The Administration for Children and Families’ initiative, A Home for Every Child, is designed to help achieve at least a one-to-one ratio of foster homes available for children and youth in foster care, where the numerator is the number of foster homes available and the denominator is the number of children in care.
Reports
Displaying 1 - 50 of 4479
Strategies to Improve the Ratio of Homes Available to Children in Foster Care: Findings from Five States
The goal of the Administration for Children and Families’ (ACF’s) A Home for Every Child initiative is to have a safe and supportive home available for every child or youth in foster care. ACF measures the initiative’s success by a one-to-one home-to-child ratio, meaning there are as many foster homes available as there are children in foster care.
Mission vs. Margin: Misaligned Incentives in the 340B Drug Pricing Program
Efforts by CMS to reform the 340B Drug Pricing Program aim to decrease financial incentives that place revenue over patients' health outcomes and access to care.
Children in Child Welfare are More Likely to be Prescribed Psychotropic Medication than Other Children on Medicaid: Findings from Florida and Kentucky
The use of psychotropic medications in children is a complex issue for parents, caregivers, health care professionals, researchers, and policymakers. Psychotropic medications are used to treat behavioral health conditions. When these medications are prescribed appropriately, they can be effective in managing behavioral health symptoms.
States Routinely Request to Increase LIHEAP’s Weatherization Cap, but Must Repeat the Process Every Year
This brief examines the utilization of Low-Income Home Energy Assistance Program (LIHEAP) funds for weatherization from Fiscal Year 2016 (FY16) through FY24, as well as the waiver process states can use to increase their weatherization spending limits.Key findings include:
Directed by Executive Order: Reconsideration of the Regulatory Costs of Head Start’s 2016 Final Rule
Topics
Child Care
The 2016 Head Start Program Performance Standards final regulation anticipated that improved quality would justify potential reductions in access.
Evidence-Based Measures for Chronic Disease Outcomes: A Review of Available Measures for Emergent HIV Therapies
The team conducted an environmental scan to explore the patient-reported outcome measures (PROMs) that could be used in new and emerging human immunodeficiency virus (HIV) therapies. In the context of HIV clinical trials, PROMs may be used as clinical outcome assessments (COAs) to characterize how patients feel and function and to inform regulatory evaluations.
Evidence-Based Measures for Chronic Disease Outcomes: A Review of Available Measures for Emergent Sickle Cell Disease Therapies
The team conducted an environmental scan to explore the patient-reported outcome measures (PROMs) that could be used in new and emerging sickle cell disease (SCD) therapies.
Head Start Operates Within Existing State Child Care Licensing Infrastructure and Includes Established Supports for Alignment and Coordination Between Systems
This brief describes available data on the licensing status of Head Start service locations and child care programs, and outlines existing infrastructure that can support alignment and coordination between Head Start and state licensing systems.
Nearly a Quarter of LIHEAP Funds Are Not Spent on Direct Household Energy Assistance, with Four Percent Reserved in FY25
This brief examines how states allocated Low Income Home Energy Assistance Program (LIHEAP) funds from FY16 through FY25, including spending on direct energy assistance, weatherization, administrative and other activities, and funds carried over to subsequent fiscal years. Key findings include:
Market Forces in Medicare Reimbursement: Traditional Medicare, Medicare Advantage, and Provider Resource Constraints
EXECUTIVE SUMMARY
Research Does Not Identify an Optimal Teacher-Child Ratio That Improves Child Outcomes, Though More Stringent Ratios May Increase Per Child Spending
This brief reviews the literature on the relationship between teacher-child ratios and child outcomes, then describes how Head Start ratio standards compare with existing state licensing standards. Key findings include:
Quantifying the Value of Consumer Choice: A Foundation for Regulatory Impact Analysis and Beyond
Executive SummaryRegulations often restrict the range of market choices available to consumers, yet they are promulgated without a quantitative analysis of that cost—a fundamental flaw in regulatory impact analysis. This paper fills the gap by supplying a portable choice-value factor. The factor compares value at the unconstrained mix with regulation-constrained value.
Frozen at $2,000 Since 1986: The Coverage of Non-Recurring Adoption Expenses Has Lost Two-Thirds of Its Purchasing Power Over 40 Years
KEY POINTSCoverage of non-recurring adoption expenses can help reduce upfront adoption costs for families – covering expenses like legal fees, court costs, home studies, and necessary transportation, food, and lodging – supporting permanency for children with special needs.
Aligning Initiatives to End the HIV Epidemic in the United States
KEY POINTSThe Ryan White HIV/AIDS Program (RWHAP) provides critical services to low-income peo
Title IV-E Foster Care Eligibility Rates Have Declined While Determination Costs Have Increased: Meanwhile Eligibility Review Results Have Varied Since FY00
This brief synthesizes national caseload and expenditure data related to Title IV-E foster care eligibility and summarizes the Children’s Bureau’s published Title IV-E foster care eligibility review findings. Key findings include:
Over the Past 10 Years, Head Start Administrative Spending Remained Relatively Steady and Always Below the 15 Percent Statutory Ceiling
Topics
Early Care & Education
This brief describes the share of spending on administrative expenses in Head Start. Key findings include:
Exposure to Domestic Violence/Intimate Partner Violence Is Associated With Child Welfare System Involvement
KEY POINTSExisting research shows that children’s exposure to domestic violence (DV)/ intimate partner violence (IPV) increases the likelihood of involvement with the child welfare system (including child protective services (CPS) involvement and foster care entry).
From FY16 to FY25, Fewer Head Start Families Received Comprehensive Services and the Percentage of Families Receiving Services Also Declined for Many Categories
This brief examines how Head Start’s comprehensive service delivery changed between the 2015-2016 (FY16) and 2024-2025 (FY25) program years, focused on volume (total number) and rate (percent) of children and families who received comprehensive services. Key findings include:
Structure Matters: How State Child Support Program Administration and Procedures Can Impact Federal Spending and Support Order Establishment Performance
Topics
Child Support
h3 { max-width: 100% !important; } p{max-width: 100% !important;}KEY POINTSFederal spending per child support case increased from $374.31 to $435.82 (in inflation adjusted dollars) between Fiscal Year 2015 (FY15) and FY24.
HHS' Historical Approach to Head Start Regulation Following the 2007 Statutory Reauthorization has Increased Costs and Reduced Access, without Substantial Quality Gains
This brief describes HHS' historical approach to Head Start regulation following the 2007 statutory reauthorization. Key findings include:
How Texas Achieves Strong Program Integrity in CCDF: Practical Considerations for State CCDF Lead Agencies
Topics
Child Care
To facilitate cross-state learning, the Office of Child Care (OCC), in partnership with the Assistant Secretary for Planning and Evaluation (ASPE), is launching a snapshot series to highlight promising state practices.
An Overview of State-Directed Payments and Medicaid Provider Taxes: History and Potential Effects of the Working Families and Tax Cut Legislation on Health Care Costs
Health care provider taxes and state-directed payment policies in the Working Families and Tax Cut legislation are expected to reduce non-Medicaid prices by up to 3.5 percent in markets with provider taxes and reduce spending on Medicaid, commercial and Medicare coverage.
Producing Health: Capability, Capacity, and Competitive Discovery in the Health Economy
EXECUTIVE SUMMARY
Framework for a Public Repository of Artificial Intelligence Training Datasets Using EHR Data for Comparative Effectiveness Research & A Pediatric ADHD Patient-Centered Outcomes Annotation Schema
Artificial intelligence (AI) tools, particularly those that use natural language processing (NLP), are becoming increasingly prominent in healthcare delivery. For these systems to operate safely and reliably in clinical settings, they require high-quality training datasets drawn from multiple sources, including electronic health record (EHR) data, that closely reflect real-world conditions.
Estimates of Child Care Subsidy Eligibility & Receipt for Fiscal Year 2022
Topics
Child Care
In 2022, 11.8 million children were eligible for childcare subsidies under federal rules; under state rules – which can be more restrictive – 9.1 million were eligible.1.8 million children received subsidies, representing 16 percent of those eligible under federal rules and
Harnessing the Value of Electronic Health Record Data for Research
Topics
Disability
| Electronic Health Records (EHR)
| Big Data
| Data & Information Infrastructure
| Data Governance
| Data Quality
| Data Sharing & Interoperability
| Data Sources & Measurement
| Data Standards & Standardization
| Health Informatics
| Health Outcomes
| Chronic Conditions & Illnesses
| Patient-Centered Outcomes Research
The United States (U.S.) faces urgent health challenges, including poor maternal and childhood health outcomes, childhood obesity, opioid use disorder, cancer, and chronic conditions, which require personalized care tailored to each patient’s unique circumstances.
The Changing Insulin Affordability Landscape: Lower Out-of-Pocket Costs and Expanded Access Pathways
KEY POINTS
Increases in Head Start Change in Scope Requests from FY21 to FY24 Have Resulted in the Largest Reduction of Funded Slots in the History of Head Start
Topics
Early Care & Education
KEY POINTS
Building infrastructure and evidence for COVID-19 related research, using integrated data from NCHS Data Linkage Program
The overall goal of the project is to expand the utility of National Center for Health Statistics (NCHS) linked data resources to support patient-centered outcomes research (PCOR) through the development of publicly available synthetic linked data files.
Welfare Indicators and Risk Factors, Twenty-Fifth Report to Congress
Topics
Caseload Trends & Dynamics
| Evidence-Based Policies & Practices
| Child Welfare
| Family Well-Being
| Teen Pregnancy
| Administrative Data
| Demographic Data
| Evidence-Based Policymaking
| Modeling & Simulation
| Key Indicators
| Employment & Self-Sufficiency
| Social Safety Net
| Welfare, Welfare Reform, & TANF
| Human Services Policy
The Welfare Indicators Act of 1994 (Public Law 103-432) requires the Secretary of the Department of Health and Human Services to prepare an annual report to Congress on indicators and predictors of “welfare dependence.” That Act requires the report to include three programs: Temporary Assistance for Needy Families (TANF) program (which replaced the Aid to Families with Dependent Children (AFDC)
Creating Effective Medicaid Data Linkages for Health Outcomes Research
Patients, clinicians, decision makers, and other stakeholders depend on robust, evidence-based information to make informed health care decisions. Linking Medicaid data to other sources enables a deeper understanding of how Medicaid services and interventions influence health outcomes.
Child Welfare Technology System Implementation Shows Minimal Progress: After 10 years and $2 Billion, Modern Information Systems Are Still Out of Reach
This summary highlights key findings from this study. Readers are encouraged to download the full report for complete details and analysis.
The Title IV-E Guardianship Assistance Program (GAP): Use of Guardianship is Growing, but Lags Adoption Assistance and is Unevenly Used Across States
Topics
Child Welfare
The Title IV-E Guardianship Assistance Program (GAP): Use of Guardianship is Growing, but Lags Adoption Assistance and is Unevenly Used Across States May 2026 Administration for Children and Families & Office of the Assistant Secretary for Planning and Evaluation
Child Welfare Ombudsman Offices Provide System Oversight That Can Lead to Policy and Practice Reforms
This brief provides an overview of child welfare ombudsman offices, describes the landscape of state child welfare ombudsman programs and their common functions, reviews the effectiveness of their oversight, and identifies successes in improving child welfare processes and procedures. Key findings include:
The State of Rural Hospitals in the U.S, 2012-2023
ASPE’s Office of Health Policy has developed an Issue Brief modeling the key determinants of rural hospital closure or conversion as well as an interactive Rural Hospital Dashboard to highlight key characteristics and trends among rural hospitals.
Advancing an Operational Definition of Intellectual and Developmental Disabilities for Use in Research
Background. Accurately estimating the prevalence of intellectual and developmental disabilities (ID/DD) in the United States remains a challenge, with reported rates varying widely (3%-17%) based on the definitions and data sources used.
Consolidating Grants for Insular Areas Under SSBG Enables Funding Flexibility and Cuts Grant Administrative Burden
This brief describes Consolidated Block Grant (CBG) authority, which allows federal agencies to consolidate grants to insular areas into a single block grant, and how it is used with the Social Services Block Grant (SSBG) within the Administration for Children and Families (ACF). Key findings include:
While often similar in design, home visiting models eligible for MIECHV and Title IV-E Prevention Services reflect the different programmatic goals of child and family wellbeing versus foster care prevention.
This brief address the HHS programs that fund evidence-based home visiting models. It provides a high-level comparison of the primary federal funding streams supporting home visiting. Key points are:
Availability of Care for Older Adults in Outpatient Behavioral Health Facilities
Behavioral health (BH) conditions are rising among older adults, who are less likely to receive mental health (MH) or substance use disorder (SUD) treatment compared to younger adults. This study examined the availability of care for older adults in outpatient BH facilities across the United States both quantitatively and qualitatively.
Integrated Care and Health Outcomes for Dual Eligible Individuals
This report examines how integrated care models served full-benefit dually eligible Medicare‑Medicaid beneficiaries in 2021. It compares three types of integrated plans—PACE, FIDE‑SNPs, and D‑SNPs—to standard Medicare Advantage plans, with a focus on hospitalizations, emergency department visits, nursing facility use, home‑ and community‑based services, and mortality.
Environmental Scan of Pathways to Economic Self-Sufficiency for People with Disabilities
In the U.S., about 11 percent of people ages 18 to 64 living in the community have a disability. Health conditions that cause disability can negatively affect the human capital development of children and the ability of adults to engage in the labor force.