Department  of  Health  and  Human  Services 
OFFICE  OF

INSPECTOR  GENERA  .

. 
LD WELFARE

OVERSIGHT  OF  STATE  CH 
PROGRAMS

+<  ? 
~v 
JUNE  GIBBS  BROWN 
G  Inspector  General 
: ~ 
b 
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%.>,  JUNE 1994 
OEI-01-92-00770  EXECUTIVE  SUMMARY

PURPOSE 
Toassess  andtofind  ways to improve  oversight  of State  child welfare  programs. 
BACKGROUND 
In 1980, Congress  passed  The  Adoption  Assistance  and  Child  Welfare  Act

(P.L.  96-272)  in order  to lessen the  emphasis  on foster  care  placements  and  to

encourage  greater  efforts  to find permanent  homes  for children.  The  law signaled  a

new direction  in child welfare  and  highlighted  an awakened  Federal  interest  in how

States  manage  their  child welfare  programs.

The  Department  of Health  and  Human  Services  (HHS)  funds  State  child welfare

services  through  three  significant  mechanisms,  all of which  are  under  the  Social

Security  Act.  The  largest  proportion  of monies  comes  from  Title  IV-E,  with lesser

amounts  from  Title  XX and  Title  IV-B (see  appendix  A for details  on the  programs).

The  HHSS Administration  for Children  and  Families  (ACF)  oversees  State  child

welfare  services  using the  following  formal  mechanisms:  Title  IV-E  reviews,  Section

427 reviews,  program  reviews,  and  State  plans  (see  appendix  B for details  on oversight

mechanisms).  The  content  of both  Title  IV-E  and  Section  427 reviews  is determined

by P.L. 96-272.

Members  of Congress,  HHS  officials,  the  General  Accounting  Office,  directors  of

State  child welfare  agencies,  and  representatives  of the  Child  Welfare  League  of

America  and  the  American  Public  Welfare  Association  are  among  those  who  have

voiced  concerns  about  these  processes.  In particular,  they have  been  concerned  that

the  reviews  elevate  process  issues  over quality  of services.

On August  10, 1993, the  President  signed  into  law the  Omnibus  Budget  Reconciliation

Act of 1993.  This  law increased  funding  for Title  IV-B to encourage  State  efforts  to

support  and  preserve  families.  The  original  version  of the  bill proposed  major

alterations  to the  oversight  process.  While  the  law, as passed,  left  most  of the

oversight  processes  unchanged,  the  fact that  Congress  considered  reshaping  these

requirements  indicates  a high level  of interest  and  concern  about  oversight  issues.

Given  this level  of interest  and  activity, changes  to the  oversight  system  are  likely.

This  report  presents  information  which we hope  will be  helpful  to decision  makers  as

they consider  improvements  to oversight  of child welfare  programs.  In this report,  we

evaluate  the  scope  of and  approach  to Federal  oversight  activities  (which includes  the

statutorily  mandated  features  of oversight),  as well as the  conduct  of these  activities.

This  report  is focused  on a range  of Federal  oversight  activities,  including  technical

assistance,  planning,  and  review of programs.  The  focus is primarily  on ACF  oversight

i  activities,  although  HHS  leadership  and  Congress  have  significant  roles  in determining 
these  activities.  Audits  and  reviews  conducted  by agencies  other  than  ACF,  such  as 
the  Office  of Audit  Services  in the  OIG  or the  General  Accounting  Office  (GAO), 
were  not within  the  scope  of this study.  Furthermore,  we did not  reevaluate  specific 
findings  or disallowances  from  any reviews of State  child welfare  programs.  We  intend 
this report  to establish  the  context  and  provide  general  perspective  for officials  to 
make  improvements  in the  oversight  system.  Our  Office  of Audit  Services  has  issued 
a draft  report  which  focuses  on specific  improvements  in the  eligibility  process. 
Finally,  because  ACF  itself has  expressed  concerns  about  the  oversight  processes  and 
has initiated  several  examinations  of them,  we are  certain  ACF  is familiar  with many 
of the  shortcomings  we identi~  in this report.  Our  focus  is not  primarily  on assessing 
how good  a job  ACF  is doing in conducting  oversight,  but  on assisting  ACF  in its 
deliberations  on improving  the  processes. 
We  collected  data  from  three  primary  sources.  First,  we reviewed  the  results  of the 
most  recent  Section  427 reviews, Title  IV-E  reviews,  and  program  reviews  conducted 
in each  State  in the  last five years.  Second,  we interviewed  State  child welfare  officials 
in 13 States.  Finally,  we interviewed  officials in each  of the  10 ACF  regional  offices 
and  had  numerous  discussions  with officials in the  central  office  of ACF. 
ACCOMPLISHMENTS 
Federal overnight of State child welfare prograrm has served some  tiportant  purposes, 
pamcular$ in establkhing  new directions for chiki welfare ik the early 1980s. 
Since  the  early  1980s, Federal  oversight  of State  child welfare  programs  has been 
focused  on assuring  States  adherence  to P.L. 96-272.  Several  State  and  Federal 
officials we intemiewed  spoke  about  the  positive  new directions  in State  programs 
resulting  from  P.L. 96-272 and  Federal  reviews focused  on the  law.  In addition, 
oversight  has helped  prevent  States  from  illegally receiving  Federal  funds  for ineligible 
activities  or on behalf  of ineligible  families.  There  is little  question  that  the  oversight 
mechanisms  in use since  the  early  1980s have served  important  purposes. 
SHORTCOMINGS 
Despite  the  accomplishments  stated  above,  there  are  indications  that  the  oversight 
mechanisms  and  framework  make  it difficult for the  Federal  government  to provide 
adequate  stewardship  of Federal  funds  or leadership  to States  for the  1990s and 
beyond.  Evidence  of these  indications  follows.  There  are  shortcomings  both  in the 
overall  approach  to oversight  as well as in the individual  processes.  Many  of the 
shortcomings  stem  directly  from  the  requirements  set  out by Federal  statute,  while 
others  are  matters  of administrative  discretion  not  strictly  determined  by statute. 
ii  The overall approach  to Federal overnight has not addressed many of the vzlal irsues 
States face  in administetig  child we~are program. 
	 Federal  oversight  has  not  recently  prompted  States  to improve  and  address  new 
and  complex  problems  in child welfare. 
	 Federal  oversight  reviews  have  not  identified  severe  problems  with several 
States  child welfare  programs  that  were  specified  unsuccessful  lawsuits  against 
the  States. 
	 Section  427 and Title  IV-E  reviews  have  been  focused  onthewritten  record  of 
case work,  not  on how well children  are  served. 
	 Disallowances  have  often  been  based  on issues  that  child welfare  agencies  do 
not  control. 
	 The  ACF  has  movided  limited  technical  assistance  to States;  State  officials  say 
that  ACF  does not  provide  them  with new information  when  it identifies   
program  strengths  and  weaknesses  and  solutions  to problems. 
I+obIems with the conduct  of Federal review and phmning actiwhmhave hampered  their 
eficienq  and q$ectiventxr. 
	 Federal  review  activities  have  been  resource  intensive  for State  agencies  and 
ACF  regional  offices. 
.	 Review  reports  have  not  been  issued  to States  in a timely  manner.  This  has 
diminished  their  capacity  to improve  child welfare  programs. 
	 States  expressed  confusion  about  the  Federal  review procedures  resulting  from 
poor  communication  by Federal  officials. 
.	 There  has been  inadequate  Federal/State  interaction  on child welfare  oversight 
issues. 
	 Officials  from  ACF  and  States  question  whether  Federal  review  and  planning 
mechanisms  have been  adequately  meeting  their  stated  objectives. 
RECOMMENDATIONS 
Oversight  of State  child welfare  programs  continues  to be of intense  interest  to the 
Congress,  HHS,  the  States,  and  others.  The  ACF,  itself, is engaged  in efforts  to 
improve  its oversight.  We  hope  this report  can provide  information  to help  guide 
decisions  on the  course  of oversight.  It is important  for ACF  to pursue  two principles 
in its oversight  of State  child welfare  programs.  The  ACF  must  continue  to assure  the 
integrity  of States  use of Federal  funds.  It is equally  necessary  for ACF  to work  in 
... 
111  partnership  with  States  tomakeprograms  work well.  Our  recommendations  are 
focused  at helping  ACF  and  the  States  pursue  both  these  principles. 
We  present  a wide  range  of options  for each  recommendation.  Some  options  are  not 
consistent  with  others,  while other  options  fit together  very well.  Our  goal is to 
provide  as many  practical  ideas  as possible. 
In many  cases,  the  current  oversight  approaches  and  processes  are  set  by Federal 
statute.  Some  of the  options  we present,  if implemented,  may therefore  require 
legislative  changes  (these  are  denoted  by a  6).  Other  options  could  be  enacted  at the 
discretion  of ACF  without  Congressional  approval. 
In order to tiprove  its ovecrzght of State child we~are programs, the ACF shoti 
Provide  States  with  more  and  better  feedback  on issues related  to program 
performance. 
Implementation  options 
c  Performance  Indicators  Develop  performance  indicators,  collect  State-by-State 
information  on them,  and  disseminate  this information  to all States  on a periodic 
basis. 
Outcome-Based  Reviews J  Replace  existing review  mechanisms  with new review 
	
processes  that  relate  resources  to outcomes. 
Find  new ways to work with  States  to  make  program  improvements  and  address 
problems. 
Implementation  options 
Corrective  Action  PlansJ  Rather  than  automatically  sanctioning  States  financially 
	
in response  to adverse  review findings,  use, when  appropriate  (i.e., at the  discretion 
of the  Secretary),  the  results  of reviews  to develop  corrective  action  plans,  with 
agreed-upon  time  frames,  to improve  programs  and  enforce  legal requirements. 
Waive  or reduce  disallowances,  when  appropriate  (at  the  discretion  of the 
Secretary),  if States  comply with plans  and  time  frames. 
AccreditationJ  Using  new or existing accreditation  bodies,  make  accreditation  of 
	
programs  a Title  IV-B State  plan  requirement.  Oversee  the  accreditation  bodies  to 
assure  that  they  are  fair, reasonable,  and  pursuing  continuous  improvement. 
May  require  new legislation. 
iv  .  Qualitv  Assurance  Require  States  to have  quality  assurance  programs  that  look  at 
the  quality  of case work. 
Improve  current  planning  and  review  processes  to make  them  more  effective. 
Implementation  options 
Title  IV-B Plannin~  Emphasis  Put  less emphasis  on compliance  reviews  (such  as 
	
the  Section  427 reviews)  to assure  protections  are  in place  in States  and,  instead, 
use  a revitalized  joint  planning  pro~ess  to provide  strategic  direction  that  will lead 
States  to effective  child welfare  programs. 
Substantive  Title  IV-E  ReviewsJ  Use  the  Title  IV-E  review  process  to assure 
	
States  are  substantially  complying  with foster  care  case  planning  and  review  and 
judicial  determination  requirements.  Limit  disallowances  to instances  of substantial 
non-compliance. 
Section  427 Incentivesd  Alter  the  Section  427 review  process  to provide  better 
	
incentives  for improvement.  Rather  than  using full compliance  with process 
requirements  as the  standard  for 427 funding,  score  States  based  on quality  of case 
planning  and  reviews  once  they have  passed  a triennial  review  and  make  the  size 
of the  grants  in the  coming  three  years  dependent  on  the  scores. 
Focus  Program  Reviews  Change  the  approach  of program  reviews  to use them 
	
only when  indicators  of problems  are  raised  through  other  reporting  or review 
mechanisms.  Develop  strategies  to address  those  problems  only. 
One  State  PlanJ  Require  States  to submit  one  coordinated  State  plan  for all child 
	
welfare  services. 
Make  more  efficient  use  of resources  required  to  conduct  reviews. 
Implementation  options 
Title  IV-E  Reviews  - Automation  Automate  the  Title  IV-E  review  process. 
 
Title  IV-E  Reviews  - Self-CertificationJ  Allow States  to certi@ that  their  payments 
	
are  eligible  under  Title  IV-E. 
Title  IV-E  Reviews  - Limited  Scope&  Limit  the  Title  IV-E  reviews  to income 
	
eligibility and  payment  allowability  issues. 
May  require  new legislation. 
v  Section  427 ReviewsJ  Discontinue  Section  427 reviews  or sharpjy  reduce  the  use 
	
of them. 
Discontinue  Planning  and  Prom-am Reviews J  Use  other  technical  assistance  efforts 
	
instead  of Title  IV-B joint  planning  and  program  reviews. 
Limit  Background  Sections  Shorten  introductions  to reports,  which often  focus  on 
	
information  about  which the  States  are  aware. 
Provide  States  with  more  useful,  comprehensive,  and  expert  advice  on management 
program,  and  technical  issues. 
Implementation  options 
Existing  Mechanisms  Focus  more  resources  on joint  planning,  program  reviews, 
	
and  the  training  of regional  officials to conduct  technical  assistance. 
Non-~overnmental  Contracts  Use funds  to contract  with non-governmental 
	
organizations  to  provide  general  technical  assistance  to States. 
Problem  Areas  Using  a combination  of ACF  officials  and  outside  contractors, 
	
provide  intensive  technical  assistance  to States  or regions  of States  that  have 
extreme  problems. 
More  effectively  share  information  with and  among  States. 
Implementation  options 
Effective  Practices  Using oversight  mechanisms,  identify  effective  practices. 
	
Produce  regular  (at  least  semi-annual)  reports  that  outline  these  practices  and  list 
contacts  in the  States.  Actively  share  reports  and  State  plans  that  outline  effective 
practices. 
On-Line  Service  Develop  a simple,  electronic,  on-line  service  for States  to share 
	
information  about  strategies,  innovations,  and  other  issues. 
Improve  and  clar@  communication  with States  about  program  standards. 
Implementation  options 
Reasonable  Efforts  Collect  information  on States  definitions  of reasonable 
	
efforts  and  identi~  model  definitions. 
May  require  new  legislation. 
vi  Central  Office  Hotline  Establish  a central  office hotline  to respond  promptly  to 
	
regional  office  and  State  inquiries  about  review  policy, standards,  and 
interpretation  of regulations  and  statements.  Follow  up inquiries  wth written 
confirmations  that  are  shared  with  all States  and  regional  offices. 
Program  Remdations  Publish  comprehensive  program  regulations  for Section  427 
	
and  Title  IV-E  that  would be  subject  to notice  and  comment. 
Improve  the  timeliness  of reporting  on results  of reviews. 
Implementation  options 
Mandatom  Turnaround  Require  reports  to be  issued within  a set  time  after  a 
	
review  is complete. 
Performance  Reporting  Develop  goak  for turnaround  of reports.  Then  collect 
	
and  disseminate  information  on the  timeliness  of reporting. 
Streamline  Decision-making  Clari&  who in ACF  has the  authority  to decide  on 
	
policy matters  and  final reports. 
Limit  Scope  of Reviews J  Reduce  the complexity  of the  reports  by narrowing  the 
	
scope  of the  reviews. 
COMMENTS  ON  OUR  DRAFI  REPORT 
We shared  our  draft  report  with and  solicited  comments  from  the  Administration  for 
Children  and  Families  (ACF),  the  Assistant  Secretary  for Planning  and  Evaluation 
(ASPE),  the  Assistant  Secretary  for Management  and  Budget  (ASMB),  and  the 
Assistant  Secretary  for Legislation.  We received  written  comments  from  ACF  and 
ASPE.  We  reproduce  these  comments  and  provide  detailed  responses  to each  in 
appendix  C. 
We  are  pleased  that  both  ACF  and  ASPE  concurred  w-th our recommendations  and 
found  the  report  useful.  We made  changes  in our  report  based  on the  technical 
comments  we received. 
May  require  new legislation. 
vii  TABLE  OF  CONTENTS

PAGE 
EXECUTNE  SUMMARY 
~oIWmW. 
.  . .  . . . . . . . . .. . . . . .  . . . . . . . . . . . . . . . . . . . . . . . . . . ...1

ACCOMPLISHMEm  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...7

SHORTCO~GS

O=RALL  APPROACH  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...8

PROCESS.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13

RECOMMENDATION. S..  .  . . . . . . . . .  . . . . . . . . . . . . . . . . . . . . . . . . . . . ...19

cO=~ONTHE  DRAFT  REPORT  . . . . . . . . . . . . . . . . . . . . . . . . . . ...29

APPENDI~

&Major  Child  Welfare  Programs  . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . .  A-1

B:  Federal  Oversight  Mechanisms  for State  Child  Welfare  Programs  . . . . . . . . .  B-1

C:	 Detailed  Comments  andOIG  Response  . . . . . . . . . . . . . . . . . . . . . . . .

. . . .  c-1

D:  Methodolo~  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..D-l 
E:  Detailed  Evacuation  of Implementation  Options  . . . . . . . . . . . . . . . . . . . . . .  E-1

ENotes.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..F-l  INTRODUCTION 
PURPOSE 
To  assess and  to find ways to improve  oversight  of State  child welfare  programs. 
BACKGROUND 
In  1980, Congress  passed  The  Adoption  Asistance  and  Child  Welfare  Act 
(P.L.  96-272)  in order  to lessen the  emphasis  on foster  care  placements  and  to 
encourage  greater  efforts  to find permanent  homes  for children.1  The  law signaled  a 
new direction  in child welfare  and  highlighted  an awakened  Federal  interest  in how 
States  manage  their  child welfare  programs.  Among  other  things,  the  law increased 
funding  for  a variety  of State  child welfare  semices  and  separated  funding  for foster 
care  and  adoption  assistance  payments  from  Title  IV-A of the  Social Security  Act  (Aid 
to Families  with  Dependent  Children,  or AFDC).  It also refocused  Federal  oversight 
of child welfare  by requiring  that  certain  child protections  be  in place  for States  to be 
eligible  for Federal  funds  for foster  care  and  other  child welfare  services.  One  major 
change  was a greater  emphasis  on the  enforcement  of legal  requirements  to ensure 
the  eligibility  of children  in the  foster  care  system.  For  example,  State  court  judges 
were  required  to include  certain  findings  about  the  appropriateness  of the  foster  care 
placement  before  a child could  be  considered  eligible  for Federal  matching  payments. 
Fundkg 
The  Federal  government  funds  State  child welfare  services  through  three  significant 
mechanisms,  all of which  are  under  the  Social Security  Act .2  The  largest  proportion 
of monies  comes  from  Title  IV-E,  with lesser  amounts  from  Title  XX and  Title  IV-B 
(see  appendix  A for  more  details).  A majority  of Federal  funding  goes  for foster  care 
maintenance  payments  and  administrative  and  training  expenses  associated  with foster 
care  under  Title  IV-E.3  Costs for administration  and  training  are  a huge  and  growing 
proportion  of Federal  child welfare  funding! 
Title  IV-E 
Title  IV-E  funding  is limited  to foster  care,  adoption  assistance,  independent  living, 
and  administration  and  training  associated  with those  programs;  only children  whose 
families  are  eligible  for AFDC  are  eligible  for Title  IV-E  foster  care  and  adoption 
assistance  funding.  Title  IV-E  is an open-ended  entitlement  program.5  In fiscal year 
1993, it is estimated  that  $2.9 billion  was spent  on Title  IV-E  programs. 
1
 Title  XX 
Title  XX-funded  social  semices  block  grants  may be used  for a variety  of child welfare 
services.  In total,  Title  XX social  selvice  block grants  were  funded  for $2.8 billion  in 
1993.  The  money  may be  used  to help  States  meet  five social  services  objectives;  only 
one  is directly  related  to child welfare  services.  According  to a  1986 survey  conducted 
by the  American  Public  Welfare  Association,  States  spent  27.5 percent  of Title  XX 
funding  on child welfare  services. 
Title  IV-B 
Title  IV-B Subpart  1 is a capped  entitlement  program  that  can  be used  for a wide

variety  of child welfare  services;  children  and  families  who benefit  from  the  services  do

not  have  to meet  any income  eligibility  criteria.  Substantial  supplemental  Title  IV-B

funding  is available  to States  under  Section  427.6  The  Section  427 funding  was  set up

to provide  incentives  to States  to establish  and  maintain  certain  protections  for

children  in the  States  care.  The  Title  IV-B appropriation  for fiscal year  1993 was

$295 million.  The  Omnibus  Budget  Reconciliation  Act of  1993 (OBRA  93) created

Subpart  2 under  Title  IV-B.  This  new capped  entitlement  is for family  preservation

and  family support  services.  Congress  authorized  $60 million  in Subpart  2 funding  for

fiscal year  1995 and  $930 million  over  five years.  Section  427 is not  applicable  to

Subpart  2 funding.

OvernightMechanisms 
The  Federal  government,  through  the  Departments  Administration  for  Children  and 
Families  (ACF),  oversees  State  child weifare  services  using the  following  formal 
mechanisms:  Title  IV-E  reviews,  Section  427 reviews,  program  reviews,  and  State  plans 
(see  appendix  B for details  on oversight  mechanisms).  In addition,  ACF  acts  as a 
resource  for States  on a variety  of fiscal, administrative,  and  programmatic  issues.  The 
ACF  has not  conducted  reviews  of Title  XX block  grants,  although  it has the  authority 
to do SO. 
Title  IV-E  Reviews 
Title  IV-E  reviews  are  intended  to assure  that  States  spend  Title  IV-E  money 
appropriately.  They  are  usually  conducted  by a team  of both  fiscal and  programmatic 
staff from  the  ACF  regional  office and,  when  possible,  from  ACF  headquarters.  The 
ACF  conducts  reviews  of Title  IV-E  foster  care  maintenance  payments,  adoption 
assistance  payments,  and,  occasionally,  administrative  and  training  expenses. 
The  foster  care  and  adoption  assistance  reviews determine,  through  record  reviews, 
whether  the  childs family is financially  eligible, whether  there  is documentation 
indicating  adequate  review by courts  and  case workers,  whether  foster  homes  are 
licensed,  and  whether  individual  payments  are  allowable. 
2
 The  administrative  and  training  reviews  focus  on whether  systems  for claiming  and 
apportioning  costs  are  accurate.  Included  in these  reviews  are  checks  on systems  for 
internal  control  in the  areas  of rate  setting  and  of payment  and  edit  check  procedures, 
and  examination  of the  accuracy  of methods  used  for assigning  administrative  and 
training  costs to Title  IV-E. 
Standards  for Title  IV-E  reviews  are  based  on specific  statutory  requirements. 
Section  427 Reviews 
The  main  objective  of Section  427 reviews  is to ensure  that  States  have  the  necessary 
systems  and  policies  in place  to be  eligible  for incentive  funds.  Among  the  required 
protections  are  that  States  must  take  steps  to prevent  the  need  for removal  of a child 
from  his/her  home,  they  must  develop  a case  plan  and  review  system  for each  child, 
and  they  must  set goals for all children  in foster  care.  States  must  also have 
implemented  a Statewide  information  system  on children  in foster  care. 
Federal  oversight  of Section  427 is a two-stage  process:  (1) an administrative  review 
that  is done  the  year  after  a State  claims  to be  eligible  for 427 funds,  and  (2) a survey 
of case  records  which  is done  periodically  after  the  administrative  review  has been 
passed.8  The  Administrative  Procedures  Review  determines  whether  States  have 
developed  systems  to assure  protections  for children  in foster  care.  The  Case  Record 
Survey  confirms  that  the  Section  427 protections  are  in place  in a certain  percentage 
of childrens  records  in the  State  review  files.  If a State  is found  out  of compliance, 
ACF  issues a disallowance  against  the  States  allotment  of Title  IV-B funds  for the 
following  fiscal year  and  incentive  funds  are  no longer  granted.9 
Standards  for Section  427 reviews  are  based  on specific  statutory  requirements.  ~ 
Program  Reviews 
Prior  to  1980, qualitative  program  reviews  were  the  primary  mechanism  for Federal 
oversight  of States  child welfare  systems.  With  the  move  toward  fiscal and 
compliance-based  reviews  as a result  of P.L. 96-272, the  Federal  government 
suspended  program  reviews  in 1983.  Program  reviews were  reinstated  in 1990 when 
ACF  identified  the  need  for States  to have  their  child welfare  programs  assessed  in a 
systematic  way and  to receive  more  technical  assistance.l 
The  ACF  designed  program  reviews  to improve  semices  to children  and  their  families 
by periodically  assessing  State  and  local  programs.  States  participate  voluntarily. 
Teams  of State  agency  staff, Federal  regional  office  reviewers,  and  a Childrens 
Bureau  specialist  conduct  on-site  interviews  and  review  case  records  with State  agency 
officials, program  beneficiaries,  and  staff  of local  agencies. 
The  objectives  of a program  review  are  (1) to provide  a systematic  method  of 
assessing  the  effectiveness  and  efficiency  of child welfare  programs  at  the  State  and 
3  local  levels  of service  delivery;  (2) to provide  a basis for assisting  States  and  local  sites 
to identi&  areas  in which  program  improvement  is needed;  and  (3) to provide  a flow 
of management  information  between  the  States,  local  sites,  and  the  Childrens 
Bureau.11  Program  reviews  identifi  exemplary  programs  as well as program 
weaknesses  and  recommend  specific  p]ans for improvement.  There  are  no penalties 
attached  to the  reviews,  nor  are  States  required  to implement  the  recommendations. 
State  Plan  Processes 
P.L. 96-272 also  requires  ACF  to confer  with States  about  their  child welfare  programs 
through  the  State  plan  process.  States  must  have  specific  plans  for the  provision  of 
child welfare  services  in order  to be eligible  for payments  under  Titles  IV-B and 
IV-E.*2  There  are  separate  planning  processes  for Titles  IV-B and  IV-E. 
State  and  HHS  staff jointly  develop  the  Title  IV-B State  plan;  the  plans  describes 
States  child welfare  setices  and  the  steps  they  plan  to take  to expand  and  strengthen 
ensting programs.  These  plans  must  be submitted  at least  once  every  three  years. 
The  Title  IV-E  foster  care  and  adoption  assistance  programs  are  included  in States 
Title  IV-B plans,  but  these  programs  apply  only to children  eligible  for AFDC.13 
There  is a separate  Title  IV-E  State  plan  which is developed  by the  State,  and 
submitted  to the  Secretary  for  approval.  It is based  on a set of questions  developed 
by HHS  requiring  information  from  the  States  about  specific  goals  as to the  maximum 
number  of children  in care  for more  than  two years,  a description  of steps  to meet 
these  goals,  and  a case  plan  review  system. 
Z?ieOmnibus Budget Reconciliation Act  of 1993 (OBRA  93) 
On August  10, 1993, the  President  signed  into  law OBRA  93.  This  law increased 
funding  for Title  IV-B to encourage  State  efforts  to support  and  preseme  families 
(known  as Title  IV-B Subpart  2).  The  original  version  of the  bill proposed  major 
alterations  to the  oversight  process. 14 The  law, as passed,  left most  of the  oversight 
processes  unchanged.  The  OBRA  93 has an impact  on oversight  in three  areas.  First, 
additional  Title  IV-B Subpart  2 funding  ($2 million  in fiscal year  1994 and  $6 million 
thereafter)  has been  authorized  for ACF  to use for evaluation,  research,  training,  and 
technical  assistance;  next, Title  IV-B State  plan  requirements  were  changed  to reflect 
Subpart  2; and  finally,  the Federal  government  was barred  from  issuing disallowances 
as a result  of Section  427 and  Title  IV-E  reviews  until  October  1, 1994. 
Basis for and Scope of Our Study 
Members  of Congress,  HHS  officiak,  the  General  Accounting  Office,  directors  of 
State  child welfare  agencies,  and  representatives  from  the  Child  Welfare  League  of 
America  and  the  American  Public  Welfare  Association  are  among  those  who have 
voiced  concerns  about  the  Federal  oversight  processes.ls  At hearings  conducted  in 
1991 by the  House  Committee  on Ways and  Means,  witnesses  testified  at length  about 
4  the  problems  with Federal  oversight;  in particular,  they were  concerned  that  the

reviews  elevate  process  issues over  quality  of services.lG

Critics  believe  that,  in several  ways, the  oversight  processes  do not  support  the  intent

of P.L. 96-272.  In addition  to the  OBRA  93 moratorium,  Congress  twice acted  to

suspend  penalties  levied  against  States  that  have  been  found  out  of compliance  during

427 reviews.17  The  ACF  has convened  several  task  forces  and  engaged  in high-level

deliberations  about  how to improve  the  review  processes.18  As part  of their  efforts

to improve  oversight,  ACF  officials  requested  that  we prowde them  with an

assessment  of oversight  activities  and  develop  a range  of proposals  to address

problems  we identified.

Given  the  level  of interest  expressed  by Congress,  the  States,  the  Administration,  and

child welfare  advocates  in child welfare  and  Federal  oversight  of State  programs,

changes  to the  oversight  system  are  likely.  This  report  presents  information  which we

hope  will be  helpful  to decision  makers  as they consider  improvements  to the

oversight  of child welfare  programs.  In this report,  we evaluate  the  scope  of and

approach  to Federal  oversight  activities  (which includes  the  statutorily  mandated

features  of oversight),  as well as the  conduct  of these  activities.

This  report  is primarily  focused  on the  review  and  planning  mechanisms  used  by ACF

to oversee  State  child welfare  programs.  In our  interviews  with  State  and  ACF

officials we also discussed  the  other  less formal  mechanisms  that  ACF  uses to  oversee

States  such as technical  assistance  efforts,  The  report  therefore  often  uses the  term

oversight  activities  in a general  way,  This report  is not  focused  on reevaluating

specific  findings  or disallowances  from  any reviews  of State  child welfare  programs.

We  assume,  and  have  no reason  to believe  otherwise,  that  all disallowances  taken  as a

result  of reviews  were  based  on direct  application  of Federal  statute.

In addition,  although  our  primary  focus is on ACF  oversight  activities,  we feel  it is

simpler  and  more  appropriate  to speak  about  Federal  oversight  activities.  The  ACF

is not  alone  in responsibility  for administering  and  designing  oversight  activities.  The

HHS  and  Congress  have significant  roles in this process.  As noted  throughout  the

report,  many  aspects  of the  oversight  processes  are  defined  by Federal  statute.

However,  our  use  of the  term  Federal  oversight  is not  intended  to include  reviews

and  audits  of State  child welfare  programs  outside  of ACFS purview--for  example,

reviews  and  audits  conducted  by the  OIG  Office  of Audit  Services  or the  General

Accounting  Office.

While  many  observers  of and  participants  in the  oversight  processes  have  raised  issues

similar  to those  raised  in this report,  this report  is meant  to serve  several  unique

purposes.  First,  we provide  detailed  analysis of the  oversight  process,  using multiple

sources  of information.  The  methods  we used  allow us to make  well-balanced  and

conclusive  statements  about  the  approaches  and  performance  of oversight.  Second,  as

mentioned  above,  we assessed  the  entire  system  of Federal  oversight  including

technical  assistance  activities,  planning  activities,  and  review  activities.  Finally,  our

5  central  objective  is to find ways to improve  oversight.  We  do not  prescribe  a specific 
course  of action,  but  instead  identify  key areas  in which improvement  is necessary. 
We then  present  a range  of implementation  options  in each  area.  The  report  is, 
therefore,  meant  to be  a single,  comprehensive  document  that  will hopefully  establish 
the  context  and  provide  general  perspective  for officials to make  improvements  in the 
oversight  system.  Our  Office  of Audit  Services  has  issued  a draft  report  which focuses 
on specific  improvements  in the  eligibility  process.lg 
Methodology 
We collected  data  from  three  primary  sources.  First,  we conducted  document  reviews.

We reviewed  all available  reports  from  Section  427 reviews, Title  IV-E  reviews,  and

program  reviews  conducted  in each  State  in the  last five years.  We gathered  and

analyzed  reports,  journal  articles,  legislative  and  regulatory  proposals,  and  information

from  court  proceedings.  Second,  we interviewed  State  child welfare  officials.  We

conducted  inteniews  on-site  in 3 States  and  over  the  telephone  in  10 States--one  in

each  HHS  region.  Finally,  we intemiewed  officials  in each  of the  10 ACF  regional

offices  over  the  telephone  and  held  numerous  discussions  with officials  in the  central

office of ACF.  (See  appendix  D for a complete  description  of the  primary  data

collection  methods  and  sample  selection  criteria.)

In our  presentation,  we blended  information  from  these  three  sources.  We

supplemented  the  opinions  and  conclusions  of State  and  ACF  officials with evidence

from  review  reports,  literature,  laws, regulations,  and  court  proceedings.  Whenever

possible,  to account  for  potential  biases,  we balanced  interview  data  from  State

officials with interview  data  from  ACF  officials.  We did not  evaluate  the  accuracy  of

statements  made  in interviews  about  the  accomplishments  and  shortcomings  of

Federal  oversight  except  by using the  above-noted  sources.  Nonetheless,  because

State  officials  frequently  agreed  with ACF  officials  and  the  evidence  from  reports  and

other  sources  support  the  interview  information,  we are  confident  of the  validity  of our

conclusions.

We conducted  this inspection  in accordance  with the  Quality Sandards  for  Inspections

issued  by the  Presidents  Council  on Integrity  and  Efficiency.

6
 ACCOMPLISHMENTS 
Federal ovtzright of State child welfare programs has served some  important purposes, 
parhcuhw-lyin establishing new directions for child welfare in the early 1980s. 
Since  the  early  1980s, Federal  oversight  of State  child welfare  programs  has been 
focused  on assuring  States  adherence  to P.L. 96-272.  Several  State  and  Federal 
officials we interviewed  spoke  about  the  positive  new directions  in State  programs 
resulting  from  P.L. 96-272 and  Federal  reviews  focused  on the  law.  States  were 
prompted  to  develop  written  case  plans  and  conduct  periodic  judicial  and 
administrative  reviews  of childrens  cases;  these  were  procedural  breakthroughs  in 
many  States.  The  requirement  to make  reasonable  efforts  to prevent  family breakups 
and  reunify  separated  families  was a significant  shift in objectives  on the  part  of the 
Federal  government.  State  officials we spoke  with said that  oversight  led  them  to 
create  new laws parallel  to Federal  laws, clean  up existing laws, and  formalize  existing 
procedures.  Officials  from  ACF  cited  more  effective  coordination  between  agencies 
and  State  judiciaries,  and  better  family-centered  services  resulting  from  the  law and 
the  oversight  process,  and  mentioned  that  children  are  less likely to get  lost in the 
foster  care  system. 
In addition,  oversight  has helped  prevent  States  from  illegally receiving  Federal  funds 
for ineligible  activities  or on behalf  of ineligible  families.  For  example,  in one  State, 
ACF  recovered  over  $200,000 in Federal  funds  because  payments  were  made  to 
ineligible  or unlicensed  providers.  In another  State,  ACF  recovered  over  $190,000 
spent  by the  State  for  children  from  families  without  financial  need.  The  fact  that 
ACF  verifies  through  a review  process  that  funds  are  spent  legally undoubtable  deters 
States  from  making  ineligible  claims.  While  it is impossible  to measure  this effect,  it is 
nonetheless  important. 
There  is, therefore,  little  question  that  the  oversight  mechanisms  in use  since  the  early 
1980s have  served  important  purposes.  There  are  indications,  however,  that  the 
oversight  mechanisms  and  framework  do not  allow the  Federal  government  to provide 
adequate  stewardship  of Federal  funds  or leadership  to States  for the  1990s and 
beyond.  Evidence  of these  indications  follows.  Many  of the  shortcomings  stem 
directly  from  the  requirements  set out  by Federal  statute,  while  others  are  matters  of 
administrative  discretion  not  strictly  determined  by statute. 
7
 SHORTCOMINGS 
IN GENERAL  APPROACH 
i%e overall approach to Federal ovemzght has not addressed many of the vital ti 
States face  in adminktetig  child welfare programs. 
	 Federal  oversight  has not  recently  prompted  States  to improve  and  address  ne 
and  complex  problems  in child welfare. 
The  state  of child welfare  services  has  changed  significantly  since P.L.  96-272 was 
passed.  Many  sources  have  identified  a crisis in child welfare  services.  Numerous 
disastrous  incidents  have  occurred  lately  to children  under  State  supervision.20  State 
child welfare  agencies  are  overwhelmed  by escalating  case  loads  and  the  increasingly 
complex  problems  of children  in care.  There  are  increasing  numbers  of infants  in 
State  care,  many  of whom  have  difficult  medical  problems  caused  by substance-
abusing  parents.z*  In addition,  adolescents  and  teenagers  in care  frequently  have 
substance  abuse  or mental  health  problems,  or have  been  involved  in criminal 
offenses .22 These  issues  complicate  substitute  care  situations  and  greatly  decrease 
the  chances  of successful  permanent  placements.  They  also  place tremendous  burden 
on case-worker  systems  that  are  already  at or above  capacity. 
State  officials we spoke  with did not  think  recent  Federal  oversight  activities  have 
helped  them  cope  with current  crises,  because  reviews  do not  address  the  most 
important  issues in child welfare  (such  as appropriate  methods  to assist very troubled 
children  and  families).  Some  program  improvements  (such  as reductions  in numbers 
of children  in long-term  foster  care  placement  and  more  effective  coordination 
between  agencies  and  their judiciaries)  have  occurred  recently,  but  oversight  is usually 
not  spurring  advancements  in State  programs.  In fact,  some  States  find that  Federal 
oversight  has had  detrimental  effects  or has never  had  much  positive  effect  on their 
programs.  Some  cited  no changes  at  all.  States  cited  a variety  of changes  that 
oversight  has recently  spurred  that  were  not  positive.  For  example,  State  officials  felt 
that  alterations  to the  case  review  process  such  as timing  of the  reviews,  new 
procedural  changes  to an automated  pa~ment  system,  and  changes  to a case  planning 
document  to  assure  the  documentation  of requirements  had  no positive  effects;  in fac 
they  felt these  responses  required  attention  and  resources  that  could  have  been  used 
to address  important  issues. 
Several  State  officials mentioned  that  they had  a hard  time  convincing  their 
legislatures  of the  need  for change  without  Federal  dollars  being  at risk.  Nevertheless, 
even  though  every State  has had  a 427 review, only five States  have  failed  427 reviews 
since  1988 and,  because  of Congressional  moratoria,  no State  has lost Federal  funding 
because  of a failure  in that  time  period.  Some  observers  feel  it is time  to move 
beyond  the  Section  427 requirements,  in part  because  most  States  have  adequately 
met  the  requirements.  z  States  have  been  somewhat  less successful  in Title  IV-E 
8
 reviews;  nevertheless,  of the  States  reviewed  by ACF,  only twelve  States  have  had 
major  (Stage  II) disallowances  in Title  IV-E  foster  care  reviews  and  only two States 
have  had  major  (Stage  11) disallowances  in Title  IV-E  adoption  assistance  reviews  in 
the  last five years. 
Even  if the  reviews  were  addressing  the  current  set  of problems,  State  action  as a 
result  of the  reviews  is voluntary.  Except  in the  rare  cases  of disallowances, 
disregarding  ACF  findings  may not  have  ramifications  for the  States.  When  States 
fare  poorly,  ACFS only mechanism  for verifying  improvement  is to review  them  in the 
future.  In general,  ACF  does  not  monitor  or require  documentation  of policy, 
program,  or system  responses  to Federal  reviews. 
.	 Federal  oversight  reviews  have  not  identified  severe  problems  with several 
States  child welfare  programs  that  were  specified  in successful  lawsuits  against 
States. 
In 4 of the  13 States  in our  study,  lawsuits  based  on charges  that  States  were  violating

Federal  law resulted  in court-approved  settlements.  These  suits all were  initiated  after

the  passage  of P.L.  96-272.  While  the  allegations  of the  lawsuits  were  never  subject  to

court  adjudication,  the  plaintiffs  in these  suits accused  the  States  of not  making

reasonable  efforts  to prevent  removal  of children  from  their  homes  and/or  to

rehabilitate  their  families  so that  the  children  could  return  home.  Titles  IV-B and  IV

E require  States  to make  these  efforts.  Problems  identified  in these  cases included

failure  to adequately  track  children  in care,  poor-quality  child  protection  investigations,

extremely  long placements  in out-of-home  care,  and  lack of State  oversight  of county-

based  sewices.24  Lawsuits  have  been  brought  against  more  than  20 States;  many

have  been  based  on violation  of Federal  law.fi

In three  of the  four  cases,  according  to State  officials, Federal  reviews  covered  the

period  of time  that  the  suits plaintiffs  were  in State  care.  In the  other  case,  according

to State  officials,  the  lawsuit  was not  specific  as to timeframe,  According  to officials  in

all four  States,  Federal  officials did not  identify  the  issues  raised  in the  suits during

reviews  conducted  before  the  States  were  sued.  During  reviews,  ACF  made  no

explicit  mention  of States  inadequately  preventing  removal  or rehabilitating  families.

.	 Section  427 and  Title  IV-E  reviews  have  been  focused  on the  written  record  of 
case  work,  not  on how well children  are  served. 
The  review  standards  for Section  427 and Title  IV-E  reviews, which  are  derived  from 
Federal  statute,  are  oriented  toward  documentation  and  the  meeting  of timing 
requirements.  The  Section  427 reviews look solely at whether  actions  were  taken  (and 
documented),  not  whether  the  actions  were  done  well or had  any positive  impact  on 
the  child.  The  Title  IV-E  foster  care  and  adoption  assistance  re~iews  also look  at 
documentation  issues  and  not  at how well services  were  provided. 
9
 It is not  clear  that  the  statuto~  requirements  for these  reviews  ensure  effective  sewice 
provision.  In fact,  several  State  and  regional  officials  raised  the  possibility  that  States 
could  pass  reviews  and  still have  poor  child welfare  programs.  Most  of the  State 
officials  and  all of the  regional  officials we spoke  with had  problems  with the  process 
orientation  of the  Section  427 and  Title  IV-E  reviews.  Officials  from  every  regional 
office  mentioned  that  there  needs  to be  more  emphasis  on qualitative  measures  and 
less on quantitative  measures.  A common  concern  was that  the  Section  427 reviews 
only check  to make  sure  States  are  meeting  certain  timeframes  rather  than  whether 
services  provided  yield  improvement.  This focus has made  States  emphasize  passing 
the  reviews  rather  than  following the  intent  of the  law. 
Almost  all State  and  regional  office  officials felt the  Section  427 reviews  should  have 
objectives  in addition  to ensuring  certain  child protections  are  in place  and  assuring 
implementation  of information  systems  on children  in foster  care.ti  Eight  of eleven 
responding  States  and  se~en of ten  responding  regional  offices felt  that  the  427 
reviews  should  have  different  objectives.  Officials  in seven  States  and  in six regions 
wanted  the  objectives  to be focused  on quality  issues such  as how fast a child gets 
placed  and  whether  case  plans  are  appropriate. 
Many  State  and  regional  office officials felt that  IV-E  reviews  should  have  objectives 
in addition  to determining  whether  payments  are  made  on behalf  of eligible  children, 
assuring  payments  are  made  to eligible  providers,  and  assessing  whether  payment 
levels are  allowable.2G  For  example,  officials in some  States  felt  that  the  IV-E 
reviews  should  be  focused  on quality  issues such as whether  children  are  being  moved 
through  and  out  of the  system  quickly enough.  Regional  officials  said that  the  reviews 
should  have  a variety  of other  objectives  including  focusing  more  on administrative 
and  training  costs,  assessing  fiscal and  program  issues together,  and  measuring  quality. 
State  and  regional  office  officials suggested  changes  to the  entire  oversight  system  to 
address  these  problems.  Officials in almost  every State  and  many  regional  officials 
expressed,  in a variety  of ways, a desire  to have  the  Federal  oversight  system  focused 
less on compliance  with  standards  and  more  on the  quality  of child welfare  services. 
Common  suggested  improvements  included  changing  the  process  to be more  helpful; 
focusing  efforts  on technical  assistance;  having  oversight  be  outcomes-based,  and 
emphasizing  models  for good practice.27 
	 Disallowances  have  often  been  based  on issues that  child welfare  agencies  do 
not  control. 
Several  of the  items  that  Federal  statute  requires  ACF  to review  in Section  427 
reviews  and  Title  IV-E  reviews  relate  to issues over which State  child welfare  agencies 
do not  have  complete  control.  For  example,  during  Title  IV-E  reviews,  the  Federal 
government  verifies  that  court  orders  indicate  that  reasonable  efforts  were  taken  to 
prevent  family  breakup  or to reuni~  the  family; and  during  Section  427 reviews,  ACF 
checks  each  case  to be  sure that  dispositional  hearings  are  held  within  18 months  of 
the  original  placement.  A 1993 survey of States  done  by the  American  Public  Welfare 
10  Association  found  that  the  leading  reason  for failure  on Title  IV-E  reviews was related

to judicial  determinations;  and  on 427 reviews, was related  to dispositional  hearings.a

Our  respondents  also reported  difficulties  complying  with Federal  requirements

related  to court  orders  and  timing  of hearings;  our  analysis  of review  reports

demonstrated  this problem  as well.29  In theory,  taking  money  away from  State  child

welfare  agencies  (and  therefore  from  State  budgets)  might  influence  State  courts  to

respond  with new policies  or procedures,  but  many  State  officials  spoke  about  the  lack

of control  and  leverage  they  have  over  courts,  and  therefore,  how unfair  and

ineffective  it is to impose  disallowances  based  on problems  with the  courts.

The  courts,  in some  cases  of disallowances,  may simply be neglecting  to provide

needed  documentation.  For  example,  ACF  officials we spoke  with mentioned  that,  for

some  cases,  they were  able  to assess  that  high quality  case work was being  done  that

would  meet  any standard  of reasonable  efforts,  and  yet the  court  documents  did not

include  language  to that  effect.  These  reviewers  speculated  that  court  officials simply

neglected  to put  the  language  in the  documents;  the  fact  that  they  failed  to include  the

language  did not  indicate  that  they  thought  efforts  were  less than  reasonable.  Despite

this, ACF  reviewers  were  required  to find cases  such  as these  in error.

A draft  OIG  report,  by the  Office  of Audit  Services,  further  discusses  the  difficulties

States  have  complying  with  statutory  eligibility requirements.30  The  report  also

examines  problems  raised  by legal determinations  prepared  by courts  and  discusses  the

notion  that  eligibility  requirements  can be satisfied  when  substantial  compliance  has

been  achieved  through  reasonable  efforts.

	 The  ACF  has  provided  limited  technical  assistance  to States;  State  officials  say 
that  ACF  does  not  provide  them  with new information  when  it identifies 
program  strengths  and  weaknesses  and  solutions  to problems. 
The  most  direct  forms  of technical  assistance  ACF  has provided  to States  are  now 
rarely  available.  Funding  is no longer  available  for  technical  assistance  provided  by 
Child  Welfare  Resource  Centers  (CWRCS).  Most  State  and  regional  office officials 
who had  experience  with or knowledge  of the  CWRCS  felt they  had  provided  useful 
setices  to States.  (However,  some  central  office  officials felt that  some  non-CWRC 
contractors  who  offer  technical  assistance  have  provided  States  with inaccurate  and 
overly expensive  services.)  Program  reviews,  the  only oversight  mechanism  explicitly 
designed  to provide  technical  assistance,  have  not  been  performed  on a wide scale  and 
have  often  been  fraught  with problems.  The  reviews  have  been  done  in only 15 States 
since being  reinstituted  in 1990 and,  according  to a senior  ACF  official, ACF  is not 
planning  to conduct  more  in the  near  future.  Many  State  and  regional  officials 
mentioned  problems  with the  timeliness,  scope,  and  design  of program  reviews  (we 
detail  many  of these  problems  later  in this report). 
Many  State  and  regional  office  officials would  like ACF  to be more  involved  in and 
better  trained  at providing  technical  assistance.  Officials  in some  States  would  like to 
see  the  entire  orientation  of Federal  oversight  to be  on technical  assistance.  Many 
11
 others  felt  this was an important  role,  but  recognized  that  Federal  officials are  not 
expert  in providing  technical  assistance  and  need  to be better  informed  about  the  field 
of child welfare.  Some  regional  officials  also expressed  a desire  to be more  involved 
in consultative  work  with the  States.  Many  recognized  a need  to be  more 
knowledgeable  about  State  programs,  specialized  areas,  and  innovations  in child 
welfare  in general.  Officials  in the  central  office  of ACF  were  particularly  concerned 
that  ACF  has not  provided  adequate  assistance  to States  on legal  and  compliance 
issues. 
The  ACF  has convened  regular  meetings  of States  and  made  other  efforts  to share 
information  with  them,  but  many  State  officials said  that  ACF  has not  adequately 
shared  information  among  States.  Officials  in States  mentioned  the  specific  need  for 
the  Federal  government  to share  information  on exemplary  programs,  on emerging 
issues, and  on State  practices.  State  officials also mentioned  their  desire  to be  able  to 
read  other  States  plans  in order  to get  a sense  of issues, problems,  and  innovations. 
Despite  the  fact  that  one  of the  goals  of program  reviews  is to identify  exemplary 
approaches,  Federal  officials have  acknowledged  that  no formal  effort  has been  made 
to share  information  from  these  reviews  among  the  States.  In addition,  central  office 
officials  point  out  that  knowledge  about  States  is usually localized  to particular 
individuals  in regional  offices;  there  is no existing central  repository  for information 
about  States. 
It appears  that,  in general,  Federal  oversight  has not  effectively  identified  program 
strengths  and  weaknesses  and  helped  States  solve problems.  All the  responding  States 
felt that  the  information  ACF  provided  them  on strengths,  weaknesses,  and  solutions 
was information  of which  they were  already  aware.  On average,  respondents  from 
States  rated  the  effectiveness  of Title  IV-E  reviews,  427 reviews,  and  the  Title  IV-B 
State  planning  process  in identi~ing  strengths,  weaknesses,  and  solutions  as less than 
adequate.  Regional  office  ratings  were  slightly higher,  but  respondents  from 
individual  regions  felt these  processes  couid  more  effectively  address  program  issues  in 
States. 
12
 SHORTCOMINGS  IN PROCESS

Problems  with the conduct of Federal review and planning activities have hampered  thek 
@i%iency and effectiveness. 
	 Federal  review  activities  have  been  resource  intensive  for State  agencies  and 
ACF  regional  offices. 
Almost  every State  felt  that  preparing  for and  participating  in Federal  reviews  was an 
unnecessarily  time-consuming  process.  Some  State  officials  complained  that  far too 
much  time  and  money  are  invested  in reviews  that  no longer  do much  to improve  the 
quality  of services  for children  and  families.  State  officials  stated  that  many  hours  are 
spent  preparing  for, participating  in, and  following  up on an individual  review  (officials 
in one  State  estimated  that  4,400 staff hours  were  spent  on these  activities  for  one 
review).  The  ACFS own estimates  make  clear  how resource  intensive  preparing  for, 
conducting,  and  following  up on Section  427 and  Title  IV-E  reviews  have  been  for 
States  and  the  Federal  government  (see  figure  1). 
FIGURE  1 
All of the  States  with  How Labor  Intensive  Are Federal  Reviews? 
county-administered 
child welfare 
programs  we spoke 
with said they  have 
Mm; 
faced  additional 
burdens  when  12s0 
preparing  for Federal 
mm 
reviews.  Because 
their  programs  are  7SQ 
decentralized,  they 
Sm 
have  an additional 
layer  of bureaucracy  2s0 
to deal  with  in   
o 
preparing  for  reviews. 
For  example,  one 
State  official 
explained  that  costs in one  county  for copying and  shipping  records  to the  State  office 
for a 427 review  were  over $2,000. 
On average,  according  to ACF  central  office officials, program  reviews  have  involved 
15 people  as reviewers  and  dozens  more  as participants.  One  large  State,  which  has  a 
county-based  child welfare  program,  had  a program  review  that  involved  over  100 
people  from  ACF  central  and  regional  offices, the  State  ageney,  county  agencies,  State 
universities,  agency  staff, clients,  and  advocacy  groups.31 
13
 Almost  every  State  we spoke  with  has  spent  significant  time  and  money  monitoring

cases  to ensure  compliance  with Federal  requirements.  Some  States  have  established

elaborate  systems  whose  primary  purpose  is to prepare  cases  for Title  IV-E  and

Section  427 reviews.

Federal  officials  spend  much  time  drafting  and  redrafting  reports.  Central  office

officials  point  out  that  many  reports  to States  include  lengthy  introductory  and

background  sections  that  go into  extensive  detail  on the  States  organization,

operation,  and  program  choices--which  is information  about  which the  States  are  fully

aware.

	 Review  reports  have  not  been  issued  to States  in a timely  manner.  This  has 
diminished  their  capacity  to  improve  child welfare  programs. 
Six of the  15 States  that  had  program  reviews  in the  last five years  had  not yet 
received  even  draft  copies  of their  review  reports  by April  1993.  Two States  in our 
sample  had  yet  to receive  reports  for Title  IV-E  reviews--one  of which was conducted 
in 1983.  Two States  had  yet to receive  Section  427 review  reports;  one  of these  States 
had  not  received  any formal  feedback  from  reviewers  who conducted  their  427 review 
in 1987. 
Officials  in  11 out  of the  13 States  recounted  specific  incidents  of not  receiving  review 
reports  in a timely  manner  once  the  review had  been  completed.  For  example,  7 of 
the  12 States  that  had  had  IV-E  reviews  reported  that  they  had  waited  at least  one 
year  for their  final  reports.  Officials  in regional  offices supported  State  claims  that 
there  have  often  been  long lag times  between  the  conduct  and  issuance  of review 
reports,  particularly  for Title  IV-E  and  program  reviews.  In fact, eight  of the  nine 
responding  regional  offices said  that  Title  IV-E  review  reports  were  rarely  or never 
timely;  all of the  responding  regional  offices report  that  program  reviews were  rarely 
or never  timely. 
Moreover,  as our  examination  of 69 review reports  show, reviews have  taken  place 
and  reports  have  been  released  long  after  the  fiscal year  under  review was over.  On 
average,  Title  IV-E  reviews were  released  over  two and  a half years  after  the  end  of 
the  fiscal year  under  review  and  Section  427 review  reports  were  released  almost  a 
year-and-a-quarter  after  the  end  of the  fiscal year  under  review. 
Despite  the  fact  that  States  have  often  been  briefed  on the  findings  of a review  during 
an exit conference,  State  and  regional  officials reported  that  delays  in issuing review 
reports  diminished  their  effectiveness  and usefulness.  Regional  and  State  officials 
considered  the  retrospective  nature  of reviews to be  a significant  weakness  of the 
oversight  process  because  it focuses  attention  on past  rather  than  current  practice;  this 
problem  is heightened  by a lack of timeliness  in issuing the  reports.  State  officials 
mentioned  that  untimely  reviews  have  identified  issues that  have  become  irrelevant  to 
current  State  programs;  others  were  frustrated  because  windows  of opportunity  for 
14
 change  have  been  closed  by the  time  reports  are  released.  In some  cases,  States  have 
been  left wondering  about  the  outcomes  or bases  for disallowances. 
Officials  in all of the  responding  regional  offices  identified  central  office reviews  as a 
major  barrier  to timely  reporting.  The  ACF  does  not  impose  requirements  on 
turnaround  time  for review  of reports  in the  central  office.  Most  regional  officials 
claimed  that  reports  have  been  reviewed  by too  many  central  office staff.  The  ACF 
central  office  is aware  of this problem,  and  has recently  taken  steps  to remedy  it for 
program  reviews.  They  have  revised  the  review  protocol  for program  review  reports 
so that  reports  are  circulated  only through  the  Childrens  Bureau  rather  than  all of 
Administration  on Children,  Youth  and  Families  (ACYF)  before  being  returned  to  the 
regional  offices. 
Also, central  office  officials, while  acknowledging  shortcomings  in the  report  review 
process,  pointed  out  that  this is not  the  sole source  of problems  with timeliness.  They 
viewed  the  report  writing  process  as a collaborative  one  and  therefore  felt  that  both 
regional  and  central  offices  are  responsible  for the  timeliness  of reporting. 
	 States  expressed  confusion  about  the  Federal  review  procedures  resulting  from 
poor  communication  by Federal  officials. 
While  most  State  officials  said  that  they were  given information  about  standards  by 
their  regional  offices  prior  to the  reviews, officials  in  11 of the  13 States  cited  specific 
problems  with the  transmission  and  communication  of standards.  State  officials 
mentioned  difficulty  getting  ACF  to resolve  review-specific  policy issues,  differing 
interpretations  of standards  between  ACF  central  office and  regional  office  staff, 
recently  issued  review  handbooks  that  were  already  obsolete,  and  inconsistent 
messages  in reviews  over  time.  This  poor  communication  apparently  caused  serious 
problems  for States.  For  example,  one State  was unsure  how to claim  foster  parent 
training  costs;  another  could  not  get  policy guidance  on State  and  tribal  jurisdiction. 
Inconsistent  messages  about  sample  selection  for Section  427 reviews has  made 
another  State  unsure  about  when  to conduct  periodic  reviews  and judicial 
determinations  (see  table  1 for other  examples  of States  problems  with 
communication  of standards).  We  did not  independently  validate  the  accuracy  of 
States  claims  about  inconsistencies  and  inadequacies  in communication  about 
standards.  Nevertheless,  we believe  the very fact  that  States  feel  these  are  problems 
indicates  a need  for better  communication. 
Some  State  and  regional  office  officials have  attributed  poor  communication  of review 
standards  and  regulations  to the  lack of formal  review  guidelines  and  regulations.  For 
example,  Section  427 reviews were  first implemented  in 1980, and  to date,  there  are 
still no  regulations.  Another  source  of confusion  has been  the  absence  of final Title 
IV-E  review  regulations  on methodology  and  audit  procedures. 
While  States  have  cited  problems  with communication  of standards,  we did not  find 
evidence  that  ACF  has misapplied  Federal  statutory  requirements  in developing 
15  TABLE  1 
SPIXIFXC  PROBLEMS  WITH  STANDARDS 
ACCORDING  TO  WATE  OFFICIALS 
COMMUNICATION 
* 
The State  was never given a cow  of the most  recent  Title IV-E  review  handbook 
* 
A critical  change  to the IV-E  review  checklist  was not communicated  in advance. 
* 
The State has not yet seen the IV-E foster parent  training regulations. 
* 
Z$ere  was somt  confhsion  in communication  fi-om the Federal  government  over how  dtjjferent 
fimding  streams  work 
* 
Ihe  current  427 handbook  k  already  out-o fidate. 
* 
Some  standards  in the reviews  are not consistent  with information  presented  in policy  guidances. 
* 
Because  communication  from  the regional  ofice  is poor  and sometimes  incoruistent,  the State 
speh  directly  with central  ofice  ACF  officials  and outside  organimdons  about  interpretatiotw 
* 
Subtle  twkts  and  variations  on standards  have  been added  during  reviews. 
*  Reponal of~ces  and States had  d~ficulty  resolving policy  questions  around  mbalversus State 
jurisdictions  (re: fitnding). 
* 
States  were unable  to get regonal office response  on whether  medical  and educmon  records  were to 
be included  in the Section  427 reviews. 
CONSISTENCY  OVER  TIME 
* 
The State  was cnticued  for something  that it had  been praised  for  two years  earlier.

* 
I%ere was a new twist in the latest review  on whether  administrative  case plain  should  be signed  in

evety review.

* 
Zkere has been a lack of coritktency  in guidance  on what to consider  the date  of removal.

* 
There has been a lack of consistency  in communications  about  whether  to include  children  in

relative  care in the 427 sample.

* 
The regonal ofice  has changed  its opinion  on whether standards  applied  to adoption  services.

* 
The regional  ofice  ha  inconstktently  ruled on whether  agreed orders  are acceptable.

* 
The State  was sutprised  by the standards  on licensure  and on child  support  enforcement  issues on

the Title IV-E  review.

* 
Review  standards  have become  sticter over time.

CONSISZENCYACROSS  SZAIES 
* 
The State  wm  required  to pay back  voluntary  IV-E money,  while  another  State  was not  (this was

appealed  and the State  won).

* 
Federal  oficials  did a ~ennial 427 review@  years  after the State had pawed  a triennial  review.

* 
U4thin the region  there have been different  interpretations  in several  States  on how to allocate

university  training  costs for IV-E  admtnistrative cost claims.

* 
The removal-from-home  standard  was different for  a State in another  regio~

* 
States  are held  to standards  issued  after the end of the fucal  year under review.

Source:  Interviews with 13 States conducted  by Ofice  of Inspector  Genera~ May  1993. 
Note:  Z%  OIG  did not inakperuiew~  validate  the accuracy  of dwse  claims. 
16
 review  standards. 
	 There  has been  inadequate  Federal/State  interaction  on child welfare  oversight 
issues. 
The  majority  of regional  officials  said that  States  should  be  reviewed  more  frequently. 
0fficialsin60f  the  10regional  offices  reported  that  States  have  not  been  retiewed 
frequently  enough.  Since  1988, according  to ACF  records,  five States  have  not  had 
their  Title  IV-E  foster  care  or adoption  assistance  payments  reviewed;  only  15 States 
have  hadprogram  reviews  since  they were  reinstatedin  1990.  State  officials stated 
that  the  lack  of contact  has made  it difficult  for ACF  officials  to understand  the  local 
child welfare  context. 
Many  State  and  regional  office  officials would  like to increase  the  level of 
collaboration  around  the  IV-B joint  State  plan  process.  Officials  in about  half of the 
States  viewed  the  Title  IV-B joint  State  planning  process  as an effective  mechanism, 
but  usually  despite,  and  not  because  of, ACF  involvement.  State  officials  cited  a 
general  lack  of contact  with regional  office officials  as a major  problem  with the 
process.  Most  regional  officials  reported  that  they were  only able  to make  one  or two 
visits to the  States  per  year  to work  on the joint  State  plan,  but  they believed  for 
planning  to be  truly collaborative  they  should  be  making  quarterly  visits.  Regional 
officials felt  the  lack  of travel  money  constrained  them  from  conducting  site visits to 
the  States. 
	 Officials  from  ACF  and  States  question  whether  Federal  review  and  planning 
mechanisms  have  been  adequately  meeting  their  stated  objectives. 
Many  regional  and  State  officials were  uncertain  about  whether  the  Title  IV-E  review 
process  was meeting  all of its objectives.  Regional  officials, in particular,  said that  the 
Title  IV-E  reviews  were  too  broad;  they were  expected  to examine  so many  different 
areas  that  it was almost  impossible  to check  any one  area  as thoroughly  as they would 
have  liked.  Because  the  Title  IV-E  review was so broad,  regional  office and  State 
officials questioned  how well these  reviews  assured  that  payments  were  made  to high 
quality  homes  and  institutions.  There  was no effort  to inspect  the  sites, and  most 
reviewers  just  checked  to see  if homes  and  institutions  were  on a list provided  by the 
State.  Some  regional  and  State  officials were  also uncertain  about  whether  payment 
levels were  allowable  under  Office  of Management  and  Budget  (OMB)  provisions.32 
This was primarily  due  to lack of knowledge  of what  the  Federal  and  State  funding 
levels should  be. 
Officials  in seven  of eight  responding  regions  said that  program  reviews were  not 
meeting  at least  one  of their  objectives.  The  most  frequently  mentioned  reason  why 
they thought  program  reviews were  not  meeting  their  objectives  was that  they were 
too  comprehensive.  Other  problems  with the  program  review  cited  by regions  were 
lack  of any clear  methodology,  an unwieldy  data  collection  instrument,  inconsequential 
findings,  and  lack  of information  to help  States  solve programmatic  problems. 
17  Half  of the  regional  offices  reported  that  Section  427 reviews  have  not  been  meeting 
all of their  objectives.  In particular,  they thought  these  reviews  were  not  adequately 
assuring  the  implementation  of a State-wide  foster  care  information  system.  Regions 
said  that  the  level  of sophistication  of the  State-wide  information  systems varied  from 
simple  handwritten  lists of cases  to computerized  management  information  systems. 
Most  regional  office  and  State  officials thought  that  Title  IV-B joint  State  plans  have 
not  been  developed  collaboratively.  Many State  officials  mentioned  that  the  process 
was not  truly  joint because  the  Federal  government  does  not  provide  much  in the 
way of suggestions  for planning.  Some  did not find  the  State  plan  at all helpful.  Six 
States  remarked  that  ACF  has  done  nothing  in the  way of oversight  or assistance  to 
assure  that  the  State  plans  are  implemented. 
The  Title  IV-E  State  plan  was seen  as largely  a paper  exercise.  State  officials  and 
ACF  officials  agreed  that  it is rarely,  if ever,  looked  at by ACF. 
18
 RECOMMENDATIONS

Oversight  of State  child welfare  programs  continues  to be  of intense  interest  to the 
Congress,  HHS,  the  States,  and  others.  Congress  has placed  a moratoriumon  Section 
427 and  Title  IV-E  review  disallowances  untilOctober  1994.  This  moratorium  has 
coincided  with  efforts  thatACF  is makingto  reevaluate  monitoring  activities 
throughout  the  agency  andlook  specifically  at program  review  and  State  planning 
actiwties.  Many  review  activities  are  on hold.  Senior  ACF  officials  have  indicated,  in 
discussions  with us, their  desire  for improvements  to the  oversight  process;  they view 
the  coming  year  as an opportune  time  for changes.  Legislation  proposing  to reshape 
certain  aspects  of the  oversight  process  (such  as eliminating  Section  427 and 
reformulating  some  arts  of it as State  plan  requirements)  was introduced  on 
f
November  17, 1993.3 
We  hope  this report  will provide  information  to help  guide  decisions  on the  course  of 
oversight.  We  intend  for the  following  recommendations  to set out  the  key areas  in 
which  improvements  are  needed.  We  list broad  recommendations,  then  more  specific 
implementation  options  for each.  We do not  prescribe  a specific  course  of action,  but 
instead  offer  options  for policymakers  to consider  and  leads  for them  to follow as they 
develop  an  oversight  framework  and  specific  approaches  (see  appendix  E for a more 
detailed  evaluation  of the  options).  Some  options  are  not  consistent  with  others,  while 
other  options  fit together  very well.  Our  goal is to offer  as many  practical  ideas  as 
possible. 
Coming  up with solutions  to the  problems  we have  raised  will not  be easy.  In many 
cases,  the  current  oversight  approaches  and  processes  are  set by Federal  statute. 
Some  of the  options  we present  may therefore  require  changes  to the  statute  (these 
are  denoted  by a  6).  Other  options  could be implemented  at the  discretion  of ACF 
without  Congressional  approval  (see  appendix  E). 
In recent  years,  ACF  has focused  oversight  activities  primarily  on  assuring  that  Federal 
funds  are  spent  legally--that  eligibility  requirements  are  met,  that  legal protections  are 
documented,  that  claims  are valid,  etc.  It is important  for ACF  to maintain  this 
principle  of stewardship  of Federal  funds.  It is at least  as important  for ACF  to work 
in partnership  with States  to make  programs  work  well.  Therefore,  as a second  and 
equal  principle,  oversight  activities  should  encourage  States  to constantly  improve 
programs  so as to better  assist families  and  children  in need.  The  ACFS oversight 
activities,  for  a variety  of reasons,  have  not  adequately  encouraged  States  to improve. 
Our  recommendations  are  focused  at helping  ACF  and  the  States  pursue  both  these 
principles. 
19
 In order to improve it$ ovenight  of State chiki weljare programs, the ACF should 
Provide  States  with more  and  better  feedback  on issues related  to program 
performance. 
Officials  at the  State  and  Federal  level  asserted  that  the  current  oversight  mechanisms 
focus too  much  on process  issues  that  have  little  to do with the  quality  of services 
provided  to children  in need. 
Implementation  options 
Performance  Indicators  Develop pe~onnance  indicators, collect State-by-State 
	
informahon on them,  and dkseminate  this information  to all States  on a periodic 
bask  Because  there  are  not  any widely accepted  definitions  of successful  child 
welfare  practice,  it could  be  extremely  complicated  to develop  performance 
indicators.  The  task  could  be  limited  initially by pilot-testing  a small  number  of 
indicators.  Some  of the  difficulty  gaining  States  acceptance  of the  indicators  would 
be lessened  by not  linking  the  indicators  to financial  sanctions.  States  would  likely 
find it very helpful  to track  performance  over  time  and  compare  themselves  with 
others.  Getting  this information  would  help  raise  questions  and  keep  State  officials 
focused  on results.  The  development  and  testing  of performance  indicators  in this 
way could  evolve  into  an outcomes-based  review  system  as outlined  below.  The 
ACF  could  pursue  one  of a number  of avenues  in its development  of performance 
indicators;  here  we suggest  two.  One  idea  is for ACF  to identi~  how States 
currently  measure  their  own performance  and  what  kinds  of information  they 
collect  on a regular  basis to inform  their  funding  and  program  decisions.  It could 
be  that  many  States  already  agree  upon  a small  set of measures  and  these  could  be 
used  as a basis for pilot  testing  national  collection  of this information.  Another 
idea  is to hire  a contractor,  possibly  one  associated  with a national  association  that 
already  has  contact  with the  States,  to develop  a pilot  indicator  system.x 
Outcome-Based  Reviews8  Replace  exzking review mechanisms  with new review 
 
processes  that relate resources to outcomes.  Some  States  have  argued  that  this is the 
direction  they  think  reviews  should  go--in part  because  it would  allow them  to 
argue  very forcefully  with their  legislatures  for adequate  funding  (in fact,  several 
legislatures  are  considering  requiring  agencies  to justi~  funding  based  on 
outcomes).  On  the  other  hand,  the  difficulties  mentioned  above  about 
development  of performance  indicators  would  be heightened  if outcomes  measures 
were  used  in reviews.  If financial  assistance  were  based  on performance,  it could 
be  enormously  difficult  to decide  upon  measures  to be  used.  It will be necessa~  to 
develop  measures  using the  approach  outlined  in the  first option  in order  to reach 
a practical  consensus  on expectations.  This option  might  require  new legislation. 
May  require  new  legislation. 
20  Any of the  existing  review mechanisms,  including  Title  IV-E  reviews,  could  be 
altered  to become  outcome-based. 
Find  new ways to work  with States  to make  program  improvements  and  address 
problems. 
Existing  oversight  mechanisms  do very little  to encourage  States  to make 
improvements  and  to address  problems.  The  mechanisms  are  not  helping  States  be 
innovative  and  do  not  encourage  continuous  improvement. 
Implementation  options 
Corrective  Action  PlansJ  Rather  than  automatically  sanctioning  States financially  in 
	
response to adverse review findings,  use, when appropriate  (i.e., at the discretion  of the 
Secreta~),  the results of reviews to develop  corrective action plans,  with agreed-upon 
time frames,  to improve programs and enforce legal requirements.  Waive or reduce 
dkallowances,  when appropriate  (at the dkcretion  of the Secreta~),  if States comply 
with plans  and  time frames. 35 The  existing oversight  system, with  its disallowances 
and  financial  penalties,  can have  the  effect  of further  weakening  States  that  are 
having  problems.  By allowing  for improvement  and  laying out  specific  actions  that 
must  be  taken,  ACF  would  become  a partner  with  States  and  prospects  for 
improvements  in programs  would  be greater.  The  law might  have  to be  altered  to 
implement  this  option  without  precluding  ACF  from  disallowing  State  funding 
when  Federal  law is being  significantly  neglected  and  without  imposing  a re-
review burden  on ACF.  Any existing or future  review  mechanisms  could  use 
corrective  action  plans. 
Accreditationd  Using new or existing accreditation  bodies, make  accreditation  of 
 
programs  a Title IV-B  State plan  requirement.  Oversee the accreditation  bodies to 
assure that they are fair, reasonable,  and pursuing  continuous  improvement.  By 
relying  on independent  bodies  to accredit  States,  ACF  could  potentially  avoid  some 
conflict  with States  and  free  up resources  for other  oversight  mechanisms. 
Finalizing  reliable  accreditation  standards  will not  be simple  for any body  to devise, 
but  work  has begun  in this area  already.  To change  State  plan  requirements,  it is 
important  to change  the  law.  States  would  have  to be  able  to get  reimbursement 
from  ACF  for the  costs of accreditation. 
Qualitv  Assurance  Require  States to have quality assurance programs  that look  at the 
 
quality  of case work  Many  States  conduct  quality  assurance  activities  that  look 
primarily  at whether  documents  are  in place  to  comply with Federal  requirements. 
The  units  that  conduct  these  activities  could be  focused  on more  significant  quality 
assurance  activities;  they could  involve case workers  in the  assessment  exercises. 
Although  the  States  could  see  this as too  prescriptive,  ACF  could  specify in 
May  require  new legislation. 
21  guidance  or regulation  what  types  of quality  assurance  should  be  done  by States. 
This  would  put  the  onus  of program  improvement  on the  States.  According  to 
some  ACF  officials,  the  States  are  harder  on themselves  than  ACF  is.  The 
additional  administrative  expenses  for States  could  be  significant  for this option, 
but  it would,  after  implementation,  require  little  day-to-day  management  by ACF. 
An important  issue to resolve  is the  level and  nature  of Federal  reviews  of each 
States  quality  assurance  activities. 
Improve  current  planning  and  review  processes  to make  them  more effective. 
State  and  ACF  officials feel  the  current  review  processes  are  too  focused  on 
unimportant  documentation  details.  The  current  methods  also do not  give States 
incentives  to improve.  If the  current  review  methods  are  replaced  in the  future,  new 
methods  should  remain  attentive  to issues of effectiveness. 
Implementation  options 
Title  IV-B  Planning  Emphasis  Put less emphasis  on compliance  reviews (such as the 
	
Section  427 reviews) to assure protections  are in place  in States and,  instead, use a 
revitalized joint  planning  process lo provide strategic direction  that  will lead States  to 
effechve child  welfare programs.  While  the  Title  IV-B planning  process  is currently 
not very effective,  more  leadership  from  ACF  on the  process  could  allow it to push 
for the  types  of improvements  that  many  of the  compliance  reviews  now seek. 
Regional  staff  might  need  additional  training  to properly  undertake  this role,  but 
this shift in roles  could  make  the  oversight  process  more  efficient  and  effective. 
The  ACF  has mentioned  in draft  program  instructions  the  possibility  of more 
emphasis  on joint  planning. 
Substantive  Title  IV-E  Reviews8  Use tile Title IV-E  review process  to assure States 
	
are substantially  complying  with foster  care case planning  and review and judicial 
determination  requirements.  Limit  disallowances  to instances  of substantial  non-
compliance. 36 The  Title  IV-E  review  process  is often  focused  on whether  certain 
forms  are  filled  out  appropriately  rather  than  whether,  in fact,  the  purpose  of the 
law in preventing  unnecessary  placements  is being  met.  The  option  may require 
reviewers  to dig much  deeper  into  case records  to test  whether  the  States  have 
substantially  complied  with  requirements.  This will make  the  reviews  more  labor-
intensive  and  may require  training  of reviewers  to make  them  able  to judge 
substantial  compliance.  Legislation  to alter  current  law would  be  necessary  to 
implement  this option.  A draft  OIG  report,  by the  Office  of Audit  Semces, 
includes  much  detail  on this subject. 37 Clearly,  this option  might  lessen  the 
responsibility  and  authority  the  courts  have  in assuring  child protections.  One 
approach  that  might  preserve  the  authority  of the  courts  and  address  some 
problems  would  be  for reviewers  to make  independent  judgments  on compliance 
May  require  new legislation. 
22  with the  court-related  protections  only when  the  courts  did not  make  explicit 
judgment  one  way or the  other  on the  protections.  For  example,  if a court  simply 
did not  specify  that  reasonable  efforts  were  made,  using this approach,  reviewers 
would  be  able  to make  that  judgment  independently.  However,  if the  court 
specified  that  reasonable  efforts  were  NOT  made,  reviewers  could  not  second-
guess  this judgment. 
427 IncentivesJ  Alter  the Section  427 review process to provide  better incentives for 
	
improvement.  Rather  than  having full  compliance  with process requirements  be the 
standard for  427 funding  score States bused on qualip  of case planning  and reviews 
once they have pas.wd a triennial review and make  the size of the grunts in the coming 
three years dependent  on the scores.  States  may prefer  the  current  system,  but  this 
option  would  allow for two things:  (1) qualitative  assessments  of State 
performance  and  (2) explicit  incentives  for improvement.  Creating  a qualitative 
assessment  mechanism  would  be very complex--the  outcomes  measures  mentioned 
in the  first recommendation  might  be necessary.  With  the  current  moratorium  on 
427 disallowances  and  many  observers  calling into  question  the  whole  mechanism, 
it may not  be  sensible  to seek  adjustments  to Section  427.  This  approach  could 
require  legislative  action. 
	 Focus  Program  Reviews  Change the approach of program  reviews to use them  only 
when  indicators  of problems  are raked  through other reporting or review mechanisms. 
Develop  strategies to address those problems  only.  This  option  would  significantly 
change  the  purpose  and  conduct  of program  reviews  by requiring  them  to be  much 
more  focused  on investigating  particular  problems.  By focusing  the  reviews,  the 
likelihood  of the  reviews  adding  value  to the  States  would  be  increased.  While  an 
attempt  to address  any one  problem  could  require  an analysis  of many  aspects  of a 
States  child welfare  program,  a scope  that  is narrower  than  all child welfare 
services  would  likely be  less costly than  current  reviews.  Also, with a narrower 
scope,  it would  be  more  likely ACF  could  produce  reports  in a timely  fashion. 
	 One  State  PlanJ  Require  States to submit  one coordinated  State plan for all child 
welfare services.  Currently  States  must  submit  separate  planning  documents  for 
Title  IV-B Subpart  1 child welfare  services,  Title  IV-B Subpart  2 family 
preservation  and  family support,  Title  IV-E  foster  care  and  adoption  assistance, 
Title  IV-E  independent  living, and  child abuse  and  neglect.  The  Title  IV-E  foster 
care  and  adoption  assistance  plan,  in particular,  appears  to serve  little  purpose. 
The  ACF  could  coordinate  all of these  planning  activities  and  thus  encourage 
States  to think  comprehensively  about  child welfare  services.  The  law might  have 
to be changed  to implement  this option.  The  ACF  mentioned  in draft  program 
instructions  the  possibility  of creating  a consolidated  State  planning  process. 
May  require  new legislation. 
23  Make  more  efficient  use  of resources  required  to conduct  reviews. 
Significant  State  and  Federal  resources  go into  preparing  for  and  conducting  reviews. 
It appears  that  the  reviews  may not  be conducted  efficiently.  Improved  review 
efficiency  could  allow ACF  a more  active  role  in other  important  areas  such as 
technical  assistance.  If current  review  processes  are  not going  to be  replaced,  they 
should  be  made  more  efficient;  regardless,  the  lessons  learned  here  should  be  heeded 
under  any oversight  system. 
Implementation  options 
Title  IV-E  Reviews  - Automation  Automate  the  Title IV-E  review process. This 
 
would  require  a massive  investment  in improving  management  information  systems 
in States  (a worthwhile  cause  in its own right),  but  could  allow for much  simpler 
review  and  oversight  of eligibility  and  payment  issues.  Clearly,  this is not  an  option 
that  could  be  pursued  in the  short  run,  but  may be  a long  run  objective. 
.	 Title  IV-E  Reviews  - Self-CertificationJ  Allow  States to certifi  that their payments 
are eligzbleunder  Tide IV-E.  Some  States  argued  that  they  are  being  reviewed  over 
and  over  for the  same  issues.  The  Federal  government  allows States  to conduct 
State-wide  (A-128)  audits.  The  State-wide  auditors  look  at  the  same  issues  as ACF 
auditors.  In general,  when  a State  has conducted  an A-128  audit,  ACF  will accept 
the  States  findings  and  not  conduct  a review  in that  year.  This practice  could  be 
expanded  or some  other  form  of self-certification  or review  could  be  instituted. 
The  ACF  would  have  to be aggressive  about  following  up  on self-certification  or 
audit  processes. 
Title  IV-E  Reviews  - Limited  Scope& Limit  the  Title IV-E  reviews to income 
	
eligibility and payment  allowability  bsues.  Given  the  lack of control  State  child 
welfare  agencies  have  over  courts,  basing  disallowances  on issues  such  as content 
and  timing  of court  orders  may be the  wrong  emphasis.  Furthermore,  giving States 
fewer  resources  may not  make  it any easier  for States  to  meet  these  requirements. 
It is possible  that  ACF  could  use  other  mechanisms--such  as technical  assistance  or 
better  State  planning  efforts--to  encourage  States  to meet  the  spirit  of these 
requirements.  Since  Federal  statute  lays out  these  requirements,  in order  to 
implement  this option,  the  law would  have  to be  changed. 
Section  427 Reviewsd  Dkcontinue  Section  427 reviews or sharph  reduce the use of 
	
them.  Most  States  have  been  successful  on Section  427 reviews.  It may no longer 
be  cost-efficient  to review  all States  for these  requirements.  Once  a State  has 
passed  a triennial  review,  it could  be argued  that  it has met  Federal  requirements 
and  does  not  have  to be reviewed  using the  same  standard  again.  It could  also be 
argued  that  because  the  reviews  look only at process  issues,  they  should  not  be 
May  require  new legislation. 
24  doneat  all.  However,  this would  miss the  few States  that  arenot  currently  in 
compliance  with the  Section  and  might  allow currently  complying  States  to fall out 
of compliance. 
Discontinue  Planning  and  Program  Revie~  d  Use other technical  assktance  eflorts 
	
instead  of Title IV-B joint planning  and program reviews.  If technical  assistance  is 
going to be  provided  by outside  contractors  as stated  above,  it may not  make  sense 
for ACF  to be heavily  imolved  in technical  assistance.  In fact, many ACF  and 
State  officials  felt that  many ACF  staff have  not  been  given sufficient  training  to 
perform  technical  assistance. 
	 Limit  Backmound  Sections  Shorten  introductions  to reports, which  often focus  on 
information  about  which  the  States  are aware.  This  option  would  make  the  product 
of reviews  more  readable  and  would  probably  improve  timeliness  of reporting.  It 
would,  however,  make  reports  less effective  as general  informational  resources  for 
ACF  and  for  other  States. 
Provide  States  with more  usefu~  comprehensive,  and  expert  advice  on managemen~ 
program,  and  technical  issues. 
A common  theme  in comments  by State  and  ACF  officials was the  need  for better 
and  more  technical  assistance.  Good  technical  assistance  can help  States  devise 
solutions  to problems.  It probably  does  not  make  sense,  for reasons  of cost, to 
implement  more  than  one  of these  options. 
Implementation  options 
Existing  Mechanisms  Focus more resources on joint planning  program reviews, and 
	
the training of re~onaloflciak  to conduct  technical  assistance.  While  planning  and 
program  reviews  have  had  many  problems,  more  attention  and  funding  to them 
would  greatly  alleviate  many  of the  issues.  To  increase  these  efforts  effectively, 
central  office  and  regional  office  officials should  have  access  to adequate  training 
in program  areas  and  technical  assistance.  Coordinating  training  so that  all ACF 
officials providing  technical  assistance  in a particular  area  will provide  similar 
information  to States  would be  helpful. 
	 Non-~overnmental  Contracts  Use funds  to contract  with non-govenlrnental 
organizations  to provide general technical  assktance  to States.  This  option  has the 
advantage  of depending  on existing  expertise.  Since some  ACF  officials have 
expressed  concerns  about  some  technical  assistance  providers,  the  process  for 
selecting  contractors  would likely need  to be  rigorous.  While  the  contracts  could 
be similar  to  ones  for  the former  Child  Welfare  Resource  Centers,  States  did not 
use the  centers  services  fully because  they were  unable  to afford  the  services. 
Therefore,  the  Federal  government  will likely need  to provide  much  more  funding 
to have  States  utilize  the  contracts  fully.  This  effort  would  require  significant  new 
25  funding.  The  ACF  has indicated  its plans  to continue  to contract  with non-
governmental  organizations  to provide  technical  assistance  to States. 
s  Problem  Areas  Using a combination  of ACF  ofjicials and outside  contractor, 
provide  intensive  technical  assktance  to Stales or regions of States  lhul have  exlreme 
problems.  This  allows the  combined  strengths  of ACF  officials  and  outside 
contractors  to be  used  to focus on big problems.  While  individual  efforts  would  be 
expensive  and  disruptive  to daily work, this approach  would  not  require  ongoing 
funding  or staff  attention.  It has been  done  in one  State  successfully.  The  focused 
program  reviews,  mentioned  above,  could be  tied  in with these  efforts. 
More  effectiveslhyareinformation  withandamong  States. 
Many  States  mentioned  the  need  for more  and  better  information  about  what  other 
States  are  doing. 
Implementation  options 
Effective  Practices  Using oversight mechamkms,  identifi  ej$ective practices.  Produce 
	
regular (at least semi-annual)  reports that oudine  these practices  and list contacts  in 
the Slates.  Actively  share reports and State plans  that outline  eflective practices.  This 
would  be  a relatively  low-cost  process.  It appears  regional  offices  are  already 
identifying  effective  practices  in many  review  reports;  they  are just  not  sharing  this 
information  widely.  State  officials  spoke  about  difficulty getting  ACF  to share 
information  from  other  States.  While  ACF  currently  has no  central  repository  for 
reports  and  State-specific  information,  States  and  ACF  might  find it very helpful  if 
a repository  were  developed  and  information  from  it were  distributed. 
s	 On-Line  Service  Develop  a simple,  electronic, on-line service for  States to share 
informanon about  strategies, innovations,  and odler ksues.  While  this option  might 
be  expensive  to set up, it would  be  inexpensive  to run  and  would  encourage  active 
dialogue  among  States. 
Improveandclarifcjo mmunicatiown thStateasb
 outprogramstandards.

State  officials  expressed  a high degree  of dissatisfaction  with communication  about 
standards  for  reviews.  The  ACF  has recently  funded  a contract  for  a policy retrieval 
system  that  will make  all policy issuances,  program  announcements,  information 
memoranda,  etc.,  electronically  available  to States  and  others.  While  this should 
improve  the  situation,  we offer  some  further  suggestions. 
Implementation  options 
Reasonable  Efforts  Collect information  on States definitions  of  reasonable efforts 
 
and identifi  model  definitions.  One  of the  key areas  about  which  States  are 
extremely  confused  is in the  definition  of this term;  Congress  is considering 
26  requesting  a study  on this issue.%  Identifying  model  definitions  would  help  States 
immensely  but  would  cause  controversy. 
.  Central  Office  Hotline  Establish  a central ojj?ce hotline  10 respond prompdy  to 
regional office  and State  inquiries about  review policy,  s~andards, and interpretation  of 
regulations and statements.  Follow  up inquineswith wnlten  confhnations  that  are 
shared  with all States and regional offices,  A hotline  would  require  responsive 
decision  making  and  authoritative  statements  on matters  of concern  to States.  It 
might  take  some  responsibility  and  autonomy  away from  the  regional  offices,  but 
could  address  significant  problems  States  have  had  getting  clear  and  prompt 
responses.  It could  possibly  result  in States  having  less frequent  and,  therefore, 
less productive  contact  with regional  offices; on the  other  hand,  it could  free 
regional  officials  from  having  to provide  review-specific  policy interpretations  and 
allow them  to have  more  contact  on programmatic  issues. 
	 Promam  Redations  Publish  comprehensive  program  regulations for  Section  427 
and  Title IV-E  that would  be subject  to notice and  comment.  State  officials  and 
others  have  noted  a need  to have  review  policies  much  more  clearly  defined.  The 
most  straightfonvard  solution  would  be  to produce  final regulations. 
Improvethetimelineosfsr eportinogn resultosf
reviews.

One  of the  least  complex  problems  identified  in this  report  was the  lack  of timeliness 
of reporting  to States  the  results  of Federal  reviews. 
Implementation  options 
	 Mandatorv  Turnaround  Require  reports to be issued within  a set time  after a review 
k  complele.  This  is the  most  straightforward  way to improve  timeliness,  but  it may 
bind  ACF  too  much.  If ACF  does  not  complete  reviews  in a timely  manner,  States 
would  be  able  to appeal  decisions  on that  ground  alone. 
Performance  Reporting  Develop goals for turnaround  of reports.  T+en collect  and 
	
disseminate  information  on the timeliness  of reporting.  This  is a low-risk option  for 
ACF,  but  it may not  provide  enough  incentive  for improvement.  Increasing  the 
awareness  of the  magnitude  of timeliness  problems  would  likely be  helpful. 
Streamline  Decision-making  Clanjj  who in ACF  has tile authority  to decide  on 
 
policy  matters and final  reports.  Currently,  there  are  frequent  discussions  over  who 
has authority  to make  what  decision.  This change  could  clari~  roles  quite  a bit 
and  potentially  speed  the  process.  The  recent  initiative  to streamline  the  review 
process  on program  reviews  is a step  in the  right  direction.  Similar  (and  further) 
streamlining  could  be considered  for all types of reports. 
27
 Limit  Scope  of Reviews6Reduce  dte complexity  of Chereports by narrowing the 
 
scope of the reviews.  It could  be  that  by narrowing  the  scope  of the  reviews,  the 
ACF  report  clearance  process  would  be  dramatically  simplified.  There  are  several 
options  on how to lessen  the  complexity  of the  reviews,  including  limiting  the  scope 
of Title  IV-E  reviews  (as noted  above)  and  parsing  reviews  into  stages. 
May  require  new legislation. 
28  COMMENTS  ON  THE  DRAFT  REPORT

We  shared  our  draft  report  with and  solicited  comments  from  the  Administration  for 
Children  and  Families  (ACF),  the  Assistant  Secretary  for  Planning  and  Evacuation 
(ASPE),  the  Assistant  Secretary  for Management  and  Budget  (ASMB),  and  the 
Assistant  Secretary  for Legislation  (ASL).  The  ASMB  and  ASL advised  us that  they 
had  no comments.  We  received  written  comments  from  ACF  and  ASPE.  We 
reproduce  these  comments  and  provide  detailed  responses  to each  in appendix  C. 
We  are  pleased  that  ACF  concurred  with our  recommendations  and  found  the  report 
useful.  While  ACF  did not  suggest  any changes  to the  report,  we altered  the  report  to 
reflect  the  action  they  have  taken  already  on the  recommendations.  Staff  in ACF 
informally  provided  minor  technical  comments  to the  report  which  resulted  in several 
changes. 
We are  also  pleased  that  ASPE  felt the  report  was informative  and  valuable.  The 
ASPE  made  several  technical  comments,  mostly  aimed  at clarifying  our  discussion  of 
the  Family  Presemation  and  Family  Support  Act.  We have  made  necessary  changes  in 
response  to  those  comments.  APPENDIX  A

MAJOI FEDERJ  L  CHILD  1 !ELFARE  PROGRAMS
~~ 
TITLE	 1993  Funding  type  Covered  services  E[igibihy  Match  role  Financial 
estimated  cntma  oversight 
funding  mechanisms 
fV-E  $2.854  Billion  Open-ended  Foster care and
 Children from  Medicaid  Title  IV-E 
entitlement  adoption
 AFDC-eligible  match rate for  reviews, Tkle 
assistance
 families only  maintenance,  IV-E State plans 
maintenance
 50 percent for 
payments,
 administration, 
independent  living,
 and 75 percent 
administration  and
 for training 
training

IV-B  $295  Million  Capped  Full range of child
 None  75 percent	 Title W-B joint 
entitlement  welfare sewiccs
 plans, Section 
with incentive  including family
 427 reviews 
funding  presenfat ion

efforts, child

protection

sesvices, and

reunification

services.

xx 
$770 Million  Block grant  Social services
 None	 No State  ~ None 
(estimated  including child
 funding 
claims for  protective acrvicea,
 required 
child welfare  services to prevent

Seticea)  placement in

foster care, and

substitute care

programs.

____l

A-1  APPENDIX  B

FEDERAL  OVERSIGHT  MECHANISMS 
FOR  STATE  CHILD  WELFARE  SERVICES 
REV7EW  Servicer  i  Are case  Can monq  be  Are  How  ofien are  Are the 
PROCESS  reviewed  ~ records  taken away as a  administrative  the reviews  reviews 
! reviewed?  re.su[t of reviews?  costs reviewed?  conhcted?  manaktory? 
~ How  many  are 
! rm,iewed? 
Tkle  IV-E  Foster care  ~ Yes.  Stage I  Yea. Stage 1:  Yes, either in  No set  Yes. statea 
reviews  and adoption  ~ reviews  50  only claims in  combination  schedule.  are subject to 
assistance  ~ payments.  If  error are  with or  Some States  review once 
!	 high error  recouped.  S[age  separately  are reviewed  they receive 
rate. then  II: sample error  from other  yearly  others  Title IV-E 
: Stage 11  rate applied to  reviews.  have not been  funding. 
\ reviews at least  univeme of  reviewed in 
~ 200 payments  payments  over five years. 
Section 427  Foster care  !	 Yes.  Sample  Yes.  State can  No,  but  At least once  Yes. Statea 
reviewa  of 140 Casea  lose incentive  administrative  eve~  three  are subject to 
drawn from  funding.  I	 procedures  years.  review once 
children in  are reviewed  they certi~ 
	 fo.wer care for  in the initial  eligibility for 
at least 6  review.  427 funds. 
months. 
Program  AN child  I	 an  tx, but no  No.	 ho,  but  No set  No. 
reviews  welfare  number is set  administration  schedule.  No 
services  in advance.  of the  State has been 
program is  reviewed more 
reviewed.  than once 
since 
reinstated. 
STATE  PLAN  Services  How  ofsen ore  Do States  Format  Are annual  Are there 
PROCESS  covered  develop  it alone?  I  Updam.r  perraltitn  ~ 
1 ~t~iued?  required?	 State plans 
ore not 
adhered  to? 
Title fV-B	 AU child  At least once  No.  Statea and  The format is  Yea.  No.

welfare  every three  ACF are  relatively

aeMcea,  years.  supposed to  unstructured.

including Title  develop plans

fV-E services  jointly

and setices 
not funded by 
HHS 
fitle fV-E  Foster care,  At least once  Yea.	 Statea fill out  No.  No. 
adoption  evety three
 preprinted 
assistance,  yeara.
 forms. 
independent

living, training

and

administration

for AFDC-

eligible

children.

B-1
 APPENDIX  C

DETAILED  COMMENTS  ON THE  DRAFT  REPORT  AND 
OIG  RESPONSE  TO  THE  COMMENTS 
In this appendix,  we present  in full the  comments  on the  draft  report  offered  by the 
Administration  for Children  and  Families  (ACF)  and  the  Assistant  Secretary  for 
Planning  and  Evaluation  (ASPE).  We  also present  our  response  to each  set  of 
comments. 
c-1  P\ 
z~   DEPARTMENT OFHEALTH& HUMAN  !jERVICEs
: 
z
.4  + 
*.*~* 
>
ADMINiSTRATION  FOR CHILDREN ANO FAMILIE 
Office of Ihe Assistant  SeCf6!la(y,  Suite  600 
370  LEn(ant Promenade.  S.W. 
Washington,  D.C.20447 
April  13, 1994 
TO:	 June Gibbs Brown

Inspector General

FROM:  Ma&: Jo Bane  -V&+_

Assistant Secretary

for Children and Faud.lias

llov~r~igh~
of state Child Welfan
SUBJECT:  OIG Draft  Report: 
Programs,11()~1-01-92-0()770 
Thank  you  for the opportunity to comment on the draft report, 
Oversight of state Child Welfare Programs.  We appreciate the 
thoughtful and provocative document that your office has 
developed in its review of the Federal stewardship process and We 
concur  with  the  issues  and  recommendations  that are outlined in 
thQ report. 
The Administration for Children and Families (ACF)  is presently 
involved in revising its monitoring policies and procedures, and 
this report is especially  ttiely  and helpful in that regard.  It 
will also assist  establishing guidelines to ensure the 
the  M)?  in 
administration of quality child welfare programs which will 
positively affect children and families. 
staff from the Children9s Bureau (CB) have collaborated with your 
staff and have commented on earlier versions of  this  report; 
their commants have been incorporated. The ACF has already begun

to implement some of the recommendations that are presented in

this report.  Specifically, the development of a single,

coordinated State Plan that encompasses title IV-B, title IV-E,

child abuse and  neglect, and thQ range of child welfare services

into one document  is  a proposal that we are pursuing actively.

The  AFCARS (Adoption  and  Foster Care Analysis and  R~po~thg

System)  regulations  have  been  published  and the CB expects to

begin receiving State-specificdata by May 1995.  Further, the

plans to negotiate with private contractors to provide general

CB 
technical assistance to states.  Finally, several months ago the

CB awarded a contract for a policy retrieval system that will

make all policy issuances,program announcements, information

memoranda, etc., electronically available to State and local

agencies, public and private organizations, advocacy  groups,

educational institutions,and the general public.  This system

will be  fully operational in  July 1994.

We look forward to the issuance of a final report and a

continuing dialogue with you and your staff.
 OIG  RESPONSE  TO  ACF  COMMENTS 
We  are  pleased  that  ACF  concurs  with our  issues and  recommendations.  We  are  also 
pleased  that  it has  already  begun  to implement  some  of the  recommendations.  We 
have  made  changes  in our  report  to reflect  these  actions. 
In particular,  we included  references  to the  action  ACF  is considering  on consolidating 
the  State  planning  processes,  added  a reference  to the  continuation  of non-
governmental  contracts  to provide  general  technical  assistance,  made  clear  the  action 
ACF  has  taken  on  improving  policy dissemination,  and  removed  references  to the 
need  to develop  final  regulations  for the  Adoption  and  Foster  Care  Analysis  and 
Reporting  System. 
Staff  at ACF  informally  extended  minor  technical  comments  to the  draft  report,  all of 
which  resulted  in changes  to the  report.  None  of these  changes  affected  the  thrust  of 
our  discussion. 
The  ACF  recently  drafted  a report  on its monitoring  activities  (including  for  child 
welfare).  It indicates  a bold,  ambitious,  and  extremely  important  new  direction  for 
monitoring.  If implemented,  the  ACFS draft  recommendations  would  address  many 
of the  issues and  respond  to many  of the  recommendations  in our  report. 
c-3  DEPARTMENT OF HEALTH& HUMAN  SERVICES  C) fflce of the Secretary 
Washington,  D.C.  20201 
41994 
~ 
TO:	 June Gibbs Brown 
Inspector  General 
FROM:  Assistant  Secretary 
for  Planning  and  Evaluation 
SUBJECT :  OIG  Draft  Report  oversight  of  State  Child  Welfare 
Programs,  OEI-01-92-O0770 
Thank  you  for  the  opportunity  to  review  and  comment  on  the  draft 
I  found  it 
report  Oversight  of  State  Child  Welfare  Programs. 
to  be  an  informative  report  that  provides  useful  information 
regarding  Federal  oversight  of  State  child  welfare  program. 
While,  as  the  report  notes,  many  of  the  observations  have  also 
been  made  by  other  sources,  independent  confirmation  is  helpful. 
This  report  should  prove  valuable  as  H13S considers  changes  in 
these  programs.  In  particular,  the  observation  that  oversight 
activities  focus  primarily  on  narrow  papemork  compliance  issues 
rather  than  on  how  well  children  are  being  served  should  lead  us 
to  improve  these  programs  and  our  admini.strati.on  of  them. 
We  have  attached  Some  comments,  most  of  which  clarify  the 
discussion  of  the  new  Family  Preservation  and  Support  law. 
Attachment 
PREPARED BY:OS/ASPE/HSP/CYP:BBroman:  690-6461 
.-
C-4
 Comments  on  OIG  oversight  of  State  Child  Welfare  PrOgrms 
1.  On  pages vii and  29,  the  report  indicates  the  need  to 
publish	 the  Adoption  and  Foster  Care  Reporting  System 
(AFCARS)  regulations,  They  were  published  in  the  Federal 
Reuister  on  December  22,  1993.  Also,  you  should  note  that 
OBRA 93  provided  for  an  enhanced  match  for  AFCARS.  The 
interium  final  rule  on  this  provision was also published in 
.
the Federal  Reulstez on December  22,  1993. 
2.  The  Title  IV-B  discussion  on  page  2  is  inaccurate.  The  new 
Family  Preservation  and  Support  capped  entitlement  program, 
passed  as  part  of  OBRA 93,  established  a  new  Subpart  2  of 
the  Title  IV-B  Child  Welfare  Services  section.  This  capped 
entitlement  is  $60  million  in  FY  95  and  $930  million  over 
five  years.  The  existing  Child  Welfare  Services  program,  a 
discretionary  program  of  $295  million  in  FY 9S,  is  now 
Subpart  1  of  lV-B.  Section  427  only  applies  to  Subpart  1. 
A  discussion  of  the  services  under  each  of  these  subparts 
should  be  handled  separately.  Other  places  in  the  report, 
such  as  on  page  25,  will  also  need  to  be  changed. 
3.	 The  discussion  of  OBRA 93  on  page  4  also  needs  to  be  changed 
to  reflect  our  comment  above.  In  addition  there  are  several 
other  problems  with  the  section--
0  The  oriqinal  bill,  which  was  the  Administrations  bill, 
include~  not only the new family  preservation  and 
support program but a variety of improvements  to  the 
current  child  welfare  and  foster  care  programs.  These 
were  dropped  due  to  the  Byrd  rule. 
o	 The  other  provisions  passed  in  OBRA 93  that  you  refer 
to  are  confusing. 
--First,  the  $2  million  in  FY 95  and $6  million  each 
year  thereafter  for  research,  evaluation,  training  and 
technical  assistance  is  for  the  new  Title  IV-B  Subpart 
2  capped  entitlement  for  family  preservation  and 
support.  It  i.s  not  for  broad  child  welfare  senices 
evaluation  and  training  and  technical  assistance.  ASPE 
and ACF have developed  an evaluation strategy for this 
new program and work has begun to award contracts for 
this work.  The bulk of the funding set-aside in the 
capped entitlement will be for evaluation. 
--Second, the changes in the state plan requirements 
for  the  child  welfare  services  program  was  dropped  from 
the  law  due  to  the  Byrd  rule. 
4.	 On  page  7,  we  sugguest  that  you  review  the  statement  that 
children  no  longer  get  lost  in  the  foster  care  system  to 
C-5  States  are  improving  their  ability  to  track  children  in 
foster  care. 
5.	 The  reference  on  page  22  and  27  to  the  researc~j,  training, 
and  technical  assistance  should be dropped sin~e this  set-
aside is for the family preservation  and suppo:t program. 
6.	 The  discussion  on  page  23  about  corrective  action  plans 
could  be  strengthen  by  mentioning  that  the  Administrations 
bill  included  a  provision  on  conformity  review:.  While  this 
provision  got  dropped  because  of  the  Bryd  rule  it  does 
demonstrate  that  the  Department  recognizes  tha=  changes  to 
this  process  are  needed. 
7.  You  may  want  to  mention  under  Title  IV-B  Planr!ina  EmDhasis 
on  page  24,  and  again  on  page  25  under  One  st~~e  Plan,  that 
ACF  discusses  the  possibility  of  a  joint  planning  process  in 
the  Program  Instructions  for  the  Family  PreserTJation  and 
Support  program. 
8.  Also  ,  on  page  24  under  the  Substantive  Title  ~~-E  Reviews 
you  may  want  to  mention  the  grants  to  States  co  assess  and 
improve  handling  of  proceedings  relating  to  fester  care  and 
adoption.  These  are  funded  out  of  the  new  Title  IV-B 
Subpart  2  capped  entitlement  program  for  family  preservation 
and  support. 
9.	 On  page  18,  you indicate  that  congress  is  conci.dering 
requesting  a  study  on  reasonable  efforts.  We  suggest  that 
YOU clarify  this  to  indicate  that  the  Congress  included  in 
the  Conference  Report  accompanying  OBRA 93  thz.t  the 
Department  should  conduct  a  study  on  reasonable  efforts. 
10.	 We suggest that you drop  the  reference  to  OMB on  pag@  z% 
program  regulations.  It  refers  to  an  internal  review 
process  in  which  we  should  not  single  out  OMB. 
C-6
 OIG  RESPONSE  TO  ASPE  COMMENTS 
We are  pleased  that  ASPE  found  our  report  informative  and  useful  and  that  the 
Department  is considering  changes  to the  programs. 
The  ASPE  had  a number  of technical  comments,  most  of which  related  to our 
discussion  of the  Omnibus  Budget  Reconciliation  Act  of 1993 provisions  related  to 
Family  Preservation  and  Famiiy  Support.  We have  made  a number  of improvements 
to the  report  in response  to those  comments.  In particular,  we removed  our  reference 
to the  need  to publish  final regulations  on the Adoption  and  Foster  Care  Reporting 
System,  clarified  our  discussion  of Title  IV-B changes  in several  places  in the  report, 
eliminated  references  to the  newly available  technical  assistance  funds,  included 
references  to ACFS proposal  to consolidate  planning  activities,  and  deleted  our 
reference  to OMB  review  of regulations. 
We did not,  however,  make  changes  in the  report  to reflect  the  provisions  of the 
Family  Presemation  and  Family  Support  Act that  were  not  adopted  because  of the 
Byrd rule.  Instead,  we make  a general  reference  to the  more  recent  Senate  bill that 
proposes  these  same  provisions. 
c-7  APPENDIX  D

METHODOLOGY 
DOCUMENT  RHZEWS 
We  reviewed  relevant  literature  and  reports.  We  also  analyzed  current  and  proposed 
legislation,  regulations,  and  policy statements. 
ANALYSIS  OF ACF  REWEW  REPOR73: 
We first requested  copies  of all review  reports  sent  to States  since  January  1988.  We 
then  reviewed  69 reports  from  ACF-conducted  reviews  to profile  content,  reporting 
procedures,  timing  of reviews  and  reports,  and  resources  used  in the  reviews.39 
When  we were  given multiple  years  of one  type  of report  for a given State,  we 
reviewed  only the  most  recent  report.  We only reviewed  reports  that  were  actually 
sent  to States  (some  reports  we received  had  not  yet been  sent  either  as draft  or final 
reports  to the  State). 
INTERVIEWS: 
State  Officials 
We  conducted  two day, on-site  interviews  with various  child welfare  officials  in three 
States  (Maine,  Ohio,  and  Washington).  These  States  were  selected  from  the  group  of 
States  in which  ACF  had  conducted  a Title  IV-E  review,  a program  review,  and  a 
Section  427 review  in the  past  5 years.  The  selection  was based  on getting  diversity  in 
terms  of geography  and  size; we also wanted  to visit at least  one  State  in which  child 
welfare  services  were  county-based  and  at least  one  State  in which  the  services  were 
State-run, 
We  conducted  telephone  intemiews  with senior  child welfare  officials  in ten  States-
one  per  HHS  region  (Connecticut,  New Jersey,  the  District  of Columbia,  Florida, 
Wisconsin,  Oklahoma,  Missouri,  Montana,  Nevada,  and  Oregon).  These  States  were 
selected  using  a weighted  random  selection  method.  Each  State  that  was not  a site-
visit State  was assigned  a weight  (W)  equivalent  to the  number  of different  types  of 
reviews  (i.e., Title  IV-E,  Section  427, and  program  reviews)  in the  past  5 years  plus 
half of the  number  of reviews  beyond  one  for each  type  of review.  Each  States  odds 
of selection  were  equal  to W divided  by the  sum of W for all States  in the  region. 
D-1
 ACF  Officials 
We  conducted  telephone  interviews  with senior  officials in each  ACF  regional  office. 
We  also had  discussions  and  other  detailed  communication  with  officials  in ACYF, 
Childrens  Bureau. 
Other  Exuerts 
We  held  discussions  with other  Departmental  staff,  Congressional  staff,  GAO  staff, 
interest  group  representatives,  and  academic  experts. 
D-2
 APPENDIX  E 
DETAILED  EVALUATION  OF  IJfPLEMENTATION  OPTIONS 
E-1  DETAILED  EVALUATION  OF IMPLEMENTATION  OPTIONS 
)ption  Likefy Budget  May Need  May Need  Likely State  jike[y Possible  Major Pros?  ~ Major Cons? 
[mpact?  Legislation?  Regulation?  Reaction?  Iiming? 
------------- . -------------,  --------------- ----- ----- ----- -------------- -------------- --------------- --------------
performance  Use new technical  No  No  Relatively positive  Pilot soon  Raises questions  Complicated to 
ndicators  assistance money  Focuses on results  kvelop 
May evolve into  Could be ignored 
rcwimvs  by Stfilcs 
.    .-. ---
Mtcome+tased  Redirect  money  Yes  Ycs  Rclalivcly negative  [-ong term  Results bccomc  Ilighly 
kviews  from other reviews  entire focus  comrovcrsial 
Allows States to  Long dcxwlopmcnt 
argue forcefully  period 
with their 
legislatures
 
~orrect ive Act ion  Minimal  Yes  Yes  Strongly positive  Soon  Build partnership  Lessening of 
lans  improvements  sanctions 
more likely  More difficult to 
No further  do than straighl 
weakening of weak  reviews 
States 
 
kcreditation  More  Yes  Yes  Relatively negative  Long term  Relies on outside  Iack  of direct 
administrative  experlise  Federal control 
funds necessary  Focuses on  Controvemy about 
proactive action  standards 
2uality Assurance  More  No  Yes  Relatively negative  Soon  Gives States  Difficulty 
administrative  control  designing 
funds necessary  States would be  Could be very 
tough on  expensive 
themselves 
lltle  Redirect  money  No  No  Relatively positive  Immediate  Focuses on  Need ACF 
fV-B Planning  from other reviews  proactive action  training 
Emphasis  More expensive 
than current 
Substantive Title  More review  Yes  Yes  Relatively positive  Soon  Focuses on  More complex 
IV-E Reviews  funding, may  substantive issues  reviews 
reduce 
disallowances  _  
E-2
  
 
1, 
II 
DETAILED  EVALUATION  OF IMPLEMENTATION  OPTIONS 
IIOption  ~ikely Budget  May Need  May Need  Likely State  -ikely Possible  Major Pros?  Major Cons? 
Impact?  Legislation?  Regulation?  Reaction?  fiming? 
Section 427  More review  Yes  Yes  Relatively positive  bon  Focuses on results  Requires new 
Incentives  [unding  Makes 427 a real  training for ACF 
incentive program  Difficult to make a 
true incentive 
I  , 
Focus Program  Strongly positive  More potential 10  Not as 
Reviews  add value  comprehensive 
Should be more 
timely 
 
F 
-esa time  Yes  Yes  Strongly positive  ;oon  Minimize  Each plan more 
r  evicwing plans  duplication of  complex 
efforts 
Title IV-E - Xvelopment  No  Yes  Strongly negative  .ong term  Simplify reviews  iqsenrse 
s
Automation Funding  Use stale-of-art  -0ss of access 10 
technology  .ecords 
  ... 
Relatively positive  [mmediate  More State  Lack of direct 
autonomy  Federal control 
_  ...-
kThle IV-E Limited  Less funding  Yes  Yes  S1rongty positive  Soon  Reduce  No formal check 
scope  expenditures  on some 
More appropriate  requirements 
review  Smaller
disallowances 
Section 427  Less funding  Yes  Yes  Strongly positive  Soon  Reduce review  May miss outliers 
Reviews  expcndit ures 
End/reduce  use of 
troublesome 
L-----
process 
. 
Discontinue  Less funding  Yes  Mixed  Immediate  Reduce review  Reduces Federal 
Planning and  cxpcndit urcs  input on impot-tant 
Program Rcvimvs  End usc of  SIatc dccisi(ms
I 
Iroublcsomc  No dircci Iixfcral 
process  TA process
   
L____ 
Limited  Minimal  No  No  Relatively positive  Immediate  Should streamline  Reports wont
Background
 report-writing  setve general
Sections  I  information role

I  I 
E-3
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I  1 
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1 
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I 
1  DETAILED  EVALUATION  OF IMPLEMENTATION  OPTIONS 
Option  Likefy Budget  May Need  May Need  Likely State  Likely Possible  Major Pros?  Major Cons? 
Impact?  Legislation?  Regrslation?  Reaction?  Timing? 
Performance  Minimal new  No  No  Relatively positive  Immediate  Would increase  Might not improve 
Reporting  funding  awareness  timeliness 
Streamline  Minimal nav  No  No  Miscd  S(um  Mighl irnprovc  Rcgimml office 
Decision-Making  funding  timeliness  resistance 
Clarify authority 
Limit Scope of  Minimal new  Yes  Yes  Strongly positive  Soon  Could improve  Might allow some 
Reviews  funding  timeliness  activities to go 
Could reduce  un-reviewed for 
complexity  some time 
 
I I 
E-5
 APPENDIX  F

NOTES 
1.  S. Rep.  No. 336, 96th  Cong.,  Summary  1450 (1980). 
2.  Small  amounts  of additional  Federal  money  are  available  through  the  following 
programs:  (l)the1974  Child  Abuse  Prevention  and  Treatment  Act funds 
adoption  opportunities,  child abuse  State  grants,  child  abuse  challenge  grants, 
child  abuse  discretionary  programs,  family violence  programs,  and  emergency 
child  abuse  prevention  services  (in  1991, total  funding  was about  $82 million); 
(2) abandoned  infants  assistance  (in  1991, funding  was about  $13 million);  and 
(3) temporary  child  care  for  children  with disabilities  and  crisis nurseries  grants 
(in  1991, funding  was about  $11 million).  See  J. Rovner,  Under  the  Child-
Welfare  Banner  Lies  a Patchwork  of Federal  Programs,  Congressional 
Quartedy,  30 March  1991,798-799. 
3.	 In  1992, Title  IV-E  foster  care  maintenance,  training,  and  administrative 
expenses  made  up  an estimated  61 percent  of Federal  child welfare  spending; 
Title  XX made  up  21 percent;  Title  IV-B made  up  7 percent,  and  Title  IV-E 
adoption  assistance  maintenance,  training,  and  administrative  expenses  made  up 
6 percent.  Much  of the  Title  XX funding  and  Title  IV-B funding  was likely 
spent  by States  on foster  care  maintenance  payments  for  children  not  eligible 
for AFDC. 
4.	 In  1992, Title  IV-E  administrative  and  training  expenses  made  up 32 percent  of 
the  total  Federal  funding  effort.  From  fiscal year  1985 to fiscal year  1992, 
foster  care  administrative  expenses  rose  from  $143 million  to $981 million.  As 
the  Office  of Inspector  General  pointed  out  in an earlier  report,  it is important 
to understand  that  States  have  been  given the  authority  to claim  many  types  of 
services  as administrative  expenses  including  pre-placement  sewices  (see 
Department  of Health  and  Human  Services,  Office  of Inspector  General, 
Oppo~nihes  for Cost Containment  by Modifiing Federal Reimbunement  to 
Statesfor Administrative Costs Underthe FosterCareProgram,A-07-90-00274, 
August1990.) 
5.  The  Title  IV-E  Independent  Living program  is not  open-ended;  it is a capped 
entitlement  program.  For  more  information  on the  program,  see  an upcoming 
OIG  report  entitled  Independent  Living Program  for Foster  Care  Youth: 
Strategies  for  Improved  ACF  Management  and  Program  Reporting  (OEI-Ol-
93-00090). 
6.	 Of the  $273 million  of Title  IV-B claims in 1992, $132 million--less  than  4 
percent  of all Federal  funding  of child welfare--was  Section  427 funding. 
F-1
 7.  On  occasion,  the  Office  of Inspector  General  performs  audits  of Title  IV-E 
funds.  These  are  identical  in scope  and  content  to the  ACF-conducted  reviews. 
8.  The  ACF  conducts  initial  reviews  after  States  certify  that  they  are  eligible  for 
427 funding.  The  initial  review  consists  solely of the  Administrative  Procedures 
Review.  If the  State  passes  that  review,  a case  record  review  is conducted  the 
following year.  If the  State  passes  this subsequent  review,  it receives  funding 
for three  years  prior  to another  review  (known  as a triennial  review).  At this 
review,  ACF  conducts  another  case  record  review  and  receives  assurances  from 
the  State  about  administrative  procedures.  The  standards  for the  triennial 
review  are  stricter  than  for the  subsequent  review.  Once  a State  has  passed 
two consecutive  triennial  reviews,  the  triennial  reviews  are  conducted  every  five 
years. 
9.  Administration  for Children  and  Families,  Section  427 Review Handbook, 
August  1988. 
10.  S. Rep  No.  118, 10lst  Cong.,  Foster  Care,  Adoption  Assistance,  and  Child 
Welfare  Services,  103 (1990). 
11.  Administration  for Children  and  Families,  Draft  Child  We~are Services Program 
Review  Manual,  December  1990. 
12.  Adoption  Assistance  and  Child  Welfare  Act  of 1980, Pub.  L. No. 96-272, 94 
Stat.  517 (1980). 
13.  Office  of Human  Development  Services  Task  Force  on Foster  Care  and 
Adoption  Assistance,  Report  on Title  IV-E~itle  IV-B Programs,  February  6, 
1987, 3. 
14.  H.R.  2264, as introduced  in the  103rd Congress,  included  the  following  major 
changes  to the  oversight  process:  elimination  of Section  427 reviews,  creation 
of new Title  IV-B State  plan  requirements  that  mimicked  Section  427, and 
establishment  of a new review  process  for Title  IV-B. 
15.  For  example,  see  H. R. Rep.  No. 395, 10lst  Cong.,  No Place  to Call Home: 
Discarded  Children  in America,  79-84 (1990);  United  States  General 
Accounting  Office, Foster Care: Incomplete  Implementation  of the Reforms  and 
Unknown  Effectiveness,  GAOIPEMD-89-17,  August  1989; S. Rep.  No.  118, 10lst 
Cong.,  Foster  Care,  Adoption  Assistance,  and  Child  Welfare  Services, Senate 
(1990);  M. Allen,  Crafting  a Federal  Legislative  Framework  for Child  Welfare 
Reform,  American Journal of Orthop.ychiat~, 61 (October  1991) 4: 610-623; 
and  American  Public  Welfare  Association,  Report  on State Public  Child  Welfare 
Agencies  Experiences  wirh Title IV-E  and Section  427 Reviews,  Draft  #3,  January 
25, 1993.  -
F-2
 16.  Family  Preservation Act  of 1991: Hearing Before the House  Subcommittee  on 
Human  Resources,  102nd Cong.,  42 (June  11 and  12, 1991). 
17.  S. Rep.,  Foster  Care,  Adoption  Assistance,  and  Child  Welfare  Services,  110. 
18.  The  ACF  has convened  a task  force  to look  at all of its monitoring  activities,  is 
currently  working  on evaluating  the  costs and  benefits  of a quality  control 
system,  and  is finalizing  new guidance  on  IV-B joint  planning.  Oversight  issues 
were  discussed  in the  prior  Administration  as well.  See,  for  example, 
Administration  for Children  and  Families,  Final Repoti of lhe Section 427 
Revrkion Task Force, Briefing  Memorandum,  April  16, 1990; Office  of Human 
Development  Services  Task  Force  on Foster  Care  and  Adoption  Assistance, 
Repon  on  Tide IV-E/Tide  IV-B  Programs; and  Administration  for  Children  and 
Families,  Child  We~are Monitoring  Task Force: Draft  Concept  Papers (Revked), 
internal  HHS  document,  July  16, 1992. 
19.  Department  of Health  and  Human  Services,  Office  of Inspector  General, 
Oppommities  to Improve  Fos~er Care Eligibili~  Decerrninations, A-12-93-00022, 
May  1994 (draft). 
20.  For  example,  see  H. R. Rep.  No 395, 10lst  Cong., No Place to Call Home: 
Discarded  Children in America,  39-44 (January  12, 1990);  C. W. Dugger, 
Shortage  of Trained  Caseworkers  imperils  Young  Victims  of Abuse:  The 
Cracked  Shield,  A Child  Welfare  System  Stumbles,  New York Times, December 
28, 1992, Al,  B8; Wronging  Children,  Washington  Post, February  10, 1991, 1; 
C.W. Dugger,  Troubled  Children  Flood  Ill-Prepared  Care  System:  Shattered 
Lives, When  Foster  Care  Fails, New York  Times, September  8, 1992, Al,  B7. 
21.  See  H. R. Report,  No Place lo Call Home,  33-36; Department  of Health  and 
Human  Services,  Office  of Inspector  General,  Crack Babies,  OEI-03-89-01540, 
June  1990, and  Department  of Health  and  Human  Services,  Office  of Inspector 
General,  Trends in Foster Care, OEI-01-90-00490,  Januaxy  1992. 
22.  See H.  R. Rep.,  No Place to Call Home, 33-36; and  S. Evans,  Desperate 
Parents  Cast  Unruly  Children  Into  Hands  of a Burdened  Government,   
Washington  Post, September  30, 1991, 1. 
23.  Notably,  officials  from  both  the  American  Public  Welfare  Association  and  the 
Child  Welfare  League  of America  mentioned  this. 
24.  The  Institutes  for  Health  and  Human  Services,  Inc., Directoy  of Child  We@e 
Class Action  Lawsuits,  October  1, 1992. 
25.  Many  of these  have  resulted  in States  settling  consent  decrees  out  of court. 
The  consent  decrees  often  have  resulted  in dramatic  changes  in State 
procedures  and  laws.  See  The  Institutes  for Health  and  Human  Services,  Inc., 
F-3
 Directo~  of Child  We~are C[am Action  Lawsuits,  October  1, 1992 and  National 
Center  for Youth  bw,  Foster Care Refom:LitigatiotZ  Docket,  1989. 
26.  These  are  the  objectives  ACF  has defined  for the  reviews. 
27.  Most  changes  such as these  would  require  revisions  to existing  statute. 
28.  APW~  Repoti  on Experiences  with Title IV-E  and  Section  427 Reviews. 
29.  Our  data  show that  in one  State,  over  $1 million,  or almost  6 percent  of the 
Federal  Title  IV-E  foster  care  funding,  was disallowed  on a Title  IV-E  review 
solely for reasons  that  appear  to be  outside  of the  control  of the  child welfare 
agen~,  in another  State,  over  10 percent  (more  than  $500,000)  was disallowed. 
These  reasons  (as stated  in the  review  reports)  were:  court  order  did not 
indicate  reasonable  efforts,  court  order  did not  indicate  contrary  to the 
welfare  of the  child, and  no judicial  determination  done  within  180 days. 
30.  OIG,  Opportunities  to lrnprove Foster Care Eligibility Determinations,  May  1994 
(draft). 
31.  Of the  small  number  of reviews from  which we were  able  to gather  this 
information,  this review  involved  the  most  people.  We  suspect  that  in other 
States,  reviews  involved  large  numbers  approaching  those  in this  example. 
32.  Four  of the  10 regions  and  4 of the  13 States  responded  No or Dont know 
to the  question  about  whether  Title  IV-E  reviews  are  meeting  this  objective. 
33.  S. Bill No.  1886, 103rd Cong., Social  Security  Act Amendments  of 1993, 
introduced  on November  17, 1993 by Senator  Daniel  Patrick  Moynihan. 
34.  This  method  was used  quite  successfully  by the  Public  Health  Sefice.  The 
PHS,  in response  to a recommendation  we made,  funded  the  Federation  of 
State  Medical  Boards  to develop  performance  indicators  for State  medical 
boards.  The  system  the  Federation  developed  has gained  wide  acceptance  and 
is serving  very useful  informational  purposes  for the  States  (and  for PHS). 
35.  The  original  legislation  upon  which the  OBRA  93 family preservation  and 
family support  provisions  were  based  included  a provision  to put  in place 
corrective  action  plans. 
36.  The  new Title  IV-B Subpart  2 includes  funding  for grants  to State  judiciaries  to 
assess  and  improve  handling  of proceedings  related  to foster  care  and  adoption 
assistance. 
37.  OIG,  Oppotiunities  to Improve  Foster Care Eli@bili~ Determinations,  May  1994 
(draft>.
\ / 
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 38.	 The  initial  legislation  that  resulted  in the  OBRA  93 child welfare  provisions  (as 
well as the  conference  report  on OBRA  93) included  a requirement  that  the 
Department  conduct  a study  on reasonable  efforts. 
39.	 In addition,  we reviewed  the  content  of audits  conducted  by OIG  Office  of 
Audit  Setices  in five States.  The  Office  of Audit  Setices  conducts  audits  of 
State  programs  that  are  very similar  to the  Title  IV-E  reviews  conducted  by 
ACF.  The  OIG  reports  were  not  included  in our  analysis  of the  timeliness  of 
reporting  or the  resources  used  in reporting.  They  did, however,  contribute  to 
our  analysis  of and  understanding  of the  content  of review  reports. 
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