United States Government Accountability Office

GAO Testimony 

Before the Subcommittee on Human 

Resources, Committee on Ways and 

Means, House of Representatives

CHILD WELFARE 

Federal Oversight of State 

IV-B Activities Could Inform 

Action Needed to Improve 

Services to Families and 

Statutory Compliance 

Statement of Cornelia M. Ashby, Director 

Education, Workforce, and Income Security Issues 

For Release on Delivery

Expected at 2:00 p.m. EDT

Tuesday, May 23, 2006

 

GAO-06-787T 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

May 23, 2006

CHILD WELFARE

Federal Oversight of State IV-B Activities 

Could Inform Action Needed to Improve 

Services to Families and Statutory 

Compliance 

Highlights of GAO-06-787T, a testimony to 

Chairman, Subcommittee on Human 

Resources, Committee on Ways and 

Means, House of Representatives 

States used Title IV-B funds to provide a broad range of services to prevent 

the occurrence of abuse, neglect, and foster care placements in addition to 

other child welfare services. While there was some overlap, states reported 

using Title IV-B subpart 1 funds primarily to operate child welfare programs 

and serve families in the foster care system, while states reported using 

subpart 2 funds primarily for family services targeted to families at risk of 

child removal due to abuse and neglect. Some costs to operate programs 

included direct services to children and families. For example, nearly half 

of subpart 1 staff costs paid salaries for social worker positions in child 

protective services. Family services under subpart 2 included those to 

support, preserve, and reunify families by providing mentoring programs, 

financial assistance to help with rent and utilities, parenting classes, child 

care, and support groups.

States Reported Use of Federal Funds under Title IV-B, Fiscal Year 2002 

Subpart 1 Subpart 2 

Service category Amount Percent Amount Percent

Program operation $114,108,675 44.4 17,843,725 6.9

Child protective services 40,543,000 15.8 2,248,690 0.9 

Family services 36,624,068 14.2 182,720,128 71.3

Foster care and adoption 35,255,267 13.7 36,695,036 14.4

Miscellaneous 30,623,527 11.9 16,299,500 6.4

Total $257,154,537 100.0% $255,807,079 100.0% 

Source: GAO survey. 

Note: Percentages do not always total to 100 due to rounding. 

HHS provided relatively little oversight specific to state spending under 

subpart 1. HHS did not collect data on subpart 1 expenditures and regional 

officials paid little attention to statutory limits in states’ planned use of 

funds. In response to GAO’s survey, 10 states reported actual 2002 subpart 

1 expenditures that exceeded the spending limits by over $15 million in total. 

Research is limited assessing the effectiveness of services provided under 

Title IV-B. In GAO’s survey, 22 states reported providing services other than 

foster care and adoption assistance payments, staff salaries, or 

administration under subpart 1; however, none of these states had 

sufficiently evaluated the outcomes of these services. Similarly, GAO’s 

literature review showed that few evaluations had been conducted, and 

evaluations that had been conducted showed mixed results. HHS evaluations 

of subpart 2 services also have shown no or little effect in reducing out-ofhome placement, maltreatment recurrence, or improved family functioning 

beyond what normal casework services achieved. 

For federal fiscal year 2004, state

and local child protective services

staff determined that an estimated

872,000 children had been victims 

of abuse or neglect. Title IV-B 

subparts 1 and 2 authorize a wide

array of child welfare services, with 

some restrictions on states’ use of

funds. This testimony discusses: 

(1) how states used Title IV-B 

dollars to serve families under

subparts 1 and 2; (2) the extent that

federal oversight ensured state

compliance with spending

requirements under subpart 1; and 

(3) what the research said about

the effectiveness of services states 

have provided to families using

Title IV-B funds. 

This testimony was primarily based 

on a 2003 report (GAO-03-956). 

What GAO Recommends

The 2003 report recommended that

the Secretary of Health and Human

Services (HHS) consider collecting 

data on states’ use of Title IV-B 

subpart 1 funds, use these data in 

its design of alternative financing

options, and provide the necessary 

guidance to ensure state

compliance with statutory

restrictions on the use of subpart 1 

funds. HHS’s Administration for 

Children and Families (ACF) 

agreed with the report’s findings 

and implemented the 

recommendation to provide 

guidance to states. ACF disagreed

with the recommendation to collect

data from states and did not 

comment on using these data for its 

financing option. 

www.gao.gov/cgi-bin/getrpt?GAO-06-787T.

To view the full product, including the scope 

and methodology, click on the link above. 

For more information, contact Cornelia Ashby 

at (202) 512-8403 or ashbyc@gao.gov. 
United States Government Accountability Office

Washington, DC 20548 

 

Mr. Chairman and Members of the Subcommittee: 

I am pleased to be here today to present information from our 2003 report 

on how states used funds authorized under Title IV-B of the Social 

Security Act to help families address problems that lead to child abuse and 

neglect and subsequent separation of children from their families.1

 For 

federal fiscal year 2004, child protective services (CPS) staff in state and 

local child welfare agencies reported investigating or assessing an 

estimated 3 million allegations of child maltreatment and determined that 

approximately 872,000 children had been the victims of child abuse or 

neglect by their parents or other caregivers. Established in 1935, Title IV-B

first authorized funds to states that could be used to provide a wide array 

of child welfare services including those necessary to investigate reports 

of child maltreatment, remove children from their home and place them 

with a temporary foster family, help preserve or reunify families, and place 

children who cannot be safely reunified with their families in an adoptive 

home. 

The Congress has passed various laws over the years emphasizing the 

need for states to use Title IV-B funding to provide supportive services to 

preserve and reunify families. In 1980, for example, the Adoption 

Assistance and Child Welfare Act established a dollar cap on the amount 

of child welfare funds that states could use under Title IV-B for foster care 

and certain other activities to encourage states to use additional funding 

for services to families. In 1993, the Congress established the family 

preservation and family support services program under Title IV-B subpart 

2, authorizing funding to states for family preservation and communitybased family support services. The Adoption and Safe Families Act of 1997 

further encouraged spending on family support services by reauthorizing 

subpart 2, renaming it Promoting Safe and Stable Families, and expanding 

the types of programs on which states were authorized to spend Title IV-B

funds to include adoption promotion and support services and timelimited family reunification services. In fiscal year 2006, the Congress 

appropriated $287 million for child welfare services under subpart 1 and 

$394 million for family support services under subpart 2.2

 These funds are 

 1

GAO, Child Welfare:Enhanced Federal Oversight of Title IV-B Could Provide States

Additional Information to Improve Services, GAO-03-956 (Washington, D.C.: Sept. 12, 

2003). 

2

States are required to provide matching funds in order to receive federal Title IV-B 

funding. 

Page 1 GAO-06-787T 
administered to states by the Department of Health and Human Services’ 

(HHS) Administration for Children and Families (ACF). 

My testimony today is primarily based on information included in our 2003 

report. Specifically, I will be discussing: (1) how states used Title IV-B 

dollars to serve families under subparts 1 and 2; (2) the extent that federal

oversight ensured state compliance with spending requirements under 

subpart 1; and (3) what the research said about the effectiveness of 

services states have provided to families using Title IV-B funds. 

In summary, while overlap exists, states reported using Title IV-B subpart 

1 funds primarily to staff and administer child welfare programs and serve 

families in the foster care system, while states reported using subpart 

2 funds primarily for prevention and support services for families at risk of 

child abuse and neglect. It is difficult, however, to clearly differentiate 

among the various service categories and populations served. HHS 

provided relatively little oversight in how states spent federal funds under 

subpart 1, and at least 10 states spent a total of over $15 million over the 

legislated cap for foster care and adoption assistance payments. Although 

the predominance of federal funding spent for foster care and adoption 

assistance has long been cited as providing a disincentive to preserve and 

reunify families, little research is available on the effectiveness of the 

services subpart 1 funds provide and HHS evaluations of services funded 

under subpart 2 have generally shown no or little effect. Similarly, the 

extent that differences in how states spent funds to support children and 

families resulted in better or worse outcomes for children is unknown. 

To help address this information gap, our 2003 report recommended that

the Secretary of HHS consider the feasibility of collecting and using data 

on states’ use of Title IV-B subpart 1 funds. We made this recommendation 

not only to facilitate federal oversight and analysis of how states’ spending 

patterns correlate to child outcomes, but also so that HHS could use this 

data to inform the design of alternative funding proposals that would give 

states more flexibility in spending federal child welfare funds. We also 

recommended that the Secretary provide the necessary guidance to ensure 

compliance with statutory restrictions on the use of Title IV-B subpart 

1funds. ACF agreed with our findings and implemented guidance to states 

reminding them of the statutory requirements for subpart 1 spending. 

However, ACF disagreed with our recommendation to consider collecting 

data on subpart 1 expenditures. ACF believed that its level of oversight 

was commensurate with the scope and intent of subpart 1, noting that its

oversight efforts were more appropriately focused on reviews of the 

states’ overall child welfare systems. ACF did not comment on our 

Page 2 GAO-06-787T
recommendation to use such data to inform the design of an alternative

financing option. 

Our review was based on two surveys to child welfare directors to obtain 

information on how they use Title IV-B funds. We also visited four states—

California, New Jersey, Ohio, and Washington—where we interviewed 

state and local officials and service providers. We also held discussions 

with HHS headquarters and regional office officials and child welfare 

experts. We reviewed results from HHS’s assessments of state child 

welfare agencies as well as the literature assessing the effectiveness of 

various child welfare services. 

Title IV-B of the Social Security Act authorizes funds to states to provide 

an array of child welfare services to prevent the occurrence of abuse, 

neglect, and need to place children in foster care. The Administration for 

Children and Families within HHS is responsible for the administration 

and oversight of federal funding to states for child welfare services under

Title IV-B. HHS headquarters staff are responsible for developing 

appropriate policies and procedures for states to follow in obtaining and 

using federal child welfare funds, while staff in HHS’s 10 regional offices 

are responsible for providing direct oversight of state child welfare 

systems. No federal eligibility criteria apply to the children and families 

receiving services funded under Title IV-B. The amount of subpart 1 funds 

a state receives is based on its population under the age of 21 and the state 

per capita income, while subpart 2 funding is determined by the 

percentage of children in a state whose families receive food stamps. 

Background 

Subpart 1 provides grants to states for child welfare services, that are 

broadly defined. Subpart 1 funds are intended for services that are 

directed toward the accomplishment of the following purposes: 

• protect and promote the welfare of all children; 

• prevent or remedy problems that may result in the abuse or neglect

of children;

• prevent the unnecessary separation of children from their families 

by helping families address problems that can lead to out-of-home 

placements;

• reunite children with their families; 

• place children in appropriate adoptive homes when reunification is 

not possible; and 

Page 3 GAO-06-787T
• ensure adequate care to children away from their homes in cases in 

which the child cannot be returned home or cannot be placed for 

adoption. 

Subpart 2 services are similar to those allowed under subpart 1, although 

the range of services allowed under subpart 2 is more limited in some 

cases. For example, time-limited family reunification services can only be 

provided during a child’s first 15 months in foster care, while no such 

restriction is placed on the use of subpart 1 funds. In addition, states must 

spend a “significant portion” of their subpart 2 funds on each of four 

service categories:3

• Family preservation service. Services designed to help families at 

risk or in crisis, including services to (1) help reunify children with 

their families when safe and appropriate; (2) place children in 

permanent homes through adoption, guardianship, or some other 

permanent living arrangement; (3) help children at risk of foster 

care placement remain safely with their families; (4) provide followup assistance to families when a child has been returned after a 

foster care placement; (5) provide temporary respite care; and 

(6) improve parenting skills. 

• Family support services. Community-based services to promote 

the safety and well-being of children and families designed to 

increase the strength and stability of families, to increase parental 

competence, to provide children a safe and supportive family

environment, to strengthen parental relationships, and to enhance 

child development. Examples of such services include parenting 

skills training and home visiting programs for first time parents of 

newborns. 

• Time-limited family reunification services. Services provided to a 

child placed in foster care and to the parents of the child in order to 

facilitate the safe reunification of the child within 15 months of 

placement. These services include counseling, substance abuse 

treatment services, mental health services, and assistance to 

address domestic violence. 

 3

HHS program instructions require states to spend at least 20 percent of their subpart 

2 funds on each of the four service categories, unless a state has a strong rationale for 

some other spending patterns. By statute, states can spend no more than 10 percent of 

subpart 2 funds on administrative costs.

Page 4 GAO-06-787T
• Adoption promotion and support services: Services designed to 

encourage more adoptions of children in foster care when adoption 

is in the best interest of the child, including services to expedite the 

adoption process and support adoptive families. 

Federal child welfare funding has long been criticized for entitling states 

to reimbursement for foster care placements, while providing little funding

for services to prevent such placements. When the Congress enacted the 

Adoption Assistance and Child Welfare Act of 1980, it created a new 

funding source for foster care and adoption assistance under Title IV-E of 

the Social Security Act. Title IV-E provides an open-ended entitlement for 

foster care maintenance payments to cover a portion of the food, housing, 

and incidental expenses for all foster children whose parents meet certain

federal eligibility criteria.

4

 Title IV-E also provides payments to adoptive 

parents of eligible foster children with special needs.5

 While states could 

still use Title IV-B funding for foster care and adoption assistance for 

children ineligible under Title IV-E, the law established a dollar cap on the 

amount of Title IV-B funds that states could use for three categories of 

service: foster care maintenance payments, adoption assistance payments, 

and child care related to a parent’s employment or training. The law 

requires that the total of subpart 1 funds used for these categories cannot

exceed a state’s total 1979 subpart 1 expenditures for all types of services. 

The intent of this restriction, according to a congressional document, was 

to encourage states to devote increases in subpart 1 funding as much as 

possible to supportive services that could prevent the need for out-of-

 4

States are entitled to Title IV-E reimbursement on behalf of children who would have been 

eligible for Aid to Families with Dependent Children (AFDC) (as AFDC existed on July 16,

1996), but for the fact that they were removed from the home of certain specified relatives. 

While the AFDC program was replaced by the Temporary Assistance for Needy Families 

program in 1996, eligibility for Title IV-E payments remains tied to the income eligibility 

requirements of the now defunct AFDC program. In addition, certain judicial findings must

be present for the child, and all other requirements included in section 472 (a) and (b) of

the Social Security Act must be met, in order for the child to be eligible for Title IV-E foster

care maintenance payments. 

5

Special needs are characteristics that can make it difficult for a child to be adopted and 

may include emotional, physical, or mental disabilities, emotional disturbance, age, or 

being a member of a minority race. To qualify for an adoption subsidy under Title IV-E, a 

state must determine that the child cannot or should not return home; a state must make a

reasonable, but unsuccessful effort to place the child without the subsidy; and a specific 

factor or condition must exist that makes it difficult to place the child without a subsidy. 

Page 5 GAO-06-787T
home placements.6

 However, this restriction applies only to the federal

portion of subpart 1 expenditures, as the law provides that states may use 

any or all of their state matching funds for foster care maintenance 

payments. 

For the fourth consecutive year, the President’s budget proposes a Child 

Welfare Program Option. HHS developed the proposal to give states more 

flexibility in using Title IV-E foster care funds for preventive services such 

as those under Title IV-B. Under this proposal, states could voluntarily 

choose to receive a fixed IV-E foster care allocation (based on historic 

expenditure rates) over a 5-year period, rather than receiving a per child 

allocation. States could use this allocation for any services provided under

Titles IV-B and IV-E, but would also have to fund any foster care 

maintenance payments and associated administrative costs from this fixed 

grant or use state funds. No legislation to enact this option has been 

introduced.

While overlap exists, states reported using subpart 1 funding primarily for 

costs to staff and administer child welfare programs and serve families in

the foster care system, while states reported using subpart 2 funding for 

family support services and to serve families at risk for child abuse and 

neglect. Officials in almost all of HHS’s regional offices supported 

retaining the current balance between allowing states some flexibility in 

use of funds and targeting some resources toward prevention. States 

reported in our survey that flexibility was important to meet the needs of

their child welfare systems, and thus generally preferred the financing 

structure of subpart 1 over subpart 2 

States Used Subparts 

1 and 2 to Support 

Similar Services and 

Populations, but 

Funding Emphasis 

Differed 

States Emphasized 

Different Services under 

Subparts 1 and 2 

While states funded similar services under subparts 1 and 2, most states 

reported using subpart 1 funds primarily to pay for costs associated with 

operating child welfare programs, while most states reported using 

subpart 2 funds for family services as shown in table 1. For example, 

states used over 44 percent of subpart 1 funds to pay for staff salaries and 

costs to administer and manage programs. In contrast, states spent over 

 6

Staff of the House Committee on Ways and Means, 106th Congress, Background Material 

and Data on Programs Within the Jurisdiction of the Committee on Ways and Means 

(Comm. Print 2000). 

Page 6 GAO-06-787T
71 percent of subpart 2 funds for services to support, preserve, and reunify 

families. 

Table 1: States’ Reported Use of Federal Funds Under Title IV-B, fiscal year 2002 

Subpart 1 Subpart 2 

Service Category 

Number of 

states Amount Percent

Number of 

states Amounta Percent

b

Child Protective Services 17 $40,543,000 15.8 5 $2,248,690 0.9 

Program Operation

Staff positions 25 $70,965,578 27.6 17 $6,229,058 2.4

Administration and management 16 43,143,097 16.8 18 11,614,667 4.5

 Subtotal n/a $114,108,675 44.4 n/a $17,843,725 6.9

Family Services

Family support/prevention 17 19,840,891 7.7 28 127,430,496 49.8

Counseling and mental health services 2 8,350,562 3.2 5 1,354,763 0.5

Family preservation 7 5,986,045 2.3 23 30,308,896 11.8

Family reunification 4 2,446,570 1.0 26 23,625,973 9.2

Subtotal n/a $36,624,068 14.2 n/a 182,720,128 71.3

Foster care and adoption

Foster care maintenance payments 17 27,890,783 10.8 2 647,154 0.3

Adoption subsidy payments 7 4,657,546 1.8 2 737,412 0.3

Recruitment and training for foster/adoptive 

parents 

9 2,260,061 0.9 16 6,828,885 2.7

Adoption support and preservation services 2 446,877 0.2 27 28,481,585 11.1 

Subtotal n/a $35,255,267 13.7 n/a $36,695,036 14.4

Miscellaneous

Multiple responsesc8 25,806,347 10.0 4 3,503,585 1.4 

Other 11 4,817,180 1.9 15 12,795,915 5.0

Subtotal n/a $30,623,527 11.9 n/a $16,299,500 6.4

Total

d

 n/a $257,154,537 100.0 $255,807,079 100.0 

Source: GAO survey. 

Notes: Percentages do not always total to 100 due to rounding. 

Data on subpart 1 expenditures are based on survey responses from 46 states and data on subpart 2 

expenditures are based on survey responses from 44 states. While Pennsylvania responded to our 

survey, it did not provide expenditure data for subparts 1 or 2. 

a

When providing data for our survey, states were asked to indicate the single service category that 

best described the type of program funded by subparts 1 and 2. States may not have been consistent

in categorizing services. For example, several HHS officials told us that the delineation between 

family support and family preservation services is not clear, thus two states providing the same 

services to the same types of families may report them in different categories. Inconsistencies such

as these could have an effect on any measured differences among service categories. 

Page 7 GAO-06-787T
b

States may spend less than 20 percent of their subpart 2 funds on any of the required service 

categories if they have a strong rationale. Some HHS regional officials said that they approve 

exceptions to the 20 percent requirement if a state is spending a significant amount of nonfederal 

funds on a subpart 2 service category. 

c

Although states were asked to indicate the single service category that best described the type of 

program funded by subparts 1 and 2, several states selected multiple program categories when 

responding to our survey. For example, Rhode Island reported that it funded a home visitation 

program and indicated that this program includes family support, health, and family reunification 

services. Thus, the responses from states that reported multiple categories for a program are 

represented by this category. 

d

The aggregate dollars reported in the service categories do not match the total allocations for 

subparts 1 and 2 in fiscal year 2002. States have 2 years to spend their Title IV-B allocations. As a

result, expenditures in fiscal year 2002 may include dollars from a state’s fiscal year 2001 Title IV-B 

allocation, as well as its fiscal year 2002 Title IV-B allocation. Similarly, some fiscal year 2002 

allocations may not have been spent until fiscal year 2003. 

The majority of subpart 1 funds were spent on staff salaries, and 

Washington officials said that in their state, over half of these costs paid 

for staff providing direct services to children and families. Overall, states 

reported that nearly half of Title IV-B funds used for staff salaries 

supported social worker positions in child protective services. Another 20 

percent of funds supported positions for other social workers. The 

remaining costs supported other staff including those providing 

supervision of caseworkers and legal services. (See fig. 1.) 

Subpart 1 Services 

Page 8 GAO-06-787T
Figure 1: Proportion of Title IV-B Funds States Reported Using to Support Staff 

Salaries under Subpart 1 by Position, Fiscal Year 2002 

47%

CPS social workers/staff

20% All other social workers

20%

•

Other staff

• • • •

•

•

3%

Supervisory social workers

3%

Legal services staff

4%

Administrative staff

4%

Management staff

Source: GAO survey data.

Notes: Some states spent subpart 1 funds on salaries, but could not provide information on the types 

of staff positions included. 

Percentages do not total to 100 due to rounding.

The remaining subpart 1 funds were split fairly evenly among 

administration and management, child protective services, and foster care

maintenance payments:

• Administration and management comprised the second largest 

category of subpart 1 expenditures, accounting for almost 17 

percent of subpart 1 dollars. These services included rent and

utilities for office space, travel expenses for agency staff, and staff 

training.7

 7

This amount may be understated since some states may not have separately reported

administrative expenses associated with a specific program. For example, officials in one 

state reported that the total spending for a family support program included salaries for 

agency staff, overhead expenses, and related staff travel. 

Page 9 GAO-06-787T
• Child protective services represent the third largest category of 

subpart 1 expenditures. States reported using about 16 percent of 

their subpart 1 funds to provide a variety of CPS services, such as 

telephone hotlines for the public to report instances of child abuse 

and neglect, emergency shelters for children who needed to be

removed from their homes, and investigative services. 

• States reported using nearly 11 percent of their subpart 1 funds to 

make recurring payments for the room and board of foster children 

who were not otherwise eligible for federal reimbursement. For 

example, New Jersey officials reported spending over half of the 

state’s subpart 1 funds on foster care maintenance payments.

States reported using over 70 percent of their subpart 2 dollars on serving 

families, with nearly half of these funds used to fund family support and 

prevention services. These services included mentoring programs to help 

pregnant adolescents learn to be self-sufficient, financial assistance to lowincome families to help with rent and utilities, parenting classes, child 

care, and support groups provided by community-based resource centers. 

Subpart 2 Services 

The remaining subpart 2 funds were split fairly evenly among family 

preservation, family reunification, and services to support and preserve 

adoptive families. 

• Family preservation services accounted for nearly 12 percent of 

subpart 2 dollars. Services provided by Washington state in this 

category included counseling and parent training services for up to 

6 months for families with children who were at risk of being placed 

in foster care. 

• Adoption support and preservation services accounted for over 11 

percent of subpart 2 dollars. With these funds, states provided

services such as counseling for children who were going to be

adopted, family preservation services to adoptive families, and 

respite care for adoptive families. Officials in Ohio reported using 

almost half of its subpart 2 dollars for adoption services, including 

post adoption services and services to recruit families for children 

in need of homes. 

• Family reunification services accounted for over 9 percent of 

subpart 2 funds. These services included supervised visitation

centers for parents to visit with their children who were in foster 

care and coordinators for alcohol and drug treatment services for 

families whose primary barrier to reunification was substance 

abuse. New Jersey funded a supervised visitation program that 

offered parenting education, counseling, transportation, and 

Page 10 GAO-06-787T
support groups and was located in a private home, allowing families 

to visit together in a homelike setting and engage in more natural 

interactions.

States Emphasized 

Different Populations 

Served Under Subparts 

1 and 2 

States served similar populations under subparts 1 and 2; however, states 

reported using most subpart 1 funds primarily to serve families whose 

children had been removed from the home, while most subpart 2 funds 

were reported to serve families with children at risk of removal due to 

child abuse or neglect, as shown in table 2. For example, states used 42 

percent of subpart 1 funds to serve children in foster care and/or their 

parents. In contrast, states used 44 percent of subpart 2 funds for children 

at risk of child abuse and neglect and/or their parents. 

Table 2: Populations Served under Subparts 1 and 2 of Title IV-B as Reported by States, Fiscal Year 2002 

Subpart 1 Subpart 2 

Population served 

Number of 

services 

Amount of

funding 

Percent of

funding 

Number of 

services 

Amount of

funding 

Percent of

funding 

Children in foster care and/or their parents 33 $34,732,673 42 46 $15,218,065 9 

Children at risk of child abuse and neglect 

and/or their parents 

28 13,751,328 17 133 73,996,404 44

Multiple populations 21 11,949,444 14 43 18,119,756 11

Children at risk of child abuse or neglect 

and/or their parents and children living in

foster care and/or their parents 

12 7,077,448 9 39 17,606,172 11

All populations 5 7,513,368 9 7 11,028,464 7

Children waiting for adoption, adopted 

children, and adoptive parents 

9 4,153,271 5 54 27,340,372 16

Other populations, such as delinquent 

teens and foster parents 

10 3,492,142 4 16 3,336,070 2

Total

a

118 $82,669,674 100 338 $166,645,301 100

Source: GAO survey. 

Note: This analysis is based on survey responses from 35 states with state-administered child welfare 

systems that provided population data for their subpart 1 services and 39 states with stateadministered child welfare systems that provided population data for their subpart 2 services. 

Therefore, these data can only be generalized to states with state-administered child welfare 

systems. 

a

The dollar totals in this table do not match those in table 1 because we do not have population data 

from states that completed the county-administered survey. Due to the differences in information 

available from states with county-administered child welfare systems, we did not request data from 

these states on the types of children and families who received services funded by Title IV-B. In 

addition, we did not collect data on the populations served for the category of staff salaries, and we

excluded population data for the category of administration and management expenses since these 

expenses are not targeted to a particular population of children and families.

Page 11 GAO-06-787T
In our survey, we asked states for more detailed information about the 

populations served by programs under subparts 1 and 2, such as 

demographic and socioeconomic characteristics. However, few states 

were able to provide this data. For selected subpart 1 services, 10 states 

were able to estimate the extent to which the same children and families 

also received services under subpart 2: 

• four states reported that generally none or almost none of the 

recipients also received a service funded by subpart 2, 

• three states reported that generally less than half of the recipients 

received subpart 2 services, 

• one state reported that all or almost all recipients received subpart 

2 services, and 

• two states provided varying estimates for different subpart 1 

services. 

HHS Officials and States 

Supported Flexibility of 

Title IV-B Funding 

Officials in almost all of HHS’s regional offices supported retaining the 

current balance between allowing states some flexibility in use of funds 

and targeting some resources toward prevention, regardless of whether 

federal funding sources are combined under alternative financing options. 

One regional official noted that the current financing structure of subpart 

1 gives states the flexibility to address unexpected circumstances affecting 

the child welfare system—for example, the need to develop substance 

abuse treatment programs for parents affected by the cocaine epidemic of

the 1980s.8

 Other regional officials noted that the spending requirements 

under subpart 2 helped ensure that states used some funds on family 

support services and prevention activities to help preserve families and 

keep children from entering foster care. 

States reported in our survey that flexibility was important to meet the 

needs of their child welfare systems, and thus generally preferred the 

financing structure of subpart 1 over subpart 2, as shown in figure 2. 

 8

States face similar challenges addressing the service needs of families caused by the

current epidemic of methamphetamine use. 

Page 12 GAO-06-787T
Figure 2: State Reported Preferences for Financing Structure of Subparts 1 and 2 of

Title IV-B 

0

5

10

15

20

25

30

Allowable 

spending

categories

Spending

restrictions

Subpart 1 preferred

Subpart 2 preferred

Equally preferred

Not applicable

Source: GAO survey data.

Number of states expressing a preference

Note: Data on state preferences are based on responses from 46 states, although they did not all 

respond to each item. 

HHS provided relatively little oversight specific to state spending under 

subpart 1. HHS does not collect data on subpart 1 expenditures, relying 

instead on cursory reviews of plans submitted by states that discuss how 

they intend to use their subpart 1 funds in the coming year. HHS regional 

officials reported that they review these plans for relatively limited 

purposes because there are few restrictions on how states can spend 

subpart 1 dollars. We also found that HHS regional offices had paid little 

attention to statutory limits in states’ planned use of subpart 1 funds. In 

response to our survey, 10 states reported actual 2002 subpart 1 

expenditures that exceeded the spending limits by over $15 million in 

total. 

Federal Oversight 

Insufficient to Ensure 

State Compliance 

with Title IV-B 

Spending 

Requirements under 

Subpart 1 

Page 13 GAO-06-787T
HHS received forms from states each year that showed how they planned 

to spend subpart 1 funds, but had little information on how states actually 

spent these funds. Officials from four HHS regional offices said that they 

generally reviewed the forms to ensure that states were requesting the 

total amount of subpart 1 funds to which they were entitled, and that they 

complied with the requirement to match 25 percent of subpart 1 funds 

with state funds. Most regional offices indicated that their review of the 

state submitted forms focused more on subpart 2 than subpart 1. For 

example, they reported reviewing planned subpart 2 spending to ensure 

that states complied with the requirement to spend at least 20 percent of 

funds on each of the service categories and spend no more than 10 percent 

of funds for administrative purposes. Several HHS officials said that they 

did not monitor subpart 1 funds as closely as other federal child welfare 

funds due to the relatively small funding amount and the lack of detailed 

requirements about how these funds could be spent. 

HHS Had Little 

Information about States’ 

Use of Subpart 1 Funds 

Oversight of subpart 1 was further limited because spending plans states 

provided on the annual forms may not reliably show how states actually 

spent Title IV-B funds. HHS officials explained that states’ actual 

expenditures may vary from planned expenditures as states address 

unforeseen circumstances. The timing for submitting the annual forms 

also affected how well states could plan Title IV-B spending. HHS required 

states to submit their initial spending plans for the upcoming year by June 

30, prior to states receiving information on program appropriations for the 

upcoming year. While we did not conduct a review comparing state 

submitted planned expenditures to actual expenditures for previous years, 

we did identify instances that suggested differences in planned and actual

expenditures as well as data on actual expenditures that were not always

accurate. For example, two states with county-administered child welfare 

systems said they could not reliably estimate planned spending by service 

category because the states did not collect expenditure data from county 

child welfare agencies that administer Title IV-B funds.9

One regional official explained that the only way to determine how a state 

actually used its Title IV-B funds was to review its financial accounts. At 

the time of our review, three regional offices had indicated that they had

begun asking states to provide Title IV-B expenditure data. 

 9

Most states administer their child welfare systems at the state level; however a few states 

delegate administrative responsibility and control to counties or other local entities. 

Several large states, such as California, New York, Ohio, and Pennsylvania, are countyadministered. 

Page 14 GAO-06-787T
HHS regional offices paid little attention to the statutory limits on the use 

of subpart 1 funds for foster care maintenance and adoption assistance. 

Officials in only 1 of HHS’s 10 regional offices said that they ensured state 

plans complied with statutory spending limits for subpart 1. In contrast, 5 

regional offices were unaware that any limits on the use of subpart 1 funds 

existed. Four other regional offices were aware that some limitations 

existed, but did not ensure state compliance with them. 

HHS Regional Offices Were 

Unaware of Spending 

Limits or Did Not Enforce 

Them 

Two regional offices said they did not monitor planned expenditures for 

subpart 1 because they had no data to calculate the spending limit for each 

state, and HHS had not provided guidance on how to enforce the limits. 

Officials in another region said that their office discontinued subpart 1 

compliance reviews because they considered the limits to be meaningless 

because state and federal funds are fungible and state funds spent on child 

welfare services greatly exceeded subpart 1federal funds. In other words, 

any attempt to enforce the limits, according to these officials, would only 

lead to changes in how states accounted for state and federal funds. 

Some states reported in our survey that they spent 2002 subpart 1 funds in

excess of the statutory authority for foster care maintenance and adoption 

assistance payments. (See fig. 4.) While spending excesses were small in 

some states, they were large in others, ranging from a low of $27,000 in

New Hampshire to nearly $4 million in Michigan. In total, reported actual

spending by the 10 states exceeded the statutory limit by over $15 million.

Page 15 GAO-06-787T
Figure 4: States Reporting Actual Expenditures in Excess of Statutory Authority for Foster Care Maintenance and Adoption 

Assistance Payments under Title IV-B, Subpart 1, Fiscal Year 2002 

Statutory limit on total subpart 1 spending for foster care maintenance and adoption assistance payments

Combined subpart 1 expenditures for foster care maintenance and adoption assistance payments (as

reported on GAO’s survey)

Source: Analysis of GAO survey and HHS data.

Dollars in millions

$0

Colo. Fla. Kans. Mich. Nev. N.H. N.J. N. Mex. Okla. S. Dak.

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

$7,000,000

Subsequent to our review, ACF issued guidance to states reminding them 

of the statutory spending limits for Title IV-B subpart 1 funds in November 

2003. This guidance included information needed by each state to 

calculate its spending limit for foster care and adoption assistance 

payments, and day care related to employment or training. 

Page 16 GAO-06-787T
Research on the effectiveness of services provided under subpart 1of Title 

IV-B was limited, and HHS evaluations of subpart 2 services showed no or 

little effect on children’s outcomes. In our survey, 22 states reported 

providing services other than maintenance payments, staff salaries, or 

administration under subpart 1; however, none of these states had 

evaluated the outcomes of these services. One state official said that few 

states could afford to divert resources away from direct services to 

families in order to conduct formal program evaluations, given the 

tremendous service needs of families involved in the child welfare system. 

Little Research 

Existed on the 

Effectiveness of Title 

IV-B Services 

Similarly, our literature review showed that few evaluations had been

conducted, and evaluations that had been conducted produced mixed 

results. For example, one study evaluating a program10 in Texas to increase 

family literacy and prevent child abuse by enhancing parent-child 

interactions cited results showing positive effects on children’s measured 

competence and classroom behavior. However, evaluation of the same 

program in New York did not consistently show differences in outcomes 

for children and parents in the program compared to those in a control 

group. 

HHS evaluations of subpart 2 services also have shown no or little effect, 

as reported by the Congressional Research Service.11 The Congress 

required HHS to evaluate the effectiveness of programs funded under 

subpart 2 as part of its initial approval of funding for family preservation 

and family support services. HHS focused on the use of subpart 2 funds in 

three large-scale evaluations. One looked at overall implementation issues 

for the program, the second looked at the effectiveness of two models of 

family preservation services (both providing relatively intensive 

casework), and the third looked at the effectiveness of a wide range of 

family support services. Overall, the findings were similar across all 

evaluation sites showing subpart 2 services provided no or little effect in 

reducing out-of-home placement, maltreatment recurrence, or improved 

 10The Home Instruction for Parents of Preschool Youngsters (HIPPY) program has a goal to 

prevent academic underachievement of children when they enter school. HIPPY works 

with parents in their homes or in parent groups to increase the degree of literacy in the 

home. The program also seeks to prevent child abuse by enhancing child-parent 

interactions and focuses on economically disadvantaged parents who may not be involved

in parenting programs. 

11Congressional Research Service, The Promoting Safe and Stable Families Program: 

Reauthorization in the 109th Congress, April 7, 2006., pp. 10-18. 

Page 17 GAO-06-787T
family functioning beyond what normal casework services achieved.12 No 

similar large scale evaluations of time-limited reunification services or of 

adoption promotion and support services have been made. 

Our 2003 report recommended that the Secretary of HHS provide the

necessary guidance to ensure that HHS regional offices are providing 

appropriate oversight of subpart 1, consider the feasibility of collecting 

data on states’ use of these funds to facilitate program oversight and 

guidance to states, and use the information gained through enhanced 

oversight of subpart 1 to inform its design of alternative child welfare 

financing options. ACF agreed with our findings and implemented 

guidance to states reminding them of the statutory requirements for 

subpart 1 spending. ACF disagreed with our recommendation to consider 

collecting data on subpart 1 expenditures. ACF believed that its level of 

oversight was commensurate with the scope and intent of subpart 1, 

noting that its oversight efforts are more appropriately focused on reviews 

of the states’ overall child welfare systems. ACF did not comment on our 

recommendation to use such data to inform the design of an alternative

financing option. 

Prior 

Recommendations 

Mr. Chairman, this completes my prepared statement. I would be happy to

respond to any questions you or other Members of the Subcommittee may 

have. 

 12U.S. Department of Health and Human Services, Evaluation of Family Preservation and

Reunification Programs, Final Report (Volumes 1 and 2), Dec. 2002. 

Page 18 GAO-06-787T
Page 19 GAO-06-787T

Appendix I: GAO Contact and 

Acknowledgments 

For further information regarding this testimony, please contact me at 

(202) 512-8403. Individuals making key contributions to this testimony 

include Lacinda Ayers, Diana Pietrowiak, and Michelle St. Pierre. 
Appendix II: Related GAO Products 

Page 20 GAO-06-787T

Appendix II: Related GAO Products 

Lessons Learned for Protecting and Educating Children after the Gulf 

Coast Hurricanes. GAO-06-680R. Washington, D.C.: May 11, 2006. 

District of Columbia: Federal Funds for Foster Care Improvements Used 

to Implement New Programs, but Challenges Remain. GAO-05-787. 

Washington, D.C.: July 22, 2005. 

Child Welfare: Better Data and Evaluations Could Improve Processes 

and Programs for Adopting Children with Special Needs. GAO-05-292. 

Washington, D.C.: June 13, 2005. 

Indian Child Welfare Act: Existing Information on Implementation 

Issues Could Be Used to Target Guidance and Assistance to States. 

GAO-05-290. Washington, D.C.: April 4, 2005. 

Foster Youth: HHS Actions Could Improve Coordination of Services and 

Monitoring of States’ Independent Living Programs. GAO-05-25. 

Washington, D.C.: November 18, 2004. 

D.C. Child And Family Services Agency: More Focus Needed on Human 

Capital Management Issues for Caseworkers and Foster Parent 

Recruitment and Retention. GAO-04-1017. Washington, D.C.: September 

24, 2004. 

Child And Family Services Reviews: States and HHS Face Challenges in

Assessing and Improving State Performance. GAO-04-781T. Washington,

D.C.: May 13, 2004. 

D.C. Family Court: Operations and Case Management Have Improved, 

but Critical Issues Remain. GAO-04-685T. Washington, D.C.: April 23, 

2004. 

Child and Family Services Reviews: Better Use of Data and Improved 

Guidance Could Enhance HHS’s Oversight of State Performance. 

GAO-04-333. Washington, D.C.: April 20, 2004. 

Child Welfare: Improved Federal Oversight Could Assist States in 

Overcoming Key Challenges. GAO-04-418T. Washington, D.C.: January 28, 

2004. 

D.C. Family Court: Progress Has Been Made in Implementing Its 

Transition. GAO-04-234. Washington, D.C.: January 6, 2004. 
Appendix II: Related GAO Products 

Child Welfare: States Face Challenges in Developing Information 

Systems and Reporting Reliable Child Welfare Data. GAO-04-267T. 

Washington, D.C.: November 19, 2003. 

Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide 

States Additional Information to Improve Services. GAO-03-956. 

Washington, D.C.: September 12, 2003. 

Child Welfare: Most States Are Developing Statewide Information 

Systems, but the Reliability of Child Welfare Data Could be Improved.

GAO-03-809. Washington, D.C.: July 31, 2003. 

D.C. Child and Family Services: Key Issues Affecting the Management of 

Its Foster Care Cases. GAO-03-758T. Washington, D.C.: May 16, 2003. 

Child Welfare and Juvenile Justice: Federal Agencies Could Play a 

Stronger Role in Helping States Reduce the Number of Children Placed 

Solely to Obtain Mental Health Services. GAO-03-397. Washington, D.C.: 

April 21, 2003. 

Foster Care: States Focusing on Finding Permanent Homes for Children, 

but Long-Standing Barriers Remain. GAO-03-626T. Washington, D.C.: 

April 8, 2003.

Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare 

Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March 

31, 2003. 

Foster Care: Recent Legislation Helps States Focus on Finding 

Permanent Homes for Children, but Long-Standing Barriers Remain. 

GAO-02-585. Washington, D.C.: June 28, 2002. 

District of Columbia Child Welfare: Long-Term Challenges to Ensuring 

Children’s Well-Being. GAO-01-191. Washington, D.C.: December 29, 2000. 

Foster Care: HHS Should Ensure That Juvenile Justice Placements Are 

Reviewed. GAO/HEHS-00-42. Washington, D.C.: June 9, 2000.

Juvenile Courts: Reforms Aim to Better Serve Maltreated Children.

GAO/HEHS-99-13. Washington, D.C.: January 11, 2000. 

Foster Care: States’ Early Experiences Implementing the Adoption and 

Safe Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999. 

Page 21 GAO-06-787T
Appendix II: Related GAO Products 

Foster Care: HHS Could Better Facilitate the Interjurisdictional 

Adoption Process. GAO/HEHS-00-12. Washington, D.C.: November 19, 

1999. 

Foster Care: Effectiveness of Independent Living Services Unknown. 

GAO/HEHS-00-13. Washington, D.C.: November 5, 1999. 

Child Welfare: States’ Progress in Implementing Family Preservation 

and Support Services. GAO/HEHS-97-34. Washington, D.C.: February 18, 

1997. 

Child Welfare: Opportunities to Further Enhance Family Preservation 

and Support Activities. GAO/HEHS-95-112. Washington, D.C.: June 15, 

1995. 

(130583) Page 22 GAO-06-787T
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