworking fathers, also had higher rates of child maltreatment. Reductions in State welfare benefits were associated with higher rates of child neglect and foster care, but with small decreases in physical abuse (possibly because of changes in household composition and parental employment). These studies suggest that welfare reform has significant implications for child welfare clients and services because of its potential impact on family formation patterns, parental employment, amount and composition of household income, poverty status, and other socioeconomic circumstances that may be associated with family dysfunction and child maltreatment. However, as of spring 2000, few studies are available on the impact of welfare reform on child welfare-related measures. NATIONAL FOSTER CARE AND ADOPTION INFORMATION Data Collection Systems Historically, there has been a lack of reliable data on foster care and adoption. In fact, not every State even reported its average monthly foster care caseload under the federally assisted program until 1975. Moreover, before 1980 States were not required to collect data on nonfederally- assisted foster care, which in a typical State constitutes about half the cases in foster care. This lack of data was one of several concerns that Congress hoped to address with enactment of the Adoption Assistance and Child Welfare Act of 1980 (Public Law 96-272). The 1980 law imposed several requirements on States as a condition for incentive funds under the Title IV-B Child Welfare Services Program, including a one-time inventory of children in foster care and a statewide information system for tracking children in foster care. Shortly after enactment of the 1980 legislation, DHHS wrote detailed guidelines for the implementation of these requirements, which were published as an interim final rule on December 31, 1980. However, DHHS withdrew these regulations the following March, stating that the Office of Management and Budget had not reviewed and approved certain sections. In 1982, the Department issued a policy information question (ACYF-PIQ-82-06) which restated the law's requirement that States have an information system, but did not specify the system's content. The 1980 regulations were never reissued. Starting in 1982, DHHS funded the American Public Human Services Association (APHSA, formerly the American Public Welfare Association) to conduct a voluntary annual survey of States, known as the Voluntary Cooperative Information System (VCIS). Until recently, VCIS was the only source of national data on the number and characteristics of children in foster and adoptive care. However, the VCIS was of limited use for several reasons: (1) not all States participated fully in the survey; (2) reporting periods were not consistent among States; (3) there was a serious time lag between data collection and publication; and (4) data were available only in an aggregated, State-specific format, preventing the type of analysis that could be conducted with case-specific data. In response to the need for better data collection, Congress in 1986 approved an amendment to title IV-E (section 479) requiring that an advisory committee be established and submit a report to Congress and DHHS with recommendations for establishing, administering, and financing a system for collecting data on adoption and foster care. This amendment, contained in the Omnibus Budget Reconciliation Act, Public Law 99-509, required that the Secretary of DHHS issue final regulations for the new data system by December 31, 1988, and that mandatory data collection be fully implemented no later than October 1, 1991. The advisory committee submitted its final report in 1987, and in May 1989, DHHS submitted an implementation plan to Congress. On September 27, 1990, DHHS proposed regulations to implement the data collection system known as the Adoption and Foster Care Analysis and Reporting System (AFCARS). The population to be covered was children under the responsibility of the State child welfare agency and financing was to come from the title IV-E administrative cost match. States were to claim only that portion of their costs that related to children eligible for title IV-E, although the system would have required States to collect data on non-IV-E children as well. In 1993, as part of the Omnibus Budget Reconciliation Act (Public Law 103-66), Congress authorized an enhanced Federal matching rate to States for certain costs related to data collection for fiscal years 1994-96. Welfare reform legislation enacted in 1996 (Public Law 104-193) extended this enhanced match through fiscal year 1997. The statute specified that this enhanced match of 75 percent was available for costs of planning, design, development and installation of statewide mechanized data collection and information retrieval systems, including costs of hardware, as long as the systems did the following: complied with DHHS regulations; to the extent practicable, interfaced with State child abuse and neglect data collection systems and with AFDC (now TANF) data collection systems; and provided more efficient, economical, and effective administration of State Child Welfare Programs, as determined by DHHS. The law also provided that ongoing operational costs of State data collection and information retrieval systems are matched at the 50 percent Federal rate available for administrative expenses under title IV-E. Further, the amendment specified that States may claim reimbursement for data collection systems without regard to whether they are used for foster and adoptive children who are not eligible for title IV-E assistance. On December 22, 1993, DHHS published two sets of rules in the Federal Register: interim final rules for Statewide Automated Child Welfare Information Systems (SACWIS), issued in response to enactment of Public Law 103-66; and final rules implementing AFCARS. Under the interim final rules for SACWIS, States were required to develop ``comprehensive'' child welfare data collection systems, of which AFCARS must be a component, in order to qualify for Federal funding, including the 75 percent enhanced match. According to DHHS, ``comprehensive'' means that a State SACWIS system must include child welfare services, foster care and adoption assistance, family preservation and support services, and independent living. State SACWIS systems must do the following, at a minimum: 1. Meet the AFCARS data collection and reporting requirements; 2. Provide for intrastate electronic data exchange with data collection systems operated under TANF, Medicaid, child support enforcement, and the National Child Abuse and Neglect Data System (NCANDS) (unless not practicable for certain reasons); 3. Provide for automated data collection on all children in foster care under the responsibility of the State child welfare agency to support implementation of statutory child protections and requirements; 4. Collect and manage information necessary to facilitate delivery of child welfare services, family preservation and family support services, family reunification services, and permanent placement; 5. Collect and manage information necessary to determine eligibility for the Foster Care, Adoption Assistance, and Independent Living Programs and to meet case management requirements for these programs; 6. Monitor case plan development, payment authorization and issuance, and review and management including eligibility determinations and redeterminations; and 7. Ensure confidentiality and security of information. In addition, optional SACWIS functions could include (if cost-beneficial) resource management, tracking and maintenance of legal and court information, administration and management of staff and workloads, licensing verification, risk analysis, and interfacing with other automated information systems. Under the final AFCARS rules, States are required to collect case-specific data on all children in foster care for whom the State child welfare agency has responsibility for placement, care, or supervision, regardless of their eligibility for title IV-E. Further, States are required to collect data on all adopted children who were placed by the State child welfare agency, and on all adopted children for whom the State provides adoption assistance (ongoing payments or for nonrecurring expenses), care, or services either directly or by contract with other private or public agencies. States must report data to DHHS twice a year. Full penalties for noncompliance with AFCARS requirements can be imposed for reporting periods beginning on or after October 1, 1998. Table 11-16 shows the status of State SACWIS projects and those States that submitted detailed case data to NCANDS for 1998. Trends in Foster Care Caseloads The incidence of all children in the United States who are in foster care has increased from 3.9 per 1,000 in 1962 to an estimated 7.7 per 1,000 in 1999. The incidence of children in foster care fluctuated during the 1960s and 1970s. However, the incidence of children in foster care in 1982 was 3.9 per 1,000--exactly the same as 20 years earlier. Since 1982, the incidence has risen steadily each year. In just 2 years between 1987 and 1989, the incidence rose from 4.5 per 1,000 to 5.6 per 1,000. The incidence has continued to rise to an estimated 7.7 per 1,000 in 1999, the most recent year for which data are available (table 11-17). TABLE 11-16.--STATUS OF STATE PARTICIPATION IN CHILD WELFARE DATA COLLECTION SYSTEMS ------------------------------------------------------------------------ Status of information system States ------------------------------------------------------------------------ Operating (or partially operating) Arizona, Arkansas, California, SACWIS (as of February 2000). Connecticut, Delaware, District of Columbia, Idaho (partial), Indiana, Iowa, Kentucky, Maine, Massachusetts, Montana, Nebraska, New Hampshire, New Mexico, New York (partial), North Dakota (partial), Oklahoma, Rhode Island, South Dakota (partial), Texas, Virginia, Washington, West Virginia, Wisconsin (partial), Wyoming Implementing SACWIS (as of February Alabama, Colorado, Florida, 2000). Michigan, Minnesota, Mississippi, Missouri, Nevada, Oregon, South Carolina, Tennessee, Utah Planning SACWIS (as of February 2000).. Alaska, Georgia, Illinois, Kansas, Maryland, New Jersey, Ohio No SACWIS activity reported (as of Hawaii, Louisiana, North February 2000). Carolina, Pennsylvania, Vermont Submitted detailed case data to NCANDS Colorado, Connecticut, for 1998. Delaware, Florida, Illinois, Kentucky, Louisiana, Nebraska, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Vermont, West Virginia, Wyoming ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service, from data obtained from the U.S. Department of Health and Human Services. TABLE 11-17.--U.S. FOSTER CARE AND IV-E FOSTER CARE POPULATIONS AND FOSTER CARE INCIDENCE IN U.S. POPULATION AGES 0-18, 1962-99 ------------------------------------------------------------------------ U.S. foster U.S. foster IV-E foster children care care children per 1,000 Year population (average in U.S. (end of monthly population fiscal number) \2\ ages 0-18 year) \1\ \3\ ------------------------------------------------------------------------ 1962.......................... 272,000 989 3.9 1963.......................... 276,000 2,308 3.9 1964.......................... 287,000 4,081 4.0 1965.......................... 300,000 5,623 4.1 1966.......................... 309,400 7,385 4.2 1967.......................... 309,600 8,030 4.2 1968.......................... 316,200 8,500 4.3 1969.......................... 320,000 16,750 4.3 1970.......................... 326,000 34,450 4.4 1971.......................... 330,400 57,075 4.5 1972.......................... 319,800 71,118 4.4 1973.......................... NA 84,097 NA 1974.......................... NA 90,000 NA 1975.......................... NA 106,869 NA 1976.......................... NA 114,962 NA 1977.......................... NA 110,494 NA 1978.......................... NA 106,504 NA 1979.......................... NA 103,771 NA 1980.......................... 302,000 100,272 4.4 1981.......................... 274,000 104,851 4.1 1982.......................... \4\ 262,000 97,309 3.9 1983.......................... \4\ 269,000 93,360 4.0 1984.......................... \4\ 276,000 102,051 4.1 1985.......................... \4\ 276,000 109,122 4.1 1986.......................... \4\ 280,000 110,749 4.2 1987.......................... \4\ 300,000 118,549 4.5 1988.......................... \4\ 340,000 132,757 5.0 1989.......................... \4\ 387,000 156,871 5.6 1990.......................... \4\ 400,000 167,981 5.9 1991.......................... \4\ 414,000 202,687 6.0 1992.......................... \4\ 427,000 223,315 6.1 1993.......................... \4\ 445,000 231,100 6.3 1994.......................... \4\ 468,000 245,000 6.6 1995.......................... \4\ 483,000 260,800 6.7 1996 (estimate)............... \5\ 507,000 273,600 7.0 1997 (estimate)............... \5\ 537,000 289,400 7.3 1998 (estimate)............... \5\ 560,000 306,500 7.6 1999 (estimate)............... \5\ 568,000 304,422 7.7 ------------------------------------------------------------------------ \1\ Data from Child Welfare Research Notes #8 (July 1984), published by the Administration for Children, Youth, and Families at the U.S. Department of Health and Human Services. This note cites as sources of data for the foster care population: annual reports from 1962 to 1972 of the Children's Bureau and the National Center for Social Statistics, Social and Rehabilitation Services; National Study of Social Services to Children and their Families, published by the Administration for Children, Youth, and Families in 1978, for 1977 data; and the Office of Civil Rights, DHHS, report, ``1980 Children and Youth Referral Survey: Public Welfare and Social Service Agencies'' for 1980 data. \2\ Incomplete data based on voluntary reporting to the Department of Health, Education and Welfare, prior to 1975. \3\ Based on data from U.S. Census Bureau, Population Division, unpublished data (1962-80); U.S. Bureau of the Census, Current Population Reports, Series 1095 (1980-89), PPL-41 (1990-95), and 1130 (1996-99). \4\ American Public Welfare Association (now the American Public Human Services Association). \5\ U.S. Department of Health and Human Services. NA--Not available. Source: Compiled by staff of the House Committee on Ways and Means and the Congressional Research Service. The number of children in federally assisted foster care has grown significantly in the years since funding first became available under AFDC in the early 1960s. The number grew from 1962 to 1976, then decreased from 1976 to 1983. Between 1983 and 1998, the number of foster care children funded under title IV-E has increased steadily (table 11-17). More detailed information is available on trends in foster care caseloads in certain States through the Multistate Foster Care Data Archive at the Chapin Hall Center for Children. Using State administrative data, Chapin Hall has conducted analyses of foster care dynamics from 1983 through 1997 (Wulczyn, Brunner, & Goerge, 1999). Current participants are Alabama, California, Illinois, Iowa, Maryland, Michigan, Missouri, New Mexico, New York, Ohio, and Wisconsin, although not all States have participated in the archive for all years. In general, the data show that in recent years caseload growth has become more a function of longer lengths of stay and changes in the composition of the caseload, rather than the marked increases in admissions that characterized the late 1980s. Looking at the number of children in care at a given point in time, Chapin Hall found different patterns among States, although virtually all States that submitted data for the late 1980s showed growth during that period. For five States (California, Illinois, Michigan, Missouri, and New York), net caseload growth was the highest between 1988 and early 1990, averaging an additional 2,000 cases per month, primarily due to rapid growth in California and New York. California's caseload in general has grown steadily since 1983. Illinois also has seen steady growth in its caseload, especially since 1988, but showed a decline in 1997. After rapid growth between 1986 and 1991, the New York caseload has been steadily dropping. Meanwhile, Alabama's caseload declined slightly each year from 1989 to 1995, and then began to grow. Maryland and Wisconsin have seen steady growth in their caseloads since 1991 and 1992, although data for these States for earlier years are not available from the archive. Caseloads in Michigan and Missouri have grown steadily since 1983. The size of a State's caseload is a function of several factors, including the number of children entering and exiting. To control for differences in State population sizes, Chapin Hall examined data on entries into foster care by looking at entry rates; i.e., the number of new entrants in a given year per 1,000 children in the State. Again, States show various patterns. In New York, entry rates more than doubled from less than 2.5 per 1,000 children in 1983 to almost 6 per 1,000 in 1989, and then declined to less than 3 per 1,000 in 1995 before climbing again slightly. In Illinois, entry rates rose from 1.7 per 1,000 in 1983 to 4.4 per 1,000 in 1994, but have sharply declined since then. California entry rates have stayed relatively stable at 3 per 1,000 since 1991, after a slight decrease between 1989 and 1991. Entry rates in Michigan and Missouri fluctuated but slowly increased between 1983 and 1997, from less than 2 to almost 3 per 1,000 in Michigan and from less than 2.5 to more than 3 per 1,000 in Missouri. Entry rates in Maryland, Ohio, and Wisconsin have been fairly stable since 1990, at around 2 per 1,000 children in Maryland, around 3 per 1,000 in Ohio, and between 3 and 3.5 per 1,000 in Wisconsin. Finally, entry rates in Alabama and New Mexico declined slowly since the late 1980s, although Alabama's rate increased again in 1995. The rate in Alabama has generally been between 2 and 1.5 per 1,000; in New Mexico, the entry rate has fluctuated between 2.5 and 2 per 1,000. Chapin Hall found that caseload growth in the 11 archive States in the late 1980s coincided with a change in the age distribution of children entering the system for the first time, with a dramatic increase in infants and a decrease in adolescents. The percent of new entrants who were infants rose from 15 percent in 1983-86 to almost 25 percent during the peak years of 1987-94. As a percent of new entrants, infants have since declined somewhat, but they remain the single largest group of children entering care, accounting for 20 percent of new entrants in 1995-97. Comparing children ages 0-4 with children ages 5-17, Chapin Hall found that younger children are twice as likely to enter care as older children. To further understand the dynamics of State foster care caseloads, Chapin Hall examined the length of time that children remained in care during their first spell, for the years 1988-97. The investigators found that in every State except Illinois, a quarter of the children had completed their first spell (i.e., exited from the system) within the first 5 months of placement. The comparable figure was 10 months in Illinois. Another 25 percent of children spent more than three times longer in foster care than the first 25 percent; nonetheless, half the children exited foster care in 1 year or less in the following States: Alabama, Iowa, Michigan, Missouri, New Mexico, Ohio, and Wisconsin. At the same time, at least 25 percent of children, in all States except Iowa, spent more than 18 months in foster care. Median durations in care varied widely, from 3 months in Iowa to almost 3.5 years in Illinois. Median duration in Maryland was just over 1 year; New York was 1.5 years. In eight of the archive States, children who entered as infants stayed longer than others, although in Illinois, Iowa, and Maryland, median durations were high for all children who entered before age 12. Median duration was also high for children from major cities and African-American children, except in Missouri. Children in kinship care stayed significantly longer than children in nonrelative foster care, especially in Maryland, Missouri, and New York. Meanwhile, congregate care was associated with shorter spells in Alabama, Illinois, Michigan, New Mexico, New York, and Ohio, but the opposite was true in Iowa. Finally, Chapin Hall found that length of stay appears to be increasing in Alabama, California, Illinois, and Missouri, while declining or remaining stable in the other States. Children who entered the system as infants had the highest rates of adoption, with the likelihood of adoption decreasing each year after the first birthday. Children who entered at age 14 or older were less likely than younger children to exit through family reunification or placement with relatives, except in Alabama. Of children who left the system and had been in nonrelative foster care, 19 percent were adopted, compared with 11 percent of children who had been in kinship foster homes. On the other hand, kinship children were somewhat more likely to be reunited with their families than children in nonrelative foster care. Children in congregate care were least likely to exit through adoption and more likely to age out or run away. White and Hispanic children were more likely to be reunified with their families than African-American children, who were more likely to be permanently placed with a relative or be adopted. Finally, Chapin Hall looked at the relationship between length of stay and type of discharge, and found that 15 percent of children returned to their families in the first 3 months of placement. The rate of family reunification fell sharply after that, although there was an increase between months 12 and 15, possibly due to the case review process. On the other hand, the likelihood of adoption increased over time, and was the most likely discharge for children who had been in care for 3 years or more. National Data on Foster Care and Adoption As described earlier, States now are required to participate in a mandatory data collection system known as AFCARS. Tables 11-18 through 11-40, below, present national and State AFCARS data on the following: (1) total numbers of children in foster care, including numbers of children entering and exiting the system; (2) characteristics of children in foster care and conditions of their placement; (3) characteristics of foster children who are awaiting adoption; and (4) number and characteristics of children who have been adopted through the public child welfare system, including their relationship with their adoptive parents. Data included in these tables are for those States whose data were considered of sufficient quality by the U.S. Department of Health and Human Services (DHHS). (AFCARS data, as well as complete tables from the earlier VCIS system, can be found on the DHHS web site at http://www.acf.dhhs.gov/programs/cb/stats/index.htm.) Over the years, States have made great strides in collecting, analyzing and submitting child welfare data to the Federal Government for inclusion in AFCARS. Nonetheless, State capacity to collect and report valid data in a nationally consistent format continues to be a challenge. As States transition from older, payment-focused systems to more comprehensive, child-focused systems, they face difficult implementation decisions, while also addressing such issues as training workers, revising manuals, and synchronizing paper and automated information systems. Many States have been and continue to be engaged in the development and implementation of SACWIS. The construction of a SACWIS normally requires sequential stages of development; i.e., planning, design, development, and implementation. Until a State's SACWIS is fully utilized by staff, operational statewide, and all programming errors have been corrected, care should be exercised in utilizing their data (see table 11-16 for the status of individual States' SACWIS development). For those States that indicated general concerns about the reliability of their 1998 AFCARS data as a result of SACWIS conversion, a footnote is shown in the tables. In addition, several tables include other footnotes, which reflect comments made by certain States about specific data elements. This year's Green Book contains more tables, including data from more States, than available in previous years from AFCARS, and DHHS has indicated confidence that these data will continue to improve in quantity and quality each year. To that end, DHHS provides ongoing technical assistance to States in improving the quality of their AFCARS data (and child abuse data reported into NCANDS), as well as in implementing SACWIS systems. This technical assistance also includes the creation of a new national resource center for information technology in child welfare. Number of children in foster care Table 11-18 illustrates the ``flow'' of children through the foster care system in 1982-99; i.e., the number of children in care at the start of each year, the number who entered or exited foster care during the course of the year, the total number of children served during the year, and the number of children who remained in care at the end of the year. These numbers indicate steady increases in the foster care population that were most dramatic in the late 1980s and that continue today, as also illustrated in chart 11-2. It should be remembered that these data reflect the total foster care population and are not limited to those children receiving subsidies under title IV-E. DHHS estimates that 55 percent of the total foster care population is eligible for assistance under title IV-E. TABLE 11-18.--NUMBER AND MOVEMENT OF SUBSTITUTE CARE CHILDREN, 1982-99 ---------------------------------------------------------------------------------------------------------------- Start of Entered Total End of Year year care served Left care year ---------------------------------------------------------------------------------------------------------------- 1982..................................................... 273,000 161,000 434,000 172,000 262,000 1983..................................................... 263,000 184,000 263,000 178,000 263,000 1984..................................................... 272,000 184,000 456,000 180,000 276,000 1985..................................................... 270,000 190,000 460,000 184,000 276,000 1986..................................................... 273,000 183,000 456,000 176,000 280,000 1987..................................................... 280,000 222,000 502,000 202,000 300,000 1988..................................................... 312,000 199,000 511,000 171,000 340,000 1989..................................................... 347,000 222,000 569,000 182,000 387,000 1990..................................................... 379,000 238,000 617,000 217,000 400,000 1991..................................................... 400,000 224,000 624,000 210,000 414,000 1992..................................................... 414,000 238,000 652,000 225,000 427,000 1993..................................................... 427,000 230,000 657,000 212,000 445,000 1994..................................................... 444,000 254,000 698,000 230,000 468,000 1995..................................................... 455,000 255,000 710,000 227,000 483,000 1996..................................................... 488,000 237,000 725,000 218,000 507,000 1997..................................................... 507,000 251,000 758,000 231,000 537,000 1998..................................................... 537,000 262,000 799,000 241,000 560,000 1999..................................................... 560,000 266,000 826,000 244,000 568,000 ---------------------------------------------------------------------------------------------------------------- Source: Data for 1997, 1998, and 1999 are estimates from AFCARS, U.S. Department of Health and Human Services. Data for 1982-96 were obtained from the American Public Human Services Association. CHART 11-2. CHILDREN IN SUBSTITUTE CARE, END OF YEAR, 1982-99 <GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT> Source: U.S. Department of Health and Human Services and the American Public Human Services Association. Table 11-19 shows the number of children who entered care during fiscal year 1998, the number of children who exited care during fiscal year 1998, and the total number of children who were in care as of September 30, 1998. Table 11-20 lists the average monthly number of children in foster care who received Federal funding under title IV-E for the years 1989, 1993, 1997, and 1999. These figures are lower than AFCARS estimates of the total number of children in foster care because they do not include the substantial number of children who were not eligible for Federal funding (primarily because they were not from AFDC-eligible homes). Characteristics of children in foster care Much of the data collected on children in foster care reflect three different groupings of children: children who entered foster care during the study period (fiscal year 1998); children who left care during the study period; and children who remained in care on the last day of the study period. Tables 11-21 and 11-22 present data on the age composition of children in these three categories, for all States combined whose data was of sufficient quality to be included in AFCARS; and on the ages of children who were in care on September 30, 1998. In addition, tables 11-23 and 11-24 show the racial and ethnic composition of children in each category for all States combined, and of children who remained in care on September 30, 1998, for each State. TABLE 11-19.--CHILDREN ENTERING AND EXITING CARE IN FISCAL YEAR 1998, AND CHILDREN IN CARE ON SEPTEMBER 30, 1998, BY STATE ------------------------------------------------------------------------ State Entering Exiting In care ------------------------------------------------------------------------ Alabama............................. 2,803 2,851 5,198 Arizona............................. 4,300 2,190 5,608 Arkansas............................ 2,737 2,094 3,138 California.......................... 52,997 50,049 112,767 Colorado............................ 7,147 5,202 7,951 Connecticut......................... 5,222 3,682 6,683 Delaware............................ 1,023 333 1,480 District of Columbia................ 1,039 792 3,188 Florida............................. 13,980 7,934 26,320 Georgia \1\......................... 3,724 3,632 9,937 Hawaii.............................. 1,774 1,410 2,441 Idaho............................... 851 572 963 Illinois............................ 9,229 12,627 48,737 Indiana \1\......................... 6,328 9,524 5,070 Kansas \1\.......................... 6,683 3,400 8,488 Louisiana........................... 3,051 2,399 6,301 Maine \1\........................... 1,646 712 3,595 Maryland............................ 4,467 3,296 12,890 Minnesota........................... 11,772 10,512 8,618 Mississippi......................... 1,821 1,325 3,359 Missouri............................ 6,504 4,950 12,495 Montana............................. 1,503 1,223 1,991 New Jersey.......................... 4,748 4,385 9,191 New Mexico.......................... 1,480 1,137 821 New York............................ 19,749 20,324 53,555 North Carolina...................... 5,464 3,993 11,314 North Dakota........................ 1,067 728 1,125 Oklahoma............................ 6,346 5,337 7,233 Oregon.............................. 5,212 4,512 7,266 Pennsylvania........................ 13,019 10,933 23,070 Puerto Rico......................... 2,171 1,615 6,629 Rhode Island \1\.................... 1,623 915 2,844 South Carolina...................... 3,191 3,689 4,644 Texas............................... 6,539 3,760 17,103 Utah................................ 2,196 1,956 2,468 Vermont............................. 783 655 1,316 Virginia \1\........................ 2,683 1,856 6,838 Washington.......................... 7,243 6,560 8,980 West Virginia....................... 2,011 1,767 3,082 Wisconsin........................... 5,566 4,846 10,076 Wyoming............................. 961 863 883 ----------------------------------- Total......................... 242,653 210,540 475,656 ------------------------------------------------------------------------ \1\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Note.--Delaware reports underreporting in the above number for children exiting foster care and overreporting in the number of those remaining in foster care at the end of 1998. Oklahoma, Texas, and Utah report underreporting in the above numbers for children exiting foster care. Source: Table prepared by the Congressional Research Service from data provided by the U.S. Department of Health and Human Services. TABLE 11-20.--TITLE IV-E FOSTER CARE AVERAGE MONTHLY NUMBER OF CHILDREN, SELECTED FISCAL YEARS 1989-99 ---------------------------------------------------------------------------------------------------------------- Fiscal year Percent change State --------------------------------------------------------- 1989 \1\ 1993 1997 1999 1993-99 1989-99 ---------------------------------------------------------------------------------------------------------------- Alabama............................................... 1,119 810 1,152 1,304 61 17 Alaska................................................ 253 303 317 487 61 93 Arizona............................................... 714 1,774 3,382 3,634 105 409 Arkansas.............................................. 372 715 1,299 1,624 127 337 California............................................ 35,659 48,928 71,042 78,222 60 119 Colorado.............................................. 1,866 2,529 2,874 2,653 5 42 Connecticut........................................... 1,646 1,482 3,192 4,528 205 175 Delaware.............................................. 244 183 342 378 107 55 District of Columbia.................................. 356 748 1,101 1,297 73 264 Florida............................................... 2,464 4,191 6,545 8,842 111 259 Georgia............................................... 2,244 3,254 4,382 4,208 29 88 Hawaii................................................ 42 326 1,172 1,101 238 2521 Idaho................................................. 272 225 375 510 126 87 Illinois.............................................. 8,578 11,514 30,668 28,592 148 233 Indiana............................................... 1,559 2,541 4,061 3,963 56 154 Iowa.................................................. 1,157 1,502 2,197 2,810 87 143 Kansas................................................ 1,167 1,371 466 2,356 72 102 Kentucky.............................................. 1,509 1,797 2,796 3,018 68 100 Louisiana............................................. 3,061 2,824 3,850 2,908 3 -5 Maine................................................. 815 1,000 1,482 2,013 101 147 Maryland.............................................. 869 3,073 4,533 5,090 66 486 Massachusetts \2\..................................... 2,021 7,839 7,910 7,340 -6 263 Michigan.............................................. 7,914 8,672 8,609 9,338 8 18 Minnesota............................................. 2,030 2,984 3,696 4,115 38 103 Mississippi........................................... 673 868 1,088 1,000 15 49 Missouri.............................................. 2,139 4,570 5,263 5,620 23 163 Montana............................................... 426 557 782 950 71 123 Nebraska.............................................. 924 1,291 1,549 1,477 14 60 Nevada................................................ 436 620 759 1,345 117 209 New Hampshire \3\..................................... 444 526 639 625 19 41 New Jersey............................................ 3,064 3,873 5,453 6,124 58 100 New Mexico............................................ 746 875 869 1,183 35 59 New York.............................................. 34,607 53,475 42,679 38,049 -29 10 North Carolina........................................ 1,557 2,983 4,586 4,854 63 212 North Dakota.......................................... 309 402 504 486 21 57 Ohio.................................................. 4,513 6,546 7,849 4,936 -25 9 Oklahoma.............................................. 732 1,379 2,555 4,039 193 452 Oregon................................................ 2,067 1,882 3,129 3,193 70 54 Pennsylvania.......................................... 9,638 14,760 14,816 15,054 2 56 Puerto Rico \4\....................................... NA NA NA 5,110 NA NA Rhode Island.......................................... 569 673 775 629 -7 11 South Carolina........................................ 1,123 1,652 1,695 1,146 -31 2 South Dakota.......................................... 210 225 211 340 51 62 Tennessee............................................. 1,586 6,533 6,269 6,327 -3 299 Texas................................................. 3,588 4,920 6,434 6,757 37 88 Utah.................................................. 436 454 771 730 61 67 Vermont............................................... 734 874 1,130 1,151 32 57 Virginia.............................................. 1,986 2,100 3,266 3,260 55 64 Washington............................................ 2,477 2,484 1,748 2,603 5 5 West Virginia......................................... 1,004 1,017 1,949 823 -19 -18 Wisconsin............................................. 3,174 4,834 4,995 4,037 -16 27 Wyoming............................................... 104 97 198 242 149 133 --------------------------------------------------------- Total........................................... 157,197 231,055 289,404 297,312 29 89 ---------------------------------------------------------------------------------------------------------------- \1\ Based on accrual method accounting. \2\ Fiscal year 1999 data include estimates for the third and fourth quarters. \3\ Fiscal year 1999 data include estimates for the average monthly number of children. \4\ Did not begin to participate in title IV-E foster care until fiscal year 1999. It is not included in the fiscal year 1999 total. If Puerto Rico were included, the total average monthly number of children in fiscal year 1999 would be 302,422. NA--Not applicable. Note.--Totals may differ from sum of State amounts because of rounding. Source: U.S. Department of Health and Human Services. TABLE 11-21.--AGES OF CHILDREN ENTERING AND EXITING CARE IN FISCAL YEAR 1998, AND IN CARE ON SEPTEMBER 30, 1998 [In percent] ------------------------------------------------------------------------ Age range Entering Exiting In care ------------------------------------------------------------------------ Under 1 year........................... 13 4 4 1-5 years.............................. 25 26 26 6-10 years............................. 22 23 27 11-15 years............................ 29 24 27 16-18 years............................ 11 20 14 19 years or older...................... 0 2 1 Mean age (years)....................... 8.57 10.24 9.62 Median age (years)..................... 8.47 10.25 9.55 ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service from information provided by the U.S. Department of Health and Human Services. TABLE 11-22.--AGES OF CHILDREN IN CARE ON SEPTEMBER 30, 1998, BY STATE [In percent; 469,578 total cases] ---------------------------------------------------------------------------------------------------------------- Age --------------------------------------- Mean Median State Under years years 1 1-5 6-10 11-15 16-18 19+ ---------------------------------------------------------------------------------------------------------------- Alabama.................................................. 4 24 25 29 17 2 10.20 10.50 Arizona.................................................. 5 27 26 28 14 0 9.33 9.41 Arkansas................................................. 4 23 24 31 18 1 10.30 10.93 California............................................... 4 28 29 27 12 0 9.25 9.11 Colorado................................................. 4 19 22 34 20 1 10.83 11.92 Connecticut.............................................. 4 29 28 28 11 1 9.23 8.97 Delaware................................................. 4 25 25 26 20 0 10.12 10.14 District of Columbia..................................... 2 26 28 23 15 6 10.25 9.66 Florida.................................................. 5 31 30 24 10 1 8.62 8.18 Georgia \1\.............................................. 3 28 29 27 12 1 9.31 9.18 Hawaii................................................... 7 33 27 23 11 0 8.35 7.79 Idaho.................................................... 4 26 30 28 13 0 9.35 9.21 Illinois................................................. 3 28 30 24 12 3 9.49 9.05 Indiana \1\.............................................. 4 27 24 25 15 4 9.88 9.79 Kansas \1\............................................... 6 15 18 36 25 1 11.52 13.55 Louisiana................................................ 3 21 25 36 15 (\2\) 10.45 11.19 Maine \1\................................................ 5 22 26 30 16 2 10.14 10.43 Maryland................................................. 3 23 30 28 13 3 10.09 9.99 Minnesota................................................ 3 16 22 35 23 1 11.47 12.76 Mississippi.............................................. 4 26 27 27 14 2 9.71 9.56 Missouri................................................. 4 23 26 30 15 2 10.05 10.21 Montana.................................................. 5 25 26 29 14 0 9.58 9.85 New Jersey............................................... 7 32 23 24 13 0 8.64 8.19 New Mexico............................................... 7 33 30 23 7 (\2\) 8.02 7.72 New York................................................. 4 27 28 26 13 3 9.67 9.50 North Carolina........................................... 5 28 27 29 12 1 9.32 9.30 North Dakota............................................. 6 13 19 35 26 1 11.55 13.41 Oklahoma................................................. 5 27 26 26 16 0 9.55 9.48 Oregon................................................... 5 30 29 27 9 0 8.76 8.60 Pennsylvania............................................. 4 21 23 30 20 1 10.58 11.27 Puerto Rico.............................................. 3 29 32 27 9 (\2\) 8.94 8.61 Rhode Island \1\......................................... 4 21 20 28 23 4 11.06 12.16 South Carolina........................................... 5 23 25 30 16 2 10.04 10.50 Texas.................................................... 5 30 28 26 11 0 8.91 8.71 Utah..................................................... 4 20 23 33 20 1 10.75 11.71 Vermont.................................................. 2 12 16 39 30 0 12.53 14.37 Virginia \1\............................................. 2 19 23 31 22 3 11.24 12.15 Washington............................................... 6 32 27 24 11 0 8.63 8.14 West Virginia............................................ 3 18 21 32 25 2 11.48 12.78 Wisconsin................................................ 2 21 26 31 18 3 10.78 11.23 Wyoming.................................................. 2 19 20 38 21 0 11.26 13.03 ------------------------------------------------------ Total.............................................. 4 26 27 27 14 1 9.62 9.55 ---------------------------------------------------------------------------------------------------------------- \1\ State indicated general concern with reliability of 1998 data due to conversion process to Statewide Automated Child Welfare Information Systems (SACWIS). \2\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. Note.--Vermont reports that foster care population includes children in the juvenile justice system, which accounts for the significant percentage of children in foster care who are 11-18 years of age. Source: U.S. Department of Health and Human Services. TABLE 11-23.--RACIAL/ETHNIC BACKGROUND OF CHILDREN ENTERING AND EXITING CARE IN FISCAL YEAR 1998, AND IN CARE ON SEPTEMBER 30, 1998 [In percent] ------------------------------------------------------------------------ In Race/ethnicity Entering Exiting care ------------------------------------------------------------------------ White........................................ 45 44 34 Black........................................ 30 33 44 Hispanic..................................... 16 15 15 Other........................................ 4 4 3 Unknown...................................... 5 4 4 ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service from information provided by the U.S. Department of Health and Human Services. TABLE 11-24.--RACE/ETHNICITY OF CHILDREN IN CARE ON SEPTEMBER 30, 1998 [In percent; 474,906 total cases] ---------------------------------------------------------------------------------------------------------------- American Indian/ Asian/ State White Black Alaska Pacific Hispanic Unknown Native Islander ---------------------------------------------------------------------------------------------------------------- Alabama................................................ 44 55 0 0 1 0 Arizona................................................ 51 13 4 0 27 4 Arkansas............................................... 56 41 0 0 2 1 California............................................. 30 35 1 2 31 1 Colorado............................................... 53 16 2 1 25 3 Connecticut............................................ 33 35 0 0 32 (\1\) Delaware............................................... 31 59 0 (\1\) 5 5 District of Columbia................................... 1 97 (\1\) (\1\) 0 2 Florida................................................ 45 50 0 0 5 0 Georgia \2\............................................ 35 59 0 0 1 3 Hawaii................................................. 12 2 1 77 2 5 Idaho.................................................. 86 2 4 (\1\) 7 1 Illinois............................................... 17 77 0 0 5 1 Indiana \2\............................................ 59 35 0 0 1 4 Kansas \2\............................................. 69 19 1 1 7 2 Louisiana.............................................. 34 65 0 0 1 0 Maine \2\.............................................. 91 2 1 0 2 4 Maryland............................................... 19 80 0 0 1 (\1\) Minnesota.............................................. 56 24 13 2 5 1 Mississippi............................................ 40 58 (\1\) 0 1 0 Missouri............................................... 55 43 0 0 1 0 Montana................................................ 64 2 27 0 3 4 New Jersey............................................. 22 64 0 0 9 4 New Mexico............................................. 28 8 5 (\1\) 56 2 New York............................................... 14 46 0 0 15 25 North Carolina......................................... 40 52 1 0 6 0 North Dakota........................................... 61 2 34 0 3 0 Oklahoma............................................... 55 24 15 0 4 0 Oregon................................................. 63 11 4 1 6 15 Pennsylvania........................................... 36 52 0 1 11 0 Puerto Rico............................................ 0 0 0 0 99 0 Rhode Island \2\....................................... 56 23 2 1 14 4 South Carolina......................................... 36 62 0 0 1 1 Texas.................................................. 33 33 0 0 31 2 Utah................................................... 74 4 4 1 14 4 Vermont................................................ 96 2 0 0 1 1 Virginia \2\........................................... 42 54 0 1 3 1 Washington............................................. 63 18 10 2 7 0 West Virginia.......................................... 86 12 (\1\) 0 1 1 Wisconsin.............................................. 43 48 3 1 4 (\1\) Wyoming................................................ 84 3 2 0 8 2 -------------------------------------------------------- Total............................................ 34 44 2 1 15 4 ---------------------------------------------------------------------------------------------------------------- \1\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. \2\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. Source: U.S. Department of Health and Human Services. Characteristics of foster care As table 11-25 shows, 40 percent of the children who were in foster care on September 30, 1998, had permanency plans of reunification with their families, while 20 percent had plans of adoption. For 7 percent of the children, the permanency plan was long-term foster care. As for the living arrangements of these children, table 11-26 shows that slightly less than half were in foster family homes with people unrelated to them, while another 29 percent were in foster care with relatives, and 15 percent of these children were either in a group home or institution. As shown in table 11-27, almost two-thirds of the children in care on September 30, 1998, had experienced between one and two placements during their current spell in foster care, while 21 percent had experienced three or four, and 16 percent had experienced five or more. TABLE 11-25.--PERMANENCY PLANS OF CHILDREN IN CARE ON SEPTEMBER 30, 1998, BY STATE [In percent; 470,431 total cases] ---------------------------------------------------------------------------------------------------------------- Long- Live with term Not yet State Reunify relative(s) Adoption foster Emancipation Guardianship established care ---------------------------------------------------------------------------------------------------------------- Alabama........................ 45 14 15 23 (\1\) (\1\) 3 Arizona........................ 42 8 24 8 9 3 7 Arkansas....................... 40 6 10 7 7 0 29 California..................... 14 4 3 4 (\1\) 2 73 Colorado....................... 59 3 16 11 6 3 1 Connecticut.................... (\1\) (\1\) (\1\) (\1\) (\1\) (\1\) 100 Delaware....................... 23 4 9 4 4 1 54 District of Columbia........... 23 7 32 12 17 (\1\) 10 Florida........................ 71 2 16 10 2 (\1\) (\1\) Georgia \2\.................... 67 2 21 4 6 0 0 Hawaii......................... 54 4 16 6 (\1\) 3 17 Idaho.......................... 67 0 8 6 1 2 17 Illinois....................... 24 0 45 1 19 8 3 Indiana \2\.................... 34 3 8 2 2 3 48 Kansas \2\..................... 70 0 21 3 3 1 1 Louisiana...................... 58 5 18 16 3 0 (\1\) Maine \2\...................... 28 1 32 21 2 0 15 Maryland....................... 31 14 15 18 9 10 4 Minnesota...................... 55 4 12 13 2 1 14 Mississippi.................... 55 17 18 3 3 1 3 Missouri....................... 64 2 17 5 6 3 3 Montana........................ 40 4 19 18 4 1 14 New Jersey..................... 53 8 32 5 2 (\1\) 0 New Mexico..................... 25 (\1\) 13 0 6 1 55 New York....................... 57 (\1\) 30 (\1\) 10 1 3 North Carolina................. 37 14 34 (\1\) 2 12 2 North Dakota................... 42 3 19 15 5 0 15 Oklahoma....................... 56 1 21 12 4 1 5 Oregon......................... 70 1 17 11 1 1 (\1\) Pennsylvania................... 51 2 20 18 4 2 3 Puerto Rico.................... 72 11 8 6 2 0 1 Rhode Island \2\............... 53 1 20 13 12 0 1 South Carolina................. 35 3 39 12 10 0 1 Texas.......................... 24 9 39 10 8 4 6 Utah........................... 29 (\1\) 1 1 0 0 70 Vermont........................ 53 2 12 17 9 1 7 Virginia \2\................... 25 7 29 24 15 0 0 Washington..................... 59 3 24 5 1 6 2 West Virginia.................. 33 4 29 31 1 1 1 Wisconsin...................... 79 2 8 4 1 (\1\) 6 Wyoming........................ 53 3 6 19 6 1 11 -------------------------------------------------------------------------------- Total.................... 40 3 20 7 5 3 23 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Note.--Connecticut reports that missing data is an indication of the complexity of the system, and/or a mapping difficulty between the State elements and the Adoption and Foster Care Analysis and Reporting System. Source: U.S. Department of Health and Human Services. TABLE 11-26.--PLACEMENT SETTINGS OF CHILDREN IN CARE ON SEPTEMBER 30, 1998, BY STATE [In percent; 455,411 total cases] ---------------------------------------------------------------------------------------------------------------- Pre- adopt- Foster Foster home Group Supervised Trial State ive home (nonrelative) home Institution independent Runaway home home (relative) living visit ---------------------------------------------------------------------------------------------------------------- Alabama..................... 1 14 57 3 16 0 2 7 Arizona..................... (\1\) 26 42 20 10 (\1\) 1 1 Arkansas.................... 9 11 67 (\1\) 10 1 2 0 California.................. 0 46 38 10 3 (\1\) 1 3 Colorado.................... 4 10 60 3 20 1 2 0 Connecticut................. 4 25 50 3 17 0 (\1\) (\1\) Delaware.................... 2 16 61 6 14 1 (\1\) (\1\) District of Columbia........ 8 (\1\) 66 12 8 2 0 5 Florida..................... 4 46 41 6 1 1 1 (\1\) Georgia \2\................. 6 19 60 7 6 0 1 2 Hawaii...................... 2 37 53 2 4 1 1 0 Idaho....................... 2 8 74 9 7 (\1\) (\1\) 1 Illinois.................... 6 46 35 1 6 3 2 2 Indiana \2\................. 0 21 54 4 20 0 (\1\) 1 Kansas \2\.................. 2 10 38 12 8 1 1 27 Louisiana................... 0 11 62 8 14 0 0 4 Maine \2\................... 2 3 74 4 8 2 0 6 Maryland.................... 1 28 58 9 4 0 0 0 Minnesota................... 5 16 55 16 7 0 0 (\1\) Mississippi................. 2 26 36 15 7 1 1 12 Missouri.................... 7 25 41 2 20 2 1 3 Montana..................... (\1\) 25 64 10 1 (\1\) (\1\) (\1\) New Jersey.................. 2 2 68 8 18 2 (\1\) (\1\) New Mexico.................. 5 29 56 5 3 2 0 (\1\) New York.................... 0 24 54 2 14 0 (\1\) 4 North Carolina.............. 5 18 45 7 7 0 5 13 North Dakota................ 6 9 54 6 25 (\1\) 0 (\1\) Oklahoma.................... 2 28 49 14 6 0 0 0 Oregon...................... (\1\) 27 63 1 9 0 (\1\) (\1\) Pennsylvania................ 2 8 61 9 18 1 0 1 Puerto Rico................. 2 40 41 8 7 0 1 1 Rhode Island \2\............ 2 22 32 33 2 3 6 (\1\) South Carolina.............. 6 2 50 38 2 0 0 1 Texas....................... 14 13 46 5 16 0 1 5 Utah........................ 3 6 37 13 3 2 3 33 Vermont..................... 3 10 58 14 3 3 (\1\) 9 Virginia \2\................ 6 2 69 18 1 1 1 2 Washington.................. 2 34 57 5 1 0 2 0 West Virginia............... 5 6 61 14 11 2 1 (\1\) Wisconsin................... 2 6 75 6 11 (\1\) (\1\) (\1\) Wyoming..................... 0 18 47 13 22 1 0 (\1\) ----------------------------------------------------------------------------------- Total................. 3 29 48 7 8 1 1 3 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Note.--Minnesota reports that 80 percent of placements in the largest county are initially in emergency shelters, which may be characterized as institutional settings. Oklahoma reports that group home data include children experiencing brief shelter stays. South Carolina reports that an estimated one-third of the children in group homes, shown above, are misidentified. Source: U.S. Department of Health and Human Services. TABLE 11-27.--NUMBER OF PLACEMENTS OF CHILDREN IN CARE ON SEPTEMBER 30, 1998, BY STATE [In percent; 394,707 total cases] ------------------------------------------------------------------------ 7 or State 1-2 3-4 5-6 more ------------------------------------------------------------------------ Alabama..................................... 74 15 5 5 Arizona..................................... 14 9 8 68 Arkansas.................................... 67 19 7 8 California.................................. 69 21 6 4 Colorado.................................... 63 22 8 7 Connecticut................................. 77 18 3 1 Delaware.................................... 90 7 2 2 District of Columbia........................ 59 21 9 10 Georgia \1\................................. 71 18 6 6 Hawaii...................................... 67 21 7 5 Idaho....................................... 57 33 5 5 Illinois.................................... 53 26 11 10 Indiana \1\................................. 97 2 1 1 Kansas \1\.................................. 48 23 11 17 Louisiana................................... 46 25 13 16 Maine \1\................................... 47 20 10 23 Maryland.................................... 85 13 2 0 Minnesota................................... 65 21 8 6 Mississippi................................. 74 14 6 6 Missouri.................................... 53 25 10 12 Montana..................................... 59 25 10 5 New Jersey.................................. 69 19 7 5 New Mexico.................................. 97 3 1 0 North Carolina.............................. 47 26 12 15 North Dakota................................ 83 13 3 1 Oklahoma.................................... 56 27 10 8 Oregon...................................... 64 21 8 7 Pennsylvania................................ 62 22 9 7 Puerto Rico................................. 96 3 1 0 Rhode Island \1\............................ 56 22 10 12 South Carolina.............................. 61 22 9 7 Texas....................................... 46 28 12 14 Utah........................................ 29 29 22 19 Vermont..................................... 38 27 15 20 Virginia \1\................................ 94 5 1 0 Washington.................................. 53 24 10 14 West Virginia............................... 87 9 2 2 Wisconsin................................... 83 14 3 1 Wyoming..................................... 78 16 4 2 --------------------------- Total................................. 64 21 8 8 ------------------------------------------------------------------------ \1\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. The amount of time that children spend in foster care is an issue of public policy concern. As shown in table 11-28, children who left care during fiscal year 1998 had generally shorter lengths of stay from the time of removal from home than those children who remained in care on September 30, 1998. Table 11-29 shows the length of stay, by State, for children in care on September 30, 1998. TABLE 11-28.--LENGTH OF STAY FOR CHILDREN EXITING CARE DURING FISCAL YEAR 1998, AND FOR CHILDREN IN CARE ON SEPTEMBER 30, 1998 [In percent] ------------------------------------------------------------------------ Exiting Length of stay care In care ------------------------------------------------------------------------ Under 1 month..................................... 20 4 1-5 months........................................ 18 15 6-11 months....................................... 14 15 12-17 months...................................... 10 11 18-23 months...................................... 7 9 24-29 months...................................... 5 7 30-35 months...................................... 4 5 3-4 years......................................... 11 16 5 years or longer................................. 10 18 Mean (months)..................................... 22.45 33.26 Median (months)................................... 11.2 21.19 ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service from information provided by the U.S. Department of Health and Human Services. TABLE 11-29.--LENGTH OF STAY FOR CHILDREN IN CARE ON SEPTEMBER 30, 1998, BY STATE [In percent; 474,839 total cases] -------------------------------------------------------------------------------------------------------------------------------------------------------- Less State than 1 1-5 6-11 12-17 18-23 24-29 30-35 3-4 5 years Mean Median month months months months months months months years or more months months -------------------------------------------------------------------------------------------------------------------------------------------------------- Alabama.............................................. 4 15 13 11 10 8 5 13 21 38.35 22.28 Arizona.............................................. 7 25 24 11 8 5 4 11 7 20.02 10.74 Arkansas............................................. 8 25 16 13 10 7 4 10 7 20.95 12.22 California........................................... 3 13 16 12 9 7 5 14 20 35.17 21.62 Colorado............................................. 7 26 19 12 7 5 4 11 8 21.16 11.14 Connecticut.......................................... 7 24 20 15 10 8 5 9 3 16.46 11.50 Delaware............................................. 7 29 19 12 6 6 4 10 6 18.31 9.46 District of Columbia................................. 2 9 12 11 8 7 6 21 23 41.40 29.96 Florida.............................................. 5 21 21 13 9 7 5 11 9 22.53 13.31 Georgia \1\.......................................... 0 10 14 12 11 9 8 19 18 36.58 26.22 Hawaii............................................... 5 22 22 13 10 5 5 11 7 20.80 12.29 Idaho................................................ 7 22 19 15 8 6 4 12 6 19.73 12.35 Illinois............................................. 2 7 7 7 8 8 7 28 27 45.26 40.02 Indiana \1\.......................................... 5 17 16 11 7 8 6 17 13 28.89 19.06 Kansas \1\........................................... 5 28 31 12 6 4 3 6 5 15.82 8.80 Louisiana............................................ 4 20 14 10 7 6 5 15 18 33.40 19.65 Maine \1\............................................ 2 17 20 9 6 6 5 15 19 33.57 18.73 Maryland............................................. 3 11 12 11 9 8 6 20 20 36.08 26.18 Minnesota............................................ 8 25 18 10 7 6 4 11 13 25.30 11.99 Mississippi.......................................... 5 18 16 12 9 8 4 14 15 30.06 17.45 Missouri............................................. 4 17 15 12 9 8 6 15 13 28.83 18.79 Montana.............................................. 5 20 15 11 8 8 6 15 11 26.96 16.99 New Jersey........................................... 4 16 15 12 10 8 6 18 12 29.45 19.81 New Mexico........................................... 10 36 21 33 (\2\) (\2\) (\2\) (\2\) (\2\) 7.62 6.93 New York............................................. 3 11 12 10 8 7 6 15 27 42.54 28.58 North Carolina....................................... 4 19 16 14 10 8 5 13 11 25.93 16.33 North Dakota......................................... 6 25 26 10 6 6 9 11 1 15.79 11.47 Oklahoma............................................. 5 25 18 13 9 7 5 10 8 21.88 12.88 Oregon............................................... 6 20 17 14 11 8 4 14 7 22.71 14.95 Pennsylvania......................................... 5 18 16 10 8 7 5 14 20 34.42 19.63 Puerto Rico.......................................... 2 12 14 11 7 7 8 22 17 35.12 28.01 Rhode Island \1\..................................... 4 22 20 12 11 6 4 12 9 23.67 14.19 South Carolina....................................... 4 17 14 9 6 6 6 19 19 35.03 24.80 Texas................................................ 4 16 14 12 8 7 5 17 17 31.89 20.99 Utah................................................. 6 23 19 16 10 7 4 10 4 18.01 12.45 Vermont.............................................. 5 17 18 12 9 8 7 15 10 26.16 17.54 Virginia \1\......................................... 4 13 13 8 9 8 5 19 21 37.70 25.76 Washington........................................... 5 16 17 13 10 8 5 16 10 26.37 17.05 West Virginia........................................ 4 19 17 11 9 6 6 14 14 29.49 16.76 Wisconsin............................................ 4 15 12 10 9 9 7 19 14 31.61 23.85 Wyoming.............................................. 7 25 20 14 10 3 3 12 7 19.54 11.04 -------------------------------------------------------------------------------------------------- Total.......................................... 4 15 15 11 9 7 5 16 18 33.26 21.19 -------------------------------------------------------------------------------------------------------------------------------------------------------- \1\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. \2\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. Source: U.S. Department of Health and Human Services. Finally, table 11-30 shows the reasons for discharge for children who left foster care during fiscal year 1998, and indicates that the majority (62 percent) of these children were reunified with their families. Another 14 percent were adopted, 9 percent left to live with other relatives, and 7 percent were emancipated (i.e., ``aged out''). TABLE 11-30.--DISCHARGE REASONS FOR CHILDREN EXITING CARE, BY STATE, FISCAL YEAR 1998 [In percent; 166,035 total cases] ---------------------------------------------------------------------------------------------------------------- Live with State Reunification other Adoption Emancipation Guardianship Other relative ---------------------------------------------------------------------------------------------------------------- Alabama................................. 58 33 (\1\) 3 (\1\) 5 Arizona................................. 95 (\1\) (\1\) 2 (\1\) 3 Arkansas................................ 66 21 3 3 (\1\) 7 California.............................. 73 (\1\) 10 8 4 5 Colorado................................ 69 6 7 5 1 12 Connecticut............................. 63 7 15 2 10 4 Delaware................................ 95 (\1\) (\1\) 1 (\1\) 4 District of Columbia.................... 28 27 20 11 1 13 Florida................................. 30 41 16 9 (\1\) 4 Georgia \2\............................. 53 19 15 7 2 4 Hawaii.................................. 62 2 23 7 4 2 Idaho................................... 77 8 5 3 (\1\) 7 Illinois................................ 52 6 35 5 0 1 Indiana \2\............................. 100 (\1\) (\1\) (\1\) (\1\) (\1\) Kansas \2\.............................. 66 5 9 6 1 14 Louisiana............................... 49 24 10 13 2 2 Maine \2\............................... 73 4 6 11 1 5 Maryland................................ 48 15 11 7 3 16 Minnesota............................... 90 3 2 2 0 2 Mississippi............................. 56 25 10 5 3 3 Missouri................................ 67 3 13 10 3 4 Montana................................. 59 14 16 5 1 4 New Jersey.............................. 71 (\1\) 16 8 (\1\) 5 New Mexico.............................. 76 10 0 1 5 8 New York................................ 49 11 24 7 (\1\) 8 North Carolina.......................... 47 16 17 6 10 4 North Dakota............................ 70 8 1 6 0 15 Oklahoma................................ 71 10 11 2 1 5 Oregon.................................. 68 2 17 2 5 7 Pennsylvania............................ 61 11 12 6 1 10 Rhode Island \2\........................ 56 3 13 4 2 22 South Carolina.......................... 61 13 17 8 0 1 Texas................................... 48 37 2 11 (\1\) 2 Utah.................................... 54 (\1\) 14 6 22 4 Vermont................................. 62 3 16 9 1 8 Virginia \2\............................ 50 23 10 11 0 6 Washington.............................. 71 (\1\) 13 6 7 3 West Virginia........................... 54 13 11 7 1 14 Wisconsin............................... 58 10 11 6 (\1\) 16 Wyoming................................. 56 9 2 2 4 27 ----------------------------------------------------------------------- Total............................. 62 9 14 7 2 6 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Note.--California reports that its foster care population includes probation children who enter at older ages and may not be good candidates for adoption; therefore, their inclusion skews data to show a lower rate of adoption. Also, the data conversion process resulted in missing cases for this data element. Delaware reports that no exits to adoption, as shown in the table, is an error. Florida reports that children exiting to reunification include guardianship cases. Source: U.S. Department of Health and Human Services. Characteristics of children awaiting adoption Tables 11-31 through 11-33 show characteristics of children who were awaiting adoption at the end of fiscal year 1998; i.e., children in foster care who had permanency plans of adoption and/or whose parental rights had been terminated. Children whose permanency plan was emancipation are not included in these tables. As the tables show, nearly 60 percent were between the ages of 6 and 15; more than half (53 percent) were black; and more than half (54 percent) had been in foster care for 3 years or longer. TABLE 11-31.--AGE DISTRIBUTION OF CHILDREN AWAITING ADOPTION, BY STATE, FISCAL YEAR 1998 [In percent; 103,329 total cases] ---------------------------------------------------------------------------------------------------------------- less State than 1 1-5 6-10 11-15 16-18 ---------------------------------------------------------------------------------------------------------------- Alabama............................................................ 2 31 39 21 6 Arizona............................................................ 5 38 39 17 1 Arkansas........................................................... 4 30 33 30 2 California......................................................... 8 55 26 9 2 Colorado........................................................... 2 30 39 26 3 Connecticut........................................................ 1 37 40 19 3 Delaware........................................................... 1 39 46 13 1 District of Columbia............................................... 1 40 43 15 1 Florida............................................................ 3 32 37 25 3 Georgia \1\........................................................ 2 33 36 24 5 Hawaii............................................................. 2 32 31 24 10 Idaho.............................................................. 3 31 39 21 6 Illinois........................................................... 2 36 40 21 2 Indiana \1\........................................................ 2 44 32 18 4 Kansas \1\......................................................... 8 20 23 39 11 Louisiana.......................................................... 2 31 41 24 2 Maine \1\.......................................................... 5 30 36 22 7 Maryland........................................................... 1 31 43 22 2 Minnesota.......................................................... 3 23 37 29 8 Mississippi........................................................ 1 27 37 26 9 Missouri........................................................... 2 30 36 27 5 Montana............................................................ 2 27 28 34 9 New Jersey......................................................... 5 43 28 18 6 New Mexico......................................................... 5 33 37 23 2 New York........................................................... 1 30 38 28 3 North Carolina..................................................... 5 35 33 23 4 North Dakota....................................................... 25 27 30 17 2 Oklahoma........................................................... 3 33 36 25 3 Oregon............................................................. 3 43 39 14 1 Pennsylvania....................................................... 3 36 37 21 3 Puerto Rico........................................................ 3 18 41 31 6 Rhode Island \1\................................................... 1 40 41 15 2 South Carolina..................................................... 3 30 34 28 5 Texas.............................................................. 3 35 35 24 3 Utah............................................................... 7 35 37 19 2 Vermont............................................................ 3 28 26 34 8 Virginia \1\....................................................... 3 38 41 16 1 Washington......................................................... 7 45 32 14 3 West Virginia...................................................... 4 34 40 21 2 Wisconsin.......................................................... 2 32 36 25 6 Wyoming............................................................ 2 26 38 28 6 -------------------------------------------- Total........................................................ 3 35 37 22 3 ---------------------------------------------------------------------------------------------------------------- \1\ State indicated general concern with reliability of 1998 data due to conversion process to Statewide Automated Child Welfare Information Systems (SACWIS). Source: U.S. Department of Health and Human Services. TABLE 11-32.--RACE/ETHNICITY OF CHILDREN AWAITING ADOPTION, BY STATE, FISCAL YEAR 1998 [In percent; 103,217 total cases] ---------------------------------------------------------------------------------------------------------------- American Indian/ Asian/ State White Black Hispanic Alaska Pacific Unknown Native Islander ---------------------------------------------------------------------------------------------------------------- Alabama................................................ 43 56 1 0 (\1\) 0 Arizona................................................ 53 14 26 4 0 3 Arkansas............................................... 55 43 0 (\1\) (\1\) 2 California............................................. 40 27 30 1 1 0 Colorado............................................... 47 22 27 2 1 2 Connecticut............................................ 36 39 25 (\1\) 0 (\1\) Delaware............................................... 27 57 6 (\1\) (\1\) 10 District of Columbia................................... 1 97 (\1\) (\1\) (\1\) 1 Florida................................................ 44 50 4 0 0 0 Georgia \2\............................................ 38 57 1 0 0 4 Hawaii................................................. 14 3 3 2 76 3 Idaho.................................................. 86 3 10 1 (\1\) (\1\) Illinois............................................... 12 83 4 0 0 1 Indiana \2\............................................ 55 39 2 0 (\1\) 4 Kansas \2\............................................. 62 28 4 1 (\1\) 4 Louisiana.............................................. 37 61 1 0 (\1\) 1 Maine \2\.............................................. 93 3 1 1 1 1 Maryland............................................... 20 79 1 0 0 (\1\) Minnesota.............................................. 48 35 6 11 1 0 Mississippi............................................ 35 64 (\1\) (\1\) 1 (\1\) Missouri............................................... 53 45 1 0 0 0 Montana................................................ 73 1 3 19 1 4 New Jersey............................................. 18 70 9 0 0 2 New Mexico............................................. 23 5 69 3 (\1\) (\1\) New York............................................... 10 51 14 0 0 25 North Carolina......................................... 39 54 5 1 0 1 North Dakota........................................... 54 2 2 41 1 (\1\) Oklahoma............................................... 47 35 5 14 (\1\) 0 Oregon................................................. 68 10 7 3 0 11 Pennsylvania........................................... 30 58 11 0 0 0 Puerto Rico............................................ 0 (\1\) 100 (\1\) (\1\) (\1\) Rhode Island \2\....................................... 50 27 15 2 0 5 South Carolina......................................... 31 67 1 0 0 1 Texas.................................................. 30 35 32 0 0 3 Utah................................................... 73 4 18 1 1 3 Vermont................................................ 96 2 1 (\1\) (\1\) 1 Virginia \2\........................................... 38 56 4 0 1 1 Washington............................................. 65 20 7 6 1 0 West Virginia.......................................... 84 15 1 (\1\) (\1\) 0 Wisconsin.............................................. 56 33 4 7 0 (\1\) Wyoming................................................ 77 8 13 2 (\1\) (\1\) -------------------------------------------------------- Total............................................ 29 53 11 1 1 5 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. TABLE 11-33.--LENGTH OF STAY FOR CHILDREN AWAITING ADOPTION, BY STATE, FISCAL YEAR 1998 [In percent; 103,325 total cases] ---------------------------------------------------------------------------------------------------------------- Less than 1-5 6-11 12-17 18-23 24-29 30-35 36-59 60 or State 1 months months months months months months months more month months ---------------------------------------------------------------------------------------------------------------- Alabama.................................. 1 2 4 6 9 13 9 22 35 Arizona.................................. 2 9 20 9 11 11 7 24 6 Arkansas................................. (\1\) 7 10 9 11 10 11 31 11 California............................... 1 6 11 16 17 15 9 16 9 Colorado................................. 3 12 11 11 9 10 8 23 15 Connecticut.............................. 7 31 25 16 9 6 2 3 2 Delaware................................. (\1\) 6 5 13 9 14 7 36 11 District of Columbia..................... 0 2 6 8 9 9 10 30 26 Florida.................................. 1 10 11 10 10 11 9 23 15 Georgia \2\.............................. 0 2 4 7 9 11 10 28 29 Hawaii................................... 0 3 9 9 19 7 9 28 16 Idaho.................................... (\1\) 3 8 3 9 12 12 32 20 Illinois................................. 0 1 3 5 8 9 8 35 29 Indiana \2\.............................. 0 2 5 9 12 8 7 27 29 Kansas \2\............................... 5 22 36 4 4 5 2 9 13 Louisiana................................ (\1\) 2 3 6 9 10 9 28 33 Maine \2\................................ 1 9 22 13 9 7 6 17 15 Maryland................................. 0 1 4 6 8 9 8 32 33 Minnesota................................ 3 10 9 9 10 9 7 18 23 Mississippi.............................. 0 4 5 6 7 9 5 28 36 Missouri................................. 0 2 5 8 9 12 10 28 24 Montana.................................. 1 3 8 12 11 12 10 25 19 New Jersey............................... 1 7 7 9 10 11 8 29 18 New Mexico............................... (\1\) 21 24 55 (\1\) (\1\) (\1\) (\1\) (\1\) New York................................. 0 1 2 3 5 7 6 24 51 North Carolina........................... 2 9 11 14 12 10 7 20 15 North Dakota............................. 3 13 18 12 10 8 19 15 2 Oklahoma................................. 1 5 8 12 12 13 9 25 15 Oregon................................... 1 4 9 14 12 14 9 30 7 Pennsylvania............................. 0 2 5 8 10 10 8 26 31 Puerto Rico.............................. 1 3 3 4 2 4 8 27 55 Rhode Island \2\......................... 0 5 7 11 19 12 10 21 15 South Carolina........................... 1 6 7 7 6 9 10 30 23 Texas.................................... 0 4 9 12 10 9 8 25 22 Utah..................................... 2 11 18 22 13 10 6 14 5 Vermont.................................. 1 3 9 10 13 10 7 23 24 Virginia \2\............................. 1 7 10 8 10 11 8 27 19 Washington............................... 1 6 11 14 12 11 8 24 13 West Virginia............................ 1 6 10 11 13 12 9 24 15 Wisconsin................................ 2 7 8 6 8 12 9 28 21 Wyoming.................................. (\1\) 8 8 8 8 (\1\) 4 43 23 ---------------------------------------------------------------------- Total.............................. 1 4 7 8 9 10 8 27 27 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. Number and characteristics of adopted children The Adoption and Foster Care Analysis and Reporting System (AFCARS) collects data on children who were adopted with the involvement of public child welfare agencies (see table 11-34). As explained earlier, this is not necessarily the same as the number of adoptions reported by States for purposes of earning adoption incentive payments, which are based specifically on adoptions of children from foster care. Table 11-35 compares the racial and ethnic composition of children who were adopted through the child welfare system in fiscal year 1998 with the race and ethnicity of children who were waiting for adoption during that year. Black children were the largest racial group in either category, but comprised a larger share of waiting children (53 percent) than of children for whom adoptions had been finalized (46 percent). The opposite was true for white children, who made up 14 percent of waiting children but 34 percent of adopted children. Table 11-36 shows the racial and ethnic background of children adopted in fiscal year 1998, by State. TABLE 11-34.--NUMBER OF AGENCY-INVOLVED ADOPTIONS BY STATE, FISCAL YEAR 1998 ------------------------------------------------------------------------ Number of State adoptions ------------------------------------------------------------------------ Alabama...................................................... 47 Alaska....................................................... 95 California................................................... 3,965 Colorado..................................................... 265 District of Columbia......................................... 75 Florida...................................................... 1,549 Georgia \1\.................................................. 646 Hawaii....................................................... 293 Illinois..................................................... 4,566 Indiana \1\.................................................. 99 Iowa......................................................... 296 Kansas \1\................................................... 254 Kentucky..................................................... 111 Louisiana.................................................... 198 Maine \1\.................................................... 18 Maryland..................................................... 400 Massachusetts................................................ 1,060 Michigan..................................................... 1,941 Minnesota.................................................... 403 Mississippi.................................................. 135 Missouri..................................................... 585 Montana...................................................... 130 New Hampshire................................................ 51 New Jersey................................................... 713 New York..................................................... 4,561 North Carolina............................................... 797 North Dakota................................................. 39 Ohio......................................................... 1,212 Oklahoma..................................................... 472 Oregon....................................................... 490 Pennsylvania................................................. 504 Puerto Rico.................................................. 35 Rhode Island \1\............................................. 101 South Carolina............................................... 278 South Dakota................................................. 85 Tennessee.................................................... 272 Texas........................................................ 1,388 Utah......................................................... 190 Vermont...................................................... 69 Virginia \1\................................................. 107 Washington................................................... 441 West Virginia................................................ 207 Wisconsin.................................................... 621 Wyoming...................................................... 28 ---------- Total.................................................. 29,792 ------------------------------------------------------------------------ \1\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. TABLE 11-35.--RACIAL AND ETHNIC BACKGROUND OF CHILDREN AWAITING ADOPTION AND ADOPTED, FISCAL YEAR 1998 [In percent] ------------------------------------------------------------------------ Waiting Adopted Race/ethnicity children children ------------------------------------------------------------------------ White............................................... 29 34 Black............................................... 53 46 Hispanic............................................ 11 12 Other............................................... 2 2 Unknown............................................. 5 5 ------------------------------------------------------------------------ Source: Compiled by the Congressional Research Service from information provided by the U.S. Department of Health and Human Services. Additional State-by-State information on children adopted through the public child welfare system is shown in tables 11- 37 through 11-40, including age at the time of adoption finalization, the prior relationship between adoptive parents and children, the length of time between termination of parental rights (TPR) and adoption finalization, and the basis of children's special needs. Readers should note (table 11-38) that most children who are adopted out of foster care are adopted by their foster parents. In table 11-40, the percentages shown are of all children identified in the individual States as having special needs. Note also that slightly more than half the children classified as ``special needs'' received this classification because of either their age or their membership in a sibling group. TABLE 11-36.--RACE/ETHNICITY OF CHILDREN ADOPTED IN FISCAL YEAR 1998, BY STATE [In percent; 29,773 total cases] ---------------------------------------------------------------------------------------------------------------- American Asian/ Indian/ State White Black Hispanic Pacific Alaska Unknown Islander Native ---------------------------------------------------------------------------------------------------------------- Alabama.............................................. 45 55 (\1\) (\1\) (\1\) (\1\) Alaska............................................... 22 22 3 (\1\) 53 (\1\) California........................................... 37 25 34 3 1 1 Colorado............................................. 60 14 23 0 2 1 District of Columbia................................. 1 99 (\1\) (\1\) (\1\) (\1\) Florida.............................................. 49 40 10 0 (\1\) 0 Georgia \2\.......................................... 37 59 2 (\1\) (\1\) 2 Hawaii............................................... 12 1 4 79 2 2 Illinois............................................. 18 76 5 0 0 1 Indiana \2\.......................................... 80 11 3 (\1\) (\1\) 6 Iowa................................................. 71 19 3 2 5 1 Kansas \2\........................................... 69 19 8 (\1\) 2 2 Kentucky............................................. 60 25 5 (\1\) (\1\) 9 Louisiana............................................ 28 71 (\1\) (\1\) (\1\) 1 Maine \2\............................................ 94 (\1\) 6 (\1\) (\1\) (\1\) Maryland............................................. 32 63 3 1 (\1\) 1 Massachusetts........................................ 46 23 23 1 0 7 Michigan............................................. 37 58 3 0 1 1 Minnesota............................................ 40 43 6 1 9 (\1\) Mississippi.......................................... 44 52 2 (\1\) 1 (\1\) Missouri............................................. 58 41 0 0 1 0 Montana.............................................. 82 2 4 (\1\) 12 (\1\) New Hampshire........................................ 84 8 6 (\1\) 2 (\1\) New Jersey........................................... 21 70 9 (\1\) (\1\) 1 New York............................................. 9 53 14 0 0 23 North Carolina....................................... 40 55 3 0 2 1 North Dakota......................................... 97 (\1\) (\1\) (\1\) 3 (\1\) Ohio................................................. 46 47 2 (\1\) (\1\) 5 Oklahoma............................................. 58 26 3 0 12 0 Oregon............................................... 76 11 10 1 2 1 Pennsylvania......................................... 52 35 13 1 (\1\) (\1\) Puerto Rico.......................................... (\1\) (\1\) 100 (\1\) (\1\) (\1\) Rhode Island \2\..................................... 33 38 7 (\1\) (\1\) 23 South Carolina....................................... 30 67 0 (\1\) 0 2 South Dakota......................................... 65 2 1 (\1\) 32 (\1\) Tennessee............................................ 51 45 4 (\1\) 0 (\1\) Texas................................................ 27 40 28 0 0 5 Utah................................................. 74 5 17 2 3 1 Vermont.............................................. 99 1 (\1\) (\1\) (\1\) (\1\) Virginia \2\......................................... 48 49 1 (\1\) (\1\) 3 Washington........................................... 67 19 7 1 5 1 West Virginia........................................ 84 9 1 1 (\1\) 4 Wisconsin............................................ 42 48 5 0 5 (\1\) Wyoming.............................................. 68 4 14 (\1\) 7 7 ---------------------------------------------------------- Total.......................................... 34 46 12 1 1 5 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. TABLE 11-37.--CHILD'S AGE AT ADOPTION FINALIZATION, BY STATE, FISCAL YEAR 1998 [In percent; 29,791 total cases] ---------------------------------------------------------------------------------------------------------------- State under 1 1-5 6-10 11-15 16-18 19+ ---------------------------------------------------------------------------------------------------------------- Alabama................................................... (\1\) 47 34 19 (\1\) (\1\) Alaska.................................................... (\1\) 48 37 15 (\1\) (\1\) California................................................ 3 62 28 7 1 (\1\) Colorado.................................................. 3 50 38 7 2 (\1\) District of Columbia...................................... (\1\) 48 32 17 3 (\1\) Florida................................................... 1 47 35 15 2 0 Georgia \2\............................................... 2 47 35 15 2 (\1\) Hawaii.................................................... 2 53 36 9 1 (\1\) Illinois.................................................. 0 38 42 17 2 0 Indiana \2\............................................... (\1\) 37 39 21 2 (\1\) Iowa...................................................... 0 36 45 15 3 (\1\) Kansas \2\................................................ 1 37 37 22 3 (\1\) Kentucky.................................................. (\1\) 35 49 13 3 (\1\) Louisiana................................................. 1 28 52 18 1 (\1\) Maine \2\................................................. (\1\) 33 50 17 (\1\) (\1\) Maryland.................................................. 2 42 43 13 1 (\1\) Massachusetts............................................. 1 46 40 13 1 (\1\) Michigan.................................................. 1 44 40 13 2 (\1\) Minnesota................................................. 0 34 48 15 2 (\1\) Mississippi............................................... (\1\) 16 44 31 8 (\1\) Missouri.................................................. 1 42 38 17 2 (\1\) Montana................................................... (\1\) 36 42 19 2 (\1\) New Hampshire............................................. (\1\) 51 33 14 2 (\1\) New Jersey................................................ 1 56 32 11 0 (\1\) New York.................................................. 0 31 43 22 4 0 North Carolina............................................ 3 43 34 16 3 0 North Dakota.............................................. 3 64 18 15 (\1\) (\1\) Ohio...................................................... 3 53 30 13 2 (\1\) Oklahoma.................................................. 1 44 35 17 3 (\1\) Oregon.................................................... 0 49 38 12 1 (\1\) Pennsylvania.............................................. 1 48 38 12 2 (\1\) Puerto Rico............................................... (\1\) 51 31 17 (\1\) (\1\) Rhode Island \2\.......................................... 1 52 39 8 (\1\) (\1\) South Carolina............................................ (\1\) 26 46 26 3 (\1\) South Dakota.............................................. 1 44 36 18 1 (\1\) Tennessee................................................. 0 38 38 20 4 (\1\) Texas..................................................... 2 47 37 13 1 (\1\) Utah...................................................... 4 49 33 13 1 (\1\) Vermont................................................... (\1\) 48 39 12 1 (\1\) Virginia \2\.............................................. (\1\) 30 49 19 3 (\1\) Washington................................................ 0 60 31 8 1 (\1\) West Virginia............................................. 1 44 39 14 3 (\1\) Wisconsin................................................. 1 43 38 16 3 (\1\) Wyoming................................................... (\1\) 50 25 25 (\1\) (\1\) ----------------------------------------------------- Total............................................... 1 44 38 15 2 0 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. TABLE 11-38.--PRIOR RELATIONSHIP OF ADOPTIVE PARENT(S) TO CHILD, BY STATE, FISCAL YEAR 1998 [In percent; 23,014 total cases] ------------------------------------------------------------------------ Foster Other State Nonrelative parent Stepparent relative ------------------------------------------------------------------------ Alaska...................... 1 59 (\1\) 40 Arkansas.................... 30 60 (\1\) 10 California.................. 7 58 (\1\) 35 Colorado.................... 15 60 1 24 Connecticut................. 24 52 (\1\) 23 Delaware.................... 14 83 (\1\) 3 District of Columbia........ 2 98 (\1\) (\1\) Florida..................... 36 54 (\1\) 10 Georgia \2\................. 1 89 (\1\) 10 Hawaii...................... 3 40 (\1\) 58 Indiana \2\................. 83 11 (\1\) 6 Kansas \2\.................. 21 60 (\1\) 19 Kentucky.................... 78 21 0 1 Louisiana................... 24 75 (\1\) 1 Maine \2\................... 82 14 (\1\) 4 Maryland.................... 19 60 (\1\) 21 Michigan.................... 12 55 (\1\) 33 Minnesota................... 36 31 (\1\) 33 Mississippi................. 32 58 2 8 Missouri.................... 15 66 0 18 Montana..................... (\1\) 78 (\1\) 22 New Hampshire............... 20 65 (\1\) 16 New Jersey.................. 21 79 (\1\) (\1\) New Mexico.................. 65 6 (\1\) 29 North Carolina.............. 32 51 1 17 North Dakota................ 52 45 (\1\) 4 Oklahoma.................... 37 38 (\1\) 25 Oregon...................... 30 39 (\1\) 31 Pennsylvania................ 53 45 0 2 Puerto Rico................. 22 32 9 37 Rhode Island \2\............ 10 53 (\1\) 37 South Carolina.............. 37 58 (\1\) 5 South Dakota................ 38 51 (\1\) 12 Tennessee................... 34 64 (\1\) 3 Texas....................... 27 59 0 14 Utah........................ 37 57 0 6 Vermont..................... 42 55 (\1\) 3 Virginia \2\................ 10 84 (\1\) 6 Washington.................. 40 58 2 0 West Virginia............... 8 74 (\1\) 18 Wisconsin................... 13 76 (\1\) 11 Wyoming..................... 29 55 (\1\) 16 ------------------------------------------- Total................. 26 55 0 19 ------------------------------------------------------------------------ \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Note.--Relative foster parents are shown as ``other relative.'' Source: U.S. Department of Health and Human Services. Trends in Child Welfare and Foster Care Costs As a result of the trends in foster care caseloads and the Federal requirements of Public Law 96-272, funding for the Title IV-E Foster Care Program has increased significantly since it began in 1981. Based on administration estimates for fiscal year 1999, Federal title IV-E expenditures have increased thirteenfold, from $308.8 million to $4 billion, between 1981 and 1999. Funding for the Title IV-B Child Welfare Services Program increased by almost 80 percent from 1981 to 1999 ($163.6 million to $292 million). Funding for the Title XX Social Services Block Grant (SSBG), which States may use for child welfare services, has actually fallen. TABLE 11-39.--TIME BETWEEN TERMINATION OF PARENTAL RIGHTS AND ADOPTION FINALIZATION, BY STATE, FISCAL YEAR 1998 [In percent; 28,339 total cases] ---------------------------------------------------------------------------------------------------------------- Less than 1-5 6-11 12-17 18-23 24-29 30-35 3-4 5+ State 1 month months months months months months months years years ---------------------------------------------------------------------------------------------------------------- Alabama..................... (\1\) 13 29 21 4 8 8 12 4 Alaska...................... 2 20 27 19 7 3 11 7 3 Arkansas.................... 2 26 27 20 6 8 5 6 1 California.................. 0 13 34 22 12 7 4 5 2 Colorado.................... 1 30 22 22 12 5 3 4 1 Connecticut................. (\1\) 12 44 21 10 6 3 3 1 Delaware.................... (\1\) 25 48 3 11 2 (\1\) 2 10 District of Columbia........ 26 23 17 10 8 6 5 5 1 Florida..................... 0 12 27 21 15 9 6 8 2 Georgia \2\................. 0 3 27 25 19 8 6 8 3 Hawaii...................... 3 25 33 15 8 6 3 4 1 Illinois.................... 1 25 41 16 8 4 2 3 1 Indiana \2\................. 9 21 22 21 9 7 3 6 2 Iowa........................ (\1\) 19 27 29 13 4 3 4 1 Kansas \2\.................. 1 5 33 20 21 5 3 4 8 Kentucky.................... 12 3 27 22 9 13 3 8 2 Louisiana................... 0 8 32 19 13 8 4 14 1 Maryland.................... (\1\) 27 30 18 11 6 3 4 2 Massachusetts............... 1 24 27 18 13 7 5 4 1 Michigan.................... 0 10 31 25 13 9 5 5 2 Minnesota................... 0 6 13 15 20 14 16 12 4 Mississippi................. 3 8 26 20 10 11 9 11 3 Missouri.................... 15 14 22 19 9 6 3 8 3 Montana..................... 3 13 25 19 10 3 8 13 6 New Hampshire............... 22 14 38 14 3 5 (\1\) (\1\) 5 New Jersey.................. 4 13 32 25 10 7 4 4 1 New Mexico.................. 2 8 43 14 12 11 4 5 1 North Carolina.............. 1 21 31 20 9 5 4 5 3 North Dakota................ 4 14 64 10 6 1 1 (\1\) (\1\) Oklahoma.................... 2 7 24 27 14 9 4 11 2 Oregon...................... (\1\) 5 27 30 20 8 4 4 1 Pennsylvania................ 20 22 24 17 7 3 3 4 1 Puerto Rico................. 70 4 9 5 8 2 (\1\) 1 1 Rhode Island \2\............ 12 41 19 11 5 4 3 5 2 South Carolina.............. 4 10 49 19 10 2 0 3 2 South Dakota................ (\1\) 11 31 34 8 5 6 5 1 Tennessee................... 2 13 25 20 13 8 4 12 2 Texas....................... 1 17 31 19 11 8 3 7 2 Utah........................ 6 42 22 17 5 6 1 1 (\1\) Vermont..................... (\1\) 7 37 17 23 12 2 3 (\1\) Virginia \2\................ (\1\) 1 31 22 10 11 7 12 7 Washington.................. 1 16 27 19 12 8 4 11 3 West Virginia............... 4 5 15 20 15 16 9 12 6 Wisconsin................... 1 43 28 16 6 3 1 1 1 Wyoming..................... 16 34 34 6 (\1\) (\1\) (\1\) 6 3 ----------------------------------------------------------------------------------- Total................. 3 17 31 20 11 7 4 6 2 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to SACWIS. Source: U.S. Department of Health and Human Services. TABLE 11-40.--BASIS OF SPECIAL NEEDS FOR ADOPTED CHILDREN WITH SPECIAL NEEDS, BY STATE, FISCAL YEAR 1998 [In percent; 29,764 total cases] ---------------------------------------------------------------------------------------------------------------- Medical condition or Racial/ Sibling mental, State original Age group physical, Other background emotional disabilities ---------------------------------------------------------------------------------------------------------------- Alabama.................................................. 51 32 (\1\) 13 4 Alaska................................................... 2 14 4 74 6 California............................................... 13 13 23 14 38 Colorado................................................. 2 3 6 89 (\1\) District of Columbia..................................... (\1\) 40 32 23 5 Florida.................................................. 41 22 (\1\) (\1\) 37 Georgia \2\.............................................. 19 10 41 4 26 Hawaii................................................... 0 13 58 15 14 Illinois................................................. (\1\) 92 6 2 (\1\) Indiana \2\.............................................. (\1\) (\1\) (\1\) 100 (\1\) Iowa..................................................... 2 4 6 88 (\1\) Kansas \2\............................................... 4 27 14 55 (\1\) Kentucky................................................. 18 13 7 55 6 Louisiana................................................ 28 5 4 64 (\1\) Maryland................................................. 18 13 36 29 5 Massachusetts............................................ 19 3 18 2 59 Michigan................................................. 18 74 4 3 0 Minnesota................................................ 9 9 24 40 19 Mississippi.............................................. 2 25 38 36 (\1\) Missouri................................................. 23 14 37 20 6 Montana.................................................. 2 72 20 6 (\1\) New Hampshire............................................ 4 29 47 10 10 New Jersey............................................... 30 2 17 30 21 New York................................................. (\1\) 17 32 31 21 North Carolina........................................... 2 2 24 50 22 North Dakota............................................. (\1\) 44 18 38 (\1\) Ohio..................................................... 43 32 15 11 (\1\) Oklahoma................................................. 13 30 33 7 17 Oregon................................................... (\1\) (\1\) 59 41 (\1\) Pennsylvania............................................. 22 16 16 40 6 Puerto Rico.............................................. (\1\) 3 66 31 (\1\) Rhode Island \2\......................................... 42 3 25 2 29 South Carolina........................................... (\1\) 38 31 31 (\1\) South Dakota............................................. 14 2 33 39 12 Tennessee................................................ 17 15 8 57 3 Texas.................................................... 14 18 45 24 (\1\) Utah..................................................... 6 25 44 18 6 Vermont.................................................. (\1\) 28 43 14 14 Virginia \2\............................................. 12 24 32 22 9 Washington............................................... 4 35 0 61 (\1\) West Virginia............................................ 47 36 11 (\1\) 6 Wisconsin................................................ 7 2 2 83 5 Wyoming.................................................. 11 7 39 36 7 ------------------------------------------------------ Total.............................................. 12 31 20 21 15 ---------------------------------------------------------------------------------------------------------------- \1\ No cases were reported; a 0 indicates that the percentage of reported cases rounded to zero. \2\ State indicated general concern with reliability of 1998 data due to conversion process to Statewide Automated Child Welfare Information Systems (SACWIS). Source: U.S. Department of Health and Human Services. In recent years, an increasing proportion of title IV-E costs has been expended on child placement services, administration, and training. Table 11-42 shows U.S. Department of Health and Human Services (DHHS) and Congressional Budget Office (CBO) estimates of title IV-E expenditures through fiscal year 2005. Table 11-41 shows Federal foster care expenditures by State in 1987, 1991, 1996, and 1999. Between 1991 and 1999, total foster care expenditures increased by 103 percent. Over this same time period, foster care maintenance costs increased by 75 percent. Because of the large increase in administrative and placement costs relative to maintenance costs, the share of total costs represented by maintenance costs decreased between 1991 and 1999. In an effort to gain more complete information on total child welfare spending, including sources in addition to titles IV-B and IV-E of the Social Security Act, the Urban Institute conducted a survey to which 49 States responded with information about spending in fiscal year 1996 (Geen, Boots, & Tumlin, 1999). Geen et al. found that States spent $14.4 billion in that year, and estimated that Federal funds accounted for 44 percent of total spending, that State funds also constituted 44 percent, and that local sources accounted for 13 percent. Of Federal expenditures, 49 percent was from title IV-E and 16 percent was from the SSBG. Medicaid and the former Aid to Families with Dependent Children (AFDC)-Emergency Assistance (EA) Program each accounted for 13 percent, 6 percent came from title IV-B, and other sources accounted for the rest. Thus, the authors concluded that nontraditional funding streams (i.e., Medicaid, SSBG, and EA) were surprisingly important sources of funds. The report also found that the financing of child welfare services varies considerably by State, and that the largest single category of expenditure was for out-of-home care, with residential or group care being the most costly. TABLE 11-41.--FEDERAL FOSTER CARE EXPENDITURES BY STATE, 1987-99 \1\ -------------------------------------------------------------------------------------------------------------------------------------------------------- Fiscal year total expenditures (in Maintenance costs Maintenance costs millions of dollars) (in millions of as a percentage of Percentage State ---------------------------------------- dollars) total growth in ---------------------------------------- total 1991- 1987 \2\ 1991 1996 \3\ 1999 \3\ 1991 1999 1991 1999 99 -------------------------------------------------------------------------------------------------------------------------------------------------------- Alabama..................................................... $2.09 $5.17 $5.23 $13.24 $1.43 $2.53 0.28 0.19 156 Alaska...................................................... 0.39 3.75 7.99 9.42 1.67 2.34 0.45 0.25 151 Arizona..................................................... 3.02 11.43 44.12 54.32 3.72 25.63 0.33 0.47 375 Arkansas.................................................... 1.06 4.85 26.64 32.06 1.76 8.17 0.36 0.25 561 California.................................................. 163.61 354.69 727.89 911.80 185.50 437.77 0.52 0.48 157 Colorado.................................................... 5.65 7.46 20.35 42.55 4.49 7.99 0.60 0.19 470 Connecticut................................................. 4.32 24.04 66.83 91.78 8.18 33.04 0.34 0.36 282 Delaware.................................................... 0.4 1.35 7.40 8.31 0.57 1.65 0.42 0.20 515 District of Columbia........................................ 6.62 4.70 22.89 42.95 2.68 22.38 0.57 0.52 814 Florida..................................................... 6.61 25.36 78.70 120.77 10.98 39.09 0.43 0.32 376 Georgia..................................................... 9.77 24.19 24.52 42.89 7.39 19.98 0.31 0.47 77 Hawaii...................................................... 0.07 1.23 11.77 15.81 0.09 4.92 0.07 0.31 1,186 Idaho....................................................... 0.41 1.23 6.70 7.92 0.28 1.29 0.23 0.16 544 Illinois.................................................... 37.03 67.45 238.33 273.27 40.36 100.77 0.60 0.37 305 Indiana..................................................... 1.27 7.12 50.82 53.32 2.49 30.43 0.35 0.57 649 Iowa........................................................ 3.73 14.02 16.96 29.62 3.60 19.55 0.26 0.66 111 Kansas...................................................... 3.98 12.94 23.90 30.89 6.36 20.20 0.49 0.65 139 Kentucky.................................................... 6.86 30.68 51.58 46.11 11.96 22.46 0.39 0.49 50 Louisiana................................................... 13.15 26.12 36.68 50.14 14.67 29.73 0.56 0.59 92 Maine....................................................... 4.19 8.01 18.78 32.18 4.79 27.84 0.60 0.86 302 Maryland.................................................... 15.43 28.95 76.46 96.73 14.23 42.42 0.49 0.44 234 Massachusetts \4\........................................... 12.42 29.47 95.20 75.23 17.01 28.41 0.58 0.38 155 Michigan.................................................... 55.87 128.27 104.57 135.96 52.49 67.91 0.41 0.50 6 Minnesota................................................... 16.09 24.83 44.55 72.59 12.60 30.45 0.51 0.42 192 Mississippi................................................. 0.85 2.16 8.74 9.49 1.07 2.77 0.50 0.29 339 Missouri.................................................... 14.04 29.29 45.96 73.62 14.29 33.76 0.49 0.46 151 Montana..................................................... 1.77 6.72 8.31 7.79 2.47 4.03 0.37 0.52 16 Nebraska.................................................... 3.27 7.15 20.40 25.89 3.73 13.22 0.52 0.51 262 Nevada...................................................... 0.59 2.54 5.18 14.76 0.92 4.41 0.36 0.30 481 New Hampshire............................................... 1.12 5.06 10.24 11.85 1.97 5.76 0.39 0.49 134 New Jersey.................................................. 14.33 16.30 41.38 45.64 8.07 32.53 0.50 0.71 180 New Mexico.................................................. 3.32 6.28 13.78 14.37 3.04 4.14 0.48 0.29 129 New York.................................................... 224.01 672.62 471.46 482.04 451.66 302.38 0.67 0.63 -28 North Carolina.............................................. 2.36 8.64 37.44 64.54 6.55 33.49 0.76 0.52 647 North Dakota................................................ 1.25 3.84 8.12 11.21 1.90 4.14 0.49 0.37 192 Ohio........................................................ 27.66 52.52 135.55 207.89 26.40 116.13 0.50 0.56 296 Oklahoma.................................................... 4.39 11.64 24.99 32.42 8.21 14.71 0.71 0.45 179 Oregon...................................................... 8.51 14.02 24.82 31.50 6.91 12.63 0.49 0.40 125 Pennsylvania................................................ 14.21 118.44 149.79 316.40 82.01 169.27 0.69 0.53 167 Puerto Rico \5\............................................. NA NA NA 7.28 NA 7.28 NA NA NA Rhode Island................................................ 3.74 5.77 9.17 12.59 2.57 4.54 0.45 0.36 118 South Carolina.............................................. 3.35 9.70 18.78 17.23 4.74 8.07 0.49 0.47 78 South Dakota................................................ 1.8 2.02 3.04 4.60 1.07 2.26 0.53 0.49 128 Tennessee................................................... 2.1 19.63 27.15 25.19 11.22 13.90 0.57 0.55 28 Texas....................................................... 18.94 54.75 77.22 86.96 28.54 63.76 0.52 0.73 59 Utah........................................................ 0.96 3.84 13.19 20.95 2.05 3.52 0.53 0.17 446 Vermont..................................................... 3.61 6.59 8.24 12.00 4.32 8.71 0.66 0.73 82 Virginia.................................................... 5.15 12.48 32.67 44.32 5.09 16.76 0.41 0.38 255 Washington.................................................. 7.4 17.06 24.83 29.30 6.02 11.27 0.35 0.38 72 West Virginia............................................... 6.77 7.60 8.51 17.73 5.69 11.47 0.75 0.65 133 Wisconsin................................................... 15.62 32.27 45.97 91.65 15.88 29.56 0.49 0.32 184 Wyoming..................................................... 0.31 0.89 1.92 2.19 0.61 1.21 0.69 0.55 146 ------------------------------------------------------------------------------------------- Total................................................. 765.47 1,977.13 3,085.71 4,003.96 1,116.30 1,955.33 0.56 0.49 103 -------------------------------------------------------------------------------------------------------------------------------------------------------- \1\ Does not include disputes and reconciliations. \2\ Fiscal year 1987 claims are based on accrual accounting. \3\ Fiscal year 1996 and 1999 include SACWIS expenditures. \4\ Fiscal year 1999 data include estimates for the third and fourth quarters. \5\ Did not begin to participate in title IV-E foster care until fiscal year 1999. It is not included in the fiscal year 1999 total. NA--Not applicable. Note.--Totals may differ from sum of State amounts because of rounding. Source: U.S. Department of Health and Human Services. TABLE 11-42.--PROPORTION OF TITLE IV-E FOSTER CARE EXPENDITURES SPENT ON CHILD PLACEMENT, ADMINISTRATION, AND TRAINING, FISCAL YEARS 1989-2005 ---------------------------------------------------------------------------------------------------------------- Total Placement Federal administration Placement title IV-E and training administration Fiscal year expenditures expenditures and training (in millions (in millions of proportion of of dollars) dollars) \1\ total ---------------------------------------------------------------------------------------------------------------- Actual: 1989........................................................ $1,153 $507 0.44 1990........................................................ 1,473 638 0.43 1991........................................................ 1,819 789 0.43 1992........................................................ 2,233 1,029 0.46 1993........................................................ 2,534 1,222 0.48 1994........................................................ 2,750 1,375 0.50 1995........................................................ 3,066 1,467 0.48 1996........................................................ 3,098 1,595 0.51 1997........................................................ 3,692 1,967 0.53 1998........................................................ 3,714 1,782 0.48 1999 \2\.................................................... 4,011 2,048 0.51 DHHS estimates: 2000........................................................ 4,398 2,278 0.52 2001........................................................ 5,013 2,629 0.52 2002........................................................ 5,426 2,846 0.52 2003........................................................ 5,759 2,976 0.52 2004........................................................ 6,214 3,216 0.52 2005........................................................ 6,702 3,471 0.52 CBO estimates: 2000........................................................ 4,139 2,105 0.51 2001........................................................ 4,417 2,243 0.51 2002........................................................ 4,702 2,384 0.51 2003........................................................ 4,983 2,523 0.51 2004........................................................ 5,259 2,660 0.51 2005........................................................ 5,546 2,802 0.51 ---------------------------------------------------------------------------------------------------------------- \1\ Includes regular administration, training, and for fiscal years 1994-2005, SACWIS costs. \2\ Beginning in fiscal year 1999, data includes Puerto Rico. Source: Compiled by the Congressional Research Service from data provided by the U.S. Department of Health and Human Services and Congressional Budget Office. LEGISLATIVE HISTORY (For legislative history before 1996, see previous editions of the Green Book.) During the 104th Congress, comprehensive welfare reform legislation was enacted that contained provisions affecting child welfare (Personal Responsibility and Work Opportunity Reconciliation Act, Public Law 104-193). The centerpiece of the welfare reform legislation was the repeal of AFDC and creation of a new block grant to States for Temporary Assistance for Needy Families (TANF). As a condition of receiving TANF funds, States must operate Foster Care and Adoption Assistance Programs under title IV-E of the Social Security Act. However, eligibility for title IV-E historically has been linked to AFDC eligibility. Thus, Public Law 104-193 provides that foster or adoptive children are eligible for title IV-E subsidies if their families would have been eligible for AFDC, as it was in effect in their State on June 1, 1995. (Technical amendments enacted in 1997, Public Law 105-33, subsequently changed this date to July 16, 1996.) Children eligible for SSI continue to be eligible for title IV-E adoption assistance, and foster and adoptive children continue to be eligible for Medicaid. Public Law 104-193 also amended title IV-E to enable for- profit child care institutions to participate in the Federal Foster Care Program; extended the enhanced Federal matching rate for certain data collection costs through fiscal year 1997; mandated DHHS to conduct a national random sample study of children in the child welfare system; and required States, as a component of their title IV-E plans, to consider giving preference to adult relatives in determining a foster or adoptive placement for a child. In 1997, Congress enacted the most significant changes to titles IV-B and IV-E of the Social Security Act since they were established in their current form in 1980. This legislation, the Adoption and Safe Families Act (Public Law 105-89), was intended to promote adoption and ensure safety for children in foster care. The law established that a child's health and safety must be of paramount concern in any efforts made by the State to preserve or reunify the child's family. The law retained, but clarified the requirement that States make ``reasonable efforts'' to preserve or reunify a child's family, establishing exceptions to this requirement. Also to promote safety, Public Law 105-89 required States to conduct criminal background checks for all prospective foster or adoptive parents, and required States to develop standards to ensure quality services that protect children's health and safety while in foster care. To promote permanency, the law required States to make reasonable efforts to place children, in a timely manner, who have permanency plans of adoption or another alternative to family reunification, and to document these efforts. Further, provisions were included intended to eliminate interjurisdictional barriers to adoption. Public Law 105-89 changed the name of dispositional hearings to ``permanency'' hearings, and required that they occur within 12 months of a child's placement in foster care, rather than the first 18 months. The law also revised the list of permanency goals, eliminating specific reference to long-term foster care, and required that foster parents, preadoptive parents, and relative care givers be given notice and opportunity to be heard at reviews and hearings. The Adoption and Safe Families Act required that States initiate or join proceedings to terminate parental rights on behalf of children who have been in foster care for 15 of the most recent 22 months, although certain exceptions are allowed. The law also authorized incentive payments to States to increase the number of foster and special-needs children who are placed for adoption. The law contains some provisions intended to expand health insurance coverage for special-needs adopted children who are not eligible under title IV-E, and also reauthorized and renamed the Family Preservation and Family Support Program. The program was authorized through fiscal year 2001, as the Promoting Safe and Stable Families Program. In addition, Public Law 105-89 established a new outcome measures reporting system for States, and authorized an expansion of the child welfare waiver demonstration authority established earlier. Public Law 106-169 was enacted during the 106th Congress, revising the Independent Living Program and renaming it in honor of the late Senator John Chafee. The legislation provided greater flexibility to States in their use of funds to help older foster children obtain the education and employment services necessary for a successful transition to adult living, increased the entitlement ceiling for the program, and revised the State allocation formula. The law also established an option under Medicaid for States to cover certain former foster care youth aged 18-20. REFERENCES Boots, S.W., & Geen, R. (1999, July). Family care or foster care: How State policies affect kinship providers (Series A, No. A-34). Washington, DC: Urban Institute. Committee on Ways and Means. (1990). The enemy within: Crack- cocaine and America's families (WMCP: 101-30). Washington, DC: U.S. Government Printing Office. Cook, R. (1990). A national evaluation of title IV-E foster care independent living programs for youth, phase 1. Rockville, MD: Westat. Cook, R. (1992). A national evaluation of title IV-E foster care independent living programs for youth, phase 2. Rockville, MD: Westat. Courtney, M.E., & Piliavin, I. (1998). Foster youth transitions to adulthood: Outcomes 12 to 18 months after leaving out-of-home care. Madison, WI: University of Wisconsin. Geen, R., Boots, S.W., & Tumlin, K.C. (1999, January). The cost of protecting vulnerable children: Understanding Federal, State, and local child welfare spending. Washington, DC: Urban Institute. James Bell Associates. (1999a, March). Family preservation and family support implementation study: Interim report. Arlington, VA: Author. James Bell Associates. (1999b, June). Review and analysis of State program reports related to the court improvement program. Arlington, VA: Author. National Institute on Drug Abuse. (1995). National pregnancy and health survey. Washington, DC: U.S. Department of Health and Human Services. National Institute on Drug Abuse. (1999). Research on the nature and extent of drug use in the United States: The sixth triennial report to Congress. Washington, DC: U.S. Department of Health and Human Services. Office of Inspector General. (1987). Foster care administrative costs (OAI-05-87-00012). Washington, DC: U.S. Department of Health and Human Services. Office of Inspector General. (1990). Opportunities for cost containment by modifying Federal reimbursement to States for administrative costs of title IV-E program (A-07-90-00274). Washington, DC: U.S. Department of Health and Human Services. Office of Inspector General. (1992). Using relatives for foster care (OEI-06-90-02390). Washington, DC: U.S. Department of Health and Human Services. Paxson, C., & Waldfogel, J. (1999, September). Work, welfare, and child maltreatment (Working paper 7343). Cambridge, MA: National Bureau of Economic Research. Sedlak, A.J., & Broadhurst, D.D. (1996, September). Third national incidence study of child abuse and neglect: Final report. Washington, DC: U.S. Department of Health and Human Services. Shook, K. (1999). Does the loss of welfare income increase the risk of involvement with the child welfare system? Child and Youth Services Review, 21 8/9. U.S. Advisory Board on Child Abuse and Neglect. (1995). A nation's shame: Fatal child abuse and neglect in the United States. Washington, DC: Author. U.S. Department of Health and Human Services. (1995a, May). A review of family preservation and family reunification programs. Washington, DC: Author. U.S. Department of Health and Human Services. (1995b, May). A synthesis of research on family preservation and family reunification programs. Washington, DC: Author. U.S. Department of Health and Human Services. (1997). National study of protective, preventive and reunification services delivered to children and their families. Washington, DC: Author. U.S. Department of Health and Human Services. (1997, June). Informal and formal kinship care. Washington, DC: Author. U.S. Department of Health and Human Services. (1998, November). Children placed in foster care with relatives: A multi- state study. Washington, DC: Author. U.S. Department of Health and Human Services. (1999a, April). Blending perspectives and building common ground: A report to Congress on substance abuse and child protection. Washington, DC: Author. U.S. Department of Health and Human Services. (1999b, November). Title IV-E independent living programs: a decade in review. Washington, DC: Author. U.S. Department of Health and Human Services. (2000a, March). Dynamics of children's movement among the AFDC, Medicaid and Foster Care Programs prior to welfare reform: 1995-96. Washington, DC: Author. U.S. Department of Health and Human Services. (2000b, June). Report to the Congress on kinship foster care (Contract #HHS-100-96-0011). Washington, DC: Author. U.S. General Accounting Office. (1997, February). Child welfare: States' progress in implementing family preservation and support services (GAO/HEHS-97-34). Washington, DC: Author. U.S. General Accounting Office. (1999, May). Foster care: Kinship care quality and permanency issues (GAO-HEHS- 99-32). Washington, DC: Author. U.S. General Accounting Office. (1999, November). Foster care: Effectiveness of independent living services unkown (GAO-HEHS-00-13). Washington, DC: Author. Westat, Chapin Hall Center for Children, & James Bell Associates. (1998, September). Evaluation of the New York City HomeRebuilders Demonstration. Washington, DC: U.S. Department of Health and Human Services. Wulczyn, F.H., Brunner, K., & Goerge, R.M. (1999). An update from the multistate foster care data archive: Foster care dynamics, 1983-97. Chicago: Chapin Hall Center for Children.