United States General Accounting Office

GAO Report to Congressional Requesters

November 1999 FOSTER CARE

HHS Could Better

Facilitate the

Interjurisdictional

Adoption Process

GAO/HEHS-00-12

GAO United States

General Accounting Office

Washington, D.C. 20548

Health, Education, and

Human Services Division

B-281621 

November 19, 1999

The Honorable William V. Roth, Jr.

Chairman

The Honorable Daniel Patrick Moynihan

Ranking Minority Member

Committee on Finance

United States Senate

The Honorable Bill Archer

Chairman

The Honorable Charles B. Rangel

Ranking Minority Member

Committee on Ways and Means

House of Representatives

The Adoption and Safe Families Act of 1997 (ASFA) is the most recent

federal legislation to emphasize the importance of permanence in the lives

of the 520,000 children in foster care and, in particular, the importance of

adoption when foster children cannot safely and quickly return to the care

of their birth parents. This act includes a provision prohibiting states from

delaying or denying the adoption of a foster child when an approved

family is available in a jurisdiction different from the one in which the

child resides. The Department of Health and Human Services (HHS) is

responsible for monitoring states’ adherence to this prohibition and to

other provisions in ASFA. The act also requires us to study and consider

how to improve procedures and policies to facilitate the timely and

permanent adoptions of children across state and county

jurisdictions—referred to as interjurisdictional adoptions.

As agreed with committee staff, in response to the requirement in ASFA that

we report to the Congress on interjurisdictional adoption issues, we are

providing information on (1) the number of foster children who are

available and waiting for an adoptive home to be identified, (2) the actions

taken by state and county child welfare agencies1

 and nonprofit

organizations to improve the adoption process when prospective adoptive

families and foster children live in different jurisdictions, and (3) the

actions taken by the federal government to improve the adoption process

when prospective adoptive families and foster children live in different

jurisdictions. In particular, in ASFA the Congress identified four steps

1

In this report, we use the phrase “public child welfare agencies” to refer to both state and county

child welfare agencies.

Page 1 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

related to timely and permanent interjurisdictional adoptions that our

study should address. First, states and counties may need to improve

procedures to recruit prospective adoptive parents from states or counties

different from the one in which adoptable children reside. Second, states

and counties may need to improve procedures for the acceptance of

homestudies when the studies are done in a different state or county.2

Third, states may need to assure their acceptance of termination of

parental rights orders and adoption decrees issued by a court in a different

state.3

 Fourth, states may need to improve procedures for administering

and implementing the Interstate Compact on the Placement of Children

(ICPC).4

 To develop this information, we contacted federal, state, and

county child welfare officials and experts affiliated with nonprofit

organizations interested in interjurisdictional adoption issues. We also

conducted case studies in three states—California, Florida, and Missouri.

Appendix I describes our scope and methodology. We conducted our

review from November 1998 to August 1999 in accordance with generally

accepted government auditing standards.

Results in Brief At any given time, about 1.5 percent of foster children—about 8,000—are

legally available for adoption and waiting for an adoptive home but have

no current prospects for adoption. This number is small because, of those

foster children who are adopted, about 78 percent are adopted by their

foster parents or relatives. Virtually all of the remaining foster children

who are waiting for adoptive homes are among the most difficult to place

due to their older age, their need to be placed with siblings, or other

special considerations. Because these children are hard to place, they are

likely to be candidates for adoptive placement across jurisdictions.

Public child welfare agencies have directed their efforts toward the initial

step in the interjurisdictional adoption process—recruitment of

prospective adoptive families—and have done less to improve the other

steps in the adoption process because they are largely beyond their legal

authority to change. For example, these agencies are using traditional

recruiting methods in new ways, as was the case in two of the three states

we visited. These states enter into contracts with other states to conduct

2

A homestudy is a written report used to approve individuals as adoptive parents. See the Background

section of this report for a further description of homestudies and their use in the adoption process.

3

A court order to terminate parental rights severs the legal relationship between parent and child, thus

making the child eligible for adoption. An adoption decree finalizes the adoption process and provides

full parental rights to the adopting parent.

4

The ICPC is a uniformly enacted statute that provides the legal framework for placing children in

adoptive homes across state lines. The Background section of this report further describes this

compact and its process.

Page 2 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

recruitment activities in geographic areas outside the public child welfare

agency’s jurisdiction. The agencies also use Internet web sites, which can

be accessed from anywhere in the nation, to reach beyond their borders to

recruit prospective adoptive families and publicize waiting children.

Nonprofit organizations that are working to improve interjurisdictional

adoption processes have targeted their efforts at those steps in the

adoption process that correspond to their professional interests. Such

interests include nationwide recruitment of adoptive homes for

hard-to-place waiting foster children as well as issues related to

improvements in the use of homestudies and the ICPC process.

HHS leadership could facilitate improvements in the interjurisdictional

adoption process, much of which is outside the legal authority of

individual public child welfare agencies. HHS has developed plans to

address problems in the interjurisdictional adoption process and

implemented some actions. For example, as part of its technical assistance

efforts, HHS provided guidelines for state legislation on termination of

parental rights and assistance to states on ICPC issues. However, because

the plans were made in response to two presidential directives regarding

adoption, HHS Office of Inspector General recommendations, and the

passage of ASFA, they were implemented independently rather than as part

of an organized strategy. We are recommending that HHS better coordinate

its efforts to facilitate improvements to the interjurisdictional adoption

process.

Background ASFA established as a federal priority the safe and timely placement of

foster children in permanent homes, even if those homes are located in a

jurisdiction different from that of the waiting children. Among the many

provisions in ASFA, three are specific to interjurisdictional adoption issues.

First, the act requires state plans5

 to specify that a state will not deny or

delay the placement of a child for adoption when an approved family6

 is

available outside of the jurisdiction with responsibility for handling the

case of the child. Second, state plans7

 must contain assurances that the

state will develop plans for the effective use of cross-jurisdictional

5

State plans are required under title IV-E of the Social Security Act in order for states to receive federal

foster care funds for maintenance of foster children, specific administration costs associated with

foster care programs, and adoption assistance.

6

“Approved family” generally refers to an individual with an approved homestudy. However, HHS has

not issued regulations to define this term as used in ASFA.

7

Other state plans are required under title IV-B of the Social Security Act in order for states to receive

federal funds for child welfare services.

Page 3 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

resources to facilitate timely adoptive or permanent placements for

waiting children. Third, the act established a penalty against federal foster

care funds for states that are found to deny or delay the placement of a

child for adoption when an approved family is available outside of the

jurisdiction, or that fail to promptly grant a fair hearing to an individual

who alleges such a violation. HHS has a limited role in determining the

policies and procedures used by child welfare programs, including foster

care programs. HHS is responsible for issuing federal foster care

regulations containing minimal procedural requirements, monitoring

states’ compliance with them, and administering federal foster care

funding.

The public child welfare system, which oversees the adoption of foster

children, is composed mainly of state and local child welfare agencies and

state juvenile dependency courts. State laws provide more detail and

specificity regarding the circumstances in which adoptions may occur

than do federal laws and set the parameters, consistent with federal

constitutional and statutory requirements, under which child welfare

systems operate. For example, state laws specify the legal grounds for

terminating parental rights to free a child to be adopted. The child welfare

agencies promulgate the regulations, policies, and procedures for foster

care programs and administer those programs. Thus, state child welfare

agencies have a central role in regulating the activities of foster care

programs, including the adoption of foster children. In 12 states, that

responsibility is delegated to local child welfare agencies. State courts are

responsible for reviewing child welfare agency actions for individual foster

children and their families and taking legal actions as necessary to protect

children. Such actions include ordering the placement of foster children in

temporary homes, presiding over periodic hearings to plan for a child’s

permanent placement, terminating the parental rights of birth parents

when their children cannot be safely returned to their care, and granting

adoption decrees to adoptive parents.

The ICPC provides the legal framework for the placement of children

across state lines by public and private agencies, courts, and—in some

cases—private individuals. It is a statute enacted uniformly by all 50

states, the District of Columbia, and the U.S. Virgin Islands. A nonprofit

organization, the Association of Administrators of the Interstate Compact

on the Placement of Children (AAICPC), provides guidance to states in

interpreting and revising ICPC. Use of ICPC ensures that appropriate state

laws are followed before a placement is made and that children placed

out-of-state receive the protections and services that would be provided if

Page 4 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

they remained in their home states. States provide these services on a

reciprocal basis. Of the adoptive placements made under ICPC, few are

placements of foster children; almost all interstate adoptive placements

involve adoptions either between individuals or through private adoption

agencies. However, all foster care placements across state lines must be

processed through the compact. HHS has no direct role in ICPC

administration. Figure 1 shows the ICPC process for obtaining approval for

an out-of-state placement for a foster child. Figure 2 shows the ICPC

process once the decision has been made to place a child out-of-state.

Page 5 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Figure 1: ICPC Process to Request Homestudy and Placement of Foster Child Out-of-State

aIn a few states, responsibility for contacting the state where the prospective adoptive parent

resides has been delegated to the local child welfare agency. In those locations, the ICPC state

compact administrator receives copies of the paperwork but may not be responsible for

forwarding it.

Source: GAO analysis.

Page 6 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Figure 2: ICPC Process After Homestudy Is Obtained and Placement of Foster Child Is Approved

aIn a few states, responsibility for contacting the state where the prospective adoptive parent

resides has been delegated to the local child welfare agency. In those locations, the ICPC state

compact administrator receives copies of the paperwork but may not be responsible for

forwarding it.

Source: GAO analysis.

Page 7 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Prospective adoptive parents come into the foster child’s life in a variety of

ways and through a long, complex process, particularly when a

hard-to-place child is involved. Public child welfare agencies engage in

outreach and other recruitment efforts to attract individuals to be foster

and adoptive parents and undertake a variety of concurrent activities so

that a waiting foster child can be placed with an appropriate prospective

adoptive parent. Most adoptive parents begin their relationship with the

child as the child’s foster parents. Others are relatives of the foster child. A

small percentage of adoptive parents come into the foster child’s life after

the child’s foster parents and relatives have declined to adopt the child

and another home must be sought for the child. Regardless of the way in

which a prospective adoptive parent enters the process, it can take a

prospective adoptive parent 1 to 3 years from the initial contact with a

child welfare agency to finalization of an adoption. Appendix II shows how

prospective adoptive parents enter the child welfare system, general

activities child welfare agencies undertake to make an appropriate

adoptive placement, and—when an interjurisdictional placement is

involved—when the ICPC is invoked.

The homestudy is a key component in the process of becoming a foster or

adoptive parent. Homestudies are written reports that are generally

prepared by a child welfare caseworker. The studies assess the financial

situation, current and previous relationships, life experiences, and

parenting abilities of a person wishing to become an adoptive parent. The

process also usually includes checks for criminal activity by the

prospective adoptive parent. The homestudy process is generally

combined with mandatory training for prospective foster or adoptive

parents, a combination that typically takes 3 months to complete. An

applicant is approved as a foster or adoptive parent only after the

homestudy process is completed, a written report of its findings is

approved by a child welfare agency, and the home is found to meet safety

standards. Agencies may then consider whether a prospective adoptive

parent would be an appropriate caregiver for a particular foster child.

Homestudies must be updated, in some locations as frequently as annually,

in order for a prospective adoptive parent to retain approved status. In

addition, homestudies may need to be updated at the time a prospective

adoptive parent is considered as a placement for a specific foster child in

order to determine if the person can meet that child’s special needs.

Although no standardized national homestudy format exists, appendix III

contains an example of one state’s recommended homestudy format—an

example that reflects the scope and detail typically found in homestudies.

Page 8 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Few Foster Children Are

Available and Waiting for

Adoptive Homes but Most

Who Wait Are Difficult to

Place

At any given time, an estimated 1.5 percent of foster children—about

8,000—are available for adoption and, as yet, no adoptive family has been

identified for them. About one-third of foster children will never return to

their birth parents, leaving those children in need of permanent homes. Yet

few of the children in need of new permanent homes are, at any given

time, legally freed from their birth parents and thus available for adoption.

Furthermore, HHS estimates that of the foster children who are adopted,

78 percent will be adopted by their foster parents or relatives. Figure 3

shows the likely permanency outcomes for foster children in care at any

given time.

Figure 3: Anticipated Outcomes for

Foster Children

aOther outcomes includes aging out of the foster care system at age 18 and, in some

circumstances, legal guardianship. While in foster care, children who have other outcomes live in

a variety of arrangements including the homes of relatives, foster homes, group homes, and

residential care facilities.

bFor this grouping in the figure, we expanded the information to indicate the likely legal status of

children in that grouping, at any given time, prior to attaining the anticipated outcome.

Page 9 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Source: GAO analysis of HHS data.

While estimates of the number of adoptions across state lines vary, the

number of interjurisdictional adoptions is likely small. HHS administrative

data place the number of finalized adoptions of foster children across state

lines at less than 250 in 1998. Furthermore, the Office of Inspector General

noted that one-half of states’ ICPC offices do not know how many children

they place through ICPC due to poor quality data and ineffective tracking

techniques.

The foster children who are not adopted by their foster parents or

relatives are among the most difficult to place. Almost all of them have

special needs. Typically, they are school age, have physical or mental

impairments, have siblings who should be placed with them, and are

children of color. HHS reported that of the children freed for adoption,

more than 35 percent are teenagers and an additional 17 percent are

between the ages of 9 and 12 years. In general, within the foster care

population, only these hard-to-place and legally freed children are likely to

be candidates for adoptive placements across jurisdictions.

Public Child Welfare

Agencies Focus on

Recruitment While

Nonprofit

Organizations Address

a Range of Issues

Public child welfare agencies have directed their efforts toward the initial

step in the interjurisdictional adoption process—recruitment of

prospective adoptive families—and have done less to improve the other

steps in the adoption process because changing those steps is largely

beyond their legal authority. Nonprofit organizations working to improve

interjurisdictional adoption processes have targeted their efforts at those

steps in the adoption process that correspond to the organizations’ areas

of interest. Such interests include nationwide recruitment of adoptive

homes for hard-to-place waiting foster children as well as issues related to

improvements in the use of homestudies and the ICPC process.

Public Child Welfare

Agencies Focus on

Improving the Use of

Traditional and Internet

Recruitment Methods

In the initial step of the interjurisdictional adoption process—recruitment

of prospective adoptive families—public child welfare agencies are

attempting to reach beyond their borders by using traditional recruitment

methods. In addition to using TV spots, newspaper stories, and billboards,

two of the three states we visited also contract with other organizations

for recruitment services; the contracts include provisions for recruitment

across jurisdictional lines. For example, Missouri contracts with other

organizations to recruit prospective foster and adoptive families from

several bordering states as well as from within the state. In Florida,

Page 10 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Broward County contracts with other organizations for recruitment within

its borders and in adjoining counties. Public child welfare agencies also

participate in voluntary networks—referred to as adoption exchanges—to

identify adoptive families for hard-to-place foster children. These

voluntary networks provide child welfare agencies with the opportunity to

share information about children who need adoptive homes and approved

families who want to adopt a foster child.

Public child welfare agencies are also using the Internet to expand their

ability to recruit prospective adoptive families. Almost all state child

welfare agencies have set up their own public Internet web sites, which

can be accessed from anywhere in the nation, to promote adoption of

foster children; 30 states include photolistings of freed and waiting

children.8

 Appendix IV lists public Internet web sites set up by state child

welfare agencies and a listing of the types of information that the public

can access. States have taken a variety of approaches in determining

which children to publicize on their child welfare web sites. Some state

web sites have photolistings that picture and describe all foster children in

a state who have been freed and are waiting for an adoptive home; other

states show only the hardest-to-place children; still others show a

representative sample of their available foster children.

In general, states have not evaluated the effectiveness of their sites as a

means of recruiting potential adoptive families nationwide. While many

state web sites welcome inquiries from all prospective adoptive families

nationwide, three state web sites specify that the state will consider only

applicants from within the state. Finally, public child welfare agencies also

use the Internet to participate in privately operated adoption exchanges on

password-protected sites that can be accessed only by caseworkers.

Public child welfare agencies do not have authority to specify the contents

of a homestudy prepared in another jurisdiction, but the three states we

visited have taken limited actions to increase the acceptability of the ones

they receive from other states. For example, if the public child welfare

agency requests a homestudy on a prospective adoptive parent in another

jurisdiction, the requesting agency notifies the agency preparing the

homestudy of its specific requirements so that they can be included in the

study. If the public child welfare agency receives an approved homestudy

from outside the agency’s jurisdiction, it contacts the agency that prepared

8

Public child welfare agency’s public Internet sites protect the privacy of foster children listed on

them. In general, sites limit information about the children to first name and age of a child and a brief

description of a child’s special needs. As an added safeguard, courts must grant permission for public

distribution of information about the foster children under their jurisdiction.

Page 11 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

and approved the homestudy for additional information that will allow the

homestudy to meet local requirements and allow the agency to assess the

appropriateness of prospective adoptive parents. Additionally, in two of

the states we visited that contract with other agencies to conduct

recruitment activities, the contracts specify the content of the

homestudies done by the contractors. Thus, homestudies done by the

contractor will meet the criteria set for local homestudies.

As is the case with homestudies, public child welfare agencies also have

only limited authority to improve the acceptance of court orders across

jurisdictions. The Constitution sets the framework for states to accept the

court orders of other states but neither the Congress nor case law has

specifically addressed acceptance of termination of parental rights orders

or adoption decrees.9

 In addition, the Supreme Court has ruled that states

are not obligated to honor judicial actions of other states in situations

where minimum standards of due process have not been provided to those

affected. HHS officials and experts told us that there is little to suggest that

interjurisdictional adoptions of foster children were delayed or denied

because termination of parental rights orders or adoption decrees were

not accepted across jurisdictions. One of the states we visited (Florida)

specifies in its adoption statutes that the state will accept such orders

from any other state.

Although public child welfare agencies can control only the steps in the

ICPC process that occur within their own state, two of the states we visited,

Florida and Missouri, have taken actions to avoid delays within their ICPC

offices.10 Officials in the three states we visited told us that they process

ICPC requests promptly and Florida has implemented performance goals to

further improve the timeliness of its processes. In Florida, the ICPC office

specified that ICPC requests related to adoption are to be processed

through its office within 3 days. Missouri has also instituted agreements

with two of its neighboring states with the goal of alleviating delays in

beginning homestudies requested through the ICPC office. However, the

9

The acceptance of court orders of other states—otherwise called the granting of full faith and

credit—is governed by Article IV, Section 1 of the U.S. Constitution. It states, “Full faith and credit

shall be given in each State to the public acts, records, and judicial proceedings of every other State.

And the Congress may by general laws prescribe the manner in which such acts, records and

proceedings shall be proved, and the effect thereof.” In at least five instances since 1948, the Congress

passed laws to clarify the application of this clause. Clarifying legislation usually specifies the

instances in which full faith and credit is to be granted, such as is the case with child support orders.

In one instance, the Defense of Marriage Act, the legislation specifies that full faith and credit need not

be extended to marriages between certain parties.

10For placement of children in out-of-state foster or adoptive homes, California delegates responsibility

for the in-state ICPC process to its counties. Only children whose out-of-state placements are in group

homes are handled by the state ICPC office.

Page 12 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

agreements—referred to as border agreements—have been used

infrequently, even though one of the agreements has been in place for

more than a year. State officials were surprised that the 1-year-old

agreement was used infrequently. Officials from the two states involved

have decided to review the agreement with their respective staff to

emphasize the agreement’s value in speeding the start of the homestudy

process.

Nonprofit Organizations

Also Address Issues in

Interjurisdictional

Adoption Process

Nonprofit organizations have initiated national efforts that cover many of

the steps in the interjurisdictional adoption process. The National

Adoption Center, the American Public Human Services Association

(APHSA), and its affiliate, AAICPC, are among the nonprofit organizations

leading such efforts. The National Adoption Center operates two

recruitment-related Internet sites. APHSA initiated efforts to address issues

related to homestudies, and its affiliate provides recommendations to

member states to improve the ICPC process.

The National Adoption Center established and maintains11 two

recruitment-related Internet sites—a public national photolisting service

to publicize foster children who are currently available and waiting for

adoption, and a secure web site with additional resources for use by child

welfare agencies.12 The public Internet web site, called FACES OF

ADOPTION: America’s Waiting Children,13 listed about 1,800 waiting

children from about 38 states as of August 1999. The center anticipates

that additional states will soon become members, resulting in some

increase in the number of children listed on its site in the coming months.

Prospective adoptive parents can request information about a specific

child from the center. The center’s private Internet web site, called

NAE-Online, contains additional information about the children and also

contains information about families with approved homestudies. The site

is accessible only to child welfare agencies that pay a membership fee to

the center. The center estimated that during a 2-month period in summer

1999, about 30 foster children were placed for adoption as a result of their

listings being seen on FACES OF ADOPTION.

11The Children Awaiting Parents, Inc., cosponsors the public web site.

12Similar to web sites set up by state child welfare agencies, the center’s web site protects the privacy

of foster children in the photolisting service by providing only general descriptive information about

the children listed.

13The site can be found on the Internet at http://www.adopt.org.

Page 13 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

In February 1999, APHSA convened a task force called the Geographic

Barriers Task Force of APHSA to Identify Barriers to Placements across

State Lines to explore issues related to the use of homestudies across

jurisdictions. The membership of the task force is still evolving, although it

is expected to include representatives of state child welfare agencies, child

welfare advocacy organizations, the AAICPC, and the Association of

Administrators of the Interstate Compact on Adoption and Medical

Assistance.14 As of August 1999, the task force had not set a time frame for

completion of its work or identified the scope of the work.

AAICPC provides guidance to states in interpreting ICPC and

recommendations on procedures. This group consists of representatives of

ICPC administrators from each state. AAICPC members implement

procedures that they believe will increase the timeliness of the ICPC

process. For example, ICPC Regulation 7 allows agencies to request an

expedited homestudy when a child is likely to be placed with a relative

residing in another state.

HHS Has Identified

Problems That Affect

Interjurisdictional

Adoptions but Lacks

an Organized Strategy

In response to presidential, legislative, and departmental actions, HHS

identified problems that ranged across the interjurisdictional adoption

process, but its plans were not part of an organized strategy. HHS identified

problems ranging from a shortage of adoptive families for special needs

foster children to placements by the courts that violate ICPC. HHS’ action

plans did not address all identified problems and other actions are behind

schedule. As the federal government’s primary agency for foster care and

adoption issues, HHS has a key role in providing leadership to assist states

in resolving interjurisdictional issues.

Since1996, the following presidential, legislative, and departmental actions

have directed HHS’ attention to issues related to interjurisdictional

adoption:

• On December 14, 1996, the President issued a Presidential Executive

Memorandum directing HHS to increase by 100 percent the number of

foster children adopted within 5 years.

• On November 19, 1997, ASFA was enacted, giving HHS responsibility for

issuing regulations and enforcing penalties for, among other provisions,

14The Interstate Compact on Adoption and Medical Assistance provides the legal framework to ensure

that foster children who are eligible for federal adoption assistance continue to receive medical and

other services after adoption. The compact is a statute uniformly enacted by 30 states. The Association

of Administrators of the Interstate Compact on Adoption and Medical Assistance administers this

compact under a cooperative agreement with HHS.

Page 14 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

delaying or denying adoptive placements across jurisdictions when an

approved family is available.

• On November 24, 1998, the President issued a Presidential Executive

Memorandum directing HHS to establish a national registry for freed foster

children who need adoptive homes.

• In November 1998, the HHS Office of Inspector General issued a report,

“The Interstate Compact on the Placement of Children: State Structure

and Process,” describing states’ implementation of ICPC and the number of

children affected by ICPC.

• In March 1999, the Office of Inspector General issued a companion report,

“Interstate Compact on the Placement of Children: Implementation,”

describing how well states have implemented ICPC and recommending HHS

actions for improvement.

HHS characterized its role in foster care adoptions in its response to the

President’s memorandum on increasing adoptions: “The federal role in

this initiative [Adoption 2002] is largely one of supporting states and

communities by providing financial incentives, technical assistance, policy

and programmatic leadership, and recognition of successful efforts.”15 For

interjurisdictional adoption issues, HHS’ efforts to identify problems and

develop action plans largely reflect these areas.

For recruitment, HHS determined that the pool of prospective adoptive

families who can care for children with special needs remained

insufficient.16 To improve recruitment, and in response to the presidential

directive to establish a national registry, HHS developed a plan to

implement an Internet site publicizing freed and waiting foster children.17

HHS estimated the first-year cost of the site at $1.5 million with annual

operating costs of $1.25 million. The service is slated to begin operation on

September 1, 2001. Although preliminary implementation actions were to

be completed by August 1999, HHS had not completed any of the steps

outlined in its plan by that date. For example, it has not conducted focus

groups to identify concerns or established a standing work group to

recommend photolisting service policy. However, HHS acknowledges that

this effort appears to duplicate much of the existing national photolisting

service maintained by the National Adoption Center and now plans to

reassess its approach to this effort.

15Adoption 2002: A Response to the Presidential Executive Memorandum on Adoption, U.S.

Department of Health and Human Services (Washington, D.C.: Dec. 14, 1996), p. 9.

16Adoption 2002, p. 6.

17Plan to Implement a National Internet Adoption Photolisting Service, U.S. Department of Health and

Human Services (Washington, D.C.: n.d.), www.acf.dhhs.gov/programs/cb/special/photolts/toc.htm.

Page 15 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

For homestudies, HHS found that differing state laws and requirements for

the content of homestudies hamper acceptance of homestudies across

jurisdictions.18 HHS has not published plans to address this issue. However,

officials told us that they are supportive of APHSA’s efforts to provide

leadership on interjurisdictional homestudy issues.

Although HHS did not identify a specific need to improve the acceptance of

termination of parental rights orders and adoption decrees, it planned, as

part of its technical assistance efforts to states, to develop and disseminate

guidelines for state legislation relating to terminating parental rights.19

While not prepared in response to a concern about parental rights orders,

HHS’ recently released guidelines help states review their laws and develop

statutes and policies that reflect the best practices in child welfare,

including guidance on the termination of parental rights.20

For ICPC, HHS identified several problems. According to HHS, some child

welfare agency staff as well as judges and attorneys do not understand

ICPC and lack training on its purpose and function.21 Delays may occur in

the placement process, including adoptive placements, thus lengthening

the multistep process, when key people do not comply with ICPC.

22

Furthermore, when placements in violation of ICPC23 occur, states are

sometimes unaware that children are placed in their jurisdiction.24 For

example, judges sometimes disregard the ICPC process and order

out-of-state placements without ICPC. To improve the administration of

ICPC, HHS planned to work with its National Resource Centers25 to

determine how to promote awareness of ICPC, provide training to state

18Plan to Implement a National Internet Photolisting Service, p. 8.

19Adoption 2002, p. 11.

20Adoption 2002: The President’s Initiative on Adoption and Foster Care, Guidelines for Public Policy

and State Legislation Governing Permanence for Children, U.S. Department of Health and Human

Services (Washington, D.C.: June 1999).

21Photolisting Service, p. 9; and Interstate Compact on the Placement of Children: Implementation, U.S.

Department of Health and Human Services Office of Inspector General, OEI-02-95-00044 (Washington,

D.C.: Mar. 1999), p. 7.

22Interstate Compact Implementation, pp. 2 and 8.

23Interstate Compact Implementation, p. 8.

24The Interstate Compact on the Placement of Children: State Structure and Process, U.S. Department

of Health and Human Services Office of Inspector General, OEI-02-95-00041 (Washington, D.C.:

Nov. 1998), p. 9.

25National Resource Centers are operated by contractors who are responsible for providing technical

assistance on child welfare issues to states.

Page 16 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

agency staff who operate ICPC, and support development of model

procedures to help ICPC operate more effectively.26 To promote awareness

of ICPC and provide training, HHS invited other organizations, such as

AAICPC, to make presentations about ICPC at HHS-sponsored workshops and

meetings. To support development of model procedures, HHS included

improvement of ICPC as an example of an interjurisdictional adoption issue

that could receive funding under the Adoption Opportunities grant

program.27 Although HHS received proposals for fiscal year 1998, HHS

determined that none of the proposals had sufficient merit to be

recommended for funding. HHS revised its request for proposals on

interjurisdictional adoption issues and listed both collaborative planning

to increase interjurisdictional adoptions and support for improving

implementation of ICPC as areas of special interest for fiscal year 1999

grants. HHS awarded five grants in those areas of special interest.

Conclusions The 8,000 foster children who, at any given time, are freed and waiting for

an adoptive home are not readily adoptable because of their special needs.

Searching across jurisdictional lines for an adoptive family for these

hard-to-place children may increase the likelihood that a foster child can

be matched with an appropriate family. However, the interjurisdictional

adoption process is longer and more complex than the adoption process

within a jurisdiction. Thus, opportunities for successful outcomes from

interjurisdictional searches for adoptive families depend, in large measure,

on the soundness of the process itself. While states have the primary

responsibility to regulate adoptions, nonprofit organizations are also

actively involved in developing needed improvements. However, states’

authority does not extend beyond their own borders and nonprofit

organizations cannot directly change the process. As a result, the states

and organizations cannot effect change in all steps of the

interjurisdictional adoption process. While HHS has made some efforts to

assist states in improving this process in areas such as provision of

technical assistance, a more organized strategy and a widely available plan

could facilitate dialogue and collaboration among all who have an interest

in improvements to the interjurisdictional adoption process. For example,

such a plan could present strategies to promote the standardization of

homestudies and assist states in their use of web sites.

26Interstate Compact Implementation, pp. 11-12.

27The Adoption Opportunities grant program is designed to provide support for demonstration projects

that facilitate the elimination of barriers to adoption and provide permanent loving homes for children

who would benefit from adoption, particularly children with special needs.

Page 17 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

Recommendation We recommend that the Secretary of HHS develop and make widely

available an action plan to address areas that would facilitate the

interjurisdictional adoption of foster children. The plan should critically

assess planned and ongoing activities by HHS and others and, at a

minimum, should include strategies to

• Encourage collaborative partnerships among governments and others to

promote standardization of homestudies and additional training on ICPC

and its process, and

• Provide technical assistance to states on the effective use of adoption web

sites to recruit adoptive families for hard-to-place foster children.

Agency Comments

and Our Evaluation

We provided HHS and state child welfare officials in the three states we

visited with the opportunity to comment on a draft of this report; we

received comments from HHS and the state of California. In its comments

on a draft of the report, HHS acknowledged that the interjurisdictional

adoption process is not functioning optimally. It expanded on two topics

addressed in the report—HHS’ discretionary grantmaking activities and

Internet activities—and discussed why HHS does not believe that our

recommended action is necessary. In discussing the use of discretionary

grants, such as Adoption Opportunities grants, to improve the

interjurisdictional adoption process, HHS reiterated its position on its

discretionary grantmaking activities and provided additional information

about the grants that were awarded for fiscal year 1999. In addition, HHS

noted that it considers the grantmaking process to be its mechanism for

coordinating with others to improve the interjurisdictional adoption

process. In discussing Internet activities, HHS noted that interest in Internet

activity regarding adoption is high, the interest comes from a variety of

sources, and adoption agencies have struggled to keep up with the rapidly

growing Internet technology. Furthermore, HHS seeks to support

Internet-based efforts that do not exceed states’ capacities to respond and

that do not duplicate efforts by the private sector.

In responding to our recommendation that HHS develop and make widely

available an action plan to facilitate the interjurisdictional adoption of

foster children, HHS stated that it has not had a need to create such a plan

given the changing nature of technology and the continuous efforts it is

making to facilitate the interjurisdictional adoption process. We believe

that the value of a more organized strategy and a widely available action

plan lies in the increased dialogue, and resulting collaboration, such a plan

can generate between HHS and the many public agencies and private

Page 18 GAO/HEHS-00-12 Interjurisdictional Adoption
B-281621 

organizations that have an interest in improving the interjurisdictional

adoption process. Particularly in light of HHS’ stated desire to avoid

duplicating the efforts of others and its recent decision to reassess the

value of its plan for a national photolisting service, a mechanism that

would keep interested parties abreast of HHS’ plans is warranted. HHS also

made technical comments, which we incorporated where appropriate. The

full text of HHS’ comments is contained in appendix V.

The state of California agreed with our report and noted its interest in

being involved in future efforts to improve the interjurisdictional adoption

process.

We will send copies of this report to the Secretary of Health and Human

Services and program officials in California, Florida, and Missouri. We will

also make copies available to others on request.

If you have any questions regarding this letter, please contact me at

(202) 512-7215. Key contributors to this report are listed in appendix VI.

Sincerely yours,

Cynthia M. Fagnoni

Director, Education, Workforce,

 and Income Security Issues

Page 19 GAO/HEHS-00-12 Interjurisdictional Adoption
Contents

Letter 1

Appendix I 

Scope and

Methodology

22

Appendix II 

The Adoption Process

for Foster Children

24

Appendix III 

Sample Homestudy

Format

26

Appendix IV 

Child Welfare-Related

State Web Sites as of

August 1999

34

Appendix V 

Comments From the

Department of Health

and Human Services

36

Appendix VI 

GAO Contacts and

Staff

Acknowledgments

39

Figures Figure 1: ICPC Process to Request Homestudy and Placement of

Foster Child Out-of-State

6

Figure 2: ICPC Process After Homestudy Is Obtained and

Placement of Foster Child Is Approved

7

Page 20 GAO/HEHS-00-12 Interjurisdictional Adoption
Contents

Figure 3: Anticipated Outcomes for Foster Children 9

Abbreviations

AAICPC Association of Administrators of the Interstate Compact on

the Placement of Children

APHSA American Public Human Services Association

ASFA Adoption and Safe Families Act of 1997

HHS Department of Health and Human Services

ICPC Interstate Compact on the Placement of Children

Page 21 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix I 

Scope and Methodology

To obtain a national perspective on interjurisdictional issues, we

interviewed officials at the Department of Health and Human Services

(HHS) about the department’s role and actions relevant to

interjurisdictional adoption issues. We also interviewed experts and

advocates affiliated with nonprofit organizations interested in

interjurisdictional adoption issues about their organizations’ related

activities. These organizations included the American Public Human

Services Association, the Association of Administrators of the Interstate

Compact on the Placement of Children, the Association of Administrators

of the Interstate Compact on Adoption and Medical Assistance, the

National Adoption Center, and the American Bar Association. In addition,

we reviewed the public Internet web sites maintained by the National

Adoption Center and state child welfare agencies to determine the types of

information available to prospective adoptive parents regardless of their

geographic location.

To obtain a state and county child welfare perspective on

interjurisdictional issues, we conducted case studies in three

states—California, Florida, and Missouri. We chose those states because

they are among the 10 states with the largest foster care populations and

they have varying levels of experience with the placement of foster

children across state lines. In each state, we met with state foster care and

adoption officials and their local counterparts in one county with a large

foster care population. Those counties were Contra Costa County,

California; Broward County, Florida; and Jackson County, Missouri.

We conducted our review from November 1998 to August 1999 in

accordance with generally accepted government auditing standards.

Page 22 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix I 

Scope and Methodology

Page 23 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix II 

The Adoption Process for Foster Children

Page 24 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix II 

The Adoption Process for Foster Children

Page 25 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

The specific content and format of homestudies vary by agency. This

suggested format, developed by Florida, reflects the scope and detail

typically found in homestudies.

Page 26 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 27 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 28 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 29 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 30 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 31 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 32 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix III 

Sample Homestudy Format

Page 33 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix IV 

Child Welfare-Related State Web Sites as of

August 1999

Page 34 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix IV 

Child Welfare-Related State Web Sites as of

August 1999

Page 35 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix V 

Comments From the Department of Health

and Human Services

Page 36 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix V 

Comments From the Department of Health

and Human Services

Page 37 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix V 

Comments From the Department of Health

and Human Services

Page 38 GAO/HEHS-00-12 Interjurisdictional Adoption
Appendix VI 

GAO Contacts and Staff Acknowledgments

GAO Contacts David D. Bellis, (202) 512-7278

Kerry Gail Dunn, (415) 904-2234

Acknowledgments In addition to the individuals named above, Ann T. Walker, Karen E.

Lyons, and Elizabeth Jarvis-Shean made key contributions to this report.

(116026) Page 39 GAO/HEHS-00-12 Interjurisdictional Adoption
Ordering Information

The first copy of each GAO report and testimony is free.

Additional copies are $2 each. Orders should be sent to the

following address, accompanied by a check or money order

made out to the Superintendent of Documents, when

necessary. VISA and MasterCard credit cards are accepted, also.

Orders for 100 or more copies to be mailed to a single address

are discounted 25 percent.

Orders by mail:

U.S. General Accounting Office

P.O. Box 37050

Washington, DC 20013

or visit:

Room 1100

700 4th St. NW (corner of 4th and G Sts. NW)

U.S. General Accounting Office

Washington, DC

Orders may also be placed by calling (202) 512-6000 

or by using fax number (202) 512-6061, or TDD (202) 512-2537.

Each day, GAO issues a list of newly available reports and

testimony. To receive facsimile copies of the daily list or any

list from the past 30 days, please call (202) 512-6000 using a

touchtone phone. A recorded menu will provide information on

how to obtain these lists.

For information on how to access GAO reports on the INTERNET,

send an e-mail message with "info" in the body to:

info@www.gao.gov

or visit GAO’s World Wide Web Home Page at:

http://www.gao.gov

PRINTED ON RECYCLED PAPER
United States

General Accounting Office

Washington, D.C. 20548-0001

Official Business

Penalty for Private Use $300

Address Correction Requested

Bulk Rate

Postage & Fees Paid

GAO

Permit No. G100