United States Government Accountability Office

GAO Report to the Ranking Minority

Member, Subcommittee on Human 

Resources, Committee on Ways and 

Means, House of Representatives 

CHILD WELFARE

Improving Social 

Service Program, 

Training, and 

Technical Assistance 

Information Would 

Help Address Longstanding Service-Level 

and Workforce 

Challenges 

October 2006 

 

GAO-07-75 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

October 2006

CHILD WELFARE

Improving Social Service Program, 

Training, and Technical Assistance 

Information Would Help Address Longstanding Service-Level and Workforce 

Challenges 

Highlights of GAO-07-75, a report to 

Minority Member, Subcommittee on 

Human Resources, Committee on Ways 

and Means, House of Representatives 

Despite substantial federal and state 

investment, states have not been able

to meet all outcome measures for 

children in their care. Given the 

complexity of the challenges that 

state child welfare agencies face, 

GAO was asked to determine (1) the

primary challenges state child 

welfare agencies face in their efforts 

to ensure the safety, well-being, and 

permanent placement of the children

under their supervision; (2) the 

changes states have made to improve 

the outcomes for children in the 

child welfare system; and (3) the 

extent to which states participating 

in the Department of Health and 

Human Services (HHS) Child and 

Family Services Reviews (CFSR) and 

technical assistance efforts find the 

assistance to be helpful. GAO

surveyed child welfare agencies in 

50 states, the District of Columbia, 

and Puerto Rico and visited 5 states, 

interviewed program officials, and 

reviewed laws, policies, and reports. 

What GAO Recommends

GAO recommends that HHS develop

a strategy to centralize federal 

program information, record all 

technical assistance to states in its

Technical Assistance Tracking 

Internet System, and ensure that 

these data are complete, accurate, 

and timely. HHS agreed that data 

should be complete, accurate, and

timely, but disagreed that centralized

program information and recording

all technical assistance would 

adequately address states’ child 

welfare challenges or improve their 

ability to more effectively allocate 

technical assistance to states. GAO

continues to support these

recommendations. 

In response to a GAO survey, state child welfare agencies identified three 

primary challenges as most important to resolve to improve outcomes for 

children under their supervision: providing an adequate level of services for 

children and families, recruiting and retaining caseworkers, and finding

appropriate homes for certain children. State officials also identified three 

challenges of increasing concern over the next 5 years: children's growing

exposure to illegal drugs, increased demand to provide services for children 

with special needs, and changing demographic trends or cultural sensitivities

in providing services for some groups of children in the states’ child welfare

systems. 

Child Welfare Challenges Reported by States, in Fiscal Year 2006, as the Top Three Most

Important Challenges to Resolve 

0 5 10 15 20 25 30 35 40

Research, evaluation, and planning issues

Performance and procedures issues

Collaboration and coordination of services

Distribution of federal funding

Placement issues

Recruit/retain caseworkers

Services for children/families

Number of states

Source: GAO analysis of state child welfare survey responses.

39

35

29

22

11

10

4

Most states reported that they had implemented initiatives to address challenges 

associated with improving the level of services, recruiting and retaining

caseworkers, and finding appropriate homes for children. These initiatives, 

however, did not always mirror the major challenges. For example, with respect

to services, states most frequently identified that they were challenged by the

lack of mental health and substance abuse services for children and families, yet 

only a fourth of the dissatisfied states reported having initiatives to improve the 

level of these services. In states where evaluations of their initiatives had been 

completed under a federal demonstration project, the evaluations generally

showed that states had achieved mixed results across child welfare outcomes. 

States we visited reported that HHS reviews of their child welfare systems and 

training and technical assistance efforts helped them improve their child welfare 

programs. For example, officials in three of the five states we visited reported 

that the CFSRs prompted them to develop interagency strategies for providing 

an array of needed services to children and families. Similarly, nearly all states in 

our survey reported that HHS-sponsored technical assistance was helpful to 

some degree. However, HHS officials said that several factors limited their 

ability to use their technical assistance tracking system as a management tool. 

For example, not all service providers are included in the tracking system, and 

some providers inconsistently enter required data into the system. As a result, 

HHS may be limited in its ability to determine how best to allocate technical 

assistance resources to help maximize states’ ability to address child welfare

issues. 

www.gao.gov/cgi-bin/getrpt?GAO-07-75.

To view the full product, including the scope 

and methodology, click on the link above. 

For more information, contact Cornelia M. 

Ashby at (202) 512-7215 or

ashbyc@gao.gov. 
Contents 

Letter 1

Results in Brief 3

Background 5

States Identified Several Long-standing and Emerging Challenges 

to Ensuring Child Safety, Well-Being, and Permanency 7 

Emerging Challenges Include Children’s Exposure to Illegal Drugs, 

Caring for Special Needs Children, and Responding to Changing 

Demographics of the Child Welfare Population 19 

State Initiatives Insufficiently Address State Challenges to Improve 

Child Outcomes, and Evaluations Showed Mixed Results 20 

States Generally Found HHS Reviews and Technical Assistance 

Helpful, but HHS’s Monitoring System Has Limitations 26 

Conclusions 29

Recommendations for Executive Action 30 

Agency Comments and Our Evaluation 30 

Appendix I Objectives, Scope, and Methodology 33 

Appendix II Federal Funding for State Child Welfare Programs 36 

Appendix III Type, Description, and Status of Title IV-E Waiver 

Demonstration Programs, as of August 2006 38 

Appendix IV Department of Health and Human Services Child 

Welfare National Resource Centers and whether 

They Are Included in the Technical Assistance 

Tracking Internet System Database 41 

Appendix V Comments from the Department of Health and 

Human Services 42 

Page i GAO-07-75 Child Welfare
Appendix VI GAO Contacts and Staff Acknowledgments 47 

Related GAO Products 48 

Tables 

Table 1: Child and Family Services Review Results Related to the 

Three Most Important Child Welfare Challenges Reported 

by States 10 

Table 2: State-Reported Use and Assessment of HHS Training and 

Technical Assistance 28 

Figures 

Figure 1: Child Welfare Challenges Reported by States as the Three 

Most Important Challenges to Resolve 8 

Figure 2: States Reporting Dissatisfaction with the Level of 

Services Provided to Children in the Child Welfare System 11 

Figure 3: States Reporting Dissatisfaction with the Level of 

Services Provided to Parents of At-Risk Families in the 

Child Welfare System 12 

Figure 4: States Reporting Dissatisfaction with the Level of 

Services Provided to Children and to Parents of At-Risk 

Families in the Child Welfare System 13 

Figure 5: States Reporting Dissatisfaction with Factors That Could 

Affect the State’s Ability to Recruit and Retain 

Caseworkers 15

Figure 6: States Reporting Factors of Greatest Concern in Making 

Appropriate Placements for Children 17 

Figure 7: State-Reported Emerging Issues That Are Likely to Affect 

Children in Child Welfare System over the Next 5 Years 19 

Figure 8: State-Reported Initiatives to Improve Services to Children 

and Families 22 

Figure 9: State-Reported Initiatives to Recruit and Retain 

Caseworkers 23

Figure 10: State-Reported Initiatives to Find Appropriate Homes 

for Children 25 

Page ii GAO-07-75 Child Welfare
Abbreviations 

ACF Administration for Children and Families 

CAPTA Child Abuse Prevention and Treatment Act 

CFDA Catalog of Federal Domestic Assistance 

CFSR Child and Family Services Reviews 

CHA Children's Health Act 

CPS Child Protective Services

CWLA Child Welfare League of America 

HHS Health and Human Services 

NRC national resource center 

PIP program improvement plan 

TANF Temporary Assistance for Needy Families 

TATIS Technical Assistance Tracking Internet System 

VCAA Victims of Child Abuse Act 

This is a work of the U.S. government and is not subject to copyright protection in the 

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reproduce this material separately. 

Page iii GAO-07-75 Child Welfare
United States Government Accountability Office

Washington, DC 20548 

October 6, 2006 

The Honorable Jim McDermott 

Ranking Minority Member 

Subcommittee on Human Resources 

Committee on Ways and Means 

House of Representatives 

Despite substantial federal and state investment in various social services, 

states continue to receive more than 2 million reports of child 

maltreatment each year and report having more than half a million 

children in state foster care systems. While children in foster care were 

removed from their homes to protect them from harm or neglect, states 

have struggled to meet established federal child welfare standards for 

ensuring the safety and well-being of these children in their care. Between 

March 2001 and March 2004, in its first round of Child and Family Services 

Reviews (CFSR) evaluating each state’s1 child welfare program, the U.S. 

Department of Health and Human Services (HHS) found that no state had

achieved all of the federal outcome measures for ensuring the safety, wellbeing, and permanency2

 of children.

For fiscal year 2006, Congress appropriated about $8 billion to support the 

ability of state child welfare systems to provide services that protect 

children from abuse and neglect, promote their physical and mental wellbeing, find them a permanent home, and enable families to successfully 

care for their children, including those children with special needs.3 At the 

federal level, HHS’s Children’s Bureau under the Administration for 

Children and Families (ACF) establishes federal policy, oversees states’ 

child welfare programs in part through its CFSRs, and provides technical 

assistance to states primarily through its national resource centers (NRCs) 

and HHS regional offices. State child welfare agencies administer the 

programs and monitor the children and their families. States use federal 

 1

In this report, we use the term states to refer collectively to the 50 states plus the District 

of Columbia and Puerto Rico. 

2

Permanency is defined as providing a lifetime commitment to a child in a setting where he

or she is safe, can have a sense of belonging and well-being, and can live to adulthood. 

3

Special needs are factors that can include medical, emotional, mental, or behavioral needs

that will require ongoing assistance and support, age, or membership in a minority group. 

Page 1 GAO-07-75 Child Welfare
funds to support all aspects of the child welfare program, including 

helping families stay together; providing financial support for families 

fostering children who had been removed from their homes; finding 

adoptive or other permanent homes for children; and recruiting, hiring, 

and training child welfare employees. 

Given the complexity of the challenges facing state child welfare agencies, 

you asked us to determine (1) the primary challenges state child welfare 

agencies face in their efforts to ensure the safety, well-being, and 

permanency of the children under their supervision; (2) the changes states 

have made since January 1, 20024

, to improve the outcomes for children in

the child welfare system; and (3) the extent to which states participating in

HHS’s Child and Family Services Reviews and technical assistance efforts 

find the assistance to be helpful. As part of this work, GAO also examined 

the extent to which states had developed written child welfare disaster 

plans for dealing with the dispersion of children under state care to other 

counties or states, because of disasters. In July 2006, GAO issued the 

report Child Welfare: Federal Action Needed to Ensure States Have Plans

to Safeguard Children in the Child Welfare System Displaced by 

Disasters (GAO-06-944) in response to the disaster planning part of your 

request. 

We used multiple data collection methods to obtain this information. First, 

we surveyed state child welfare directors in 50 states, the District of 

Columbia, and Puerto Rico to obtain information on the most important 

challenges that their agencies faced, the changes that their agencies had

made since 2002 to improve the outcomes for children, the extent to which 

their states participated in HHS’s oversight and technical assistance 

efforts, and the extent to which they viewed the assistance as helpful. We 

achieved a 96 percent response rate. Second, we interviewed child welfare 

officials in five states: California, New York, North Carolina, Texas, and 

Utah. These states were selected for variance in program administration

(state-administered, state-supervised/county-administered, state- and 

county-administered), the predominance of urban or rural characteristics, 

the achievement of child welfare standards on the CFSRs, changes in the 

number of children reported to be in foster care, and geographic location.

We interviewed federal child welfare officials and representatives from 

 4

The first round of HHS’s Child and Family Services Reviews began in March 2001. By 

January 2002, states had begun to develop programs improvement plans and implement 

changes to address the child welfare areas that were identified as needing improvement

during the reviews. 

Page 2 GAO-07-75 Child Welfare
national child welfare organizations concerning state child welfare 

programs, the changes that states had made since 2002 to improve the 

outcomes for children, and the extent to which states participated in 

HHS’s CFSRs and technical assistance efforts. In addition, we reviewed 

several national studies and our previous child welfare reports to 

determine the challenges that states face in their efforts to ensure the 

safety, well-being, and permanency of the children under their supervision. 

Finally, we analyzed agency documentation, legislation, and other 

documentation related to child welfare programs and requirements. We 

conducted our work between October 2005 and August 2006 in 

accordance with generally accepted government auditing standards. 

State child welfare agencies identified three primary challenges as most 

important to resolve to improve outcomes for children under their 

supervision: providing an adequate level of services for children and 

families, recruiting and retaining caseworkers, and finding appropriate 

homes for certain children. Specifically, most states expressed 

dissatisfaction with the level of mental health and substance abuse 

services for both parents and children, the high average number of child 

welfare cases per worker, and their ability to find homes for children with 

special needs, such as those with developmental disabilities. GAO, child 

welfare organizations, and the Administration have consistently shown 

these issues to be long-standing challenges for most states and have 

pointed to the need for a multi-agency approach to addressing them. For 

example, to address the lack of information on available services, the 

White House Task Force for Disadvantaged Youth recommended in 2003

that the Catalog of Federal Domestic Assistance (CFDA)—a repository of 

information on all federal assistance programs—be modified to provide a 

search function of the locations where more than 300 federal programs are 

operating to assist youth and families. State officials also identified three 

challenges of increasing concern: children’s growing exposure to illegal 

drugs; increased demand to provide services for children with special 

needs; and changing demographic trends or cultural sensitivities in 

providing services for some groups of children in the states’ child welfare 

systems. 

Results in Brief 

Most states reported that they had implemented initiatives to address 

challenges associated with improving the level of services, recruiting and 

retaining caseworkers, and finding appropriate homes for children. The 

frequency of these initiatives, however, did not always mirror the levels of 

dissatisfaction with the major challenges. For example, with respect to 

services, state child welfare agencies responding to our survey most 

Page 3 GAO-07-75 Child Welfare
frequently identified that they were challenged by the lack of mental 

health and substance abuse services for children and families, yet only a 

fourth of the states reporting dissatisfaction in these areas also reported 

having initiatives to improve the level of these services. One reason may 

be that these services are typically provided outside of the child welfare 

system, and about half of the states reporting this challenge also reported 

initiatives to improve collaboration with other agencies. Most states 

reported that they had implemented initiatives to improve recruitment and 

retention of child welfare caseworkers, but states reported little or no 

action to address two of the most frequently reported factors underlying 

this challenge. For example, while most states reported dissatisfaction 

with caseworker supervision, only two states reported specific initiatives

to address this challenge, and no states reported initiatives to address 

caseworker administrative burden. Similarly, most states reported 

initiatives to find appropriate homes for children, including finding and 

supporting kinship homes, but only three states had initiatives to find 

appropriate homes for older youth and four to find homes for children 

with special needs. In states where evaluations of their initiatives had been

completed under a federal demonstration project, the evaluations 

generally showed that states had achieved mixed results across child 

welfare outcomes. 

States we visited reported that HHS’s Child and Family Services Reviews 

and training and technical assistance efforts helped them assess their 

efforts and ability to achieve safety, permanence, and well-being for the 

children and families under their care and develop the necessary program 

improvement plans to meet federal requirements for improving their child 

welfare programs. For example, officials in three of the five states we 

visited reported that the CFSRs prompted them to develop interagency

strategies for providing an array of needed services to children and 

families. Nearly all states in our survey reported that HHS-sponsored 

technical assistance was helpful to some degree. However, HHS officials 

said that its technical assistance tracking system has several limitations 

that hinder its use as a management tool. For example, only 8 of the 

11 NRCs are required to report to the tracking system, and those that do 

inconsistently enter information into the system. As a result, HHS officials 

told us that it is difficult to determine how best to allocate technical 

assistance resources to help maximize states’ ability to address child 

welfare issues. 

We are making three recommendations to the Secretary of Health and

Human Services for improving awareness of, and access to, various social 

services, and improving the department’s ability to manage technical 

Page 4 GAO-07-75 Child Welfare
assistance. HHS agreed that technical assistance data should be complete, 

accurate, and timely, but disagreed that centralized program information 

and recording all technical assistance would adequately address states’ 

child welfare challenges or improve their ability to effectively allocate 

technical assistance to states. GAO continues to believe that implementing 

these recommendations would help states address their long-standing 

child welfare challenges. 

The well-being of children and families has traditionally been understood 

as a primary duty of state governments, and state and local governments 

are the primary administrators of child welfare programs designed to 

protect children from abuse or neglect. Child welfare caseworkers 

investigate allegations of child maltreatment and determine what services 

can be offered to stabilize and strengthen a child’s own home. If remaining 

in the home is not a safe option for the child—he or she may be placed in 

foster care while efforts to improve the home are made. In these 

circumstances, foster care may be provided by a family member, also 

known as kinship care; caregivers previously unknown to the child; or a 

group home or institution. In those instances where reuniting the child 

with his or her parents is found not to be in the best interest of the child,

caseworkers must seek a new permanent home for the child, such as an 

adoptive home or guardianship. Some children remain in foster care until 

they “age out” of the child welfare system. Such children are transitioned 

to independent living, generally at the age of 18 years. 

States use both dedicated and nondedicated federal funds for operating 

their child welfare programs and providing services to children and 

families. In fiscal year 2006, the federal government provided states with 

about $8 billion in dedicated child welfare funds, primarily authorized 

under Title IV-B and Title IV-E of the Social Security Act. (See app. II.) 

Nearly all of this funding is provided under Title IV-E, which provides 

matching funds to states for maintaining eligible children in foster care, 

providing subsidies to families adopting children with special needs, and 

for related administrative and training costs.5

 About 9 percent of funding is

provided under Title IV-B, which provides grants to states primarily for 

Background 

Federal Funding for State 

Child Welfare Programs 

 5

Title IV-E also provides grants to states for providing independent living services to youth 

who are expected to age out of foster care or who have already aged out of care. Grants are 

also provided to states for providing education and training vouchers for youth aging out of

care. 

Page 5 GAO-07-75 Child Welfare
improving child welfare services, including a requirement that most funds 

be spent on services to preserve and support families. 

A significant amount of federal funding for child welfare services also 

comes from federal funds not specifically dedicated for child welfare—

including the Temporary Assistance for Needy Families (TANF) block 

grant, Medicaid, and the Social Services Block Grant. These and hundreds 

of other federal assistance programs for children and families, including 

many that serve low-income populations, are listed in a centralized 

database administered by the General Services Administration that has a 

search feature by type of assistance and eligible population. The 

Congressional Research Service conservatively estimated that the median 

share of total federal child welfare spending derived from nondedicated 

federal funding equaled nearly half of all the federal dollars (47 percent) 

expended by state child welfare agencies,6

 based on state child welfare 

agency data reported to the Urban Institute for state fiscal year 2002. 7

Despite the large amount of federal funds spent on child welfare from 

nondedicated sources, the Congressional Research Service reported that

attention to federal child welfare financing has focused almost exclusively

on dedicated child welfare funding streams and is driven in part by the 

belief that the current structure hampers the ability of state child welfare 

agencies to achieve positive outcomes for children. Common charges are

that the current structure does not grant states the flexibility needed to 

meet the needs of children and their families, and encourages states to rely 

too heavily on foster care. Congress authorized HHS to conduct 

demonstration projects whereby states were allowed to waive certain 

funding restrictions on the use of Title IV-B and Title IV-E funds under the 

condition that the flexible use of funds would be cost-neutral to the 

federal government. HHS reported that 24 states had participated in 

demonstration projects across eight child welfare program areas, such as

caseworker training and services to caretakers with substance abuse 

disorders. States were required to conduct an evaluation of project 

success in terms of both improving children and family outcomes and cost 

neutrality. 

 6

States’ use of nondedicated federal funding varied considerably from a high of 75 percent 

of total federal child welfare funds expended in Alabama to less than 2 percent of total 

federal child welfare funds expended in North Carolina. 

7

The Congressional Research Service reported that this is likely an understatement of

nondedicated federal funding states used for their child welfare programs. 

Page 6 GAO-07-75 Child Welfare
As Congress authorized funds for state child welfare programs, it has also 

required states to enact policies and meet certain standards related to 

those programs. HHS evaluates how well state child welfare systems 

achieve federal standards for children through its child and family services 

reviews. The CFSR process begins with a state assessment of its efforts, 

followed by an on-site review by an HHS team that interviews various 

stakeholders in the child welfare system and usually reviews a total of 

50 child welfare case files for compliance with federal requirements. After 

receiving the team’s assessment and findings, the state develops a program 

improvement plan (PIP) to address any areas identified as not in 

substantial conformity. Once HHS approves the PIP, states are required to

submit quarterly progress reports. Pursuant to CFSR regulations, federal 

child welfare funds can be withheld if states do not show adequate PIP 

progress, but these penalties are suspended during the PIP implementation

term. 

HHS provides training and technical assistance to help states develop and

implement their PIPs through its training and technical assistance 

network. This training and technical assistance focuses on building state 

agency capacity and improving the state child welfare system. Technical 

assistance providers in this network include HHS’s Children’s Bureau and 

regional offices, as well as NRCs and the department’s Child Welfare 

Information Gateway.8

State child welfare agencies identified three primary challenges as the 

most important to resolve to improve outcomes for children under their 

supervision: providing an adequate level of services for children and 

families, recruiting and retaining caseworkers, and finding appropriate 

homes for children. HHS, GAO, and child welfare organizations have 

consistently shown these issues to be long-standing challenges for most 

states. In addition, state officials identified three challenges of increasing 

concern: children’s exposure to illegal drugs; increased demand to provide 

services for children with special needs, such as those with developmental 

disabilities; and changing demographic trends or needs for cultural 

sensitivity for some groups of children in care and their families. 

HHS Child and Family 

Services Reviews and 

Technical Assistance 

States Identified 

Several Long-standing 

and Emerging 

Challenges to 

Ensuring Child Safety, 

Well-Being, and 

Permanency 

 8

The Information Gateway provides consolidated access to information on a Web site about

a range of child welfare topics, including international adoption, foster care, family 

preservation, and child abuse. 

Page 7 GAO-07-75 Child Welfare
In responding to our survey, states most frequently identified the following 

three child welfare challenges as the most important to resolve in order to 

improve the safety, permanency, and well-being of children under states’ 

care: providing adequate services to children and families, recruiting and 

retaining caseworkers, and finding appropriate homes for children. (See 

fig. 1.) 

Long-standing Challenges 

Include Providing 

Adequate Services, 

Recruitment and Retention 

of Caseworkers, and 

Placement Issues 

Figure 1: Child Welfare Challenges Reported by States as the Three Most Important Challenges to Resolve 

0 5 10 15 20 25 30 35 40

Research, evaluation, and planning issues

(e.g., reliability of child welfare information systems)

Performance and procedures issues

(e.g., timeliness of adoptions)

Collaboration and coordination of services

(e.g., state child welfare system working with schools)

Distribution of federal funding across services

Placement issues

(e.g., finding appropriate homes for children)

Ability to recruit and retain caseworkers

Level of services to children and families

Number of states

Source: GAO analysis of state child welfare survey responses. 

39 

35 

29 

22 

11 

10 

4 

GAO and child welfare organizations have previously reported on the longstanding nature of these challenges. For example, GAO previously 

reported that gaps in the availability and access to services delayed states’

ability to file for a petition to terminate parental rights—a necessary step 

in obtaining a permanent home for children who cannot live with their 

parents—because parents were unable to obtain timely access to 

substance abuse treatment and other services, such as mental health

Page 8 GAO-07-75 Child Welfare
services and housing.9

 GAO and other organizations have also previously 

reported that public and private child welfare agencies face a number of 

challenges recruiting and retaining qualified caseworkers and 

supervisors.10 For example, we reported that high caseloads, poor 

supervision, and the burden of administrative responsibilities have, in

some cases, prompted caseworkers to voluntarily leave their employment 

with child welfare agencies. We also reported difficulties in recruiting 

adoptive parents for children with special needs. 11

The most important challenges identified by state child welfare agencies 

are consistent with HHS’s CFSR findings and states’ self-assessments of 

their programs. For example, according to the Congressional Research 

Service, HHS reviewers found that 43 states needed improvement in 

providing accessible services to children and at-risk families in all 

jurisdictions of the state and 31 states needed improvement in conducting

diligent recruitment of foster and adoptive parents.12 The number of states 

needing improvement in performance indicators related to child welfare 

services, recruitment and retention of caseworkers, and placement of 

children in appropriate homes is shown in table 1. 

 9

One provision of the Adoption and Safe Families Act of 1997 requires states to file a 

termination of parental rights with the courts if the child has been in foster care for 15 of 

the most recent 22 months unless, among other reasons, the state has not provided services

needed to make the home safe for the child's return. For additional information, see GAO,

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). 

10See GAO, 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.: Sept. 24, 2004), and 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). 

11See GAO-02-585, and GAO, 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)

12See Congressional Research Service, Child Welfare: State Performance on Child and 

Family Services Reviews, (Washington, D.C.: June 29, 2005).

Page 9 GAO-07-75 Child Welfare
Table 1: Child and Family Services Review Results Related to the Three Most 

Important Child Welfare Challenges Reported by States 

Child welfare 

challenge Performance Indicator

Number of states 

needing improvement

Services Providing accessible services to children 

and at-risk families in all jurisdictions 

within a state 

43

Services Responsiveness of services to the needs 

of children and at-risk families

27

Services Tailoring services to the unique needs of 

children and at-risk families 

22

Recruitment and 

retention of 

caseworkers 

Providing ongoing training for staff that 

addresses the skills and knowledge 

needed to carry out their duties 

25

Recruitment and 

retention of 

caseworkers 

Providing initial training for all staff who 

provide child welfare services

18

Placement of 

children in

appropriate homes 

Ensuring the diligent recruitment of foster 

and adoptive parents 

31

Source: GAO analysis of Congressional Research Service data. 

A Large Array of Specific 

Services Needed by 

Children and Families, 

Especially in the Area of 

Mental Health and 

Substance Abuse, Underlie 

the Challenge 

State child welfare agencies identified specific services underlying their 

challenge to serve children and families, citing constraints on federal 

funding and limited awareness of services among eligible families as 

contributing factors. Regarding children, more than half of states reported 

that they were dissatisfied with the level of mental health services, 

substance abuse services, housing for foster youth transitioning to 

independence, and dental care. (See fig. 2.) 

Page 10 GAO-07-75 Child Welfare
Figure 2: States Reporting Dissatisfaction with the Level of Services Provided to

Children in the Child Welfare System

0 5 10 15 20 25 30 35

Advocacy or case management

services for children

Physical health services

and access to Medicaid

Legal services for children

Medical care for special or

high needs-children

Assessments of the

need for services

Mentoring for youth

Educational services for

special or high-needs children

General education

services for children

Dental care for children

Housing for foster youth

transitioning to independence

Substance abuse

services for children

Mental health

services for children

Number of states

Source: GAO analysis of state child welfare survey responses. 

32 

31 

31 

29 

19 

17 

17 

13 

13 

12 

10 

8

States also reported that they were dissatisfied with the level of services 

provided to at-risk families in the child welfare system. These services are 

needed to help prevent the removal of children from their homes or help 

facilitate the reunification of children with their parents after removal. 

Specifically, more than half of states responded that they were dissatisfied 

with mental health services, substance abuse services, transportation 

services, and housing for parents of at-risk families. (See fig. 3.) 

Page 11 GAO-07-75 Child Welfare
Figure 3: States Reporting Dissatisfaction with the Level of Services Provided to

Parents of At-Risk Families in the Child Welfare System

0 5 10 15 20 25 30 35

Educational services for parents

Assessments of family's

need for services

Advocacy or case

management services

Legal services for parents

Physical health services

and access to Medicaid

Prevention services

Housing for parents

Transportation for parents

Substance abuse

services for parents

Mental health services

for parents

Number of states

Source: GAO analysis of state child welfare survey responses. 

32 

30 

28

26 

21 

18

18

18

16 

16 

For some types of services, states expressed more dissatisfaction with 

services available to at-risk families than with services available to 

children. For example, more states reported dissatisfaction with the level 

of at-risk family services than with children’s services in the areas of 

assessment of their service needs, legal services, and advocacy or case 

management. (See fig. 4.) 

Page 12 GAO-07-75 Child Welfare
Figure 4: States Reporting Dissatisfaction with the Level of Services Provided to

Children and to Parents of At-Risk Families in the Child Welfare System 

0 5 10 15 20 25 30 35

Advocacy or case

management services

Physical health services

and access to Medicaid

Legal services

Assessments of the

need for services

Substance abuse services

Mental health services

Children 

Parents of at-risk families

Number of states

Source: GAO analysis of state child welfare survey responses. 

32 

32 

31 

30 

13 

16 

12 

18

10 

18

8

18

States we visited reported that funding constraints were among the 

reasons maintaining an adequate level of services was difficult. For 

example, while maintenance payments to foster families for children 

under state care is provided as an open-ended entitlement for federal 

funding under Title IV-E, federal funding for family support services is 

capped at a much lower level under Title IV-B. In addition, because the 

proportion of children in foster care who are eligible for federal support 

has been declining, states had to provide a greater share of funding at a 

time when many states were experiencing budget deficits that adversely 

affected overall funding for social services. In prioritizing funding needs, 

child welfare officials in 40 states responding to our survey reported that

family support services, such as those that could prevent removal of a 

child or help with reunification of a family, were the services most in need 

of greater federal, state, or local resources. Officials from 29 states 

responded that child protective services such as investigation, assessment 

of the need for services, and monitoring were next in need of additional 

resources. 

Page 13 GAO-07-75 Child Welfare
Officials in a state we visited indicated that some caseworkers and 

families may be unaware of the array of existing services offered by 

numerous public and private providers. In North Carolina, for example, 

state officials reported that about 70 percent of children and families in the 

child welfare system received services from multiple public agencies, and

the CFDA—a repository of information on all federal assistance programs 

that is periodically updated—lists over 300 federal programs that provide 

youth and family services. However, caseworkers and families are not 

always aware of the range of services that are available to support them, 

and child welfare officials cited the need for additional information to help

link children and families with needed services. In October 2003, the White 

House Task Force for Disadvantaged Youth recommended that the CFDA 

be modified to provide a search feature linked to locations where federally 

funded programs were operating. A similar model may be found on an 

HHS Web link, http://ask.hrsa.gov/pc/, where users can enter a ZIP code to 

find the closest community health center locations offering medical, 

mental, dental, and other health services on a sliding fee scale.

Large Caseloads, 

Administrative Burden, 

and the Effectiveness of 

Supervision Underlie the 

Caseworker Recruitment 

and Retention Challenge 

State child welfare officials most frequently reported dissatisfaction with 

the current status of three underlying factors that affect the state’s ability 

to recruit and retain caseworkers. Specifically, more than half of the states

reported dissatisfaction with the average number of cases per worker, 

administrative responsibilities of caseworkers, and effectiveness of 

caseworker supervision. (See fig. 5.) 

Page 14 GAO-07-75 Child Welfare
Figure 5: States Reporting Dissatisfaction with Factors That Could Affect the 

State’s Ability to Recruit and Retain Caseworkers 

0 5 10 15 20 25 30 35

Qualifications established

for positions

Quality of training or professional

development for caseworkers

Caseworker pay and benefits

relative to similar professions

Quality of training or professional

development of supervisors

Effectiveness of

caseworker supervision

Administrative responsibilities

of caseworkers

Average number of

cases per worker

Number of states

Source: GAO analysis of state child welfare survey responses.

34

28

28

21

21

12

9

Child welfare officials in each of the states we visited reported having

trouble recruiting and retaining caseworkers because many caseworkers 

are overwhelmed by large caseloads. According to a 2006 Child Welfare 

League of America (CWLA) report, some programs lack caseload 

standards that reflect time needed to investigate allegations of child 

maltreatment, visit children and families, and perform administrative 

responsibilities. The report also cites CWLA’s caseload standards of no 

more than 12 cases per caseworker investigating allegations of child 

maltreatment, and no more than 15 cases for caseworkers responsible for 

children in foster care. However, according to the report, most states, 

average caseloads in some areas are often more than double the CWLA 

standards. 

State child welfare officials we interviewed also reported that increasing 

amounts of time spent on administrative duties made it difficult to recruit 

and retain staff and limiting the amount of time caseworkers could spend 

visiting families. For example, child welfare officials in three states we 

visited estimated that some caseworkers spent a significant amount of 

time on administrative duties such as entering case data in automated 

systems, completing forms, and providing informational reports to other 

Page 15 GAO-07-75 Child Welfare
agencies. This administrative burden has limited caseworker ability to 

ensure timely investigations of child maltreatment and to make related 

decisions concerning the removal of children from their homes, according 

to officials, and influenced caseworker decisions to seek other types of 

employment. 

Some states we visited reported that the lack of effective supervision also 

adversely affected staff retention and sometimes resulted in delays 

providing appropriate services to children and families. Lack of 

supervisory support was cited as a problem in terms of supervisor 

inexperience and inaccessibility. For example, a Texas state official said 

that because of high turnover, caseworkers are quickly promoted to 

supervisory positions, with the result that the caseworkers they supervise 

complain of poor management and insufficient support. In Arizona, 

caseworkers have expressed dissatisfaction in the support they received 

from their supervisors, and this has negatively affected recruitment and 

retention. Child welfare officials reported that lack of access to 

supervisors was frustrating to caseworkers because it delayed their ability 

to specify appropriate permanency goals for children and to develop case 

plans to meet the needs of children and families in their care. 

Recruiting and Retaining 

Foster Parents for All 

Kinds of Children, but 

Especially for Children 

Who Are Older or Have 

Special Needs, Are Some 

of the Underlying 

Placement Challenges for 

States 

Relative to other challenges, state child welfare officials most frequently 

identified four factors underlying the challenge to find appropriate homes 

for children. (See fig. 6.) Recruiting and retaining foster parents and 

serving children with special needs were at the top of the list. Also, more 

than half of the states reported that finding homes for children with 

special needs, older youth, and youth transitioning into independent living, 

and finding and supporting kinship homes, were among their greatest 

concerns. 

Page 16 GAO-07-75 Child Welfare
Figure 6: States Reporting Factors of Greatest Concern in Making Appropriate 

Placements for Children

0 5 10 15 20 25 30 35 40

Arranging out-of-state and

international placements

Maltreatment of foster children

Identifying and supporting kinship

or guardianship homes

Serving aging youth and those

transitioning into independent living

Recruiting and retaining

foster and adoptive parents

Serving children with special needs

(e.g., developmental disabilities)

Number of states

Source: GAO analysis of state child welfare survey responses. 

39 

38

34 

28

7 

3 

Child welfare officials in two states we visited said that the lack of 

therapeutic foster care homes that can properly care for children who 

have significant physical, mental, or emotional needs makes it challenging 

to find them an appropriate home. In addition, these officials said that 

some of the existing facilities are inappropriate for child placement 

because they are old and in poor condition or provide outmoded treatment 

services. Because of the absence of high-quality therapeutic settings, child 

welfare officials said that it has become increasingly difficult to place

children in homes that can appropriately address their individual needs. 

Recruiting and retaining foster and adoptive parents has become an 

increasingly difficult aspect of placement for a variety of reasons, such as 

the lack of a racially and ethnically diverse pool of potential foster and 

adoptive parents, and inadequate financial support. For example, child

welfare officials said that some locations have relatively small populations

of certain races and ethnicities, making it difficult to recruit diverse foster 

and adoptive parents.13 Inadequate financial support also hinders 

 13Generally, states and other entities involved in adoption or foster care are prohibited by

law from delaying or denying the placement of a child for adoption or into foster care, on 

the basis of the race, color, or national origin of the adoptive or foster parent, or the child, 

involved. 42 U.S.C. § 1996b. 

Page 17 GAO-07-75 Child Welfare
recruiting and retaining foster and adoptive families. Financial support for 

foster and adoptive families varies widely among states and local areas, 

and may not keep up with inflation. According to a California child 

advocacy organization, for example, the state’s payments to foster parents 

of $450 per month per child have not been adjusted for inflation since 

2001. As a result, according to the organization, the supply of foster care 

providers has not increased markedly during this time. 

Obtaining permanent homes for older youth and for youth aging out of 

foster care is a continuing placement challenge for states. For example, 

Texas child welfare officials said that it is difficult to place adolescents 

with adoptive parents because older youth can choose not to be adopted.

Finding housing for youth transitioning into independence also can be 

difficult in high-cost areas or in areas where special arrangements have 

not been made with housing agencies and landlords that typically require a 

cosigner on the rental application or a large deposit before moving in.14

More than half of the states also reported that limitations in their ability to 

identify and support placements with family members or legal guardians 

limited opportunities to place children in appropriate homes. For example, 

child welfare officials in Ohio reported a lack of resources to conduct 

outreach to family members that may be able to provide a stable home for 

children in foster care with less disruption to the child. Michigan officials 

also reported that the lack of financial resources made it difficult for the 

state to meet its placement goals for those children who had been 

removed from their home and who had been directed by the court to be 

placed with other family members. 

 14See GAO, Foster Youth: HHS Actions Could Improve Coordination of Services and

Monitoring of States’ Independent Living Programs, GAO-05-25 (Washington, D.C.: Nov.

18, 2004). 

Page 18 GAO-07-75 Child Welfare
While states have experienced child welfare challenges for many years, 

states identified several emerging issues that are of increasing concern 

because of their impact on the well-being of children in the child welfare 

system. Most states reported a high likelihood that three issues will affect 

their systems over the next 5 years: children’s exposure to illegal drugs, 

caring for special or high-needs children, and changing demographics and 

cultural sensitivities. (See fig. 7.) 

Figure 7: State-Reported Emerging Issues That Are Likely to Affect Children in

Child Welfare System over the Next 5 Years 

Emerging Challenges 

Include Children’s 

Exposure to Illegal 

Drugs, Caring for 

Special Needs 

Children, and 

Responding to 

Changing 

Demographics of the 

Child Welfare 

Population 

Number of states

Source: GAO analysis of state child welfare survey responses. 

0 5 10 15 20 25 30 35 40 45

Overprescribing psychotropic

drugs to foster children

Violent behavior in children,

including access to weapons

Demographic changes and changes in

cultural sensitivity (e.g., assessment protocols

that consider immigrant populations)

Care for special needs children

(e.g., developmental disabilities)

Children's exposure to illegal drugs 41 

33 

29 

19 

15 

Although the overall percentage of drug-related child welfare cases has 

not increased, officials in the states we visited reported that the type and 

location of drug abuse underlying maltreatment cases is changing, 

requiring increased attention by child welfare agencies in certain areas. 

For example, child welfare officials reported an increasing number of 

children entering state care as a result of methamphetamine use by 

parents, primarily in rural areas. Child welfare agencies in these areas may 

need to train caseworkers on how this drug is likely to affect parents or 

caregivers who use it in order to safely investigate and remove children 

from homes, as well as assess the service needs of affected families to 

develop an appropriate case plan.15

 15Methamphetamine users often exhibit poor judgment, confusion, irritability, paranoia,

and increased violence. 

Page 19 GAO-07-75 Child Welfare
State child welfare officials in all five states we visited said that finding 

homes for special needs children is a growing issue because it is hard to 

find parents willing to foster or adopt these children and who live near the 

types of services required to meet the children’s needs. For example, child 

welfare officials in one of the states we visited reported that the state does 

not have a sufficient number of adoptive homes for children with special 

needs. As a result, these children generally stay in foster care for longer 

periods of time. 

Child welfare officials we interviewed also said that the growing cultural 

diversity of the families who come in contact with the child welfare system 

has prompted the need for states to reevaluate how they investigate 

allegations of maltreatment and the basis on which they make decisions 

that could result in the removal of children from their homes. Child 

welfare officials in several states reported that the current protocols for 

investigating and removing children from their homes do not necessarily 

reflect the cultural norms of some immigrant and other minority families. 

These differences include limitations in family functioning that may be 

caused by poverty, the environment, or culture as opposed to those that 

may be due to unhealthy family conditions or behaviors. In response to 

growing cultural diversity, several states we visited stated that they are 

revising their protocols to account for religious and language differences 

among families who come in contact with the child welfare system. 

Most states reported that they had implemented initiatives since January

2002 to address challenges associated with maintaining an adequate level 

of services, recruiting and retaining caseworkers, and finding appropriate 

homes for children. However, these initiatives did not address all of the 

key factors states reported being associated with these challenges. In 

states where evaluations of their initiatives had been completed under a 

federal demonstration project, the evaluations generally showed that 

states had achieved mixed results across child welfare outcomes. 

State Initiatives

Insufficiently Address 

State Challenges to 

Improve Child 

Outcomes, and 

Evaluations Showed 

Mixed Results

Page 20 GAO-07-75 Child Welfare
States reported implementing various initiatives to improve child 

outcomes, but these initiatives did not always mirror those factors states 

reported as most necessary to address in overcoming their primary 

challenges. For example, with respect to services, states most frequently 

identified that they were challenged by the lack of mental health and 

substance abuse services for children and families, yet only a fourth of the 

32 states dissatisfied with these services reported having initiatives to 

improve the level of these services. (See fig. 8.) This may be because these

services are typically provided outside the child welfare system by other 

agencies. About half of the states reporting dissatisfaction also reported 

initiatives to improve collaboration with other agencies.16

State Initiatives Did Not 

Address All the Key 

Factors Related to the 

Three Challenges Cited as 

Most Important to Improve 

Child Outcomes 

 16We previously reported on how problems requiring interagency solutions often go

unaddressed in such areas as transportation and housing. See GAO-05-25 and GAO, Child 

Welfare: Improved Federal Oversight Could Assist States in Overcoming Key Challenges. 

GAO-04-418T (Washington, D.C.: Jan. 28, 2004). 

Page 21 GAO-07-75 Child Welfare
Figure 8: State-Reported Initiatives to Improve Services to Children and Families 

Number of states

Source: GAO analysis of state child welfare survey responses.

0246 8 10 12 14 16 18 20

Transportation services

Housing for at-risk families and children

Educational services

Aging youth services

Diversity or cultural issues (e.g., language challenges)

Mental or behavioral health services

Training caseworkers

Substance abuse services

Physical health services

Child placement services

Funding of services

Other initiativesa

Prevention of child removal

Collaboration (e.g., child advocacy organizations)

Assessment of child and at-risk families

Case management 19 

17 

14 

12 

8

6 

4 

4 

4 

4 

4 

3 

3 

2 

2 

1 

a

Other initiatives include court-required changes of services, focusing on children 0-3 years of age, and 

creating a family division in the court system.

Similarly, most states reported that they had implemented initiatives to 

improve recruitment and retention of child welfare caseworkers, but 

states reported little or no action to address two of the most frequently 

reported factors underlying this challenge. (See fig. 9.) While most states 

reported dissatisfaction with the supervision of caseworkers, only two 

reported specific initiatives to address this challenge. Similarly, while over 

half of the states reported dissatisfaction with the administrative 

responsibilities of caseworkers, no state reported an initiative to address 

Page 22 GAO-07-75 Child Welfare
this challenge. One way of streamlining administrative responsibilities—

through new technology—may be difficult for many states because nearly 

half of the states reported that they did not have an operational statewide 

automated child welfare information system. 

Figure 9: State-Reported Initiatives to Recruit and Retain Caseworkers

0 3 6 9 12 15

Training supervisors

Diversity or cultural issues

(e.g., language challenges)

Supervision of caseworkers

Collaboration (e.g., universities)

Funding recruitment and retention

Other initiativesa

Recruitment of caseworkers

Hiring qualification

Support for caseworkers

Average caseload reduction

Training caseworkers

Pay and benefits for caseworkers

Number of states

Source: GAO analysis of state child welfare survey responses.

14 

12 

11 

8

8

7 

7 

5 

4 

3 

1 

1 

a

Other initiatives include developing a child welfare leadership program, centralizing hiring processes,

and expanding community-based services. 

Page 23 GAO-07-75 Child Welfare
Almost all states reported implementing initiatives to improve their ability 

to find appropriate homes for children, but few states addressed two of 

the three most frequently reported factors underlying this challenge (see 

fig. 10). For example, three states reported initiatives to find appropriate 

homes for older youth transitioning to independence and four states 

reported initiatives to find appropriate homes for children with special 

needs.17

 17GAO previously reported that child welfare agencies focused on preparing youth for

independent living while they were in foster care, but were less apt to work with other

agencies—such as the local housing authority—to transition youth out of care because of

conflicting policies and a lack awareness about needed services. See GAO-05-25. 

Page 24 GAO-07-75 Child Welfare
Figure 10: State-Reported Initiatives to Find Appropriate Homes for Children 

Number of states

Source: GAO analysis of state child welfare survey responses.

0246 8 10 12 14 16 18

Child maltreatment removal

Out-of-state and international placement

Aging youth transitioning into independence

Funding for placement

Pay and benefits for foster care providers

Training caseworkers

Special needs (e.g., developmental disabilities)

Mental health services

Other initiativesa

Support for foster care providers

Training foster care providers

Permanency of the child

Collaboration

(e.g., behavioral health institution)

Kinship placement

Recruitment of foster care providers

Placement services 17 

14 

14 

14 

8

8

8

8

6 

3 

3 

1 

1 

3 

4 

4 

a

Other initiatives include working with Native American groups on child placement, implementing

team decision making, and ensuring that children in out-of-region placements are seen regularly. 

States implementing initiatives under federal demonstration projects were 

required to conduct evaluations, and these evaluations showed mixed 

results. In general, the demonstration projects offered states the flexibility 

to use federal funding under Title IV-B and Title IV-E in eight different 

program areas in an effort to improve services and placements—

addressing the three primary challenges reported by states (see app. III). 

As of 2006, 24 states had implement 38 child welfare waiver 

demonstrations. However, evaluation results were mixed across child 

Page 25 GAO-07-75 Child Welfare
welfare outcomes. For example, while Illinois found strong statistical 

support for the finding that funding for assisted guardianships increased 

attainment of permanent living arrangements, none of the other four 

reporting states found similar conclusive evidence of this finding. 

Similarly, among four states using Title IV-E funds to fund services and 

supports for caregivers with substance abuse disorders, Illinois was the 

only state that demonstrated success in connecting caregivers to 

treatment services. States can no longer apply for participation in federal 

demonstration projects because the program authorization expired in 

March 2006.

States we interviewed reported that HHS’s CFSR and technical assistance 

efforts were helpful in implementing federal child welfare requirements. 

Similarly, nearly all states in our survey reported that HHS-sponsored 

technical assistance was helpful to some degree. However, HHS officials 

said that limitations in their technical assistance tracking system made it 

difficult to maximize its use as a management tool. 

State child welfare officials generally reported that HHS’s CFSR reviews 

have assisted them in assessing their efforts and ability to achieve the 

safety, permanence, and well-being for the children under their care and 

develop the necessary program improvement plans to meet federal 

requirements in this regard. Specifically, state officials responding to our 

survey reported that the reviews had helped them to implement system 

wide child welfare reform, improve their quality assurance systems, and 

increase their collaboration with other child welfare-related agencies. 

Additionally, child welfare officials in three of the five states we visited 

reported that the reviews prompted them to develop interagency strategies

for providing an array of needed services, such as mental health services 

and education for children and families. 

States Generally 

Found HHS Reviews 

and Technical 

Assistance Helpful, 

but HHS’s Monitoring 

System Has 

Limitations 

HHS Child and Family 

Services Reviews Helped 

States Assess Needs and 

Make Improvements 

Most states reported that there was not much need to improve the 

usefulness of the CFSR process to help the state ensure safety,

permanence, and well-being of children in the child welfare system, but 

some state officials expressed concern about the outcome measures used. 

Of the 48 states responding to our survey question about the CFSR 

process, 33 states reported that the usefulness of the CFSR process 

needed little to none or some improvement. Some state officials we 

Page 26 GAO-07-75 Child Welfare
interviewed were concerned, however, that the outcomes being measured 

in the reviews may not accurately reflect their child welfare program 

performance. In addition, officials in three of the five of the states we 

visited expressed concern about the small number of sample cases used 

by the reviewers to evaluate their state’s performance. Specifically, 

officials in one state reported that evaluating only 50 cases left the state 

with uncertainty about how pervasive problems are in the state and what 

its priority areas should be.18

Although the first round of HHS’s reviews showed that no state had 

reached substantial conformity on all of the federal outcome goals for 

state child welfare systems, HHS officials said that states had made 

progress in implementing federal requirements and improving their child 

welfare systems. For example, HHS officials said that the quality of data

has improved because states have put a greater focus on having accurate 

and reliable data and many states are examining their data in greater detail

than before in an effort to identify problems in their child welfare systems 

and to figure out how to meet the CFSR requirements. The next round of 

reviews is scheduled to begin at the end of fiscal year 2006, when HHS 

officials will once again measure states’ progress in meeting federal child 

welfare requirements. 

States Generally Viewed 

Federal Technical 

Assistance as Helpful, but 

HHS’s Monitoring System 

Has Limitations as a 

Management Tool 

Nearly all states reported in our survey that the federal technical 

assistance they received to improve their child welfare programs was 

helpful to some degree,19 although some resources were given higher 

ratings than others, as shown in table 2. States generally reported the 

highest levels of satisfaction with assistance provided by two of HHS’s 

national resource centers that had primary responsibility for helping with 

child protective service and organizational improvement. The federal 

resources providing technical assistance in the areas of substance abuse, 

community-based child abuse prevention, and abandoned infants received 

the fewest requests from states. 

 18See GAO, 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.: Apr. 20, 2004). 

19States responded to a survey question and said that HHS technical assistance was most 

often either helpful, very helpful, or extremely helpful.

Page 27 GAO-07-75 Child Welfare
Table 2: State-Reported Use and Assessment of HHS Training and Technical

Assistance 

Number of states 

using technical 

assistance

Number of 

states finding

assistance 

very or extremely 

helpful

Number of 

states finding

assistance 

somewhat or

moderately 

helpful

National child welfare resource centers 

Center for Child Protective 

Services 

33 31 2

Center for Organizational 

Improvement 

36 32 3

Center for Youth 

Development 

27 22 5

Collaboration to 

AdoptUsKids 

37 30 6

Center for Family-Centered 

Practice and Permanency 

Planning 

34 26 8

Center for Adoption 24 18 5

Center on Legal & Judicial 

Issues 

26 19 5

Center for Child Welfare 

Data & Technology 

31 20 11

Other federal resources 

National Adoption 

Information Clearinghouse 

29 23 6

National Clearinghouse on

Child Abuse and Neglect 

Information 

33 22 11

HHS regional offices 47 31 16

Center on Substance Abuse 

and Child Welfare 

17 11 4

Center for CommunityBased Child Abuse 

Prevention Programs 

11 7 4

National Abandoned Infants 

Assistance Resource 

Center 

6 1 4

Source: GAO analysis of state child welfare survey responses. 

HHS’s Technical Assistance Tracking Internet System (TATIS) monitors 

federal training and technical assistance requested and provided to states, 

Page 28 GAO-07-75 Child Welfare
but several limitations that hinder its use as a management tool. One 

limitation is that the system was designed to capture only assistance 

provided by eight NRCs. (See app. IV.) Because TATIS does not capture 

training and technical assistance provided by the remaining three NRCs, 

other federal resource centers, and HHS’s regional offices, HHS officials 

do not have a complete picture of the assistance requested by states and 

provided to them. For example, the NRC for substance abuse is not 

required to enter data into TATIS, but NRC records show that it provided 

47 on-site technical assistance visits to 16 states in fiscal year 2005, making 

it among one of the most frequent providers of on-site federal assistance. 

A second limitation is that the eight NRCs do not always enter information 

into TATIS as required, raising concerns about the ability of HHS to 

determine how often states use its various resources and for what 

purpose. For example, an official from one of the eight NRCs we 

interviewed said that his center is not as conscientious as it should be 

about entering all of the required data into TATIS. HHS officials said that 

without this information, it is difficult to determine how best to allocate 

technical assistance resources to help maximize states’ ability to address 

child welfare issues. 

States have been facing some of the same child welfare challenges for 

many years, and predict that some emerging challenges will have impacts 

in the next several years. The federal government has funded hundreds of 

programs to meet families’ mental health, substance abuse treatment, and 

other social service needs that could help prevent child maltreatment and 

keep families together. However, the inability to query the federal 

government’s central source of information—the CFDA—to identify which 

services across program and agencies are available in various locations 

makes it difficult to determine the extent of services available at the local 

level to serve children and families in the child welfare system. 

Conclusions 

HHS has provided state child welfare systems an array of training and 

technical assistance that states report as helpful for improving their child 

welfare programs. Maximizing the value of its training and technical 

assistance is compromised, however, because HHS’s information system 

does not capture all training and technical assistance provided to states 

from various HHS-sponsored providers, and compliance with the reporting 

requirements has not been enforced. In the absence of complete and 

timely information, HHS may be limited in its ability to determine how 

best to allocate technical assistance resources to help maximize states’ 

ability to address child welfare issues. 

Page 29 GAO-07-75 Child Welfare
We are making the following three recommendations to the Secretary of 

Health and Human Services for improving awareness of and access to 

various social services, and improving the department’s ability to manage 

technical assistance provided to state child welfare agencies.

• Develop a strategy to centralize information on federal assistance 

programs that are available to meet child welfare program and 

service needs and that can be accessed by state and local child

welfare staff and providers. This strategy could follow a previous 

Administration recommendation to develop an Internet-based

search for services through the Catalog of Federal Domestic 

Assistance (CFDA) that is linked to grantees by ZIP code. 

• Require all HHS technical assistance providers, including HHS 

regional offices and all national resource centers, to enter training 

and technical assistance data into the department’s Technical

Assistance Tracking Internet System. 

• Establish policies and procedures to ensure that complete and 

accurate data are timely reported to the Technical Assistance 

Tracking Internet System. 

We provided a draft of this report to HHS for review and comment. HHS’s 

written comments are reprinted in appendix V, and the Department’s 

technical comment was incorporated into the report. In its written 

comments, HHS stated that the report substantially supports many of the 

findings of the CFSRs, and agreed with one of our three recommendations. 

The department agreed with our recommendation to establish policies and 

procedures to ensure complete and accurate reporting of data into TATIS

and said it intended to provide written guidance to the resource centers 

requiring this reporting. However, the department stated that the report 

misconstrued the intent of the CFSRs and that the remaining 

recommendations do not adequately match the articulated needs of state 

welfare agencies. 

Recommendations for 

Executive Action 

Agency Comments 

and Our Evaluation 

HHS disagreed with GAO’s reference that no state had achieved all of the 

federal outcome measures for ensuring the safety, well-being, and 

permanency of children. The department stated that it makes separate 

determinations regarding substantial conformity for each of the seven 

outcome measures and each of the seven systemic factors reviewed. We 

revised the text to reflect that no state had reached substantial conformity 

on all of the federal outcome goals for state child welfare systems in lieu 

of stating that no state had achieved all of the federal performance goals. 

Page 30 GAO-07-75 Child Welfare
HHS disagreed with our recommendation to increase awareness of federal 

assistance programs by modifying the CFDA, stating that it was misleading 

to assume that state challenges could be significantly met or appreciably 

altered by a list of resources, in part because the recommendation 

incorrectly implies that local child welfare agencies are not aware of many 

valuable services; underestimates the substantive knowledge of resources 

currently being utilized by caseworkers; child welfare staff need access to 

actual services or service providers rather than general information on 

federal assistance programs; resource lists quickly become outdated with 

state and county programs and service providers changing annually based

on their budgets; and certain federal programs are designed to meet the 

needs of very specific, and sometimes very small, populations. 

We acknowledge that increasing awareness of available federal resources 

is not the only action needed to address the various challenges facing state

child welfare agencies, but believe that caseworker awareness and referral 

of children and families to existing resources is an important first step in 

meeting the challenge to provide an adequate level of services to them. As 

our report states, our current and past work has found that some 

caseworkers were unaware of the full array of federal resources, such as 

health and housing services, available in their locales, or had not 

coordinated with other agencies and organizations to access them. We 

continue to support the view that modifying the CFDA would allow 

caseworkers and others to more easily identify services and service 

providers funded by federal agencies in closest proximity to the families 

they serve. As the department points out, modifying the CFDA would not 

address issues related to outdated listings of state or local resources; 

however, the CFDA is updated biweekly or more often in response to new 

or changing information regarding federal assistance. Further, while it is 

true that some federal programs target specific populations, these 

populations are often low-income or minority groups that are also served 

by the child welfare system. 

The department also disagreed with our recommendation to require all 

HHS technical assistance providers to enter data into TATIS, stating that 

the system was not designed to monitor all technical assistance provided

to states, nor would it be an effective stand-alone mechanism to determine 

how best to allocate technical assistance resources to states; the 

recommendation does not give sufficient weight to the CFSR process; 

including training and technical assistance by regional offices in TATIS 

would be superfluous as these activities are in regional office job 

descriptions; and the recommendation does not recognize that training 

and technical assistance is provided to a variety of audiences beyond the 

Page 31 GAO-07-75 Child Welfare
state child welfare agencies, and including more information would 

confuse the tracking of technical assistance. 

Our report recognizes that TATIS was designed to monitor on-site training 

and technical assistance provided by 8 of the 11 resource centers. 

However, we continue to believe that expanding TATIS to capture the 

substantial on-site assistance provided by the remaining resource centers 

and other HHS providers would enhance its contribution to the 

department in determining how best to allocate training and technical 

assistance resources to states. We acknowledge the benefit of the CFSRs 

in identifying states’ technical assistance needs. However, state 

implementation of program improvement plans in response to the CFSR 

findings is only a part of training and technical assistance requested and 

provided to states. In addition, while regional office job descriptions may 

include training and technical assistance responsibilities, we do not 

believe that capturing the amount and type of this assistance actually 

provided to states would be superfluous, but rather provide a more 

complete picture of the on-site assistance received by states. Further, our 

recommendation was not intended to include training and technical 

assistance provided to audiences beyond the state child welfare agencies, 

and we modified the report text to clarify this point. 

Copies of this report are being sent to the Secretary of Health and Human 

Services, relevant congressional committees, and other interested parties. 

We will also make copies available to others upon request. In addition, the 

report will be made available at no charge on GAO’s Web site at 

http://www.gao.gov. Please contact me on (202) 512-7215 if you or your 

staff have any questions about this report. Other contacts and major 

contributors are listed in appendix VI. 

Sincerely yours, 

Cornelia M. Ashby 

Director, 

Education, Workforce, and Income Security Issues 

Page 32 GAO-07-75 Child Welfare
Appendix I: 

Methodology 

Objectives, Scope, and 

Page 33 GAO-07-75

Appendix I: Objectives, Scope, and 

Methodology 

We were asked to examine (1) the primary challenges state child welfare 

agencies face in their efforts to ensure the safety, well-being, and 

permanency of the children under their supervision; (2) the changes states 

have made since January 1, 2002, to improve the outcomes for children in

the child welfare system; and (3) the extent to which states participating in

the Department of Health and Human Services (HHS) Child and Family 

Services Reviews (CFSR) and technical assistance efforts find the 

assistance to be helpful. As part of this work, GAO also examined the 

extent to which states had developed written child welfare disaster plans 

for dealing with the dispersion of children under state care to other 

counties or states, because of disasters. In July 2006, GAO issued the 

report Child Welfare: Federal Action Needed to Ensure States Have Plans

to Safeguard Children in the Child Welfare System Displaced by 

Disasters (GAO-06-944) in response to the disaster planning part of your 

request. 

To learn more about these objectives, we conducted a Web-based survey 

of state child welfare directors and conducted site visits in five states 

where we interviewed state officials. We also interviewed federal child 

welfare officials and representatives from national child welfare 

organizations concerning state child welfare programs, the changes that 

states had made since 2002 to improve the outcomes for children, and the 

extent to which states participated in HHS’s CFSR and technical 

assistance efforts. In addition, we reviewed several national studies and 

our previous child welfare reports to determine the challenges that states 

face in their efforts to ensure the safety, well-being, and permanency of the 

children under their supervision. Finally, we analyzed agency 

documentation, legislation, and other documentation related to child 

welfare programs and requirements. We conducted our work between 

October 2005 and August 2006 in accordance with generally accepted

government auditing standards. 

Web-Based Survey To obtain state perspectives on our objectives and the relative priority 

state child welfare agencies place on the challenges they face, we 

conducted a Web-based survey of child welfare directors in the 50 states, 

the District of Columbia, and Puerto Rico. The survey was conducted 

using a self-administered electronic questionnaire posted on the Web. We 

contacted directors via e-mail announcing the survey and sent follow-up emails to encourage responses. The survey data were collected between 

February and May 2006. We received completed surveys from 48 states, 

the District of Columbia, and Puerto Rico (a 96 percent response rate). 

Child Welfare
Appendix I: Objectives, Scope, and 

Methodology 

The states of Massachusetts and Nebraska did not return completed 

surveys. 

To develop the survey questions, we reviewed several national studies and 

our previous child welfare reports to determine the challenges that states 

face in their efforts to ensure the safety, well-being, and permanency of the 

children under their supervision. We analyzed agency documentation to 

identify HHS’s oversight and technical assistance efforts. In November 

2005, we also held two discussion groups with representatives from child 

welfare stakeholder groups to identify any additional issues that may not 

be covered in the published documents we reviewed. The stakeholders 

included representatives from the Association of Administrators of the 

Interstate Compact on the Placement of Children, the Child Welfare 

League of America, the National Association of Public Child Welfare 

Administrators, the AARP Grandparent Information Center, the Pew 

Commission on Children in Foster Care, the Urban Institute, American Bar 

Association Center on Children and the Law, the Center for the Study of 

Social Policy, the American Public Human Services Association, and Casey 

Family Services. 

We worked to develop the questionnaire with social science survey 

specialists. Because these were not sample surveys, there are no sampling 

errors. However, the practical difficulties of conducting any survey may 

introduce errors, commonly referred to as nonsampling errors. For 

example, differences in how a particular question is interpreted, in the 

sources of information that are available to respondents, or how the data

are entered into a database can introduce unwanted variability into the 

survey results. We took steps in the development of the questionnaires, the 

data collection, and data analysis to minimize these nonsampling errors. 

For example, prior to administering the survey, we pretested the content

and format of the questionnaire with several states to determine whether 

(1) the survey questions were clear, (2) the terms used were precise, 

(3) respondents were able to provide the information we were seeking,

and (4) the questions were unbiased. We made changes to the content and 

format of the final questionnaire based on pretest results. In that these 

were Web-based surveys in which respondents entered their responses 

directly into our database, there was a reduced possibility of data entry 

error. We also performed computer analyses to identify inconsistencies in 

responses and other indications of error. In addition, an independent 

analyst verified that the computer programs used to analyze the data were

written correctly. 

Page 34 GAO-07-75 Child Welfare
Appendix I: Objectives, Scope, and 

Methodology 

We visited five states—California, New York, North Carolina, Texas, and 

Utah. We selected these states because they represent different types of 

program administration (state-administered, state-supervised and countyadministered, state- and county-administered), the predominance of urban

or rural characteristics, the achievement of child welfare standards on the

CFSR, changes in the number of children reported to be in foster care, and 

are geographically diverse. During these visits, we interviewed state child 

welfare officials and collected relevant state agency policies and 

procedures and reports. 

Site Visits 

Information that we gathered on our site visits represents only the 

conditions present in the states and local areas at the time of our site 

visits. We cannot comment on any changes that may have occurred after 

our fieldwork was completed. Furthermore, our fieldwork focused on indepth analysis of only a few selected states. On the basis of our site visit 

information, we cannot generalize our findings beyond the states we 

visited. 

Page 35 GAO-07-75 Child Welfare
Appendix II: Federal Funding for State Child 

Welfare Programs 

Program Final funding (in millions of dollars) 

President’s 

budget 

request 

Fiscal year 2004 2005 2006 2007

Child welfare total 7,756 7,764 7,676 7,989

Title IV-E of the Social Security Act 

Title IV-E subtotal 6,866.2 6,861.9 6,772 7,048.9

Foster care—Open-ended reimbursement of eligible state 

claims for maintaining children in foster care and for related 

administrative and training costs 

4,974 4,896 4,685 4,786

Adoption assistance—Open-ended reimbursement of eligible 

state claims for providing subsidies to special needs adoptees 

and for related administrative and training costs 

1,700 1,770 1,883 2,047

Foster care independence—Formula grants to states for 

provision of independent living services to youth expected to age 

out of foster care and to youth who have aged out of care 

140 140 140 140

Education and training vouchers—Formula grants to states to 

provide education and training vouchers to youth who have aged 

out of foster care 

44.7 46.6 46.2 46.2

Adoption incentives—Bonus funds to states that increase the 

number of foster children adopted 

7.5 9.3 17.8 29.7

Title IV-B of the Social Security Act 

IV-B subtotal 700.4 701.4 708.3 748.3

Promoting safe and stable families—Formula grants to states 

for four kinds of services: family preservation, family support, 

time-limited reunification, and adoption promotion and support 

404 404 394 434 

Child welfare services—Formula grants to states to improve 

public child welfare services 

289 290 287 287

Court improvement—Formula grants to states’ highest courts 

to strengthen handling of court child welfare proceedings 

NA NA 20 20.0

Child welfare training—Competitive grants to private nonprofit 

institutions of higher education to develop and improve 

education and training programs for child welfare workers 

7.4 7.4 7.3 7.3

Child Abuse Prevention and Treatment Act (CAPTA) 

CAPTA subtotal 89.5 101.8 95.2 95.2

Community-based grants for child abuse prevention—

Formula grants to lead entity in each state to support 

community-based services designed to prevent child abuse and 

neglect 

33.2 42.9 42.4 42.4

Basic state grants—Formula grants to states to improve their 

child protection services 

21.9 27.3 27.0 27.0

Discretionary activities—Competitive grants for research and 

demonstration programs related to preventing or treating child 

maltreatment 

34.4 31.6 25.8 25.8

Appendix II: Federal Funding for State Child 

Welfare Programs 

Page 36 GAO-07-75 Child Welfare
Appendix II: Federal Funding for State Child 

Welfare Programs 

Program Final funding (in millions of dollars) 

President’s 

budget 

request 

Victims of Child Abuse Act (VCAA) 

VCAA subtotal 26.9 28.6 28.8 25.8

Court-appointed special advocates—Competitive grants to 

support advocacy in court for child victims of abuse and neglect 

11.6 11.7 11.7 11.8

Children’s advocacy centers—Competitive grants for services 

to child victims of abuse (and nonoffending family members), to 

coordinate child abuse investigations in ways that reduce their 

trauma, and for related training and technical assistance 

13.0 15.0 14.8 11.7

Training for judicial practitioners and personnel—

Competitive grant to improve court handling of child abuse and 

neglect cases 

2.3 1.9 2.3 2.3

Children’s Health Act (CHA) 

CHA subtotal 12.8 12.8 12.7 12.7

Infant adoption awareness—Competitive grants to train staff in 

non-profit health centers about adoption 

9.8 9.8 9.7 9.7

Special needs adoption awareness—Competitive grants for a 

public campaign about adoption of children with special needs 

3.0 3.0 3.0 3.0 

Other programs 

Subtotal (other) 59.3 59.1 58.6 58.6

Adoption opportunities—Competitive grants to eliminate

barriers to adoptions—especially to special needs adoptions 

27.2 27.1 26.8 26.8

Children’s Justice Act grants—Formula grant to states to 

improve the handling, investigation, and prosecution of child

abuse and neglect cases 

20.0 20.0 20.0 20.0

Abandoned infants assistance—Competitive grants to prevent 

abandonment of infants exposed to HIV/AIDS or drugs and for 

services and programs to address needs of abandoned children 

12.1 12.0 11.8 11.8

Source: Congressional Research Service documents. 

Page 37 GAO-07-75 Child Welfare
Appendix III: Type, Description, and Status of 

Title IV-E Waiver Demonstration Programs, as

of August 2006 

Status of demonstration by state

Active demonstrations

Completed 

demonstrations

Project type and 

description

Under original 

waiver 

Under shortterm 

extension

Under 5-year 

extensiona

On time

Terminated

early 

Approved, not

implemented

Evaluation 

progress 

Assisted

guardianship/

kinship 

permanence:

Relatives/other

caregivers who

assume legal 

custody of 

children are 

eligible for a 

monthly subsidy 

equal or 

comparable to

foster care 

payments. 

Montana 

(2006) 

New Mexico

(2005) 

 Illinois (2008)

North Carolina,

Oregon (2009)

Delaware 

(2002) 

Maryland 

(2004) 

 Minnesota 

Wisconsin 

Completed: 

Delaware, 

Illinois, 

Maryland, 

North 

Carolina, 

Oregon, New 

Mexico 

Expected: 

Montana 

March 2007 

Capped IV-E 

allocations and

flexibility to

local agencies:

States give 

counties or other 

local entities 

flexibility in 

spending child 

welfare dollars for 

new services and 

supports in 

exchange for a

capped per 

child/per family

allocation of Title 

IV-E funds. 

 Indiana (2005) North Carolina,

Ohio, Oregon 

(2009) 

 Completed: 

Indiana, North 

Carolina, Ohio, 

Oregon 

Services to

caretakers with

substance use

disorders: States 

use Title IV-E 

dollars to fund 

services and 

supports for 

caregivers with

substance abuse 

disorders. 

Illinois (2005) New 

Hampshire 

(2005) 

 Delaware 

(2002) 

Maryland 

(2002) 

 Completed: 

Delaware, 

Illinois 

Expected: 

New 

Hampshire 

Pending 

Exemption: 

Maryland 

Appendix III: Type, Description, and Status of 

Title IV-E Waiver Demonstration Programs, 

as of August 2006 

Page 38 GAO-07-75 Child Welfare
Appendix III: Type, Description, and Status of 

Title IV-E Waiver Demonstration Programs, as

of August 2006 

Status of demonstration by state

Active demonstrations

Completed 

demonstrations

Project type and 

description

Under original 

waiver 

Under shortterm 

extension

Under 5-year 

extensiona

On time

Terminated

early 

Approved, not

implemented

Evaluation 

progress 

Managed care

payment 

systems: States 

use alternative 

managed care

financing 

mechanisms to 

reduce child 

welfare costs 

while improving 

permanency, 

safety, and wellbeing outcomes 

for targeted 

families. 

 Michigan 

(2003) 

Colorado, 

Washington 

(2003) 

Connecticut, 

Maryland 

(2002) 

 Completed: 

Colorado, 

Connecticut, 

Michigan, 

Washington 

Exemption: 

Maryland 

Intensive 

service options:

States increase 

the variety and

intensity of 

services and 

supports to 

reduce out-ofhome placement 

rates and improve 

other 

permanency and 

safety outcomes. 

 California 

(2005) 

 Mississippi 

(2004) 

 Completed: 

California, 

Mississippi 

Adoptions and 

postpermanency

services: States 

strengthen 

existing or 

provide new postadoption and 

postpermanency 

services and 

supports. 

 Maine (2004) Minnesota Completed: 

Maine 

Page 39 GAO-07-75 Child Welfare
Appendix III: Type, Description, and Status of 

Title IV-E Waiver Demonstration Programs, as

of August 2006 

Status of demonstration by state

Active demonstrations

Completed 

demonstrations

Project type and 

description

Under original 

waiver 

Under shortterm 

extension

Under 5-year 

extensiona

On time

Terminated

early 

Approved, not

implemented

Evaluation 

progress 

Tribal

administration

of IV-E funds:

Tribes develop

administrative 

and financial 

systems to 

administer Title

IV-E foster care 

programs 

independently 

and directly claim 

federal

reimbursement. 

New Mexico

(2005) 

 Completed: 

New Mexico 

Enhanced

training for child

welfare staff:

Training for public 

and private sector 

child welfare 

professionals 

serving children

and their families 

to improve 

permanency and 

safety outcomes. 

Illinois (2007) Expected: 

Illinois June

2008 

Source: GAO analysis of HHS information on child welfare waiver demonstrations. 

a

Evaluations will be submitted by the four states with 5-year extensions. 

Page 40 GAO-07-75 Child Welfare
Appendix IV: Department of Health and

Human Services Child Welfare National

Resource Centers and whether They Are 

Included in the Technical Assistance Tracking 

Internet System Database

Appendix IV: Department of Health and 

Human Services Child Welfare National 

Resource Centers and whether They Are 

Included in the Technical Assistance 

Tracking Internet System Database 

National resource center Description Web site 

National Resource Centers Included In the Technical Assistance Tracking Internet System Database (TATIS) 

National Child Welfare Resource Center for 

Organizational Improvement 

Assists with strategic planning, CFSRs, outcome 

evaluation and workforce training and 

development; facilitates the involvement of 

stakeholders; and monitors the technical 

assistance progress. 

http://www.nrcoi.org

National Resource Center for Child

Protective Services (CPS) 

Works to build state and local CPS capacity, 

assists in determining eligibility for the Child Abuse 

Prevention and Treatment Act (CAPTA) grant, and 

provides support to state liaison officers. 

http://www.nrccps.org 

National Child Welfare Resource Center on

Legal and Judicial Issues 

Provides states legal and judicial issue analysis for 

the CFSRs, assists in action planning and 

implementation of program improvement plans. 

http://www.abanet.org/child/rclji

National Resource Center for FamilyCentered Practice and Permanency PlanningProvides assistance through all stages of the 

CFSRs, emphasizes family-centered principles 

and practices, and builds knowledge of foster care 

issues. 

http://www.nrcfcppp.org 

National Resource Center for Child Welfare 

Data and Technology

Provides support for technical issues, conducts 

data use and management training, and helps in 

preparation and use of state data profiles. 

http://www.nrccwdt.org 

National Child Welfare Resource Center for 

Adoption 

Analyzes adoption and permanency options, 

provides support for increasing cultural

competency, and examines systematic problems 

and solutions. 

http://www.nrcadoption.org 

National Child Welfare Resource Center for 

Youth Development

Supports youth participation in child welfare policy, 

program development and planning, offers 

assistance for foster care independence and 

education voucher program implementation. 

http://www.nrcys.ou.edu/nrcyd 

The Collaboration to AdoptUsKids Provides training and technical assistance on

quality recruitment and retention services for foster 

and adoptive families. 

http://www.adoptuskids.org

National resource centers not included In TATIS

National Center on Substance Abuse and 

Child Welfare (cosponsored with the 

Substance Abuse and Mental Health Services 

Administration)

Works to develop knowledge and provides 

assistance to child welfare agencies on substance 

abuse related disorders in the child welfare and 

family court systems. 

http://www.ncsacw.samhsa.gov

National Abandoned Infants Assistance

Resource Center 

Works to enhance the quality of social and health 

services for children abandoned because of the 

presence of drugs or HIV in the family. 

http://aia.berkeley.edu/

National Resource Center for CommunityBased Child Abuse Prevention Programs Focuses on primary child abuse and neglect 

prevention, assists in implementation for family 

support strategies. 

http://www.friendsnrc.org 

Source: HHS training and technical assistance documents. 

Page 41 GAO-07-75 Child Welfare
Appendix V: Comments from the Department of Health and Human Services Appendix V: Comments from the Department 

of Health and Human Services 

Page 42 GAO-07-75 Child Welfare
Appendix V: Comments from the Department of Health and Human Services 

Page 43 GAO-07-75 Child Welfare
Appendix V: Comments from the Department of Health and Human Services 

Page 44 GAO-07-75 Child Welfare
Appendix V: Comments from the Department of Health and Human Services 

Page 45 GAO-07-75 Child Welfare
Appendix V: Comments from the Department of Health and Human Services 

Page 46 GAO-07-75 Child Welfare
Appendix VI: 

A

GAO Contacts and Staff 

cknowledgments 

Page 47 GAO-07-75

Appendix VI: GAO Contacts and Staff 

Acknowledgments 

Cornelia M. Ashby, (202)512-7215, ashbyc@gao.gov

Cindy Ayers (Assistant Director) and Arthur T. Merriam Jr. (Analyst-inCharge) managed all aspects of the assignment. Mark E. Ward made 

significant contributions to this report, in all aspects of the work. 

Christopher T. Langford and Kathleen L. Boggs analyzed the results of the 

GAO survey of child welfare challenges and assisted in the report 

development. In addition, Carolyn M. Taylor contributed to the initial 

design of the engagement, Carolyn Boyce provided technical support in 

design and methodology, survey research, and statistical analysis; James 

Rebbe provided legal support; and Charles Willson assisted in the message 

and report development.

GAO Contact 

Staff 

Acknowledgments 

Child Welfare
Related GAO Products Related GAO Products 

Child Welfare: Federal Action Needed to Ensure States Have Plans to 

Safeguard Children in the Child Welfare System Displaced by Disasters. 

GAO-06-944. Washington, D.C.: July 28, 2006. 

Foster Care and Adoption Assistance: Federal Oversight Needed to 

Safeguard Funds and Ensure Consistent Support for States’

Administrative Costs. GAO-06-649. Washington, D.C.: June 15, 2006. 

Child Welfare: Federal Oversight of State IV-B Activities Could Inform 

Action Needed to Improve Services to Families and Statutory 

Compliance. GAO-06-787T. Washington, D.C.: May 23, 2006.

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. 

Page 48 GAO-07-75 Child Welfare
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: Better Policy Implementation and 

Documentation of Related Activities Would Help Improve Performance.

GAO-03-646. Washington, D.C.: May 27, 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. 

Child Welfare: New Financing and Service Strategies Hold Promise, but 

Effects Unknown. GAO/T-HEHS-00-158. Washington, D.C.: July 20, 2000.

Foster Care: States’ Early Experiences Implementing the Adoption and 

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

Page 49 GAO-07-75 Child Welfare
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: Kinship Care Quality and Permanency Issues. 

GAO/HEHS-99-32. Washington, D.C.: May 6, 1999.

Foster Care: Agencies Face Challenges Securing Stable Homes for 

Children of Substance Abusers. GAO/HEHS-98-182. Washington, D.C.: 

September 30, 1998. 

(130526) Page 50 GAO-07-75 Child Welfare
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