Grandparents Raising Grandchildren:

A Call To Action 

Administration for Children and Families, Region IV
INTRODUCTION

The Administration for Children and Families (ACF),

in partnership with the Administration on Aging (AoA)

in Region IV, has demonstrated its commitment to supporting vulnerable families by undertaking a leadership role

to establish a network of services for grandparents raising

grandchildren. Beginning in 2002, the southeastern offices

of ACF and AoA collaborated with federal, state and local

public welfare, academic, and community service agencies

in Georgia to form a provider consortium to identify the

needs of grandparent-headed families, and to develop and

execute a service delivery plan to address their needs. This

consortium serves as a model for other localities wanting

to design and execute community-based services for intergenerational families. 

Participating agencies included the DHHS/Office

on Women’s Health, Georgia Council on Aging, Atlanta

Regional Commission, Georgia Department of Human

Resources, the Georgia Division on Aging, and Georgia

State University (See the Appendix for a full listing of 

participating agencies). During a three year period 

(2002-2005), several town hall meetings and planning

groups were held that brought together service providers 

and administrators, as well as grandparents from the Atlanta

metropolitan area, to voice their concerns and needs, and

to begin planning an approach to address their issues in a

collaborative fashion. 

These efforts produced the following results: (1) the

joint sponsorship of the Minority Grandparents Raising

Grandchildren Summit – Taking Care of Others: The Balancing

Act (2003) – an information and resource dissemination

event for caregivers, service providers and program administrators; (2) the development of resource directories to help

grandparents find services in their local communities, such

as financial assistance, legal guidance, child care, recreation

services, and specialized services for children with disabilities;

and (3), the establishment of the Clayton County Kinship

Care Resource Center, a local service providing direct and

referral assistance to grandparents raising grandchildren.

Services offered through the Kinship Care Center include

monthly support group meetings for grandparents, child

care, case management, material assistance, parent/child

group activities, and transportation to center activities. 

As a result of the efforts led by ACF, there are ongoing

communication and working relationships with state and

local agencies in Georgia, which have been highly successful

and demonstrate the promising effects of establishing a

collaborative network. But there is more work that needs

to occur. Generally, local services for grandparent-headed

households continue to be limited, fragmented, uncoordinated,

or simply unavailable to many of them, especially for families

in isolated communities (Generations United, 2002). As a

result, the focus of this paper is to describe the incidence of

grandparents raising grandchildren in Region IV, illustrate

the collaborative efforts occurring among federal, state and

local agencies in the Atlanta community that may serve as

a model for other localities, and suggest federal options to

build upon past successes, as well as to address ongoing/

future challenges for grandparent-headed families within

the region. 

Box 1 

Administration for Children and

Families, Region IV

Region IV is one of ten regional ACF 

offices nationwide and serves eight 

southeastern states:

» Alabama » Mississippi

» Florida » North Carolina

» Georgia » South Carolina

» Kentucky » Tennessee
BACKGROUND

When parents are not able to raise their children, it is

often grandparents who step in to assume this responsibility.

Many take on this role to “keep the family together,” rather

than have their grandchildren grow-up in the foster care system.

In most cases, grandparents never anticipated the need to raise

their grandchildren, and they are often ill-prepared to care

for one or more children. Unlike traditional foster parents,

many grandparent caregivers who informally assume responsibility for their grandchildren are offered no training to raise

traumatized children, and receive limited financial assistance

to meet their grandchildren’s basic needs. Regardless of

these challenges, many take on the parenting role valiantly,

but grandparent caregivers may be financially poor and

have little experience navigating bureaucratic systems for

specialized services. Ultimately, the grandchildren are at

risk for not receiving adequate supports for positive growth

and development. 

The number of grandparents serving as primary caregivers for their grandchildren has increased nationally in the

past twenty years, but the phenomenon is most prevalent in

the southern region of the nation. According to the 2005

American Communities Survey, there are an estimated

5.7 million grandparents living with grandchildren in their

households; 2.4 million co-resident grandparents are the

primary caregivers for their grandchildren, representing 42%

of all grandparents residing with their grandchildren (U.S.

Census Bureau, 2006). Grandmothers constitute the largest

proportion (63%) of these caregivers, and African American

families represent the majority (52%) of all caregiving grandparents (U.S. Census Bureau, 2006). The southern region of

the nation has the highest percentage (47.2%) of grandparent

caregivers; the proportion of grandparent caregivers living in

poverty is also highest in the south (23%). (See map on

page 13). 

GRANDPARENT CAREGIVERS IN

REGION IV

Within Region IV on average, 28% of grandparent caregivers are over age 60, as many as 30% live in poverty, and

at least 32% have cared for their grandchildren 5 or more years

(U.S. Census Bureau, 2006). Table I presents the distribution

of co-resident grandparents and their grandchildren in

Region IV. Over 636,500 grandchildren – 13% of all children

living in grandparent-headed households nationally – are

being raised by their grandparents in the southeast region. 

1

Region IV

States

Number of

grandparents

living with 

grandchildren 

Number of

grandparents

responsible

for co-resident

grandchildren

Percent of 

co-resident

grandparents

responsible for

grandchildren

Number of

grandchildren

living with

grandparents

Number of

grandchildren

under responsibility of

grandparents

Percent of

grandchildren

under responsibility of

grandparents 

Alabama

Florida

Georgia

Kentucky

Mississippi

N. Carolina

S. Carolina

Tennessee

United States

111,975

357,729

193,219

82,199

89,412

165,345

90,978

124,366

5.7 million

65,719

154,029

93,189

44,172

53,564

82,149

47,657

68,381

2.4 million

58.6

43.0

48.2

53.7

59.9

49.7

52.4

54.9

42.1

105,820

289,610

170,454

67,394

86,045

146,875

85,359

103,458

4.6 million

67,708

167,162

104,355

39,726

58,699

84,232

51,724

62,902

2.5 million

63.9

57.7

61.2

58.9

68.2

57.3

60.6

60.7

54.3

Table I: 

Distribution of Co-Resident Grandparents and Grandchildren in Region IV – 2005

Sources: U.S. Census Bureau, 2005 American Community Survey, Table S1001 – Grandchildren Characteristics;

Table S1002 – Grandparent Characteristics.
Based on 2004 population estimates using the American

Community Survey, significant growth in the number of

grandparent caregivers in the region is expected, particularly

in Georgia, Tennessee, and North Carolina, where the estimates range from 7%-15% higher than in 2000 (U.S. Census

Bureau, 2004a). Therefore, Region IV currently has the

greatest density of grandparent-headed families in the U.S.;

a majority of these grandparents are poor and advancing in

age. It is anticipated that the growth of grandparent caregivers

will continue in the near future, warranting the need for a

stronger alignment of existing service delivery systems to

meet their needs, and the needs of their grandchildren. 

The reasons grandparents are parenting their grandchildren

in the region are similar to those of other grandparent-headed

families nationally. Placement of children with grandparents

can occur abruptly, or after a long and difficult period with

the biological parents. There are multiple and oftentimes

interrelated reasons children are raised by grandparents. They

include parental substance abuse, child abuse and neglect,

psychiatric disorders of parents, parental incarceration, and

homicide resulting from domestic violence events (Dowdell,

1995; Kelley, 1993; Kelley, Yorker, Whitley, & Sipe, 2001). 

The rising incidence of methamphetamine addiction,

largely in rural communities, is impacting grandparent

caregivers across America. In 2004, the Drug Enforcement

Administration recorded a total of 17,170 methamphetamine

incidents, including seizures of manufacturing labs, equipment,

and dumpsites; 20.8% of those incidents occurred in the

southeast region, with Tennessee having the most incidents

(1,327) (Drug Enforcement Administration, 2005). In

response to this national phenomenon, Georgia enacted a state

law making it a felony to manufacture methamphetamine in

the presence of children (Perdue, 2006). Similar laws are

being considered in other states. As a result, state authorities

in Georgia are removing children from homes where

methamphetamine laboratories are located, and many are

placed under the care of their grandparents. 

For families of color, HIV/AIDS is another emerging

issue that is contributing to the growing numbers of grandparent-headed households (CDC, 2003). According to

research conducted in 2004 by the Henry J. Kaiser Family

Foundation (2005), racial and ethnic minorities represent

72% of new AIDS cases, and 65% of all persons living with

AIDS. Further, in the same period, the southern region had

the highest AIDS case rate per 100,000 (18.7), second only

to the northeast region. Certainly, these are indicators that

potentially impact grandchildren and their grandparents,

requiring collaborative efforts among public health, child

welfare and other social welfare providers. 

KINSHIP CARE ARRANGEMENTS

There are three main types of kinship placements for

children – public kinship foster care, voluntary kinship care

and informal/private kinship care. By far, a majority of

children in kinship care placements are in informal care.

According to the Urban Institute (2003), over 1.7 million

grandchildren in the U.S. are living with relative caregivers

(mostly grandparents) in informal arrangements, that is,

family members made the decision privately about the child’s

living arrangements. Another 400,000 children are in kinship

foster care, and 140,000 children are in voluntary kinship

care (Urban Institute, 2003). (See definitions for kinship

arrangements in Box 2). 

In Region IV, as of 2003, there were 84,200 children in

out-of-home placements; 25% of these children were living

with relatives in kinship placements (Child Welfare League

of America, 2006). Although there is a strong preference

among child welfare agencies to use kinship care arrangements

rather than non-relative care placements, fewer services and

supports are provided to them in comparison to non-relative

caregivers. According to several research studies (Chipungu

et al., 1998; Barth et al., 1994; Berrick, Barth, and Needell,

1994), kinship caregivers request fewer services, are offered

fewer services, and therefore, receive fewer services than

non-kin providers. 

In some cases, this is due to case workers assuming that

the kinship caregiver knows the child and would take sufficient care of them, and that agency assistance is, therefore,

unnecessary. But even if a relative caregiver wanted a particular

service from an agency, often that service is available only to

non-kin caregivers (Jantz, Geen, et al., 2002). So, there is a

general fallacy that because the kinship caregiver has a blood

relationship with the child, agency services and supports are

not a priority for these families. Consequently, children may

not receive benefits and services needed to enhance their

development, and grandparents are frustrated and distressed

because they do not have the necessary assistance to support

positive family functioning.

2
CAREGIVING EFFECTS ON 

GRANDPARENTS

Evidence has emerged indicating that grandparents

raising grandchildren are often negatively affected by their

caregiving responsibilities. Across the nation, including

Region IV, reported conditions by grandparents after taking

on parenting roles draw attention to major areas of need

that require designated services and policy considerations. 

Financial Needs – Access to stable and sufficient financial

resources is a primary need of custodial grandparents. According

to the Urban Institute (2003), 54% of all grandchildren,

nationally, are raised by grandparents whose incomes are below

200 percent of the federal poverty level. Many grandparents

have accumulated some financial assets from years of working,

but are now living on fixed incomes. Raising one or more

children in their homes stretches their retirement funds to the

point where basic needs can not be met for all family members.

While many grandparents are eligible for public welfare benefits

(TANF, SSI), some are hesitant to apply for them because of

negative past experiences with the public welfare system. For

others, whose values about self-sufficiency and keeping their

family matters private are so ingrained, seeking public welfare

benefits is not seen as a viable option. The household assets of

some families may put them just above the eligibility level for

public benefits. Many grandparents are simply unaware of what

resources are available and how to access them. As a result,

the financial costs associated with feeding, clothing, and meeting medical costs for grandchildren become a private burden. 

Housing – A majority (77%) of caregiving grandparents 

in Region IV own their homes as opposed to renting them

(U.S. Census Bureau, 2004b). Even though this is considered

a financial asset, consideration must be given to the structural

condition of the home, the number of persons residing in the

home, and one’s ability to pay all costs associated with homeownership (e.g., utilities, repairs, local taxes). The structural

condition of the homes of some low income families may not

be appropriate for housing multiple children. Some seniors

“downsize” their homes when they retire, but when one or

more grandchildren are brought into their care, the living

space can become overcrowded (Macomber & Geen, 2002).

Most grandparents cannot afford to add more space onto their

present dwellings. Ultimately, overcrowded living conditions

affect all family members, contributing to increased mental

stress and tension in the household. 

In some cases, grandparent caregivers residing in seniorcitizen designated facilities are forced to relocate to another

residence because children are prohibited from living in the

facility. This can be an expensive undertaking or a nearly

impossible task for low-income families trying to find a residence based on current housing market rates because timely

access to public housing units is extremely limited. 

Food Insecurity – Providing adequate food for family

members is a source of worry for low-income grandparents

when grandchildren come to live with them. According to 

a report by Macomber & Geen (2002) based on the 1999

National Survey of American Families (NSAF), 48% of 770

grandchildren living with grandparent caregivers experienced

some level of food insecurity (i.e., insufficient food to last an

entire month in the household, or some adults eating small

portions or skipping meals to stretch available food supplies).

As noted earlier, many grandparents are reluctant to utilize

public assistance programs, including food stamps. Based

on the same NSAF study, less than half (43%) of the grandchildren living in grandparent-headed families received food

stamps (2002). While the need for food assistance is clear, developing strategies to reach out to grandparents about the benefits

of utilizing public food resources must become a priority. 

3

Box 2

Kinship Placement Arrangements

Below are the definitions for kinship care

arrangements:

Public Kinship Foster Care: Children are

placed in the legal custody of the state,

and a child welfare agency (as representative of the state) places the child with a

relative, such as a grandparent.

Voluntary Kinship Care: State does not

have legal custody of the child, but child

welfare may have involvement in placing

the child with a relative, sometimes with

supports to stabilize family situations for

the benefit of the child. 

Informal/Private Kinship Care: Decisions

about where a child resides are made 

by family members; there is no formal

involvement with child welfare services 

or the courts, although one or both may

become involved after the child has

begun living with a relative.
Mental Stress – When grandparents assume the role of

primary caregivers for their grandchildren, it can take a toll

on their emotional state. Many grandparents have mixed

emotions about raising their grandchildren. They often describe

the joys of having their grandchildren live with them (Burton,

1992). For some grandparents, caregiving provides a purpose

in life; other grandparents may see it as a second chance to

raise a child. While they enjoy having them in their homes,

some grandparents also are angry with their adult children who

caused them to be in the parenting role again, with all its

consequences. In a study of grandparent caregivers living in

the southeast region, Kelley, et al., (2000) found that lack of

economic resources, poor physical health, and, to a lesser extent,

lack of social supports predicted higher levels of psychological

distress. The level of stress may be exacerbated when grandchildren have medical or developmental problems that require

extensive supports, but grandparents are uncertain how to

access needed services. 

Other studies noted a majority of grandparents (55%)

are raising their grandchildren alone, without the support of

a spouse; isolation from friends and family can occur as a result

of caregiving responsibilities, giving grandparents few social

outlets (Jendrek, 1994; Ehrle, 2001). Parenting due to AIDS

or drug abuse can sometimes isolate caregivers because they

are ashamed or embarrassed to publicly acknowledge these

issues, cutting them off further from necessary social networks

(Roe and Minkler, 1999). In a national study on the needs

of children in grandparent care by the Urban Institute

(Scarcella, et al., 2003), nearly one-third of the grandchildren were raised by grandparents experiencing poor mental

health, and 23% lived with a “highly aggravated caregiver”

(p.4). The level of mental strain associated with raising their

grandchildren is noteworthy, suggesting the necessity for

mental health support services for grandparent caregivers. 

Physical Health – Another consequence of raising

grandchildren is the deterioration of the grandparent’s

physical health. In a study of 100 grandparents residing in

the southeast, Whitley, Kelley and Sipe (2001) found that

23% had diabetes, over one-half (54%) had high blood

pressure, 22% had high cholesterol levels, and 80% met

the criteria for obesity. Usually, it is not a question of

grandparents not having access to health care; access to

medical services through public health insurance (Medicare

and Medicaid) or private insurance is a resource held by many

grandparents. But grandparents younger than retirement age

and working part-time with no medical benefits may have

very limited access to health services, causing them to rely

on emergency rooms or community-based free clinics for

their primary health care. 

For the majority of grandparent caregivers, utilizing

primary care health services for their own care is problematic

because of the extensive time commitments related to raising

their grandchildren. Minkler and Roe (1993) found that

38 percent of grandparent caregivers in their study reported

their health had worsened since assuming full-time parenting responsibilities for their grandchildren. But despite

deteriorating physical health, half of the caregivers reported

breaking medical appointments during the past year because

of child care responsibilities, and one-third had not been to

a doctor in three years or more. 

Parenting an infant or toddler may present additional

physical strain for some grandparents because they are not

able to lift and carry their grandchildren, participate in play

activities, or accompany them on outings away from home.

Researchers have reported that children being cared for by

grandparents go on fewer outings than children living with

other relatives (Scarcella, et al., 2003; Ehrle, & Moore, 1999).

In addition, these researchers found grandparents are more

likely to have physical difficulty attending school activities/

meetings, or after-school or week-end recreational activities

as compared with other relative or non-relative caregivers.

In summary, reported studies and their findings suggest

specific areas of concern that are commonly experienced by

grandparent-headed families across Region IV. Identifying

support services to address grandparent needs for financial

support, housing, health, food assistance and mental stress

will be essential to any program design. 

4
CAREGIVING EFFECTS ON 

GRANDCHILDREN

Placing a child with grandparents has positive effects for

the child, as well as the whole family. Keeping children with

family members sustains their connection to their family

roots; usually they are in close proximity to other relatives,

including siblings, which allows them to receive family support that is unavailable or infrequent with non-kin placements

(Chipungu, et al., 1998). This is important for children who

may experience separation anxiety and attachment disorders

following traumatic events with their parents. But little research

has described the distinct needs of grandchildren living in

grandparent households, or explored how these children are

coping. What is known about these children is largely based

on information extrapolated from general research on traumatized children, or is derived from health and social data

about grandparent caregivers and inferences about how

grandparent caregiving impacts the well-being of grandchildren (Scarcella, et al., 2003). 

Young Grandchildren – The incidence of maternal

substance abuse raises concerns about the developmental 

status of young grandchildren being raised by grandparents.

An unpublished study by Whitley, Kelley & Campos (2006)

explored the developmental status of 74 young AfricanAmerican grandchildren being raised by their grandparents

in Georgia. Fifty-seven grandchildren, ages 1-5 years, were

ultimately evaluated by a team of child development specialists. 

Based on the evaluation results, 40 (70.18%) grandchildren had a verified developmental disability, including fetal

alcohol syndrome (full or partial) (32.5%), cognitive delay

(12.5%), gross motor, communication, and social/emotional

delays (7.5%, respectively), and fine motor delay (2.5%).

The magnitude of disabilities that is exhibited by these young

children warrants targeting early intervention screening and

evaluation services to them. Without appropriate early

intervention services, the risk for educational and social failure

among these children is very clear, and certainly avoidable. 

Adolescent Grandchildren – The early trauma experienced by adolescent grandchildren has multiple effects on

their social/emotional functioning. Physical abuse, neglect,

sexual abuse, and abandonment by the biological parents are

common events in their lives. In addition, many grandchildren

have been exposed to homicide, rape, assault, robbery and

other crimes associated with substance abusing parents or

other family members (Jendrek, 1994; Minkler & Roe,

1993). Consequently, these youth are at risk for expressing

anti-social emotions and behaviors. Emotions such as anger

and frustration due to feelings of abandonment, parental

confusion, and attachment disorder may be manifested in

early sexual activity, gang activity, drug use, poor school

performance, and violent behavior toward peers and/or

family members (McGuigan & Pratt, 2001; Herrenkohl,

Guo, et al., 2001; Brendgen, Vitaro, et al., 2000). 

Current literature suggests grandparent stress is often

related to teenage children exhibiting behavior problems,

truancy, and unaddressed physical and mental health

problems (Robbins, et al., 2006). Estimations derived

from the 1999 NSAF survey suggest that nearly 10% of

grandchildren between the ages of 6 and 17 and living

with their grandparents experience high levels of behavioral

or emotional problems (Scarcella, et al., 2003). Grandparents

are sometimes at a loss as to how best to interact and discipline their grandchildren, sometimes intensifying existing

attachment disorders. 

In a study by Peterman (2005) of grandmothers raising

grandchildren, suggested factors associated with negative

attachment among adolescent grandchildren included lack

of exhibited warmth and closeness by grandmothers, little

involvement with their grandchildren, and little or poor

supervision. As a result, these grandchildren are at risk for

poor social functioning. Certainly, not all grandchildren

exhibit negative behaviors when living with their grandparents, but there is enough evidence that raises concerns

and suggests specialized mental health intervention for

grandchildren is a vital support service for these families. 

Therefore, in summary, too little attention has been

given to the needs of grandchildren living with grandparents.

A number of child welfare researchers and practitioners

suggest that unaddressed developmental and socio-emotional

effects among grandchildren can increase risks for poor

outcomes related to education and peer interaction, and

contribute to negative family functioning.

5
CURRENT RESOURCES

A growing number of agencies in Region IV provides

services for grandparent caregivers and their grandchildren.

The current public and private service system offers various

supports to any family in need, and most of these services

are available to grandparent-headed families; however, they

are sometimes not interconnected, requiring individuals to

negotiate several bureaucratic mazes in order to receive benefits. Informal caregivers tend to have less access to public

services because their grandchildren are not involved with

the child welfare system, although their needs are just as

critical as those of any family in the system. Many community-based services provide information and referral services,

or support group meetings for grandparents; few provide

comprehensive services to address the multiple, interrelated

issues facing grandparent caregivers. 

Financial Assistance – Traditional public assistance

benefits available to meet basic family needs are available

to grandparent families. Generally, all grandparent-headed

families can receive TANF – child only grants; food stamps,

Medicaid, WIC, and child support payments are also available

according to certain eligibility criteria. However, grandparent

caregivers do not represent a market group that is consistently

targeted by public welfare administrators. Therefore, grandparents are not fully aware that they too are eligible for

certain services and benefits. 

Ehrle and Geen (2002) suggest that outreach materials

about public welfare benefits are presently marketed to

“parents,” which may be ignored by other caregivers. The

stigma of receiving public benefits is a barrier that welfare

agencies must continue to address when designing service

delivery strategies that facilitate access to grandparent caregivers. Broadening relationships with diverse organizations

and public offices (e.g., aging, Social Security, school systems,

faith-based organizations) to develop outreach approaches

to grandparent families may help to facilitate greater access

to pubic assistance programs. 

As of 2004, state subsidized guardianship is available in

35 states and the District of Columbia, including Florida,

Georgia, Kentucky and North Carolina in the southeast

region (Children’s Defense Fund, 2004). Each program

provides ongoing financial support to relative caregivers

who accept permanent legal guardianship of related children,

when reunification or adoption is not possible or desired.

Generally, this option provides permanency for older children,

sibling groups, and children who have spent long periods 

of time in the child welfare system. But understanding and

accessing this program can be difficult for grandparent caregivers because the program has different names in different

states and different versions in a single state, with varying

eligibility criteria, and different subsidy amounts for 

children. For grandparents with informal arrangements, 

this program may not be an option since the children must

be in state custody at some point (ranging from 6 months 

to one year). Only six states provide subsidized guardianship

to informal caregivers, and none is in Region IV (Children’s

Defense Fund, 2004). Post placement support services are

not uniformly available to caregivers across states, placing

many children at risk for not receiving needed services such

as clothing allowances, school supply allowances, and access

to summer camps (Geen, 2003).

Another potential financial resource for grandparent

caregivers is Title IV-E Adoption Assistance. If grandparents

wish to adopt their grandchildren, and the children are in

state custody or involved with a placement agency, financial

assistance is available to the family through Title IV-E. But

as noted above, many grandparents are informally raising

their grandchildren; they are not involved in the child welfare

system. These families do not have easy access to the more

generous public payments (compared to TANF) that would

provide an economic cushion to meet some of their needs.

States cannot use Title IV-E funding to support kinship placements outside of the formal foster care system and it cannot

be used to support kinship guardianship placements, except

through a limited waiver process (Generations United, 2004). 

Child support is another financial option open to

grandparent caregivers. Services to assist them to obtain

child support orders, locate non-custodial parents, and

redirect existing child support funds are available. But some

grandparents may be hesitant to seek child support due to

possible negative repercussions from non-custodial parents.

(Generations United, 2004).

Legal Assistance – Determining the legal relationship

with their grandchild is a critical area where grandparents

need assistance. Too often, grandparents do not have a

legal relationship with their grandchildren, largely due

to the informal way in which they obtained responsibility

for their grandchildren, and their lack of knowledge of its

benefits (Yorker, et al., 1998). Some grandparents do not

understand the advantages/disadvantages of each legal option.

Many would rather not establish a legal relationship because

they are hopeful the grandchildren’s parents will resume

responsibility for them. Another concern is the cost associated with legalizing their relationship, a financial item that

has less priority than immediate needs, such as feeding and

clothing their grandchildren. (See Box 3 for definitions of

legal arrangements.)

6
Educational Assistance – Finding educational services

to meet grandchildren’s needs is often frustrating for grandparents. Their expressions of concern may not be addressed

by schools in a timely manner, or the grandparents may

have difficulty voicing their concerns to teachers or school

administrators. Too often, grandparents are left to defend

their grandchildren’s rights with little knowledge about or

experience with education policies or school systems. For

example, many grandparents are unaware of the Individuals

with Disabilities Education Act (IDEA) relative to developmental assessment and evaluation, prescribed individual

family service plans (IFSP), individual educational plans

(IEP), or transition planning. Being unfamiliar with educational policies or services can put any parent at a disadvantage,

but the lack of knowledge in this area can present a major

challenge for grandparents who may be intimidated by

public systems. 

As a result, grandchildren may not get the services

needed for school success, increasing their risks for school

failure and other social consequences that may diminish

positive life outcomes. But knowing how to access early

education (e.g., Head Start/Early Head Start), or special

education programs is critical for any caregiver of a child,

and in particular, a child with disabilities. This suggests

that formal and informal support networks within schools,

early child development programs, health and public welfare

systems must work collaboratively to help grandparents access

information and services to influence educational outcomes.

GEORGIA: A MODEL OF 

COLLABORATION

Georgia, specifically the work that has begun in the

Atlanta metropolitan area, is regarded as a model for developing successful joint ventures among ACF, state and private

agencies to address the needs of grandparent caregivers.

Since Atlanta is recognized as the center of state leadership

in Georgia, it is a reasonable assumption that the foundation

for building statewide partners would begin in the Atlanta

community. Under the leadership of ACF, a coalition of

public and private agencies is working together to address

the common needs faced by caregivers by expanding the

current service delivery system to target grandparents and

the children under their care. In many cases, existing 

services in Georgia were restructured to ensure grandparentheaded families have easy access to them; in other cases

new initiatives were established with support from the ACF

regional office, as well as other state and local agencies. 

7

Box 3

Defined Legal Arrangements

Guardianship: Parental rights not terminated, and the grandparent is not

financially responsible for the grandchild;

allows grandparent to enroll child in

school and receive medical care.

Legal Custody: Grandparent petitions for

custody if he/she can demonstrate parent

is “unfit,” and grandparent retains physical possession of the grandchild.

Relative Foster Care: Child is in the

custody of the state, but the grandchild

resides in the relative’s home (including

grandparents).

Non-relative Foster Care: Child is in the

custody of the state, but the grandchild

resides with persons not related to the child.

Adoption: Parental rights are severed;

grandparent assumes all legal and 

financial responsibilities for the child. 

Other options available in some states:

Stand-by Guardianships: Parent retains

custody, but a stand-by guardian is named

for the child when the parent dies.

Subsidized Guardianships: Financial

support is provided for children in state

custody; caregiver becomes the legal

guardian, replacing the state. 
Georgia’s Grandparent Caregivers

» A total of 48.2% of all grandparents co-residing

with grandchildren are primary caregivers.

» Fulton (6,154), Dekalb (5,033) and Clayton

(3,622) counties have the highest concentration of

grandparent caregivers in the state.

» A total of 24% of care giving grandparents are 60

years of age or older.

» A total of 28.7% live in poverty.

» A total of 32% have parented their grandchildren

for 5 or more years.

» As of 2005, 17,194 children were in state custody

foster care services – 4,126 (24%) were placed in

relative foster care.

Sources: Simmons, T., & Dye, J. I. (2003). Grandparents

living with children: 2000. (Census 2000 Brief Report

C2KBR-31). Washington, D.C. U.S. Census Bureau;

Child Welfare League, (2006). State Fact Sheets for 2006.

Washington, D.C.: CWLA; U.S. Census Bureau, (2004).

2004 American FactFinder by County. Available at:

http://factfinder.census.gov/home/saff/main.html: U.S.

Census Bureau, 2006, American Communities Survey.

In response to the growing number of grandparent

caregivers in Georgia, Governor Sonny Perdue made a commitment to establish 12 Kinship Care Centers across the state.

The purpose of these facilities is to provide a central location

for grandparents (and other relative caregivers) to obtain

information about community services to meet their needs.

This initiative collaborates with the Georgia Division on

Aging and Area Agency on Aging (AAA) offices in Georgia,

where there is at least one caregiver/kinship care specialist

working at each of the 12 AAA sites. Currently, Kinship

Care Centers operate in metropolitan Atlanta (Clayton

County), Coastal Georgia, and South/Southeast Georgia.

A Kinship Care Center opened in Central Savannah River at

the Medical College of Georgia in fall, 2006. Each of these

centers provides information and assistance, support groups,

and public education services, and they serve as the vehicle

for initiating partnerships on special projects with other

community and public agencies. 

In 2005, the Georgia consortium of service providers 

in child welfare, aging, and other social services worked with

the Commissioner for the Department of Human Resources

(DHR) to institute grandparent liaisons at county welfare

offices. The Georgia Kinship Navigator program provides

work training through the Jewish Family and Career Services

and Atlanta Regional Commission to train 10 seniors wanting

to become grandparent liaisons at the DHR, Division of

Family and Children Services (DFCS) offices. Their role is

to help grandparents navigate the public welfare system to

ensure they are getting all the entitled benefits. 

While TANF and the Relative Foster Care Subsidy are

necessary public supports for families, they are not specific to

grandparent caregivers. As of July, 2006, two new initiatives

were announced by DHR to impact grandparent caregivers

directly through the expansion of TANF funds from DFCS.

Under the leadership of DHR Commissioner B.J. Walker, two

cash assistance programs were announced to support grandparents who are 60 years of age and older, and/or disabled:

Emergency/Crisis Intervention Services Payment (CRISP)

is a one time cash payment provided to grandparents raising

their grandchildren. The payment may be used for any

verified need defined by the grandparent. The amount of

cash assistance is up to three times the maximum TANF

benefit for a family. The funds are regarded as a support 

of last resort for families needing to meet an immediate

emergency. Examples of emergencies include the purchase

of beds and clothing, payment of utilities, legal expenses,

and even transitional mental health services to help families

adjust to their new arrangements. 

Grandparents Raising Grandchildren Monthly Subsidy

Payment is another targeted benefit for grandparents raising

grandchildren provided under the Department of Family

and Children Services as of July, 2006. Grandparent-headed

families can receive $50/child/month to assist with child

care expenses. The advantage of this benefit is that the

grandchild does not have to be in state custody in order for

grandparents to access it. The goal is to support grandparents

as they manage the daily expenses of raising their grandchildren. This is designed to be an ongoing benefit for

families (Georgia Department of Human Resources, 2006).

8
Other strategies to help custodial grandparents in Georgia

gain access to services and information include the development and dissemination of community resource directories,

the establishment of senior hotlines, and legal outreach

services. The Atlanta Regional Commission, aided by AARP,

developed a community directory for grandparent caregivers

in 2005. The directory contains contact information on

primary services needed by grandparents. Macon and Savannah

are also developing community resource directories. The

Georgia Senior Hotline of the Atlanta Legal Aid Society

opened a Relative Caregiver Hotline to help grandparents

address legal questions regarding their grandchildren. A

toll-free statewide number is available to give caregivers from

across the state access to this service. 

Finally, the Georgia Legal Services Program established

a Kinship Care Project, which also provides legal and outreach services to grandparent caregivers, largely outside the

Atlanta metropolitan area. These initiatives highlight the

collaborative efforts by public and private providers working

to ensure that grandparent-headed families have their immediate needs of financial assistance, service information and

referral, and legal guidance addressed through an accessible

delivery system. 

CONTINUED NEEDS

The major needs/challenges facing grandchildren and

their grandparents in all states in Region IV are similar to

those of families in other parts of the country. Table II

presents the specific needs of grandparents and grandchildren

living under their care in the region:

While initial strides to develop a network of services to

support grandparents and grandchildren have been made 

in Georgia, this effort is not reflected across Region IV.

Presently, there is little evidence that statewide collaborative

initiatives are occurring in other states in the region. However,

it is likely that efforts similar to those occurring in Georgia

can be replicated. Led by ACF, public and private agencies

can establish a service coalition willing to collaborate on

planning activities and share resources to meet the needs of

grandparents and their grandchildren. Such initiatives may

include establishing legal hotlines; instituting grandparent

liaisons in state child welfare offices, public health facilities,

or school settings; and establishing full service Kinship Care

Centers in communities. 

Georgia, like other localities, has struggled with providing

adequate services to caregivers living in rural communities.

Although their needs generally mirror the concerns of all other

grandparents, the growing incidence of methamphetamine

addiction is likely to exacerbate their needs in the future.

Custodial grandparents in these areas have difficulty securing

basic resources to meet their needs, in particular, obtaining

specialized services. The isolation they encounter resulting

from inadequate public transportation, limited health and

mental health services, and unavailable specialized child

services, as well as the limited number of family-focused

agencies in their communities, makes it especially hard to

address their needs. 

It is imperative that agencies in rural localities are 

supported to pool their resources to address grandparent

caregivers’ needs. The work that is occurring in Georgia’s

rural communities is the result of collaborative efforts with

9

Table II: Service Needs of Grandparent Caregivers and their Grandchildren

Grandchildren’s Needs

Early intervention and treatment services 

(Birth - 5 years of age)

Mental health/behavior services 

Support groups

School readiness for young grandchildren

Academic resources 

Tutor/Mentor services 

Positive youth development services

Summer/weekend camps

Child care services

Grandparents’ Needs

Public financial benefits

Health care services

Support groups

Parent training

Information and referral public benefits

Legal assistance 

Housing assistance

Respite services

Transportation
ACF, the Administration on Aging, Georgia Department of

Human Resources, Area Agency on Aging, Georgia Division

on Aging, local universities and health organizations. A

resource that has not been tapped extensively is faith-based

organizations. But with sufficient financial assistance, there

is ample room to secure their support to provide space or

other resources for group meetings, development of local

directories, or transportation to planned events.

NEXT STEPS

Georgia has taken the first steps toward establishing

lasting partnerships with relevant agencies and service

organizations in the public and private sectors to support

grandchildren and their grandparents. But while these

efforts are highly successful in one state, they need to be

replicated in other parts of the region, as well as the nation.

In most localities, there are independent services in

communities that address individual aspects of family needs.

However, coordinated efforts that would provide a seamless

system by which grandchildren and their grandparent caregivers receive services are lacking. Too often service delivery

systems are designed as if “one size fits all.” As this paper

illustrates, grandparent-headed families face unique challenges;

they need an integrated service environment that will support

their needs. Suggested federal offices that may partner

together to initiate or expand existing services include: 

the Office of Head Start, Office of Family Assistance,

Office of Community Services, Child Support Enforcement Office, Food and Nutrition Service, Housing and

Urban Development, Administration on Developmental

Disabilities, and Center for Faith-based and Community

Initiatives. The following are program suggestions to 

support grandchildren and their grandparent caregivers:

Potential ACF Initiatives

Head Start – Provide funding for specialized training of

Head Start/Early Head Start staff on the unique aspects of

grandchildren living in grandparent households, in particular

recognizing issues related to aging, developing outreach and

recruitment strategies for relative caregiver families, identifying

community-based service delivery systems designed for grandparents and grandchildren, and learning how to advocate for

grandparent-headed families in local communities.

Establish a Head Start/Early Head Start Grandchildren

Raised by Grandparents Initiative to include programming

that supports child development through parenting classes,

grandparent support groups, legal support for establishing

legal relationships with grandchildren (e.g., custody,

adoption), and early identification and intervention for 

developmental disabilities. 

Children’s Bureau – Provide financial assistance to agencies

offering support groups for grandchildren and/or grandparents, including costs for refreshments, child care and

transportation.

Expand early intervention outreach services for young

grandchildren residing with their grandparents, especially

families living in rural communities, to identify and treat

developmental disabilities, e.g., establish mobile screening

units in partnership with the public health service.

Support collaborations with allied health professional

schools to expand early intervention services to families in

isolated communities, targeting grandchildren in grandparent families.

Facilitate partnerships among faith-based organizations, youth serving agencies, community social service

agencies and school systems to establish after-school 

programs, tutor/mentoring and summer/weekend camps 

to meet the social/recreational needs of grandchildren in

grandparent households.

10
Potential Initiatives by Other Federal Partners – Explore

with the Food and Nutrition Service, USDA, the potential

to develop a pilot program on Food stamp – child only grants.

Coordinate with the Centers for Medicare and

Medicaid to develop and pilot specialized community-based

mental health services for grandchildren and grandparents.

Services should include counseling (individual and family),

group support for grandchildren, especially adolescents,

support groups for grandparents, and reimbursement for

transportation services.

Expand housing services to support grandchildren

living in grandparent households. Housing subsidies, 

furniture allowances, and utility assistance should be

targeted to support grandparent caregivers. 

Coordinate funding opportunities between ACF and

Administration on Aging offices to provide respite care,

support groups, transportation, and parenting services for

grandparent caregivers, giving special attention to families

living in rural communities. 

CONCLUSION

The phenomenon of grandparents raising grandchildren impacts multiple ACF programs, as this Call to Action

paper demonstrates. As evidenced by the work being

conducted in Georgia, ACF regional offices can provide

leadership with states, universities, faith-based and community

organizations to address the multiple challenges facing

grandparent-headed families. The potential effect of this

effort is a coordinated service delivery system that promotes

strong and stable families. 

11

ABOUT ACF

The Administration for Children and Families

(ACF), located within the U.S. Department

of Health and Human Services, provides

national leadership and direction for the

administration of comprehensive and

supportive programs for vulnerable children

and families. ACF has a strong commitment

to supporting initiatives and programs

that address the needs and strengths of

underserved populations. Through its

federal leadership, the Administration

brings together a broad range of federal

programs that promote the economic and

social well-being of families, children,

individuals and communities. Major

program services include:

» TANF (Temporary Assistance to 

Needy Families)

» Child Care and Development Fund

(CCDF)

» Child Support Enforcement

» Child Welfare

» Developmental Disabilities

» Runaway and Homeless Youth

» Head Start
APPENDIX

Georgia Grandparents Raising Grandchildren

Consortium – A consortium of federal, state and local

agencies and organizations in Georgia that collaborated 

to establish a network of services for grandchildren and

their grandparents.

Atlanta Regional Commission/Area Agency on Aging

American Association of Retired Persons (AARP)

Dekalb County School System

DHHS/Administration on Aging

DHHS/Administration for Children and Families

DHHS/Centers for Medicare and Medicaid Services

DHHS/Office on Women’s Health

DHHS/Office of General Council

Georgia Consortium for African American Aging

Georgia Council on Aging

Georgia DHR/Division of Aging Services

Georgia DHR/Division of Family and Children

Services/Childcare

Georgia DHR/Division of Family and Children

Services/Foster Care

Georgia State University National Center on Grandparents

Raising Grandchildren

Georgia State University Neighborhood Collaborative

Senior Corps

Georgia State University/Project Healthy Grandparents

Grady Memorial Hospital – Senior Services Department

Georgia State University/Project Healthy Grandparents

Grandparent Relative Caregiver Project/Atlanta Legal Aid

Society, Inc

Quality Living Services, Inc.

Social Security Administration

USDA Food and Nutrition Services

VISTA/GSU Neighborhood Collaborative Senior Corps

Grandparents Raising Grandchildren: Clayton County

Alliance represents the efforts of human services agencies

and organizations to provide and identify support for grandparents who are primary caregivers of their grandchildren in

Clayton County:

Atlanta Legal Aid Society, Inc.

Atlanta Regional Commission

AARP of Georgia

Clayton County Aging Program/Grandparents Raising

Grandchildren Resource Center

Clayton County Alzheimer’s Support Services, Inc.

Clayton County Community Services Authority, Inc.

Clayton County Court Appointed Special Advocates Program

Clayton County Extension Services

Clayton County Library System

Clayton County Department of Family and Children Services

Clayton County Board of Health

DHHS/Administration on Aging

DHHS/Administration for Children and Families

Georgia Center for Adoption Resources and Support

Georgia State University, National Center on Grandparents

Raising Grandchildren

Georgia State University, Project Healthy Grandparents

12
13

WA85,051

ALASKA13,181HAWAII53,462

OR51,852

CA885,034

NV51,473

UT43,998AZ122,247

CO63,960

MT12,088WY7,045

ND5,083

MN49,719IA31,131

SD8,132NE18,818KS39,372

MO99,482

IL239,281

IN98,394

KY82,199

TN124,366

NC165,345

VA

132,669

MD 117,654

WV

29,718

MS89,419

AL111,975

GA193,219

SC90,978

FL357,729

PR131,355

OH189,401

PA197,705

NJ 169,052

RI 15,705

NY

368,942

ME

13,410

MA 98,304

CT

50,107

6,334

VT

16,732

NH MI

154,402

WI61,176

OK71,850

NM48,087

TX584,885

AR57,802

LA115,164

ID19,735

D.C. 11,078

DE 18,645

Census 2005: Grandparents Living with Grandchildren < 18 years

Region I

Region II

Region IIIRegion IVRegion V

Region VIRegion VIIRegion VIIIRegion IXRegion X
14

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THIS PAPER WAS PREPARED BY:

Deborah M. Whitley, Ph.D.

Associate Director, Project Healthy Grandparents/

National Center on Grandparents Raising Grandchildren

Susan J. Kelley, Ph.D.

Dean, College of Health and Human Sciences

Director, Project Healthy Grandparents/

National Center on Grandparents Raising Grandchildren

Georgia State University, Atlanta, GA

WITH THE ASSISTANCE OF:

Carlis Williams, Regional Administrator, ACF Region IV

Dorothy Mabry, Special Assistant, ACF Region IV

January 2007

15
NOTES

16
NOTES

17
Administration for Children and Families, Region IV