11-1 

SECTION 11 - CHILD PROTECTION, FOSTER CARE, AND 

ADOPTION ASSISTANCE 

CONTENTS 

Introduction 

Federal Child Welfare Programs Today 

 The Title IV-B Child Welfare Programs 

 The Title IV-E Foster Care Program 

 The Title IV-E Adoption Assistance Program 

 The Title IV-E Adoption Incentives Payment Program 

 The Title IV-E Foster Care Independence Program 

State Accountability and Federal Oversight 

 History of Federal Review Efforts 

 Federal Conformity Review System 

 Interethnic and Interjurisdictional Adoption Provisions 

 State Performance Reports 

Federal Waivers of Title IV-B and IV-E Provisions 

Recent Trends Affecting Child Welfare Populations and Programs 

 Child Abuse and Neglect 

 Substance Abuse 

 Kinship Care 

 Welfare Reform 

National Foster Care and Adoption Information 

 Data Collection Systems 

 Trends in Foster Care Caseloads 

 National Data on Foster Care and Adoption 

 Trends in Child Welfare and Foster Care Costs 

Legislative History 

References

INTRODUCTION 

 Child welfare services aim to improve the conditions of children and their 

families and to improve or provide substitutes for functions that parents have 

difficulty performing. Child welfare services encompass a broad range of activities, 

including protection of abused or neglected children, support and preservation of 

families, care of the homeless and neglected, support for family development, and 

provision of out-of-home care, including adoption. Services may help the family 

cope with problems or they may protect children while the family learns to perform 

appropriate parenting roles. 

 It is generally agreed that it is in the best interests of children to live with their 

families. To this end, experts emphasize both the value of preventive and 

rehabilitative services and the need to limit the duration of foster care placements. 
11-2 

However, if children must be removed, a major principle of professional social 

work is the provision of permanent living arrangements, either by returning children 

to their homes in a timely fashion or by moving children into adoption or other 

permanent arrangements. 

 Many private, nonprofit and government entities work to provide child 

welfare services to families in need. The primary responsibility for child welfare 

services in the government, however, rests with the States. Each State has its own 

legal and administrative structures and programs that address the needs of children. 

The Federal Government has also been involved in efforts to improve the welfare of 

children in specific areas of national concern since the early 1900s. The largest 

Federal programs are authorized under titles IV-B and IV-E of the Social Security 

Act, are administered by the U.S. Department of Health and Human Services 

(HHS), and are under the jurisdiction of the House Committee on Ways and Means. 

Additional non-Social Security Act Federal programs include grants to States, local 

governments and nongovernmental agencies for prevention and treatment of child 

abuse and neglect, advocacy centers for victims of sexual abuse, services for 

abandoned infants and children with AIDS, promotion of adoption, child 

abuse-related training for judicial personnel, federally administered research and 

demonstration, Indian child welfare programs, family violence programs, and a 

number of other small programs. Of these non-Social Security Act programs, most 

have annual funding of less than $25 million. In addition, services related to child 

welfare may be provided at State discretion under the Social Services Block Grant 

(title XX of the Social Security Act), described in section 10, and States also use 

funds under the Temporary Assistance for Needy Families program, described in 

section 7, for activities related to child welfare. Finally, a tax credit of up to 

$10,160 in 2003 (and indexed for future years) is available to adoptive parents to 

offset some of the initial expenses associated with adoption (including for children 

with special needs); see section 13. 

 This section will focus specifically on Child Welfare, Foster Care, and 

Adoption Assistance Programs authorized under titles IV-B and IV-E of the Social 

Security Act. 

FEDERAL CHILD WELFARE PROGRAMS TODAY 

 The Social Security Act contains the primary sources of Federal funds 

available to States for child welfare, foster care, and adoption activities. These 

funds include both discretionary authorizations (for which the amount of funding 

available is determined through the annual appropriations process) and entitlements 

(under which the Federal Government has a binding obligation to make payments to 

any person or unit of government that meets the eligibility criteria established by 

law). The programs include the title IV-B Child Welfare Services, Promoting Safe 

and Stable Families, and Mentoring Children of Prisoners programs; and the title 

IV-E Foster Care, Adoption Assistance, and Foster Care Independence programs. 

 Table 11-1 lists these programs, and describes their funding. Table 11-2 

provides data on the level of Federal funds provided to States under titles IV-B and 
11-3 

IV-E for fiscal years 1989-2001, and the HHS projections for fiscal years 

2002-2008. 

TABLE 11-1 -- MAJOR FEDERAL PROGRAMS DEDICATED TO THE 

SUPPORT OF CHILD WELFARE ACTIVITIESP

1

P

Program Budgetary classification Federal support of total 

Title IV-E Foster Care Program 

Foster care assistance payments Entitlement Open-ended Federal match at 

Medicaid rate 

Placement services and 

administrative costs 

Entitlement Open-ended Federal match of 

50 percentP

2

P

Training expenses Entitlement Open-ended Federal match of 

75 percent 

Title IV-E Adoption Assistance Program 

Adoption assistance payments Entitlement Open-ended Federal match at 

Medicaid rate 

Nonrecurring adoption expenses Entitlement Open-ended Federal match of 

50 percent, 

P

(up to $2,000 per 

adoption) 

Placement services and 

administrative costs 

Entitlement Open-ended Federal match of 

50 percent 

Training expenses Entitlement Open-ended Federal match of 

75 percent 

Title IV-E Independent Living 

Chafee Foster Care Independence 

ProgramP

3

P

Entitlement 80 percent Federal funding, total 

capped at State allotment 

Education and Training VouchersP

4

P Discretionary 80 percent Federal funding, total 

capped at State allotment 

Title IV-B Child Welfare Services 

Program 

 

Subpart 1 - Child welfare services Discretionary Federal match of 75 percent, 

total capped at State allotment 

Subpart 2 

Promoting Safe and Stable 

FamiliesP

5

P

Entitlement Federal match of 75 percent, 

total capped at State allotment 

Discretionary Federal match at 75 percent, total 

capped at State allotment 

Mentoring Children of 

PrisonersP

6

P

Discretionary Federal match of 75 percent in 

the first two fiscal years in which 

the grant is awarded and 50 

percent in the third and each 

succeeding year, total capped at 

State allotment 

P

1 POther Federal entitlement funds also may be used to support these services. For example, States use 

the capped entitlements funds available through the Temporary Assistance for Needy Families 

(TANF) program and the Social Services Block Grant (SSBG). 

P

2 P

Seventy-five percent matching was available from fiscal year 1994 through fiscal year 1997 for 

certain costs related to data collection. 
11-4 

TABLE 11-1 -- MAJOR FEDERAL PROGRAMS DEDICATED TO THE 

SUPPORT OF CHILD WELFARE ACTIVITIESP

1

P

-continued

P

3 P

The Chafee Foster Care Independence Program (CFCIP) was established by Public Law 106-169 in 

1999 and replaced the previously existing Independent Living program. During fiscal years 1991 

through 1999, States were required to provide 50 percent matching for any Federal funding claim that 

exceeded $45 million. When CFCIP was enacted, the Federal share of expenditures became 

80 percent. 

P

4 P

The education and training vouchers program was established through Public Law 107-133 in 2001. 

P

5 P

Public Law 107-133 added a discretionary funding component to the Promoting Safe and Stable 

Families Program. 

P

6 P

The mentoring children of prisoners program was established by Public Law 107-133. 

Source: Congressional Research Service. 

 Funds available to States from the title IV-B programs may be used for 

services to families and children without regard to family income. Federal matching 

funds for foster care maintenance payments under title IV-E are provided only in 

those cases in which the child would have been eligible for the old Aid to Families 

with Dependent Children (AFDC) program if still in the home. All children 

determined to have “special needs” related to their being adopted, as defined under 

title IV-E, are eligible for reimbursement of certain non-recurring costs of adoption 

under the Title IV-E Adoption Assistance Program. However, only AFDC- or 

Supplemental Security Income (SSI)-eligible “special-needs” children qualify for 

federally-matched adoption assistance payments available under title IV-E. Funds 

available to States for the Title IV-E Chafee Foster Care Independence Program 

may be used for services which facilitate the transition of children from foster care 

to independent living, regardless of whether they are eligible for foster care 

assistance under title IV-E. 

 In addition to the programs described above, title IV-B authorizes funds for 

research and demonstration activities and for direct Federal grants to public and 

private entities for child welfare staff training. Under title IV-E, incentive payments 

are authorized for States that increase their number of adoptions of foster children, 

including children with special needs, above specified baselines. 

 Table 11-3 provides HHS data and projections on participation under the title 

IV-E programs; data on participation in title IV-B programs are not available. 

Table 11-4 shows the Congressional Budget Office (CBO) projections for Federal 

foster care and adoption assistance caseloads and outlays for fiscal years 

2003-2008. According to CBO, between 2003 and 2008, the federally-funded foster 

care caseload is projected to decline from 250,000 to 228,000 (9 percent). Over the 

same time period, title IV-E foster care outlays are expected to increase 14 percent, 

from $4.6 billion to $5.2 billion. Also over the same time period, the adoption 

assistance caseload is projected to increase from 317,000 to 451,000 (42 percent), 

while total adoption assistance outlays are estimated to increase from $1.5 billion to 

$2.5 billion (66 percent). 
TABLE 11-2 -- FEDERAL FUNDING TO STATES FOR CHILD WELFARE ACTIVITIES UNDER TITLES IV-B 

IV-E OF THE SOCIAL SECURITY ACT, 1995-2008 

[Dollars in millions]

Title IV-E foster care State claims Title IV-E adoption assistance State claims Fiscal 

year 

Title IV-B-1 

Child 

Welfare 

Services 

Title IV-B-2 

Promoting 

Safe and 

Stable 

FamiliesP

1

P Total P

2

P Maintenance 

payments 

Admin./ 

Training P

3

P SACWIS (operation and development)

Title IV-E 

Chafee Foster 

Care 

Independence 

ProgramP

4

P TotalP

5

P Assistance 

payments 

Admin./ 

Training 

1995 292 150 3,066 1,599 1,355 112 70 411 306 105 31996 277 225 3,098 1,503 1,322 273 70 483 361 122 41997 292 240 3,692 1,725 1,620 347 70 590 429 161 41998 291 255 3,704 1,922 1,669 113 70 697 512 185 51999P

6

P 292 275 4,012 1,963 1,952 97 70 843 621 222 5

2000 292 295 4,256 2,015 2,125 116 140 1,012 726 286 5

2001 292 305 4,382 2,070 2,190 122 140 1,197 902 295 62002P

P 292 375 4,519 2,033 2,317 169 140 1,342 1,037 305 6

2003P

7

P 290 404 4,690 2,061 2,448 181 182 1,525 1,192 333 7

2004P

7

P 292 505 4,917 2,103 2,586 228 200 1,692 1,338 354 7

20057

P 292 505 5,044 2,165 2,647 232 200 1,871 1,495 376 7

2006P

7

P 292 505 5,276 2,248 2,791 237 200 2,064 1,664 400 8

20077

P 292 P

8

P 5,516 2,336 2,939 241 200 2,269 1,845 424 8

20087

P 292 P

8

P 5,770 2,431 3,092 247 200 2,491 2,040 451 8

P1 PIn FY 1998, FY 1999, FY 2000, and FY 2001 $16 million, $18 million, $19 million and $21 million, respectively, lapsed. P2

P This total includes administration, SACWIS (Statewide Automated Child Welfare Information System), and training expenditures, as well as maint

payments. 

P3

P Includes administration, child placement services, and training costs. 

P4

P Beginning in FY 2003, this includes funding for the discretionary Education and Training Vouchers program. 

P5

P This total includes administration and training expenditures and maintenance payments. 
TABLE 11-2 -- FEDERAL FUNDING TO STATES FOR CHILD WELFARE, FOSTER CARE, AND ADOPTION 

ACTIVITIES UNDER TITLES IV-B AND IV-E OF THE SOCIAL SECURITY ACT, 1995-2008, 

UNDER CURRENT LAW-continued

P6

P Beginning in FY 1999, Title IV-E foster care and adoption assistance State claims data include Puerto Rico. In addition, IV-E maintenance payme

claims (both foster care and adoption assistance) include claims for child welfare demonstration projects. 

P7

P Estimate based on current law. Except that for 2003 amounts shown for Title IV-B programs and the Chafee Foster Care Independence Program ar

as for prior years, appropriated levels. 

P8

P Not authorized. 

Note- Totals may differ from sum of amounts because of rounding. Source: U.S. Department of Health and Human Services. 
11-7 

TABLE 11-3--PARTICIPATION IN FOSTER CARE, ADOPTION, 

AND INDEPENDENT LIVING ACTIVITIES UNDER TITLE IV-E 

OF THE SOCIAL SECURITY ACT, 1988-2008 

Fiscal 

year 

Title IV-E foster care 

maintenance paymentsP

1

P

Title IV-E adoption 

assistance paymentsP

1

P

Title IV-E foster care 

independence programP

2

P

1988 132,757 34,698 18,931 

1989 156,871 40,666 44,191 

1990 167,981 44,024 44,365 

1991 202,687 54,818 45,284 

1992 222,315 66,197 57,360 

1993 231,100 78,000 57,918 

1994 245,000 91,200 71,081 

1995 260,800 106,200 73,137 

1996 273,600 124,700 85,261 

1997 289,400 146,900 84,309 

1998 306,500 168,400 87,446 

1999P

3 302,400 195,200 95,134 

2000 287,800 228,300 96,982 

2001 264,900 257,800 97,954 

2002 254,000 285,600 99,441 

2003P

4

P 245,400 317,000 NA 

2004P

4

P 240,600 348,700 NA 

2005P

4

P 238,100 381,800 NA 

2006P

4

P 237,600 416,200 NA 

2007P

4

P 237,300 451,500 NA 

2008P

4

P 237,300 488,600 NA 

P

1

P

 Average monthly number of recipients. 

P

2

P

 The figures are estimates of the number of children receiving independent living services. 

 The estimates from 1988 through 1998, and for 2002, utilized the best available data 

submitted by the States. Estimates for 1999-2001 are based on a methodology that utilized 

the average monthly number of children receiving Title IV-E foster care maintenance 

payments. 

P

3 PBeginning in FY 1999, data for average monthly number of recipients include Puerto 

Rico. 

P

4

P

 Estimate based on current law. 

NA - Not Available 

Source: U.S. Department of Health and Human Services. 

TITLE IV-B CHILD WELFARE PROGRAMS 

Grants to States for child welfare services 

 The Child Welfare Services Program under subpart 1 of title IV-B 

permanently authorizes 75 percent Federal matching grants to States for services 

that protect the welfare of children. These services: address problems that may 

result in neglect, abuse, exploitation or delinquency of children; prevent the 

unnecessary separation of children from their families and restore children to their 

families, when possible; place children in adoptive families when appropriate; and 

assure adequate foster care when children cannot return home or be placed for 
11-8 

adoption. There are no Federal income eligibility requirements for the receipt of 

child welfare services. 

TABLE 11-4 -- CBO BASELINE CASELOAD AND OUTLAY 

PROJECTIONS FOR THE FEDERAL FOSTER CARE AND ADOPTION 

ASSISTANCE PROGRAMS, FISCAL YEARS 2003-2008 

Program 2003 2004 2005 2006 2007 2008 

Foster Care: 

Title IV-E caseload (in thousands) 250 246 241 237 232 228 

Average monthly maintenance 

 payments (Federal Share) $625 $653 $682 $712 $744 $777 

Federal outlays (in millions): 

Maintenance Payments $1,856 $1,895 $1,943 $1,992 $2,040 $2,088 

Administration and child 

 placement services 2,292 2,375 2,407 2,489 2,576 2,670 

Training 249 251 252 254 255 256 

Demonstrations 195 199 203 208 213 218 

Total Outlays 4,592 4,719 4,806 4,943 5,086 5,232 

Adoption Assistance: 

Title IV-E caseload (in thousands) 317 347 374 400 426 451 

Average monthly payments 

 (Federal share) $320 $332 $345 $357 $369 $382 

Federal outlays (in millions): 

Assistance Payments $1,162 $1,324 $1,489 $1,653 $1,823 $2,001 

Administrative and child 

placement services 278 301 326 351 375 400 

Training 45 49 54 58 62 66 

Total Outlays 1,486 1,675 1,869 2,061 2,260 2,467 

Total OutlaysP

1

P 6,208 6,534 6,816 7,145 7,486 7,839 

P

1 P

Includes $130 million for 2003 and $140 million in each of the succeeding years for the Foster Care 

Independence Program. 

Note - Numbers may not add to totals due to rounding. 

Source: Congressional Budget Office, March 2003 baseline. 

 Under legislation originally enacted in 1980 (Public Law 96-272), States are 

limited in the amount of their title IV-B allotments that may be used for child day 

care, foster care maintenance payments, and adoption assistance payments. 

Specifically, States may use no more than their portion of the first $56.6 million in 

Federal title IV-B appropriations for these three activities. The intent of this 

restriction is to devote as much title IV-B funding as possible to supportive services 

that could prevent the need for out-of-home placement. In November 2003, HHS 

issued a Program Instruction (ACYF-CB-PI-03-07) showing each State’s title IV-B 

subpart 1 funding limit for foster care, adoption assistance, or work-related child 

care and instructing States to ensure that their estimated expenditures for those 

items, which are included in annual and 5-year planning documents, do not exceed 

these limits. 

 Between 1977 and 1990, the annual authorization level for the Child Welfare 

Services Program remained flat at $266 million. The authorization level was 
11-9 

increased to $325 million under Public Law 101-239 beginning with fiscal year 

1990. Appropriations for the program - the amount of money Congress actually 

made available for spending each year - increased from $163.6 million in fiscal year 

1981 to $294.6 million in fiscal year 1994. Appropriations decreased, to $292 

million in fiscal year 1995 and $277.4 million in fiscal year 1996, and have 

generally remained at $292 million since fiscal year 1997 (see Table 11-2). Table 

11-5 details the State-by-State distribution of child welfare service funds for 

selected fiscal years. Child welfare service funds are distributed to States on the 

basis of their under 21 population and per capita income. 

TABLE 11-5 -- STATE -BY-STATE ALLOCATIONS FOR TITLE IV-B 

(SUBPART 1) -- CHILD WELFARE SERVICES, 

SELECTED FISCAL YEARS 1994-2003 

[Dollars in thousands]

State 1994 1996 1998 2000 2001 2002 2003 

Alabama 5,623 5,106 5,244 5,248 5,130 5,298 5,263 

Alaska 754 725 776 352 436 396 302 

Arizona 5,034 5,015 5,291 4,972 5,214 5,237 5,030 

Arkansas 3,424 3,178 3,349 3,299 3,296 3,313 3,292 

California 31,732 31,049 33,893 34,127 34,036 34,280 34,052 

Colorado 3,866 3,719 3,959 3,846 4,095 3,939 3,910 

Connecticut 2,120 2,052 2,075 1,884 2,027 2,078 2,064 

Delaware 726 713 688 700 705 778 773 

District of Columbia 447 345 333 319 302 367 365 

Florida 13,146 12,781 13,806 14,202 14,213 14,402 14,307 

Georgia 8,426 8,032 8,479 8,674 8,740 8,892 8,834 

Hawaii 1,204 1,117 1,207 1,195 1,158 1,231 1,223 

Idaho 1,703 1,622 1,753 1,737 1,732 1,778 1,765 

Illinois 11,773 11,067 11,633 11,550 11,446 11,455 11,380 

Indiana 6,952 6,367 6,613 6,601 6,583 6,750 6,706 

Iowa 3,475 3,223 3,310 3,289 3,249 3,244 3,223 

Kansas 3,068 2,873 3,001 3,054 3,042 3,030 3,011 

Kentucky 5,030 4,624 4,806 4,644 4,719 4,685 4,654 

Louisiana 6,527 5,910 6,015 5,836 5,780 5,748 5,708 

Maine 1,482 1,378 1,443 1,369 1,350 1,361 1,358 

Maryland 4,343 4,156 4,453 4,455 4,488 4,567 4,537 

Massachusetts 4,708 4,579 4,624 4,623 4,615 4,592 4,561 

Michigan 10,885 10,075 10,118 10,102 10,039 10,179 10,075 

Minnesota 5,092 4,785 4,913 4,636 4,870 4,631 4,584 

Mississippi 4,293 3,949 4,051 3,964 3,912 3,912 3,875 

Missouri 6,146 5,727 6,055 6,063 5,993 6,024 5,985 

Montana 1,207 1,158 1,201 852 866 851 893 

Nebraska 2,071 1,879 1,991 1,989 1,954 1,910 1,893 

Nevada 1,401 1,379 1,625 1,785 1,855 1,846 1,834 

New Hampshire 1,087 1,096 1,137 1,133 1,143 1,169 1,161 

New Jersey 5,224 5,368 5,679 5,716 5,687 5,997 5,958 
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TABLE 11-5 -- STATE -BY-STATE ALLOCATIONS FOR TITLE IV-B 

(SUBPART 1) -- CHILD WELFARE SERVICES, 

SELECTED FISCAL YEARS 1994-2003-continued 

[Dollars in thousands] 

State 1994 1996 1998 2000 2001 2002 2003 

New Mexico 2,510 2,418 2,530 1,984 1,925 1,935 1,826 

New York 15,452 14,148 14,817 14,532 14,228 14,941 14,843 

North Carolina 8,112 7,728 8,179 8,410 8,413 8,313 8,232 

North Dakota 945 858 893 743 723 721 716 

Ohio 12,878 11,853 11,996 11,392 11,815 11,768 11,690 

Oklahoma 4,406 4,133 4,325 3,093 2,664 2,671 2,309 

Oregon 3,556 3,321 3,582 3,551 3,502 3,452 3,435 

Pennsylvania 12,148 11,076 11,515 11,341 11,209 11,450 11,375 

Rhode Island 1,054 984 993 995 998 1,028 1,022 

South Carolina 4,948 4,544 4,613 4,680 4,632 4,744 4,713 

South Dakota 1,075 991 1,028 807 860 772 706 

Tennessee 6,210 5,792 5,959 5,934 5,913 6,080 6,040 

Texas 23,795 22,401 23,889 24,496 24,680 24,240 24,083 

Utah 3,474 3,284 3,475 3,503 3,494 3,376 3,348 

Vermont 715 674 710 685 674 708 704 

Virginia 6,373 6,114 6,444 6,455 6,482 6,583 6,540 

Washington 5,699 5,231 5,679 5,703 5,729 5,563 5,515 

West Virginia 2,486 2,189 2,243 2,156 2,120 2,083 2,070 

Wisconsin 6,022 5,574 5,742 5,741 5,667 5,614 5,546 

Wyoming 724 638 671 659 645 619 616 

Indian Tribes P

1

P P

1

P P

1

P 4,216 4,473 4,444 5,279 

American Samoa 193 183 187 185 184 182 181 

Guam 351 329 338 334 331 326 324 

Northern Mariana Islands 142 136 138 137 137 135 135 

Puerto Rico 8,105 7,480 7,722 7,627 7,543 6,042 6,003 

Virgin Islands 280 263 269 267 265 261 259 

Adjustments P

2

P ---- ---- ---- 97 4 ---- ---- 

Total 294,624 277,390 291,459 291,939 291,986 291,986 290,088 

P

1

P

 For years preceding fiscal year 2000, Indian tribal allotments are included in the state grants. 

P

2

P

 The $97,000 adjustment in 2000 was a payment for a judgment against HHS, and the $4,000 

adjustment in 2001 was to rectify a grant error from fiscal year 2000. 

Note: Totals may differ from sum of State amounts because of rounding. 

Source: U.S. Department of Health and Human Services. 

 Because of minimal reporting requirements, no reliable data are available on 

the exact number of children or families served, their characteristics, or the services 

provided with child welfare service funds. The U.S. General Accounting Office 

reported in September 2003 that, based on its own surveys, States spent about 

28 percent of Child Welfare Services funds (title IV-B, subpart 1) in fiscal year 

2002 on salaries for child welfare agency staff, primarily social workers who 

perform such activities as child protective services investigations, recruitment of 

foster parents, and making referrals for families in need of services (GAO, 2003). 

Another 17 percent was used for administration and management, 16 percent for 
11-11 

child protective services (e.g., telephone hotlines, emergency shelters, and 

investigative services), and 11 percent for foster care maintenance payments. GAO 

further found that 42 percent of funding in fiscal year 2002 was targeted toward 

children in foster care and their parents, another 17 percent was targeted toward 

children at risk of abuse or neglect and their parents, and additional funds were 

spent on a combination of these populations. About 5 percent of subpart 1 funding 

was targeted toward children waiting for adoption, or adopted children and adoptive 

parents, and 4 percent of subpart 1 funding was targeted toward such populations as 

delinquent youth or foster parents. GAO reported that HHS conducts little specific 

oversight of States’ use of subpart 1 funds, and does not generally monitor State 

compliance with the statutory provision limiting the use of these funds for foster 

care, adoption assistance, or work-related child care. 

 A 1997 study funded by HHS provided some information on the number and 

characteristics of children and families served by the child welfare system in 1994, 

and examined changes in this population since a similar study was conducted of 

children and families served in 1977 (U.S. Department, 1997). This study looked at 

children served by all components of the child welfare system, regardless of 

funding source, and found a significant decline in the number of children receiving 

services from the child welfare system, from an estimated 1.8 million children in 

1977 to an estimated 1 million in 1994. Of these totals, about the same number of 

children in each of the 2 years were in foster care (543,000 in 1977 and 502,000 in 

1994). However, HHS found a sharp drop in the number of children receiving 

services while still living at home, and a substantial increase in the percent of 

children receiving services as a result of abuse or neglect (45 percent in 1977 

compared with 80 percent in 1994). The report suggests that child welfare agencies 

in 1994 were dealing with more difficult cases that required more extensive services 

and therefore were forced to set priorities and narrow their focus from a broader 

population of children and families to those in more immediate crisis. It is also 

worth noting that this study was conducted just prior to the full implementation of 

the Promoting Safe and Stables Families program. 

Grants to States for promoting safe and stable families 

 Grants to States for family preservation and family support services were 

originally authorized as a capped entitlement under subpart 2 of title IV-B, 

beginning in fiscal year 1994. States already had the flexibility to expend their child 

welfare services funds available under subpart 1 of title IV-B for family support and 

preservation activities, but few States used a significant share of such funds for 

these two categories of services. Entitlement funding was authorized for five years 

at the following levels: $60 million in fiscal year 1994; $150 million in 1995; $225 

million in 1996; $240 million in 1997; and either $255 million in 1998 or the 1997 

level adjusted for inflation, whichever was greater. The Adoption and Safe Families 

Act (Public Law 105-89), enacted in November 1997, reauthorized and changed the 

name of this program to Promoting Safe and Stable Families (PSSF). Entitlement 

ceilings were set at the following levels: $275 million for fiscal year 1999, $295 

million for 2000, and $305 million for 2001. The Promoting Safe and Stable 
11-12 

Families Amendments of 2001 (Public Law 107-133) reauthorized the program for 

five years (fiscal years 2002 through 2006) at $305 million per year in mandatory 

funds and also authorized an additional $200 million per year in discretionary 

funding, for a total authorization of $505 million per year. Of this discretionary 

authorization, Congress appropriated $70 million in fiscal year 2002 and $99.4 

million in fiscal year 2003. The 2001 reauthorization also allowed for PSSF funds 

that are certified as unused by a State to be reallocated to other States. 

 From the mandatory ceiling amounts, $6 million is reserved each fiscal year 

for use by the Secretary of HHS to fund research, training, technical assistance, and 

evaluation of PSSF activities. In addition, $10 million is reserved each fiscal year 

for a grant program for State courts (described below). Indian tribes are allotted one 

percent of the mandatory PSSF funds. From any discretionary funds appropriated, 

the following set-asides are made: 3.3 percent for evaluations, research, training, 

and technical assistance, 3.3 percent for State court improvement grants, and 2 

percent for Indian tribes. 

 After these set-asides are made, the remaining funds are allocated among 

States according to their relative shares of children receiving food stamps, subject to 

a 25 percent non-Federal match. Table 11-6 shows State allotments of Promoting 

Safe and Stable Families funds in fiscal years 1999-2003. 

 States must submit a plan to HHS that provides a detailed account of how the 

money will be used. Prior to the enactment of Public Law 105-89, at least 90 

percent of the funds had to be used for two categories of services: family 

preservation services and community-based family support services. Public Law 

105-89 added two additional categories: time-limited family reunification services, 

and adoption promotion and support services. No more than 10 percent of funds can 

be used for administration. 

 The Federal statute does not specify a percentage or minimum amount of 

funds that must be spent on any particular category of service, but says that States 

must devote “significant portions” of their expenditures to each of the four 

categories. HHS has issued annual program instructions specifying that States must 

have a “strong rationale” for spending less than 20 percent of their allotments on 

each of the four categories of services. 

 Family preservation services are intended for children and families, including 

extended and adoptive families that are at risk or in crisis. Services include: 

programs to help reunite children with their biological families, if appropriate, or to 

place them for adoption or another permanent arrangement; programs to prevent 

placement of children in foster care, including intensive family preservation 

services; programs to provide follow-up services to families after a child has been 

returned from foster care; respite care to provide temporary relief for parents and 

other care givers (including foster parents); services to improve parenting skills; and 

services to support infant “safe haven” programs (added by Public Law 107-133). 
11-13 

TABLE 11-6 -- STATE BY STATE ALLOCATIONS FOR TITLE IV-B 

(SUBPART 2) PROMOTING SAFE AND STABLE FAMILIES, 

FISCAL YEARS 1999-2003 P

1 P

State 1999 2000 2001 2002 2003 

Alabama 4,998,474 5,467,218 5,676,189 7,223,812 8,126,370 

Alaska 447,625 529,555 578,120 792,286 802,952 

Arizona 4,774,662 5,070,424 4,879,258 6,346,894 6,128,987 

Arkansas 2,412,199 2,716,339 2,995,798 4,412,657 4,792,316 

California 37,749,671 40,544,805 42,820,130 55,883,291 54,344,637 

Colorado 2,362,463 2,496,711 2,558,014 3,366,643 3,229,794 

Connecticut 2,138,651 2,349,394 2,435,537 3,417,595 3,451,772 

Delaware 522,229 586,057 618,571 813,972 751,375 

District of Columbia 920,117 1,031,541 1,095,861 1,575,506 1,663,618 

Florida 13,105,452 14,020,393 14,081,307 17,701,135 16,972,981 

Georgia 7,559,881 8,335,896 8,972,963 12,352,474 12,613,263 

Hawaii 1,019,589 1,222,967 1,395,807 2,184,128 2,264,404 

Idaho 746,041 812,739 854,866 1,067,760 1,179,032 

Illinois 10,046,684 11,393,553 12,156,022 16,476,219 16,215,135 

Indiana 3,978,885 3,909,002 3,936,876 5,562,410 6,032,973 

Iowa 1,641,290 1,760,182 1,772,922 2,382,460 2,374,904 

Kansas 1,666,158 1,811,435 1,690,873 2,174,220 2,084,006 

Kentucky 4,003,753 4,411,229 4,630,500 6,409,881 6,721,320 

Louisiana 6,888,444 7,195,319 7,399,328 10,130,810 10,752,766 

Maine 969,853 1,066,598 1,129,206 1,587,519 1,522,755 

Maryland 3,680,469 4,079,010 4,345,321 5,827,063 5,359,587 

Massachusetts 3,978,885 4,149,338 4,194,263 5,593,489 5,479,505 

Michigan 8,952,491 9,485,814 10,076,821 13,731,216 13,663,718 

Minnesota 2,934,428 2,998,745 2,973,941 3,801,649 3,947,255 

Mississippi 4,327,037 4,532,892 4,542,968 6,024,915 6,044,140 

Missouri 5,172,550 5,577,218 5,669,371 7,571,740 7,792,604 

Montana 646,569 714,863 771,293 1,065,149 1,114,473 

Nebraska 1,019,589 1,078,461 1,173,889 1,679,725 1,676,252 

Nevada 920,117 1,049,293 1,042,018 1,294,455 1,277,233 

New Hampshire 497,361 523,548 538,497 721,274 744,582 

New Jersey 5,147,682 5,616,230 5,851,720 7,727,122 7,353,201 

New Mexico 2,262,991 2,485,020 2,577,951 3,483,414 3,574,752 

New York P

2

P P

2

P P

2

P 0 27,803,878 

North Carolina 5,520,703 6,068,954 6,593,769 8,607,159 9,721,261 

North Dakota 348,152 379,765 408,390 600,246 604,581 

Ohio 9,972,080 10,110,000 9,593,174 12,224,628 12,147,563 

Oklahoma 3,232,844 3,490,646 3,601,289 5,024,273 5,157,022 

Oregon 2,437,067 2,631,579 2,679,320 3,692,435 3,952,543 

Pennsylvania 9,574,192 10,468,059 10,963,891 15,044,630 15,056,585 

Rhode Island 895,249 989,602 1,054,981 1,504,529 1,607,744 

South Carolina 3,556,128 3,927,057 4,271,814 6,022,201 6,176,202 

South Dakota 472,493 533,640 576,418 836,500 908,525 

Tennessee 5,669,911 5,999,983 6,379,011 8,775,755 9,126,213 

 
11-14 

TABLE 11-6 -- STATE BY STATE ALLOCATIONS FOR TITLE IV-B 

(SUBPART 2) PROMOTING SAFE AND STABLE FAMILIES, 

FISCAL YEARS 1999-2003P

1 P

-continued

State 1999 2000 2001 2002 2003 

Texas 24,793,426 26,985,190 26,826,968 34,112,074 31,891,353 

Utah 1,143,929 1,225,329 1,297,522 1,886,385 1,895,953 

Vermont 522,229 536,382 531,165 688,968 725,014 

Virginia 4,874,134 5,300,937 5,461,822 7,107,738 6,748,131 

Washington 4,351,905 4,833,043 4,933,484 6,290,048 5,995,213 

West Virginia 2,287,859 2,486,708 2,714,953 3,748,510 3,835,571 

Wisconsin 3,158,240 3,270,921 3,113,707 3,935,636 3,975,572 

Wyoming 323,284 349,572 349,495 468,447 488,150 

American Samoa 171,567 179,043 181,698 221,474 214,477 

Guam 302,757 319,890 325,976 409,423 401,092 

Northern Mariana Islands 129,247 133,608 135,157 160,845 154,278 

Puerto Rico 6,722,614 7,212,312 7,386,246 7,860,670 7,799,503 

Virgin Islands 243,510 256,282 260,818 324,543 316,814 

Subtotal 238,195,810 256,710,291 265,077,269 349,930,000 376,755,900 

Set-asides: 

Indians 2,750,000 2,950,000 3,050,000 4,450,000 5,037,000 

Research & Eval 6,000,000 6,000,000 6,000,000 8,294,696 9,278,550 

Courts 10,000,000 10,000,000 10,000,000 12,310,000 13,278,550 

Subtotal 18,750,000 18,950,000 19,050,000 25,054,696 27,594,100 

Lapsed funds2 18,054,190 19,339,709 20,872,731 1,304 -- 

Total 275,000,000 295,000,000 305,000,000 374,986,000 404,350,000 

P

1

P

 Amounts shown for fiscal years 1999 through 2002 are final awards. Amounts for fiscal year 

2003 are statutory allotments. 

P

2

P

 Through fiscal year 2001, lapsed funds largely represent the statutory allotment amount to New 

York, which has not chosen to receive this program money. Public Law 107-133 allows for the 

re-allotment of any unclaimed funds beginning with fiscal year 2002. Thus, New York’s final 

2002 award equals $0 and the funds it would have received went to other States instead of lapsing 

(returning to Federal Treasury). 

Note: Totals may differ from sum of State amounts because of rounding. 

Source: U.S. Department of Health and Human Services 

 Family support services are intended to reach families that are not yet in crisis 

and to prevent child abuse or neglect from occurring. Family support services are 

generally community-based activities designed to promote the well-being of 

children and families, to increase the strength and stability of families (including 

adoptive, foster, and extended families), to increase parents' confidence and 

competence, to provide children with a stable and supportive family environment, 

to enhance child development, and to strengthen parental relationships and promote 

healthy marriages (added by Public Law 107-133). Examples include parenting 

skills training, respite care to relieve parents and other care givers, structured 

activities involving parents and children to strengthen their relationships, drop-in 

centers for families, information and referral services, and early developmental 

screening for children. 
11-15 

 As added by Public Law 105-89, time-limited reunification services are 

services and activities intended to facilitate the safe and appropriate reunification of 

children who have been removed from home and placed in foster care with their 

parents in a timely fashion; i.e., within 15 months of having entered foster care. 

Reunification services for children and their families include counseling, substance 

abuse treatment services, mental health services, assistance to address domestic 

violence, temporary child care and therapeutic services such as crisis nurseries, and 

transportation to and from these activities. Adoption promotion and support 

services, also added by Public Law 105-89, are services and activities designed to 

encourage more adoptions out of the foster care system, including pre- and postadoptive services and activities designed to expedite adoptions and support adoptive 

families. 

 In regulations proposed on October 4, 1994 and made final on November 18, 

1996, HHS set forth a series of child and family services “principles” that were 

intended to guide State implementation of the program. According to HHS, these 

principles emphasize the paramount importance of safety for all family members, 

including victims of child abuse and neglect and victims of domestic violence and 

their dependents. In the preamble to its regulations, HHS stated that family 

preservation “does NOT mean that the family must stay together or ‘be preserved’ 

under all circumstances.” The principles also were intended to support a familyfocused approach while allowing for individual needs and a service delivery 

approach that stresses flexibility, accessibility, coordination, and respect for cultural 

and community strengths. 

 The Secretary of HHS is required to evaluate activities under subpart 2 of title 

IV-B. In September 1994, the Secretary funded three evaluation projects: a study of 

the implementation of family preservation and family support programs; a national 

evaluation of family preservation and reunification programs; and a national 

evaluation of family support programs. Summaries of the findings are found below. 

 James Bell Associates released the final report (2003) on the family 

preservation and family support services implementation study, reporting on State 

and local planning efforts, the relationship of planning to service delivery, and the 

design of programs. The report stated that services did not fall neatly into the 

categories defined in the legislation, particularly for family preservation and family 

support, and, as was discussed in the interim report, the majority of services were in 

general more characteristic of family support programs. However, the final report 

revealed that program sites appear to be moving toward a greater balance in service 

provision among the four categories. This is also evidenced in the budget planning 

documents submitted by States to HHS, which show that funds have been shifted 

from family support programs to programs focusing on time-limited family 

reunification and adoption promotion and support. 

 The final evaluation of family preservation and reunification (Westat, Chapin 

Hall Center for Children, James Bell Associates, 2002) studied programs in four 

States (Kentucky, New Jersey, Tennessee, and Pennsylvania); three sites used the 

Homebuilders model, and one used a broader, home-based model. The evaluation 

found no significant differences between the experimental and control groups for 
11-16 

rates of foster care placement, days in care, case closings, or subsequent 

maltreatment. In two of the four States, caretakers in the experimental groups 

tended to report greater improvement in their lives than those in the control group. 

The evaluation’s findings of minimal effects and benefits of family preservation 

programs are similar to those from previous evaluations and research. The 

evaluation cautioned that these results should not be taken to mean that family 

preservation programs serve no useful purpose, but rather that they should indicate 

that these programs may need to undergo several changes, such as providing more 

targeted services to various subgroups and rethinking program objectives. 

 The final evaluation of family support programs (Abt Associates, 2001) found 

varied results on the effectiveness of these programs. The evaluation’s analysis of 

existing research on family support programs found that focusing on specific at-risk 

groups, such as children with special needs or teenage parents with young children, 

and providing support services in groups managed by professional staff, rather than 

home visits by paraprofessionals, were shown to have positive effects on parents 

and children. Additionally, in order to positively affect children’s cognitive 

development and school readiness, family support services must be provided 

directly to children rather than through parenting education. However, although 

certain family support strategies have proven to be effective with specific 

populations, no single program approach was determined to be effective across all 

populations. 

 Some additional information on States’ use of PSSF funds was included in the 

September 2003 report by GAO on title IV-B in general (referred to earlier). 

Through surveys, GAO found that States spent almost half of their subpart 2 funds 

in fiscal year 2002 on family support and prevention activities and another 

12 percent on family preservation. About 14 percent was used for adoption 

activities and post-adoption services and 9 percent was used for family 

reunification. 

Court Improvement Program 

 A portion of the Promoting Safe and Stable Families funds is reserved for a 

grant program to the highest State courts to assess and improve certain child welfare 

proceedings. The court set-aside equals $10 million in mandatory funds and 

3.3 percent of any discretionary funds appropriated for each of fiscal years 2002-

2006. A 25 percent non-Federal match is required. 

 Courts use their grant funds to assess their procedures and effectiveness in 

determinations regarding foster care placement, termination of parental rights 

(TPR), and recognition of adoptions. Courts also can use these grant funds to 

implement changes found necessary as a result of the assessments. According to 

HHS, as of fiscal year 2003, 50 States and the District of Columbia were 

participating in this program. 

 According to a review conducted for HHS on court improvement activities 

during 1995-98, States conducted thorough assessments of their judicial systems 

and came up with various recommendations (James Bell Associates, 1999). 

Categories where improvement was most commonly recommended were: 
11-17 

representation of parties, timeliness of decisions, management information systems, 

quality of court hearings, judicial expertise, multidisciplinary training for court 

participants, coordination between the courts and child welfare agency or service 

providers, treatment and participation of parties, and resources for courts and social 

services. The activities most commonly implemented included: development of 

training and educational materials; pilot programs; revision of legislation, court 

rules and judicial directives; development of automated case tracking systems, 

public relations campaigns and local work groups; supplemental assessments or 

studies; increased number of attorneys, judges and other court personnel; hiring of 

court improvement coordinating staff; and improved treatment of parties. The report 

found that court improvement changes were still at an early stage, partially because 

initial assessments took longer to complete than expected and also because reforms 

requiring new legislation or staff take time to implement. However, the report 

concluded that the Court Improvement Program had raised the visibility of courts 

within the child welfare system and provided States with flexibility and resources to 

address court-related challenges. 

Mentoring Children of Prisoners 

 The Promoting Safe and Stable Families Amendments of 2001 (Public Law 

107-133) created new program authority to provide mentoring services to children 

of prisoners. This program is authorized to be funded at $67 million for each of 

fiscal years 2002 and 2003 and for such sums as necessary in succeeding years. 

Funding for this program is separate from the $505 million authorized for PSSF 

activities. This program received initial funding of $10 million in fiscal year 2003. 

HHS may provide grants of up to $5 million each to State or local governments, 

community- and faith-based organizations, and tribes or tribal groups in areas where 

there are significant numbers of children of prisoners. Grantees must use nonFederal resources to make a minimum 25 percent in-kind or cash match of Federal 

funds for the first two years of a grant reward and a minimum of 50 percent match 

in succeeding years. Two and a half percent of annually appropriated funds for this 

program are reserved for evaluation. 

Child welfare research, training, studies 

 In addition to providing funds to the States for services, title IV-B authorizes 

the Secretary of HHS to make direct grants for research and demonstration, training, 

and studies. Specifically, section 426 authorizes direct grants from HHS to public 

and private organizations and institutions of higher education for research and 

demonstration projects related to child welfare, and for training projects for 

personnel in the child welfare field. For fiscal year 2003, $7.4 million was 

appropriated for child welfare training, but no funding was provided for research 

and demonstration under section 426. 

 Section 429A was added to title IV-B by the welfare reform legislation 

enacted in 1996 (Public Law 104-193). This provision authorized and appropriated 

funds for HHS to conduct a national longitudinal study of children at risk for abuse 

or neglect, and of children who have been identified as victims of abuse or neglect. 
11-18 

For this study, the welfare reform law appropriated $6 million for each of fiscal 

years 1996-2002; however, Congress subsequently rescinded the appropriations for 

each year, with the understanding that adequate funding was available for the study 

in the broader appropriation for social services and income maintenance research. 

 In response to the section 429A provision, HHS has undertaken the National 

Survey of Child and Adolescent Well-Being (NSCAW). HHS anticipates that this 

study will provide nationally representative data on children and families that come 

into contact with the child welfare system, which will enable analysis of child and 

family well-being outcomes in relation to the experience of children and families 

with the child welfare system, as well as characteristics of the families, the 

community environment, and other factors. The study is being conducted over a 

6-year period (1997-2003) and includes a sample of more than 6,000 children, ages 

0-14, from 100 child welfare agencies nationwide. 

 In addition to child-level data, NSCAW is collecting data from State and local 

administrators, and findings from this component of the study were reported in June 

2001. Of the 46 State administrators participating in the survey, two-thirds reported 

that the Adoption and Safe Families Act of 1997 (Public Law 105-89) has caused 

improvements or changes in at least one of the following areas: child safety, 

permanency, collaboration with the courts, and data collection. State administrators 

reported that formal collaborations have increased between agencies and groups 

serving child welfare clients, and that participation in multidisciplinary teams has 

increased, involving more partners (including families) and beginning at earlier 

stages of a case. Local agencies described a dynamic system; 40 percent of local 

agencies had developed new initiatives in the previous 12 months. The Adoption 

and Safe Families Act resulted in shortened permanency planning time frames for 

almost all local agencies, greater emphasis on safety for about 60 percent, and 

increased emphasis on adoption for children in kinship foster care for the majority 

of local agencies. Local agencies agreed that regulations, paperwork, and the 

number of hours worked per case had increased, with no decrease in the actual 

number of cases. Local agencies reported less impact from interethnic adoption 

provisions enacted by Congress in the 1990s, reporting some increased training on 

this issue but no increase in transracial foster or adoptive placements for 77 percent 

of local agencies. 

THE TITLE IV-E FOSTER CARE PROGRAM 

Eligibility criteria 

 The Foster Care Program under title IV-E is a permanent entitlement that 

provides open-ended matching payments to States for the costs of maintaining 

certain children in foster care, and associated administrative, child placement, and 

training costs. Several eligibility criteria apply to the foster children on whose 

behalf Federal reimbursement is available to States. First, children must have been 

removed from families that would have been eligible for Aid to Families with 

Dependent Children (AFDC), as the program existed in their State on July 16, 1996. 

Although welfare reform legislation enacted in 1996 (Public Law 104-193) repealed 
11-19 

the AFDC Program, its eligibility criteria continue to be used for determining 

children's eligibility under title IV-E. Under Public Law 104-193 as originally 

enacted, foster children would be eligible under title IV-E if their families met the 

AFDC criteria of June 1, 1995; however, technical corrections enacted in 1997 

changed this date to July 16, 1996 (Public Law 105-33). The welfare reform 

legislation replaced AFDC with a block grant to States called Temporary Assistance 

for Needy Families (TANF), and requires all States participating in TANF to certify 

that they will operate a foster care and adoption assistance program under title IVE. 

 States are required to provide foster care maintenance payments to AFDCeligible children removed from the home of a relative if the child received or would 

have received AFDC prior to removal from the home and if the following also 

apply: (1) the removal and foster care placement were based on a voluntary 

placement agreement signed by the child's parents or guardians or a judicial 

determination that remaining in the home would be contrary to the child's welfare; 

(2) reasonable efforts were made to eliminate the need for removal or to return the 

child home (unless certain exceptions apply, which are described later in the 

section); and (3) care and placement of the child are the responsibility of the State. 

Children whose expenses are eligible for reimbursement under title IV-E also are 

deemed eligible for Medicaid. Finally, States may claim reimbursement on behalf of 

eligible children who have been placed in licensed or approved foster family homes 

or child care institutions, which can be public or private, including both for-profit 

and nonprofit. Public child care institutions can accommodate no more than 

25 children, although no limitation applies to the size of private institutions. 

Detention facilities for children determined to be delinquent are not eligible for 

Federal reimbursement under title IV-E. 

 Not all foster children meet the Federal eligibility criteria just described. 

Table 11-7 shows, for each of fiscal years 1999 through 2001, the average monthly 

number of foster children in each State who were eligible for Federal subsidies 

under title IV-E, and the total number of foster children in each State who were in 

care on September 30 of the given fiscal year. While these two sets of numbers are 

not directly comparable, they can be used to give rough estimates of the percent of 

foster children who are supported solely with State and/or local funds. 

Financing structure 

 The Federal matching rate for foster care maintenance payments for a given 

State is that State’s Medicaid matching rate, which is inversely related to State per 

capita income, may vary annually, and can range from 50 to 83 percent. States may 

claim open-ended Federal matching at a rate of 50 percent for their child placement 

services and administrative costs, including costs of data collection. States may 

claim open-ended Federal matching at a rate of 75 percent for costs of training 

personnel employed (or preparing for employment) by State or local agencies 

administering the program and for training current and prospective foster and 

adoptive parents. During fiscal years 1994-97, States also were able to receive 

Federal matching at the 75 percent rate for certain costs related to the development 
11-20 

of Statewide Automated Child Welfare Information Systems (SACWIS); currently, 

these costs are matched at the 50 percent rate. 

TABLE 11-7-- TITLE IV-E AND TOTAL FOSTER CARE CASELOADS, 

BY STATE, FISCAL YEARS 1999-2001 

1999 2000 2001 State 

IV-E P

1

P Total P

2

P IV-E P

1

P Total P

2

P IV-E P

1

P Total P

2

P

Alabama 1,305 5,511 1,441 5,621 1,647 5,859 

Alaska 487 2,248 409 2,193 392 1,993 

Arizona 3,634 7,034 3,098 6,475 3,090 6,234 

Arkansas 1,624 2,919 2,705 3,045 2,739 2,959 

California 78,222 117,937 74,469 112,807 65,960 107,168 

Colorado 2,653 7,639 2,552 7,533 2,673 7,138 

Connecticut 4,528 7,487 3,292 6,996 2,788 7,440 

Delaware 378 1,193 410 1,098 405 1,023 

District of Columbia 1,297 3,466 1,960 3,054 1,619 3,339 

Florida 8,842 34,292 9,395 36,608 6,852 32,477 

Georgia 4,209 11,991 4,191 11,204 4,658 12,414 

Hawaii 1,101 2,205 1,126 2,401 1,195 2,584 

Idaho 510 959 568 1,015 491 1,114 

Illinois 28,592 38,975 23,289 32,079 20,210 28,460 

Indiana 3,963 8,933 3,293 7,482 2,589 8,383 

Iowa 2,810 4,854 2,796 5,068 2,281 5,202 

Kansas 2,356 6,774 2,252 6,569 2,270 6,409 

Kentucky 3,019 5,942 3,161 6,017 3,248 6,141 

Louisiana 2,908 5,581 2,555 5,406 2,547 5,024 

Maine 2,013 3,154 2,453 3,191 2,484 3,226 

Maryland 5,091 13,455 5,764 13,113 5,612 12,564 

Massachusetts 7,340 11,169 3,935 11,619 4,399 11,568 

Michigan 9,338 20,300 9,923 20,034 9,313 20,896 

Minnesota 4,115 8,996 4,069 8,530 3,873 8,167 

Mississippi 1,000 3,196 1,034 3,292 839 3,261 

Missouri 5,621 12,577 5,695 13,181 5,770 13,349 

Montana 950 2,156 940 2,180 737 2,008 

Nebraska 1,477 5,146 1,643 5,674 1,211 6,254 

Nevada 1,345 NA 1,335 1,615 983 1,789 

New Hampshire 625 1,385 791 1,311 563 1,288 

New Jersey 6,124 9,494 6,238 9,794 6,366 10,666 

New Mexico 1,183 1,941 1,505 1,912 1,289 1,757 

New York 38,049 51,159 33,529 47,118 28,916 43,365 

North Carolina 4,854 11,339 4,118 10,847 3,864 10,130 

North Dakota 486 1,143 492 1,129 454 1,167 

Ohio 4,936 20,078 5,074 20,365 4,725 21,584 

Oklahoma 4,039 8,173 5,111 8,406 5,201 8,674 

Oregon 3,193 9,278 3,715 9,193 3,490 8,966 

Pennsylvania 15,054 22,690 12,548 21,631 11,334 21,237 
11-21 

TABLE 11-7-- TITLE IV-E AND TOTAL FOSTER CARE CASELOADS, 

BY STATE, FISCAL YEARS 1999-2001-continued

1999 2000 2001 State 

IV-E P

1

P Total P

2

P IV-E P

1

P Total P

2

P IV-E P

1

P Total P

2

P

Puerto Rico 5,110 7,760 5,613 NA 5,438 8,476 

Rhode Island 629 2,621 743 2,302 751 2,414 

South Carolina 1,146 4,545 1,339 4,525 1,587 4,774 

South Dakota 340 1,101 413 1,215 463 1,367 

Tennessee 6,327 10,796 6,290 10,144 6,078 9,679 

Texas 6,757 16,326 7,123 18,190 7,609 19,739 

Utah 730 2,273 763 1,805 797 1,957 

Vermont 1,151 1,445 1,159 1,318 997 1,360 

Virginia 3,260 6,778 3,327 6,789 3,251 6,866 

Washington 2,603 8,688 2,694 8,945 3,127 9,101 

West Virginia 823 3,169 855 3,388 881 3,298 

Wisconsin 4,037 5,853 4,329 6,697 4,311 7,290 

Wyoming 242 774 311 815 309 965 

Total 302,422 564,898 287,824 542,939 264,670 540,563 

P

1

P

 Based upon the average monthly caseload of Title IV-E foster care children. 

P

2

P

 Based upon the number of foster children in care on September 30 of the fiscal year. 

Note-NA indicates that insufficient data was provided and is not included in the totals. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 

Foster care expenditures and participation rates 

 The average estimated monthly number of children in title IV-E foster care 

grew by 131 percent between 1988 and 1998, from 132,757 to 306,500 (Table 

11-3). However, between 1998 and 2002, the number declined 17 percent, to 

254,000, and is projected to continue a gradual decline to 237,300 in 2008. Also 

between the years 1998 and 2002, while the caseload grew smaller, Federal 

spending on title IV-E foster care increased 22 percent, from $3.7 billion to an 

estimated $4.5 billion (Table 11-2). Table 11-8 provides a State breakdown of 

foster care expenditures in fiscal year 2002, showing maintenance payments, child 

placement services and administration, information systems, training, and 

expenditures under waiver demonstrations. Note that California, New York, 

Pennsylvania, Illinois and Ohio accounted for 56 percent of total Federal foster care 

expenditures in fiscal year 2002. California alone accounted for 26 percent of all 

Federal foster care expenditures in that year. 

 Federal expenditures for child placement services, administrative costs, 

training, and information systems have grown more rapidly (increasing by 

390 percent from fiscal year 1989 to fiscal year 2002) than expenditures for foster 

care maintenance payments (which grew by 214 percent during that time period). In 

fiscal year 1989, expenditures for child placement services, administration, training, 

and information systems equaled $507 million, or 44 percent of total Federal foster 

care expenditures. In fiscal year 2002, Federal expenditures for child placement 

services, administration, training, and information systems totaled almost 
11-22 

$2.5 billion, or 55 percent of total Federal expenditures for foster care. HHS 

regulations give the following examples of allowable child placement services and 

administrative costs for foster care under title IV-E: referral to services, preparation 

for and participation in judicial determinations, placement of the child, development 

of the case plan, case reviews, case management and supervision, recruitment and 

licensing of foster homes and institutions, rate setting, and a proportionate share of 

agency overhead. In addition, Federal matching is available for certain expenses 

related to data collection and automation of child welfare information systems (see 

below). Expenditures for child placement services and administration also include 

expenditures made on behalf of children before and during the time a title IV-E 

eligibility determination is made; as a result, Federal reimbursement is provided for 

expenditures made for some children who, ultimately, are determined not eligible 

for title IV-E maintenance payments. 

 In response to concerns about the rapid growth in administrative costs, the 

101st Congress enacted legislation as part of the Omnibus Budget Reconciliation 

Act of 1990 (Public Law 101-508) that was intended to provide better information 

on State reimbursement for administrative costs. Under Public Law 101-508, “child 

placement services'' was added as a separate category for which States could claim 

reimbursement, in addition to administrative costs. Prior to this provision, child 

placement services were included among administrative costs and not identified 

separately. HHS reports that of claims filed for child placement and administrative 

costs in fiscal year 2001, 45 percent were for case planning and management 

activities, 19 percent were for preplacement activities, 4 percent were for eligibility 

determinations, and the remaining 32 percent were for other activities including 

traditional administrative and overhead costs. 

Foster care payment rates 

 Table 11-9 shows each State's “basic” monthly foster care payment rates in 

1994, 1998, and 2000 for children ages 2, 9, and 16, as reported in surveys 

conducted by the Child Welfare League of America. States are allowed to set the 

payments at any level; thus, as the Table shows, the rates vary widely. The basic 

monthly foster care rates shown in the Table are those paid for family foster care, 

and differ from rates paid for group or congregate care. 

The family foster care rates shown in the table are only generally comparable 

due to variations among States regarding the items that are covered under the basic 

rate, additional services that are provided by supplements (which are not shown in 

this table), and the States' administrative structures. Room and board is covered in 

all of the basic family foster care rates shown; some of the rates shown also include 

amounts for supervision or clothing. States include other items in their basic rates, 

such as child care, respite care, transportation, personal allowance, school supplies, 

recreational and community activities, and incidentals. In addition, many States and 

counties supplement their basic rates for items such as education, child care, respite 

care, level of need, clothing, transportation, health and medical care (other than
TABLE 11-8 -- ESTIMATED FEDERAL IV-E FOSTER CARE EXPENDITURES, FISCAL YEAR 2002

State Net Maintenance PaymentsP

2

P Child placement services and administration SACWIS (operation and development) Training DemonstrationsP

3

P T

Alabama 6,507,161 14,618,219 3,124,669 2,562,604 0 26,8Alaska 1,913,686 6,511,597 596,552 1,773 0 9,0Arizona 20,894,326 15,420,921 989,568 2,682,946 0 39,9Arkansas 12,854,952 11,654,634 932,967 7,241,169 0 32,6

California 402,213,699 615,485,943 65,999,351 76,786,660 10,785,467 1,171

Colorado 13,391,878 28,337,609 4,537,856 861,675 232,896 47,3Connecticut 13,090,111 34,458,341 0 2,660,269 -33,830 50,1Delaware 1,419,222 6,936,833 1,812,853 447,244 50,713 10,6

District of Columbia 15,840,750 8,984,393 255,261 0 0 25,0

Florida 27,503,714 78,852,099 14,355,767 6,085,126 0 126,

Georgia 28,631,456 29,389,502 -31,494 3,643,191 0 61,6Hawaii 3,853,508 11,926,549 0 1,265,419 0 17,0Idaho 1,866,335 3,277,786 390,020 156,919 0 5,6Illinois 56,315,965 88,536,604 15,735,747 7,740,502 152,876,835 321,

Indiana 25,880,981 13,968,129 3,104,489 351,494 3,569,525 46,8

Iowa 11,513,059 7,686,597 276,079 1,036,458 0 20,5Kansas 5,003,426 21,473,067 0 1,887,476 0 28,3

Kentucky 28,129,898 14,878,936 1,729,494 9,432,353 0 54,1Louisiana 22,355,413 23,793,603 703,251 5,998,406 0 52,8Maine 25,233,345 3,429,040 1,676,618 3,448,729 -364,022 33,4

Maryland 58,320,081 64,374,960 5,790,465 6,786,518 5,934,922 141,

Massachusetts 31,330,039 24,206,179 -717,174 0 0 54,8Michigan 73,661,114 68,995,838 404,804 772,405 1,039,754 144,

Minnesota 22,634,258 33,882,375 6,706,450 11,254,576 0 74,4Mississippi 2,015,038 2,982,091 4,771,549 131,534 88,762 9,9Missouri 24,900,065 35,833,790 383,305 5,993,052 0 67,1

Montana 5,821,743 3,763,391 25,217 39,448 106,587 9,7
TABLE 11-8 -- ESTIMATED FEDERAL IV-E FOSTER CARE EXPENDITURES, FISCAL YEAR 2002P

1

P-con

State Net Maintenance PaymentsP

2

P Child placement services and administration SACWIS (operation and development) Training DemonstrationsP

3

P To

Nebraska 11,955,428 7,065,678 91,370 2,853,150 0 21,96Nevada 3,854,147 6,418,259 2,788,043 772,640 0 13,83New Hampshire 5,077,968 4,830,262 499,832 1,279,298 112,968 11,80

New Jersey 32,553,577 40,589,881 113,956 3,833,196 0 77,09New Mexico 3,383,627 7,446,405 0 5,031,922 32,593 15,89

New York 296,058,821 161,251,697 11,754,680 10,560,977 0 479,62

North Carolina 17,962,589 28,927,733 0 1,779,029 14,953,122 63,62

North Dakota 4,959,357 7,473,996 -4,704 676,720 0 13,10Ohio 118,955,006 89,323,470 0 13,221,456 451,444 221,95Oklahoma 15,317,644 7,767,556 1,416,586 4,665,330 0 29,16Oregon 13,435,092 16,015,115 345,423 795,715 1,290,854 31,88

Pennsylvania 189,695,986 139,008,103 1,457,005 15,091,730 0 345,25Puerto Rico 13,435,698 0 0 0 0 13,43Rhode Island 4,501,167 6,863,286 2,158,784 336,443 0 13,85South Carolina 12,464,415 17,162,958 2,350,180 3,353,688 0 35,33South Dakota 2,781,489 2,720,716 207,500 84,888 0 5,794

Tennessee 15,543,551 6,769,456 2,253,423 -356,825 0 24,20Texas 75,205,354 66,374,527 0 6,485,577 0 148,06

Utah 3,078,789 14,200,750 834,607 1,975,024 0 20,08

Vermont 9,074,824 2,408,969 0 1,311,417 0 12,79Virginia 27,219,581 47,463,399 1,451,781 5,091,709 0 81,22

Washington 16,290,322 32,170,806 3,229,208 1,450,897 -10,000 53,13West Virginia 18,600,506 2,113,177 1,774,879 763,250 0 23,25

Wisconsin 26,117,466 45,931,332 5,269,992 2,725,514 0 80,04

Wyoming 1,289,792 1,062,819 472,100 62,338 0 2,887

Total 1,881,907,419 2,035,019,376 172,018,309 243,113,029 191,118,590 4,523,1
P1P Amounts shown are for claims submitted by the States and do not reflect deferrals or disallowances. Actual outlays may vary. P2P Net maintenance payments are the claimed maintenance payments minus those State child support collections that are used to make mainten

payments. P3P Demonstration projects must be cost neutral to the Federal government. These are expenditures that would otherwise be claimed under othe

categories (such as maintenance or administrative costs) but were spent as a part of the State's demonstration project. 

Source: U.S. Department of Health and Human Services. 
11-26 

Medicaid or State-funded medical assistance), and special emotional, behavioral, 

medical, or psychological needs. 

 Public Law 96-272 (1980) stipulated that title IV-E foster care payments 

could be made for children in public institutions, whereas previously under title IVA (AFDC), payments were limited to children in private nonprofit institutions or 

foster family homes. To qualify for Federal payments, these public institutions may 

not accommodate more than 25 children. Facilities operated primarily for the 

detention of delinquents, including forestry camps and training schools, are 

ineligible for Federal funds. Legislation enacted in 1996 (Public Law 104-193) also 

allows participation of for-profit institutions. It is generally agreed that the costs 

associated with institutional care are substantially higher than the cost of family 

foster care. However, definitive data are not available. 

History of Federal protections for children in foster care 

 The 1980 legislation that established the current framework of titles IV-B and 

IV-E contained several provisions intended to protect foster children and children at 

risk of foster care placement. Under the 1980 law as originally enacted, States were 

not eligible for all of their Federal title IV-B funds unless the following protections 

had been implemented: (1) a one-time inventory of children who had been in foster 

care more than 6 months to determine the appropriateness of and necessity for their 

current foster care placement, whether the child should be returned home or freed 

for adoption, and the services needed to achieve this placement goal; (2) a statewide 

information system containing the status, demographic characteristics, location, and 

placement goals of every child in care for the preceding 12 months; (3) a case 

review system to assure procedural safeguards for each child in foster care, 

including a 6-month court or administrative review and an 18-month dispositional 

hearing to assure placement in the least restrictive (most family-like) setting 

available, in close proximity to the child's original home, and consistent with the 

child’s best interest; and (4) a reunification program to return children to their 

original homes. 

 These provisions were originally contained in section 427 of the Social 

Security Act. Effective for fiscal years beginning after April 1, 1996, however, 

these protections are required of States as a component of their State plans under 

section 422 of the act. This change was enacted under the Omnibus Budget 

Reconciliation Act of 1993 (Public Law 103-66). In addition, the Adoption and 

Safe Families Act (Public Law 105-89) made significant changes in the case review 

system, including a requirement that dispositional hearings (renamed permanency 

hearings) be held at 12 months after placement and a requirement that States initiate 

procedures to terminate parental rights after a child has been in foster care a certain 

period of time (see below). 

 Since April 1, 1996, States have been required to implement preplacement 

preventive services as a component of their State plans. In addition, under Public 

Law 103-66, States are required to review their policies and procedures related to 

abandoned children and to implement any changes necessary to enable permanent 

placement decisions to be made expeditiously for such children. 
11-27 

 States must comply with certain State plan requirements under title IV-B that 

are intended to protect all children in foster care. The law reinforces these 

protections by specifically requiring that they be provided in the case of children for 

whom Federal reimbursement is claimed under title IV-E. In addition, the law 

requires States to establish specific goals for title IV-E-eligible children who will 

remain in foster care more than 24 months, and to describe the steps the State will 

take to meet these goals. 

Mandatory procedural safeguards: “reasonable efforts” 

 The 1980 legislation required that in every case, “reasonable efforts'' must be 

made to prevent placement of a child in foster care and to reunify a foster child with 

her parents. The Adoption and Safe Families Act (Public Law 105-89), enacted in 

November 1997, modified this provision. First, the law now specifies that a child's 

health and safety must be of “paramount” concern in all efforts made by the State to 

preserve or reunify the child's family. States continue to be required to make 

reasonable efforts to preserve or reunify the family, but the 1997 law established 

exceptions to this requirement. Specifically, States are not required to make such 

efforts if a court finds that a parent had killed another of their children, or 

committed felony assault against the child or a sibling, or if their parental rights to 

another child had previously been involuntarily terminated. 

 In addition, the law establishes that efforts to preserve or reunify a family are 

not required if the court finds that a parent had subjected the child to “aggravated 

circumstances.” Each State may define these circumstances in State law; the act 

cites abandonment, torture, chronic abuse, and sexual abuse as examples. Moreover, 

the law does not preclude judges from using their discretion to protect a child's 

health and safety regardless of whether the specific circumstances are cited in 

Federal law. If the court determines that reasonable efforts to preserve or reunify a 

child and family are not required, the law now requires that a permanency hearing 

be held within 30 days of the child entering foster care, and that reasonable efforts 

be made to place the child for adoption or in an alternative permanent setting in a 

timely manner. 

 Notwithstanding the exceptions allowed under the Adoption and Safe 

Families Act, reasonable efforts to preserve or reunify a family are still required in 

most cases. The Social Security Act establishes this requirement in two separate 

provisions. First, in order for a State to be eligible for title IV-E funding, its plan 

must specify that reasonable efforts will be made prior to a child's placement in 

foster care to prevent the need for placement or to help the child return home, 

unless the exceptions described above apply (section 471(a)(15)). Second, for every 

title IV-E-eligible child placed in foster care, a judicial determination must be made 

and documented that reasonable efforts were made to prevent placement into foster 

care in that particular case, unless an exception applies (section 472(a)(1)). 
TABLE 11-9 -- FOSTER CARE BASIC MONTHLY MAINTENANCE RATES FOR CHILDREN AGES 2, 9, A

SELECTED YEARS 1994-2000 

Age 2 Age 9 Age 16 State 

1994 1998 2000 1994 1998 2000 1994 1998 

Alabama 205 230 230 229 254 254 241 266 AlaskaP

1

P 588 652 644 523 580 572 621 689 

ArizonaP

2

P 297 297 297 286 286 286 365 365 

Arkansas 300 400 400 325 425 425 375 475 CaliforniaP

3

P 345 375 375 400 436 436 484 528 

Colorado 319 349 349 319 392 349 379 423 

ConnecticutP

1

P 567 622 670 586 642 690 637 708 

DelawareP

4

P 342 410 447 342 410 447 440 511 

District of ColumbiaP1,3P 431 445 445 431 445 445 519 536 Florida 296 345 369 296 355 380 372 425 GeorgiaP

1

P 300 338 365 300 338 365 300 338 

HawaiiP

5

P 529 529 529 529 529 529 529 529 

Idaho 228 228 228 250 250 250 338 358 

Illinois 322 343 360 358 382 400 390 415 IndianaP3,6P 405 486 486 462 536 536 518 603 

IowaP1,3P 306 387 387 322 409 409 382 474 KansasP1,5P 205 205 512 277 277 512 351 351 Kentucky 263 375 599 285 350 599 330 398 Louisiana 298 331 331 331 365 365 364 399 

MaineP1,5P 296 296 438 304 304 447 353 353 

Maryland 535 535 535 535 535 535 550 550 

MassachusettsP

7

P 410 448 454 410 464 471 486 515 

MichiganP1,8P 383 398 409 383 398 409 454 493 MinnesotaP

1

P 377 458 473 377 458 473 487 561 
Mississippi 175 325 325 205 355 355 250 390 4

MissouriP

9

P 212 316 216 259 364 264 286 392 2

MontanaP1,5P 330 330 415 330 330 415 416 416 5NebraskaP

5

P 326 326 222 394 394 292 461 461 3

Nevada 281 403 403 281 403 403 337 494 4New HampshireP

5

P 314 314 373 342 342 406 404 404 4

New Jersey 272 294 406 288 312 437 340 368 5New Mexico 308 308 308 341 341 341 367 367 3New YorkP10P 367 367 405 441 441 487 510 510 5North Carolina 315 315 315 365 365 365 415 415 4North Dakota 265 317 344 318 359 389 424 469 5OhioP11P 413 603 274 413 603 274 413 603 2Oklahoma 300 300 300 360 360 360 420 420 4Oregon 315 356 370 327 370 385 404 457 4

PennsylvaniaP

2

P 315 315 315 368 368 368 473 473 4

Rhode IslandP12P 279 308 315 279 285 295 341 348 3South Carolina 212 212 332 239 239 359 305 305 4South Dakota 259 353 382 317 353 382 382 424 4TennesseeP13P 335 336 346 262 262 270 385 385 3TexasP1,5P 476 476 516 476 476 516 476 476 5UtahP

1

P 300 326 395 300 326 395 300 326 3

VermontP

3

P 416 360 360 416 360 360 504 440 4

Virginia 256 270 294 300 316 344 376 400 4Washington 292 338 351 359 410 427 425 481 5West Virginia 161 400 400 202 400 400 242 400 4Wisconsin 276 289 299 301 315 326 361 374 3Wyoming 400 400 400 400 400 400 400 400 4

Average monthly ratesP14P 328 373 387 348 388 404 406 447 4
TABLE 11-9 -- FOSTER CARE BASIC MONTHLY MAINTENANCE RATES FOR CHILDREN AGES 2, 9, AND 

SELECTED YEARS 1994-2000-continued

P1

P These States provided family foster care maintenance rates which were converted to monthly rates using the formula: (daily rate) x 30. Alaska's ba

rate changes for regular foster care became effective July 1, 1998. 

P2

P Neither 1998 or 2000 data were available. Data shown are for 1994. 

P3

P 2000 data were not available. Data shown are for 1998. 

P4

P The foster care maintenance rates provided for 1998 are midpoints. Delaware has a range of payments for each age. 

P5

P 1998 data were not available. Data shown are for 1994. 

P6

P Basic monthly payment rates for 1998 are State averages of rates set at the county level. They are estimated from daily maintenance payments of $

$17.88, $20.10 and $27.35 respectively. For 2000, each county sets an individual scale. There is no State rate. Foster parents can negotiate with thecounty director. 

P7

P Every child in foster care also receives a $50 birthday payment and a $100 holiday payment. 

P8

P Michigan has two age ranges for payment rates in family foster care: 0 to 12 and 13 to 18. 

P9

P All licensed foster homes who have been through the 27 hours of STARS training and meet the 5 competencies receive an additional $100 per mon

eligible child (transitional, behavioral, medical). 

P10P New York State has two levels of regular family foster care payments. In 2000, the payments for age 2 were $444, for age 9 were $523, and for ag

were $523 for the metro region (New York City, Nassau, Suffolk, Westchester, and Rockland Counties). Data for 2000 in the Table represent payme

rates for all other counties. 

P11 POhio's foster care rates range depending on the county; the rates provided in the Table are the overall average for 88 counties, converted from Ohio

daily rate to a monthly rate. Rates are determined by the county agency, but must be within the approved uniform Statewide standards for per diem f

care maintenance rates. In 2000, the rates for temporary care provided to children in State custody for regular family foster care range from $9 to $1

day or $274 to $3589 per month. 

P12P Regular family foster care basic monthly maintenance rates apply to age ranges. The amount presented for age 2 applies to ages 0 to 3; the amoun

age 9 applies to ages 4 to 11; the amount for age 16 applies to ages 12 and up.

P13P In addition to payment rates, foster children also receive a semiannual clothing allotment of $96 (ages 3 to 4), $138 (ages 5 to 12) or $198 and rou

transportation (ages 13 and older). 

P14P Average monthly rate data for 1998 and 2000 do not include all the States. Data for 1998 are based on 41 States. Data for 2000 are based on 44 S

Source: Child Welfare League of America. 
11-31 

 The term “reasonable efforts” is not defined in law or regulations. Instead, 

U.S. Department of Health and Human Services (HHS) regulations have required 

State plans to include a description of the services provided to prevent removal or to 

reunify families. The regulations provide an illustrative list of the types of 

preplacement preventive and reunification services that may be offered. This list 

includes: 24-hour emergency caretaker and homemaker services; day care; crisis 

counseling; emergency shelters; access to available emergency financial assistance; 

respite care; home-based family services; self-help groups; services to unmarried 

parents; provision of or arrangement for mental health; drug and alcohol abuse 

counseling; vocational counseling or vocational rehabilitation; and postadoption 

services. 

 Because “reasonable efforts” is not defined by statute, Federal courts have 

been active in defining reasonable efforts in individual cases. Over the 20 years 

since enactment of Public Law 96-272, numerous lawsuits have been filed by foster 

children, parents, and advocacy groups against State and local child welfare 

systems, challenging their failure to make reasonable efforts to preserve or reunify 

families. Many of these cases have been broad in scope, and some Federal courts 

have become involved in the overall child welfare system, although this 

traditionally has been an area of exclusive State jurisdiction. 

 As a result of the U.S. Supreme Court's decision in one such case (Suter v. 

Artist M., 1992), Congress enacted legislation in 1994 (Public Laws 103-382 and 

103-432). These laws added a new section to the Social Security Act, which was 

inadvertently enacted twice, as section 1123 and section 1130A. The provision 

establishes that, in any action brought to enforce a provision of the Social Security 

Act, the provision is not to be deemed unenforceable because of its inclusion in a 

section of the act requiring a State plan. Congress explicitly stated that it does not 

intend to limit or expand any grounds for determining the availability of private 

actions to enforce State plan requirements. The provision also is not intended to 

alter the Court's decision in Suter that the reasonable efforts requirement is not 

enforceable in a private right of action. 

Mandatory procedural safeguards: case planning and case reviews 

 The law specifies case review provisions that apply to all foster children, as 

required by the title IV-B State plan, and to title IV-E-eligible children in order for 

States to claim Federal reimbursement for expenditures made on their behalf. The 

case review process must include a written case plan that: describes the child's 

placement, including its safety and appropriateness; describes a plan for assuring 

the child receives safe and proper care and that services are provided to enable the 

child to return home or to another permanent setting; includes the child's health and 

education records; describes services to help the child prepare for independent 

living, if the child is age 16 or older; and for children with permanency plans of 

adoption or another permanent arrangement, documents the steps taken or planned 

by the agency to place the child in accordance with that plan. Children must have a 

case plan that is designed to achieve a safe setting, that is the least restrictive (most 
11-32 

family-like) and most appropriate setting available, in close proximity to the child's 

parent's home, and is consistent with the child's best interest and special needs. 

 The law also requires an administrative or judicial review at least every 6 

months for children in foster care to determine the continuing need and 

appropriateness of the foster care setting, compliance with the case plan, progress 

made toward improving the conditions that caused the child to be placed in foster 

care, and projecting a date by which the child can be returned home or placed for 

adoption or legal guardianship. 

 The mandatory case review process also includes a judicial permanency 

hearing, to be held no later than 12 months after a child has entered foster care (as 

amended by Public Law 105-89), and every subsequent 12 months. This hearing 

determines the child’s permanency plan; i.e., whether the child should be returned 

to the parents, placed for adoption (in which case, the State also will initiate 

proceedings to terminate parental rights), referred for legal guardianship, or placed 

in another planned, permanent arrangement (if other options, including placement 

with a fit and willing relative, are not in the child's best interest). Prior to enactment 

of Public Law 105-89 in 1997, long-term foster care also was a specified 

permanency plan. Also as amended in 1997, the law provides that States may make 

efforts to reunify a child and family concurrently with efforts to place the child for 

adoption or guardianship. This practice, referred to as “concurrent planning,” allows 

States to develop a backup plan, to save time in case efforts to restore the original 

family are unsuccessful. 

 The permanency hearing also must ensure safeguards for children placed 

outside their home State; must determine the independent living services needed for 

foster children aged 16 and older; and must ensure safeguards for the parental rights 

pertaining to children in foster care. A child's foster parents, preadoptive parents, or 

relative caretakers must be given notice and an opportunity to be heard at any 

review or hearing held with respect to the child. 

Mandatory procedural safeguards: filing for termination of parental rights (TPR) 

 One of the most significant provisions of the 1997 Adoption and Safe 

Families Act requires States to initiate proceedings to terminate parental rights for 

certain foster children. There was no comparable provision in prior law. 

Specifically, the act requires States to initiate or join TPR proceedings for children 

who have been in foster care for 15 of the most recent 22 months, or for infants 

determined under State law to be abandoned, or in any case in which the court has 

found that a parent has killed another of their children or committed felony assault 

against the child or a sibling. States can opt not to initiate such proceedings if the 

child is in a relative’s care, or if the State agency has documented in the child's case 

plan a compelling reason to determine that TPR would not be in the child's best 

interest, or if the State had not provided necessary services to the family. According 

to final regulations issued by HHS on January 25, 2000, exceptions to the TPR 

requirement must be made on a case-by-case basis; States may not establish blanket 

exceptions for categories of children. For purposes of the TPR provision and the 

12-month permanency hearing, children are considered to have entered foster care 
11-33 

on the first date that the court finds they have been subjected to abuse or neglect, or 

60 days after their removal from home, whichever occurs first. 

THE TITLE IV-E ADOPTION ASSISTANCE PROGRAM 

 The Title IV-E Adoption Assistance Program is an open-ended entitlement 

program required of States that participate in TANF. Like the IV-E Foster Care 

Program, the IV-E Adoption Assistance Program funds three distinct types of 

activities: assistance payments for qualified children who are adopted, 

administrative payments for expenses associated with placing children in adoption, 

and training of professional staff and parents involved in adoptions. 

 Under the Adoption Assistance Program, which is permanently authorized, 

States develop adoption assistance agreements with parents who adopt eligible 

children with special needs. Federal matching funds are provided to States that, 

under these agreements, provide adoption assistance payments to parents who adopt 

AFDC- or SSI-eligible children with special needs. In addition, the program 

authorizes Federal matching funds for States that reimburse the nonrecurring 

adoption expenses of adoptive parents of special-needs children (regardless of 

AFDC or SSI eligibility). 

Definition of special needs 

 A special-needs child is defined in the statute as a child with respect to whom 

the State determines there is a specific condition or situation, such as age, 

membership in a minority or sibling group, or a mental, emotional, or physical 

disability, which prevents placement without special assistance. Before a child can 

be considered to be a child with special needs, the State must determine that the 

child cannot or should not be returned to the biological family, and that reasonable 

efforts have been made to place the child without providing adoption assistance. 

States have discretion in defining special-needs eligibility criteria and individually 

determining whether a child is eligible. For example, some States add religion or 

not being able to place the child without subsidy to the definition of special needs. 

Adoption assistance agreements and payments 

 An adoption assistance agreement is a written agreement between the 

adoptive parents, the State IV-E agency, and other relevant agencies (such as a 

private adoption agency) specifying the nature and amount of assistance to be 

given. Under the adoption assistance agreement, States may make federally 

subsidized monthly adoption assistance payments for AFDC- and SSI-eligible 

children with special needs who are adopted. 

 The amount of adoption assistance payments is based on the circumstances of 

the adopting parents and the needs of the child. No means test can be used to 

determine eligibility of parents for the program; however, States do consider the 

adoptive parents' income in determining the payment. Payments may be adjusted 

periodically if circumstances change, with the concurrence of the adopting parents. 

However, the payments may not exceed the amount the family would have received 
11-34 

on behalf of the child under foster care. Adoption assistance payments may 

continue until the child is age 18, or, at State option, age 21 if the child is mentally 

or physically disabled. Payments are discontinued if the State determines that the 

parents are no longer legally responsible for the support of the child. Federally 

subsidized payments may start as soon as an agreement is signed and the child has 

been placed in an adoptive home. 

 Not all families of adopted IV-E eligible children with special needs actually 

receive adoption assistance payments. The adoptive parents' circumstances may be 

such that an adoption subsidy is not needed or wanted. Adopted AFDC- or SSIeligible children with special needs are also eligible for Medicaid if an adoption 

assistance agreement is in effect, regardless of whether adoption assistance 

payments are being made. Pursuant to the 1985 budget reconciliation legislation, a 

child for whom an adoption assistance agreement is in effect is eligible for 

Medicaid from the State in which the child resides regardless of whether the State is 

the one with which the adoptive parents have an adoption assistance agreement. 

 States also have the option under the Medicaid Program to provide Medicaid 

coverage for other special-needs children (those not eligible for AFDC or SSI) who 

are adopted under a State-funded adoption subsidy program. According to the 

Association of Administrators of the Interstate Compact on Adoption and Medical 

Assistance (AAICAMA), all States but two currently take this option, with regard 

to children for whom they have an adoption assistance agreement in effect. (The 

two that do not take this option are Connecticut and New Mexico.) In addition, 

AAICAMA reports that 32 States provide Medicaid to children living in their States 

who have State-funded adoption assistance agreements from other States, and 

another 9 States provide Medicaid to children with State-funded adoption assistance 

agreements from other States, but only if those States are members of the Interstate 

Compact on Adoption and Medical Assistance. As of February 2003, an additional 

three States were in the process of developing reciprocity policies. 

 The Adoption and Safe Families Act (Public Law 105-89) contains additional 

requirements regarding health insurance coverage for special-needs adopted 

children who are not eligible for title IV-E adoption assistance. Specifically, the 

1997 law requires States to provide health insurance coverage to non-title IV-E 

children for whom they have an adoption assistance agreement in effect, if the 

children have special needs for medical, mental health or rehabilitative care. This 

health coverage can be through Medicaid or another program, as long as benefits 

are comparable. In addition, the law prohibited States from receiving adoption 

incentive payments (described below), or from receiving waivers of title IV-B or 

IV-E provisions (also described below), unless they provided health coverage for 

non-title IV-E children who are living in their State, but who are covered by an 

adoption assistance agreement from another State. 

 The structure of adoption subsidy programs varies across States. Some States 

offer basic maintenance payments and also allow additional payments for certain 

activities (such as family counseling) or for certain groups of children (such as 

children with severe disabilities). Other States offer one level of payment to 

everyone with no special allowances. Some States allow parents to request changes 
11-35 

in payment levels on a regular basis if circumstances change for a child; others 

allow very little change once the adoption agreement is signed. Some States start 

payments as soon as placement is made; others not until the adoption is finalized. 

(Table 11-10 shows basic adoption subsidy rates by State for 2002, as published by 

the North American Council on Adoptable Children in May 2003.) 

 Not all children who receive adoption subsidies from States are eligible for 

Federal title IV-E funds. HHS reports that in 2001, 74 percent of children adopted 

from foster care received Federal title IV-E adoption assistance and 14 percent 

received State-funded adoption assistance; the remainder did not receive ongoing 

adoption assistance. The non-IV-E children's adoption subsidies are paid solely by 

the State in which their adoption agreement was signed. 

Nonrecurring adoption costs 

 The Adoption Assistance Program also authorizes Federal matching funds for 

States to pay the one-time adoption expenses of parents of special-needs children 

(regardless of AFDC or SSI eligibility). In order to be eligible, the child must be a 

child with special needs, as defined in section 473(c) of the Social Security Act and 

described above. 

 Through the program, parents may receive reimbursement of up to $2,000 per 

child for these nonrecurring adoption expenses, and States may claim 50 percent 

Federal matching for these reimbursements. Qualified adoption expenses are 

defined as reasonable and necessary adoption fees, court costs, attorney fees, and 

other expenses that are directly related to the adoption of a child with special needs. 

States may vary in the maximum amount they allow parents to receive under this 

provision. 

 All States and the District of Columbia have implemented the program; 

Delaware does not operate a separate program for reimbursing these one-time 

expenses. Table 11-10 shows State-by-State data on maximum reimbursement rates 

for nonrecurring expenses, as reported by the North American Council on 

Adoptable Children in May 2003. It should be noted that these are maximum 

payment rates, which are not necessarily the amounts received by an individual 

family; a 1996 survey by the American Public Human Services Association found 

that the average reimbursements did not equal the maximum for many States. In 

addition, parents adopting children from public child welfare agencies may not 

necessarily claim these reimbursements because many costs incurred in public 

agency adoptions are already covered under the States' adoption programs. 

Adoption assistance expenditures 

 The number of children receiving adoption assistance payments and the 

Federal expenditures for these payments have increased significantly since the 

program began. In fiscal year 1981, only six States participated in the program, with 

payments being made for an average of 165 children per month. In fiscal year 2002, 

50 States plus the District of Columbia and Puerto Rico participated, and an average 

of 285,600 children (Table 11-3) were served per month. Federal expenditures for 

adoption assistance payments have increased from less than $400,000 in fiscal year 
11-36 

1981 to $1.3 billion in fiscal year 2002, and are expected to reach almost $2.5 

billion by fiscal year 2008 (Table 11-2). HHS data indicate that expenditures for 

child placement services and administration for the Adoption Assistance Program 

also have increased significantly in recent years. In fiscal year 1981, claims totaled 

$100,000; in fiscal year 2002 they totaled $305 million and are expected to be $451 

million in fiscal year 2008. 

TABLE 11-10 -- ADOPTION ASSISTANCE BASIC RATES AND 

MAXIMUM NONRECURRING EXPENSE ALLOWANCE, BY AGE, 2002 

Basic Rates Nonrecurring State 

Age 2 Age 9 Age 16 Expenses 

Alabama $230 $254 $266 $1,000 

Alaska 580 to 820 580 to 820 580 to 820 2,000 

Arizona 358 358 419 2,000 

Arkansas 400 425 475 1,500 

California 375 436 528 400 

Colorado 293 293 352 800 

Connecticut 615 652 719 1,200 

Delaware 397 397 511 2,000 (pre paid) 

District of Columbia 718 718 791 2,000 

Florida 295 304 364 1,000 

Georgia 388 411 433 2,000 

Hawaii 529 529 529 2,000 

Idaho 251 275 394 2,000 

Illinois 369 410 445 1,500 

Indiana 406 464 464 1,500 

Iowa 428 452 505 2,000 

Kansas 400 400 400 2,000 

Kentucky 600 600 660 1,000 

Louisiana 265 292 319 1,000 

Maine 432 to 513 441 to 522 494 to 577 2,000 

Maryland 535 535 535 2,000 

Massachusetts 448 464 542 400 

Michigan 444 444 547 2,000 

Minnesota 247 277 337 2,000 

Mississippi 325 355 400 1,000 

Missouri 225 275 304 2,000 

Montana 428 428 520 2,000 

Nebraska 222 291 351 1,500 

Nevada 402 402 494 250 

New Hampshire 552 601 709 2,000 

New Jersey 412 444 516 2,000 

New Mexico 408 441 467 2,000 

New York 460 Metro; 541 Metro; 626 Metro; 2,000 

 419 Upstate 504 Upstate 583 Upstate 
11-37 

TABLE 11-10 -- ADOPTION ASSISTANCE BASIC RATES AND 

MAXIMUM NONRECURRING EXPENSE ALLOWANCE, BY AGE, 

2002-continued

Basic Rates Nonrecurring State 

Age 2 Age 9 Age 16 Expenses 

North Carolina 315 365 415 2,000 

North Dakota 351 397 517 2,000 

Ohio 250 250 250 2,000 

Oklahoma 270 324 378 1,200 

Oregon Based on FC 

rate 

Based on FC 

rate 

Based on FC 

rate 2,000 

Pennsylvania Varies by 

county 

Varies by 

county 

Varies by 

county 2,000 

Puerto Rico NA NA NA NA 

Rhode Island 311 289 352 1,000 

South Carolina 332 359 425 250 

South Dakota 397 397 477 1,500 

Tennessee 527 402 532 2,000 

Texas 521 521 521 2,000 

Utah 390 390 390 2,000 

Vermont 426 472 524 2,000 

Virginia 294 344 436 2,000 

Washington 323 398 472 1,500 

West Virginia 400 400 400 2,000 

Wisconsin 302 329 391 2,000 

Wyoming 399 399 399 2,000 

Note- Some States reported their rates in per diem and weekly amounts. For comparison, all State 

data are presented in monthly rates. Rates are rounded to the nearest dollar. 

NA - Not available. 

Source: North American Council on Adoptable Children 

 Table 11-11 below shows estimated Federal adoption assistance expenditures 

in fiscal year 2002, by State, broken down by assistance payments, administration, 

training, and expenditures under waiver demonstrations. Table 11-12 shows 

average monthly participation in adoption assistance, by State, in fiscal years 1999, 

2000, and 2001. 
11-38 

TABLE 11-11 -- ESTIMATED FEDERAL ADOPTION ASSISTANCE 

EXPENDITURES UNDER TITLE IV-E, FISCAL YEAR 2002P

1

P

State Assistance 

payments 

State and local 

administration Training DemonstrationsP

2

P

Total 

Alabama 2,127,222 1,121,983 1,036,897 0 4,286,102 

Alaska 5,093,740 493,015 8,642 0 5,595,397 

Arizona 16,623,044 2,465,586 0 0 19,088,630 

Arkansas 3,431,028 1,074,649 15,106 0 4,520,783 

California 175,110,389 43,610,659 2,488,187 0 221,209,235 

Colorado 13,019,079 3,356,610 1,404,426 0 17,780,115 

Connecticut 11,709,542 2,747,447 2,237,039 0 16,694,028 

Delaware 1,258,511 524,775 191 61,438 1,844,915 

District of 

Columbia 6,629,225 2,243,504 0 0 8,872,729 

Florida 27,235,513 14,000,999 838,151 0 42,074,663 

Georgia 19,808,127 5,468,006 4,452,292 0 29,728,425 

Hawaii 5,423,937 855,101 39,497 0 6,318,535 

Idaho 1,661,809 651,096 241 0 2,313,146 

Illinois 63,010,254 9,264,473 477,306 0 72,752,033 

Indiana 22,239,452 1,983,619 0 0 24,223,071 

Iowa 20,301,301 2,625,138 167,045 0 23,093,484 

Kansas 7,837,190 1,523,909 0 0 9,361,099 

Kentucky 11,118,107 1,000,723 1,418,808 0 13,537,638 

Louisiana 8,450,854 2,437,060 659,342 0 11,547,256 

Maine 7,234,075 1,868,208 2,007,071 647,734 11,757,088 

Maryland 407,505 69,324 0 0 476,829 

Massachusetts 22,111,805 3,503,580 0 0 25,615,385 

Michigan 84,714,041 5,981,312 0 0 90,695,353 

Minnesota 10,678,931 3,737,224 1,858,089 0 16,274,244 

Mississippi 2,958,111 617,119 0 0 3,575,230 

Missouri 15,058,443 4,911,896 0 0 19,970,339 

Montana 2,919,831 1,682,677 21,330 0 4,623,838 

Nebraska 5,237,492 392,480 0 0 5,629,972 

Nevada 2,407,104 848,568 370,032 0 3,625,704 

New Hampshire 1,131,571 369,428 6,087 0 1,507,086 

New Jersey 13,961,389 10,686,728 107,761 0 24,755,878 

New Mexico 7,788,417 2,000,543 0 133,666 9,922,626 

New York 180,126,737 5,818,074 337,972 0 186,282,783 

North Carolina 16,960,778 837,048 53,055 0 17,850,881 

North Dakota 1,579,157 479,426 0 0 2,058,583 

Ohio 50,527,340 77,445,773 9,721,571 0 137,694,684 

Oklahoma 10,661,363 4,268,494 970,073 0 15,899,930 

Oregon 16,462,585 1,818,995 0 0 18,281,580 

Pennsylvania 35,001,132 14,160,109 3,729,848 0 52,891,089 

Puerto Rico 195,202 0 0 0 195,202 

Rhode Island 5,371,733 389,202 339,676 0 6,100,611 
11-39 

TABLE 11-11 -- ESTIMATED FEDERAL ADOPTION ASSISTANCE 

EXPENDITURES UNDER TITLE IV-E, FISCAL YEAR 2002P

1

P

-continued

State Assistance 

payments 

State and local 

administration Training DemonstrationsP

2

P

Total 

South Carolina 10,086,093 1,206,178 1,432,013 0 12,724,284 

South Dakota 1,463,317 157,770 0 0 1,621,087 

Tennessee 9,782,846 1,013,129 -233 0 10,795,742 

Texas 37,001,113 5,682,969 788,314 291,458 43,763,854 

Utah 4,453,675 917,213 339,398 0 5,710,286 

Vermont 4,698,144 1,370,438 649,690 0 6,718,272 

Virginia 9,452,460 297,430 3,580,319 0 13,330,209 

Washington 15,218,875 3,693,532 39,054 0 18,951,461 

West Virginia 5,058,237 2,960,898 973,293 0 8,992,428 

Wisconsin 22,957,498 5,056,479 0 0 28,013,977 

Wyoming 501,473 88,030 0 0 589,503 

Total 1,036,256,797 261,778,626 42,567,583 1,134,296 1,341,737,302 

P

1

P

 Amounts shown are for claims submitted by the States and do not reflect deferrals or 

disallowances. Actual outlays may vary. 

P

2 P

States’ estimates used for fourth quarter. Demonstration projects must be cost neutral to the 

Federal government. These are expenditures that otherwise would have been claimed under the 

assistance payments, administration or training categories. 

Source: U.S. Department of Health and Human Services. 

TABLE 11-12 -- TITLE IV-E ADOPTION ASSISTANCE AVERAGE 

MONTHLY CASELOADS, BY STATE, FISCAL YEARS 1999-2001 

State 1999 2000 2001 

Alabama 429 522 625 

Alaska 731 888 1,059 

Arizona 2,161 2,856 3,466 

Arkansas 688 1,294 1,443 

California 24,786 29,972 37,294 

Colorado 2,992 3,622 3,881 

Connecticut 1,748 1,907 2,236 

Delaware 267 323 406 

District of Columbia 485 536 467 

Florida 8,900 9,347 9,868 

Georgia 3,570 4,514 5,459 

Hawaii 675 901 1,109 

Idaho 271 418 517 

Illinois 16,242 22,095 25,912 

Indiana 3,574 4,228 5,064 

Iowa 2,670 3,138 3,529 

Kansas 2,975 3,393 3,604 

Kentucky 1,148 1,403 1,854 

Louisiana 1,874 1,948 2,406 

Maine 754 889 1,066 

Maryland 2,179 2,567 3,199 

Massachusetts 4,552 5,303 5,026 

Michigan 14,213 15,663 17,445 
11-40 

TABLE 11-12 -- TITLE IV-E ADOPTION ASSISTANCE AVERAGE 

MONTHLY CASELOADS, BY STATE, FISCAL YEARS 1999-2001-

continued

State 1999 2000 2001 

Minnesota 2,246 3,115 3,751 

Mississippi 419 579 732 

Missouri 3,341 4,136 4,806 

Montana 501 608 745 

Nebraska 877 952 1,115 

Nevada 419 543 703 

New Hampshire 313 230 330 

New Jersey 3,788 4,038 4,301 

New Mexico 1,377 1,689 1,945 

New York 32,759 35,295 36,339 

North Carolina 3,506 4,214 3,628 

North Dakota 202 244 307 

Ohio 12,355 13,674 14,962 

Oklahoma 1,671 2,068 2,621 

Oregon 4,081 4,468 5,540 

Pennsylvania 5,706 6,048 6,776 

Puerto Rico 92 124 144 

Rhode Island 1,053 1,168 1,247 

South Carolina 1,679 1,986 2,363 

South Dakota 363 432 485 

Tennessee 1,790 2,253 2,368 

Texas 6,969 8,229 9,347 

Utah 951 1,278 1,478 

Vermont 667 732 809 

Virginia 2,011 2,280 2,290 

Washington 4,563 5,619 6,459 

West Virginia 386 813 1,059 

Wisconsin 3,211 3,682 4,071 

Wyoming 68 90 139 

Total 195,243 228,307 257,790 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 

THE TITLE IV-E ADOPTION INCENTIVES PAYMENT PROGRAM 

 The Adoption and Safe Families Act (ASFA) of 1997 (Public Law 105- 89) 

established a new provision intended to promote adoption through incentive 

payments to States that increase their number of foster child adoptions, with 

additional incentives for the adoption of special-needs foster children with adoption 

assistance agreements under title IV-E. This discretionary program was authorized 

to grant payments for adoptions finalized in each of fiscal years 1998 through 2002; 

funds to make these grants were authorized through fiscal year 2003. Incentive 

payments equaled $4,000 for each foster child whose adoption was finalized (over a 
11-41 

certain State-specific baseline) and an additional $2,000 for each special-needs 

child whose adoption was finalized (over a State-specific baseline). For adoptions 

finalized in fiscal year 1998, the baseline was the State’s average number of 

adoptions in fiscal years1995-97. For adoptions finalized in fiscal years 1999-2002, 

the State’s baseline was the highest number of adoptions in any preceding year, 

beginning with fiscal year 1997. Table 11-13 shows each state’s baseline and 

number of incentive-qualifying adoptions for fiscal years 1998, 2000, and 2002. 

Qualifying adoptions shown in this Table are those of children who were in foster 

care before their adoption and are not necessarily the same as adoptions made with 

the involvement of public child welfare agencies. Through fiscal year 2002, States 

earned a total of $159.7 million in adoption incentive payments. Table 11-14 shows 

the adoption incentives payments, by State, in fiscal years 1999 through 2003 which 

are payments for adoptions completed in each of fiscal years 1998 through 2002. 

 Public Law 105-89 originally authorized appropriations of $20 million 

annually for fiscal years 1999-2003 for adoption incentive payments. In addition, 

discretionary budget caps were adjusted to help ensure that the funds were actually 

appropriated for each year. However, in several years, the amount of incentive 

payments that States earned exceeded the $20 million level and Congress provided 

additional funds in several years to ensure States received their full incentive 

earnings. For example, States earned $42.5 million for adoptions finalized in fiscal 

year 1998; $51.5 million for adoptions finalized in fiscal year 1999; and $33.2 

million for adoptions finalized in fiscal year 2000. However, States earned 

adoption incentives of $17.6 million and $14.9 million for adoptions finalized in 

fiscal years 2001 and 2002, respectively. 

 Congress enacted Public Law 108-145 in December 2003 reauthorizing 

annual appropriations of $43 million for the Adoption Incentives program for fiscal 

years 2004 through 2008, to reward States for increased adoptions finalized in fiscal 

years 2003 through 2007. Under this latest version of the program, States continue 

to be rewarded for all increased adoptions of foster children, above a baseline, and 

the incentive payment remains at $4,000 for each adoption above the baseline. 

However, the baseline is updated to the number of such adoptions in fiscal year 

2002 (for adoptions finalized in fiscal year 2003), and the highest previous year 

beginning with fiscal year 2002 (for adoptions finalized in fiscal year 2004 and 

subsequent years). States also continue to be rewarded for increased adoptions of 

special needs children, and this additional payment remains at $2,000. However, 

the special needs payment is now limited only to adoptions of special needs 

children who are under age 9 at the time the adoption is finalized, and the baseline 

is set at the number of such adoptions in fiscal year 2002 (for adoptions finalized in 

fiscal year 2003), and the highest previous year beginning with fiscal year 2002 (for 

adoptions finalized in FY2004 and subsequent years). Public Law 108-145 creates 
TABLE 11-13 -- BASELINE AND NUMBER OF INCENTIVE-QUALIFYING ADOPTIONS, BY STATE

SELECTED FISCAL YEARS 1998-2002 

FY1998 

BaselineP

1

P FY1998 Number of Incentive- Qualifying 

AdoptionsP

2

P FY2000 BaselineP

3

P FY2000 Number of Incentive- Qualifying 

AdoptionsP

2

P FY2002 BaselineP

3

P FY2002 

of Inc

Qual

Adop

States 

Total IV-E Total IV-E Total IV-E Total IV-E Total IV-E Total 

Alabama 139 41 119 23 237 79 200 56 237 79 249 Alaska 108 85 95 80 278 229 202 181 278 229 192 Arizona 357 277 327 0 931 643 851 611 931 643 788 Arkansas 138 122 251 194 353 278 311 274 353 278 295 California 3,287 2,414 3,958 3,030 8,852 7,502 8,221 6,570 8,852 7,502 8,647 Colorado 417 310 560 470 711 578 679 503 711 578 835 Connecticut 207 172 229 0 499 230 499 186 499 230 562 Delaware 39 23 33 13 117 89 103 61 117 89 133 District of Columbia 110 37 96 96 236 129 236 129 236 129 195 Florida 987 398 1,549 646 1,605 786 1,605 719 1,605 786 2,246 Georgia 493 247 672 367 1,029 551 984 497 1,029 551 1,081 Hawaii 85 63 297 190 297 190 259 180 297 190 349 Idaho 44 36 14 0 110 92 102 81 110 92 92 Illinois 2,200 1,470 4,656 3,861 7,031 6,242 5,670 5,056 7,031 6,242 3,585 Indiana 495 322 774 660 1,143 711 1,143 711 1,143 711 881 Iowa 350 298 517 359 751 491 751 437 751 491 882 Kansas 349 215 229 165 558 449 435 296 558 449 501 Kentucky 211 148 204 88 542 313 384 175 542 313 551 Louisiana 268 220 236 171 469 346 469 341 469 346 466 

Maine 108 96 112 100 405 361 405 361 405 361 297 Maryland 342 165 420 347 801 628 513 398 801 628 922 

Massachusetts 1,116 601 1,137 2 1,161 657 861 332 1,161 657 808 Michigan 1,905 1,634 2,254 1,938 2,979 2,492 2,800 2,360 2,979 2,492 2,845 
Minnesota 258 176 427 349 615 530 615 530 615 530 627 

Mississippi 114 45 169 134 290 256 290 256 290 256 175 Missouri 557 415 616 404 1,205 832 1,205 832 1,205 832 1,273 Montana 115 89 144 86 264 159 228 137 264 159 244 Nebraska 185 99 35 18 289 153 282 153 289 153 294 

Nevada 149 94 0 0 244 172 229 155 244 172 251 New Hampshire 45 36 50 0 95 70 95 67 95 70 114 New Jersey 621 366 755 533 1,043 806 834 661 1,043 806 1,370 New Mexico 147 110 197 0 369 330 346 288 369 330 272 New York 4,716 4,403 4,822 4,332 4,979 4,697 4,225 3,932 4,979 4,697 3,160 

North Carolina 467 296 303 220 1,244 961 1,244 961 1,244 961 1,324 North Dakota 47 34 83 29 138 64 92 29 138 64 119 Ohio 1,287 1,143 1,263 1,225 2,002 1,912 1,777 1,612 2,002 1,912 2,185 

Oklahoma 338 242 456 304 995 625 995 566 995 625 985 

Oregon 445 335 665 519 1,071 850 831 649 1,071 850 1,115 

Pennsylvania 1,224 1,050 1,494 1,140 1,700 1,480 1,700 1,480 1,700 1,480 1,993 

Rhode Island 261 166 222 132 292 189 260 139 292 189 256 South Carolina 256 146 465 260 465 311 378 247 465 311 343 South Dakota 56 36 58 36 92 55 87 39 92 55 142 Tennessee 328 233 295 196 555 377 403 278 555 377 758 Texas 880 510 1,365 976 2,278 1,430 2,010 1,430 2,278 1,430 2,295 Utah 225 130 250 89 369 174 302 174 369 174 344 Vermont 75 67 116 92 138 121 105 95 138 121 133 Virginia 298 190 158 109 491 333 246 167 491 333 417 Washington 607 425 759 431 1,207 991 1,110 713 1,207 991 1,031 

West Virginia 182 80 211 86 360 227 350 175 360 227 361 Wisconsin 467 379 589 455 712 641 712 641 712 641 939 Wyoming 15 5 30 5 46 36 46 26 46 36 46 Puerto RicoP

4

P 0 0 0 0 164 25 57 12 164 25 176 

Total 28,120 20,694 34,736 24,960 54,807 42,873 48,737 36,959 54,807 42,873 50,144 
TABLE 11-13 -- BASELINE AND NUMBER OF INCENTIVE-QUALIFYING ADOPTIONS, BY STA

SELECTED FISCAL YEARS 1998-2002-continued

P1 PThe FY1998 baseline drew on the 3-year average for adoptions from FY1995-FY1997.P2 PQualifying adoptions shown in this Table are those of children who were in foster care before their adoption and are not necessarily the same 

made with the involvement of public child welfare agencies. 

P3 PThe baseline in years after FY1998 is the highest number of adoptions in any preceding year, beginning with FY1997. P4 PPuerto Rico did not participate in the adoption incentive program in fiscal year 1998. 

Source: U.S. Department of Health and Human Services. 

TABLE 11-14 -- ADOPTION INCENTIVES PAYMENTS, BY STATE, FISCAL YEARS 1999-2003 

[Dollars in Thousands]

State 1999 2000 2001 2002 2003 To

Alabama $ 0 $ 108 $ 192 $ 186 $ 96 $ 5Alaska 0 166 382 400 0 9Arizona 0 1,326 684 384 0 2,3

Arkansas 596 194 206 176 0 1,California 3,916 11,698 12,434 4,388 0 32Colorado 892 820 0 0 496 2,2Connecticut 88 500 384 0 547 1,Delaware 0 28 336 112 64 5District of Columbia 0 136 346 0 0 4

Florida 2,744 0 370 0 3,520 6,Georgia 956 1,796 0 0 374 3,Hawaii 1,102 0 0 0 208 1,3Idaho 0 312 0 34 0 3Illinois 14,606 14,262 0 0 0 28

Indiana 1,792 0 1,578 0 0 3,3Iowa 790 1,062 28 0 524 2,4Kansas 0 842 0 0 0 8
Kentucky 0 630 176 796 204 1,

Louisiana 0 292 662 0 0 9Maine 24 530 1,164 0 0 1,7Maryland 676 576 0 1,510 712 3,4Massachusetts 84 0 0 0 0 8Michigan 2,004 1,108 1,920 980 0 6,0Minnesota 1,022 654 460 0 82 2,2Mississippi 398 402 326 0 0 1,Missouri 236 1,150 2,054 0 366 3,Montana 116 128 258 188 0 6

Nebraska 0 56 434 28 20 5

Nevada 0 354 86 94 28 5New Hampshire 20 114 160 0 158 4

New Jersey 870 0 572 1,126 1,932 4,New Mexico 200 440 504 176 0 1,3

New York 424 0 0 0 0 4North Carolina 0 1,282 1,924 0 320 3,North Dakota 144 220 0 0 0 3Ohio 0 1,136 1,146 1,500 1,100 4,Oklahoma 596 2,234 564 0 0 3,3Oregon 1,248 410 514 1,362 224 3,7Pennsylvania 1,260 0 992 0 1,172 3,4Rhode Island 0 378 0 0 0 3

South Carolina 1,064 0 0 0 0 1,0

South Dakota 8 122 20 32 322 5Tennessee 0 428 168 806 1,148 2,Texas 2,872 2,990 498 1,072 68 7,Utah 100 404 0 0 0 5
TABLE 11-14 -- ADOPTION INCENTIVES PAYMENTS, BY STATE, FISCAL YEARS 1999-2003-contin

[Dollars in Thousands] 

State 1999 2000 2001 2002 2003 T

Vermont 214 146 0 0 0 Virginia 0 212 0 922 0 1Washington 620 918 876 944 0 3West Virginia 128 384 248 144 18 

Wisconsin 640 302 562 0 1,158 2Wyoming 60 96 10 0 0 Puerto Rico 0 142 0 218 66 

Total $ 42,510 $ 51,488 $ 33,238 $ 17,578 $ 14,927 $ 1

Source: U.S. Department of Health and Human Services. 
11-47 

a third incentive payment, equal to $4,000 for each increased adoption of foster 

children who are age 9 or older at the time of adoption. States must exceed their 

baseline number of such “older child” adoptions to earn this payment, set at the 

number of such adoptions in fiscal year 2002 (for adoptions finalized in fiscal year 

2003), and the highest previous year beginning with fiscal year 2002 (for adoptions 

finalized in fiscal year 2004 and subsequent years). The older child adoption 

incentive payment is independent of the basic foster child incentive payment, so 

that a State can earn a payment on the basis of an increase in its older child 

adoptions, but not necessarily be eligible for an incentive payment based on its total 

number of foster child adoptions. Under the revised program, a State can receive a 

special needs incentive payment (for children with special needs who are under age 

9) only if they also qualify for an incentive payment on the basis of either an 

increase in total foster child adoptions or older child adoptions. 

THE TITLE IV-E FOSTER CARE INDEPENDENCE PROGRAM 

 In 1986, title IV-E was amended by Public Law 99-272 (Consolidated 

Omnibus Budget Reconciliation Act of 1985) to include section 477, which 

established the Independent Living Program to assist youth who would eventually 

be emancipated from the foster care system. Several surveys conducted during the 

mid-1980s showed that a significant number of homeless shelter users had been 

recently discharged from foster care, prompting Congress to establish a program to 

help youngsters in foster care establish their independence. 

 Initially, an annual entitlement amount of $45 million was established for 

1987 and 1988 to provide States with the resources to create and implement 

independent living services. These services were designed to assist title IV-Eeligible children age 16 and over make a successful transition from foster care to 

independent adult living when they became ineligible for foster care maintenance 

payments at age 18. In 1988, the program was expanded under Public Law 100-647, 

which permitted States to provide independent living services to all youth in foster 

care aged 16 to 18 (not just title IV-E-eligible youth); States could also provide 

follow-up services to youth up to 6 months after their emancipation from foster 

care. Under Public Law 101-508, States had the option of serving individuals up to 

age 21 in the Independent Living Program. Funds were allocated on the basis of 

each State's share of children receiving title IV-E foster care in 1984. 

 Public Law 101-239 increased the amount of Federal entitlement funds 

available to the States for the Independent Living Program to $50 million for fiscal 

year 1990, $60 million for fiscal year 1991, and $70 million for fiscal year 1992. 

Beginning in fiscal year 1991, States were required to provide 50 percent matching 

for any Federal funding claimed that exceeded the original $45 million funding 

level. In 1993, Congress permanently extended the authority for independent living 

under Public Law 103-66. 

 In response to continuing concerns about the adjustment problems faced by 

older children leaving foster care, the 106th Congress enacted the Foster Care 

Independence Act of 1999 (Public Law 106-169). The law replaced section 477 
11-48 

with new language and renamed the program the John H. Chafee Foster Care 

Independence Program, in honor of the Rhode Island Senator who was one of the 

law's sponsors and who died before it was enacted. As amended in 1999, the Foster 

Care Independence Program is intended to help States provide services to children 

who are likely to remain in foster care until age 18 (no minimum age is specified for 

participation in the program), as well as former foster children between the ages of 

18 and 21. To participate in the program, States must submit a 5-year plan to HHS 

and must certify that, among other things, no more than 30 percent of program 

funds will be used for room and board for 18-20 year olds and that services will be 

coordinated with related Federal and State youth programs, including transitional 

living youth projects funded under the Juvenile Justice and Delinquency Prevention 

Act, abstinence education, housing programs, programs for disabled youth, and 

school-to-work activities. The law also allows foster care youth to accumulate 

assets up to $10,000 without losing their Title IV-E eligibility status and it permits 

States to extend Medicaid coverage to former foster children between 18 and 21 

years of age. As of the end of 2003, 9 States included this optional coverage in 

their Medicaid plans. 

 States have flexibility in the use of their Foster Care Independence Program 

funds within the general purposes outlined in the law. These purposes include 

helping eligible children make the transition to self-sufficiency through such 

services as assistance in obtaining a high school diploma, career exploration, 

vocational training, job placement and retention, training in daily living skills, 

training in budgeting and financial management skills, substance abuse prevention, 

and preventive health activities. 

 The revised Foster Care Independence Program is a capped entitlement with 

an annual ceiling set at $140 million, which is double the entitlement ceiling level 

prior to enactment of Public Law 106-169. States are entitled to an amount based on 

their share of the Nation's foster care population, in the most recent year for which 

information is available. However, no State may receive less than the greater of 

$500,000 or the amount received by the State in fiscal year 1998. The law contains 

a ratable reduction provision to ensure total State allotments do not exceed the 

national ceiling of $140 million. The law also requires a 20 percent non-Federal 

match. 

 In 2001, under Public Law 107-133, Congress authorized an additional $60 

million in discretionary funds for education and training vouchers. Youths 

otherwise eligible for the Foster Care Independence Program, as well as youths who 

are adopted from foster care after reaching 16 years of age, are eligible for 

education and training vouchers worth up to $5,000 per year for the cost of 

attendance at an institution of higher education. States may allow youths 

participating in the education and training voucher program when they reach age 21 

to remain eligible for the program until age 23, so long as they are enrolled in a 

postsecondary education or training program and making satisfactory progress 

toward completion. For fiscal year 2003, the first year in which this program was 

funded, Congress appropriated $41.7 million for the vouchers 
11-49 

 Table 11-15 shows FY2003 allotments to States under the Foster Care 

Independence Program, both for the general program and for education and training 

vouchers. 

TABLE 11-15 -- STATE-BY-STATE TITLE IV-E FOSTER CARE 

INDEPENDENCE PROGRAM ALLOTMENTS, FISCAL YEAR 2003 

State Allotment Education and 

Training Vouchers Total 

Alabama $ 1,424,559 $ 433,609 $ 1,858,168 

Alaska 517,913 157,643 675,556 

Arizona 1,472,642 448,245 1,920,887 

Arkansas 739,431 225,069 964,500 

California 26,242,256 7,987,650 34,229,906 

Colorado 1,820,708 554,189 2,374,897 

Connecticut 1,792,958 545,743 2,338,701 

Delaware 500,000 75,363 575,363 

District of Columbia 1,091,992 242,690 1,334,682 

Florida 7,917,723 2,410,006 10,327,729 

Georgia 3,009,395 916,003 3,925,398 

Hawaii 637,044 193,904 830,948 

Idaho 500,000 80,969 580,969 

Illinois 7,033,085 2,140,739 9,173,824 

Indiana 2,268,529 690,498 2,959,027 

Iowa 1,262,606 384,314 1,646,920 

Kansas 1,538,906 468,414 2,007,320 

Kentucky 1,637,226 498,341 2,135,567 

Louisiana 1,358,131 365,892 1,724,023 

Maine 772,443 235,117 1,007,560 

Maryland 2,998,630 912,727 3,911,357 

Massachusetts 2,904,616 884,111 3,788,727 

Michigan 7,490,475 2,279,960 9,770,435 

Minnesota 1,980,507 602,829 2,583,336 

Mississippi 730,819 222,448 953,267 

Missouri 3,180,677 968,138 4,148,815 

Montana 500,000 147,230 647,230 

Nebraska 1,487,234 452,686 1,939,920 

Nevada 500,000 136,090 636,090 

New Hampshire 500,000 93,639 593,639 

New Jersey 2,631,426 800,957 3,432,383 

New Mexico 500,000 124,876 624,876 

New York 11,585,958 3,309,917 14,895,875 

North Carolina 2,425,696 735,715 3,161,411 

North Dakota 500,000 83,591 583,591 

Ohio 5,253,762 1,599,147 6,852,909 
11-50 

TABLE 11-15 -- STATE-BY-STATE TITLE IV-E FOSTER CARE 

INDEPENDENCE PROGRAM ALLOTMENTS, FISCAL YEAR 2003-

continued

State Allotment Education and 

Training Vouchers Total 

Oklahoma 2,173,319 661,517 2,834,836 

Oregon 1,639,378 479,336 2,118,714 

Pennsylvania 5,201,373 1,583,200 6,784,573 

Rhode Island 588,722 179,196 767,918 

South Carolina 1,162,373 353,804 1,516,177 

South Dakota 500,000 107,692 607,692 

Tennessee 2,351,538 715,764 3,067,302 

Texas 4,654,993 1,416,892 6,071,885 

Utah 530,592 161,502 692,094 

Vermont 500,000 101,649 601,649 

Virginia 1,747,745 531,981 2,279,726 

Washington 2,177,865 662,901 2,840,766 

West Virginia 792,537 241,234 1,033,771 

Wisconsin 2,541,480 773,579 3,315,059 

Wyoming 500,000 73,834 573,834 

Puerto Rico 2,130,738 648,557 2,779,295 

Set Aside for Technical 

Assistance P

1

P

2,061,628 623,750 2,685,378 

Total $139,961,628 $41,724,845 $181,686,473 

P

1

P

 HHS used slightly less than the full statutory set-aside amount for fiscal year 2003, which 

accounts for the totals falling just below the appropriated amounts of $140 million in mandatory 

funds and $41,727,000 in discretionary funds. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 

 

 As originally enacted in 1986, section 477 instructed HHS to conduct a study 

of independent living services, which was done in two phases by Westat, Inc. 

(Cook, 1990, 1992). Looking at youths who emancipated from foster care between 

January 1987 and July 1988, Westat reported that they were a troubled population, 

with low rates of education or job experience and high rates of emotional 

disturbance, drug abuse, health problems, and pregnancy. 

 Later research conducted by the University of Wisconsin had similar findings 

(Courtney & Piliavin, 1998). Looking at Wisconsin youths 12-18 months after they 

emancipated from foster care in 1995, researchers found that 37 percent had still not 

completed high school and 12 percent had been homeless at least once since their 

discharge from foster care. While 81 percent had held at least one job since their 

discharge, only 61 percent reported being employed at the time of their interview, 

suggesting that job retention was a problem for some. Of females, 40 percent were 

receiving public assistance, as were 23 percent of the males. Access to medical care 

was a problem for 44 percent of the youths, usually because of a lack of health 

insurance. While almost half of the youths had received mental health services 

when still connected to the child welfare system, 21 percent reported receiving such 
11-51 

services after they left foster care. Although they were not reunited with their 

biological families by the child welfare system, many of the youths had contact with 

their original families after their discharge from foster care, with about one-third 

actually living with their families. At the same time, 40 percent reported continued 

and frequent contact with their foster parents. About 18 percent of the youths had 

been incarcerated at some point since their discharge. 

 The U.S. General Accounting Office (GAO) reported in 1999 that State and 

local administrators felt they could not provide youths who were leaving foster care 

with all the support they needed to make a successful transition to independent adult 

living. Also in 1999, HHS released a report reviewing the history of the 

Independent Living Program over the 10 years from 1987 through 1996 (U.S. 

Department, 1999b). This report found that many eligible youth did not receive 

independent living services at all. Specifically, in 30 States that reported data for 

fiscal year 1996, 37 percent of eligible youth received no services. Of those youth 

served in fiscal year 1996, 65 percent were either 16 or 17 years old, while 

22 percent were 18 and the remainder were 19 or 20. Half the youth were white, 

and slightly more than half were females. African-American youth comprised 38 

percent and Hispanic youth 9 percent. Half of the youth served had been in foster 

care less than 2 years, while 20 percent had been in care 5 years or longer. Slightly 

more than a quarter of the youth had special needs, and 9 percent were parents or 

pregnant. 

 To enable assessments of State independent living activities, Public Law 

106-169 directed the Secretary of HHS to develop a series of outcome measures, 

including the following: educational attainment, high school diploma, employment, 

avoidance of dependency, homelessness, nonmarital childbirth, incarceration, and 

high-risk behaviors. The Secretary was directed to identify data elements that can 

be used to track the number and characteristics of children receiving independent 

living services, the type and quantity of services provided, and State performance 

on the outcome measures. HHS reported to Congress in September 2001 on its plan 

for this data system and piloted data collection instruments in seven states (HHS, 

2001). The Department expects States to collect some characteristic data needed 

through their existing data collection systems, but is developing additional 

characteristic, services and outcome data items that will be unique. State collection 

of these data is expected to begin in October 2006 with the first State reports 

submitted to HHS in 2007. Once this data collection plan is in effect, States must 

submit the required reports or face financial penalties. In addition, the law requires 

the Secretary to conduct evaluations of innovative State Independent Living 

Programs or programs that have potential national significance. The law reserves 

1.5 percent of each year's appropriation for such evaluation, technical assistance, 

performance measurement, and data collection. 
11-52 

STATE ACCOUNTABILITY AND FEDERAL OVERSIGHT 

 Federal child welfare law requires States to comply with a series of provisions 

that are intended to protect children who have been placed in foster care or who are 

at risk of foster care placement. States are required to comply with these provisions 

to be eligible to receive Federal funds, but the extent to which the Federal 

Government actually holds States accountable has been an issue of ongoing 

concern. On January 25, 2000, HHS published final regulations establishing a new 

system, mandated by Congress, for monitoring and enforcing the implementation by 

States of Federal child welfare laws. The new regulations took effect on 

March 27, 2000. In addition, the law establishes specific penalties for violations of 

certain provisions intended to eliminate ethnic or geographic barriers to adoption. 

Finally, the Adoption and Safe Families Act in 1997 (Public Law 105-89) mandated 

that HHS establish a series of outcome measures to be used to rate the performance 

of State child welfare programs, and to report annually on State performance in 

meeting these outcome measures. HHS published the outcome measures on August 

20, 1999, and has issued annual reports for 1998 through 2000. The Federal review 

system, the penalties applicable to violations of ethnic or geographic discrimination 

provisions, and the outcome measures used to measure State performance are 

described in detail below. 

HISTORY OF FEDERAL REVIEW EFFORTS 

 The history of Federal child welfare review efforts goes back to passage of 

the Adoption Assistance and Child Welfare Act of 1980 (Public Law 96-272). 

Many of the original foster child protections were established by that legislation as 

part of section 427 and were voluntary incentives for States to meet to receive their 

full allotment of title IV-B funds. In addition, the 1980 law established eligibility 

requirements that were used to determine which children could qualify for federally 

subsidized foster care and adoption assistance payments. These eligibility criteria 

contained provisions that were intended to work together with the “section 427 

requirements” to protect children in foster care. 

 In the early 1980s, HHS developed and operated review systems for 

monitoring State compliance with section 427 protections and with the Federal 

foster care requirements under title IV-E. However, child welfare advocates, State 

and Federal officials, and Members of Congress grew dissatisfied with the early 

review systems for various reasons, both procedural and programmatic, and 

beginning in 1989, Congress suspended the collection of penalties resulting from 

these reviews. 

 Procedural concerns included a lack of formal regulations, frequently 

resulting in confusion about the standards that States were expected to meet. 

Reviews were conducted retrospectively, sometimes for fiscal years that had long 

past, so that current practices were not examined. Exacerbating this problem was 

the late release of final reports by HHS, so their findings and recommendations 

were sometimes irrelevant by the time they were issued. State officials had limited 
11-53 

ongoing contact with Federal regional office staff, so that formal reviews were seen 

as adversarial and punitive, rather than collaborative and potentially helpful. The 

reviews were often seen as time consuming, labor intensive, and burdensome for 

the States. 

 Of greater concern, however, was the perception that the reviews did not 

result in improved services for children and families. Both section 427 and title IVE eligibility reviews focused on paper compliance with legal requirements. 

Moreover, States were sometimes held accountable for circumstances beyond their 

control, such as the schedule or actions of the courts. Reviews were criticized for 

focusing on isolated components of a State's child welfare system, rather than the 

system as a whole. When problems were identified, penalties were imposed but 

little technical assistance was provided. The review system contained no 

mechanism for helping States improve the quality of their child welfare programs, 

and also was criticized for failing, in some cases, to identify problems in State 

programs. 

 In 1989, Congress imposed the first in a series of moratoriums, prohibiting 

HHS from collecting penalties associated with these reviews. Finally, in 1994, 

Congress enacted two significant provisions as part of the Social Security Act 

amendments of that year (Public Law 103-432). First, Congress restructured title 

IV-B so that the foster child protections previously contained in section 427 were 

no longer voluntary incentives, but rather mandatory components of the State title 

IV-B plan. Second, Congress mandated the development of a new system to review 

State conformity with Federal requirements, including State plan requirements, 

under titles IV-B and IV-E. 

 The 1994 legislation directed HHS to develop a review system that would 

incorporate the concepts of technical assistance and corrective action. Specifically, 

HHS was directed to specify the Federal requirements that would be subject to 

review and the criteria that would be used to determine if a State was substantially 

meeting those requirements. The law further directed HHS to specify a method for 

determining the amount of financial penalties that would be imposed in cases of 

substantial nonconformity. However, Congress also mandated that before such 

penalties could be imposed, States must be given an opportunity to implement a 

corrective action plan, and required that HHS provide the States with necessary 

technical assistance. 

FEDERAL CONFORMITY REVIEW SYSTEM 

 The 1994 legislation directed HHS to promulgate regulations establishing the 

new review system by July 1, 1995, to take effect on April 1, 1996. After pilot 

testing the system in several States, HHS proposed regulations in the Federal 

Register of September 18, 1998, and issued them as final on January 25, 2000, with 

an effective date of March 27, 2000. Two types of reviews were established: child 

and family services reviews of activities funded by both titles IV-B and IV-E to 

determine system wide State compliance with Federal law; and title IV-E eligibility 
11-54 

reviews to determine the eligibility of State expenditures for foster care or related 

activities for Federal reimbursement under title IV-E. 

Child and family services reviews: the process 

 The child and family services review primarily measures outcomes and 

results, and allows States to undertake corrective action if they are not found in 

substantial conformity with the law. HHS established three outcomes for children 

and families and seven specific criteria as indicators of States' conformity with 

Federal law: 

1. Child safety 

- children are first and foremost protected from abuse and neglect, and 

- children are safely maintained in their own homes whenever possible 

 and appropriate; 

2. Permanency for children 

- children have permanency and stability in their living situations, and 

-the continuity of family relationships and connections is preserved for 

 children; 

3. Child and family well-being 

- families have enhanced capacity to provide for their children's needs, 

- children receive appropriate services to meet their educational needs, 

 and 

- children receive adequate services to meet their physical and mental 

 health needs. 

 In addition, the review system measures State performance on the following 

seven systemic factors that reflect a State's capacity to deliver services leading to 

improved outcomes for children and families. These factors are: 

1. Statewide information system on children in foster care; 

2. Case review system for all children in foster care; 

3. Standards to protect the health and safety of children in foster care and 

an identifiable quality assurance system; 

4. Staff development and training program; 

5. Service array for children and families; 

6. Agency responsiveness to the community; and 

7. Foster and adoptive parent licensing, recruitment, and retention. 

 The child and family services review is conducted by a joint Federal-State 

team, and a full review consists of two steps: first, a statewide assessment 

conducted by the State members of the team, and second, an onsite review 

conducted by the joint Federal-State team. The statewide assessment examines each 

of the seven systemic factors listed above; assesses State performance in each of the 

three child and family outcomes listed above, using statewide data, and analyzes the 

State's performance in meeting national standards established for these outcomes; 
11-55 

assesses characteristics of the State agency that enable it to deliver services that 

lead to improved outcomes; and assesses the State's strengths and areas that require 

further examination during the onsite review. 

 HHS has developed national numerical standards to measure State 

performance on several of the criteria related to child and family outcomes, based 

on data reported by the States through the National Child Abuse and Neglect Data 

System (NCANDS) and the Adoption and Foster Care Analysis and Reporting 

System (AFCARS). The standards are set at the 75P

thP

 percentile of all States’ 

performance in all or parts of 1997 and 1998, and States are required to meet these 

standards to demonstrate substantial conformity with Federal law. Both the 

standards, and the outcomes for which standards are established, may change over 

time, as the availability and quality of data change. As most recently revised by 

HHS, the national standards are as follows (State performance in meeting these 

standards is summarized in Table 11-17): 

 

 For the child safety outcome: 

- percent of children with substantiated or indicated child abuse or 

neglect reports, for whom a subsequent abuse or neglect report is 

substantiated or indicated: standard – no more than 6.1 percent; 

- percent of foster children who are the subject of substantiated or 

indicated abuse or neglect by a foster parent or facility staff: standard 

– no more than 0.57 percent. 

 For the child permanency outcome: 

- of children who entered foster care during a review period, the percent 

who reentered within 12 months of a prior foster care episode: 

standard – no more than 8.6 percent; 

- of children in foster care less than 12 months, the percent who had no 

more than two placement settings: standard – no less than 86.7 

percent; 

- of foster children who were reunified with their parents, the percent 

who were reunified in less than 12 months: standard – no less than 

76.2 percent; 

- of foster children who were adopted, the percent who left foster care in 

less than 24 months: standard – no less than 32 percent. 

 Sources of information to determine whether a State is in substantial 

conformity with Federal law include at a minimum: specific case records on 

children and families served by the agency; interviews with the children and 

families; interviews with caseworkers, foster parents, and service providers for the 

cases selected for review; and interviews with “key stakeholders,” including 

individuals involved in developing the State's child and family services plan, courts, 

administrative review bodies, guardians ad litem, and other individuals or 

organizations with responsibility for representing the best interests of children. 

 The onsite review examines a sample of cases (drawn randomly from 

AFCARS and NCANDS data) that may range in size from 30 to 50. The sample 
11-56 

size may be increased to ensure that all program areas (i.e., children in foster care, 

children and families receiving in-home services) are adequately represented. If 

discrepancies appear between the statewide assessment and the findings of the 

onsite review, the State may submit additional data or the State and HHS may 

jointly review additional cases, up to a specified maximum. 

 A State is considered in substantial conformity with regard to the three 

child and family outcomes (and seven associated criteria), if its performance meets 

the appropriate national standard; and if each of the outcomes is “substantially 

achieved” in 95 percent of cases examined during an onsite review (90 percent for 

an initial review). The compliance level for each of the cases, including the extent 

to which relevant statutory and regulatory requirements or assurances were met, is 

determined through a review of the written records and interviews with the involved 

children and families, case managers, and any major service providers.

 A State is determined in substantial conformity with the seven systemic 

factors if the Statewide Assessment, and subsequent on-site review interviews with 

stakeholders, indicate the required service capacity is in place and that no more than 

one of the specified statutory or regulatory requirements associated with each of 

those seven factors fails to function. (Table 11-18 lists each of the factors with its 

associated requirements.) 

 If a State is found not to be in substantial conformity with any of the outcome 

or systemic factors, the HHS regulations require development and implementation 

of a corrective action plan before financial penalties may be assessed. The plan 

must be approved by HHS. States subject to a mandatory program improvement 

plan must report quarterly to HHS on their progress, and have a specified time in 

which to complete the plan, based on the seriousness and complexity of the 

remedies required to correct program deficiencies. In general, the maximum time 

allowed to complete the program improvement plan is 2 years, although HHS may 

grant 1-year extensions in rare circumstances. Priority goes to correcting 

deficiencies that affect child safety, which must be addressed in less than 2 years. 

 For States that are not in substantial conformity, HHS must determine the 

amount of Federal funds to be withheld from that State as a penalty. HHS will not 

actually withhold these funds while an approved program improvement plan is in 

effect, if the State is actively implementing the plan. HHS can suspend the 

withholding of funds for no longer than 3 years, or the amount of time allowed for 

completing the improvement plan, whichever is shorter. Ultimately, funds are 

withheld for those States that fail to complete their plan by the specified date, or for 

States that fail to submit quarterly progress reports, or if reports indicate that the 

State is not making satisfactory progress toward achieving the steps outlined in the 

plan. 

 The amount of Federal funds to be withheld from a particular State can vary, 

depending on the extent of the State's nonconformity. Penalties are calculated as a 

percentage of the following pool of funds: the State's allotment of title IV-B funds 

(both subparts 1 and 2) for the year(s) to which the withholding applies; and 10 

percent of the State's Federal reimbursement claims for administrative costs related 

to foster care under title IV-E, for the years to which the withholding applies. 
11-57 

 In the case of a first finding of substantial nonconformity, the amount to be 

withheld equals 1 percent of the pooled amount described above, for each of the 

seven criteria associated with child and family outcomes and for each of the seven 

systemic factors subject to review. For example, if a State does not substantially 

achieve two of the seven child and family outcome indicators, then 2 percent of the 

pooled amount of funds it would otherwise receive would be withheld. Likewise, if 

a State is not in substantial conformity with one of the systemic factors, then 

1 percent of the pooled amount would be withheld. The maximum penalty is 

14 percent of the pooled amount (i.e., 1 percent for each of the 14 factors). 

 If a State completes a program improvement plan but is found to be in 

substantial nonconformity during a second full review, the amount of pooled funds 

to be withheld increases to 2 percent for each of the child and family outcomes or 

systemic factors that are not achieved, for a maximum penalty of 28 percent. In the 

case of a third finding of nonconformity, after completion of a program 

improvement plan, the penalty increases to 3 percent for each factor, for a 

maximum of 42 percent. If a State refuses to develop a program improvement plan 

altogether, it is subject to the maximum 42 percent withholding. Once funds are 

withheld from a State, the withholding continues until a subsequent full review 

finds the State in substantial conformity or until the State successfully completes a 

program improvement plan developed as a result of the subsequent review. 

 All States are required to complete an initial full review under the regulation 

within the 4-year period that began March 27, 2000. Those States that are found to 

be in substantial conformity must complete a subsequent full review every 5 years, 

and submit a completed statewide assessment 3 years after their last onsite review. 

This assessment must be reviewed by the State and HHS to determine the State's 

continuing substantial conformity, but is not subject to formal HHS approval. If an 

initial or subsequent full review finds that a State is not in substantial conformity, 

the State must develop and implement a program improvement plan and must begin 

a subsequent full review 2 years after the plan is approved. 

 If HHS has any information suggesting that a State is no longer operating in 

substantial conformity, it may conduct an inquiry and request data from the State 

and may, depending on the outcome of the inquiry, require a full or partial review at 

any time, regardless of when the State was last reviewed. Moreover, if HHS learns 

that a State is not complying with a title IV-B or IV-E requirement that is outside 

the scope of the child and family services review, it may conduct an inquiry and 

institute a partial review at any time, which could result in a mandatory program 

improvement plan and potentially a financial penalty. 

 Final determinations of substantial nonconformity, and withholding or 

reduction of funds, may be appealed to the HHS Departmental Appeals Board 

within 60 days of the State receiving notice of the nonconformity. States may seek 

judicial review of an adverse decision by the Board in Federal district court. 

Child and family services reviews: the results 

 Reviews were conducted in 32 States (including the District of Columbia) 

during fiscal years 2001 and 2002, with 13 scheduled for fiscal year 2003 
11-58 

(including Puerto Rico) and the final seven scheduled for fiscal year 2004. A HHS 

summary of the first 32 States indicates that State performance has been strongest 

on safety-related outcomes and has needed the most improvement in the outcomes 

related to permanency and well-being. On systemic factors, State performance has 

been the weakest in areas related to the case review system. No State so far has 

been found in substantial conformity on all outcomes and factors; therefore, most 

States are in some stage of developing or implementing a program improvement 

plan. HHS has posted on its web site the final reports of most States that have 

completed a child and family services review. 

 Tables 11-16 through 11-18 summarize the results of the 32 child and family 

service reviews (CFSRs) conducted in fiscal years 2001 and 2002. Table 11-16 

shows the number of States that were or were not in substantial conformity on the 

safety, permanency, and well-being outcomes and the number of States that showed 

a particular indicator as a strength or an area needing improvement. Table 11-17 

shows the number of States that met the national numerical standards established 

for the safety and permanency outcomes (see discussion above for explanation of 

standards), and Table 11-18 shows the number of States that were in substantial 

conformity on the seven systemic factors and the associated required elements. 

TABLE 11-16 -- SUMMARY OF FY2001 AND FY2002 CHILD AND 

FAMILY SERVICES REVIEW FINDINGS ON SAFETY, PERMANENCY, 

AND WELL-BEING OUTCOMES 

Outcomes and Indicators 

States in 

Substantial 

Conformity

States not in 

Substantial 

Conformity 

Strength 

Area 

Needing 

Improvement 

Safety Outcome 1: Children are, first and 

foremost, protected from abuse and neglect. 5 27 -- -- 

Item 1. Timeliness of initiating 

investigations -- -- 15 17 

Item 2. Repeat maltreatment -- -- 13 19 

Safety Outcome 2: Children are safely 

maintained in their own homes whenever 

possible and appropriate. 

4 28 -- -- 

Item 3. Services to protect children 

and prevent removal -- -- 16 16 

Item 4. Risk of harm to children -- -- 11 21 

Permanency Outcome 1: Children have 

permanency and stability in their living 

situations. 

0 32 -- -- 

Item 5. Foster care re-entriesP

1

P -- -- 8 (2001) 8 (2001) 

-- -- 8 (2002) 8 (2002) 

Item 6. Stability of foster care 

placements -- -- 5 27 
11-59 

TABLE 11-16 -- SUMMARY OF FY2001 AND FY2002 CHILD AND 

FAMILY SERVICES REVIEW FINDINGS ON SAFETY, PERMANENCY, 

AND WELL-BEING OUTCOMES-continued

Outcomes and Indicators 

States in 

Substantial 

Conformity

States not in 

Substantial 

Conformity 

Strength 

Area 

Needing 

Improvement 

Item 7. Permanency goal for child -- -- 5 27 

Item 8. Reunification, guardianship, -- -- 8 (2001) 9 (2001) 

relative placementP

1

P -- -- 3 (2002) 12 (2002) 

Item 9. Adoption -- -- 5 27 

Item 10. Other planned permanent 

living arrangement -- -- 14 18 

Permanency Outcome 2: The continuity of 

family relationships and connections is 

preserved for children. 

5 27 -- -- 

Item 11. Proximity of foster care 

placement -- -- 31 1 

Item 12. Placement with siblings -- -- 24 8 

Item 13. Visiting with parents and 

siblings in care -- -- 12 20 

Item 14. Preserving connections -- -- 17 15 

Item 15. Relative placement -- -- 18 14 

Item 16. Relationship of child in care 

with parents -- -- 17 15 

Well-Being Outcome 1: Families have 

enhanced capacity to provide for their 

children’s needs. 

0 32 -- -- 

Item 17. Needs/services of child, 

parents, foster parents -- -- 1 31 

Item 18. Child/family involvement in 

case planning -- -- 5 27 

Item 19. Worker visits with child -- -- 10 22 

Item 20. Worker visits with parents -- -- 7 24 

Well-Being Outcome 2: Children receive 

appropriate services to meet their 

educational needs. 

7 25 -- -- 

Item 21. Educational needs of children -- -- 7 25 

Well-Being Outcome 3: Children receive 

adequate services to meet their physical and 

mental health needs. 

1 31 -- -- 

Item 22. Physical health of child -- -- 12 20 

Item 23. Mental health of child -- -- 2 30 

P

1

P

 Data elements 5 and 8 were modified between the 2001 and 2002 reviews, and are not 

comparable from one year to the next. Therefore, they are reported here separately for the two 

years. 

Note- Results are based on 32 States. 

Source: U.S. Department of Health and Human Services. 
11-60 

TABLE 11-17 -- SUMMARY OF FY2001 AND FY2002 CHILD AND 

FAMILY SERVICES REVIEW FINDINGS ON NATIONAL STANDARDS 

FOR SAFETY AND PERMANENCY OUTCOMES 

Indicator National Standard States Meeting the 

National Standard 

Percent of children experiencing a recurrence of 

maltreatment 

6.1% or less 13 

Percent of children who are abused or neglected by a 

foster care parent or facility staff 

0.57% or less 17 

Percent of children who reenter foster care within 

12 months of a prior foster care episode 

8.6% or less 16 

Percent of children reunited with their families 

within 12 months 

76.2% or more 11 

Percent of children adopted within 23 months 32% or more 9 

Percent of children who had no more than 

2 placement settings 

86.7% or more 9 

Note-Results are based on 32 States. 

Source: U.S. Department of Health and Human Services. 

TABLE 11-18 -- SUMMARY OF FY2001 AND FY2002 CHILD AND 

FAMILY SERVICES REVIEW FINDINGS ON SYSTEMIC FACTORS 

Systemic Factor 

States in 

Substantial 

Conformity 

Required Element States that Met 

Requirement 

Statewide information 

system 

32 Information system that can indentify 

specific information for each child in 

foster care 

28 

Case review system 12 Written case plan developed jointly with 

parents 

6 

 Periodic reviews of case plans 28 

Permanency hearings for children 16 

Process for termination of parental rights 19 

Notification of foster and pre-adoptive 

parents of hearings and reviews 

21 

Quality assurance system 27 Standards for quality services 29 

 Identifiable quality assurance system 21 

Staff and provider 

training 

23 Initial staff training 24 

 Ongoing staff training 19 

Training for foster and adoptive parents 27 

Service array 21 Array of services 22 

 Accessibility of services 9 

Ability to individualize services 21 

Agency responsiveness to 

community 

31 Collaboration with other agencies 31 

 Develops annual progress reports 25 

Coordinates services and benefits with 

other agencies 

27 
11-61 

TABLE 11-18 -- SUMMARY OF FY2001 AND FY2002 CHILD AND 

FAMILY SERVICES REVIEW FINDINGS ON SYSTEMIC FACTORScontinued

Systemic Factor 

States in 

Substantial 

Conformity 

Required Element States that Met 

Requirement 

Foster and adoptive 

parent licensing, 

recruitment, retention 

27 Standards for foster and adoptive homes 31 

 Standards applied to all homes 27 

 Criminal background checks 30 

 Diligent recruitment 12 

 Use of cross-jurisdictional resources 28 

Note-Results are based on 32 States. 

Source: U.S. Department of Health and Human Services. 

Title IV-E eligibility reviews 

 Like the child and family services reviews, title IV-E eligibility reviews are 

conducted by a Federal-State team and include an onsite review. From AFCARS 

data, HHS officials select a random sample of 80 cases, plus a 10 percent 

“oversample” of 8 additional cases, from the pool of children eligible for federally 

funded foster care maintenance payments. Cases from the oversample are used to 

replace any cases in the basic sample that are found to be invalid for some reason. 

The State submits to HHS the complete payment history for all cases in the sample 

and the oversample prior to the onsite review. 

 The Federal-State team reviews the sample to determine whether any cases 

are ineligible under title IV-E. In an initial review, a State is considered in 

substantial compliance with the law if no more than 8 cases (from the sample of 80) 

are determined to be ineligible. In a subsequent review, a State is considered in 

substantial compliance if no more than 4 cases (again, from a sample of 80) are 

found ineligible. 

 If a State is found in substantial compliance, it is not subject to another 

review for 3 years. If a State is not found in substantial compliance, it must develop 

a program improvement plan followed by a secondary review. The program 

improvement plan must be developed by the joint Federal-State team, identify 

weaknesses to be corrected and steps to correct them, and specify a timetable for 

achieving these steps. However, in contrast to the child and family services review, 

the program improvement plan for a title IV-E eligibility review can last no longer 

than 1 year, unless enactment of State legislation is required, in which case an 

extension of one legislative session may be granted. 

 In the secondary review, HHS draws a sample of 150 cases (plus a 10 percent 

oversample) from AFCARS data, for review by the joint Federal-State team. The 

team calculates for the sample both an ineligibility error rate and a dollar error rate. 

If neither of these error rates, or only one, is more than 10 percent, a disallowance is 

assessed for the ineligible cases in the sample. If both error rates exceed 10 percent, 
11-62 

an extrapolated disallowance is assessed based on the State's entire foster care 

population. 

 The following title IV-E State plan requirements and regulations, which relate 

to the eligibility of children and foster care providers, are subject to review: 

1. For each child, there must be judicial finding that “reasonable efforts” 

were made by the State to prevent removal of the child and to finalize a 

permanency plan, and that remaining in the biological home would be 

“contrary to the welfare” of the child; 

2. If a child was placed through a voluntary placement agreement, the 

agreement must meet specified criteria; 

3. The State agency must have responsibility for the child's placement and 

care; 

4. The child must be placed in a licensed foster family home or child care 

institution; and 

5. The child must meet Aid to Families with Dependent Children (AFDC) 

requirements, as in effect on July 16, 1996. 

 Compliance with State plan requirements regarding licensing authorities and 

criminal background checks are also reviewed. 

INTERETHNIC AND INTERJURISDICTIONAL ADOPTION PROVISIONS 

 States are separately subject to penalties if they violate certain provisions of 

law that were enacted to eliminate barriers to adoption. Specifically, States may not 

discriminate in adoption or foster care placements on the basis of race, color or 

national origin, and also may not deny or delay a child's adoptive placement when 

an approved family is available outside of the jurisdiction that has responsibility for 

handling the child's case. The law establishes specific penalties for violations of 

these provisions. 

Interethnic provisions 

 Regarding discrimination on the basis of race or ethnicity, Congress initially 

enacted the Multiethnic Placement Act (MEPA) in 1994 (Public Law 103-382), 

which prohibited any agency or entity that received Federal assistance from 

discriminating on the basis of the child's or the potential adoptive or foster parents' 

race, color, or national origin. However, as enacted in 1994, MEPA originally 

allowed agencies to consider the child's cultural, ethnic, or racial background, and 

the capacity of the prospective parents to meet the child's needs, as one of the 

factors used to determine the child’s best interest. The 1994 legislation also 

provided a right of action in U.S. district court for individuals who were aggrieved 

by a MEPA violation and deemed noncompliance with MEPA to be a violation of 

title VI of the Civil Rights Act. In addition, the 1994 law amended title IV-B of the 

Social Security Act to add, as a State plan requirement, that States must provide for 

the diligent recruitment of potential foster and adoptive families that reflect the 

ethnic and racial diversity of children who need homes. 
11-63 

 In 1996 Congress revised the interethnic discrimination provisions as part of 

the Small Business Job Protection Act (Public Law 104-188). The 1996 law 

repealed the prior MEPA provision that allowed consideration of a child's cultural, 

ethnic, or racial background in making placement decisions. Further, the law 

amended title IV-E of the Social Security Act to provide that neither the State nor 

any other entity that receives Federal funds may discriminate in adoption or foster 

care placements on the basis of race, color or national origin. The law specified a 

penalty for violations of this State plan requirement equal to 2 percent of Federal 

title IV-E funds for a first violation, 3 percent for a second violation, and 5 percent 

for a third or subsequent violation. Private agencies that violate the interethnic 

provisions are required to pay back any Federal funds received. Under the current 

law, private individuals may continue to seek relief in U.S. district court. However, 

Public Law 104-188 provides that no action may be brought more than 2 years after 

the alleged violation occurs. None of these interethnic provisions affect the 

application of the Indian Child Welfare Act. 

 The final child welfare review regulations, published by HHS on January 25, 

2000, did not establish a specific monitoring system for the antidiscrimination 

provisions of MEPA, as amended by the 1996 law. However, the regulations 

established a procedure for responding to reports of violations of these provisions, 

and for enforcing the law in cases where violations are found to have occurred. (In 

March 2003, HHS issued an information memorandum, “to reiterate support” for 

these antidiscrimination provisions and to note that penalties may be imposed in 

cases of violation.) Specifically, whenever HHS becomes aware of a possible 

violation, either through a child and family services review or filing of a complaint 

or any other mechanism, it refers the case to the Department's Office for Civil 

Rights (OCR) for investigation. If, on the basis of OCR's investigation, a violation 

actually has occurred, enforcement action will be taken, based on the nature of the 

violation. 

 If OCR (or a court) finds that a State has discriminated against an individual, 

on the basis of race, color, or national origin in the course of a foster or adoptive 

placement, a penalty is assessed for the quarter in which the State is notified of the 

violation. The penalty equals 2 percent of the State's total title IV-E funds for the 

quarter in the case of a first violation in a given fiscal year, and continues for 

subsequent quarters in that fiscal year until the State completes a corrective action 

plan or comes into compliance. In the case of a second violation in the same fiscal 

year, the penalty equals 3 percent, and 5 percent for a third or subsequent violation 

in a given fiscal year. Violations that remain uncorrected at the end of the fiscal 

year may be subject to another review and additional penalties. 

 If a MEPA violation results from a State's statute, regulation, policy, 

procedure, or practice, and no individual is directly affected, the State has 30 days 

to develop and submit a corrective action plan for HHS approval. If the State hasn't 

completed the plan and come into compliance within 6 months of HHS approving 

the plan, penalties are assessed. Findings of MEPA violations and related financial 

penalties may be appealed to the HHS Departmental Appeals Board, and States may 

seek judicial review of an adverse decision by the Board in Federal district court. 
11-64 

OCR has investigated alleged MEPA violations in a number of States and 

counties and these investigations usually have been resolved without fines through 

negotiation of corrective actions. In November 2003, however, HHS issued its first 

MEPA violation fines based on an OCR investigation in Hamilton County, Ohio. A 

$1.8 million fine was assessed against that county and the State of Ohio based on 

OCR findings that the county denied or delayed adoption in 16 individual 

transracial cases and that it systematically applied additional requirements for 

parents interested in transracial placements, as well as considered the racial makeup of the neighborhoods in which prospective parents interested in transracial 

adoption lived. OCR also found that the State of Ohio had violated the law when it 

issued certain administrative rules governing transracial adoption and foster care. 

Interjurisdictional provisions 

 As amended in 1997 by the Adoption and Safe Families Act (Public Law 105-

89), title IV-E provides that States may not deny or delay a child's placement for 

adoption if an approved family is available outside the jurisdiction responsible for 

the child's case. Further, States must provide an opportunity for a fair hearing to 

anyone whose allegation of a violation of this provision is denied by the State or not 

acted upon promptly. The law (as amended by Public Law 105-200) specifies that 

the same penalty structure applicable to violations of the interethnic provisions 

described above also applies to violations of this provision. 

 HHS did not specifically address enforcement of this interjurisdictional 

provision in the January 25, 2000 child welfare monitoring regulations. However, 

the Department issued a program instruction on October 7, 2002 outlining the 

following procedures. If HHS becomes aware of a potential violation of the law’s 

interjurisdictional provisions, it will conduct a partial review giving the State an 

opportunity to demonstrate compliance and allowing the State 6 months to complete 

a corrective action plan if a violation is found. If the State fails to come into 

compliance within 6 months, then penalties will be imposed as authorized in law. If 

an individual violation is found through the fair hearing process, HHS will impose a 

penalty after allowing the State an opportunity to exhaust legal remedies; however, 

there is no provision for a corrective action plan in this case. 

STATE PERFORMANCE REPORTS 

 The Adoption and Safe Families Act (Public Law 105-89) required the 

Secretary of HHS, in consultation with Governors, State legislatures, State and local 

public officials, and child welfare advocates, to develop a set of outcome measures 

that could be used to assess State performance in operating programs under titles 

IV-B and IV-E. The law required that these outcome measures include length of 

stay in foster care, number of foster care placements, and number of adoptions. The 

law also required that HHS develop a system for rating State performance on these 

outcome measures and publish an annual report on each State's performance, 

examining the reasons for high and low performance and making recommendations 
11-65 

for how State performance could be improved. As of October 2003, the outcome 

reports for 1998, 1999, and 2000 had been issued. 

 HHS published preliminary outcomes and measures to be studied on February 

2, 1999, and published a final list of child welfare outcomes and measures on 

August 20, 1999. Some of the outcomes and measures were revised for the 1999 

outcome report (published in February 2002). See the notes for Table 11-19, which 

identifies the child welfare outcomes and measures, for further details on the 

changes. 

TABLE 11-19 -- CHILD WELFARE PERFORMANCE OUTCOMES AND 

RELATED MEASURES 

Outcome Measure 

Reduce recurrence of child 

abuse and or neglect 

Of all children who were victims of substantiated or indicated 

child abuse and/or neglect during the first six months of the 

reporting period, what percentage had another substantiated or 

indicated report within a six-month period?P

1

P

Reduce the incidence of child 

abuse and/or neglect in foster 

care 

Of all children who were in foster care during the reporting 

period (January 1 - September 30 for this outcome), what 

percentage was the subject of substantiated or indicated 

maltreatment by a foster parent or facility staff? 

Increase permanency for 

children in foster care 

For all children who exited foster care, what percentage left 

either to reunification, adoption, or legal guardianship? 

 For children who exited foster care and were identified as 

having a diagnosed disability, what percentage left either to 

reunification, adoption, or legal guardianship? 

 For children who exited foster care and were older than age 12 

at the time of their most recent entry in to care, what 

percentage left either to reunification, adoption, or legal 

guardianship?P

2

P

 Of all children exiting foster care to emancipation, what 

percentage was age 12 or younger at the time of entry into 

care? 

 For all children who exited foster care, what percentage by 

racial/ethnic category left either to reunification, adoption, or 

legal guardianship? 

Reduce time in foster care to 

reunification without increasing 

re-entry 

Of all children who were reunified with their parents or 

caretakers at the time of discharge from foster care, what 

percentage was reunified in the following time periods: less 

than 12 months from the time of latest removal from home; at 

least 12 months, but less than 24 months; at least24 months, 

but less than 36 months; at least 36 months, but less than 

48 months; and 48 or more months? 

Reduce time in foster care to 

adoption 

Of all children who exited foster care to a finalized adoption, 

what percentage exited care in the following time periods: less 

than 12 months from the time of the latest removal from home; 

at least 12 months, but less than 24 months; at least 24 months, 

but less than 36 months; at least 36 months, but less than 48 

months; and 48 or more months?P

3

P

 
11-66 

TABLE 11-19 -- CHILD WELFARE PERFORMANCE OUTCOMES AND 

RELATED MEASURES-continued

Outcome Measure 

Increase placement stability Of all children served who had been in foster care for the time 

periods listed below, what percentage had no more than two 

placement settings during that time period: less than 12 months 

from the time of the latest removal from home; at least 12 

months, but less than 24 months; at least 24 months, but less 

than 36 months; at least 36 months, but less than 48 months; 

and 48 or more months? 

Reduce placements of young 

children in group homes or 

institutions 

For all children who entered foster care during the reporting 

period and were age 12 or younger at the time of the most 

recent placement, what percentage was placed in a group home 

or institution? 

P

1 P

The previous time frame for this measure was 12 months. The time frame was changed to six 

months in order to better reflect actual maltreatment recurrence. Research indicates that most 

maltreatment recurrence during the first 12 months after a substantiated maltreatment report 

takes place within the first six months. This change was made beginning with the 1999 

outcome report. 

P

2 P

In prior reports, the children studied were 12 years of age and older; the revised measure 

studies children older than age 12. This change was made because, in other outcome measures, 

12-year-old children were grouped with younger rather than older children. This change was 

made beginning with the 1999 outcome report. 

P

3

P

 An additional measure regarding time to adoption from entry into care for children aged three 

or older was dropped. The measure was originally included because of a research finding that 

children who entered foster care at ages three and older tended to spend more time in care 

before adoption than younger children. The measure was dropped because data from 1998 and 

1999 did not replicate this finding. HHS reports that another measure may be developed as 

more information becomes available regarding age at entry and time to adoption. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services 

FEDERAL WAIVERS OF TITLE IV-B AND IV-E PROVISIONS 

 To provide States flexibility to design innovative child welfare programs, 

Congress enacted a provision in 1994 (Public Law 103-432) that authorized the 

Secretary of HHS to approve up to 10 demonstration projects requiring waivers of 

provisions under titles IV-B and IV-E. This authority was established by section 

1130 of the Social Security Act and was subsequently amended by the Adoption 

and Safe Families Act (ASFA) in 1997. ASFA allowed HHS to approve an 

additional 10 demonstration projects in each of fiscal years 1998-2002. The 

Secretary was authorized to waive any provision of either title IV-B or title IV-E if 

necessary to enable the State to carry out its demonstration project, with some 

exceptions, such as provisions that would compromise child safety. Demonstrations 

are limited to 5 years, although the Secretary may grant extensions of up to five 

years. They must include an evaluation component and be cost-neutral to the 

Federal Government. The authority to grant new waivers under this program had 

expired with fiscal year 2002 but in June 2003 was reauthorized through the end of 

fiscal year 2003 (P.L. 108-40) and in October 2003 through March 31,2004 (P.L. 
11-67 

108-89). 

 As of December 2003 a total of 25 projects had been implemented in 

17 States for waiver agreements that were approved between 1996 and 2001. All of 

the projects involve waivers of Title IV-E provisions. No new waivers have been 

approved since 2001. However, HHS issued an Information Memorandum in 

November 2003 calling for States to submit new proposals and it expects to approve 

new demonstration projects prior to the scheduled expiration of its waiver-granting 

authority in March 2004. States have broad discretion on the type of waiver projects 

they can propose and implement. To date States have undertaken projects in 8 

categories: assisted guardianship/kinship permanence (7 States); capped IV-E 

allocations and flexibility to local agencies (4 States); services to substance-abusing 

caretakers (4 States); managed care payment systems (5 States); intensive service 

options (2 States); adoption services (1 State); tribal administration of IV-E funds 

(1 State); and enhanced training for child welfare staff (1 State). 

 Table 11-20 summarizes the 25 waiver projects that are ongoing or have 

been completed/terminated. Of these, 8 (located in 6 States) have been completed or 

were terminated early by the State and as of December 2003 there were 17 ongoing 

demonstration projects located in 12 States. Nine of the ongoing projects 

(in 7 States) were operating on the basis of a short-term extension pending HHS 

review of their final evaluation reports and a decision on a full 5-year extension. 

 As of December 2003, each of the 5 managed care projects had been 

completed (Michigan) or were ended by the State (Colorado, Connecticut, 

Washington, Maryland) and no State had requested an extension of these waivers. 

All 4 States (Indiana, North Carolina, Ohio, Oregon) that implemented capped IV-E 

allocation projects had also completed their initial demonstration projects but were 

continuing them after seeking waiver extensions. Five of the 7 States that 

implemented assisted guardianship/kinship permanence projects had completed the 

original demonstration and each sought an extension. As of December 2003, 

Delaware’s guardianship project had been denied an extension; Illinois’s 

guardianship project was extended for a full five years (effective January 1, 2004); 

guardianship projects in Maryland, North Carolina and Oregon were operating 

under short-term extensions of the waiver (and New Mexico and Montana 

continued their original projects). Four States implemented projects designed to test 

provision of services to substance abusing caretakers. As of December 2003, 

Delaware’s request for an extension of its waiver for this project had been denied, 

Maryland had terminated its project in this area, and Illinois and New Hampshire 

continued implementation of these projects. Two States, California and Mississippi, 

implemented intensive services projects; as of December 2003, California had 

received approval to extend its project on a short term basis and Mississippi’s 

project was ongoing. Maine implemented the sole adoption- related project and, as 

of December 2003, had been granted short-term approval to extend the project. 

Projects to test the tribal administration of Title IV-E funds (New Mexico) and for 

enhanced training for child welfare staff (Illinois) were also ongoing as of the end 

of 2003. 
11-68 

TABLE 11-20--SUMMARY OF APPROVED STATE CHILD WELFARE 

WAIVER DEMONSTRATIONS 

CALIFORNIA Type: Intensive Services 

Approved: August 19, 1997 Final Report: Expected April 2004 

Summary: Seven counties are providing intensive services, including family preservation, 

placement prevention, and permanency, to children and families in order to prevent or shorten 

foster care placements. No outcome findings are currently available. 

 

COLORADO Type: Managed Care 

Approved: September 14, 1999 Final Report: Expected March 2007 

Summary: The one county participating in this project (others are permitted to join) negotiated 

a payment rate with a child welfare service provider to deliver needed services, such as case 

coordination and residential services. No outcome findings are currently available. 

 

CONNECTICUT Type: Managed Care 

Approved: September 29, 1998 Final Report: June 2003 

Summary: The State contracted with a lead service agency to provide services, such as case 

management, group care, home-based services, outpatient services, and aftercare, for youth 

aged 7 to 15 with significant behavioral problems and who were already in or authorized to be 

placed in residential care or a group home. No significant differences were found between the 

experimental and control groups for the percentage of children that experienced changes in 

custody, percentages of time during the first 12 months spent in residential treatment centers 

and group homes, and mental health status. Further analysis of this project is expected. 

 

DELAWARE Type: Substance Abuse Services 

Approved: June 17, 1996 Final Report: March 2002 

Summary: Substance abuse counselors worked with child protective services (CPS) staff to 

identify eligible families and arrange for services. Outcome findings indicate a 31% reduction 

of days in foster care for experimental group children (204 days compared to 294 days in the 

control group). No statistically significant differences were found in length of time to achieve 

permanency or the percentage of cases closed due to case plan completion. 

 

DELAWARE Type: Assisted Guardianship 

Approved: June 17, 1996 Final Report: March 2002 

Summary: Assisted guardianship was offered for Title IV-E eligible children who had been 

living in a foster placement for at least 1 year and had a strong attachment to the potential 

guardian. The State provided guardians with a payment equal to its foster care payment. This 

project was implemented statewide. Outcome findings for this project were limited; the State 

received a minimal response to mail surveys and interview requests. . 
11-69 

TABLE 11-20--SUMMARY OF APPROVED STATE CHILD WELFARE 

WAIVER DEMONSTRATIONS-continued

ILLINOIS Type: Assisted Guardianship 

Approved: September 18, 1996 Final Report: February 2003 

Summary: The State offered guardians throughout the State a subsidy payment equal to that of 

an adoption assistance payment along with a variety of services. Children assigned to the 

guardianship-eligible group were significantly more likely than children in the control group to 

achieve permanency (77.9% v. 71.8%). The withdrawal of regular administrative oversight and 

casework services for the experimental group did not result in higher rates of child abuse and 

neglect reports. HHS granted Illinois a full 5-year extension of this project effective 

January 1, 2004. 

 

ILLINOIS Type: Substance Abuse Services 

Approved: September 19, 1999 Final Report: Expected December 2005 

Summary: Parents are assigned a Recovery Coach, who assists the family during and after 

treatment to prevent relapse and facilitate reunification, along with typical child welfare and 

substance abuse treatment services. This project is being implemented in one county. The 

target population is custodial parents with a substance abuse problem and may include 

custodial parents who deliver drug-exposed infants. As of September 2002, 528 parents were 

in the experimental group, and 211 were in the control group. No outcome findings are yet 

available. 

 

ILLINOIS Type: Enhanced Training 

Approved: August 2, 2001 Final Report: Expected February 2008 

Summary: The State will provide enhanced training to newly hired public and private sector 

child welfare professionals in order to enhance staff competency in assessing child and family 

needs, providing appropriate services, and decision-making. No outcome findings are currently 

available. 

 

INDIANA Type: Capped IV-E 

Approved: July 18, 1997 Final Report: September 2003 

Summary: The State allows the counties to use up to $9,000 annually per child (additional 

costs are borne by the county) to provide intensive services to children in order to improve 

child well-being and develop home- or community-based alternatives to institutional 

placements. From data available from December 2001, children in the experimental group 

remained in care for a significantly shorter period when compared to the control group (366 

days v. 491 days). Also, reunifications were more likely among the experimental group (66%) 

than the control group (59%), and placement recidivism was less likely in the experimental 

group (15% had at least one new out-of-home placement) as compared to the control group 

(20%). 

 

MAINE Type: Adoption Services 

Approved: September 17, 1998 Final Report: Expected December 2004 

Summary: This project consists of two parts: (1) training for public and private sector 

professionals about special needs adoptions and (2) the provision of an array of post-adoption 

services to families who adopt children with special needs. This project is being implemented 

statewide. Outcome findings are not yet available. 

 
11-70 

TABLE 11-20--SUMMARY OF APPROVED STATE CHILD WELFARE 

WAIVER DEMONSTRATIONS-continued

MARYLAND Type: Assisted Guardianship 

Approved: April 17, 1997 Final Report: August 2003 

Summary: The State offers assisted guardianship for children who have been living with a 

relative or kinship caregiver for a minimum of 6 months. The caregiver would then become a 

legal guardian of the child and receive $300 per month, an amount between the foster care 

subsidy ($600) and the TANF child-only payment for kinship caregivers ($211). Outcome 

findings revealed statistically significant differences between the control and experimental 

groups regarding case closure. As of January 2000, 29% of children in the experimental group 

had exited care, as compared to 23% of children in the control group. 

 

MARYLAND Type: Managed Care 

Approved: September 16, 1999 Final Report: Expected June 2005 

Summary: The State contracted with one child placement agency to provide case management, 

placement, permanency planning, and support services to all referred children. As of 

November 2000, exit rates were not significantly different for the two groups, but the 

experimental group had a higher rate of adoptions than the control group. 

 

MARYLAND Type: Substance Abuse Services 

Approved: September 16, 1999 Final Report: Expected June 2005 

Summary: Female primary caregivers with a child in foster care or at risk of having a child 

placed in foster care receive a variety of services from Family Support Services Teams (FSST), 

which are comprised of Chemical Addiction Counselors, local child welfare agency staff, 

treatment providers, parent aides, and mentors. No outcome findings are currently available. 

 

MICHIGAN Type: Managed Care 

Approved: December 19, 1997 Final Report: Expected June 2004 

Summary: The State has contracted with providers in six counties to provide comprehensive 

services to children (ages 0 to 18) who meet any of the following criteria: previously in out-ofhome-care; currently in out-of-home care and case suitable for reunification; at risk of 

placement; or in residential care but could be returned to community. No statistically 

significant differences have been found between the groups regarding number of placements, 

re-entry into care, or safety outcomes. 

 

MISSISSIPPI Type: Intensive Services 

Approved: September 17, 1998 Final Report: Expected December 2006 

Summary: The State provides intensive services, both currently existing and newly developed, 

to children involved in the child welfare system as well as their parents, potential and current 

foster or adoptive parents, custodial relatives, and siblings. No outcome findings are currently 

available. 

MONTANA Type: Assisted Guardianship 

Approved: September 29, 1998 Final Report: Expected March 2007 

Summary: Caretakers can become legal guardians of foster children who have been in their 

care for at least 6 months and have been designated as having special needs. The monthly 

subsidy amount can not exceed the amount of a foster care subsidy. No outcome findings are 

yet available. 
11-71 

TABLE 11-20--SUMMARY OF APPROVED STATE CHILD WELFARE 

WAIVER DEMONSTRATIONS-continued

NEW HAMPHIRE Type: Substance Abuse Services 

Approved: September 24, 1998 Final Report: Expected July 2005 

Summary: Substance abuse specialists work with child welfare staff to provide screening, 

assessment, referrals and services for substance abuse issues. As of January 2003, only 

preliminary results were available; none of these results were statistically significant. 

 

NEW MEXICO Type: Tribal Administration 

Approved: June 14, 1999 Final Report: Expected December 2005 

Summary: Up to five eligible Tribes may enter into an agreement with the State to be allowed 

to administer their own Title IV-E programs, including foster care, adoption assistance, 

independent living, and staff and parent training. Outcome data on this project are limited. 

 

NEW MEXICO Type: Assisted Guardianship (State or Tribal) 

Approved: June 14, 1999 Final Report: Expected December 2005 

Summary: Children in State custody or in tribal custody (under a Joint Powers Agreement or 

the Tribal Administration of Title IV-E Funds waiver project) may be placed in assisted 

guardianships and the guardians may receive subsidy payments that do not exceed those for 

adoption assistance. Insufficient data are available for outcome analysis. 

NORTH CAROLINA Type: Capped IV-E 

Approved: November 14, 1996 Final Report: November 2002 

Summary: The State granted individual counties the opportunity to receive a capped amount of 

Title IV-E funds that may be used to serve children and families to develop its own set of 

initiatives under the project. The probability of placement in out-of-home care declined at a 

greater rate in the experimental counties than in the control counties. Additionally, children in 

both the experimental and control counties showed similar rates of decline in length of stay, 

even though the risk factors for children entering into the experimental group became more 

severe as the project continued. 

 

NORTH CAROLINA Type: Assisted Guardianship 

Approved: November 14, 1996 Final Report: November 2002 

Summary: The eight counties choosing to implement an assisted guardianship initiative in 

North Carolina’s Capped Title IV-E Allocations waiver project are also considered part of this 

waiver project. Outcome findings for this initiative were not reported separately from the other 

North Carolina waiver project. 

 
11-72 

TABLE 11-20--SUMMARY OF APPROVED STATE CHILD WELFARE 

WAIVER DEMONSTRATIONS-continued

OHIO Type: Capped IV-E 

Approved: February 14, 1997 Final Report: June 2003 

Summary: Fourteen counties were granted the ability to flexibly use capped allocations in 

order to provide – or establish contracts for – all services necessary to achieve safety, 

permanency, and well-being in children at risk of entering or already in foster care. Length of 

stay in foster care remained the same for both the experimental and control groups. 

 

OREGON Type: Capped IV-E 

Approved: October 31, 1996 Final Report: March 2003 

Summary: Branch offices in the State may receive a portion of their foster care budgets to 

spend more flexibly and consider the following three options for the use of these funds: (1) 

foster care prevention, (2) expansion of established services, and (3) innovative service plans. 

Children in counties with some form of flexible funding were more likely to remain at home or 

return home within 12 months of placement than children in counties with no flexible funding. 

 No significant differences were found between the groups in the rate of re-abuse within 1 year 

or in permanency rates within 1 year of removal. 

 

OREGON Type: Assisted Guardianship 

Approved: October 31, 1996 Final Report: March 2003 

Summary: Under this project, Oregon may establish assisted guardianship for children who 

meet the following eligibility requirements: have been in substitute care for more than 12 

months; have lived with the prospective guardian for at least 6 months; and be at least 12 years 

old if the prospective guardian is not a relative (or any age if the guardian is a relative). No 

outcome findings were available for this project. 

 

WASHINGTON Type: Managed Care 

Approved: September 29, 1998 Final Report: Expected September 2007 

Summary: The State is allowed to contract with providers for all necessary care, maintenance, 

and direct social services for eligible children. No outcome findings have been reported. 

Source: Table prepared by the Congressional Research Service (CRS) based on information 

provided by the States (as of February 2003) and included in Summary of the Child Welfare 

Waiver Demonstration Projects and Profiles of the Child Welfare Waiver Demonstration 

Projects, James Bell Associates, Inc., Arlington, Va., 2003. Updated information on the status 

of final reports is included from Appendix III, “Summary of Title IV-E Waiver Demonstration 

Projects” of the November 24, 2003 Information Memorandum from HHS (ACYF-CB-IM-03-

06). 

RECENT TRENDS AFFECTING CHILD WELFARE POPULATIONS 

AND PROGRAMS 

 Certain social problems and trends are inextricably linked with the child 

welfare system and its clients, and data and information on these issues are 

sometimes used as indicators of the need for child protection and preventive 

services for families. Most children enter foster care as a result of child abuse or 

neglect; thus, data on the incidence and trends of maltreatment are of great interest 

to child welfare practitioners and policymakers. Likewise, substance abuse is cited 

as a factor in many of the cases coming to the attention of child welfare agencies, so 
11-73 

that information on substance abuse among families with children and responses to 

the problem of substance abuse is also of interest. Kinship care also is a 

phenomenon that has had a significant impact on the child welfare system. In 

addition, as a major policy change affecting low-income families with children, the 

welfare reform law of 1996 has implications for both the child welfare system and 

its clients. These issues are described briefly below. 

CHILD ABUSE AND NEGLECT 

Child Abuse Prevention and Treatment Act 

 Between 1963 and 1967, every State and the District of Columbia enacted 

some form of child abuse and neglect reporting law. The model reporting law 

disseminated by the U.S. Children's Bureau facilitated the States' rapid adoption of 

these laws; after 1974 reporting laws were modified to conform to the standards 

established by the Child Abuse Prevention and Treatment Act of 1974 (CAPTA). 

CAPTA provides formula grants to States to help support their child protective 

service systems ($22 million in fiscal year 2003), in exchange for which States must 

comply with various requirements related to the reporting, investigation, and 

treatment of child maltreatment cases. The law also authorizes Federal discretionary 

research and demonstration projects ($34 million in fiscal year 2003), grants to 

States for community-based family resource and support services ($33 million in 

fiscal year 2003), and grants to States to improve investigation and prosecution of 

child maltreatment cases (funded through a $20 million set-aside of the victims of 

crime fund). 

 CAPTA requires States to have procedures for reporting known or suspected 

cases of child abuse or neglect, for investigating such reports, and for taking 

immediate steps to protect children who might be in danger. The law requires States 

to provide immunity from prosecution for individuals who make good faith reports 

of suspected abuse or neglect, and to provide confidentiality of records. States also 

must have procedures for public disclosure of information about cases of abuse or 

neglect which result in a child's death or near-death. State CAPTA plans must 

provide for cooperation with law enforcement officials, courts, and human service 

agencies, and for the expungement of records in cases that are false or 

unsubstantiated. Further, States must appoint a guardian ad litem, who may be an 

attorney or court-appointed special advocate, to represent children in judicial 

proceedings. 

 The 1996 reauthorization of CAPTA (Public Law 104-235) required States to 

establish citizen review panels, composed of volunteer community representatives, 

to evaluate State and local child protection activities. In addition, the law required 

States to have procedures for expedited termination of parental rights (TPR) in any 

case of an abandoned infant, and to have procedures for individuals to appeal an 

official finding of abuse or neglect. States are required to provide that efforts 

toward family reunification are not mandatory for a surviving child with a parent 

who committed or aided in the murder or voluntary manslaughter of another of their 

children, or who committed a felony assault that resulted in serious bodily injury to 
11-74 

any of their children. States are required to provide that conviction of any of these 

felonies will constitute grounds for TPR. CAPTA also requires States to have 

procedures for responding to cases of medical neglect. 

 CAPTA was most recently amended and reauthorized in 2003 (Public Law 

108-36) and the new law added a number of State requirements. Specifically, in 

requesting basic CAPTA grants, States must assure that they will: require that 

health care providers involved in delivery of an infant who was prenatally exposed 

to an illegal drug and is affected by this substance abuse report the child’s birth to 

child protective services and require that a "safe plan of care" for this newborn be 

developed; have triage procedures for the appropriate referral of children who are 

not at risk of imminent harm to a community organization or voluntary preventive 

service; disclose confidential information to Federal, State, and local government 

entities (or their agents) if the information is needed to carry out their lawful duties 

to protect children; have provisions to ensure that alleged child maltreatment 

perpetrators promptly are informed of the allegations made against them; develop 

(within 2 years of the law's enactment) provisions for criminal background checks 

of all adults in prospective adoptive and foster care homes; have provisions for 

improving the training, retention, and supervision of caseworkers; have provisions 

to address training of child protective service workers on their legal duties in order 

to protect the legal rights and safety of children and families; and develop 

procedures for referral of child maltreatment victims under 3 years of age to the 

statewide early intervention program (for developmental assessment and services) 

operated under Part C of the Individuals with Disabilities Education Act (IDEA). 

Child abuse and neglect statistics 

 The 1996 CAPTA amendments required States (to the “maximum extent 

practicable”) to submit annual aggregate data to HHS on child maltreatment for 

inclusion in the National Child Abuse and Neglect Data System (NCANDS). States 

with the capacity to do so may also submit case-level data. NCANDS was 

established by the 1988 amendments to CAPTA and has published annual reports 

each year beginning with 1990, although prior to the 1996 amendments States 

participated in NCANDS on a voluntary basis. Other sources of national data on 

child maltreatment have included the American Association for Protecting Children 

(of the American Humane Association), which collected information from 1976 to 

1987, and Prevent Child Abuse America (formerly called the National Committee 

to Prevent Child Abuse), which has been conducting an annual survey of States 

since 1986. Finally, HHS has periodically funded the National Incidence Study of 

Child Abuse and Neglect (NIS), which collects data on children who have been 

investigated by child protection agencies, but also includes information from 

community professionals on children who were either not reported to child welfare 

agencies or whose cases were not investigated. The NIS has been conducted three 

times, in 1980, 1986, and 1993. The most recent CAPTA amendments (Public Law 

108-36) require that HHS conduct a fourth NIS. 

 The latest data available from NCANDS are for 2001, and include 

aggregate data from all States and the District of Columbia and case-level data from 
11-75 

39 States. Data for 2001 show that 2.7 million reports of possible maltreatment 

were made to child welfare agencies in that year (U.S. Department, 2003). Almost 

two-thirds of these reports were investigated, and 903,000 children were estimated 

to have been victims of abuse or neglect, for an incidence rate of 12.4 per 1,000 

children. These numbers mark a continuation of a downward trend that began in 

1993, when more than 1 million children were substantiated as victims, for an 

incidence rate of 15.3 per 1,000 children. Table 11-21 shows NCANDS data on the 

incidence of children alleged to have been victims, and substantiated or indicated 

victimization, by State, in 1998 and 2001, and the percent change between those 

years. Chart 11-1 illustrates nationwide changes in the incidence of substantiated or 

indicated maltreatment between 1990, when NCANDS began, and 2001, and also 

shows trends in the incidence of physical abuse and neglect between 1996 and 

2001. 

TABLE 11-21--INCIDENCE OF CHILD MALTREATMENT 

ALLEGATIONS AND VICTIMIZATION, BY STATE, 1998-2001 

Children alleged 

to be victims 

per 1,000 

children 

Child victims 

per 1,000 

State children 

1998 2001 

Percentage 

change in 

allegation rate, 

1998-2001 

1998 2001 

Percentage 

change in 

victimization rate, 

1998-2001 

Alabama 33.1 26.6 -20 15.4 8.2 -47 

Alaska 58.9 95.4 62 37.1 82.6 123 

Arizona 48 38.4 -20 7.1 3.8 -46 

Arkansas 45.2 37.6 -17 13.1 10.1 -23 

California 46.4 51.7 11 17.7 13.6 -23 

Colorado 37.6 27.5 -27 6.7 4.3 -36 

Connecticut 51.7 56.2 9 21.4 14.4 -33 

Delaware 54.1 42.8 -21 16.2 8.5 -48 

District of Columbia 95.8 64.3 -33 47.7 25.5 -47 

Florida 52.8 71.4 35 23.2 33.3 44 

Georgia 36.7 51.7 41 12.1 16.6 37 

Hawaii 12 24.2 102 7.3 13.2 81 

Idaho 76 26.6 -65 22.6 9.5 -58 

Illinois 34.7 44 27 11.2 8.5 -24 

Indiana 67.3 33.9 -50 12.5 13.4 7 

Iowa 38.9 51.6 33 10.1 17.5 73 

Kansas 38.4 NA NA 7.6 10.2 34 

Kentucky 64.2 56.6 -12 23.1 16.6 -28 

Louisiana 38 31.3 -18 11.6 9.2 -21 

Maine 31 30.2 -3 12.3 14.4 17 

Maryland 43.5 NA NA 11.1 14.4 30 

Massachusetts 36.3 40.9 13 18.9 22.1 17 

Michigan 61.3 66.3 8 8.9 11.0 24 

Minnesota 19.7 18.4 -7 8.4 7.6 -10 

Mississippi 42.8 40 -7 8 5.9 -26 
11-76 

TABLE 11-21--INCIDENCE OF CHILD MALTREATMENT 

ALLEGATIONS AND VICTIMIZATION, BY STATE, 1998-2001-continued

Children alleged 

to be victims 

per 1,000 

children 

Child victims 

per 1,000 

children 

State 

1998 2001 

Percentage 

change in 

allegation rate, 

1998-2001 

1998 2001 

Percentage 

change in 

victimization rate, 

1998-2001 

Missouri 53.4 56.4 6 8.9 6.5 -27 

Montana 84.7 65.4 -23 14.7 8.4 -43 

Nebraska 32.9 23.8 -28 9.5 7.4 -22 

Nevada 49.7 41.9 -15 17.2 9.2 -47 

New Hampshire 30.1 38.6 28 3.9 3.5 -10 

New Jersey 38.2 33.8 -12 4.9 4.1 -16 

New Mexico 26.6 45.6 71 8.4 13.6 62 

New York 53.4 53.7 1 18.6 16.6 -11 

North Carolina 65.6 61.5 -6 19.5 18.4 -6 

North Dakota 43.7 43.8 0 0 8.5 NA 

Ohio 47.7 39.5 -17 20.4 17.7 -13 

Oklahoma 68.6 71.1 4 18.9 15.3 -19 

Oregon 33.5 29.9 -11 12.3 10.5 -15 

Pennsylvania 7.9 7.9 0 1.9 1.6 -16 

Rhode Island 41.5 45.7 10 14.5 13.3 -8 

South Carolina 39.9 36.2 -9 8.8 11.0 25 

South Dakota 26.4 49.2 86 13.2 18.3 39 

Tennessee 24.2 36.2 50 7.5 6.8 -9 

Texas 30.7 32.9 7 7.1 7.4 4 

Utah 38.8 39 1 11.4 14.0 23 

Vermont 14 24 71 6.3 7.7 22 

Virginia 29.8 21.6 -28 5.9 5.6 -5 

Washington 32.1 23.2 -28 8.8 3.9 -56 

West Virginia 159.5 67.2 -58 19.3 19.8 3 

Wisconsin 16.5 29.3 78 6 8.7 45 

Wyoming 17.1 32.4 89 6.2 7.7 24 

Total 42.5 41.9 -1 12.9 12.4 -4 

Source: Table prepared by the Congressional Research Service using data provided by the U.S. 

Department of Health and Human Services. 

 The long-term trend in child abuse reporting has been one of substantial 

growth, with the number of maltreatment reports more than quadrupling since 1976. 

However, increased reporting does not necessarily mean an equivalent increase in 

actual abuse or neglect. It is generally agreed that some part of the dramatic growth 

in reporting over the last two to three decades is due to greater public awareness 

and recognition of child abuse and neglect, especially since the 1960s and 1970s 

when States enacted mandatory reporting laws. Moreover, not all reports are 

substantiated, and the percentage of substantiated reports has declined over time. 

According to NCANDS data, 27.5 percent of investigations in 2001 resulted in a 

substantiated case of child maltreatment, and another 4.4 percent found that 

maltreatment was “indicated.” Looking at data from earlier sources, 65 percent of 

child abuse or neglect reports were substantiated in 1976. However, researchers and 
11-77 

professionals also agree that not all children who are victims of abuse or neglect are 

reported to child welfare agencies. According to the most recent NIS survey, more 

than 1.5 million children were victims of abuse or neglect in 1993 under the “harm” 

standard (i.e., children who have suffered demonstrable harm by objective 

measures), for a 67 percent increase from 1986, and a 149 percent increase from 

1980 (Sedlak & Broadhurst, 1996). The NIS also found that 2.8 million children 

could be counted in 1993 under the “endangerment” standard (a more subjective 

measure, including children who were not actually harmed but who might be 

considered at risk), which was almost double the number counted in 1986. The 

endangerment standard was not used in the 1980 NIS. 

CHART 11-1 -- INCIDENCE OF CHILD MALTREATMENT, 1990-2001 

[Per 1,000 children in the U.S. population] 

TSource: Figure prepared by the Congressional Research Service based on data from the U.S. Department 

of Health and Human Services (HHS), National Child Abuse and Neglect Database System. One child 

may be reported as the victim of more than a single maltreatment type. Victimization rates for sexual 

abuse, medical neglect, psychological maltreatment, and “other abuse” are not shown.T

Of child victims in 2001, more than 59 percent experienced neglect 

(including medical neglect), while almost 19 percent were physically abused. 

Almost 10 percent were sexual abuse victims and almost 7 percent had been 

psychologically abused. Other forms of maltreatment were found for 19.5 percent 

of child victims in 2001, with some children falling into more than one of these 

categories. According to NCANDS data, the number of children who died in 2001 

as a result of substantiated abuse or neglect was about 1,300, for an incidence rate 

of 1.8 child abuse-related deaths per 100,000 children in the general population. 

These deaths included 18 that occurred in foster care. 

2.3

7.1

2.5 2.3

2.9

3.5 3.3

7.3

6.5 6.9

7.6 7.5

12.2 11.8

12.9

13.4

14.0

15.1 15.3 15.2 14.7 14.7 13.8

12.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

All types of maltreatment

Neglect

Physical abuse
11-78 

SUBSTANCE ABUSE 

 Substance abuse has been a major challenge facing the child welfare system, 

especially in the last 15-20 years. It is widely believed that the dramatic increase in 

foster care placements in the mid to late 1980s resulted, at least in part, from the 

introduction of crack cocaine. Children born drug exposed often enter substitute 

care shortly after birth, either because of their own medical problems or because of 

abuse or neglect by their parents. However, children exposed prenatally to drugs or 

alcohol are a small portion of the children affected by parental substance abuse. The 

abuse of alcohol, marijuana, cocaine, heroin, and hallucinogens, as well as the nonmedical use of prescription pain relievers, tranquilizers, stimulants, and sedatives by 

adults affects the welfare of children in a variety of ways. Substance abuse can 

impair the priorities and judgment of a caretaker, leading to decreased supervision, 

assistance, and provision, and a high risk of child maltreatment. Children of all 

ages typically enter foster care because of abuse or neglect, and substance abuse is a 

factor in many of these cases. 

 According to the most recent annual National Household Survey on Drug 

Use and Health (NHSDUH, formerly called the National Household Survey on 

Drug Abuse, published by the Substance Abuse and Mental Health Services 

Administration), 19.5 million people or 8.3 percent of the U.S. population over age 

12 engaged in illicit drug use in 2002 (SAMHSA, 2003). The most commonly used 

illicit drug was marijuana (6.2 percent of the population), while slightly less than 1 

percent of the population were current cocaine users. About 2.6 percent of the 

over-age-12 population used psychotherapeutic drugs for nonmedical reasons. 

Among pregnant women aged 15 to 44, 3.3 percent had used illicit drugs in the 

month prior to being interviewed for the NHSDUH, compared with 10.3 percent of 

nonpregnant women in the same age group. More than half (51 percent) of 

Americans, or 120 million individuals over the age of 12, reported current use of 

alcohol, with 6.7 percent identifying themselves as heavy drinkers. 

 An estimated 8.3 million children live with substance-abusing or substancedependent parents, according to a congressionally mandated HHS study (U.S. 

Department, 1999a). African-American parents have higher rates of illegal drug 

abuse than white parents, especially for cocaine, and substance abusing parents in 

general have less education, are less likely to be working full time, are less likely to 

be married, and more likely to be receiving welfare than other parents. Of all forms 

of parental substance abuse, alcohol abuse is the most prevalent. Although 

relatively few of the children in substance abusing families ever come into contact 

with the child welfare system, substance abuse is a major factor in the child welfare 

caseload. For children with substantiated reports of abuse or neglect, HHS found 

that substance abuse is a factor in between one-third and two-thirds of cases, and is 

a factor in two-thirds of the cases of children in foster care. While mothers and 

fathers are equally represented in substance abusing households with children, 

mothers more typically come to the attention of the child welfare system. 

 The National Center on Addiction and Substance Abuse estimates that 

substance abuse and addiction account for some $10 billion in Federal, State, and 
11-79 

local government spending, or 70 percent of the $14.4 billion in total child welfare 

spending in 1995 (National Center, 1999). The National Center further estimates 

that hospital costs for newborns whose mothers abused illegal drugs amount to 

$360 million annually, and that yearly health care costs and related services for 

children and surviving adults who suffer from Fetal Alcohol Syndrome are $2 

billion. 

 In a report mandated by Congress and released in 1999, HHS identified 

various barriers to meeting the needs of child welfare clients with substance abuse 

problems, including the different perspectives and philosophies of the substance 

abuse treatment and child welfare fields. For example, differences exist with regard 

to the definition of “client,” the establishment of reasonable expectations for 

outcomes and timetables, and responses to setbacks in treatment. Additional 

barriers cited by HHS include certain Federal and State laws, the crisis environment 

affecting many child welfare agencies, shortages of substance abuse treatment 

facilities, the particular shortage of services appropriate for women with children, 

and confidentiality requirements. HHS identified certain key features as important 

components of a comprehensive approach to addressing joint substance abuse and 

child maltreatment problems, including preventative services for children, training 

for caseworkers, enhanced risk assessment and referral capacity, increased access to 

substance abuse treatment, client retention, recognition of the importance of 

permanency for children, and support for ongoing recovery. 

KINSHIP CARE 

 The number of children living with relatives who are not their parents has 

increased in recent years, especially among minority populations. According to the 

Urban Institute’s most recent National Survey of America’s Families, 2.3 million 

children lived with relatives – apart from their parents – in three different types of 

arrangements in 2002: 76 percent in “private” kinship care, where the family made 

the arrangement with no involvement by a social services agency or court; 6 percent 

in “voluntary” kinship care, where a social services agency helped place the child 

with relatives but the court was not involved; and 17 percent in kinship “foster” 

care, where the child was formally placed with relatives by a social services agency 

with approval of the court (Urban, 2003). However, of the more than half million 

children identified in this survey as having been placed in kinship care with the 

involvement of social service agencies (including more than 405,000 with court 

involvement), it appears most do not enter State-supervised foster care. On the last 

day of fiscal year 2001, an estimated 131,000 children lived in State-supervised 

kinship fostercare (Ehrle, Geen and Main). Grandparents were the caregivers for 

more than half of kinship children (59 percent), and more than half of the children 

were minorities (43 percent African-American and 17 percent Hispanic). Slightly 

more than half (52 percent) of the children were age 11 or older, and almost half (46 

percent) lived in the South. Kinship children often lived with families with modest 

means (52 percent had incomes below 200 percent of the Federal poverty level), 

with a single caregiver (54 percent), and with caregivers over age 50 (52 percent). 
11-80 

Almost a quarter of kinship children lived with caregivers who lacked a high school 

degree. 

 The Census Bureau also recently released data on grandparents living with 

their grandchildren, obtained from questions added to the 2000 Census in response 

to a congressional directive in the 1996 welfare reform law (Public Law 104-193) 

(U.S. Census, 2003). Census found 5.8 million “coresident” grandparents (i.e., 

grandparents living with their minor grandchildren), of which 2.4 million were 

“grandparent caregivers” or people with primary responsibility for their 

grandchildren. Of these grandparent caregivers, 39 percent had been caring for 

their grandchildren for five or more years. Among black grandparents living with 

their grandchildren, 52 percent were the primary caregiver, while 42 percent of 

white coresident grandparents were their grandchildren’s primary caregiver. 

Hispanic coresident grandparents (of any race) were least likely to be primary 

caregivers (35 percent). Younger grandparents (under age 60) were more likely to 

be primary caregivers than those age 60 or more; half of coresident grandparents 

under age 60 were primary caregivers, compared with 31 percent of those age 60 or 

older. The majority of coresident grandparents (64 percent) were women, and 19 

percent of grandparent caregivers were poor. 

 Looking specifically at kinship foster care, the Urban Institute surveyed 

foster care administrators in 1999 to obtain information on State policies and found 

considerable variation among States (Urban, 2000). Almost all States gave 

preference to relatives over nonrelative foster care providers, and actively sought 

out relatives as preferred placements. However, States defined “kin” differently, 

with 23 States and the District of Columbia limiting the definition to those related 

by blood, marriage or adoption, while 21 States have more expansive definitions 

and six States have no formal definition. Licensing policy also varied among 

States, particularly with regard to the stringency of requirements applied to relative 

caregivers. According to a 2001 survey conducted by the Urban Institute, 15 States 

required kinship caregivers to meet the same licensing standards as nonrelative 

foster parents, 23 States waived certain licensing standards (typically training) for 

kinship caregivers, and 20 States (including 7 of those that waive standards) have a 

separate licensing process for relative caregivers that is less stringent than the 

process for non-relatives (Urban, 2002). All States provide full foster care 

payments to relatives who are licensed under the same standards that apply to nonrelative foster care providers. However, most States do not provide a full foster 

care payment to relatives who meet less stringent criteria that are developed 

specifically for kinship caregivers. In some cases, these families may be eligible for 

Temporary Assistance for Needy Families (TANF) benefits. 

 The U.S. General Accounting Office (GAO) reported in 1999 on quality and 

permanency issues raised by kinship care. Looking at open foster care cases in 

California and Illinois, as of September 1997, GAO found the quality of kinship 

care and other foster care was good and the experiences of children in both types of 

settings were comparable. GAO's review confirmed the generally held view that 

children in kinship care have more stability than children in other forms of foster 

care, but also found that caseworkers had somewhat less confidence that kinship 
11-81 

care givers would enforce court-ordered restrictions on parental visits with their 

children. In addition, the two States held kinship caregivers to somewhat lower 

standards than other foster parents and provided a lower level of support to these 

families as well. Kinship care children in California spent about the same length of 

time in foster care as other foster children, while kinship care children in Illinois 

spent significantly less time in the system, according to GAO. 

 More recently, HHS released a report to Congress on kinship care in 

response to a mandate in the 1997 Adoption and Safe Families Act (U.S. 

Department, 2000b). The report included a research review, and also identified the 

following principles to guide policy discussions on kinship care: the child welfare 

system should continue to focus on safety, permanency, and well-being of children; 

kinship placement decisions should be based on the best interests of the child; the 

child welfare system should not supplant family efforts or income assistance 

programs; and relatives should be viewed as potential resources but should be 

assessed on a case-by-case basis. 

WELFARE REFORM 

 Congress enacted landmark welfare reform legislation in 1996, the Personal 

Responsibility and Work Opportunity Reconciliation Act (Public Law 104-193), 

which has been of great interest to child welfare practitioners, researchers, and 

policymakers because of its potential implications for the child welfare system and 

its clients. The 1996 law replaced the 61-year-old program of Aid to Families with 

Dependent Children (AFDC) with a State-administered block grant of Temporary 

Assistance for Needy Families (TANF). Receipt of public assistance now is time 

limited and conditioned on participation in work activities (see section 7). 

 The 1996 legislation had an immediate programmatic impact on child 

welfare agencies because of the legal connection between AFDC eligibility and title 

IV-E foster care and adoption assistance. As explained earlier, the law now limits 

title IV-E funding to those children who would have been eligible for the former 

AFDC Program as it existed on July 16, 1996. Thus, States must maintain these 

eligibility criteria, even though AFDC has been repealed, for use in determining 

title IV-E (and Medicaid) eligibility. Some analysts have observed that over time, 

these eligibility criteria could erode in value and the number of foster and adoptive 

children for whom States can claim Federal reimbursement may decrease. 

 The financing of welfare reform also has potential implications for child 

welfare. The law replaced an open-ended entitlement program with a capped block 

grant, while allowing foster care and adoption assistance under title IV-E to remain 

uncapped. There is overlap between the populations served by TANF and title IVE, raising the possibility that States might have an incentive to shift expenditures 

from TANF to the open-ended title IV-E program, particularly for kinship care 

families who might be able to meet Federal title IV-E eligibility criteria. Despite 

such apparent incentives, a third of children receiving TANF benefits in fiscal year 

2001 were “child-only” cases (see section 7), which means the adult in the 

household was not part of the assistance unit. In about two-thirds of these cases, the 
11-82 

adult was a parent who was not eligible for TANF benefits because of immigration 

status or another reason, but slightly more than 30 percent of these children were 

living with grandparents or other relatives without their parents present in the 

household. Both welfare and child welfare analysts are particularly interested in the 

dynamics of this population and the extent to which these children and families 

resemble those in formal kinship foster care arrangements. 

 Beyond these issues, child welfare professionals are closely watching the 

implementation of welfare reform to determine its impact on the well-being of 

children and families, especially as measured through changes in the incidence of 

child maltreatment or entry into foster care. Although relatively few welfare 

families ever come into contact with the child welfare system, a disproportionately 

large share of child welfare clients receive or have received cash assistance. Thus, 

changes in welfare programs that affect a small percentage of clients may have a 

significant impact on the size of the child welfare population and the workload of 

the child welfare system. HHS reported on the interaction between welfare 

assistance (specifically, receipt of AFDC), Medicaid, and foster care prior to 

enactment of welfare reform (U.S. Department, 2000a). Using administrative data 

from California, Illinois, and North Carolina in 1995-96, HHS found that less than 3 

percent of children who entered AFDC during the study period were subsequently 

placed in foster care. However, about 60 percent of the foster care entries in the 

three States during the study period were from AFDC families. 

 Numerous evaluations have been conducted or are underway on the impact 

of welfare reform on various outcomes, including the transition of welfare 

recipients to work, the family formation patterns of welfare recipients, the economic 

status of families receiving or formerly receiving welfare, and the behavior and 

well-being of children and adolescents (see appendix L). 

 Some research also has attempted to identify the impact of various welfare 

policies on specific child welfare outcomes. For example, a comparative analysis of 

State-level data from 1990-1998 suggests that certain welfare policies, including 

benefit size and work requirements, may affect child maltreatment rates and/or outof-home placement rates for children (Paxson and Waldfogel, 2001). This study’s 

researchers reported that more generous welfare benefits are associated with 

significantly lower levels of neglect and smaller numbers of children in out-of-home 

care. (Or conversely, reduced benefits are associated with higher levels of neglect 

and larger numbers of out-of-home placements.) These researchers also reported 

that family cap policies, which typically mean that a family’s benefit is not 

increased for an infant born 10 months or more after the family begins to receive 

cash aid, are associated with lower numbers of substantiated cases of maltreatment 

but increased numbers of out-of-home placements. 

 An experimental study in Delaware suggests a connection between strong 

work requirements and increased levels of child neglect (Fein and Lee, 2000). The 

Abt Associates evaluation of Delaware’s pre-TANF waiver program found higher 

rates of neglect (after three years) among families that were subject to strong work 

requirements and time-limited benefits (as compared to those subject to the old cash 

aid program). However, researchers who used administrative data to study the 
11-83 

effect of welfare reform on the incidence of child maltreatment among Illinois 

children entering AFDC/TANF found a decline in reported child maltreatment after 

enactment of Federal welfare reform (Goerge and Lee, 2000). For children who 

received cash benefits in the years 1994-1996 (during which Illinois instituted a 

Work Pays program to encourage employment among adult welfare recipients), the 

incidence of reported child maltreatment one year after first receiving cash benefits 

remained stable. But for children who first received cash aid in 1997 – after 

Federal welfare reform was enacted – there was a 10 percent decrease in 

substantiated maltreatment cases. 

 A study comparing Utah families who left TANF because of sanctions to 

those who left for other reasons found the sanctioned families were no more likely 

than non-sanctioned families to have a child welfare case opened at some time 

within three years after their cash aid ended (Derr & Cooley, 2002). Both groups 

had relatively high involvement with the child welfare system, however, and among 

families with child welfare involvement, those that had been sanctioned were much 

more likely to have been found without adequate resources to support their families 

and to have an open child welfare case at the end of the three years. 

NATIONAL FOSTER CARE AND ADOPTION INFORMATION 

DATA COLLECTION SYSTEMS 

 Historically, there has been a lack of reliable data on foster care and adoption. 

In fact, not every State even reported its average monthly foster care caseload under 

the federally assisted program until 1975. Moreover, before 1980 States were not 

required to collect data on nonfederally-assisted foster care, which in a typical State 

constitutes about half the cases in foster care. This lack of data was one of several 

concerns that Congress hoped to address with enactment of the Adoption Assistance 

and Child Welfare Act of 1980 (Public Law 96-272). 

 The 1980 law imposed several requirements on States as a condition for 

incentive funds under the Title IV-B Child Welfare Services Program, including a 

one-time inventory of children in foster care and a statewide information system for 

tracking children in foster care. HHS issued a policy information question (ACYFPIQ-82-06) which restated the law's requirement that States have an information 

system, but did not specify the system's content. Final regulations were never 

issued. 

 Starting in 1982, HHS funded the American Public Human Services 

Association (APHSA, formerly the American Public Welfare Association) to 

conduct a voluntary annual survey of States, known as the Voluntary Cooperative 

Information System (VCIS). Until the mid-1990s, VCIS was the only source of 

national data on the number and characteristics of children in foster and adoptive 

care. However, the VCIS was of limited use for several reasons: (1) not all States 

participated fully in the survey; (2) reporting periods were not consistent among 

States; (3) there was a serious time lag between data collection and publication; and 

(4) data were available only in an aggregated, State-specific format, preventing the 

type of analysis that could be conducted with case-specific data. 
11-84 

 In response to the need for better data collection, Congress in 1986 approved 

an amendment to title IV-E (section 479) requiring that an advisory committee be 

established and submit a report to Congress and HHS with recommendations for 

establishing, administering, and financing a system for collecting data on adoption 

and foster care. The advisory committee submitted its final report in 1987, and in 

May 1989, HHS submitted an implementation plan to Congress. On September 27, 

1990, HHS proposed regulations to implement the data collection system known as 

the Adoption and Foster Care Analysis and Reporting System (AFCARS). The 

population to be covered was children under the responsibility of the State child 

welfare agency and financing was to come from the title IV-E administrative cost 

match. States were to claim only that portion of their costs that related to children 

eligible for title IV-E, although the system would have required States to collect 

data on non-IV-E children as well. 

 In 1993, as part of the Omnibus Budget Reconciliation Act (Public Law 103-

66), Congress authorized an enhanced Federal matching rate to States for certain 

costs related to data collection for fiscal years 1994-96. Welfare reform legislation 

enacted in 1996 (Public Law 104-193) extended this enhanced match through fiscal 

year 1997. The statute specified that this enhanced match of 75 percent was 

available for costs of planning, design, development and installation of statewide 

mechanized data collection and information retrieval systems, including costs of 

hardware, as long as the systems did the following: complied with HHS regulations; 

to the extent practicable, interfaced with State child abuse and neglect data 

collection systems and with AFDC (now TANF) data collection systems; and 

provided more efficient, economical, and effective administration of State child 

welfare programs, as determined by HHS. The law also provided that ongoing 

operational costs of State data collection and information retrieval systems would 

be matched at the 50 percent Federal rate available for administrative expenses 

under title IV-E. Further, the amendment specified that States may claim 

reimbursement for data collection systems without regard to whether they are used 

for foster and adoptive children who are not eligible for title IV-E assistance. 

 On December 22, 1993, HHS published: (1) interim final rules for Statewide 

Automated Child Welfare Information Systems (SACWIS), issued in response to 

enactment of Public Law 103-66; and (2) final rules implementing AFCARS. Under 

the interim final rules for SACWIS, States were required to develop 

“comprehensive”' child welfare data collection systems, of which AFCARS must be 

a component, in order to qualify for Federal funding, including the 75 percent 

enhanced match. According to HHS, “comprehensive” means that a State SACWIS 

system must include child welfare services, foster care and adoption assistance, 

family preservation and support services, and independent living. 

 State SACWIS systems must do the following, at a minimum: 

1. Meet the AFCARS data collection and reporting requirements; 

2. Provide for intrastate electronic data exchange with data collection 

systems operated under TANF, Medicaid, child support 

enforcement, and the National Child Abuse and Neglect Data 

System (NCANDS) (unless not practicable for certain reasons); 
11-85 

3. Provide for automated data collection on all children in foster care 

under the responsibility of the State child welfare agency to 

support implementation of statutory child protections and 

requirements; 

4. Collect and manage information necessary to facilitate delivery of 

child welfare services, family preservation and family support 

services, family reunification services, and permanent placement; 

5. Collect and manage information necessary to determine eligibility 

for the Foster Care, Adoption Assistance, and independent living 

programs and to meet case management requirements for these 

programs; 

6. Monitor case plan development, payment authorization and 

issuance, and review and management including eligibility 

determinations and redeterminations; and 

7. Ensure confidentiality and security of information. 

 In addition, optional SACWIS functions could include (if cost-beneficial) 

resource management, tracking and maintenance of legal and court information, 

administration and management of staff and workloads, licensing verification, risk 

analysis, and interfacing with other automated information systems. 

 Under the final AFCARS rules, States are required to collect case-specific 

data on all children in foster care for whom the State child welfare agency has 

responsibility for placement, care, or supervision, regardless of their eligibility for 

title IV-E. Further, States are required to collect data on all adopted children who 

were placed by the State child welfare agency, and on all adopted children for 

whom the State provides adoption assistance (ongoing payments or for nonrecurring 

expenses), care, or services either directly or by contract with other private or public 

agencies. States must report data to HHS twice a year. 

 Table 11-22 shows the status of State SACWIS projects as of November 

2003. 

TRENDS IN FOSTER CARE CASELOADS 

 The incidence of all children in the United States who are in foster care has 

increased from 3.9 per 1,000 in 1962 to an estimated 7.1 per 1,000 in 2001, 

although the 2001 incidence rate is a decline from the estimated peak of 7.5 per 

1,000 in 1999. The incidence of children in foster care fluctuated during the 1960s 

and 1970s, although it was the same (3.9 per 1,000) in 1982 as it was 20 years 

earlier. From 1982 to 1999, the incidence rose steadily each year, and sometimes 

climbed sharply. For example, in the 2 years between 1987 and 1989, the incidence 

rose from 4.5 per 1,000 to 5.6 per 1,000. The incidence of children in foster care 

declined in both 2000 and 2001 (see Table 11-23). 
11-86 

TABLE 11-22 - STATUS OF DEVELOPMENT OF STATEWIDE 

AUTOMATED CHILD WELFARE INFORMATION SYSTEMS (SACWIS), 

NOVEMBER 2003 

Status of SACWIS States 

Operating (28) 

Arizona, Arkansas, California, Colorado, Connecticut, Delaware, 

District of Columbia, Idaho, Indiana, Iowa, Kentucky, Maine, 

Massachusetts, Minnesota, Montana, Nebraska, Nevada, New 

Hampshire, New Mexico, Oklahoma, Rhode Island, South Dakota, 

Texas, Utah, Virginia, Washington, West Virginia, Wyoming 

Partially Operating (10) Alabama, Florida, Illinois, Michigan, Mississippi, New York, Oregon, 

South Carolina, Tennessee, Wisconsin 

Implementing (2) Alaska, Maryland 

Planning (7) Georgia, Kansas, Louisiana, Missouri, New Jersey, Ohio, Pennsylvania 

No SACWIS activity (4) Hawaii, North Carolina, North Dakota, Vermont 

Source: Table prepared by the Congressional Research Service based on information received from 

the U.S. Department of Health and Human Services 

 The number of children in federally-assisted foster care has grown 

significantly in the years since funding first became available under AFDC in the 

early 1960s. The number grew from 1962 to 1976, then decreased from 1976 to 

1983. Between 1983 and 1998, the number of foster care children funded under title 

IV-E increased steadily, but has declined in each year from 1999 to 2001 (Table 11-

23). 

TABLE 11-23 -- U.S. FOSTER CARE AND IV-E FOSTER CARE 

POPULATIONS AND FOSTER CARE INCIDENCE IN U.S. 

POPULATION AGES 0-18, 1962-2001 

Year US foster care population 

(end of fiscal year)P

1

P

IV-E foster care children 

(average monthly number)P

2

P

U.S. foster children per 

1,000 in U.S. population 

ages 0 through 18P

3

P

1962 272,000 989 3.9 

1963 276,000 2,308 3.9 

1964 287,000 4,081 4.0 

1965 300,000 5,623 4.1 

1966 309,400 7,385 4.2 

1967 309,600 8,030 4.2 

1968 316,200 8,500 4.3 

1969 320,000 16,750 4.3 

1970 326,000 34,450 4.4 

1971 330,400 57,075 4.5 

1972 319,800 71,118 4.4 

1973 NA 84,097 NA 

1974 NA 90,000 NA 

1975 NA 106,869 NA 
11-87 

TABLE 11-23 -- U.S. FOSTER CARE AND IV-E FOSTER CARE 

POPULATIONS AND FOSTER CARE INCIDENCE IN U.S. POPULATION 

AGES 0-18, 1962-2001-continued

Year US foster care population 

(end of fiscal year)P

1

P

IV-E foster care children 

(average monthly number)P

2

P

U.S. foster children per 

1,000 in U.S. population 

ages 0 through 18P

3

P

1976 NA 114,962 NA 

1977 NA 110,494 NA 

1978 NA 106,504 NA 

1979 NA 103,771 NA 

1980 302,000 100,272 4.4 

1981 274,000 104,851 4.1 

1982 262,000 97,309 3.9 

1983 269,000 93,360 4.0 

1984 276,000 102,051 4.1 

1985 276,000 109,122 4.1 

1986 280,000 110,749 4.2 

1987 300,000 118,549 4.5 

1988 340,000 132,757 5.0 

1989 387,000 156,871 5.6 

1990 400,000 167,981 5.9 

1991 414,000 202,687 6.0 

1992 427,000 223,315 6.1 

1993 445,000 231,100 6.3 

1994 468,000 245,000 6.6 

1995 483,000 260,800 6.7 

1996 507,000 273,600 7.0 

1997 537,000 289,400 7.3 

1998 559,000 305,194 7.3 

1999 567,000 302,422 7.4 

2000P

4

P 552,000 287,824 7.1 

2001P

4

P 543,000 264,670 7.0 

P

1

P

 Data from Child Welfare Research Notes #8 (July 1984), published by the Administration for 

Children, Youth and Families at the U.S. Department of Health and Human Services for 1962-

1980; the American Public Human Services Association for 1981-1995 data, and the U.S. 

Department of Health and Human Services for 1996-2001 data. Caseload data from Puerto Rico 

is included beginning with 1998. 

P

2 P

Incomplete data based on voluntary reporting to the Department of Health, Education and 

Welfare, prior to 1975. 

P

3

P

 Based on data from U.S. Census Bureau, Population Division, unpublished data (1962-80); U.S. 

Bureau of Census, Current Population Reports, Series 1095 (1980-89), PPL-41 (1990-95), 1130 

(1996-97), and U.S. Bureau of Census, Population Division, “Intercensal Estimates of the United 

States Resident Population by Age and Sex, 1990-2000: All Months” (1998-2001 – estimate as of 

April 1 used for each year, except that April 1, 2000 data was used for both 2000 and 2001). For 

1998 and later years, Puerto Rico is not included in calculation of the incidence rate. 

P

4

P

 Data are subject to revision and are therefore estimates. 

NA - Data are not available. 

Source: Compiled by staff of the House Committee on Ways and Means and the Congressional 

Research Service. 
11-88 

Multistate data on caseload trends 

 More detailed information is available on trends in foster care caseloads 

through the Multistate Foster Care Data Archive at the Chapin Hall Center for 

Children. Using State administrative data, Chapin Hall has conducted analyses of 

foster care dynamics from 1983 through 2001. The most recent analysis, looking at 

trends between 1990 and 2001, is based on data from nine States: Alabama, 

California, Illinois, Maryland, Michigan, Missouri, New Jersey, New York, and 

Ohio (Chapin Hall, 2003). (Additional States have participated in the archive, but 

only the above States are included in the following discussion. Moreover, 

California data on exits from foster care were excluded from the analysis discussed 

below because of a change in their information system.) In general, Chapin Hall 

has reported in recent years that caseload growth has become more a function of 

longer lengths of stay and changes in the composition of the caseload, rather than 

the marked increases in admissions that characterized the late 1980s. 

 Chapin Hall found that caseload growth in the late 1980s coincided with a 

change in the age distribution of children entering the system for the first time, with 

a dramatic increase in infants and a decrease in adolescents. Infants remain the 

single largest group of children entering care; however, the proportion of children 

entering care who were under age 1 decreased from nearly 25 percent in 1990-1993 

to 20 percent for children entering in 1998-2001. Children entering as infants had 

incidence rates (per 1,000 children) that were four to five times higher than children 

ages 1-17; likewise, regardless of age, children entering care in primary urban areas 

had higher incidence rates than children in other areas. Looking at age, race or 

ethnicity, and children’s geographic location, Chapin Hall researchers found 

African-American infants in primary urban areas had the highest incidence of foster 

care and the greatest likelihood of entering foster care. Looking at types of 

placement, Chapin Hall found that 47 percent of first placements were with nonrelatives in 1994, increasing to 58 percent of first placements for children who 

entered in 2000. About 21 percent of first placements were in congregate care 

throughout the period from 1990-2001, while kinship care rose from 23 percent of 

first placements in 1990 to 25 percent in 1994, but since declined to 20 percent in 

each of 2000 and 2001. 

 To further understand the dynamics of State foster care caseloads, Chapin 

Hall examined the length of time that children remained in care during their first 

spell and found that a quarter of the children, regardless of their year of entry, had 

completed their first spell (i.e., exited from the system) within the first 4 months of 

placement. However, first spells had lengthened over time, with 25 percent of 

children who entered care in 1990 having completed their first spell in less than 

3 months. Again, regardless of their year of entry, half of the children completed 

their first spell within 13 to 16 months, and, between 1994 and 1999, the length of 

time required for 75 percent of children to complete their first spell decreased from 

almost 45 months to less than 32 months. Researchers found that children who 

entered foster care from primary urban areas had longer initial spells than children 

from other areas; children entering as infants also had significantly longer initial 

spells than older children; and African-American children had longer spells than 
11-89 

children of other races or ethnicities. Children placed in kinship care stayed longer 

than children in non-relative foster care, and children in congregate care had shorter 

spells than children in other types of placements. 

 Children who entered the system as infants had the highest rates of adoption, 

with the likelihood of adoption decreasing each year after the first birthday. 

Children who entered at age 14 or older were less likely than younger children to 

exit through family reunification, and the likelihood of exiting to the home of a 

relative decreased for children who entered care at age 8 or older. White and 

Hispanic children who left care were more likely to be reunified with their families 

than African-American children, who in turn were more likely to be adopted or exit 

to the home of a relative. Finally, Chapin Hall researchers looked at children who 

reentered foster care within 2 years of exiting, and found that children with longer 

initial spells in care were less likely to reenter care than those with shorter initial 

spells. Infants were least likely to reenter, and children who entered care between 

the ages of 6 and 17 were the most likely to reenter. Children discharged from 

congregate care had the highest rates of reentry within 2 years, while children 

discharged from kinship care had the lowest rates. 

Circumstances of foster children at one year after entry 

 As discussed earlier, the 1996 welfare reform law authorized a national 

longitudinal study of children at risk of abuse or neglect or identified as victims, 

and HHS responded by establishing the National Survey of Child and Adolescent 

Well-Being (NSCAW). In October 2003, the first NSCAW report on individual 

case-level data was released, providing information on 700 children who had been 

in foster care for one year (HHS, 2003). These children are a subset of the total 

NSCAW population of more than 6,200 children who have come in contact with the 

Nation’s child welfare system. 

 Researchers found that the majority of children at one year after entry into 

foster care were 6 years old or older (32 percent were between ages 6 and 10, and 

27 percent were 11 or older), 24 percent were between 1 and 2 years old, and 

17 percent were between the ages of 3 and 5. The single largest group of children 

were African-American (45 percent); 31 percent were white; and 17 percent were 

identified as Hispanic. 

 Neglect was identified as the most serious form of maltreatment for 

60 percent of the children in this cohort. Physical abuse was identified as the most 

serious form of maltreatment for 10 percent of the children; sexual abuse for 

8 percent; emotional, moral/legal, or education abuse, or abandonment for 

14 percent of the children; and 8 percent entered foster care for reasons other than 

abuse or neglect, such as domestic violence, or access to mental health services. 

 At one year in foster care, 44 percent of the children were in non-relative 

foster homes, and 24 percent were in kinship foster care. Another 7 percent were in 

group homes or residential placements, and about a quarter of the children had 

actually gone home by the time of their interview. Researchers attributed this last 

result to the likelihood of a timely one-year permanency review that resulted in 

reunification. 
11-90 

 Caregivers reported that more than a quarter of the children had lasting or 

recurring physical or mental health problems, and assessments of the children’s 

developmental functioning showed scores marginally below the norm on almost all 

measures. Researchers suggested this last finding might also result from the high 

likelihood that the children came from poor backgrounds. Children generally 

showed low social skills, low daily living skills, and a high degree of behavior 

problems. 

 The majority of caregivers (62 percent) were age 40 or older, with kinship 

caregivers more likely to be 60 or older and caregivers in group homes more likely 

to be under 40. Racially, caregivers generally matched the children; 42 percent 

were African-American, 36 percent were white, and 15 percent were Hispanic. 

Somewhat less than half (45 percent) of caregivers were single and somewhat more 

than half (53 percent) were married, and more than half (56 percent) had no 

education beyond high school. A little over a third (36 percent) did not work; the 

remainder worked full or part-time. Almost half had fewer than three years 

experience as a foster parent, although non-relative caregivers had more experience 

than kin. 

 At one year after entry into foster care, children age 6 or older generally 

reported that they liked the people they were living with (90 percent) and felt like 

part of the family (92 percent), though about 11 percent had attempted to run away. 

Half the children wanted their current placement to become their permanent home; 

however, 58 percent believed they would live with their parents again and more 

than half of the children wanted to see their parents more often. Children in group 

homes were less happy with their placements than children in family foster care, 

and children in kinship care reported more contact with their parents and were less 

likely to have attempted to run away. 

 Child welfare workers reported the most common risk factor at the time of 

placement was the lack of a second supportive caregiver in the family. Workers 

referred biological parents most often to Medicaid for services, with income 

assistance, child care, mental health and substance abuse services also frequently 

needed by families. Almost a quarter of the children had received some type of 

“specialty” mental health service during their year in foster care, with children in 

group care and white children more likely to receive such services. About a third 

(36 percent) of children with clinical or borderline test scores on at least one 

standardized test received special education, although most of these children 

(92 percent) received special education or supplementary services, such as 

assessment, tutoring or counseling. 

 Of children in foster care for one year, about a quarter had a permanency plan 

of family reunification, while another quarter had already returned home, as noted 

above. Reunification efforts had been made at some time during the year for 

84 percent of children whose permanency goal was not reunification at the one-year 

point. Only about 8 percent of children had never had a reunification plan. 

Children whose most serious type of maltreatment was “failure to supervise” were 

more likely to have a current reunification plan than children who had suffered from 

“failure to provide.” Among children who had not yet gone home, children in 
11-91 

group care were more likely to have reunification plans than children in kinship 

foster care. In addition, most foster parents (68 percent) had considered adopting 

their foster child, assuming adoption became an option for the child. 

 Unlike caregivers, child welfare workers were relatively young, with more 

than half under age 40. Almost half (46 percent) were white, 32 percent were 

black, 11 percent were Hispanic, and 12 percent identified themselves as “other.” 

About 60 percent of workers had a bachelor’s degree, with 40 percent of those in 

social work. Another 20 percent had a master’s in social work, and 16 percent had 

a master’s in another field of study. 

NATIONAL DATA ON FOSTER CARE AND ADOPTION 

 As described earlier, States now are required to participate in a mandatory 

data collection system known as AFCARS. Tables 11-24 through 11-48, below, 

present national and State AFCARS data on the following: (1) total numbers of 

children in foster care, including numbers of children entering and exiting the 

system; (2) characteristics of children in foster care and conditions of their 

placement; (3) characteristics of foster children who are awaiting adoption; and (4) 

number and characteristics of children who have been adopted through the public 

child welfare system, including their relationship with their adoptive parents. 

 Over the years, States have made great strides in collecting, analyzing and 

submitting child welfare data to the Federal Government for inclusion in AFCARS. 

Nonetheless, State capacity to collect and report valid data in a nationally consistent 

format continues to be a challenge. As States transition from older, 

payment-focused systems to more comprehensive, child-focused systems, they face 

difficult implementation decisions, while also addressing such issues as training 

workers, revising manuals, and synchronizing paper and automated information 

systems. Many States have been and continue to be engaged in the development and 

implementation of SACWIS. The construction of a SACWIS normally requires 

sequential stages of development; i.e., planning, design, development, and 

implementation. Until a State's SACWIS is fully utilized by staff, operational 

statewide, and all programming errors have been corrected, care should be 

exercised in utilizing their data (see Table 11-22 for the status of individual States' 

SACWIS development). 

 This year’s Green Book contains numerous expanded tables that provide State 

AFCARS data on a single item across three years. HHS has indicated that child 

welfare data reported by States have improved in each of these years and readers 

are advised to keep this in mind as they compare information across these years. 

HHS provides ongoing technical assistance to States to promote continued 

improvement of AFCARS data reports, (and child abuse data reported in 

NCANDS), and to assist States in implementing SACWIS systems. This technical 

assistance includes services provided by the National Resource Center for 

Information Technology in Child Welfare. 
11-92 

Number of children in foster care

 Table 11-24 illustrates the “flow” of children through the foster care system 

in 1982-2001; i.e., the number of children in care at the start of each year, the 

number who entered or exited foster care during the course of the year, the total 

number of children served during the year, and the number of children who 

remained in care at the end of the year. These numbers indicate steady increases in 

the foster care population that were most dramatic in the late 1980s and that 

continued until 2000 and 2001; declines occurred in both those years (also see chart 

11-2). It should be remembered that these data reflect the total foster care 

population and are not limited to those children receiving subsidies under title IV-E. 

For State-by-State estimates of the percent of title IV-E eligible children, see 

Table 11-7. 

 

TABLE 11-24 -- NUMBER AND MOVEMENT OF SUBSTITUTE CARE 

CHILDREN, FISCAL YEARS 1982-2001 

[In thousands]

 Start of year Entered care Total served Left care End of year 

1982 273 161 434 172 262 

1983 263 184 447 178 269 

1984 272 184 456 180 276 

1985 270 190 460 184 276 

1986 273 183 456 176 280 

1987 280 222 502 202 300 

1988 312 199 511 171 340 

1989 347 222 569 182 387 

1990 379 238 617 217 400 

1991 400 224 624 210 414 

1992 414 238 652 225 427 

1993 427 230 657 212 445 

1994 444 254 698 230 468 

1995 455 255 710 227 483 

1996 488 237 725 218 507 

1997 507 251 758 231 537 

1998 527 299 817 257 559 

1999 559 293 818 250 567 

2000 567 293 824 272 552 

2001 552 295 811 269 543 

Source: Congressional Research Service based on data provided by the American Public Human 

Services Association (1982-96) and the U.S. Department of Health and Human Services (1997-

2001). 
11-93 

 

CHART 11-2--CHILDREN IN SUBSTITUTE CARE, END OF YEAR, 

 1985-2001 

543,000

552,000

567,000

559,000

537,000

483,000

445,000

414,000

387,000

300,000

276,000

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Total 

Entries

Exits

Source: Figure prepared by Congressional Research Service (CRS) based on data from the American 

Public Human Services Association, 1985-1996 and the U.S. Department of Health and Human Services, 

Adoption and Foster Care Analysis Reporting System (AFCARS), 1997-2001. Data for FY2000 and 

FY2001 are interim and preliminary estimates, respectively, and are subject to change. 

 Table 11-25 shows the number of children who entered and exited care 

during fiscal years 1999, 2000, and 2001, and the total number of children in care 

on September 30 of each of those three years, by State. Table 11-26 lists the 

average monthly number of children in foster care, by State, who received Federal 

funding under title IV-E for the years 1993, 1997, 1999, and 2002. These figures 

are lower than AFCARS estimates of the total number of children in foster care 

because they do not include the substantial number of children who were not 

eligible for Federal funding (primarily because they were not from AFDC-eligible 

homes). 

Characteristics of children in foster care 

 Much of the data collected on children in foster care reflect three different 

groupings of children: children who entered foster care during the study period; 

children who left care during the study period; and children who remained in care 

on the last day of the study period. Table 11-27 presents data on the age 

composition of children in these three categories, for all States combined, in fiscal 

years 1999, 2000, and 2001; and Table 11-28 presents data, by State, on the ages of 

children who were in care on September 30, 2001. Table 11-29 shows the racial and 

ethnic composition of children in each category, for all States combined, in fiscal 

years 1999, 2000, and 2001, while Table 11-30 shows these data, by State, for 

children who remained in care on September 30 of 1999, 2000, and 2001. 
TABLE 11-25 -- NUMBER OF CHILDREN ENTERING AND EXITING CARE DURING FISCAL YEAR, AND 

NUMBER OF CHILDREN IN CARE ON SEPTEMBER 30, BY STATEP

1

P: FISCAL YEARS 1999-2001 

Entering Care Exiting Care In Care on September 3

State 

FY1999 FY2000 FY2001 FY1999 FY2000 FY2001 FY1999 FY2000 FY

Alabama 2,734 2,661 2,672 2,062 2,334 2,271 5,511 5,621 5,Alaska 1,180 1,096 999 732 913 996 2,248 2,193 1,

Arizona 4,372 4,644 4,542 4,853 5,056 4,496 7,034 6,475 6,Arkansas 2,489 3,542 3,347 2,160 3,679 3,244 2,919 3,045 2,California 43,587 45,685 45,176 39,156 50,112 44,096 117,937 112,807 107

Colorado 7,183 6,942 7,007 5,675 5,512 5,200 7,639 7,533 7,

Connecticut 3,098 2,763 2,713 2,169 2,368 1,943 7,487 6,996 7,Delaware 1,002 950 939 811 886 916 1,193 1,098 1,District of Columbia 1,231 775 822 659 315 390 3,466 3,054 3,Florida 21,118 18,765 18,673 8,117 15,510 17,061 34,292 36,608 32

Georgia 7,218 7,028 8,024 6,267 4,657 5,093 11,991 11,204 12Hawaii 1,683 1,929 2,193 1,634 1,682 1,920 2,205 2,401 2,Idaho 999 1,127 1,209 806 1,011 1,084 959 1,015 1,Illinois 7,756 6,582 6,587 13,904 11,608 9,507 38,975 32,079 28

Indiana 4,808 5,576 5,399 4,313 5,197 4,750 8,933 7,482 8,Iowa 5,343 5,620 5,829 5,443 5,414 5,712 4,854 5,068 5,Kansas 3,376 3,191 2,834 1,562 1,788 1,801 6,774 6,569 6,Kentucky 4,170 4,128 4,456 3,350 3,364 3,599 5,942 6,017 6,Louisiana 2,912 3,157 3,014 2,854 3,146 3,184 5,581 5,406 5,

Maine 1,014 1,052 1,047 535 721 715 3,154 3,191 3,

Maryland 3,936 3,928 3,662 2,933 3,110 3,064 13,455 13,113 12Massachusetts 7,368 7,381 7,174 7,749 6,392 6,636 11,169 11,619 11Michigan 10,929 10,707 12,283 6,740 7,802 8,312 20,300 20,034 20Minnesota 10,724 10,803 10,012 9,743 9,939 9,269 8,996 8,530 8,

Mississippi 1,750 2,005 1,923 1,676 1,726 1,670 3,196 3,292 3,

Missouri 6,341 7,216 7,268 5,304 5,509 5,749 12,577 13,181 13Montana 1,596 1,588 1,506 1,331 1,327 1,497 2,156 2,180 2,
Nebraska 2,806 3,134 3,350 2,100 2,514 2,636 5,146 5,674 6,

Nevada NA /2/ 673 707 NA /2/ 387 442 NA /2/ 1,615 1,

New Hampshire 522 484 534 401 491 468 1,385 1,311 1,New Jersey 4,768 4,654 5,433 4,178 4,109 4,607 9,494 9,794 10

New Mexico 1,829 1,780 1,887 1,691 1,716 1,754 1,941 1,912 1,New York 18,172 16,605 15,135 20,497 20,337 18,703 51,159 47,118 43North Carolina 5,391 5,458 5,301 4,317 4,481 5,239 11,339 10,847 10North Dakota 965 1,006 1,013 827 851 828 1,143 1,129 1,

Ohio 15,946 15,396 16,157 12,819 14,131 14,136 20,078 20,365 21Oklahoma 6,484 6,558 6,487 4,746 5,364 5,864 8,173 8,406 8,Oregon 4,818 4,675 4,537 4,558 4,563 4,587 9,278 9,193 8,Pennsylvania 13,299 12,235 12,420 12,419 11,926 11,730 22,690 21,631 21Puerto Rico 2,703 NA /2/ 3,254 1,510 NA /2/ 977 7,760 NA /2/ 8,

Rhode Island 1,403 1,409 1,493 1,018 1,348 1,227 2,621 2,302 2,South Carolina 2,923 3,172 3,405 2,853 3,137 3,107 4,545 4,525 4,South Dakota 1,308 1,441 1,357 1,106 1,042 1,173 1,101 1,215 1,Tennessee 5,968 5,480 5,667 3,481 4,370 5,089 10,796 10,144 9,Texas 8,938 9,869 10,680 8,200 7,989 8,858 16,326 18,190 19Utah 2,383 2,148 2,006 2,332 2,264 2,009 2,273 1,805 1,Vermont 750 788 697 722 684 581 1,445 1,318 1,Virginia 2,683 2,738 2,904 1,715 1,826 2,096 6,778 6,789 6Washington 7,369 7,590 7,273 7,376 7,129 6,438 8,688 8,945 9,West Virginia 2,151 2,392 2,234 1,973 2,256 2,340 3,169 3,388 3,Wisconsin 4,550 3,738 3,204 5,338 4,867 4,443 5,853 6,697 7,Wyoming 715 786 896 683 731 689 774 815 9

TotalP

2

P 288,761 285,050 289,341 249,398 269,591 264,196 564,898 542,939 540

P1

P State data shown are current as of May 1, 2003. 

P2

P Children in jurisdictions with insufficient data ("NA") are not included in this total and the total number of children shown in this Table may not m

the totals given in another Table. Source: U.S. Department of Health and Human Services. 
11-96 

TABLE 11-26 -- TITLE IV-E FOSTER CARE AVERAGE MONTHLY 

NUMBER OF CHILDREN, SELECTED FISCAL YEARS, 1993-2002 

Fiscal Year Percent Change State 

1993 1997 1999 2002 1993-2002 1999-2002 

Alabama 810 1,152 1,305 1,777 119.4 36.2 

Alaska 303 317 487 288 -4.9 -40.8 

Arizona 1,774 3,382 3,634 3,133 76.6 -13.8 

Arkansas 715 1,299 1,624 3,021 322.4 86.0 

California 48,928 71,042 78,222 58,747 20.1 -24.9 

Colorado 2,529 2,874 2,653 2,345 -7.3 -11.6 

Connecticut 1,482 3,192 4,528 1,996 34.7 -55.9 

Delaware 183 342 378 403 119.9 6.4 

District of Columbia 748 1,101 1,297 1,435 91.8 10.6 

Florida 4,191 6,545 8,842 8,345 99.1 -5.6 

Georgia 3,254 4,382 4,209 5,268 61.9 25.2 

Hawaii 326 1,172 1,101 1,182 262.6 7.4 

Idaho 225 375 510 542 140.7 6.3 

Illinois 11,514 30,668 28,592 19,628 70.5 -31.4 

Indiana 2,541 4,061 3,963 2,601 2.4 -34.4 

Iowa 1,502 2,197 2,810 1,560 3.9 -44.5 

Kansas 1,371 466 2,356 1,777 29.6 -24.6 

Kentucky 1,797 2,796 3,019 3,227 79.5 6.9 

Louisiana 2,824 3,850 2,908 3,060 8.4 5.2 

Maine 1,000 1,482 2,013 2,028 102.8 0.7 

Maryland 3,073 4,533 5,091 5,055 64.5 -0.7 

Massachusetts 7,839 7,910 7,340 4,212 -46.3 -42.6 

Michigan 8,672 8,609 9,338 8,258 -4.8 -11.6 

Minnesota 2,984 3,696 4,115 3,566 19.5 -13.3 

Mississippi 868 1,088 1,000 500 -42.5 -50.0 

Missouri 4,570 5,263 5,621 5,766 26.2 2.6 

Montana 557 782 950 767 37.7 -19.3 

Nebraska 1,291 1,549 1,477 1,047 -18.9 -29.1 

Nevada 620 759 1,345 769 24.0 -42.9 

New Hampshire 526 639 625 560 6.5 -10.4 

New Jersey 3,873 5,453 6,124 6,388 64.9 4.3 

New Mexico 875 869 1,183 1,340 53.1 13.3 

New York 53,475 42,679 38,049 25,173 -52.9 -33.8 

North Carolina 2,983 4,586 4,854 2,438 -18.3 -49.8 

North Dakota 402 504 486 512 27.2 5.2 

Ohio 6,546 7,849 4,936 5,450 -16.7 10.4 

Oklahoma 1,379 2,555 4,039 4,402 219.2 9.0 

Oregon 1,882 3,129 3,193 3,520 87.0 10.2 

Pennsylvania 14,760 14,816 15,054 13,485 -8.6 -10.4 

Puerto Rico P

1

P P

1

P 5,110 6,778 N/A 32.6 
11-97 

TABLE 11-26 -- TITLE IV-E FOSTER CARE AVERAGE MONTHLY 

NUMBER OF CHILDREN, SELECTED FISCAL YEARS, 1993-2002-

continued

Fiscal Year Percent Change State 

1993 1997 1999 2002 1993-2002 1999-2002 

Rhode Island 673 775 629 702 4.3 11.6 

South Carolina 1,652 1,695 1,146 1,914 15.9 67.0 

South Dakota 225 211 340 500 122.1 47.2 

Tennessee 6,533 6,269 6,327 5,647 -13.6 -10.8 

Texas 4,920 6,434 6,757 8,431 71.4 24.8 

Utah 454 771 730 707 55.7 -3.2 

Vermont 874 1,130 1,151 986 12.8 -14.4 

Virginia 2,100 3,266 3,260 4,137 97.0 26.9 

Washington 2,484 1,748 2,603 3,576 44.0 37.4 

West Virginia 1,017 1,949 823 956 -6.0 16.1 

Wisconsin 4,834 4,995 4,037 3,796 -21.5 -6.0 

Wyoming 97 198 242 312 221.1 28.7 

Total 231,056 289,405 302,422 254,004 9.9 -16.0 

P

1

P

 Puerto Rico did participate in Title IV-E foster care until fiscal year 1999. 

Note-Totals may not add due to rounding. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 
TABLE 11-27 -- AGES OF CHILDREN ENTERING AND EXITING CARE DURING FISCAL YEAR, AND IN 

ON SEPTEMBER 30, FISCAL YEARS 1999-2001 

[In percentP

1

P] 

Entering Exiting In Care Sept. 30 

Age Range FY1999 FY2000 FY2001 FY1999 FY2000 FY2001 FY1999 FY2000 

Under 1 year 13 13 13 4 4 4 4 4 1-5 years 25 25 25 26 26 27 25 24 6-10 years 22 21 21 23 23 23 26 25 11-15 years 29 29 29 24 24 24 28 29 16-28 years 11 11 11 21 21 20 16 16 19 years or older 0 0 0 2 2 2 2 2 Mean age ( in years) 8.6 8.6 8.6 10.3 10.2 10.1 9.9 10.0 Median age (in years) 8.6 8.8 8.7 10.3 10.2 10.2 10.1 10.4 P1

P Percent totals may not equal 100 due to rounding. 

Source: U.S. Department of Health and Human Services. 
11-99 

TABLE 11-28 -- AGES OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATE 

[In percent; 539,691 total cases] P

1

P

Age in Years State 

Under 1 1-5 6-10 11-15 16-18 19 and over

Mean 

Years 

Median 

Years 

Alabama 4 23 23 31 17 2 10.4 11.0 

Alaska 4 31 29 27 9 1 8.8 8.6 

Arizona 5 26 21 30 16 1 9.8 10.4 

Arkansas 4 24 21 31 19 1 10.3 11.2 

California 4 22 25 30 18 2 10.4 10.9 

Colorado 4 20 19 33 22 1 11.0 12.5 

Connecticut 3 22 25 33 16 2 10.6 11.2 

Delaware 4 20 21 30 25 0 11.1 12.3 

District of Columbia 2 19 28 29 16 6 10.9 11.0 

Florida 6 33 27 24 9 1 8.4 8.1 

Georgia 6 30 25 29 10 P

2

P 8.7 8.7 

Hawaii 8 30 26 25 11 P

2

P 8.5 8.2 

Idaho 4 26 25 28 16 P

2

P 9.6 9.9 

Illinois 4 24 23 25 17 8 10.6 10.9 

Indiana 6 26 22 30 16 1 9.7 10.2 

Iowa 4 20 17 36 23 0 11.1 12.9 

Kansas 3 24 22 30 20 1 10.5 11.2 

Kentucky 4 23 21 31 19 2 10.5 11.4 

Louisiana 3 21 23 37 16 P

2

P 10.5 11.7 

Maine 4 21 22 32 18 3 10.8 11.7 

Maryland 3 19 23 31 18 5 11.1 11.7 

Massachusetts 3 19 20 34 21 3 11.2 12.5 

Michigan 6 28 25 26 15 1 9.3 9.3 

Minnesota 3 15 17 38 26 1 11.9 13.7 

Mississippi 4 27 25 27 16 2 9.8 9.9 

Missouri 4 23 24 31 16 2 10.3 10.9 

Montana 4 26 26 31 13 0 9.5 9.9 

Nebraska 2 19 18 30 30 P

2

P 11.7 13.6 

Nevada 4 31 27 24 11 2 9.0 8.7 

New Hampshire 2 21 24 35 15 1 10.6 11.4 

New Jersey 7 30 24 26 13 1 8.8 8.7 

New Mexico 4 26 26 30 14 P

2

P 9.5 9.8 

New York 3 24 25 29 15 4 10.4 10.6 

North Carolina 5 26 24 30 14 1 9.6 10.1 

North Dakota 5 17 18 35 25 0 11.3 12.9 

Ohio 6 24 22 29 18 1 9.9 10.5 

Oklahoma 5 31 25 26 11 0 8.8 8.7 

Oregon 5 31 26 28 10 0 8.8 8.7 

Pennsylvania 3 19 22 34 20 2 11.0 12.1 

Rhode Island 4 18 16 32 25 4 11.6 13.5 
11-100 

TABLE 11-28 -- AGES OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATE-continued 

[In percent; 539,691 total cases] P

1

P

Age in years State 

Under 1 1-5 6-10 11-15 16-18 19 and over

Mean 

Years 

Median 

Years 

South Carolina 5 22 21 32 18 2 10.5 11.4 

South Dakota 3 30 25 30 12 0 9.3 9.4 

Tennessee 3 17 18 32 31 0 11.9 13.8 

Texas 7 29 23 28 12 0 8.8 9.0 

Utah 4 18 18 38 20 1 11.1 12.7 

Vermont 3 13 16 38 30 1 12.5 14.5 

Virginia 3 18 20 36 23 P

2

P 11.3 12.5 

Washington 7 33 24 25 11 0 8.5 8.1 

West Virginia 3 17 17 36 25 2 11.9 13.6 

Wisconsin 1 19 27 35 16 2 11.0 11.5 

Wyoming 1 14 16 36 32 1 12.5 14.3 

Puerto Rico 3 25 30 29 12 0 9.5 9.6 

Total 4 24 24 30 17 2 10.1 10.6 

P

1

P

 Percent totals may not equal 100 due to rounding. Total cases shown represent the number 

of children for whom sufficient case record data was submitted to be included in this Table. 

This number of children does not necessarily equal the total number of cases found in other 

tables. 

P

2

P

 State does not count children age 19 and over as part of its caseload. 

Source: U.S. Department of Health and Human Services. 
TABLE 11-29 -- RACE/ETHNICITY OF CHILDREN ENTERING AND EXITING CARE DURING FISCAL YEA

CARE ON SEPTEMBER 30, FISCAL YEARS 1999-2001 

[In PercentP

1

P] 

Entering Exiting In Care on 

Race/ EthnicityP

2

P 1999 2000 2001 1999 2000 2001 1999 200

Alaska Native/American Indian 3 3 3 3 2 2 2 2 Asian/Pacific IslanderP

3

P 1 2 1 2 2 1 1 1 

Black/African American 27 29 28 29 31 30 38 40 Hispanic 16 15 16 16 15 15 17 15 White 43 47 46 42 45 45 34 37 Two or More Races P

2

P 2 2 P

2

P 1 2 P

2

P 1 

Unknown/Unable to Determine 10 4 3 9 4 4 7 4 

P1

P Percent totals may not equal 100 due to rounding. 

P2

P AFCARS race and ethnicity categories are consistent with those used by the U.S. Census Bureau. Children identified as being of Hispanic origin m

race. Children included in the other race/ethnicity categories are non-Hispanic. Additionally, Federal race reporting standards changed to allow for mreporting, therefore, a “Two or More Races” category was added beginning with FY2000. Therefore care should be used when comparing pre-FY20

FY2000 and later race/ethnicity statistics, e.g. comparing the data in these tables with data found in the Child Welfare Outcomes - Annual Report to 

P3

P For the years 2000 and 2001 this Asian/Pacific Islander category combines children reported as either "Asian" or "Native Hawaiian/Other Pacific I

two categories were first used in AFCARS in 2000 to match new Census Bureau categories. The previous Census Bureau and AFCARS category wa

Islander. Source: Table prepared by the Congressional Research Service based on information received from the U.S. Department of Health and Human Servi
TABLE 11-30 -- RACE/ETHNICITY OF CHILDREN IN CARE ON SEPTEMBER 30, BY STATE, 

 FISCAL YEARS 1999-2001P1 

P[In PercentP

2

P]

1999 P

3

P 2000 P

3

P 2001 P

3

P State

Black Hispanic White OtherP

4

P Black Hispanic White OtherP

4

P Black Hispanic White O

Alabama 55 1 44 1 55 1 44 1 51 1 47 Alaska 10 2 29 59 10 2 27 61 9 1 28 Arizona 13 33 51 3 12 33 47 8 11 33 48 

Arkansas 42 2 54 2 39 2 56 3 35 2 58 California 35 32 29 4 33 34 29 4 31 36 27 Colorado 16 26 51 7 16 27 49 8 15 29 51 Connecticut 39 26 34 2 37 25 34 5 36 26 34 Delaware 63 7 30 0 63 7 29 0 61 7 32 District of Columbia 97 1 0 2 94 1 0 4 91 1 0 Florida 47 5 47 1 46 9 42 3 44 8 45 Georgia 58 4 33 5 58 3 36 4 56 3 37 Hawaii 2 3 12 83 2 2 11 84 2 2 11 Idaho 2 13 73 13 3 10 77 10 2 12 77 

Illinois 76 5 17 2 74 5 19 2 72 5 20 Indiana 2 97 1 0 41 4 53 2 38 5 54 Iowa 12 4 72 12 11 4 71 14 12 5 70 Kansas 22 7 68 4 22 5 68 5 21 5 68 Kentucky 24 1 71 4 21 1 72 6 19 1 73 Louisiana 64 1 35 1 62 1 35 2 61 1 36 Maine 2 2 84 12 2 2 78 18 2 2 75 Maryland 79 1 20 0 78 1 19 2 78 1 19 Massachusetts 20 21 52 6 19 22 51 7 19 22 52 Michigan P

5

P P

5

P P

5

P P

5

P P

5

P P

5

P P

5

P P

5

P 47 4 45 

Minnesota 22 5 58 14 22 6 52 20 21 6 52 Mississippi 59 1 39 1 57 1 42 0 54 1 42 

Missouri 43 1 55 1 42 1 56 1 37 1 60 
Montana 2 3 61 35 1 4 58 37 1 4 57 

Nebraska 16 8 67 9 17 8 66 10 17 8 66 Nevada P

6

P P

6

P P

6

P P

6

P 22 10 57 11 22 12 52 

New Hampshire 2 5 91 1 2 5 87 5 3 5 86 New Jersey 64 8 23 5 63 8 23 7 62 7 23 New Mexico 7 57 29 7 7 55 30 9 7 55 27 

New York 45 15 14 26 45 16 15 24 46 17 17 North Carolina 51 6 41 2 49 6 42 4 47 6 43 North Dakota 3 3 62 32 2 3 61 34 3 3 59 Ohio 0 0 1 99 47 3 44 6 47 3 44 Oklahoma 23 5 56 16 19 5 49 27 19 6 49 Oregon 10 7 64 19 10 8 62 20 9 8 61 

Pennsylvania 51 11 37 1 52 9 38 1 51 9 39 

Rhode Island 21 14 58 7 21 15 59 6 20 16 58 

South Carolina 63 1 36 0 61 1 37 1 60 2 38 South Dakota 2 4 29 65 2 4 30 64 2 4 29 Tennessee 39 2 58 1 38 2 57 2 36 2 59 Texas 31 34 34 1 29 34 33 4 28 35 33 Utah 4 15 67 13 4 17 55 24 4 18 55 Vermont 2 1 97 1 2 1 96 1 2 1 97 

Virginia 53 4 42 1 51 4 43 3 50 4 43 

Washington 15 12 62 11 13 12 58 17 12 12 59 West Virginia 12 1 86 1 8 1 83 7 8 1 84 

Wisconsin 65 4 28 3 64 5 28 3 60 5 32 Wyoming 4 10 80 6 5 8 81 6 3 7 86 Puerto Rico 0 99 0 0 P

7

P P

7

P P

7

P P

7

P 0 99 1 

Total 38 17 34 10 40 15 37 8 38 17 38 

P1

P Total number of cases included in each year: 1999 (540,403), 2000 (521,769), 2001 (520,416). Total cases shown in a given year represent the num

children for whom sufficient case record data was submitted to be included in this Table. This number of children does not necessarily equal the tota

number of cases found in other tables. 

P2

P Percent totals may not equal 100 due to rounding. 
TABLE 11-30 -- RACE/ETHNICITY OF CHILDREN IN CARE ON SEPTEMBER 30, BY STATE, 

 FISCAL YEARS 1999-2001P

1

P-continued

P3

P AFCARS race and ethnicity categories are consistent with those used by the U.S. Census Bureau. Children identified as being of Hispanic origin m

of any race. Children included in the other race/ethnicity categories are non-Hispanic. Additionally, Federal race reporting standards changed to allo

multiple race reporting, therefore, a “Two or More Races” category was added beginning with FY2000. Therefore care should be used when comparpre-FY2000 data with FY2000 and later race/ethnicity statistics, e.g. comparing the data in these tables with data found in the Child Welfare OutcomAnnual Report to Congress. 

P4

P The "Other" column includes children whose race/ethnicity was reported as Alaska Native/American Indian and "unknown, unable to determine". F

1999 only it also includes children reported as Asian/Asian Pacific Islander; for 2000 and 2001 only it also includes children reported as "two or moraces", Asian, or Native Hawaiian/Pacific Islander. 

P5

P Michigan did not provide race/ethnicity data in 1999 and 2000 due to technical issues. 

P6

P Nevada was not able to provide complete data for 1999. 

P7

P Puerto Rico was not able to provide complete data for 2000. 

Source: Table prepared by the Congressional Research Service based on information received from the U.S. Department of Health and Human Servi
11-105 

Characteristics of foster care 

 As Table 11-31 shows, 44 percent of the children who were in foster care on 

September 30, 2001, had permanency plans of reunification with their families, 

while 22 percent had plans of adoption. For 9 percent of the children, the 

permanency plan was long-term foster care. (Table 11-31 shows these data for 

children in care at the end of fiscal years 1999, 2000, and 2001; Table 11-32 shows 

these data, by State, for children in care on September 30, 2001.) As for the living 

arrangements of these children, Table 11-33 shows that on September 30, 2001, 

slightly less than half were in foster family homes with people unrelated to them, 

while another 18 percent were in foster care with relatives, and 15 percent of these 

children were either in a group home or institution. (Table 11-33 shows these data 

for each of fiscal years 1999 through 2001, while Table 11-34 shows them, by 

State, for children in care on September 30, 2001.) As shown in Tables 11-35 and 

11-36, less than two-thirds of the children in care on September 30, 2001, had 

experienced between one and two placements during their current spell in foster 

care, while 22 percent had experienced three or four, and 17 percent had 

experienced five or more. (See Table 11-35 for aggregate data on placements in 

1999, 2000, and 2001; Table 11-36 shows placement data by State for children in 

care on September 30, 2001.) 

TABLE 11-31 -- PERMANENCY PLANS OF CHILDREN IN CARE ON 

SEPTEMBER 30, FISCAL YEARS 1999-2001P

1

P

[In PercentP

2

P

] 

Permanency Plan 1999 2000 2001 

Reunify 42 42 44 

Live with Relative(s) 4 4 5 

Adoption 21 21 22 

Long Term Foster Care 8 8 9 

Emancipation 6 6 6 

Guardianship 3 3 3 

Not Yet EstablishedP

3

P 17 15 11 

P

1

P

 Total number of cases per year: 1999 (554,910), 2000 (533,554), and 2001 (527,344). Total 

cases shown represent the number of children for whom sufficient case record data was 

submitted to be included in this Table. This number of children does not necessarily equal the 

total number of cases found in other tables. 

P

2

P

 Percent totals may not equal 100 due to rounding. 

P

3

P

 States are required to determine a child's permanency plan within one year of the child's entry 

into foster care. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 
11-106 

TABLE 11-32 -- PERMANENCY PLANS OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATE 

[In percent; 527,344 total cases]P

1

P

State Reunify Live with 

relative(s) Adoption

Longterm 

foster 

care 

Emancipation Guardianship Not Yet 

Established 

Alabama 45 14 17 21 P

2

P P

2

P 2 

Alaska 56 1 30 3 1 8 P

2

P

Arizona 42 7 26 9 15 1 1 

Arkansas 44 5 27 6 18 1 0 

California 38 9 6 9 P

2

P 6 31 

Colorado 55 4 21 10 8 1 1 

Connecticut 75 P

2

P P

2

P P

2

P 17 8 P

2

P

Delaware 33 5 36 3 19 2 1 

District of Columbia 18 2 34 8 13 3 22 

Florida 53 6 24 5 3 1 8 

Georgia 60 7 20 9 4 0 P

2

P

Hawaii 55 3 15 6 0 5 17 

Idaho 67 6 6 11 3 8 P

2

P

Illinois 20 P

2

P 38 2 27 12 0 

Indiana 39 2 26 4 8 3 18 

Iowa 42 2 18 11 1 1 25 

Kansas 53 0 32 P

2

P 3 2 10 

Kentucky 44 5 32 7 6 1 6 

Louisiana 55 2 27 14 2 0 P

2

P

Maine 32 2 30 23 8 0 4 

Maryland 31 16 21 17 10 2 3 

Massachusetts 39 P

2

P 24 15 14 6 2 

Michigan 52 6 29 8 6 0 P

2

P

Minnesota 56 4 14 21 P

2

P 0 5 

Mississippi 64 13 14 3 3 1 3 

Missouri 57 2 20 3 9 6 3 

Montana 40 6 23 13 2 1 14 

Nebraska 42 P

2

P 4 5 4 3 41 

Nevada 2 0 0 P

2

P P

2

P 0 98 

New Hampshire 26 1 13 16 P

2

P 5 38 

New Jersey 40 9 42 6 2 P

2

P 1 

New Mexico 36 0 38 9 9 3 5 

New York 51 P

2

P 32 P

2

P 12 1 4 

North Carolina 50 7 30 P

2

P 1 9 2 

North Dakota 46 6 28 12 6 2 0 

Ohio 41 P

2

P 19 11 4 P

2

P 25 

Oklahoma 50 0 30 12 4 2 2 

Oregon 46 1 30 20 1 3 P

2

P

Pennsylvania 52 2 22 17 4 2 2 

Rhode Island 57 1 17 8 16 0 0 

South Carolina 13 1 42 12 10 0 22 

South Dakota 55 3 16 13 2 3 9 

Tennessee 59 5 24 5 6 0 0 

Texas 31 8 33 11 8 2 8 
11-107 

TABLE 11-32 -- PERMANENCY PLANS OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATE-continued 

[In percent; 527,344 total cases]P

1

P

State Reunify Live with 

relative(s) Adoption

Longterm 

foster 

care 

Emancipation Guardianship Not Yet 

Established 

Utah 43 P

2

P 13 25 9 7 3 

Vermont 59 1 18 12 5 P

2

P 5 

Virginia 22 7 28 23 16 1 2 

Washington 69 2 18 4 1 5 2 

West Virginia 46 4 22 24 1 3 P

2

P

Wisconsin 77 4 9 5 1 P

2

P 5 

Wyoming 63 3 7 9 7 4 6 

Puerto Rico 79 10 4 3 1 0 3 

Total 44 5 22 9 6 3 11 

P

1

P

 Percent totals may not equal 100 due to rounding. Total cases shown represent the number of 

children for whom sufficient case record data was submitted to be included in this Table. This 

number of children does not necessarily equal the total number of cases found in other tables. 

P

2

P

 State did not report any cases in that category. 

Note - A “0” indicates the state reported some cases in the category but the number of cases was 

less than one-half of one percent. 

Source: U.S. Department of Health and Human Services 

TABLE 11-33 – PLACEMENT SETTINGS OF CHILDREN IN CARE ON 

SEPTEMBER 30, FISCAL YEARS 1999-2001 P

1

P

[In PercentP

2

P

] 

Placement Setting 1999 2000 2001 

Pre-adoptive home 4 4 4 

Foster home (relative) 27 25 24 

Foster home (non-relative) 47 47 48 

Group home 7 8 8 

Institution 11 10 10 

Supervised independent living 1 1 1 

Runaway 1 2 2 

Trial home visit 3 3 3 

P

1

P

Total number of cases per year: 1999 (551,798), 2000 (524,357), and 2001 (526,537). Total 

cases shown for a given year represent the number of children for whom sufficient case record 

data was submitted to be included in this Table. This number of children does not necessarily 

equal the total number of cases found in other tables. 

P

2

P

Percent totals may not equal 100 due to rounding. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services 
11-108 

TABLE 11-34 – PLACEMENT SETTINGS OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATE 

[In percent; 526,537 total cases]P

1

P

State 

Preadoptive 

home 

Foster 

home 

(relative)

Foster 

home (nonrelative) 

Group 

Home

Institution

Supervised 

Independent 

Living 

Runaway 

Trial 

Home 

Visit 

Alabama 3 13 57 4 15 0 1 6 

Alaska 2 30 43 8 2 P

2

P P

2

P 15 

Arizona 1 24 40 19 9 2 3 2 

Arkansas 4 4 69 1 11 1 3 7 

California 3 36 37 14 2 P

2

P 3 4 

Colorado 9 11 50 4 23 2 2 0 

Connecticut 2 0 67 4 26 1 P

2

P 0 

Delaware 7 10 57 8 17 0 P

2

P P

2

P

District of Columbia 1 17 55 18 8 P

2

P 1 P

2

P

Florida 2 46 39 2 8 1 1 P

2

P

Georgia 4 19 63 8 6 P

2

P 0 P

2

P

Hawaii 0 38 55 1 3 P

2

P 2 0 

Idaho 3 13 65 10 7 P

2

P 1 1 

Illinois 8 32 42 2 9 4 3 P

2

P

Indiana P

2

P 16 61 3 17 P

2

P 1 2 

Iowa 7 1 53 30 8 2 P

2

P P

2

P

Kansas 5 13 54 5 6 1 2 14 

Kentucky 3 10 51 P

2

P 35 1 P

2

P P

2

P

Louisiana 0 10 60 8 16 0 1 4 

Maine 5 4 67 8 7 5 0 4 

Maryland 5 35 38 10 3 1 1 6 

Massachusetts 5 17 50 9 12 3 2 1 

Michigan 6 32 44 0 15 2 0 0 

Minnesota 6 16 49 10 19 0 0 P

2

P

Mississippi 2 30 34 18 8 1 0 7 

Missouri 11 22 38 1 17 3 1 6 

Montana P

2

P 32 54 11 3 P

2

P P

2

P P

2

P

Nebraska 0 11 38 5 20 1 2 23 

Nevada 1 20 69 5 5 P

2

P 0 0 

New Hampshire P

2

P 12 66 21 1 0 P

2

P P

2

P

New Jersey 3 14 59 9 13 1 P

2

P P

2

P

New Mexico 13 18 53 4 7 4 P

2

P P

2

P

New York 0 21 54 3 17 0 P

2

P 5 

North Carolina 5 18 46 9 9 0 4 8 

North Dakota 8 14 48 4 26 P

2

P 0 P

2

P

Ohio 4 18 59 4 9 1 3 2 

Oklahoma 5 29 55 8 3 0 1 P

2

P

Oregon 5 20 49 1 7 0 5 13 

Pennsylvania 2 18 51 11 16 1 0 1 

Rhode Island 2 20 31 37 1 4 5 P

2

P

South Carolina 6 5 62 5 17 1 2 1 

South Dakota 2 18 53 3 23 0 0 1 

Tennessee 5 5 47 12 18 1 6 7 

Texas 4 16 48 9 17 0 1 5 

Utah 9 4 61 4 11 2 3 6 
11-109 

TABLE 11-34 – PLACEMENT SETTINGS OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATE-continued 

[In percent; 526,537 total cases]P

1

P

State 

Preadoptive 

home 

Foster 

home 

(relative)

Foster 

home (nonrelative) 

Group 

Home

Institution

Supervised 

Independent 

Living 

Runaway 

Trial 

Home 

Visit 

Vermont 6 11 55 15 3 2 1 8 

Virginia 5 4 63 4 18 1 1 4 

Washington 1 32 58 5 1 0 2 0 

West Virginia 5 4 54 32 3 2 0 1 

Wisconsin 1 7 82 3 7 P

2

P P

2

P P

2

P

Wyoming 2 14 36 13 32 1 1 1 

Puerto Rico 1 35 53 1 8 0 1 1 

Total 4 24 48 8 10 1 2 3 

P

1 P

Percent totals may not equal 100 due to rounding. The total number of cases represents the number 

of children for whom sufficient case record data was submitted to be included in this Table. This 

number of children does not necessarily equal the total number of cases found in other tables. 

P

2 P

State did not report any cases in this category. 

Note - A “0” indicates the State reported some cases in the category but the number of cases was 

less than one-half of one percent. 

Source: U.S. Department of Health and Human Services. 

TABLE 11-35 -- NUMBER OF PLACEMENTS OF CHILDREN IN CARE 

ON SEPTEMBER 30, FISCAL YEARS 1999-2001P

1 

P

[In Percent]P

2

P

Number of Placement Settings 1999 2000 2001 

1-2 62 61 61 

3-4 22 22 22 

5-6 8 9 8 

7 or more 8 8 9 

P

1

P

 Total number of cases per year: 1999 (533,791), 2000 (536,865), and 2001 (536,652). The total 

number of cases used in a given year represent the number of children for whom sufficient case 

record data was submitted to be included in this Table. This number of children does not 

necessarily equal the total number of cases found in other tables. 

P

2

P

 Percent totals may not equal 100 due to rounding. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 

TABLE 11-36 -- NUMBER OF PLACEMENTS 

(FOR CURRENT EPISODE) OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATEP

1 

P

[In percent; 536,652 total cases]P

2

P

State 1 to 2 3 to 4 5 to 6 7 or more 

Alabama 75 14 6 5 

Alaska 40 29 14 17 

Arizona 50 25 11 14 

Arkansas 50 21 11 18 

California 57 26 9 8 

Colorado 57 23 9 11 
11-110 

TABLE 11-36 -- NUMBER OF PLACEMENTS 

(FOR CURRENT EPISODE) OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATEP

1 P

-continuedP

P

[In percent; 536,652 total cases]P

2

P

State 1 to 2 3 to 4 5 to 6 7 or more 

Connecticut 100 0 0 0 

Delaware 78 12 4 5 

District of Columbia 63 23 9 5 

Florida 78 13 4 5 

Georgia 77 14 5 4 

Hawaii 67 22 5 6 

Idaho 59 27 9 5 

Illinois 48 25 13 14 

Indiana 63 23 7 6 

Iowa 65 22 7 7 

Kansas 46 24 11 20 

Kentucky 55 23 11 12 

Louisiana 58 22 9 11 

Maine 40 25 11 23 

Maryland 67 24 6 3 

Massachusetts 50 23 11 16 

Michigan 71 19 6 4 

Minnesota 60 22 8 10 

Mississippi 77 14 4 5 

Missouri 52 25 11 13 

Montana 56 27 10 8 

Nebraska 56 23 10 11 

Nevada 88 7 3 2 

New Hampshire 61 24 9 6 

New Jersey 68 18 7 6 

New Mexico 61 28 7 4 

New York 66 22 7 5 

North Carolina 42 23 14 21 

North Dakota 68 20 7 6 

Ohio 63 21 7 9 

Oklahoma 47 27 11 15 

Oregon 61 24 9 7 

Pennsylvania 61 22 9 9 

Rhode Island 55 23 11 10 

South Carolina 43 27 13 17 

South Dakota 64 27 6 2 

Tennessee 53 27 10 10 

Texas 47 25 12 16 

Utah 59 19 8 14 

Vermont 37 28 13 22 

Virginia 69 21 7 4 

Washington 55 23 9 13 

West Virginia 56 25 9 10 

Wisconsin 80 15 4 1 

Wyoming 63 23 9 5 
11-111 

TABLE 11-36 -- NUMBER OF PLACEMENTS 

(FOR CURRENT EPISODE) OF CHILDREN IN CARE ON 

SEPTEMBER 30, 2001, BY STATEP

1 P

-continued

State 1 to 2 3 to 4 5 to 6 7 or more 

Puerto Rico 99 1 0 0 

Total 61 22 8 9 

P

1

P

 A “0” indicates the state reported some cases in the category but the number of cases was less 

than one-half of one percent. 

P

2 P

Percent totals may not equal 100 due to rounding. The total number of cases shown represent 

the number of children for whom sufficient case record data was submitted to be included in this 

Table. This number of children does not necessarily equal the total number of cases found in 

other tables. 

Source: U.S. Department of Health and Human Services. 

 The amount of time that children spend in foster care is an issue of public 

policy concern. As shown in Table 11-37, children who left care during a given 

fiscal year had generally shorter lengths of stay from the time of removal from 

home than those children who remained in care at the end of the fiscal year. Table 

11-37 shows aggregate data on length of stay for children who exited care during 

fiscal years 1999 through 2001, and children who remained in care on the last day 

of each fiscal year. Table 11-38 shows the length of stay, by State, for children in 

care on September 30, 2001. 

TABLE 11-37 -- LENGTH OF STAY FOR CHILDREN EXITING CARE 

DURING FISCAL YEAR AND FOR CHILDREN IN CARE ON 

SEPTEMBER 30, FISCAL YEARS 1999-2001 

[In percent]P

1

P

 

Length of Stay Exiting In Care on September 30 

(LOS) 1999 2000 2001 1999 2000 2001 

Under 1 month 19 18 18 4 4 4 

1- 5 months 17 17 17 16 16 17 

6-11 months 14 14 15 15 15 15 

12-17 months 11 11 11 11 12 11 

18-23 months 8 8 8 9 9 9 

24-29 months 6 6 6 8 7 7 

30-35 months 4 5 5 6 6 5 

3-4 years 11 11 11 15 15 15 

5 years or longer 10 10 9 17 17 17 

Mean LOS (months) 22.6 23.1 22.4 32.1 32.6 32.6 

Median LOS (months) 11.9 12.3 12.0 20.1 20.1 19.5 

P

1

P

 Percent totals may not equal 100 due to rounding. 

Source: U.S. Department of Health and Human Services. 
TABLE 11-38 -- LENGTH OF STAY FOR CHILDREN IN CARE ON SEPTEMBER 30, 2001, BY STAT

[In percent; 540,293 total cases]P

1

P State Less than 1 month 1-5 months 6-11 months 12-17 months 18-23 months 24-29 months 30-35 months 3-4 years 5 years Mean months 

Alabama 4 16 13 11 8 8 6 15 19 36.2 Alaska 3 16 19 13 13 8 8 13 8 25.1 

Arizona 5 20 16 13 9 7 4 14 11 26.4 Arkansas 8 25 17 13 9 7 4 11 6 20.0 California 3 13 13 11 8 7 5 17 23 39.5 Colorado 8 28 21 11 8 6 4 7 9 20.0 Connecticut 3 14 13 11 7 7 7 20 18 32.5 Delaware 6 25 16 11 8 7 5 14 8 22.3 District of Columbia 2 10 9 7 8 10 8 24 21 41.2 Florida 5 21 20 13 9 8 5 10 9 23.7 Georgia 5 21 18 13 9 7 4 11 12 25.9 Hawaii 8 23 20 15 9 7 4 10 4 18.0 Idaho 7 24 21 12 10 6 5 9 6 19.4 Illinois 2 8 9 8 7 7 6 19 34 50.8 Indiana 5 23 17 12 9 7 4 11 12 25.6 

Iowa 8 26 19 13 8 6 4 9 6 18.1 Kansas 4 17 18 14 13 9 6 14 5 22.4 

Kentucky 6 22 15 11 8 7 6 18 8 24.1 Louisiana 4 21 17 12 8 6 4 11 18 31.3 Maine 2 11 15 12 10 8 6 15 20 36.8 Maryland 3 10 9 8 8 7 6 18 30 46.2 Massachusetts 5 18 16 12 9 8 6 13 13 28.7 Michigan 5 22 21 14 9 7 5 10 7 20.9 Minnesota 9 24 16 10 7 6 4 11 14 27.0 Mississippi 3 20 19 15 8 6 4 13 11 26.8 

Missouri 4 19 18 13 10 7 5 13 12 26.5 Montana 5 21 15 12 8 8 6 13 12 26.3 
Nebraska 4 18 20 14 12 8 6 13 5 21.1 

Nevada 4 17 9 7 11 10 7 19 15 34.2 New Hampshire 4 16 12 10 7 7 5 19 20 36.8 New Jersey 4 17 16 11 9 8 6 16 14 29.3 

New Mexico 6 17 18 14 9 6 6 25 21.1 

New York 2 11 11 9 8 7 6 20 24 42.9 North Carolina 4 20 16 13 10 7 5 13 11 26.3 

North Dakota 8 25 23 9 9 5 4 9 8 18.7 Ohio 6 23 18 13 8 7 5 12 10 24.6 Oklahoma 5 21 17 13 10 7 5 12 10 24.3 

Oregon 4 18 16 13 9 8 5 14 13 28.1 

Pennsylvania 4 17 15 11 8 7 6 14 18 34.1 Rhode Island 5 20 18 12 9 6 4 13 13 27.9 South Carolina 5 17 15 10 9 7 6 13 18 33.0 South Dakota 5 22 21 15 10 5 3 11 7 21.3 Tennessee 5 20 18 11 8 6 5 13 14 27.7 Texas 4 22 19 12 8 6 4 9 14 27.8 Utah 6 26 21 12 7 5 4 11 7 19.5 

Vermont 3 19 13 12 11 9 7 13 13 27.9 Virginia 3 16 14 12 9 7 6 14 18 33.5 

Washington 4 19 18 14 11 8 6 11 8 23.3 West Virginia 5 20 18 11 9 8 4 12 14 28.2 Wisconsin 2 8 7 3 11 11 9 25 25 43.9 

Wyoming 5 26 25 11 7 6 3 8 9 20.4 Puerto Rico 5 15 15 10 7 6 6 14 24 37.7 

Total 4 17 15 11 9 7 5 15 17 32.6 

P1

P Percent totals may not equal 100 due to rounding. The total number of cases shown represents the number of children for whom sufficient case 

data was submitted to be included in this Table. This number of children does not necessarily equal the total number of cases found in other tabl

Source: U.S. Department of Health and Human Services. 
11-114 

 Finally, Table 11-39 shows the reasons for discharge for children who left 

foster care during fiscal years 1999, 2000, and 2001, and indicates that a slightly 

decreasing majority of these children were reunified with their families (58 percent 

in fiscal year 1999 and 56 percent in fiscal year 2001). Another 18 percent were 

adopted in fiscal year 2001, 10 percent left to live with other relatives, and 

7 percent were emancipated (i.e., “aged out”'). Table 11-40 shows the discharge 

reasons, by State, for children in care on September 30, 2001. 

TABLE 11-39 -- DISCHARGE REASONS FOR CHILDREN EXITING 

CARE, FISCAL YEARS 1999 - 2001P

1

P

[In Percent]P

2

P

Discharge reasons 1999 2000 2001 

Reunification 58 57 56 

Live with other relative 10 9 10 

Adoption 17 17 18 

Emancipation 8 7 7 

Guardianship 3 4 3 

Other 6 5 5 

P

1 P

Total number of cases included in each year: 1999 (237,334), 2000 (258,849), and 2001 

(254,495). The total number of cases used in a given year represent the number of children for 

whom sufficient case record data was submitted to be included in this Table. This number of 

children does not necessarily equal the total number of cases found in other tables. 

P

2

P

 Percent totals may not equal 100 due to rounding. 

Source: Table prepared by the Congressional Research Service based on information received 

from the U.S. Department of Health and Human Services. 

TABLE 11-40 -- DISCHARGE REASONS FOR CHILDREN EXITING 

CARE, BY STATE, FISCAL YEAR 2001 

[In percent; 254,495 total cases]P

1

P

State Reunification 

Live with 

Other Relative Adoption Emancipation 

Guardianship Other 

Alabama 52 29 9 5 P

2

P 5 

Alaska 62 3 26 3 6 1 

Arizona 62 5 18 7 5 2 

Arkansas 57 23 12 6 1 1 

CaliforniaP

3

P 60 P

2

P 18 9 6 7 

Colorado 62 10 10 6 2 9 

Connecticut 58 5 24 2 6 6 

Delaware 66 11 13 5 3 2 

District of Columbia 44 13 15 13 1 15 

Florida 55 26 9 5 2 3 

Georgia 44 28 19 1 2 5 

Hawaii 62 2 15 7 11 2 

Idaho 77 4 10 5 P

2

P 3 

Illinois 27 3 44 16 9 1 

Indiana 61 1 24 6 6 2 

Iowa 72 8 12 5 1 3 

Kansas 77 2 1 9 7 5 
11-115 

TABLE 11-40 -- DISCHARGE REASONS FOR CHILDREN EXITING 

CARE, BY STATE, FISCAL YEAR 2001-continued 

[In percent; 254,495 total cases]P

1

P

State Reunification 

Live with 

Other Relative Adoption Eman -cipation 

Guardianship Other 

Kentucky 53 23 15 7 1 2 

Louisiana 39 17 15 10 1 18 

Maine 39 9 47 4 0 1 

Maryland 44 20 21 8 4 3 

Massachusetts 59 8 15 9 5 4 

Michigan 54 3 22 6 3 12 

Minnesota 74 8 6 6 1 6 

Mississippi 55 23 15 4 3 1 

Missouri 57 2 19 12 7 3 

Montana 55 10 22 7 3 3 

NebraskaP

4

P 98 P

2

P 1 P

2

P 1 0 

Nevada 43 26 13 6 1 11 

New Hampshire 52 6 18 12 4 8 

New JerseyP

5

P 70 P

2

P 20 6 P

2

P 4 

New Mexico 68 6 16 1 3 7 

New York 56 11 21 7 P

2

P 5 

North Carolina 43 13 25 6 10 3 

North Dakota 59 5 11 6 0 20 

Ohio 50 21 16 8 4 1 

Oklahoma 67 4 17 5 5 3 

Oregon 60 2 25 4 6 4 

Pennsylvania 58 10 15 6 1 10 

Rhode Island 65 5 14 6 3 7 

South Carolina 55 21 14 7 1 2 

South Dakota 66 6 11 4 5 9 

Tennessee 58 14 13 12 0 3 

Texas 37 26 32 4 P

2

P 2 

Utah 38 32 17 8 1 3 

Vermont 70 3 15 9 P

2

P 2 

Virginia 33 16 20 27 P

2

P 5 

WashingtonP

6

P 66 P

2

P 18 5 7 5 

West Virginia 49 12 23 6 1 9 

Wisconsin 49 9 14 6 P

2

P 22 

Wyoming 60 15 5 7 5 8 

Puerto Rico 58 33 8 1 P

2

P 1 

Total 56 10 18 7 3 5 

P

1

P

 Percent totals may not equal 100 due to rounding. This total number of cases represents the 

number of children for whom sufficient case record data was submitted to be included in this Table. 

This number of children does not necessarily equal the total number of cases found in other tables. 

P

2

P

 State did not report any cases in that category. 

P

3

P

 California's information system does not accommodate “Live with other relative” as a specific 

discharge reason; the majority of children discharging to a relative are identified as “guardianships.” 
11-116 

TABLE 11-40 -- DISCHARGE REASONS FOR CHILDREN EXITING 

CARE, BY STATE, FISCAL YEAR 2001-continued

P

4

P

 Nebraska indicated that data for fiscal year 2001 was skewed due to a technical systems error. 

The State indicated that the error has since been fixed. 

P

5

P

 New Jersey's information system does not accommodate "Live with other relative" as a specific 

discharge reason; the State anticipates system modifications in the near future to accommodate 

discharges to relatives. 

P

6

P

 Washington's information system did not accommodate "Live with other relative" as a specific 

discharge reason; the State anticipates system modifications in the near future to accommodate 

discharges to relatives. 

Note - A “0” indicates the State reported some cases in the category but the number of cases was 

less than one-half of one percent. 

Source: U.S. Department of Health and Human Services. 

Characteristics of children waiting for adoption 

 Tables 11-41 through 11-43 show, by State, characteristics of children who 

were waiting for adoption at the end of fiscal year 2001; i.e., children in foster care 

who had permanency plans of adoption and/or whose parental rights had been 

terminated. Children whose permanency plans were emancipation are not included 

in these tables. As the tables show, nearly 60 percent were between the ages of 6 

and 15 (Table 11-41), less than half (42 percent) were black (Table 11-42); and 

almost half (48 percent) had been in foster care for 3 years or longer (Table 11-43). 

TABLE 11-41 -- AGE DISTRIBUTION OF CHILDREN WAITING FOR 

ADOPTION, BY STATE, FISCAL YEAR 2001 

[In percent; 130,538 total cases]P

1

P

State Less than 

1 year 

1-5 

years 

6-10 

years 

11-15 

years 

16-18 

years 

Unknown 

Alabama 2 25 33 31 6 3 

Alaska 4 39 33 22 2 1 

Arizona 2 35 33 28 2 P

2

P

Arkansas 3 30 32 31 3 0 

California 6 40 34 17 2 0 

Colorado 4 36 32 24 3 0 

Delaware 4 34 36 24 1 P

2

P

District of Columbia 1 21 45 32 2 1 

Florida 4 35 30 26 4 0 

Georgia 3 32 33 28 4 P

2

P

Hawaii 8 33 27 25 8 1 

Idaho 1 23 33 33 9 1 

Illinois 5 37 33 24 1 0 

Indiana 2 29 32 32 5 0 

Iowa 2 34 28 28 7 1 

Kansas 2 28 27 32 9 2 

Kentucky 2 26 31 35 6 0 

Louisiana 1 25 34 33 6 P

2

P

Maine 3 30 36 28 2 1 

Maryland 1 28 34 30 5 2 

Massachusetts 3 40 37 19 1 0 
11-117 

TABLE 11-41 – AGE DISTRIBUTION OF CHILDREN WAITING FOR 

ADOPTION, BY STATE, FISCAL YEAR 2001-continued

[In percent; 130,538 total cases]P

1

P

State Less than 

1 year 

1-5 

years 

6-10 

years 

11-15 

years 

16-18 

years 

Unknown 

Michigan 6 32 30 26 5 1 

Minnesota 3 24 29 31 10 3 

Mississippi 1 18 30 30 13 7 

Missouri 2 26 31 35 5 1 

Montana 2 24 30 32 11 1 

Nebraska 2 33 39 22 4 1 

Nevada 2 30 33 27 5 2 

New Hampshire 2 32 39 24 3 P

2

P

New Jersey 6 39 29 20 5 1 

New Mexico 2 29 38 30 2 0 

New York 1 30 35 30 3 1 

North Carolina 3 28 29 32 8 1 

North Dakota 14 28 25 27 6 1 

Ohio 3 27 28 31 9 2 

Oklahoma 3 32 31 29 5 0 

Oregon 4 48 34 13 1 0 

Pennsylvania 1 30 35 28 5 1 

Rhode Island 1 31 29 33 5 1 

South Carolina 3 28 27 34 7 1 

South Dakota 3 29 28 32 7 1 

Tennessee 2 26 33 33 5 0 

Texas 5 31 29 30 4 P

2

P

Utah 6 30 32 28 3 1 

Vermont 1 22 28 40 7 1 

Virginia 4 34 38 23 1 P

2

P

Washington 3 40 30 22 5 0 

West Virginia 4 28 32 29 5 1 

Wisconsin 2 22 31 35 7 3 

Wyoming 2 25 34 32 7 1 

Puerto Rico 9 23 26 27 11 4 

Total 3 32 32 27 4 1 

P

1

P

 Percents totals may not equal 100 due to rounding. The total number of cases used represent the 

number of children for whom sufficient case record data was submitted to be included in this 

Table. This number of children does not necessarily equal the total number of cases found in other 

tables. 

P

2

P

 State did not report any cases in this category. 

Note – A “0” indicates the state reported some cases in the category but the number of cases was 

less than one-half of one percent. 

Source: U.S. Department of Health and Human Services. 
TABLE 11-42 – RACE/ETHNICITY OF CHILDREN WAITING FOR ADOPTION, BY STATE, FISCAL YEAR 20

[In percent; 130,538 total cases]P

2

P State American Indian/ 

Alaskan Native

Asian 

Black or 

African 

American 

Native 

Hawaiian/Other 

Pacific Islander

Hispanic White Unknown/Unable to Determine Two or More Races Missin

Alabama 0 P

3

P 52 P

3

P 1 46 0 1 P

3

P Alaska 62 0 9 P

3

P 1 27 1 P

3

P P

3

P Arizona 2 0 10 P

3

P 35 48 1 4 P

3

P Arkansas 0 P

3

P 38 P

3

P 2 56 1 4 P

3

P California 1 1 34 0 38 23 0 3 P

3

P Colorado 1 0 19 0 32 45 1 1 P

3

P Delaware P

3

P P

3

P 62 P

3

P 5 32 P

3

P P

3

P P

3

P District of Columbia P

3

P P

3

P 96 P

3

P 1 0 2 0 P

3

P Florida 0 0 45 0 9 42 0 3 P

3

P Georgia P

3

P 0 60 P

3

P 3 32 0 4 P

3

P Hawaii 1 20 3 38 2 8 3 26 0 

Idaho 9 0 2 P

3

P 11 79 P

3

P P

3

P P

3

P Illinois 0 0 73 P

3

P 5 20 2 P

3

P P

3

P Indiana 0 0 46 P

3

P 3 49 0 2 P

3

P Iowa 3 0 14 P

3

P 6 66 10 1 P

3

P Kansas 1 0 30 P

3

P 7 59 2 1 P

3

P Kentucky 0 P

3

P 22 P

3

P 1 71 2 4 P

3

P Louisiana 0 0 59 P

3

P 1 38 0 2 P

3

P Maine 2 0 2 P

3

P 2 78 14 1 1 

Maryland 0 0 81 P

3

P 1 17 1 1 P

3

P Massachusetts 0 2 14 P

3

P 26 42 3 2 11 

Michigan 0 P

3

P 4 P

3

P 0 4 0 0 91 

Minnesota 9 0 32 P

3

P 7 43 0 10 P

3

P Mississippi P

3

P P

3

P 64 P

3

P 0 36 P

3

P P

3

P P

3

P Missouri 0 0 45 P

3

P 1 53 0 0 P

3

P Montana 25 0 2 P

3

P 5 65 3 P

3

P P

3

P
Nebraska 9 0 22 P3P 10 58 2 P3P P3P Nevada 1 P3P 25 2 7 57 1 7 P3P New Hampshire 1 P3P 1 P3P 7 86 P3P 5 P3P New Jersey 0 0 68 0 7 18 5 2 P3P New Mexico 7 P3P 9 P3P 57 25 P3P 3 P3P New York 0 0 48 P3P 15 11 25 P3P P3P North Carolina 2 0 52 0 5 39 0 2 P3P North Dakota 31 2 3 P3P 2 59 P3P 2 P3P Ohio 0 0 54 P3P 3 38 0 5 P3P Oklahoma 11 P3P 25 P3P 5 46 0 13 P3P Oregon 3 0 10 0 10 59 18 1 P3P Pennsylvania 0 0 56 P3P 10 33 0 0 P3P Rhode Island 1 1 30 0 16 50 1 1 P3P South Carolina 0 0 63 P3P 1 35 P3P 0 P3P South Dakota 58 0 2 P3P 3 34 P3P 3 P3P Tennessee 0 0 43 P3P 2 52 0 2 P3P Texas 0 0 31 P3P 33 31 1 3 P3P Utah 1 1 5 0 25 61 7 P3P P3P Vermont 0 P3P 2 P3P 1 96 1 P3P P3P Virginia 0 0 54 P3P 4 37 1 3 P3P Washington 5 1 18 0 12 57 1 7 P3P West Virginia 0 P3P 8 P3P 1 83 2 7 P3P Wisconsin 4 P3P 52 P3P 3 40 P3P 2 P3P Wyoming 2 P3P 6 P3P 6 85 1 P3P P3P Puerto Rico P3P P3P 0 0 99 0 P3P P3P P3P Total 2 0 42 0 11 32 4 2 6 
TABLE 11-42 – RACE/ETHNICITY OF CHILDREN WAITING FOR ADOPTION, BY STATE, 

FISCAL YEAR 2001P

1

P-continued

P1 PAFCARS race and ethnicity categories are consistent with those used by the U.S. Census Bureau. Children identified as being of Hispanic origin m

be of any race. Children included in the other race/ethnicity categories are non-Hispanic. Additionally, Federal race reporting standards changed to 

allow for multiple race reporting, therefore, a “Two or More Races” category was added beginning with FY2000. Therefore care should be used whecomparing pre-FY2000 data with FY2000 and later race/ethnicity statistics, e.g. comparing the data in these tables with data found in the Child Welf

Outcomes - Annual Report to Congress. 

P2

P Percent totals may not equal 100 due to rounding. The total number of cases used represents the number of children for whom sufficient case recor

data was submitted to be included in this Table. This number of children does not necessarily equal the total number of cases found in other tables. 

P3 PState did not report any cases in that category. 

Note – A “0” indicates the state reported some cases in the category but the number of cases was less than one-half of one percent. 

Source: U.S. Department of Health and Human Services. 

TABLE 11-43 – LENGTH OF STAY FOR CHILDREN WAITING FOR ADOPTION, BY STATE, 

FISCAL YEAR 2001 

[In percent; 130,528 total cases]P

1

P State Less than 1 month 1-5 months 6-11 months 12-17 months 18-23 months 24-29 months 30-35 months 36-59 months 60 or mo

months 

Alabama 1 3 3 6 8 7 8 26 38 Alaska 0 6 12 15 14 11 13 21 9 Arizona 0 3 7 15 15 13 8 25 14 

Arkansas 1 7 12 19 15 11 8 19 8 

California 0 4 7 8 8 8 6 30 29 Colorado 1 9 15 15 12 12 7 16 13 Delaware 1 4 9 10 11 16 8 29 12 District of Columbia 0 1 3 3 7 11 11 35 29 

Florida 1 5 9 12 11 12 10 21 18 

Georgia 0 2 4 8 11 11 10 26 26 

Hawaii 3 10 17 18 12 10 6 18 6 
Idaho 0 1 6 10 16 12 12 25 18 

Illinois 1 4 7 8 8 9 8 23 31 

Indiana 0 1 5 13 16 14 7 21 21 Iowa 1 3 8 16 18 13 9 19 12 Kansas 0 3 6 10 15 13 11 30 12 Kentucky P2P 2 4 10 10 13 11 36 13 

Louisiana 0 1 5 10 12 11 7 27 27 

Maine 0 2 7 12 13 12 11 22 22 

Maryland 1 2 3 5 7 8 7 25 40 

Massachusetts 0 3 9 15 13 13 10 22 15 Michigan 1 9 16 15 13 10 8 17 12 Minnesota 1 5 7 10 10 11 8 21 27 

Mississippi 1 2 4 6 5 7 8 29 37 Missouri 1 4 6 9 14 10 9 23 25 Montana 1 4 6 12 13 13 9 23 20 

Nebraska 1 1 2 9 11 17 11 34 15 

Nevada 1 3 1 2 9 9 7 30 37 New Hampshire 1 2 5 3 10 15 7 38 20 New Jersey 2 7 11 11 11 10 7 22 19 

New Mexico P2P 1 9 18 13 10 11 37 P2P New York 0 0 1 4 6 7 8 31 42 

North Carolina 0 3 7 11 12 12 8 25 21 

North Dakota 1 9 21 11 11 10 6 18 14 

Ohio 0 4 6 10 10 13 9 26 21 

Oklahoma 0 4 7 12 14 14 9 24 15 Oregon 1 5 9 14 15 13 11 24 9 Pennsylvania 0 1 4 7 9 12 10 29 27 Rhode Island 0 2 5 9 15 12 8 25 24 South Carolina 1 2 12 14 13 10 8 21 19 South Dakota 0 6 14 20 17 7 5 17 14 
TABLE 11-43 -- LENGTH OF STAY FOR CHILDREN WAITING FOR ADOPTION, BY STATE, 

FISCAL YEAR 2001-continued 

[In percent; 130,528 total cases]P

1

P State Less than 1 month 1-5 months 6-11 months 12-17 months 18-23 months 24-29 months 30-35 months 36-59 months 60 or more months 

Tennessee 0 2 3 6 7 10 8 29 35 Texas 1 6 14 16 13 9 7 14 20 

Utah 2 8 15 20 11 7 9 16 12 Vermont P

2

P 1 4 11 17 13 9 21 23 

Virginia 1 7 11 13 12 10 9 19 19 Washington 0 2 7 12 13 13 12 22 20 West Virginia 1 5 12 12 15 13 7 18 18 Wisconsin 2 3 6 6 6 10 8 27 32 

Wyoming P

2

P 5 17 6 9 11 6 16 30 

Puerto Rico 4 12 10 8 5 5 2 11 44 

Total 1 4 8 10 11 10 8 24 24 

P1

P Percent totals may not equal 100 due to rounding. The total number of cases used represents the number of children for whom sufficient case recor

data was submitted to be included in this Table. This number of children does not necessarily equal the total number of cases found in other tables. 

P2

P State did not report any cases in that category. 

Note - A “0” indicates the state reported some cases in the category but the number of cases was less than one-half of one percent. Source: U.S. Department of Health and Human Services 
11-123 

Number and characteristics of adopted children 

 The Adoption and Foster Care Analysis and Reporting System (AFCARS) 

collects data on children who were adopted with the involvement of public child 

welfare agencies (see Table 11-44). As explained earlier, this is not necessarily the 

same as the number of adoptions reported by States for purposes of earning 

adoption incentive payments, which are based specifically on adoptions of children 

from foster care. Table 11-45 compares the racial and ethnic composition of 

children who were adopted through the child welfare system in fiscal year 2001 

with the race and ethnicity of children who were waiting for adoption during that 

year. Black children were the largest racial group among children waiting for 

adoption (42 percent), but somewhat more white children than black children (38 

percent compared with 35 percent) had actually been adopted in fiscal year 2001. 

TABLE 11-44 -- NUMBER OF AGENCY-INVOLVED ADOPTIONS BY 

STATE, SELECTED FISCAL YEARS 1995-2002 

State 1995P

1

P 1997P

1

P 1999P

2

P 2001P

2

P 2002P

2

P

Alabama 128 136 153 238 249 

Alaska 103 109 137 278 190 

Arizona 215 474 761 938 793 

Arkansas 84 146 318 362 297 

California 3,094 3,614 6,344 9,180 8,713 

Colorado 338 458 713 611 840 

Connecticut 198 278 403 444 617 

Delaware 38 33 33 117 133 

District of Columbia 86 132 166 230 252 

Florida 904 992 1,355 1,493 2,206 

Georgia 383 558 1,129 899 934 

Hawaii 42 150 281 260 349 

Idaho 46 47 107 132 118 

Illinois 1,759 2,695 7,028 4,107 3,585 

Indiana 520 592 759 878 920 

Iowa 227 440 764 661 871 

Kansas 333 421 566 428 450 

Kentucky 197 222 360 573 552 

Louisiana 292 310 356 470 487 

Maine 85 96 202 364 285 

Maryland 324 290 592 815 631 

Massachusetts 1,073 1,161 922 778 808 

Michigan 1,717 2,047 2,446 2,979 2,826 

Minnesota 232 302 633 567 626 

Mississippi 109 131 237 266 216 

Missouri 538 533 849 1,102 1,542 

Montana 104 143 187 275 234 

Nebraska 208 180 279 292 308 

Nevada 155 148 123 243 251 

New Hampshire 51 24 62 95 114 

New Jersey 616 570 732 1,028 1,365 

 
11-124 

TABLE 11-44 -- NUMBER OF AGENCY-INVOLVED ADOPTIONS BY 

STATE, SELECTED FISCAL YEARS 1995-2002-continued

State 1995P

1

P 1997P

1

P 1999P

2

P 2001P

2

P 2002P

2

P

New Mexico 141 152 258 369 275 

New York 4,579 4,979 4,864 3,934 3,160 

North Carolina 289 694 949 1,327 1,324 

North Dakota 42 57 139 145 137 

Ohio 1,202 1,400 1,868 2,230 2,396 

Oklahoma 226 418 825 956 987 

Oregon 427 441 765 1,071 1,115 

Pennsylvania 1,018 1,526 1,454 1,564 2,020 

Rhode Island 216 226 292 267 256 

South Carolina 231 318 456 384 340 

South Dakota 42 55 84 97 145 

Tennessee 458 195 382 646 922 

Texas 804 1,091 2,054 2,319 2,295 

Utah 283 268 369 349 335 

Vermont 62 80 139 116 153 

Virginia 320 276 326 495 424 

Washington 645 656 1,047 1,204 1,077 

West Virginia 139 220 312 362 361 

Wisconsin 360 530 642 754 1,028 

Wyoming 10 16 45 46 50 

Puerto Rico NA NA 483 475 388 

Total 25,693 31,030 46,750 50,213 50,950 

P

1

P

 The data for FY1995-FY1997 were reported by States to set baselines for the Adoption 

Incentive Program. They came from a variety of sources including the Adoption and Foster 

Care Analysis and Reporting System (AFCARS), court records, file reviews and legacy 

information systems. 

P

2

P

 Unless otherwise noted, the data come from the AFCARS adoption database. Because 

AFCARS adoption data are being continuously updated and cleaned, the numbers reported here 

may differ from data reported elsewhere. In addition, data reported for the Adoption Incentive 

program will differ from these data because adoptions reported for that program are identified 

through a different AFCARS data element and must qualify in other ways to be counted toward 

the award of incentive funds. Counts include adoptions reported as of 10/1/2003. Where 

appropriate, AFCARS data have been adjusted for duplication. 

Source: U.S. Department of Health and Human Services. 
11-125 

TABLE 11-45 -- RACE/ETHNICITY OF CHILDREN WAITING FOR 

ADOPTION AND ADOPTED, FISCAL YEAR 2001P

1 

[In percent]P

2

P

Race/EthnicityP

3

P Waiting Children Adopted Children 

White 32 38 

Black 42 35 

Hispanic 11 16 

Two or more races 2 3 

OtherP

4

P 2 2 

Unknown 4 5 

Missing data 6 0 

P

1

P

 Total number of children adopted is 50,940. Total number of children waiting is 130,538.

P

2

P

 Detail may not sum to 100 percent due to rounding. 

P

3 PAFCARS race and ethnicity categories are consistent with those used by the U.S. Census 

Bureau. Children identified as being of Hispanic origin may be of any race. Children included in 

the other race/ethnicity categories are non-Hispanic. Additionally, Federal race reporting 

standards changed to allow for multiple race reporting, therefore, a “Two or More Races” 

category was added beginning with FY2000. Therefore care should be used when comparing 

pre-FY2000 data with FY2000 and later race/ethnicity statistics, e.g. comparing the data in these 

tables with data found in the Child Welfare Outcomes - Annual Report to Congress. 

P

4

P

 For this Table "other" combines data reported in three categories: American Indian/Alaskan 

Native, Asian, and Native Hawaiian/Other Pacific Islander. 

Source: Table prepared by the Congressional Research Service from information provided by 

the U.S. Department of Health and Human Services. 

 Additional State-by-State information on children adopted through the public 

child welfare system is shown in tables 11-46 through 11-48, including 

race/ethnicity, age at the time of adoption finalization, and the prior relationship 

between adoptive parents and children. Readers should note that most children who 

are adopted out of foster care are adopted by their foster parents (Table 11-48). 
TABLE 11-46 -- RACE/ETHNICITY OF CHILDREN ADOPTED IN FISCAL YEAR 2001, BY STATEP

1

P [In percent; 50,940 total cases]P

2

P State American Indian/ Alaskan 

Native 

Asian 

Black or 

African 

American 

Native Hawaiian/ 

Other Pacific 

Islander 

Hispanic White 

Unknown/ 

Unable to 

Determine 

Two or 

More Missin

Alabama 1 P

3

P 42 P

3

P P

3

P 55 P

3

P 1 P

3

P Alaska 36 P

3

P 5 P

3

P 8 26 P

3

P 26 P

3

P Arizona 1 P

3

P 10 P

3

P 38 44 0 6 P

3

P Arkansas P

3

P 0 33 P

3

P 3 62 1 2 P

3

P California 0 1 17 0 37 31 12 1 P

3

P Colorado 2 1 18 P

3

P 27 50 0 1 P

3

P Connecticut P

3

P P

3

P 32 P

3

P 31 28 0 8 P

3

P Delaware P

3

P P

3

P 62 P

3

P 10 28 P

3

P P

3

P P

3

P District of Columbia P

3

P P

3

P 100 P

3

P P

3

P P

3

P 0 P

3

P P

3

P Florida 0 P

3

P 34 P

3

P 13 47 0 5 P

3

P Georgia P

3

P 1 48 P

3

P 6 36 2 7 P

3

P Hawaii 3 21 2 45 3 9 1 16 P

3

P Idaho 14 1 8 3 12 62 P

3

P P

3

P P

3

P Illinois 0 0 77 P

3

P 5 17 2 P

3

P P

3

P Indiana 0 P

3

P 50 P

3

P 3 45 0 1 P

3

P Iowa 3 1 21 P

3

P 6 63 6 P

3

P P

3

P Kansas 1 P

3

P 20 P

3

P 3 71 4 1 P

3

P Kentucky P

3

P 0 34 P

3

P 3 59 1 P

3

P 4 

Louisiana 1 P

3

P 58 P

3

P 0 39 0 2 P

3

P Maine 1 1 2 P

3

P 1 87 7 1 P

3

P Maryland P

3

P 0 73 P

3

P 2 22 P

3

P 3 P

3

P Massachusetts 0 2 17 P

3

P 23 52 2 2 1 

Michigan 1 P

3

P 49 P

3

P 4 40 0 6 P

3

P Minnesota P

3

P P

3

P 22 P

3

P 7 54 5 11 P

3

P Mississippi P

3

P 0 63 P

3

P P

3

P 36 P

3

P P

3

P P

3

P
Missouri 0 P3P 39 P3P 2 59 0 P3P P3P Montana 22 P3P 4 P3P 7 67 P3P P3P P3P Nebraska 5 0 16 P3P 8 69 1 1 P3P Nevada 1 2 23 P3P 12 62 P3P P3P P3P New Hampshire P3P P3P 3 1 5 88 P3P 2 P3P New Jersey 0 0 66 P3P 7 21 4 2 P3P New Mexico 4 0 6 P3P 56 34 P3P 1 P3P New York 0 0 46 P3P 14 13 26 P3P P3P North Carolina 2 1 48 0 6 37 0 6 0 

North Dakota 23 P3P 5 P3P 4 66 P3P 1 P3P Ohio 0 0 45 P3P 3 45 0 7 P3P Oklahoma 11 0 18 1 5 58 0 7 P3P Oregon 4 0 8 P3P 13 71 1 2 P3P Pennsylvania 0 1 46 P3P 9 44 0 0 P3P Rhode Island 2 2 24 P3P 13 47 8 3 P3P South Carolina 1 P3P 58 P3P 2 39 P3P 0 P3P South Dakota 41 P3P 2 P3P 11 41 P3P 4 P3P Tennessee 0 P3P 31 P3P 4 57 0 7 P3P Texas 0 0 24 0 38 32 1 4 P3P Utah 3 1 6 1 28 52 9 P3P P3P Vermont P3P P3P P3P P3P P3P 95 2 3 P3P Virginia P3P 1 41 P3P 5 45 0 8 P3P Washington 5 1 12 0 11 63 1 6 P3P West Virginia P3P 0 7 P3P 1 84 P3P 8 P3P Wisconsin 3 0 36 P3P 7 47 P3P 6 P3P Wyoming 7 2 P3P P3P 20 72 P3P P3P P3P Puerto Rico P3P P3P P3P P3P 100 0 P3P P3P P3P Total 1 1 35 0 16 38 5 3 0 
TABLE 11-46 -- RACE/ETHNICITY OF CHILDREN ADOPTED IN FISCAL YEAR 2001, BY STATEP

1

P-continue

P1 PAFCARS race and ethnicity categories are consistent with those used by the U.S. Census Bureau. Children identified as being of Hispanic origin m

be of any race. Children included in the other race/ethnicity categories are non-Hispanic. Additionally, Federal race reporting standards changed to 

allow for multiple race reporting, therefore, a “Two or More Races” category was added beginning with FY2000. Therefore care should be used whecomparing pre-FY2000 data with FY2000 and later race/ethnicity statistics, e.g. comparing the data in these tables with data found in the Child Welf

Outcomes - Annual Report to Congress. 

P2

P Percent totals may not equal 100 due to rounding. The total number of cases used represents the number of children for whom sufficient case recor

data was submitted to be included in this Table. This number of children does not necessarily equal the total number of cases found in other tables. 

P3

P State did not report any cases in that category. 

Note - A “0” indicates the State reported some cases in the category but the number of cases was less than one-half of one percent. Source: U.S. Department of Health and Human Services. 
11-129 

TABLE 11-47 -- CHILD'S AGE AT ADOPTION FINALIZATION, BY 

STATE, FISCAL YEAR 2001 

[In percent; 50,920 total cases]P

1

P

State Under 1 

year 

1-5 

years 

6-10 

years 

11-15 

years 

16-18 

years 

19+ 

years 

Alabama 3 47 33 16 1 P

2

P

Alaska 0 51 34 13 2 P

2

P

Arizona 1 49 30 17 2 P

2

P

Arkansas 2 41 33 19 5 P

2

P

California 3 52 31 12 2 0 

Colorado 3 51 28 15 2 P

2

P

Connecticut 1 55 32 12 1 P

2

P

Delaware 2 51 36 10 1 P

2

P

District of Columbia 3 24 52 16 4 0 

Florida 2 51 32 13 2 0 

Georgia 0 45 36 17 2 P

2

P

Hawaii 5 54 27 12 1 P

2

P

Idaho 2 55 24 17 2 P

2

P

Illinois 0 40 39 19 2 0 

Indiana 1 41 35 19 3 P

2

P

Iowa 2 44 32 19 4 P

2

P

Kansas P

2

P 42 34 19 5 0 

Kentucky 1 39 37 20 4 0 

Louisiana 0 38 41 17 3 P

2

P

Maine 2 46 34 15 3 P

2

P

Maryland 1 43 39 16 2 0 

Massachusetts 1 49 33 16 1 P

2

P

Michigan 2 43 36 17 2 0 

Minnesota 2 48 33 16 1 0 

Mississippi P

2

P 42 36 19 3 P

2

P

Missouri 3 46 32 16 3 0 

Montana 3 42 33 19 3 P

2

P

Nebraska 1 43 34 19 3 P

2

P

Nevada 1 61 26 12 1 P

2

P

New Hampshire P

2

P 47 40 12 1 P

2

P

New Jersey 1 57 30 12 1 0 

New Mexico 1 37 43 17 3 P

2

P

New York 0 34 37 25 3 0 

North Carolina 4 46 30 18 3 0 

North Dakota 28 32 21 13 6 P

2

P

Ohio 5 47 30 15 3 0 

Oklahoma 1 40 37 20 2 P

2

P

Oregon 0 48 35 15 1 P

2

P

Pennsylvania 1 43 33 19 3 0 

Rhode Island 3 53 30 13 1 P

2

P

South Carolina 3 43 32 18 4 P

2

P

South Dakota 2 52 37 7 2 P

2

P

Tennessee 1 35 37 22 5 P

2

P

Texas 4 55 29 12 1 P

2

P

Utah 9 54 27 10 1 P

2

P

Vermont 3 41 34 22 2 P

2

P
11-130 

TABLE 11-47 -- CHILD'S AGE AT ADOPTION FINALIZATION, 

FISCAL YEAR 2001, BY STATE-continued

State Under 1 

year 

1-5 

years 

6-10 

years 

11-15 

years 

16-18 

years 

19+ 

years 

Virginia 0 40 40 17 3 P

2

P

Washington 1 57 31 10 1 P

2

P

West Virginia 1 40 37 18 4 P

2

P

Wisconsin 7 44 34 14 1 P

2

P

Wyoming P

2

P 30 50 17 2 P

2

P

Puerto Rico 3 46 33 13 3 3 

Total 2 46 33 16 2 0 

P

1

P

 Percent totals may not equal 100 due to rounding. The total number of cases used 

represents the number of children for whom sufficient case record data was submitted to be 

included in this Table. This number of children does not necessarily equal the total number 

of cases found in other tables. 

P

2

P

 State did not report any cases in that category. 

Note - A “0” indicates the State reported some cases in the category but the number of 

cases was less than one-half of one percent. 

Source: U.S. Department of Health and Human Services. 

TABLE 11-48 -- PRIOR RELATIONSHIP OF ADOPTIVE PARENT(S) 

TO CHILD, BY STATE, FISCAL YEAR 2001 

[In percent; 45,239 total cases]P

1

P

State Non-relative Foster parent Step-parent Other relativeP

2

P

Alabama 97 P

3

P P

3

P 3 

Alaska P

3

P 53 P

3

P 47 

Arizona 15 43 0 42 

Arkansas 17 69 P

3

P 14 

California 8 46 0 46 

Colorado 10 62 0 28 

Connecticut 25 62 P

3

P 13 

Delaware 25 69 P

3

P 6 

District of Columbia P

3

P 80 P

3

P 20 

Florida 23 46 P

3

P 31 

Georgia 18 74 P

3

P 8 

Hawaii P

3

P 48 P

3

P 52 

Idaho 36 42 P

3

P 22 

Illinois P

3

P 100 P

3

P 0 

Indiana 52 30 P

3

P 18 

Iowa 29 71 P

3

P P

3

P

Kansas 13 66 0 21 

Kentucky 23 73 2 2 

Louisiana 17 76 P

3

P 7 

Maine 94 P

3

P P

3

P 6 

Maryland 4 55 0 41 

Massachusetts P

3

P 99 P

3

P 1 

Michigan 10 56 P

3

P 34 

Minnesota 41 32 0 26 

Mississippi 30 65 4 1 

Missouri 5 72 0 22 
11-131 

TABLE 11-48 -- PRIOR RELATIONSHIP OF ADOPTIVE PARENT(S) 

TO CHILD, BY STATE, FISCAL YEAR 2001-continued 

[In percent; 45,239 total cases]P

1

P

State Non-relative Foster parent Step-parent Other relativeP

2

P

Montana 1 76 P

3

P 23 

Nebraska 40 13 P

3

P 47 

Nevada 6 80 P

3

P 14 

New Hampshire 16 81 P

3

P 3 

New Jersey 20 80 P

3

P P

3

P

New Mexico 62 5 P

3

P 33 

North Carolina 26 50 0 25 

North Dakota 41 59 P

3

P P

3

P

Ohio 18 65 P

3

P 16 

Oklahoma 21 36 P

3

P 43 

Oregon 30 34 P

3

P 37 

Pennsylvania 37 58 P

3

P 5 

Rhode Island 6 64 0 30 

South Carolina 31 68 P

3

P 1 

South Dakota 10 69 P

3

P 21 

Tennessee 19 74 P

3

P 7 

Texas 27 49 0 24 

Utah 32 60 P

3

P 7 

Vermont 3 73 P

3

P 24 

Virginia 17 78 P

3

P 5 

Washington 39 59 2 0 

West Virginia 3 82 P

3

P 15 

Wisconsin 19 69 P

3

P 12 

Wyoming P

3

P 76 P

3

P 24 

Puerto Rico 14 46 16 24 

Total 17 59 0 24 

P

1

P

 Percent totals may not equal 100 due to rounding. The total number of cases used 

represents the number of children for whom sufficient case record data was submitted to be 

included in this Table. This number of children does not necessarily equal the total number 

of cases found in other tables. 

P

2

P

 Adoptive parents(s) identified as either relatives or relative foster parent(s) are classified 

as other relative. Some States did not identify any relative adopters. 

P

3

P

 State did not report any cases in that category. 

Note - A “0” indicates the State reported some cases in the category but the number of 

cases was less than one-half of one percent. 

Source: U.S. Department of Health and Human Services. 

TRENDS IN CHILD WELFARE AND FOSTER CARE COSTS 

 Federal spending under the title IV-E Foster Care Program has increased 

significantly since it began in 1981. Based on Administration estimates, Federal 

title IV-E expenditures have increased more than fourteenfold, from $309 million to 

$4.5 billion, between 1981 and 2002. Funding for the title IV-B Child Welfare 

Services Program increased by almost 80 percent from 1981 to 2002 

($163.6 million to $292 million). Funding for the title XX Social Services Block 
11-132 

Grant (SSBG), which States may use for child welfare services, has fallen. 

 In recent years, an increasing proportion of title IV-E costs has been 

expended on child placement services, administration, and training. Table 11-49 

shows HHS and Congressional Budget Office (CBO) estimates of title IV-E 

expenditures through fiscal year 2008. 

TABLE 11-49 -- PROPORTION OF TITLE IV-E FOSTER CARE 

EXPENDITURES SPENT ON CHILD PLACEMENT, 

ADMINISTRATION, AND TRAINING, FISCAL YEARS 1989-2008 

[Dollars in millions] 

Fiscal 

year 

Total Federal title 

IV-E expenditures 

Placement 

administration and 

trainingP

1

P

Placement, administration, and 

training as a percent of total title 

IV-E expenditures 

Actual: 

1989 1,153 507 0.44 

1990 1,473 638 0.43 

1991 1,819 789 0.43 

1992 2,233 1,029 0.46 

1993 2,534 1,222 0.48 

1994 2,750 1,375 0.50 

1995 3,066 1,467 0.48 

1996 3,098 1,595 0.51 

1997 3,692 1,967 0.53 

1998 3,704 1,782 0.48 

1999 P

2

P 4,012 2,049 0.51 

2000 4,256 2,241 0.53 

2001 4,382 2,312 0.53 

2002 4,523 2,450 0.54 

HHS estimates: 

2003 4,690 2,629 0.56 

2004 4,917 2,814 0.57 

2005 5,044 2,879 0.57 

2006 5,276 3,028 0.57 

2007 5,516 3,180 0.58 

2008 5,770 3,339 0.58 

CBO estimates: 

2003 4,592 2,541 0.55 

2004 4,719 2,626 0.56 

2005 4,806 2,659 0.55 

2006 4,943 2,743 0.55 

2007 5,086 2,831 0.56 

2008 5,232 2,926 0.56 

P

1

P

 Includes regular administration, training, and for fiscal years 1994-1995, SACWIS costs. 

P

2

P

 Beginning in fiscal year 1999, data include Puerto Rico. 

Source: Compiled by the Congressional Research Service from data provided by the U.S. 

Department of Health and Human Services and the Congressional Budget Office. 

 Table 11-50 shows Federal foster care expenditures by State in 1991, 1996, 

1999, and 2002. Between 1991 and 2002, total foster care expenditures increased 
11-133 

by 129 percent. Over this same time period, foster care maintenance costs increased 

by 68 percent. Because of the large increase in administrative and child placement 

costs relative to maintenance costs, the share of total costs represented by 

maintenance costs decreased between 1991 and 2002. 

 In an effort to gain more complete information on total child welfare 

spending, including sources in addition to titles IV-B and IV-E of the Social 

Security Act, the Urban Institute has conducted a series of State surveys; 51 States 

responded to the most recent survey with information about spending in fiscal year 

2000 (Urban, 2002b). The survey found that States spent $20 billion in that year, 

and researchers estimated that Federal funds accounted for 49 percent of total 

spending, State funds also constituted 39 percent, and local sources accounted for 

11 percent. Of Federal expenditures, 50 percent was from title IV-E but only 5 

percent was from title IV-B. Nontraditional funding sources played a significant 

role; 17 percent of Federal expenditures for child welfare came from Temporary 

Assistance for Needy Families funds, 15 percent was from the Social Services 

Block Grant, and 8 percent was from Medicaid. Other sources included 

Supplemental Security Income. The report also found that the financing of child 

welfare services varies considerably by State, and that the largest single category of 

expenditure was for out-of-home care, accounting for 45 percent of all child welfare 

spending in fiscal year 2000. 
TABLE 11-50 -- FEDERAL FOSTER CARE EXPENDITURES BY STATE, 

SELECTED FISCAL YEARS 1991-2002P

1

P Fiscal year total expenditure claims 

 (in millions of dollars) 

Maintenance claims 

(in millions of dollars) 

Maintenance claims as a 

State percentage of total 

1991 1996P

2

P 1999P

2

P 2002P

2

P 1991 2002 1991 2002 

Percen

growth in 

1991-2

Alabama 5.17 5.23 13.24 26.81 1.43 6.51 28 24 419 Alaska 3.75 7.99 9.42 9.02 1.67 1.91 45 21 141 

Arizona 11.43 44.12 54.32 39.99 3.72 20.89 33 52 250 

Arkansas 4.85 26.64 32.06 32.68 1.76 12.85 36 39 574 

California 354.69 727.89 911.80 1,171.27 185.50 402.21 52 34 230 Colorado 7.46 20.35 42.55 47.36 4.49 13.39 60 28 535 

Connecticut 24.04 66.83 91.78 50.17 8.18 13.09 34 26 109 Delaware 1.35 7.40 8.31 10.67 0.57 1.42 42 13 690 

District of Columbia 4.70 22.89 42.95 25.08 2.68 15.84 57 63 434 Florida 25.36 78.70 120.77 126.80 10.98 27.50 43 22 400 

Georgia 24.19 24.52 42.89 61.63 7.39 28.63 31 46 155 

Hawaii 1.23 11.77 15.81 17.05 0.09 3.85 07 23 128Idaho 1.23 6.70 7.92 5.69 0.28 1.87 23 33 363 

Illinois 67.45 238.33 273.27 321.21 40.36 56.32 60 18 376 

Indiana 7.12 50.82 53.32 46.87 2.49 25.88 35 55 558 

Iowa 14.02 16.96 29.62 20.51 3.60 11.51 26 56 46 

Kansas 12.94 23.90 30.89 28.36 6.36 5.00 49 18 119 

Kentucky 30.68 51.58 46.11 54.17 11.96 28.13 39 52 77 

Louisiana 26.12 36.68 50.14 52.85 14.67 22.36 56 42 102 

Maine 8.01 18.78 32.18 33.42 4.79 25.23 60 75 317 Maryland 28.95 76.46 96.73 141.21 14.23 58.32 49 41 388 

MassachusettsP

3

P 29.47 95.20 75.23 54.82 17.01 31.33 58 57 86 

Michigan 128.27 104.57 135.96 144.87 52.49 73.66 41 51 13 Minnesota 24.83 44.55 72.59 74.48 12.60 22.63 51 30 200 Mississippi 2.16 8.74 9.49 9.99 1.07 2.02 50 20 362 Missouri 29.29 45.96 73.62 67.11 14.29 24.90 49 37 129 
Montana 6.72 8.31 7.79 9.76 2.47 5.82 37 60 45 

Nebraska 7.15 20.40 25.89 21.97 3.73 11.96 52 54 207 

Nevada 2.54 5.18 14.76 13.83 0.92 3.85 36 28 445 

New Hampshire 5.06 10.24 11.85 11.80 1.97 5.08 39 43 133 New Jersey 16.30 41.38 45.64 77.09 8.07 32.55 50 42 373 New Mexico 6.28 13.78 14.37 15.89 3.04 3.38 48 21 153 New York 672.62 471.46 482.04 479.63 451.66 296.06 67 62 -29 North Carolina 8.64 37.44 64.54 63.62 6.55 17.96 76 28 636 North Dakota 3.84 8.12 11.21 13.11 1.90 4.96 49 38 241 Ohio 52.52 135.55 207.89 221.95 26.40 118.96 50 54 323 

Oklahoma 11.64 24.99 32.42 29.17 8.21 15.32 71 53 151 

Oregon 14.02 24.82 31.50 31.88 6.91 13.44 49 42 127 Pennsylvania 118.44 149.79 316.40 345.25 82.01 189.70 69 55 192 Puerto Rico NA NA 7.28 13.44 NA 13.44 NA NA NA Rhode Island 5.77 9.17 12.59 13.86 2.57 4.50 45 32 140 South Carolina 9.70 18.78 17.23 35.33 4.74 12.46 49 35 264 South Dakota 2.02 3.04 4.60 5.79 1.07 2.78 53 48 187 Tennessee 19.63 27.15 25.19 24.21 11.22 15.54 57 64 23 Texas 54.75 77.22 86.96 148.07 28.54 75.21 52 51 170 Utah 3.84 13.19 20.95 20.09 2.05 3.08 53 15 423 Vermont 6.59 8.24 12.00 12.80 4.32 9.07 66 71 94 

Virginia 12.48 32.67 44.32 81.23 5.09 27.22 41 34 551 

Washington 17.06 24.83 29.30 53.13 6.02 16.29 35 31 211 West Virginia 7.60 8.51 17.73 23.25 5.69 18.60 75 80 206 Wisconsin 32.27 45.97 91.65 80.04 15.88 26.12 49 33 148 

Wyoming 0.89 1.92 2.19 2.89 0.61 1.29 69 45 224 

TotalP4P 1,977.13 3,085.71 4,011.26 4,523.18 1,116.30 1,881.91 56 42 128 
TABLE 11-50 -- FEDERAL FOSTER CARE EXPENDITURES BY STATE, 

SELECTED FISCAL YEARS 1991-2002P1 P– continued

P1

P Does not include dispute and reconciliations. 

P2 PFiscal years 1996, 1999, and 2002 include SACWIS expenditures. P3

P Fiscal year 1999 data include estimates for the third and fourth quarters. 

P4

P Puerto Rico did not begin to participate in title IV-E foster care until fiscal year 1999. Therefore, the percentage growth from 1991-2002 is ca

without including Puerto Rico in the total. Source: Committee on Ways and Means using data provided by the U.S. Department of Health and Human Services. 
11-137 

LEGISLATIVE HISTORY 

 (For legislative history before 1996, see previous editions of the Green Book.) 

 During the 104th Congress, comprehensive welfare reform legislation was 

enacted that contained provisions affecting child welfare (Personal Responsibility 

and Work Opportunity Reconciliation Act, Public Law 104-193). The centerpiece 

of the welfare reform legislation was the repeal of AFDC and creation of a new 

block grant to States for Temporary Assistance for Needy Families (TANF). As a 

condition of receiving TANF funds, States must operate Foster Care and Adoption 

Assistance Programs under title IV-E of the Social Security Act. However, 

eligibility for title IV-E historically has been linked to AFDC eligibility. Thus, 

Public Law 104-193 provides that foster or adoptive children are eligible for title 

IV-E subsidies if their families would have been eligible for AFDC, as it was in 

effect in their State on June 1, 1995. (Technical amendments enacted in 1997, 

Public Law 105-33, subsequently changed this date to July 16, 1996.) Children 

eligible for SSI continue to be eligible for title IV-E adoption assistance, and foster 

and adoptive children continue to be eligible for Medicaid. 

 Public Law 104-193 also amended title IV-E to enable for-profit child care 

institutions to participate in the Federal Foster Care Program; extended the 

enhanced Federal matching rate for certain data collection costs through fiscal year 

1997; mandated HHS to conduct a national random sample study of children in the 

child welfare system; and required States, as a component of their title IV-E plans, 

to consider giving preference to adult relatives in determining a foster or adoptive 

placement for a child. 

 In 1997, Congress enacted the most significant changes to titles IV-B and IVE of the Social Security Act since they were established in their current form in 

1980. This legislation, the Adoption and Safe Families Act (Public Law 105-89), 

was intended to promote adoption and ensure safety for children in foster care. The 

law established that a child's health and safety must be of paramount concern in any 

efforts made by the State to preserve or reunify the child's family. The law retained, 

but clarified the requirement that States make “reasonable efforts” to preserve or 

reunify a child's family, establishing exceptions to this requirement. Also to 

promote safety, Public Law 105-89 required States to conduct criminal background 

checks for all prospective foster or adoptive parents, and required States to develop 

standards to ensure quality services that protect children's health and safety while in 

foster care. To promote permanency, the law required States to make reasonable 

efforts to place children, in a timely manner, who have permanency plans of 

adoption or another alternative to family reunification, and to document these 

efforts. Further, provisions were intended to eliminate interjurisdictional barriers to 

adoption. Public Law 105-89 changed the name of dispositional hearings to 

“permanency” hearings, and required that they occur within 12 months of a child's 

placement in foster care, rather than the first 18 months. The law also revised the 

list of permanency goals, eliminating specific reference to long-term foster care, 

and required that foster parents, preadoptive parents, and relative care givers be 
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given notice and opportunity to be heard at reviews and hearings. 

 The Adoption and Safe Families Act required that States initiate or join 

proceedings to terminate parental rights on behalf of children who have been in 

foster care for 15 of the most recent 22 months, although certain exceptions are 

allowed. The law also authorized incentive payments to States to increase the 

number of foster and special-needs children who are placed for adoption. The law 

contains some provisions intended to expand health insurance coverage for specialneeds adopted children who are not eligible under title IV-E, and also reauthorized 

and renamed the Family Preservation and Family Support Program. The program 

was authorized through fiscal year 2001, as the Promoting Safe and Stable Families 

Program. In addition, Public Law 105-89 established a new outcome measures 

reporting system for States, and authorized an expansion of the child welfare waiver 

demonstration authority established earlier. 

 Public Law 106-169 was enacted during the 106th Congress, revising the 

Independent Living Program and renaming it in honor of the late Senator John 

Chafee. The legislation provided greater flexibility to States in their use of funds to 

help older foster children obtain the education and employment services necessary 

for a successful transition to adult living, increased the entitlement ceiling for the 

program, and revised the State allocation formula. The law also established an 

option under Medicaid for States to cover certain former foster care youth aged 18-

20. 

 Public Law 107-133 reauthorized the Promoting Safe and Stable Families 

program for 5 years (FY2002-FY2006) at an annual mandatory funding level of 

$305 million, and authorized additional discretionary funds of up to $200 million 

annually. The law also granted new program authority for HHS to fund programs 

that mentor children of prisoners and expanded the Foster Care Independence 

Program by authorizing new discretionary funds for education and training 

vouchers. 

 Public Law 108-145 reauthorized adoption incentive payments to States to 

increase adoptions of foster children and children with special needs. The law 

added an additional incentive to increase adoptions of foster children ages 9 or 

older; mandated a report by HHS on State efforts to promote adoption or other 

permanency options for foster children; and authorized penalties for States that fail 

to submit AFCARS data to HHS. 

REFERENCES 

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final report. Washington, D.C: U.S. Department of Health and Human 

Services. 

Chapin Hall Center on Children. (2003). Unpublished data from the Multistate 

Foster Care Data Archive. Chicago: Author. 

Committee on Ways and Means. (1990). The enemy within: Crack-cocaine and 

America's families (WMCP: 101-30). Washington, DC: U.S. Government 

Printing Office. 
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Cook, R. (1990). A national evaluation of title IV-E foster care independent living 

programs for youth, phase 1. Rockville, MD: Westat. 

Cook, R. (1992). A national evaluation of title IV-E foster care independent living 

programs for youth, phase 2. Rockville, MD: Westat. 

Courtney, M.E., & Piliavin, I. (1998). Foster youth transitions to adulthood: 

Outcomes 12 to 18 months after leaving out-of-home care. Madison, WI: 

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Derr, M., and Cooley, V. (2002). Does welfare grant sanctioning increase child 

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Social Services Review. 

Ehrle, J., Geen G., and Main, R. (2003). Kinship Foster Care: Custody, Hardships, 

and Services. Washington, DC: Urban Institute. 

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child maltreatment. Cambridge, MA: Abt Associates. 

Goerge, R., and Lee, B. (2000). Changes in social program participation in the 

1990s: Initial findings from Illinois. Chicago: Joint Center for Poverty 

Research, Northwestern University/University of Chicago. 

James Bell Associates. (1999, June). Review and analysis of State program reports 

related to the court improvement program. Arlington, VA: Author. 

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services implementation study: final report. Arlington, VA: Author. 

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00012). Washington, DC: U.S. Department of Health and Human Services. 

Office of Inspector General. (1990). Opportunities for cost containment by 

modifying Federal reimbursement to States for administrative costs of title 

IV-E program (A-07-90-00274). Washington, DC: U.S. Department of Health 

and Human Services. 

Office of Inspector General. (1992). Using relatives for foster care (OEI-06-90-

02390). Washington, DC: U.S. Department of Health and Human Services. 

Paxson, C., & Waldfogel, J. (2001). Welfare reforms, family resources, and child 

maltreatment. [In] Meyer, B., & Duncan, G., eds. The Incentives of 

Government Programs and the Well-Being of Families. Chicago: Joint 

Center for Poverty Research, Northwestern University/University of Chicago. 

Sedlak, A.J., & Broadhurst, D.D. (1996, September). Third national incidence study 

of child abuse and neglect: Final report. Washington, DC: U.S. Department 

of Health and Human Services. 

Shook, K. (1999). Does the loss of welfare income increase the risk of involvement 

with the child welfare system? Child and Youth Services Review, 21 8/9. 

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National Household Survey on Drug Abuse Report: Children living with 

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Urban Institute. (2000). State policies for assessing and supporting kinship foster 

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