FOSTER CARE

HHS Needs to 

Improve Oversight of 

Fostering 

Connections Act 

Implementation

Report to Congressional Requesters

May 2014

GAO-14-347

United States Government Accountability Office
United States Government Accountability Office

Highlights of GAO-14-347, a report to 

congressional requesters 

May 2014

FOSTER CARE

HHS Needs to Improve Oversight of Fostering 

Connections Act Implementation

Why GAO Did This Study

Approximately 400,000 children were 

living in foster care in fiscal year 2012, 

according to the most recent data 

available. HHS oversees states’ 

implementation of federal child welfare 

requirements under title IV-E of the 

Social Security Act. In 2008, the 

Fostering Connections Act amended 

title IV-E to improve the outcomes for 

children in foster care, such as 

maintaining family and school 

connections. GAO was asked to review 

implementation of the act. 

GAO examined (1) steps states have 

taken to implement selected provisions 

of the act and challenges they have 

faced, and (2) the extent to which HHS 

has monitored states’ efforts. GAO 

reviewed relevant federal laws, 

regulations, and guidance and 

surveyed 52 state child welfare 

agencies, achieving a 100 percent 

response rate. GAO also interviewed 

HHS officials and state and local child 

welfare and educational agency

officials; caseworkers; court officials, 

and foster youth and parents in four 

states, selected to ensure variety of

program characteristics and 

geographic dispersion. 

What GAO Recommends

GAO recommends that HHS (1) 

provide guidance on how states could 

calculate savings resulting from 

changes to federal adoption assistance 

eligibility criteria, (2) systematically 

monitor states’ implementation of the 

act, and (3) update data reporting

requirements related to the act. HHS 

concurred with our recommendations. 

HHS also provided technical 

comments that were incorporated, as 

appropriate. The Department of 

Education had no comments.

What GAO Found

To implement the Fostering Connections to Success and Increasing Adoptions 

Act of 2008 (Fostering Connections Act), many states GAO surveyed (which 

included the District of Columbia and Puerto Rico) reported requiring 

caseworkers to employ multiple practices to improve outcomes for children in 

foster care; however, states continue to face challenges that can undermine 

progress. Among the practices that the Department of Health and Human 

Services (HHS) and others suggested states use, survey respondents reported 

requiring caseworkers to use group decision-making to maintain family 

connections, consult with schools, and facilitate adult connections for older youth. 

At the same time, a majority of surveyed states reported facing challenges, 

especially related to foster placements (see fig. below). 

Major Challenges Reported by States in GAO Survey Regarding Foster Placements 

Note: Responses do not sum to 52 if states selected “do not know/not applicable” or did not respond. 

Further, the Fostering Connections Act made additional children eligible for 

federal adoption assistance payments thereby potentially freeing up state funds 

previously used for this purpose. Although states are required to spend any 

resulting savings on child welfare services, only 21 states reported calculating 

these savings for fiscal year 2012, and 20 states reported difficulties performing 

the calculations. HHS has not provided states guidance in this area, and without 

it states may continue to struggle with the calculations, leading to potential lost 

program funding.

HHS approved states’ plans to implement the Fostering Connections Act; 

however, the agency has not yet monitored states’ actions. HHS regulations 

specify that states must undergo a complete review of child welfare programs 

every 5 years, yet HHS’s last review cycle began in 2007—using a tool 

developed before the act was passed. Internal control standards emphasize

using timely data for effective monitoring, but data collected by HHS do not 

reflect the act’s provisions. In March 2014, HHS announced plans to begin a 

review cycle in fiscal year 2015, but details about how it would address changes 

from the act were unavailable. Without adequate monitoring or updated data, 

HHS lacks information about the implementation of the act and the effectiveness

of states’ actions. View GAO-14-347. For more information, 

contact Kay Brown at (202) 512-7215 or 

brownke@gao.gov. 
Page i GAO-14-347 Fostering Connections Act Implementation

Letter 1 

Background 3

States Reported Implementing Suggested Practices but Continue 

to Face Challenges with Certain Requirements 9

States Reported Receiving Useful Technical Assistance from 

HHS, but HHS Has Not Yet Systematically Monitored State 

Implementation 18

Conclusions 25

Recommendations for Executive Action 26

Agency Comments and Our Evaluation 26

Appendix I Findings on Family Connections Provisions 30

Appendix II Findings on School Stability Provisions 38

Appendix III Findings on Older Youth Provisions 40

Appendix IV Scope and Methodology 44

Appendix V Comments from the Department of Health and Human Services 47

Appendix VI GAO Contact and Staff Acknowledgments 50

Table

Table 1: Selected Requirements and Options Established by the 

Fostering Connections Act Included in this Review 4

Figures

Figure 1: Top Three Practices Used by States to Implement 

Required Provisions Related to Family Connections 10

Contents
Page ii GAO-14-347 Fostering Connections Act Implementation

Figure 2: Top Three Practices Used by States to Implement 

Required Provisions Related to School Stability 11

Figure 3: Top Three Practices Used by States to Implement 

Required Provisions Related to Older Youth 12

Figure 4: States’ Views on Usefulness of HHS Technical 

Assistance to Implement Fostering Connections Act 

Provisions 20

Abbreviations

ACF Administration for Children and Families

AFCARS Adoption and Foster Care Analysis and Reporting System

CFSR Child and Family Services Review

GAP Guardianship Assistance Program

HHS Department of Health and Human Services 

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Page 1 GAO-14-347 Fostering Connections Act Implementation

441 G St. N.W.

Washington, DC 20548

May 29, 2014

Congressional Requesters:

At the end of fiscal year 2012, approximately 400,000 children were living 

in foster care, mostly as a result of having experienced neglect or abuse 

by their parents.1 Nearly half of these children were placed in non-relative 

foster family homes and more than a quarter were placed in a relative’s 

home.2

The Fostering Connections to Success and Increasing Adoptions Act of 

2008 (Fostering Connections Act) made a number of changes to part E of 

title IV (title IV-E) of the Social Security Act, which authorizes federal 

support for state foster care and adoption assistance programs.

Child welfare agencies generally try to place children with family 

members when possible; however, in many cases, agencies lack 

information on relatives’ whereabouts. Even when relatives are available 

to care for the child, they may need financial help to do so. An experience 

in foster care may disrupt other family connections important to the child’s 

well-being, such as ongoing relationships with siblings. Children in foster 

care face other challenges, such as lower academic achievement and 

higher dropout rates than their peers who are not in foster care. 

Moreover, youth who remain in foster care until adulthood are more likely 

to be homeless, unemployed, and incarcerated compared to the general 

population.

3

 

1

These are the most recent data available. See U.S. Department of Health and Human 

Services, The AFCARS Report, Preliminary FY 2012 Estimates as of July 2013, No. 20, 

HHS (Washington, D.C.: Nov. 2013).

According to its co-sponsors, the legislation was intended to address 

shortcomings in the existing foster care system that disconnected foster 

children from family and school, leaving them ill-prepared to transition out 

of care at age 18. The Department of Health and Human Services (HHS) 

is responsible for overseeing the states’ implementation of federal 

2

The remaining children and youth were in one of the following settings: pre-adoptive 

home; group home; institution; supervised independent living; trial home visit; or runaway. 

3

Pub. L. No. 110-351,122 Stat. 3949 (codified as amended in scattered sections of 42 

U.S.C.). The Fostering Connections Act also amended other parts of the Social Security 

Act, including part B of title IV, which authorizes federal funding for certain child welfare 

services. For this review, we focused primarily on title IV-E of the Social Security Act.
 

Page 2 GAO-14-347 Fostering Connections Act Implementation

requirements for child welfare services, including those established by the 

Fostering Connections Act.

You asked us to review the implementation of the Fostering Connections 

Act. This report examines: (1) the actions states have taken to implement 

selected provisions of the Fostering Connections Act, and what 

challenges, if any, states face; and (2) how HHS has provided technical 

assistance to help states implement selected provisions of the Fostering 

Connections Act and the extent to which HHS has monitored 

implementation.

We reviewed selected provisions of the Fostering Connections Act 

pertaining to family connections, school stability, support for older youth, 

and states’ savings from the change in income eligibility criteria for 

adoption assistance payments,4 and used several methodologies to 

address our objectives.5 See appendixes I-III for more information on the 

specific provisions in this review. First, we reviewed relevant federal laws 

and regulations, HHS guidance to states, and other publications. Second, 

to obtain information on states’ implementation of the selected provisions 

of the Fostering Connections Act, we conducted a survey of state child 

welfare agencies from the 50 states, the District of Columbia, and Puerto 

Rico, achieving a 100 percent response rate.6

 

4

The Fostering Connections Act changed the eligibility criteria for federal adoption 

assistance for children with special needs to eliminate income requirements for the family 

from which the child is removed. See section 402 of the Fostering Connections Act, 

amending 42 U.S.C. § 673.

The survey included 

questions about the practices states employed to implement the 

provisions, challenges they faced, and their use of HHS-funded technical 

assistance. Third, we conducted site visits to four states and two localities 

in each state to obtain further information on implementation of these 

provisions from state and local child welfare agency officials and 

caseworkers, state and local educational agency officials, court officials, 

5

We excluded selected provisions of the Fostering Connections Act, including those on 

tribal foster care and adoption assistance, as well as on health oversight and coordination 

plan requirements, from this review because they were already being studied in other 

reviews conducted by GAO or the HHS Office of Inspector General, and based on input 

from child welfare experts.

6

For the purposes of this report, we refer to the survey as a state survey. However, it also 

includes responses from the District of Columbia and Puerto Rico. When referring to 

states we surveyed throughout this report, this includes the District of Columbia and 

Puerto Rico.
 

Page 3 GAO-14-347 Fostering Connections Act Implementation

and current and former foster youth and foster parents. We selected the 

four states—California, Massachusetts, Texas, and Virginia—to represent 

a mix of factors including: type of child welfare agency (state- or countyadministered); number of children in foster care; amount of federal title IVE funds received; whether the state had implemented either of two 

optional provisions in the Fostering Connections Act (establishing a title 

IV-E guardianship assistance program or extending eligibility for title IV-E 

assistance beyond age 18);7

We conducted this performance audit from April 2013 to May 2014 in 

accordance with generally accepted government auditing standards. 

Those standards require that we plan and perform the audit to obtain 

sufficient, appropriate evidence to provide a reasonable basis for our 

findings and conclusions based on our audit objectives. We believe that 

the evidence obtained provides a reasonable basis for our findings and 

conclusions based on our audit objectives.

and geographic dispersion. The localities 

were a mix of large cities, smaller cities, and rural areas. The results from 

the site visits are not generalizeable, but provide illustrative examples of 

how states are implementing the provisions of the Fostering Connections 

Act. We also interviewed officials from HHS’s Administration for Children 

and Families, including the four regional offices serving the states we 

visited, as well as selected HHS-funded technical assistance providers 

that have provided assistance to states to implement the Fostering 

Connections Act. A more detailed explanation of our methodology can be 

found in appendix IV.

Title IV-E of the Social Security Act authorizes federal funding to states to 

help cover the costs of operating their foster care and adoption 

assistance programs. This funding primarily provides financial support for 

the care of eligible children who have been removed from their homes 

due to abuse or neglect, as well as to families who adopt eligible children 

with special needs from the foster care system. In 2008, the Fostering 

Connections Act was enacted, which amended title IV-E. According to 

 

7

Title IV-E assistance includes foster care, adoption assistance, and kinship guardianship 

payments.

Background

Title IV-E and the 

Fostering Connections Act
 

Page 4 GAO-14-347 Fostering Connections Act Implementation

two co-sponsors of the legislation, it was intended to address 

shortcomings in the existing foster care system that disconnected foster 

children from family and school, leaving them ill-prepared to transition out 

of care at age 18.8 These shortcomings are rooted in longstanding 

challenges, such as finding appropriate foster homes; coordinating 

between child welfare agencies, schools, and other service providers; and 

ensuring housing for foster youth transitioning to independence.9

Table 1: Selected Requirements and Options Established by the Fostering Connections Act Included in this Review

The 

Fostering Connections Act established requirements for states operating 

title IV-E programs as well as options states may elect to pursue to 

improve outcomes for youth in and leaving foster care. See table 1 for a 

complete list of the required and optional provisions included in our 

review.

Summary of provision Requirement Option 

Family connections

Requires that the state exercise due diligence to identify and notify all grandparents and other 

adult relatives of a child within 30 days of the child’s removal from the parents’ custody. 

•

Requires states to make reasonable efforts to place siblings removed from their home in the same 

foster care, kinship guardianship, or adoptive placement, and to provide for frequent visitation or 

other ongoing interaction between siblings who are not placed together, unless it would be 

contrary to the safety or well-being of any of the siblings to do so. 

•

Authorizes HHS to share information from the Federal Parent Locator Service with child welfare 

agencies for title IV-E purposes.a

 

•

Authorizes states to provide and receive federal reimbursement for some kinship guardianship 

assistance payments.b

 

•

Authorizes states to waive, on a case-by-case basis, non-safety licensing standards for relative 

foster family homes. 

•

School stability

Requires that the state’s title IV-E plan provide assurances that each school-age child eligible for 

a payment under the title IV-E plan is attending school full-time or has completed secondary 

school.

•

Requires that each placement of a child in foster care takes into account the appropriateness of 

the current educational setting and the proximity to the school in which the child was enrolled at 

the time of placement. 

•

 

8

154 Cong. Rec. 19, 459-61 (2008) (statements of Rep. McDermott and Rep. Weller).

9

See GAO, Child Welfare: Improving Social Service Program, Training, and Technical 

Assistance Information Would Help Address Long-standing Service-Level and Workforce 

Challenges, GAO-07-75 (Washington, D.C.: Oct. 6, 2006).
 

Page 5 GAO-14-347 Fostering Connections Act Implementation

Summary of provision Requirement Option 

Requires that the child welfare agency coordinate with appropriate local educational agencies to 

ensure that the child remains in the school in which the child is enrolled at the time of each 

placement. If remaining in that school is not in the best interests of the child, the agencies must 

provide immediate and appropriate enrollment in a new school, along with the child’s educational 

records. 

•

Authorizes the use of foster care maintenance payments to cover the cost of reasonable travel for 

the child to remain in the school in which the child was enrolled at the time of placement. 

•

Older youth

Requires that during the 90-day period prior to a child aging out of foster care, a caseworker 

assists and supports the child in developing a personalized transition plan.c

 

•

Authorizes states to provide foster care, adoption assistance, and kinship guardianship payments 

for eligible youth age 18 and older (up to age 21) in certain circumstances. 

•

Authorizes states to extend eligibility for Chafee Foster Care Independence Program services to 

youth who exit foster care to adoption or kinship guardianship at age 16 or older.d

 

•

Authorizes states to extend eligibility for education and training vouchers to youth who exit foster 

care to kinship guardianship at age 16 or older.e

 

•

Source: GAO analysis of selected provisions of the Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering 

Connections Act), Pub. L. No. 110-351, 122 Stat. 3949 (codified as amended in scattered sections of 42 U.S.C.).

Note: In this table, a provision is categorized as a “requirement” if a state must adopt it in order to be 

eligible for federal assistance under title IV-E. States may choose to adopt the provisions categorized 

as “options,” but are not required to in order to be eligible for federal assistance under title IV-E.

a

The Federal Parent Locator Service is a computerized system administered by HHS’s Office of Child 

Support Enforcement. In accordance with the Fostering Connections Act, HHS regulations permit this 

system to be used to locate relatives for title IV-E purposes. 45 C.F.R. § 302.35(d)(2). 

b

These payments are authorized to be made on behalf of eligible children to grandparents and other 

relatives who have assumed legal guardianship of the children for whom they have cared as foster 

parents and for whom they have committed to care on a permanent basis. Under title IV-E, legal 

guardianship means a judicially created relationship between child and caretaker which is intended to 

be permanent and self-sustaining as evidenced by the transfer to the caretaker of the following 

parental rights with respect to the child: protection, education, care and control of the person, custody 

of the person, and decision-making. 42 U.S.C. § 675(7). To receive funding, the child must meet title 

IV-E eligibility requirements and must live with the caregiver for at least 6 months, among other 

requirements. 

c

The plan must include specific options on housing, health insurance, education, local opportunities 

for mentors and continuing support services, and workforce supports and employment services. HHS 

guidance also encourages the caseworker to include information in the plan relating to sexual health, 

services, and resources as well. The Patient Protection and Affordable Care Act added the 

requirement to include information in the plan about the importance of designating another individual 

to make health care treatment decisions on behalf of the child if the child becomes unable to 

participate in such decisions and the child does not have, or does not want, a relative who would 

otherwise be authorized under state law to make such decisions, and provides the child with the 

option to execute a health care power of attorney, health care proxy, or other similar document 

recognized under State law. Pub. L. No. 111-148, § 2955(a), 124 Stat. 119, 352 (2010). 

d

Under provisions unaffected by the Fostering Connections Act, this program may also serve youth 

who are likely to remain in foster care until age 18, and young adults between the ages of 18 and 21 

who have “aged out” of the foster care system. These services may include help with education, 

employment, financial management, housing, emotional support, and connections to caring adults. 

e

Youth who exited foster care to adoption at age 16 or older were already eligible for these education 

and training vouchers prior to the enactment of the Fostering Connections Act. 
 

Page 6 GAO-14-347 Fostering Connections Act Implementation

In addition, the Fostering Connections Act modified a requirement related 

to eligibility for adoption assistance. Specifically, the Fostering 

Connections Act changed the eligibility criteria for federal adoption 

assistance for children with special needs to eliminate income 

requirements for the family from which the child is removed.10 This 

change is being phased in over time based on the child’s age at adoption 

(becoming applicable to children age 16 and older in fiscal year 2010, 14 

and older in fiscal year 2011, 12 and older in fiscal year 2012, and so on 

until fiscal year 2018 when the criteria will apply to children of all ages). 

As a result, more children may be eligible for federal adoption assistance 

payments and states may no longer bear the entire cost of adoption 

assistance payments on behalf of eligible children with special needs 

removed from families that did not meet the previous income 

requirements. The Fostering Connections Act also required states to 

spend any savings in state expenditures resulting from the changes to the 

adoption assistance eligibility criteria on child welfare services that may 

be provided under title IV-E or IV-B (referred to in this report as 

“reinvesting savings”). As a result of a subsequent amendment, states are 

also required to document how such amounts are spent annually.11

Promoting the well-being of children and families has traditionally been 

understood as a primary responsibility of state governments, and state 

and local governments are the primary administrators of child welfare 

programs designed to protect children from abuse or neglect. Most states 

administer their child welfare programs centrally, but in some states, 

county agencies administer their own child welfare programs with state 

supervision. At the federal level, HHS’s Children’s Bureau within the 

Administration for Children and Families (ACF) is responsible for 

 

10See section 402 of the Fostering Connections Act, amending 42 U.S.C. § 673. Children 

are eligible for federal adoption assistance payments if they meet the statutory definition of 

special needs and certain other criteria. Before the Fostering Connections Act was 

enacted, one of these criteria specified that, in addition to meeting other eligibility 

requirements, the child must have been removed from a home that met income 

qualifications for assistance under the Aid to Families with Dependent Children program 

as of July 16, 1996. The Personal Responsibility and Work Opportunity Reconciliation Act 

of 1996 replaced the Aid to Families with Dependent Children program with the 

Temporary Assistance for Needy Families program. However, this income eligibility 

criterion was not changed until the Fostering Connections Act eliminated it.

11Child and Family Services Improvement and Innovation Act. Pub. L. No. 112-34, § 

106(c). 125 Stat. 369, 377 (2011).

Oversight and Monitoring
 

Page 7 GAO-14-347 Fostering Connections Act Implementation

administering and overseeing states’ implementation of title IV-E, 

including the provisions added by the Fostering Connections Act.12 The 

ACF regional offices are responsible for reviewing and approving state 

title IV-E plans for states in their regions. Title IV-E plans include 

information on how states have implemented or plan to implement title IVE, including the provisions of the Fostering Connections Act. In 2000, 

HHS issued regulations that established a systematic review process to 

monitor states’ child welfare programs to determine whether the programs 

are in compliance with federal law, regulations, and the relevant approved 

state plan.13 These regulations specify that states must undergo a 

complete review of their child welfare programs—including title IV-E—

every 5 years.14 This systematic review process, known as the Child and 

Family Services Review (CFSR), involves a statewide assessment, a 

case-file review, and stakeholder interviews. Two rounds of the CFSRs 

have been conducted to date—the second round started in 2007, before 

the enactment of the Fostering Connections Act. HHS also compiles, 

validates, and reports data on children in foster care and children who 

have been adopted from state child welfare agencies in the Adoption and 

Foster Care Analysis and Reporting System (AFCARS). Twice a year, 

states are required to submit data on the characteristics of children in 

foster care, foster parents, adopted children, and adoptive parents.15

 

12ACF is also responsible for administering title IV-B programs, but the focus of this report 

is title IV-E. 

13Title IV-E Foster Care Eligibility Reviews and Child and Family Services State Plan 

Reviews, 65 Fed. Reg. 4020 (Jan. 25, 2000) (codified at 45 C.F.R. pts. 1355-57). These 

regulations were issued, in part, to comply with section 1123A of the Social Security Act, 

which requires HHS to issue regulations for the review of state child welfare programs, 

including those under title IV-E. The statute requires that HHS’s regulations specify certain 

features of these reviews, such as the timetable for reviews, the federal requirements 

subject to review, and the criteria used to measure whether states are in substantial 

conformity with their plans and federal requirements. Section 1123A also requires HHS to 

follow certain procedures for programs found not to be in substantial conformity. 42 U.S.C. 

§ 1320a-2a.

1445 C.F.R. § 1355.32(b) (for states found to be in substantial conformity). According to 

the regulations, states found not to be in substantial conformity will be required to develop 

a program improvement plan and begin a full review two years after approval of the 

program improvement plan. 

15See 45 C.F.R. § 1355.40 and 45 C.F.R. pt.1355, app. A-E for HHS’s AFCARS data 

collection requirements.
 

Page 8 GAO-14-347 Fostering Connections Act Implementation

ACF is responsible for developing and distributing program guidance to 

all states, and issued a comprehensive Program Instruction to state child 

welfare agencies in July 2010, with guidance on implementing the various 

provisions of the Fostering Connections Act. Some of the provisions of 

the Fostering Connections Act are general in nature and allow states 

discretion in determining how to implement them. For example, one 

provision requires states to make reasonable efforts to place siblings who 

are removed from their home in the same foster care placement, but it 

does not define what constitutes “reasonable efforts.”16

States receive additional training and technical assistance through 

regional ACF offices and the Children’s Bureau’s Training and Technical 

Assistance Network. This network is comprised of 28 technical assistance 

centers that provide training, technical assistance, research, information 

and referral, and consultation. Members of the network include 10 topicoriented national resource centers; a Training and Technical Assistance 

Coordination Center; the Child Welfare Information Gateway, which 

provides information, resources, and tools covering child welfare topics; 

and 16 other organizations dedicated to providing states training and 

technical assistance. Several of these organizations, as well as other 

child welfare-focused organizations, have issued toolkits and other 

material suggesting practices for states to consider in implementing 

Fostering Connections Act provisions.

ACF’s Program 

Instruction described ACF’s expectations for implementation of selected 

provisions and in some cases encouraged states to consider certain 

practices that could facilitate implementation. For example, the guidance 

encouraged notification of relatives via several different methods such as 

in writing and orally, and also explained ACF’s expectation that siblings 

not placed together should be in contact at least monthly. ACF issued 

subsequent Program Instructions on targeted issues and updated its 

online Child Welfare Policy Manual to provide additional guidance on 

implementing the act. 

 

16See section 206 of the Fostering Connections Act, amending 42 U.S.C. § 671(a)(31). 

Guidance and Technical 

Assistance for States
 

Page 9 GAO-14-347 Fostering Connections Act Implementation

According to our survey, to implement the various provisions of the 

Fostering Connections Act, many states required child welfare workers to 

employ multiple practices suggested by HHS and other child welfarefocused organizations. In general, these practices were not specifically 

required by the Fostering Connections Act, but stakeholder organizations 

recommended states consider them to ensure the act results in better 

outcomes for children and youth in foster care.17

For the required family connections provisions, states reported 

formalizing prior efforts and requiring or recommending practices aimed 

at identifying relatives, notifying relatives of the need for foster care 

placement, and keeping siblings together or in contact. Figure 1 shows 

the top three practices states reported in our survey within each of these 

areas. (See app. I for additional practices.) During our visits, states 

reported formalizing their prior efforts to identify and notify relatives. For 

example, according to officials, Massachusetts began requiring 

notification in writing, and California added a timeframe for notification to 

its state law. We also learned of specific ways that states are carrying out 

some of these practices. For example, in Virginia, state child welfare 

agency policy requires that a copy of a written notice to relatives be kept 

in the child’s case file and that the date the written notice was sent and of 

any relatives’ response be recorded in the state’s child welfare agency 

data system. Reasons for not notifying specific relatives—such as 

involvement in domestic violence—must be documented as well. To 

To help ensure that 

certain requirements were implemented, most states reported that they 

required case workers to document certain key efforts.

 

17States reported on specific practices we asked about in our survey. States could be

employing other practices for which we did not obtain information. 

States Reported 

Implementing 

Suggested Practices 

but Continue to Face 

Challenges with 

Certain Requirements

States Reported Requiring 

Caseworkers to Employ 

Multiple Practices to 

Implement the Fostering 

Connections Act

Family Connections
 

Page 10 GAO-14-347 Fostering Connections Act Implementation

ensure that siblings not placed together maintain contact, Texas officials 

explained that if siblings are placed more than 100 miles apart, the 

agency must ensure that the children have access to a phone and videoconferencing. Current and former foster youth we met with in 

Massachusetts said the state child welfare agency created a Sibling Bill of 

Rights, which has helped youth advocate for their right to remain in 

contact with siblings.

Figure 1: Top Three Practices Used by States to Implement Required Provisions 

Related to Family Connections 

a

Unless it would be contrary to a child’s safety or well-being. 

Among the optional family connections provisions, HHS data show that 

32 states have been approved to operate a title IV-E guardianship 

assistance program. Of these states, 21 had previously operated a 
 

Page 11 GAO-14-347 Fostering Connections Act Implementation

guardianship assistance program using state funds or through a title IV-E 

waiver demonstration project. In response to our survey, 43 states 

reported that they now allow waivers of non-safety licensing standards for 

relative foster family homes, up from 33 prior to the enactment of the 

Fostering Connections Act. In addition, 32 states reported requiring or 

recommending the use of the Federal Parent Locator Service to identify 

adult relatives.

States reported establishing new approaches to implement the school 

stability requirements. Figure 2 shows the top three practices reported in 

our survey. (See app. II for additional practices.) During our visits, we 

learned that the state child welfare and educational agencies in Virginia 

drafted joint guidance for localities to guide implementation of the school 

stability provisions. The guide identified factors to consider in determining 

whether the school placement is in the best interest of the child and 

clarified responsibilities for funding transportation. We learned of a similar 

effort under way in Massachusetts. In three of the four states we visited—

California, Texas, and Virginia—state law or agency policy requires 

school districts to designate “foster care liaisons” or points of contact at 

the district or school level who can assist caseworkers or foster parents 

with issues such as immediately enrolling foster youth in a new school in 

the event of a school change.

Figure 2: Top Three Practices Used by States to Implement Required Provisions 

Related to School Stability

In addition, 36 states reported using title IV-E foster care maintenance 

funds to pay for transportation so that children in foster care could remain 

in their schools—as authorized by the Fostering Connections Act.

School Stability
 

Page 12 GAO-14-347 Fostering Connections Act Implementation

For the provisions related to older youth, states reported adding to 

existing policies to incorporate requirements related to the development 

of a transition plan in the 90-day period prior to a youth aging out of care. 

Figure 3 shows the top three practices reported by states in our survey. 

(See app. III for additional practices.) Officials in Massachusetts reported 

that their existing policies already addressed many of the specific 

elements of transition plans required by the Fostering Connections Act. 

To carry out its planning practices, Texas requires in its manual for 

caseworkers that youth be provided a Youth Transition Portfolio at least 

90 days before turning 18. The portfolio is to contain key documents such 

as the birth certificate, Social Security card, immunization records, 

education records, additional health records, and an “Almost 18?” 

checklist that lists the 14 required items youth should receive. Texas child 

welfare agency policy also requires group decision-making meetings 

called Circles of Support to enable youth age 16 or older to develop a 

transition plan and to connect with supportive and caring adults who can 

help the youth after they leave foster care.

Figure 3: Top Three Practices Used by States to Implement Required Provisions 

Related to Older Youth

HHS data show that 19 states have approved plan amendments to 

implement the option to extend title IV-E assistance to eligible youth ages 

18 to 21. Of these states, 9 had previously extended the age for foster 

care with other funding sources, at least under limited circumstances.

In addition to providing information on specific practices, states reported 

that the legislative and regulatory actions they took, if any, to implement 

the selected Fostering Connections Act provisions varied. For each of the 

Older Youth
 

Page 13 GAO-14-347 Fostering Connections Act Implementation

selected provisions in our review, some states reported making changes 

to their laws and regulations to implement the provision, while others 

reported that their state laws and regulations were already consistent with 

the act.18 For example, three of the four states we visited reported that 

they enacted or revised laws or regulations to implement some of the 

family connections provisions. State officials indicated that these laws or 

regulations largely made minor changes to existing child welfare policy in 

this area. For instance, officials in California explained that county child 

welfare agencies were already required by state law to look for family 

members and consider them for placement prior to the Fostering 

Connections Act, but the state amended its law to conform to the 

requirements of the act, such as by adding a timeframe—child welfare 

workers are to identify and notify relatives within 30 days of a child’s 

removal from the home. In addition, in response to our survey, many 

states indicated that their existing laws or regulations were consistent with 

the Fostering Connections Act and that no changes were needed.19 Some 

states reported that they have undertaken efforts that are reflected in 

agency policy or practice guidance, but did not change their laws or 

regulations. For example, in our survey, Massachusetts reported making 

no changes to laws or regulations to implement the school stability 

requirements, but officials we interviewed there told us about new school 

stability efforts reflected in joint agency guidance from the state’s child 

welfare and educational agencies. Similarly, Texas officials reported 

adding a Circles of Support transition planning meeting in the 90 days 

before youth turn 18 or exit care without revising state law or regulation.

 

18Changes to state statutes or regulations are not necessarily an indication of state 

compliance with the Fostering Connections Act because states generally had discretion in 

how to implement the provisions. While legislative and regulatory actions may provide one 

indication of state efforts to implement selected provisions of the Fostering Connections 

Act, these steps may not necessarily indicate a substantial change in state policy or 

practice. We did not independently review state laws and regulations or assess their 

compliance with federal requirements.

19The number of states reporting that existing laws and regulations were consistent with 

the act and no changes were needed varied by provision. Appendixes I-III contain this 

information for selected provisions. 
 

Page 14 GAO-14-347 Fostering Connections Act Implementation

Most states reported in our survey that they face major challenges, some 

of which are rooted in difficulties finding sufficient or appropriate living 

placements for foster youth or appropriate housing for youth after 

transitioning from foster care, along with other challenges.

States reported major difficulties identifying appropriate placements for 

sibling groups, specifically finding available placements for large sibling 

groups (42 states), or sibling groups with exceptional needs (30 states) or 

with a wide age range (18 states). Although states do not collect uniform 

data on sibling placement, caseworkers and youth we met with in one 

state and foster parents in another reported that siblings are frequently 

separated. One director of a local child welfare agency we interviewed 

explained that some foster families and treatment facilities specify an age 

range for children they are willing to accept, and siblings may not fall 

within these age ranges. A case worker in another state explained that 

some families do not want to take older siblings who are more likely to 

have a higher level of trauma than younger children. In addition, 15 states 

identified competing priorities—specifically the tension among the 

priorities to place siblings together, keep a child at their school of origin, 

and place a child with a family member— as a major challenge. Local 

child welfare agency officials in two of the localities we visited told us they 

tend to give higher priority to placement with a family member than to 

placement near the school of origin. Fewer states (no more than 15) 

reported major challenges related to identifying or notifying relatives 

within 30 days of a child’s removal. Child welfare officials we interviewed 

in all four of the states we visited indicated that they had prioritized 

identifying relatives for placements prior to enactment of the Fostering 

Connections Act.

States reported that finding foster placements was a major impediment to 

implementing the school stability provisions as well. Specifically, finding 

foster placements near a student’s current school was identified as a 

major challenge by 38 states. Officials or child welfare workers we 

interviewed in six of the eight localities we visited—representing both 

urban and rural areas—told us that children are frequently placed in 

homes that are far from their current school. Child welfare workers in 

urban locations reported that in some cases older youth may be able to 

take public transportation back to their school. However, it is more difficult 

to transport younger children since they are more dependent on the foster 

parent for transportation in these cases, and foster parents may not be 

able to provide transportation due to their work schedules. Issues with 

arranging transportation back to the child’s school of origin upon 

States Reported 

Challenges, Especially 

Related to Lack of 

Available Foster 

Placements

Family Connections

School Stability
 

Page 15 GAO-14-347 Fostering Connections Act Implementation

placement outside of the district—both determining what entity should be 

responsible for transportation costs and identifying funds for 

transportation—were each raised as a major challenge by 20 states. 

Former and current foster youth we spoke with in three different states 

reported frequent school changes upon placements, and discussed the 

detrimental effects of these changes on their academic progress and 

social development. For example, new schools may not recognize credits 

they have earned elsewhere, and it can be emotionally difficult to leave 

old friends behind and make new ones. Further, 19 states reported in our 

survey that the lack of a requirement for educational agencies to 

coordinate with child welfare agencies is a major challenge they face in 

ensuring school stability for foster youth.20

Thirty-one states reported identifying appropriate housing for youth after 

they transition out of foster care as a major challenge. Finding appropriate 

housing for older youth who remain in foster care beyond age 18 was 

also cited as a challenge by the two states we visited that had extended 

foster care. Officials from one locality noted that young adults may 

voluntarily leave foster care and re-enter the program, but finding housing 

for these youth can be a challenge. Child welfare workers in another 

locality explained that finding a home that welcomes older youth with 

behavioral problems is especially problematic. In discussions with former 

and current foster youth, we heard examples of youth who were 

homeless and living in shelters upon transitioning out of care. In addition, 

21 states reported additional difficulties with transition planning; that is, 

with both identifying and engaging supportive adults from the youth’s life 

in the transition planning efforts, and the same number of states reported 

a lack of staff training or time to effectively engage youth in their transition 

planning. Some case workers we interviewed also explained that 

sometimes youth left care unexpectedly which made it difficult to 

complete the 90-day transition plan.

In our site visits, we also heard 

concerns about coordination from child welfare and school officials in five 

of the eight localities we visited.

 

20On January 14, 2013, the President signed into law the Uninterrupted Scholars Act 

which, among other provisions, authorizes disclosure of education records without 

parental consent to child welfare agencies that have a right of access to a student’s case 

plan and are legally responsible for the care and protection of the student. Pub.L. No. 112-

278, 126 Stat. 2480 (2013) (amending 20 U.S.C. § 1232g). For more information on data 

sharing practices among human services programs, see GAO, Human Services: 

Sustained and Coordinated Efforts Could Facilitate Data Sharing While Protecting Privacy, 

GAO-13-106 (Washington, D.C.: Feb. 8, 2013). 

Older Youth
 

Page 16 GAO-14-347 Fostering Connections Act Implementation

These challenges to maintaining family connections, ensuring school 

stability, and assisting older youth are not new; states have faced many of 

them since before the Fostering Connections Act was enacted. We heard 

examples of new approaches to try to address these challenges, such as 

the use of social media to locate relatives and telecommunications 

options to keep siblings connected. (See apps. I-III for additional 

examples of state practices.) However, many challenges remain 

unresolved, hindering states’ abilities to effectively meet the needs of 

children in foster care.

Regarding implementation of the Fostering Connections Act provision 

directing states to reinvest any savings due to the elimination of income 

eligibility criteria for adoption assistance payments, only 21 states we 

surveyed reported performing calculations of these savings from this 

change for fiscal year 2012, and 20 states reported performing the 

calculations for fiscal year 2011.21

Twenty states—representing both states that did report calculating 

savings and those that did not—reported facing difficulties with calculating 

the amount of savings from the change in eligibility criteria for adoption 

assistance payments.

Three states reported they were 

developing a methodology to calculate the savings. States that did 

calculate savings reported using these funds for a range of services, 

including state-funded subsidy payments, post-adoption staff and 

services, mental health services, and other child welfare uses.

22

 

21Seventeen states reported they did not calculate savings from the eligibility change for 

2011, eleven states responded that they did not know the amount saved and how funds 

were reinvested, and 4 states did not respond. For 2012, 16 states reported they did not 

calculate savings from the eligibility change, 11 states responded that they did not know 

the amount saved and how funds were reinvested, and 4 states did not respond.

Specifically, eight of these states reported facing 

challenges with identifying children who are eligible for title IV-E 

payments as a result of the change in income eligibility criteria. An 

organization that has worked with states on this calculation explained that 

some states do not track the reason for ineligibility, so they are unable to 

determine whether a currently eligible child had previously been ineligible 

for title IV-E payments due to their birth family’s income. Six states 

reported challenges either calculating the savings manually or identifying 

22Examples provided do not sum to 20 because some states reported more than one 

challenge and other states reported challenges not discussed here.

Only Twenty-One States 

We Surveyed Reported 

Calculating Savings From 

Adoption Assistance 

Income Eligibility Changes 

for Fiscal Year 2012
 

Page 17 GAO-14-347 Fostering Connections Act Implementation

a mechanism to automate the calculations. Four states reported 

challenges with developing a methodology to determine savings, and 

three states discussed the challenge of calculating the savings given the 

gradual phasing-in of more eligible youth by age or other changes in the 

eligible population. Few states identified challenges related to reinvesting 

the savings. Specifically, three states reported difficulty in planning for the 

use of the funds given the uncertainty about how much the state will have 

to spend each year. Two other states reported facing challenges 

obtaining approval within the state for their spending plans.

HHS officials attributed the low number of states that reported calculating 

savings in our survey to the lack of a reporting requirement, confusion 

over the requirement for states to document and use any savings, and the

low number of youth eligible under the new eligibility criteria to date. 

While the Fostering Connections Act did not specifically require states to 

report the amount saved as a result of the eligibility changes, the Child 

and Family Services Improvement and Innovation Act, enacted in 2011,23

HHS has not provided specific guidance on how states should calculate 

the savings, even though in 2008 the Congressional Budget Office 

required states to document how any savings were spent. Further, 

according to the officials, the calculations are complicated—requiring 

states to determine which youth would have been eligible for federal 

adoption assistance payments under the old criteria as well as the new. 

Officials also suggested that states have likely seen limited savings to 

date due to the fact that the requirement has only applied to older children 

so far. The revised eligibility criteria will apply to children ages 8 and older 

in fiscal year 2014 and to children of all ages by fiscal year 2018. In 

addition, HHS officials noted that this provision is not a “maintenance of 

effort” requirement that would require states to spend a specified level of 

funding for child welfare services. Specifically, it does not address when 

these funds must be expended or whether they must be in addition to 

other state funds used for these purposes in any specific 

period. Therefore, it is possible for a state to document that any 

calculated adoption savings were used for child welfare purposes while 

also reducing state funding for these purposes—which would not increase 

total child welfare spending.

 

23Pub. L. No. 112-34, § 106(c), 125 Stat. 369, 377 (2011) (amending 42 U.S.C. § 

673(a)(8)).
 

Page 18 GAO-14-347 Fostering Connections Act Implementation

estimated that enacting this provision could result in savings of over $1 

billion to states from fiscal years 2009 to 2018. In its 2010 Program 

Instruction on implementing the Fostering Connections Act, HHS stated 

that title IV-E agencies have the flexibility to determine the methodology 

for calculating savings. HHS officials explained they have not issued 

further guidance to states on performing the calculations because they 

have tried to implement this provision in a way that is not burdensome to 

states. In 2013, the Office of Management and Budget did, however, 

issue a revision to its single audit compliance supplement that included 

some guidance to assist auditors in evaluating states’ compliance with 

this requirement.24 HHS officials informed us that state’s assurances of 

these savings calculations are monitored using the single audit process, 

which is performed annually by state auditors. In the absence of guidance 

to states from HHS on how to perform these calculations, states may 

continue to struggle with finding ways to calculate savings resulting from 

increased federal reimbursement and thus may be missing an opportunity 

to reinvest additional funds into their child welfare programs.

 

24The Single Audit Act, as amended, requires an annual “single audit” of certain entities 

that expend more than a specified amount in federal awards. The Office of Management 

and Budget issues guidance for implementing single audit requirements as described in 

Circular No. A-133, Audits of States, Local Governments, and Non-Profit Organizations, 

and the Compliance Supplement. The Compliance Supplement provides auditors the 

information needed to understand federal programs’ objectives, procedures, and 

compliance requirements relevant to the single audit. It also provides auditors with 

guidance for determining whether federal programs are compliant with these requirements 

(laws, regulations, and provisions of contract or grant agreements).

States Reported 

Receiving Useful 

Technical Assistance 

from HHS, but HHS 

Has Not Yet 

Systematically 

Monitored State 

Implementation
 

Page 19 GAO-14-347 Fostering Connections Act Implementation

To support states in their implementation of the Fostering Connections 

Act, HHS provided broad guidance and technical assistance to all states, 

including written communications, information posted on various 

websites, and webinars. Written communications included Program 

Instructions and Information Memoranda to state agencies that clarify and 

explain procedures and methods for operationalizing program policies, 

activities, or priorities, and in some cases encouraged states to consider 

certain practices. In addition, the Training and Technical Assistance 

Coordination Center created two-page briefs for states that describe 

available training and technical assistance related to the key provisions of 

the Fostering Connections Act. As for websites, the Children’s Bureau 

and technical assistance network organizations’ websites provide 

comprehensive information, including toolkits and resource listings to help 

states review their policies and practices related to the Fostering 

Connections Act. For example, the Child Welfare Information Gateway 

website, one of the websites HHS maintains, has a specific section 

dedicated to the Fostering Connections Act that links to text of the 

legislation and other relevant resources. Lastly, according to HHS data, 

from 2008 to 2013, HHS conducted approximately 53 webinars to assist 

states in implementing the Fostering Connections Act through several 

national resource centers and the Child Welfare Information Gateway.

In addition to such broad guidance, HHS has also provided tailored 

assistance to states that requested it. According to HHS documentation, 

from fiscal year 2011 through March 2013, nearly all states requested 

tailored assistance to help them implement the Fostering Connections 

Act. This assistance may be in the form of consultation, problem solving, 

or discussions with individual states. Additionally, on some issues, the 

national resource centers provided assistance to multiple states at once. 

For example, the National Resource Center for Permanency and Family 

Connections worked with HHS and the Department of Education to 

convene a national meeting on child welfare, education, and the courts to 

encourage cross-system efforts to address educational stability issues 

and to showcase collaborative projects and initiatives at state and local 

levels that support educational well-being outcomes. In addition, the 

National Resource Center for Youth Development organized a number of 

efforts to help states implement the extension of foster care beyond age 

18, including the development of a virtual meeting place for states that 

have implemented the extension to share information and ask questions.

Overall, most states found the assistance they received from HHS and its 

technical assistance network useful. Nearly every state reported in our 

survey that they found HHS’s Program Instructions and Information 

HHS Has Provided Broad 

Guidance as well as 

Tailored Assistance, Which 

Most States Found Useful
 

Page 20 GAO-14-347 Fostering Connections Act Implementation

Memoranda (47), as well as regional office assistance (42), useful. One 

state official told us that the ongoing assistance via teleconferences and 

site visits from their regional HHS officials has been extremely helpful. In 

addition, a majority of states (40) reported that they found publications, 

such as practice briefs, toolkits, and other articles, useful. See figure 4 for 

state views on the usefulness of HHS technical assistance.

Figure 4: States’ Views on Usefulness of HHS Technical Assistance to Implement 

Fostering Connections Act Provisions 

a

Nineteen states reported in our survey that they did not use HHS technical assistance centers. 

According to HHS officials, however, nearly all states used the national resource centers. The officials 

suggested that state responses to the use of national resource centers in our survey may not reflect 

this because the respondent may not have been familiar with that particular aspect of the state’s 

activities. 
 

Page 21 GAO-14-347 Fostering Connections Act Implementation

To date, HHS’s main oversight of state implementation of the Fostering 

Connections Act has consisted of reviewing states’ title IV-E plans to 

ensure they comply with federal requirements; however, the agency has 

not yet systematically reviewed actual state implementation of the act. To 

review title IV-E plans, HHS staff in regional offices assess state laws, 

regulations, policies, and procedures for consistency with federal child 

welfare requirements, including those established by the Fostering 

Connections Act. A state’s title IV-E plan must be amended or updated as 

necessary to comply with any new federal requirements, such as changes 

to the law. According to HHS, fifty states (including the District of 

Columbia) currently have approved title IV-E plans reflecting all 

mandatory provisions of the Fostering Connections Act (and other title IVE requirements).25 According to officials in HHS regional offices that we 

interviewed, HHS’s other oversight activities include reviewing quarterly 

expenditure data and ongoing discussions with state child welfare officials 

through conference calls, site visits, technical assistance, and joint 

planning with state officials around their plans for delivering and 

improving child welfare services.

26

HHS’s last 5-year round of the CFSR process to comprehensively monitor 

state child welfare programs began in 2007, before the enactment of the 

Fostering Connections Act. HHS regulations provide that states must 

Additionally, HHS officials in one 

regional office told us that they may follow up on specific issues brought 

to their attention by advocates. While these oversight activities allow HHS 

to have some knowledge about state implementation of the Fostering 

Connections Act, at the time of our interviews, officials at all four HHS 

regional offices we spoke to told us that since the Fostering Connections 

Act was enacted, they have not comprehensively evaluated compliance 

with title IV-E plans within states after they have been approved.

 

25One state (Georgia) is working with HHS to bring its title IV-E plan into compliance with 

all federal requirements for the program. The Commonwealth of Puerto Rico is also 

working with HHS to finalize its title IV-E plan.

26HHS officials told us that they also review Annual Progress and Services Reports that 

states and tribes submit describing the progress they made in the previous year toward 

accomplishing the goals and objectives in their title IV-B plans. However, while these 

reports may include some narrative addressing aspects of the provisions covered in the 

Fostering Connections Act, these reviews are focused on title IV-B programs, and 

generally do not cover programs under title IV-E. Officials also told us that they conduct 

title IV-E eligibility reviews. However, the purpose of these reviews is to determine if 

children in foster care meet the federal eligibility requirements for foster care maintenance 

payments, not to monitor state implementation of other federal requirements.

HHS Has Not Yet 

Systematically Monitored 

State Implementation of 

the Fostering Connections 

Act
 

Page 22 GAO-14-347 Fostering Connections Act Implementation

undergo a complete review of child welfare programs—including title IVE—every 5 years, and HHS implements this requirement using the CFSR 

process. In March 2014, HHS announced plans to conduct the next round 

of CFSRs beginning in fiscal year 2015. This announcement addresses 

process changes, such as not requiring stakeholder interviews if HHS 

determines that data provided by the state sufficiently demonstrate state 

compliance in a particular area. While the assessment instrument used by 

HHS for previous CFSRs may be broad enough to capture some of the 

new provisions of the Fostering Connections Act, such as placement with 

siblings or school stability, HHS has not completed the assessment 

instrument for the forthcoming round, so it is not clear what indicators 

would be used to assess compliance with these provisions. Additionally, 

the previous CFSR instrument does not address other provisions that 

involve specific deadlines, such as the requirement that child welfare 

agencies identify and notify relatives within 30 days after a child’s removal 

from his home or that youth develop a transition plan 90 days prior to 

aging out of foster care. HHS officials told us that they are currently 

revising this instrument in preparation for the next round of CFSRs and 

expected it to be finalized in the summer of 2014.

HHS officials told us that the next round of the CFSRs, which should have 

started in 2012, was delayed because the agency was considering how to 

best address comments they solicited in 2011 on improving the CFSR 

process and what changes, if any, they would need to make to the 

regulations to monitor implementation of the Fostering Connections Act.27

In the meantime, officials in one regional office told us that with this delay 

in the CFSR process, there is no other mechanism in place for HHS to 

systematically examine actual state practices. Our previous work found 

that regional HHS staff considered the CFSR an important complement to 

a state’s planning documents—it enables HHS staff to determine both 

whether states are providing the services they report in their planning 

documents and whether those services are adequate and appropriate to 

meet the needs of the state’s children and families.28

 

27In April 2011, HHS published a request for public comment on ways to improve the 

CFSR process. See Federal Monitoring of Child and Family Service Programs; Request 

for Public Comment and Consultation Meetings, 76 Fed. Reg. 18,677 (Apr. 5, 2011).

Officials in all four 

regional offices we spoke with told us that a systematic monitoring effort, 

28See GAO, Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide 

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

12, 2003).
 

Page 23 GAO-14-347 Fostering Connections Act Implementation

like the CFSR, could help states improve their programs. An official in one 

regional office added that states can also gain the support needed to 

make improvements by showing results from systematic monitoring 

reviews.

HHS also lacks adequate data to assess if states are complying with the 

policies they outlined in their title IV-E plans or the effectiveness of states’ 

actions. Internal control standards state that management should obtain 

data on a timely basis for effective monitoring.29 Effective control 

structures depend on data analysis to determine whether agencies are 

effectively using resources and whether the agency is in compliance with 

applicable laws and regulations. However, HHS has not yet updated 

information collection requirements for case level data it collects from 

states on children in foster care through the Adoption and Foster Care 

Analysis and Reporting System (AFCARS). These data do not reflect the 

new provisions added by the Fostering Connections Act, such as those 

on sibling placement and school stability. HHS officials told us that they 

are beginning the process of revising AFCARS completely and plan to 

publish a notice of proposed rulemaking in the spring of 2014. AFCARS 

data are used to inform oversight activities conducted by HHS, including 

the CFSR process. These data will not be revised in time for the 

upcoming fiscal year 2015 CFSR process, which relies heavily on 

AFCARS for the development of statewide performance indicators. 

Meanwhile, officials in two states we visited told us that they were in the 

process of updating their state data systems and it would be helpful for 

them to know what kind of data HHS would like them to collect before 

making a costly and time-intensive investment in overhauling their 

system. Additionally, while some states may voluntarily collect information 

about the outcomes of their programs, many do not.30

 

29The five components of internal controls are (1) control environment; (2) risk 

assessment; (3) control activities; (4) information and communications; and (5) monitoring. 

See GAO, Standards for Internal Control in the Federal Government,

This lack of data 

further hinders HHS’s ability to evaluate implementation of the Fostering 

Connections Act.

GAO/AIMD-00-21.3.1 (Washington, D.C.: November 1999). 

30For example, in response to our survey, nearly half of states reported that they do not 

use data to assess their state’s performance related to reasonable efforts to place siblings 

together or federal school completion or attendance requirements. More than one half did 

not use data to assess their performance related to developing a personalized transition 

plan within 90 days before each youth ages out of foster care.
 

Page 24 GAO-14-347 Fostering Connections Act Implementation

We found examples of potential uneven implementation of state policies 

in the four states we visited.31

The experiences of the 29 current and former foster youth we met with 

also indicate that family connections, school stability, and transitions for 

older youth may still be a concern for some youth.

For example, regarding the Fostering 

Connections Act school stability provisions, officials in one state we 

visited reported that while the state policy requires child welfare agencies 

and schools to jointly determine whether changing schools would be in a 

child’s best interest, local agencies likely varied in the extent to which 

they collaborated and some may not be doing so at all. A local school 

official in another state observed that whether or not these best interest 

determinations happen may depend on individual caseworkers. 

Additionally, practices varied within the states we visited pertaining to the 

requirement that caseworkers support youth in developing a transition 

plan in the 90 days before they age out of care. All four of the states we 

visited had updated their policies to reflect the new requirement, but local 

officials in one office indicated that they did not always complete plans for 

all youth before they age out of care. Caseworkers in another state told 

us that while they aim to engage youth in the 90-day transition plan, the 

meeting held to fulfill the requirement may not include the youth in many 

cases.

32 For example, while 

nine of the youth we met with reported being placed together with their 

siblings or were in frequent contact, five youth said they had no contact 

with their siblings or had only sporadic contact.33

 

31These examples of uneven implementation are drawn from a limited number of states 

and cannot be generalized. Determining whether and to what extent these examples of 

potential uneven implementation raises concerns about compliance with the Fostering 

Connections Act was beyond the scope of this review. 

One young woman said 

that being able to see her sister was treated as a privilege rather than a 

right, and that the privilege was taken away, for example, when she did 

not perform well in school. In terms of school stability, nearly all of the 

youth we met with experienced multiple school changes and one youth 

reported missing a month of school upon entering foster care while 

waiting for records to be transferred to a new school. The youth we met 

32We did not attempt to substantiate these examples or determine the extent to which they 

were indicative of broader practice.

33At least 12 of the youth we interviewed reported being separated from some or all of 

their siblings upon placement. Placement with siblings also changed over the course of 

their experience in foster care.
 

Page 25 GAO-14-347 Fostering Connections Act Implementation

with also had mixed experiences with transition planning. Ten of the youth 

felt they had benefitted from their transition plans and group decisionmaking meetings, but eight said they did not recall having a transition 

plan or being actively involved in developing it. A systematic monitoring 

effort by HHS could help identify and address some of these problems.

The Fostering Connections Act made changes to address shortcomings 

in the foster care system, and states have reported implementing 

numerous practices aimed at achieving improved outcomes for children 

and their families. More than 5 years after its enactment, however, HHS 

has not yet monitored states’ implementation of the act in a systematic 

way. States reported facing major challenges with meeting requirements 

for sibling placement, educational stability, and several other provisions in 

the act. These challenges—some of them longstanding barriers—are 

complex, and failure to overcome them could hamper progress toward 

meeting the goals of the Fostering Connections Act. HHS has an 

important role in helping assess what states have done and what else is 

needed to improve outcomes for children in foster care. While HHS has 

plans under way to begin monitoring through a new round of CFSRs in 

fiscal year 2015, HHS has not specified how it will address changes made 

by the Fostering Connections Act. Without monitoring state 

implementation of these new provisions, it will be difficult for HHS to have 

sufficient information to determine how these approaches are working 

and whether changes to state or federal policies or federal guidance and 

assistance are needed to improve outcomes for children in foster care. At 

the same time, HHS has not yet updated data reporting requirements to 

reflect the new provisions of the Fostering Connections Act. These data 

are a fundamental element of the CFSR process, yet they will not be 

relevant to the changes made by the Fostering Connections Act for the 

next round of reviews. Without these data, it will be difficult for HHS to 

have adequate information to evaluate implementation and assess states’ 

progress towards meeting the needs of children in and transitioning out of 

foster care. Additionally, for states that have already begun revamping 

their own state data systems, incorporating federal requirements at a later 

date can lead to additional delay or expense. Lastly, only 21 states 

reported calculating their savings from the federal adoption assistance 

income eligibility changes for fiscal year 2012, despite the Fostering 

Connections Act requirement that states spend these savings on their 

child welfare programs. Although states we surveyed reported challenges 

performing these calculations, HHS has not issued guidance to states on 

how to perform them. The amount states save could grow more 

significant as the expanded eligibility criteria are phased in to include all 

youth by fiscal year 2018. The state funds freed up as a result of more 

Conclusions
 

Page 26 GAO-14-347 Fostering Connections Act Implementation

children becoming eligible for federal funding could help states address 

the persistent challenges they face serving children in foster care. In the 

absence of further guidance, states may continue to struggle with 

calculating savings and miss an opportunity to take advantage of 

increased federal funds to add to limited state resources.

To ensure implementation of the Fostering Connections Act and improve 

outcomes for children in foster care, we recommend the Secretary of 

Health and Human Services take the following three actions.

To maximize the amount of funds states are reinvesting into child welfare 

services, the Secretary of Health and Human Services should provide 

guidance on how states could calculate savings from the changes to the 

federal adoption assistance income eligibility criteria.

To help identify areas where states may need additional support or 

guidance in their efforts to provide children in foster care with services 

and assistance under title IV-E, as amended by the Fostering 

Connections Act, the Secretary of Health and Human Services should 

proceed with and expeditiously finalize plans to:

• systematically monitor state practices for compliance with policies 

outlined in their title IV-E plans that cover the new provisions 

established by the Fostering Connections Act, and

• update AFCARS to collect relevant data from states about provisions 

established by the Fostering Connections Act.

We provided a draft of this report to HHS and the Department of 

Education for review and comment. HHS provided formal comments that 

are reproduced in appendix V. HHS also provided technical comments 

that we incorporated, as appropriate. Education did not have comments.

HHS concurred with our recommendations and outlined steps it is taking 

to implement them. HHS stated that it is committed to continuing to 

support states in providing high quality child welfare services and to 

engaging in monitoring activities that hold the states accountable both for 

compliance with the law and for improved outcomes for children and 

families. 

In response to our recommendation to provide guidance on how states 

could calculate savings from the changes to the federal adoption 

assistance income eligibility criteria, HHS said the department will gather 

Recommendations for 

Executive Action

Agency Comments 

and Our Evaluation
 

Page 27 GAO-14-347 Fostering Connections Act Implementation

examples of how savings are being calculated and documented by some 

states and develop a document to provide as technical assistance to 

other states. HHS further stated that the department’s implementation of 

this provision to date has been driven by a desire to avoid imposing an 

undue administrative burden on states and the challenge of specifying a 

methodology for calculating savings that would work in all state settings. 

HHS said that state officials have signed assurances as part of their title 

IV-E plan submissions to calculate and reinvest these savings. HHS also 

stated that independent auditors are responsible for identifying an 

appropriate finding in single audit reports for any states that have not 

taken steps to calculate and account for these savings. HHS said it will 

work to assure that all needed corrective actions are taken to resolve any 

such finding in a state’s single audit.

In response to our recommendation to expeditiously finalize plans to 

systematically monitor state practices for compliance with policies 

outlined in their title IV-E plans that cover the new provisions established 

by the Fostering Connections Act, HHS stated that the CFSR process is 

designed to provide federal oversight of states’ compliance with 

provisions of titles IV-B and IV-E, and the amendments made by the 

Fostering Connections Act to titles IV-B and IV-E will be reflected in the 

revised CFSR protocol. HHS said it is in the process of finalizing the 

instruments and measures that will be used during the round of reviews 

expected to begin in fiscal year 2015 and they will be shared with the 

public when finalized. We continue to encourage HHS to ensure that the 

new provisions introduced by the Fostering Connections Act are 

incorporated into these instruments and measures and that the 

department moves quickly to complete the instruments and begin the 

third round of CFSR reviews.

In response to our recommendation that HHS expeditiously finalize plans 

to update AFCARS to collect relevant data from states about provisions 

established by the Fostering Connections Act, HHS stated that ACF has 

announced its intent to begin the regulatory process to make changes to 

AFCARS by issuing a Notice of Proposed Rulemaking, projected to be 

published in the spring of 2014. HHS did not discuss how these changes 

would incorporate the provisions in the Fostering Connections Act nor 

provide an estimate as to when these changes will be completed. We 

encourage HHS to make every effort to expedite these changes within the 

rulemaking process. As it is, the next round of CFSRs will proceed 

without the benefit of updated data from AFCARS relevant to the 

amendments made by the Fostering Connections Act. Without these 
 

Page 28 GAO-14-347 Fostering Connections Act Implementation

data, it will be difficult for HHS to have adequate information to assess 

states’ progress in implementing the Fostering Connections Act. 

We are sending copies of this report to the Secretaries of Health and 

Human Services and Education, and interested congressional 

committees. In addition, the report is available at no charge on the GAO 

website at http://www.gao.gov. 

If you or your staff members have any questions about this report, please 

contact me at (202) 512-7215 or brownke@gao.gov. Contact points for 

our Offices of Congressional Relations and Public Affairs may be found 

on the last page of this report. GAO staff who made key contributions to 

this report are listed in appendix VI.

Kay E. Brown, Director

Education, Workforce, and Income Security Issues
 

Page 29 GAO-14-347 Fostering Connections Act Implementation

List of Requesters

The Honorable Sander Levin

Ranking Member

Committee on Ways and Means

House of Representatives

The Honorable Lloyd Doggett

Ranking Member

Subcommittee on Human Resources

Committee on Ways and Means

House of Representatives

The Honorable Jim McDermott

Ranking Member

Subcommittee on Health

Committee on Ways and Means

House of Representatives
Page 30 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Practices reported by states in a nationwide survey

Relative identification and notification practices that states reported being required 

or recommended statewide

Note: The Fostering Connections Act generally does not require states to adopt particular practices. 

Totals may not sum to 52 if some states do not require or recommend the practice.

What the act says

As amended by the Fostering 

Connections to Success and 

Increasing Adoptions Act of 2008 

(Fostering Connections Act), title 

IV-E of the Social Security Act 

requires that the state exercise due 

diligence to identify and notify all 

grandparents and other adult 

relatives of a child, subject to 

certain exceptions, within 30 days 

of the child's removal from the 

parents’ custody and of the 

relatives' options to become a 

placement resource for the child. 

42 U.S.C. § 671(a)(29).

Legislative/regulatory action

States reported taking the following 

legislative or regulatory action to 

implement the relative identification 

and notification requirement: 

16 states enacted or revised a 

law: AR, CA, CO, FL, GA, HI, IN, 

IA, ME, MD, MN, MT, OK, TX, UT, 

and WI

23 states issued or revised a 

regulation: AL, AZ, CO, CT, ID, 

LA, MS, MO, NE, NH, NJ, NM, NY, 

NC, ND, OH, OK, OR, PR, TN, VA, 

WA, and WI

13 states made no changes:

(The existing law or regulation was already 

consistent with the federal requirement)

AK, DE, DC, KS, MA, MI, NV, PA, 

RI, SC, SD, VT, and WY

Note: Responses sum to 52 but not all states 

are represented as some states reported 

taking both legislative and regulatory action. 

Because states generally had discretion in 

how to implement this provision, some states 

may have used means other than law or 

regulation.

Relative identification and notification

States took steps to formalize or modify prior policies, and 

some states experienced challenges finding relatives
Page 31 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Challenges reported by states in a nationwide survey

Note: Responses do not sum to 52 if states selected “do not know / not applicable” or did not respond. 

Data collection

Federal: HHS does not collect nationwide data on relative identification 

and notification efforts. States do report data to HHS on the percentage of 

children in foster care whose most recent placement is in a relative foster 

family home, which one state noted using as a proxy measure for relative 

identification and notification efforts. HHS data indicate that this figure has 

increased somewhat in recent years (see table below).

Percentage of children in foster care whose most recent placement setting was a 

relative foster family home

Fiscal year 2008 2009 2010 2011 2012

Percentage 24% 24% 26% 27% 28%

Source: HHS, Adoption and Foster Care Analysis and Reporting System (AFCARS).

State: In our survey, 23 states reported that they use quantitative 

indicators or data to assess their state’s performance related to the 

relative identification and notification requirements. Seven states indicated 

that they collected specific data on these requirements. Eight states 

indicated that their measures relate to the placement of children with 

relatives, as discussed above, rather than identification and notification 

efforts specifically, and eight states did not provide details on what they 

collect. Additionally, two states that captured relevant data, such as the 

number of relatives identified or the timeliness of relative search efforts, 

reported that these data are not yet regularly reviewed.

Practices in selected states

States we visited reported refining 

their relative identification and 

notification practices in response to 

the Fostering Connections Act. For 

example, according to state 

officials, Massachusetts began 

requiring notification in writing, and 

California added a timeframe to its 

state law. Officials in multiple 

locations emphasized the 

importance of engaging relatives 

as early as possible, in some cases 

before a child is formally removed 

from the home. Three of the four 

states used family team meetings 

to discuss potential relative 

placement options. While all four of 

the states we visited used 

technology—such as Lexis-Nexis 

or the Federal Parent Locator 

Service—to locate relatives, 

caseworkers we interviewed in 

Texas indicated that a child’s 

parents remain the first and 

primary source of information about 

relatives. Caseworkers also 

reported using social media to 

locate relatives. Officials and 

caseworkers in three of the four 

states reported that they use both 

written notification and a telephone 

call to notify relatives. 

Selected state challenges

Officials and caseworkers reported 

that parents may not be 

forthcoming with information on 

relatives, particularly related to 

non-custodial fathers. One state 

noted that the 30-day timeframe 

can be challenging if a child is not 

already known to the agency at the 

time of removal. An official in one 

local office that serves a large 

immigrant community noted that 

identifying relatives outside of the 

country may take longer.

Relative identification and notification

Continued
Page 32 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Practices reported by states in a nationwide survey

Sibling placement practices that states reported being required or recommended 

statewide

Note: The Fostering Connections Act generally does not require states to adopt particular practices. 

Totals may not sum to 52 if some states do not require or recommend the practice.

a

Unless it would be contrary to a child’s safety or well-being

Through our survey, individual states also provided the following examples 

of practices that worked well in their efforts to meet the federal 

requirement: placement of siblings with relatives; allowing some flexibility 

around rules such as the number of children allowed in a foster home or 

sharing a bedroom; temporary use of emergency placements to maintain 

sibling groups until a suitable permanent placement is located; and 

increasing priority and awareness within the agency around sibling 

placement. In particular, one state noted that having youth alumni share 

their experiences with caseworkers has had an impact on making sibling 

placement a priority. 

What the act says

Requires states to make 

reasonable efforts to place siblings 

removed from their home in the 

same foster care, kinship 

guardianship, or adoptive 

placement, and to provide for 

frequent visitation or other ongoing 

interaction between siblings who 

are not placed together, unless it 

would be contrary to the safety or 

well-being of any of the siblings to 

do so. 42 U.S.C. § 671(a)(31).

Legislative/regulatory action

States reported taking the following 

legislative or regulatory action to 

implement the federal sibling 

placement requirement: 

12 states enacted or revised a 

law: AK, FL, GA, MN, NV, NJ, ND, 

OK, PA, TX, VA, and WI

21 states issued or revised a 

regulation: AL, AZ, AR, CT, HI, ID, 

LA, ME, MD, MS, NE, NM, ND, 

OH, OK, OR, PR, RI, TN, UT, and 

WI

17 states made no changes:

(The existing law or regulation was already 

consistent with the federal requirement)

CA, CO, DE, DC, IN, IA, KS, MA, 

MO, MT, NH, NY, NC, SC, SD, 

WA, and WY

Note: Responses do not sum to 52 because 

not all states may have responded to the 

question, and some states may have taken 

both legislative and regulatory action. 

Because states generally had discretion in 

how to implement this provision, some states 

may have used means other than law or 

regulation.

Sibling Placement

States required practices aimed at keeping siblings 

together or in contact, but the lack of appropriate 

placements for sibling groups was a major challenge
Page 33 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Challenges reported by states in a nationwide survey

Note: Responses do not sum to 52 if states selected “do not know / not applicable” or did not respond. 

Data collection

Federal:

• HHS does not collect nationwide data on sibling placement or 

visitation.

State:

• Twenty-five states reported in our survey that they use quantitative 

indicators or data to assess their state’s performance related to the 

federal sibling placement requirements. Of these, 15 indicated that 

their statewide data systems can track whether siblings are placed 

together. 

• One state we visited tracks the share of sibling groups in which all 

siblings are placed together; some siblings are together and others are 

separated; and all siblings are separated. These data can be 

compared across regions of the state. 

Practices in selected states

States that we visited revised

existing policies related to sibling 

placement. For example, officials in 

Massachusetts said that their 

sibling placement practices have 

been in place since the 1980s, but 

were put into state law in 2008. 

Officials in Texas said they 

launched a major initiative that 

included training staff on the 

importance of sibling connections. 

Texas officials also reported 

expanding the use of 

telecommunication options to keep 

siblings connected. Officials in 

three of the four states we visited 

noted that placing siblings with 

relatives is a key strategy that can 

address several challenges, such 

as difficulty finding placements for 

siblings with a wide range in age.

Selected state challenges

The lack of available placements 

for sibling groups was a challenge 

identified in all four states we 

visited. One local office noted that 

this can be particularly challenging 

in high-cost urban areas where 

potential resource families have 

limited space. Additionally, siblings 

may have different needs that may 

require separate housing, as when 

one sibling has severe behavioral 

issues that require a higher level of 

care. Caseworkers in two states

noted that groups in which siblings 

have different fathers can 

complicate placement with 

relatives. One group of foster 

parents we interviewed reported 

that the child welfare agency does 

not do enough to facilitate visitation 

between separated siblings, which 

is left to the foster parents to 

arrange.

Sibling placement

Continued
Page 34 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

States that allow waivers

In response to our survey, 43 states reported they now allow waivers of 

non-safety licensing standards for relative foster family homes, up from 33 

prior to the enactment of the Fostering Connections Act. Of these 43 

states, 19 reported allowing local or county offices to approve waivers. 

Most states that allow these waivers reported that they define “non-safety” 

or list specific standards that may be waived in state law, regulation, or 

agency policy.

States that reported defining “non-safety” or listing specific standards that may be 

waived

In state law In regulations In agency policy

Alaska ●

California ● ●

Colorado ●

Connecticut ● ●

District of Columbia ●

Georgia ●

Idaho ● ●

Illinois ●

Iowa ●

Kansas ●

Maine ●

Massachusetts ●

Minnesota ●

Mississippi ●

Missouri ● ●

Montana ● ●

Nebraska ●

New Hampshire ● ● ●

New Jersey ● ●

New York ●

North Dakota ●

Ohio ●

Oklahoma ●

Oregon ● ●

Pennsylvania ●

Rhode Island ●

Tennessee ●

West Virginia ●

Wisconsin ● ●

Wyoming ●

Source: GAO survey of the state child welfare agencies of all 50 states, the District of Columbia, and Puerto Rico.

What the act says

Authorizes states to waive, on a 

case-by-case basis, non-safety 

licensing standards for relative 

foster family homes. States have 

the discretion to determine what 

constitutes a non-safety standard. 

42 U.S.C. § 671(a)(10).

Pre-existing guidance from HHS 

permits states to grant “variances,” 

alternative equivalent methods of 

meeting licensing standards, on a 

case-by-case basis. According to 

HHS, the legislative change 

encouraged more states to actively 

engage relatives and to increase 

the percentage of relative foster 

family homes that are licensed.

Legislative/regulatory action

States reported taking the following 

legislative or regulatory action to 

implement the option to waive nonsafety licensing standards for 

relative foster family homes: 

13 states enacted or revised a 

law: AR, CA, CO, DC, GA, IN, LA, 

ME, MN, NJ, ND, TX, and WI

18 states issued or revised a 

regulation: AL, AZ, CO, CT, HI, 

LA, MD, MS, MO, NE, NV, ND, 

OH, OK, OR, TN, UT, and WI

18 states made no changes:

(The existing law or regulation was already 

consistent with the federal requirement)

AK, DE, FL, ID, IA, KS, MA, MT, 

NH, NY, NC, PA, RI, SC, SD, VT, 

WA, and WY

Note: Responses do not sum to 52 because 

not all states may have responded to the 

question, and some states may have taken 

both legislative and regulatory action. 

Because states generally had discretion in 

how to implement this provision, some states 

may have used means other than law or 

regulation.

Note to table at right: The following states 

reported that they allow waivers of non-safety 

licensing standards for relative foster family 

homes but such standards are not defined in 

state law, regulations, or agency policy: 

Arizona, Arkansas, Hawaii, Indiana, Louisiana, 

Michigan, Nevada, North Carolina, Texas, 

Utah, Vermont, Virginia, and Washington. 

Waivers of non-safety licensing standards

More states currently allow waivers for relative foster 

family homes compared to 2008, but some officials 

reported a burdensome process
Page 35 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Challenges reported by states in a nationwide survey

Note: Responses are from the 43 states that indicated that their state currently allows waivers of nonsafety licensing standards for relative foster family homes. Responses do not sum to 43 if states 

selected “do not know / not applicable” or did not respond. 

Data collection

Federal: HHS does not routinely collect nationwide data on waivers of 

non-safety licensing standards for relative foster family homes. In 2011, as 

required by the Fostering Connections Act, HHS submitted a one-time 

report to Congress on children placed in relative foster family homes and 

the use of licensing waivers. That report noted that this was the first time 

that states were asked to provide this information, and some states do not 

routinely collect these data in their automated systems. The report 

contained information on types of non-safety licensing standards waived:1

• the majority of waivers approved pertained to a child’s sleeping 

arrangements or the space requirements in the home (e.g. bedroom 

space, square footage); 

• waivers allowed a foster family home to parent more children and 

children of different ages than would normally be allowable under state 

licensing rules;

• many waivers provided relatives with exemptions from pre-license and 

ongoing foster parent training requirements, or extensions to complete 

foster parent training.

Practices in selected states

All four of the states we visited 

allowed waivers of non-safety 

licensing standards for relative 

foster family homes, but use of 

waivers varied. Officials in 

Massachusetts and California 

noted that they had been approving 

waivers of non-safety standards

before the Fostering Connections 

Act, and approve waivers, for 

example, related to square footage 

or sleeping arrangements. Officials 

in one California county explained 

that about half of the county’s 

placements are with relatives, and 

that the majority of these required 

some kind of waiver. While waivers

for relatives are allowed in Texas 

and Virginia, officials in those 

states said that they are not 

frequently used in part because of 

the lower number of relative foster 

family homes pursuing licensure.

Selected state challenges

Local officials or caseworkers in 

three of the four states we visited

told us that the process for getting 

a waiver approved can be 

burdensome or lengthy. Some 

indicated that this can lead to not 

pursuing waivers in some cases. 

Caseworkers in one state told us 

that many relative homes remain 

unlicensed in part because of the 

difficult process, but that many of 

these families are struggling and 

need the financial assistance that 

being licensed would provide. One 

official in another state said that 

caseworkers in some local offices 

may not try to get relative homes 

licensed because of local office 

attitudes against families being 

paid to care for their relatives.

1

HHS report does not provide the number of 

states that allow each of these types of 

waivers.

Waivers of non-safety licensing standards

Continued
Page 36 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Practices reported by states in a nationwide survey

Practices that the 32 states operating a title IV-E guardianship assistance program 

(GAP) reported as being required or recommended statewide

Note: The Fostering Connections Act generally does not require states to adopt particular practices. 

Totals may not sum to 32 if some states do not require or recommend the practice.

Through the survey, individual states also provided the following examples 

of practices that worked well in their efforts to implement a title IV-E GAP 

program:

• providing training on program processes and the benefits to children 

and families;

• having a specialized staff position to support guardianship efforts;

• having a state “mailbox” for local offices to submit case-specific 

questions; and

• agency culture that supports relative placements and recognizes the 

need for ongoing assistance to ensure that relative placements remain 

stable. 

Four states also noted that experience operating a state-funded 

guardianship assistance program prior to the Fostering Connections Act 

helped them to implement their programs.

What the act says

Authorizes states to provide and 

receive federal reimbursement for 

some kinship guardianship 

assistance payments and 

establishes certain eligibility 

requirements. A child may be 

eligible for a payment if, among 

other conditions, the state agency 

determines that 

• the child has been eligible for 

foster care maintenance 

payments while residing for at 

least 6 continuous months in 

the home of the prospective 

relative guardian, and

• returning home or adoption are 

not appropriate permanency

options for the child.

42 U.S.C. §§ 671(a)(28), 673(d).

States operating programs

According to HHS, the 32 states 

listed below have opted to run a 

title IV-E guardianship assistance 

program (GAP) as of February 

2014. Of these, 21 states ran GAP 

programs with state funds or 

through a title IV-E waiver 

demonstration project prior to the 

Fostering Connections Act.

16 states previously operated

a state-funded program: AK, CA, 

CT, DC, HI, ID, ME, MD, MA, NE, 

NJ, NY, OK, PA, RI, and WA

5 states previously operated

a program through a title IV-E 

waiver demonstration project: 

IL, MT, OR, TN, and WI

11 states did not previously 

operate a program: AL, AR, CO, 

IN, LA, MI, MO, SD, TX, VT, and 

WV

3 states indicated that they plan 

to implement a title IV-E GAP 

program in 2014: NC, SC, and UT

Title IV-E Guardianship Assistance Program

32 states operated a federally-subsidized kinship 

guardianship assistance program; state budget constraints 

were a major factor for many that did not
Page 37 GAO-14-347 Fostering Connections Act Implementation

Appendix I – Findings on Family Connections Provisions

Challenges reported by states in a nationwide survey

Note: Responses are from the 32 states that operated a GAP program. Responses do not sum to 32 if 

states selected “do not know / not applicable” or did not respond. 

In addition, 13 states reported that state budget constraints for the state 

match portion of payments was a major factor in their states’ decision not 

to establish a GAP program to date.

Data collection

Federal: HHS collects data from states on the number of children served 

through title IV-E GAP programs as part of states’ quarterly financial 

reporting (see table below).

Number of children served through title IV-E GAP programs

Fiscal year 2009 2010 2011 2012

Number of states claiming

federal GAP reimbursement

1 4 13 27

Average monthly number of 

children receiving assistance under 

GAP

103 3,618 3,552 15,969

Source: HHS.

Note: The latest available expenditure data were for fiscal year 2012; as of 2014, 32 states had title 

IV-E GAP programs.

Practices in selected states

Two of the states we visited, 

California and Massachusetts, 

operated a state-funded 

guardianship assistance program 

prior to enactment of the Fostering 

Connections Act. Officials in 

Massachusetts reported that their 

program has remained largely the 

same. In California, officials said 

some changes to program rules 

made in response to the Act—such 

as reducing the number of months 

(from 12 to 6) a child must be 

placed with a relative before 

guardianship could be granted—

have led to more children exiting 

foster care to guardianship. Texas 

implemented a guardianship 

assistance program for the first 

time in 2010, and officials reported 

that they have actively recruited 

kinship families and use 

specialized kinship workers to talk 

with families about guardianship as 

an option. Virginia does not 

operate a guardianship assistance 

program.

Selected state challenges

State officials in two of the states 

we visited that operate the program 

said that the requirement that 

relative families become licensed 

and that the child be eligible for 

foster care payments for 6 months 

prior to guardianship can delay or 

impede permanency. Officials in 

one state said that getting older 

youth to participate can be difficult 

in part because exiting foster care 

to guardianship could limit access 

to the services that are available to 

older youth who remain in care, 

such as education and training 

vouchers. Officials in Virginia and 

Texas said that some stakeholders 

in their states are not in favor of 

providing financial assistance to 

relative guardians.

Title IV-E Guardianship Assistance Program

Continued
Page 38 GAO-14-347 Fostering Connections Act Implementation

Appendix II – Findings on School Stability Provisions

Practices reported by states in a nationwide survey

School stability practices that states reported being required

or recommended statewide

Note: The Fostering Connections Act generally does not require states to adopt particular practices. 

Totals may not sum to 52 if some states do not require or recommend the practice.

Through the survey, individual states also provided the following examples 

of practices that worked well to implement federal school stability 

requirements: designating education and foster care liaisons who serve as 

a point of contact in their respective agencies and collaboration between 

the state-level agencies, including courts. Some of these collaborations 

led to inter-agency agreements or joint guidance. 

In addition, 36 states reported using title IV-E foster care maintenance 

funds to pay for transportation for children in foster care to remain in their 

schools, as authorized under the Fostering Connections Act. Other 

funding sources used for transportation to allow students to remain in their 

schools included title IV-E administrative funds, state funds, and 

McKinney-Vento Act funds for homeless youth.1

1

The McKinney-Vento Homeless Assistance Act of 1987 (McKinney-Vento Act) requires 

state and local educational agencies to address access to education for homeless children, 

including children awaiting foster care placement. If a child is eligible for services under the 

McKinney-Vento Act, local educational agencies are required to provide or arrange 

transportation.

What the act says

Requires that (1) each foster care 

placement take into account the 

appropriateness of the educational 

setting and the proximity to the 

school in which the child is enrolled 

at the time of placement; and (2) 

the child welfare agency coordinate 

with local educational agencies to 

ensure that the child remains in 

that school. If remaining in that 

school is not in the best interests of 

the child, the agencies must 

provide immediate enrollment in a 

new school, along with the child’s 

educational records. 42 U.S.C. §

675(1)(G). Requires states to 

provide assurances that each 

school-age child eligible for a IV-E 

payment is attending school fulltime or has completed secondary 

school. 42 U.S.C. § 671(a)(30).

Legislative/regulatory action

States reported taking the following 

legislative or regulatory actions to 

implement 42 U.S.C. § 675(1)(G):

18 states enacted or revised a 

law: CA, DC, FL, GA, IN, IA, LA, 

MD, MI, MN, MO, NV, NJ, OK, TX, 

UT, VA, and WA

18 states issued or revised a 

regulation: AL, AZ, AR, CT, KS, 

LA, ME, MD, MS, NE, NM, NY, ND, 

OH, OK, RI, TN, and WV

15 states made no changes:

(The existing law or regulation was already 

consistent with the federal requirement)

AK, CO, DE, HI, MA, MT, NC, NH, 

OR, PA, SC, SD, VT, WI, and WY

Note: Responses do not sum to 52 because 

not all states may have responded to the 

question, and some states may have taken 

both legislative and regulatory action. 

Because states generally had discretion in 

how to implement this provision, some states 

may have used means other than law or 

regulation.

School Stability 

Steps taken to implement school stability requirements

increased attention to foster youth education, but 

placement and transportation issues remained
Page 39 GAO-14-347 Fostering Connections Act Implementation

Appendix II – Findings on School Stability Provisions

Challenges reported by states in a nationwide survey

Note: Responses do not sum to 52 if states selected “do not know / not applicable” or did not respond. 

Data collection

Federal: HHS does not collect nationwide data on school stability or 

attendance.

State: 

• Twelve states reported in our survey that they use quantitative 

indicators or data to assess their state’s performance related to federal 

school stability requirements. For example, one state reported tracking 

the distance between the removal home and the school placement. 

Seven states that do not currently track data on school stability 

reported that they are working to do so.

• Estimates of the number of youth who are able to remain in their same 

school when changing placements varied widely across officials, 

caseworkers, and youth we interviewed, but most estimated that a 

significant number of youth were changing schools. Caseworkers in 

one state reported that the default option is for youth to change 

schools.

Practices in selected states

Three states that we visited 

engaged in new efforts to improve 

school stability, such as 

collaborations between their state 

child welfare and educational

agencies to jointly develop policies 

and procedures to implement the 

requirements. Some of these 

policies called for dedicated points 

of contact in the respective 

agencies, shared decision-making 

to determine which school is in a 

child’s best interest, and 

timeframes and procedures for 

school enrollment. Officials in 

Virginia noted that their school 

stability policies for foster youth 

were modeled after McKinneyVento Act policies for homeless 

youth. Officials across the four 

states we visited noted that the 

Fostering Connections Act has 

increased attention to school 

stability for foster youth. 

Selected state challenges

The lack of placements near the 

school a child was attending before 

entering foster care or changing 

placements was reported to be a 

challenge in all four states we 

visited. In cases where the 

placement is reasonably close to 

the school, officials noted some 

financial and logistical barriers, 

such as reliance on taxis or 

caseworkers to provide 

transportation. Foster youth with 

special education needs presented 

particular transportation and 

enrollment challenges, which 

sometimes delayed their starting 

classes. In addition, interaction 

between child welfare and 

educational agencies can vary 

considerably at the local level, 

where efforts sometimes depend 

on the individuals involved.

School Stability 

Continued
Page 40 GAO-14-347 Fostering Connections Act Implementation

Appendix III – Findings on Older Youth Provisions

Practices reported by states in a nationwide survey

90-day transition plan practices that states reported being required or recommended 

statewide

Note: The Fostering Connections Act generally does not require states to adopt particular practices. 

Totals may not sum to 52 if some states do not require or recommend the practice.

Through the survey, individual states also provided the following examples 

of practices that worked well in efforts to meet the federal 90-day transition 

plan requirement: prior transition planning efforts that lay the groundwork 

for the 90-day plan; Permanency Roundtables, which seek to build 

stronger connections with friends and family and increase older youth 

adoptions and reunifications; specialized units that handle older youth 

cases and receive training on the unique aspects of serving older youth in 

care; partnering with the courts to train court staff in their roles and child 

welfare agency practice; and a dedicated transition planning website.

What the act says

Requires that during the 90-day 

period prior to a child attaining 18 

years of age, or such greater age 

as the state may elect, up to 21 

years of age (“aging out of care”), a 

caseworker assists and supports

the child in developing a transition 

plan that is personalized at the 

direction of the child, and includes 

specific options on housing, health 

insurance, education, local 

opportunities for mentors and 

continuing support services, work

force supports, and employment 

services. A subsequent 

amendment also requires that the 

plan include certain information 

about designating a health care 

proxy or power of attorney. 42 

U.S.C. § 675(5)(H). 

Legislative/regulatory action

States reported taking the following 

legislative or regulatory action to 

implement the 90-day transition 

plan requirement:

13 states enacted or revised a 

law: CA, FL, GA, IN, KS, MN, NE, 

NV, OK, PA, TN, VA, and WI

27 states issued or revised a 

regulation: AL, AZ, AR, CO, DE, 

ID, IA, LA, ME, MD, MA, MS, MO, 

NE, NH, NM, NY, ND, OH, OK, 

OR, PR, RI, SC, UT, WV, and WI

11 states made no changes:

(The existing law or regulation was already 

consistent with the federal requirement)

AK, CT, DC, MI, MT, NJ, NC, SD, 

TX, WA, and WY

Note: Responses do not sum to 52 because 

not all states may have responded to the 

question, and some states may have taken 

both legislative and regulatory action. 

Because states generally had discretion in 

how to implement this provision, some states 

may have used means other than law or 

regulation.

90-day transition plan

States added to existing policies for ongoing planning to 

address new requirements, but faced challenges related to 

housing and engaging youth
Page 41 GAO-14-347 Fostering Connections Act Implementation

Appendix III – Findings on Older Youth Provisions

Challenges reported by states in a nationwide survey

Note: Responses do not sum to 52 if states selected “do not know / not applicable” or did not respond. 

Data collection

Federal: 

• HHS does not collect nationwide data on the 90-day transition plan 

requirement. 

• In 2010, HHS began collecting information through the National 

Youth in Transition Database on each youth who receives 

independent living services.1 States are required to collect 

demographic and outcome information and follow youth over time. 

While the database does not contain information on the 90-day 

transition plan, it does contain data elements on services that youth 

receive and their outcomes related to many of the elements that are 

required in the plan, such as housing, education, and employment. 

State:

• Twenty states reported on our survey that they use quantitative 

indicators or data to assess their state’s performance related to the 90-

day transition plan requirement. These indicators included whether 

and when the transition plan was completed. For example, one state 

tracks the number of plans completed in each jurisdiction and the 

number of youth requiring the plan. Three states also generate reports 

of youth that have not completed plans and can alert caseworkers to 

do so.

1

The federal government provides funding for states to establish and implement independent living 

services to assist youth age16 and older in making the transition from foster care to independent 

living. Allowable services include education and employment assistance, instruction in daily living 

skills, and other support services.

Practices in selected states

All four states we visited reported 

adapting their existing transition 

planning policies to implement the 

90-day plan requirement. In all four 

states, transition planning begins 

by age 16, and in some cases as 

early as age 14. Officials in 

Massachusetts reported that their

existing policies addressed many 

of the specific elements required by 

the Fostering Connections Act. 

One local agency director noted 

that the additional checkpoint 90 

days before youth exit care is 

valuable because youth may be 

more focused on their future than 

at earlier planning stages. 

Examples of how agencies seek to 

ensure that transition plans are 

youth-driven included seeking 

youth input on the transition plan 

template and other written 

materials; encouraging youth to 

actively participate in their court 

hearings; and allowing youth to 

select who is included in transition 

planning meetings.

Selected state challenges

According to some experts, child 

welfare officials may think the 90-

day transition plan is redundant in 

light of their existing transition 

planning efforts. Caseworkers in 

Virginia and Texas reported that 

identifying housing and lifelong 

connections with a supportive adult 

could be particularly difficult. 

Caseworkers in Massachusetts

also reported that some youth are 

eager to exit care and may be 

more difficult to engage in 

planning. In addition, officials in 

three states said some youth exit 

care unexpectedly before a plan is 

completed.

90-day transition plan

Continued
Page 42 GAO-14-347 Fostering Connections Act Implementation

Appendix III – Findings on Older Youth Provisions

Program components reported by states in nationwide survey

Program components for 19 states that have HHS-approved plans to provide federal 

title IV-E foster care maintenance payments for eligible youth age 18 and older

Extend 

eligibility 

under all 5 

conditionsa

Supervised 

independent 

living 

options 

available

Youth age 

18 and 

older may

leave and 

re-enter 

care

Voluntary 

placement 

agreements 

are made 

with youth

Payments 

can be 

made 

directly to 

certain

youth

Alabama ● ● ●

Arkansas ● ● ● ●

California ● ● ● ● ●

District of 

Columbia

● ●

Illinois ● ● ● ●

Indiana ● ● ● ●

Maine ● ● ● ● ●

Maryland ● ● ●

Massachusetts ● ● ● ● ●

Michigan ● ● ● ● ●

Minnesota ● ● ● ● ●

Nebraska ● ● ● ● ●

New York ● ● ●

North Dakota ● ● ●

Oregon ●

Tennessee ● ● ● ●

Texas ● ● ● ●

Washington ● ● ● ●

West Virginia ● ● ● ●

Sources: HHS data and GAO survey of the state child welfare agencies of all 50 states, the District of Columbia, and Puerto Rico.

a

States may choose to extend eligibility for a youth who meets the state’s age limit and is: (1) 

completing secondary education or a program leading to an equivalent credential; (2) enrolled in an 

institution which provides post-secondary or vocational education; (3) participating in a program or 

activity designed to promote or remove barriers to employment; (4) employed for at least 80 hours per 

month; or (5) incapable of doing any of the above described activities due to a medical condition, 

which incapability is supported by regularly updated information in the case plan of the child. 42 

U.S.C. § 675(8)(B)(iii). Tennessee does not extend eligibility to youth under conditions 3 and 4. 

Washington and West Virginia do not extend eligibility to youth under conditions 3, 4, or 5.

Additionally, 43 states extended eligibility for Chafee Foster Care 

Independent Living Program services and 47 extended eligibility for 

education and training vouchers.

States reported varying case review requirements for youth receiving 

extended care payments. According to HHS guidance, reviews could be 

done either by a court or a panel of appropriate persons. For example, 

one state reported requiring an administrative hearing and a permanency 

review each year, while another reported it requires only a court review.

What the act says

Authorizes states to provide foster 

care, adoption assistance, and 

kinship guardianship payments for 

eligible youth 18 and older (up to 

age 21) when certain employment,

education, or training requirements 

are met. 42 U.S.C. §§ 675(8)(B), 

672(c)(2), 673(a)(4).

Authorizes states to extend 

eligibility for Chafee Foster Care 

Independence Program services to 

youth who exit foster care to 

adoption or kinship guardianship at 

age 16 or older. 42 U.S.C. § 

677(a)(7). Also authorizes states 

to extend eligibility for education 

and training vouchers to youth who 

exit foster care to kinship 

guardianship at age 16 or older. 42 

U.S.C. § 677(i)(2).

States that extend federal 

foster care payments

9 states previously extended the 

age for foster care payments 

using other funding sources: 

AR, DC, IL, MD, MA, MN, NY, WA,

and TX 

States reported taking the following 

legislative or regulatory action to 

implement the option to extend the 

age for federal foster care 

payments:

11 states enacted or revised a 

law: CA, IN, MD, MA, MI, MN, NE, 

ND, TN, TX, and WA

9 states issued or revised a 

regulation: AL, AR, ME, MD, NE, 

ND, OR, WA, and WV

3 states made no changes:

DC, IL, and NY

Note: Responses do not sum to 19 because 

some states may have taken both legislative 

and regulatory action. Because states 

generally had discretion in how to implement 

this option, some states may have used 

means other than law or regulation.

Extension of Federal Foster Care Payments 

Beyond Age 18

19 states extended payments to youth age 18 and older;

budget constraints were a major factor for other states 
Page 43 GAO-14-347 Fostering Connections Act Implementation

Appendix III – Findings on Older Youth Provisions

Challenges reported by states in a nationwide survey

In response to our survey, 12 of the states that extend federal foster care 

payments provided comments on challenges they faced regarding 

extending federal foster care payments to youth beyond age 18. These 

challenges included

• finding appropriate housing options,

• the cost associated with providing effective supportive services,

• the additional demand on caseworker’s time, and

• developing a program that meets the specific needs of older youth.

Experts we spoke to also told us that states faced challenges marketing 

the program to youth and designing policies to meet the needs of older 

youth, such as appropriate policies that allow youth to re-enter into foster 

care after they have left.

Additionally, 17 states that did not extend federal foster care payments to 

older youth cited budget constraints as the major factor for not providing 

extended services. Other major factors included needing to change a state 

law and concerns about title IV-E administrative requirements.

Data collection

Federal: HHS collects demographic information about youth above age 

18 from states that have extended care through the Adoption and Foster 

Care Analysis and Reporting System. According to our survey, of the 19 

states that extend services beyond age 18, 13 reported using data to 

assess performance of extending such care. These states reported using 

case management data, data on enrollment and discharges, and 

educational status of eligible youth.

The number of older youth receiving title IV-E payments has risen since 

2010 (see table below).

Youth age 18 and older receiving a monthly title IV-E foster care maintenance 

payment

Fiscal year 2008 2009 2010 2011 2012

Number of older youth 3,292 2,986 2,677 4,306 4,997

Source: HHS, Adoption and Foster Care Analysis and Reporting System (AFCARS). Data as of November 2013.

Note: The numbers reported here may underestimate the number of youth receiving title IV-E foster 

care payments, as states are currently transitioning to report this expanded population of youth 

receiving title IV-E to AFCARS and not all have completed needed updates to their reporting.

Practices in selected states

At the time of our site visits, two of 

the four states we visited provided 

federal title IV-E foster care 

maintenance payments for eligible 

youth who were 18 or older 

(California and Texas) and 

Massachusetts was approved to do 

so as of February 2014. According 

to state officials, Texas and 

Massachusetts used state funds to 

provide extended services to youth 

18 or older prior to the enactment 

of the Fostering Connections Act, 

whereas California’s program did 

not begin until after the act went 

into effect. A large group of 

stakeholders including advocates, 

foundations, and government 

administrators collaborated 

extensively for nearly 5 years to 

implement extended federal foster 

care payments to youth up to age 

21 in California. After extending 

care, officials in California reported 

that they worked closely with foster 

youth and advocates to develop 

policies and train staff in child 

welfare agencies on how to work 

with older youth. 

Selected state challenges

Officials in California and Texas 

told us that designing a program 

that provided young adults 

autonomy while at the same time 

met program requirements was a 

challenge. For example, some 

youth no longer wanted to 

participate in court hearings. 

Finding appropriate housing for 

youth was a significant challenge in 

California. Additionally, states 

faced logistical challenges such as 

scheduling in-person visits with 

youth who no longer resided in the 

state. 

Extension of Federal Foster Care Payments 

Beyond Age 18

Continued
Appendix IV: Scope and Methodology

Page 44 GAO-14-347 Fostering Connections Act Implementation

This report addresses (1) actions states have taken to implement 

selected provisions of the Fostering Connections Act and what 

challenges, if any, states face, and (2) how HHS has provided technical 

assistance to help states implement select provisions of the Fostering 

Connections Act and the extent to which HHS has monitored 

implementation. We surveyed state child welfare agencies, conducted 

site visits, and reviewed relevant federal laws and regulations, HHS 

guidance provided to states, and other research publications. We also 

interviewed officials from HHS’s Administration for Children and Families, 

selected HHS-funded technical assistance providers that have provided 

assistance to states to implement the Fostering Connections Act, and 

other child welfare experts.

The provisions we selected to include in our review pertain to family 

connections, school stability, support for older youth, and states’ 

calculation of savings from the changes in income eligibility for adoption 

assistance payments.1 We excluded selected provisions of the Fostering 

Connections Act on tribal foster care and adoption assistance, as well as 

on health oversight and coordination plan requirements from this review 

because they were already being studied in other reviews conducted by 

GAO or the HHS Office of Inspector General, and based on input from 

child welfare experts.

To learn about actions states have taken to implement selected 

provisions of the Fostering Connections Act, we conducted a web-based 

survey of state child welfare officials in the 50 states, the District of 

Columbia, and Puerto Rico. For selected provisions, we asked officials if 

their state required or recommended certain practices; if their state 

enacted or revised laws or regulations to implement the provision; the 

degree to which they experienced certain challenges; whether they 

collected data in connection with the provision; and what type of technical 

assistance they received from HHS.

 

1

Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering 

Connections Act), Pub. L. No. 110-351, 122 Stat. 3949 (codified as amended in scattered 

sections of 42 U.S.C.). For this review, we focused primarily on selected amendments 

made by the Fostering Connections Act to title IV-E of the Social Security Act. See table 1 

in the body of this report for the specific provisions selected. 

Appendix IV: Scope and Methodology

Survey of State Child 

Welfare Officials
Appendix IV: Scope and Methodology

Page 45 GAO-14-347 Fostering Connections Act Implementation

Our survey population was state child welfare agencies. Because our 

survey covered a range of topics, we recognized that multiple officials 

within a state’s child welfare agency may have needed to contribute to a 

state’s survey response. To identify an appropriate point of contact within 

each state agency, we obtained a list of state child welfare directors from 

HHS. We contacted each director and proposed as a point of contact the 

individual identified by HHS as the state’s foster care manager, but 

allowed the director to designate a different individual. We ultimately 

instructed respondents to consult with others who were familiar with their 

state’s implementation of selected provisions, if doing so would provide 

more accurate responses.

To draft the closed-ended questions on the questionnaire, we drew from 

HHS guidance to states, as well as materials put forth by national 

resource centers in the Training and Technical Assistance Network and 

other organizations. After we drafted the questionnaire, we sought 

feedback from knowledgeable stakeholder organizations, HHS, and from 

an independent GAO survey professional, and made revisions based on 

their comments. We conducted six pretests by phone with state child 

welfare agency officials to check that (1) the questions were clear and 

unambiguous, (2) terminology was used correctly, (3) the questionnaire 

did not place an undue burden on agency officials, (4) the information 

could feasibly be obtained, and (5) the survey was comprehensive and 

unbiased. We selected pre-test states to ensure a mix of state- and 

county-based administration of the child welfare program and coverage of 

states that both did and did not implement two of the optional provisions 

of the Fostering Connections Act ((1) that authorized states to establish a 

title IV-E guardianship assistance program and (2) that authorized states 

to extend eligibility for title IV-E assistance beyond age 18).

We administered our web-based questionnaire through a secure server. 

When we completed the final survey questions and format, we sent an email announcement of the survey to respondents on October 30, 2013. 

They were notified that the questionnaire was available online and were 

given unique passwords and usernames on November 4, 2013. We sent 

follow-up e-mail messages on November 14, November 22, and 

December 4, 2013, to those who had not yet responded. We also 

contacted non-respondents by telephone, starting November 18, 2013. 

The questionnaire was available online until the final response was 

submitted on January 13, 2014. Questionnaires were completed by state 

child welfare agency officials in all 50 states, the District of Columbia, and 

Puerto Rico, for a response rate of 100 percent.
Appendix IV: Scope and Methodology

Page 46 GAO-14-347 Fostering Connections Act Implementation

Because this was not a sample survey, it has no sampling errors. 

However, the practical difficulties of conducting any survey may introduce 

errors, commonly referred to as non-sampling errors. For example, 

difficulties in interpreting a particular question, sources of information 

available to respondents, or entering data into a database or analyzing 

them can introduce unwanted variability into the survey results. We took 

steps in developing the questionnaire, collecting the data, and analyzing 

them to minimize such non-sampling error. In addition, for questions 

related to implementation of two optional provisions, title IV-E 

guardianship assistance program and extension of eligibility for title IV-E 

assistance beyond age 18, we compared survey responses to data 

provided by HHS on states that have been approved to implement these 

options. In the few cases where the data did not match, we considered 

HHS the definitive source and adjusted the survey data accordingly.

We conducted site visits to four states to obtain information on 

implementation of the selected provisions from state and local child 

welfare agency officials, state and local educational agency officials, child 

welfare case workers, court officials, and current and former foster youth, 

and foster parents. We selected the four states—California, 

Massachusetts, Texas, and Virginia—to represent a mix of factors 

including: type of child welfare agency (state or county administered); 

number of children in foster care; amount of title IV-E funds received; 

whether the state has established a title IV-E guardianship assistance 

program; whether the state has extended eligibility for federal title IV-E 

assistance to youth beyond age 18; and geographic dispersion. We 

visited two localities in each state. Across the four states, we visited a mix 

of large cities, smaller cities, and rural areas. In all four states, we met 

with officials from the state child welfare agency, the state educational 

agency, and in three states, we met with court officials. In each of the 

eight localities, we met with officials in the local child welfare and 

educational agencies. We held discussion groups with a total of 29 

current and former foster youth in three states, and in two states, we held 

discussion groups with a total of 11 foster parents to obtain their 

perspectives on implementation of the provisions. We also met with 

officials either in person or by phone from four regional HHS offices that 

oversee the states we visited to learn about implementation and to 

discuss oversight and any technical assistance the regional offices 

provided to the states. Although we cannot generalize our findings 

beyond these states and localities, these visits provided us with 

illustrative examples of how states are implementing the provisions of the 

Fostering Connections Act.

Site Visits to Selected 

States
Appendix V: Comments from the Department 

of Health and Human Services

Page 47 GAO-14-347 Fostering Connections Act Implementation

Appendix V: Comments from the Department 

of Health and Human Services
Appendix V: Comments from the Department 

of Health and Human Services

Page 48 GAO-14-347 Fostering Connections Act Implementation
Appendix V: Comments from the Department 

of Health and Human Services

Page 49 GAO-14-347 Fostering Connections Act Implementation
Appendix VI: GAO Contact and Staff 

Acknowledgments

Page 50 GAO-14-347 Fostering Connections Act Implementation

Kay E. Brown, (202) 512-7215, brownke@gao.gov

In addition to the contact named above, Sara Schibanoff Kelly (Assistant 

Director), Kate Blumenreich, Hedieh Fusfield, Michael Pahr, and 

Rosemary Torres Lerma made key contributions to this report. Also 

contributing to this report were James Bennett, Richard Brown, David 

Chrisinger, Sarah Cornetto, David Dornisch, Jennifer Gregory, and 

Almeta Spencer.

Appendix VI: GAO Contact and Staff 

Acknowledgments

GAO Contact

Staff 

Acknowledgments

(131247)
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