Foster Youth: HHS Actions Could Improve Coordination of Services and Monitoring of States' Independent Living Programs
Published: 2004-11-18T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: To improve outcomes for youth leaving foster care, Congress passed the Foster Care Independence Act of 1999 (FCIA), which increased the allocation of federal funds for independent living programs from $70 million to $140 million. This report reviews (1) how states' funding allocations changed to serve youth after FCIA, (2) the extent to which states have expanded services and age groups of foster youth served since the passage of FCIA and what challenges remain, (3) the extent to which states have used other federal and state programs to coordinate the delivery of services to foster youth, and (4) how the states and the Department of Health and Human Services (HHS) have fulfilled the program accountability provisions of the law and assessed the effectiveness of independent living services.
section_title: What GAO Found
paragraphs: The doubling of federal funding for independent living programs has resulted in most states receiving an increase in funds. Although some states had difficulty expanding their program infrastructure in the first 2 years of increased funding, the amount of funds states returned to HHS declined the second year. Differences in funding also appeared in the amounts available per eligible foster care youth. Following the passage of FCIA, 40 states reported in our survey expanding independent living services to younger youth, and 36 states expanded services to older youth, but gaps remain in providing some key services to youth. State differences in serving youth may have been caused by gaps in the availability of critical services, such as mental health services, mentoring, and housing, as well as challenges engaging youth and foster parents to participate in the program. Almost all states that we surveyed reported increased levels of coordination under FCIA, but linkages with other federal and state youth-serving programs were not always in place to increase services available across local areas. Despite some coordination efforts, states may not make full use of available resources. One of the barriers in linking program services reported by the 4 states we visited included the inconsistent availability of information on the array of programs that were operating in each state and local area. States and HHS have taken action to fulfill the accountability provisions of FCIA, but little information is available to assess the effectiveness of independent living services. All states submitted required plans and reports, but the absence of a uniform reporting format and lack of standard monitoring practices among HHS regional offices hindered assessments of state performance. HHS is developing an information system that may improve program accountability and reported that it expects to issue a proposed regulation in 2005.

section_title: Letter
paragraphs: Almost 40 percent of the more than 530,000 youth in foster care are  adolescents age 13 or older, and approximately 19,000 youth leave the  foster care system each year without being adopted or having a permanent  living arrangement. Research studies have shown that many of these  young people face serious problems once on their own, including  homelessness, a lack of education and stable employment, and difficulties  obtaining medical and mental health services. In response to concerns that  youth leave foster care poorly prepared to live self-sufficiently, in 1986  Congress created the Independent Living Program, which provided states  with funding to prepare foster care adolescents for adulthood. To  strengthen this program, Congress later passed the Foster Care  Independence Act of 1999 (FCIA) and created the John H. Chafee Foster  Care Independence Program (Chafee Program), which doubled overall  federal funding for independent living programs from $70 million to   $140 million. The Administration for Children and Families (ACF) within  the Department of Health and Human Services (HHS) has responsibility  for overseeing and evaluating the Chafee Program, which comprises about  2 percent of the approximately $6 billion obligated to foster care and  adoption programs under Title IV-E of the Social Security Act.
In addition to providing increased funding, FCIA resulted in other  significant changes for the independent living program. The law expanded  state flexibility to offer independent living services to youth younger than  16 and to assist youth 18 to 21 years old who are no longer in the foster  care system with room and board, Medicaid health insurance, and other  support services. Further, FCIA called for states to make every effort to  coordinate their independent living programs with other federal and state  programs that provide services to youth, such as housing and school-to- work programs. All states were required to submit a multiyear plan  describing how they planned to use the Chafee Program funds, and HHS  required states to submit annual reports on the progress made to  implement their programs. In addition, states were required to submit  certifications that they would comply with various aspects of the law.  Finally, FCIA directed HHS to develop outcome measures to be used to  assess state performance in operating independent living programs and to  conduct evaluations of state programs deemed to be innovative or of  potential national significance.
We previously reported on HHS’s and states’ efforts to implement  independent living programs prior to changes under FCIA. Because of  your interest in how HHS and states have implemented FCIA and progress  made to assist foster youth achieve self-sufficiency, you asked us to  determine (1) how states’ funding allocation changed to serve youth after  FCIA, (2) the extent to which states have expanded independent living  services and age groups of foster youth served since the passage of FCIA  and what challenges remain, (3) the extent to which states have used other  federal and state programs to coordinate the delivery of independent living  services to foster youth, and (4) how the states and HHS have fulfilled the  program accountability provisions of the law and assessed the  effectiveness of independent living services.
To conduct our work, we surveyed the independent living coordinators in  all 50 states, the District of Columbia, and Puerto Rico regarding their  experiences in developing and implementing their Chafee Programs in  federal fiscal year 2003. We received responses from 50 states and the  District of Columbia. We compared results with those of a similar survey  we administered to state independent living coordinators that gathered  information on state independent living programs operating in federal  fiscal year 1998. We checked for obvious errors and conducted some  follow-up with states, but we did not independently verify states’  responses. We analyzed federal funding amounts to the 50 states, the  District of Columbia, and Puerto Rico for independent living programs  before and after the passage of FCIA, using federal financial and foster  care population data, as well as data reported by states in our 2004 survey.  We analyzed Chafee Program plans from 49 states, the District of  Columbia, and Puerto Rico for federal fiscal years 2001-2004 to determine  states’ program strategies for meeting the goals of FCIA. We also analyzed  a total of 90 annual progress and services reports (annual reports) that  states submitted regarding the progress made in implementing their  Chafee Program plans for federal fiscal years 2001 and 2002. In addition,  we visited 4 states—Connecticut, Florida, Texas, and Washington—and 2  local areas within each state to obtain information on their experiences  developing and implementing their independent living programs. We spoke  with state and local officials, caseworkers, several groups of youth, foster  parents, and contract provider staff. We selected states that represented a  variety of approaches to implementing independent living services and  geographic diversity. Finally, we interviewed HHS officials, federal  contractors, and child welfare experts, and reviewed relevant documents  and literature. We conducted our work between August 2003 and August  2004 in accordance with generally accepted government auditing  standards. A more detailed discussion of our scope and methodology  appears in appendix I.
subsections: section_title: Background
paragraphs: In 1986, Congress amended Title IV-E of the Social Security Act to  authorize federal funds targeted to assist youth aged 16 and over in making  the transition from foster care to living independent of the child welfare  system and created the Independent Living Program (ILP). This program  was designed to prepare adolescents in foster care to live self-sufficiently  once they exited the child welfare system. As with many adolescents,  foster care youth face a time of uncertainty and change as they approach  age 18. However, research suggests that they may be at greater risk of  experiencing negative consequences in adulthood, such as unemployment,  incarceration, or poor health outcomes. For example, research indicates  that 30 to 40 percent of youth in foster care are affected by chronic  medical problems, but barriers exist to meeting those needs, such as  prolonged delays in getting referrals to specialists. In addition, research  shows that children and youth in foster care have poorer academic  experiences than do their peers not in care. For example, twice as many  youth in foster care than those not in foster care had repeated a grade,  changed schools during the year, or enrolled in a special education  program.
subsections: section_title: Foster Care Independence Act and the Chafee Program
paragraphs: Several amendments were made to the Independent Living Program over  the years, but the passage of FCIA and the creation of the Chafee Program  represented the most significant changes in the federal independent living  program since its creation. FCIA doubled the federal funds available for  independent living programs to $140 million each year. These funds are  allocated to states based on their share of the nation’s foster care  population.
In addition to providing increased funding, FCIA eliminated the minimum  age limit of 16 years and provided states with the flexibility to define the  age at which children in foster care are eligible for services to help them  prepare for independent living, as long as services are provided to youth  who are likely to remain in foster care until 18 years of age. The law  provided states the flexibility to develop programs that met the needs of  the adolescents in their care, as long as states designed and conducted  their programs based on the five key purposes outlined in the law (see  table 1).
The law also provided several new services to help youth make the  transition to adulthood. First, it allowed states to use up to 30 percent of  their state allotment for room and board for former foster care youth up to  age 21. Second, it allowed states the option to expand Medicaid coverage  to former foster care adolescents between 18 and 21. Title IV-E was  amended again in 2002 to provide foster youth vouchers for postsecondary  education and training under the Education and Training Vouchers (ETV)  program and authorized an additional $60 million for states to provide  postsecondary education and training vouchers up to $5,000 per year per  youth. Eligible participants include youth otherwise eligible for services  under the states’ Chafee Programs, youth adopted from foster care after  attaining the age of 16, and youth participating in the voucher program on  their 21st birthday (until they turn 23 years old) as long as they are  enrolled in a postsecondary education or training program and are making  satisfactory progress toward completion of that program. In federal fiscal  year 2003, approximately $41 million in federal funds was available for  states’ ETV programs. The amount increased slightly in federal fiscal year  2004 to approximately $44 million.
In addition, the law required that states make every effort to coordinate  their Chafee Programs with other federal and state programs for youth,  such as the Runaway and Homeless Youth Program, abstinence education  programs, local housing programs, programs for disabled youth, and  school-to-work programs offered by high schools or local workforce  agencies. Further, states were required to coordinate their programs with  each Indian tribe in the state and offer the state’s independent living  services to Indian children.
section_title: State Responsibilities under FCIA
paragraphs: To receive funds under the Chafee Program, states were required to  develop multiyear plans describing how they would design and deliver  programs in accordance with FCIA and to submit program certifications.  The multiyear Chafee plans must include a description of the state’s  program design, including its goals, strategies, and its implementation plan  for achieving the five key purposes detailed in the law. States were also  required to certify that they would operate a statewide independent living  program that complied with the specific aspects of the law, such as  providing training to help foster parents, adoptive parents, workers in  group homes, and case managers understand and address the issues  confronting adolescents preparing for independent living. Further, to  receive annual funds, ACF required states to submit annual reports that  described the services provided and activities conducted under their  Chafee Programs, including information on any program modifications  and their current status of implementation; provide a record of how funds  were expended; and include a description of the extent to which the funds  assisted youth age 18 to 21 in making the transition to self-sufficiency.
section_title: Federal Oversight
paragraphs: FCIA required that HHS develop and implement a plan to collect  information needed to effectively monitor and measure a state’s  performance, including the characteristics of youth served by independent  living programs, the services delivered, and the outcomes achieved.  Further, FCIA required HHS to conduct evaluations of independent living  programs deemed to be innovative or of potential national significance  using rigorous scientific standards to the maximum extent practicable,  such as random assignment to treatment and control groups.
Currently, ACF’s 10 regional offices conduct much of the federal oversight  for the Chafee Program. They hold the responsibility for reviewing and  approving the state plans, certifications, and annual reports. In addition,  the regional offices provide assistance and guidance to the states on  implementing and operating their programs. Technical assistance is also  available to states from 10 national resource centers. In particular, the  National Resource Center for Youth Development (NRCYD) provides  states and tribes assistance with helping youth in care establish permanent  connections and achieve successful transitions to adulthood. Upon request  from the states and approval from the regional offices, the NRCYD has  facilitated stakeholder meetings to bring together officials from various  state and federal programs within a state to facilitate communication,  awareness, and information sharing, and provide strategies to promote  long-term collaborative efforts around independent living.
In 2001, ACF implemented an outcome-oriented process, known as the  Child and Family Services Review (CFSR), in part, to determine states’  substantial conformity with Title IV-E provisions and hold states  accountable for improving child welfare outcomes. The CFSR measures  state performance on 45 performance items, which correspond to   7 outcomes and 7 systemic factors. States that were reviewed during the  first year of the CFSR were rated on the provision of independent living  services to youth in their care 16 years or older. This item was removed  from the CFSR in subsequent reviews when ACF redesigned the review  instrument to focus more on setting and achieving appropriate  permanency goals for children and less on service delivery. With the  redesigned instrument, reviewers were instructed to consider the  provision of independent living services in other measures, such as when  determining if the youths’ needs were assessed and if appropriate services  were provided.
section_title: FCIA Increased Independent Living Allocations for Most States, but Some States Had Difficulty Absorbing Large Increases in Funds
paragraphs: While overall federal funding for state independent living programs  doubled with the passage of FCIA, there were significant variations in the  changes to state allocations, and some states had difficulty expanding  their programs quickly enough to spend all of the new funds. Prior to the  passage of FCIA, states were awarded independent living funds based on  the number of children receiving federal foster care payments in 1984.  The new law updated the formula, which generally allocates funds to each  state based on the state’s proportion of the nation’s population of children  in foster care—regardless if the child is receiving federal or state funded  foster care payments. In addition, the new formula includes a hold- harmless provision to ensure that each state will receive at least the  amount it received in federal fiscal year 1998 or $500,000, whichever is  greater. Once the states subject to the hold-harmless provision are funded,  the remaining funds within the cap of $140 million are allotted to the other  states. Under the previous independent living program, states received  funds ranging from $13,000 in Alaska to more than $12 million in  California. In the first year of funding under FCIA, Alaska and eight other  states received the minimum of $500,000, while California received more  than $27 million (see table 2). In most cases, states received an increase of  funds. However, the District of Columbia, Louisiana, and New Jersey  received no additional funds the first year because their allocations under  the new formula were initially lower than the amounts they received in  1998. Therefore, because of the hold-harmless clause, they received the  same amount awarded in 1998.
Some states were unable to spend all of their federal allocations in the first  2 years of increased funding under the program. In 2001, 20 states returned  nearly $10 million in federal funding to HHS, and in 2002, 13 states  returned more than $4 million. ACF regional officials reported that one  reason for these unspent funds was that some states did not initially have  the infrastructure in place to quickly absorb the influx of funds. Texas, for  example, planned to use some of its $2.75 million in additional funds to  develop services for youth in rural areas, but state officials said that the  process of identifying and issuing contracts to service providers was  lengthy and initially hampered by the need to identify service providers  who were able to provide matching contributions required to receive  federal funds under FCIA. As a result, over $500,000 of the state’s total   $4.6 million allocation went unspent in federal fiscal year 2001.
We could not determine the amount of FCIA funding states had available  to spend on each youth eligible for independent living services because of  the lack of data on eligible youth emancipated from foster care. However,  available data on youth in foster care suggest that states may have  different amounts of funds available for services to youth in foster care.  We compared each state’s 2004 FCIA allocation with its 2002 population of  eligible youth in foster care. This comparison showed that funding for  independent living services ranged from $476 per foster youth in West  Virginia to almost $2,300 per youth in Montana, as shown in figure 1.  These differences were due in part to the new provision in FCIA that  allowed states to define the age ranges within which youth were eligible  for independent living services. For example, 4 states reported in our  survey offering independent living services to youth at age 12, while   27 states reported offering services at age 14. In addition, the funding  formula is based on the total number of all children in foster care.  However, some states have a larger share of youth eligible for independent  living services than other states. For example, of the 15 states reporting in  our survey that youth are eligible for services between the ages of 14 and  21, 3 states had 25 percent or less of their foster care population within  this age range, while in 3 other states, this age range accounted for over   40 percent of the total foster care population.
section_title: States Expanded and Improved Services for Youth after FCIA, but Gaps in Critical Services Remain
paragraphs: Following the passage of FCIA, many states reported expanding eligibility  for independent living services to younger and older youth and to provide  new services, such as Medicaid health insurance, to youth who had  already left the foster care system. Further, the states we visited reported  using the new funds to improve the quality of existing independent living  services, refocus the attention of their programs, or develop new services  to assist youth of all ages in independent living programs. However, states  varied in the proportion of eligible youth served. For example, 40 states  providing these data in our survey reported serving between 10 and   100 percent of foster care youth eligible for independent living services in  2003. A number of factors may have contributed to these differences,  including gaps in the availability of critical services, such as mental health  services, mentoring, and housing, as well as challenges in engaging youth  and foster parents to participate in the program.
subsections: section_title: FCIA Allowed States to Serve Younger and Emancipated Youth and to Improve Services for All Youth in Independent Living Programs
paragraphs: After the passage of FCIA, 40 states reported in our survey expanding  services to youth younger than they had previously served, and 36 states  reported serving older youth, and the states we visited reported improving  service quality. While some states had been using nonfederal funds to  provide services to youth in these broader age groups, the number of  states that reported providing core independent living services, such as  independent living skills assessments, daily living skills training, and  counseling, to youth younger than 16 more than doubled after FCIA.  Similarly, more states reported offering these supports and services to  youth who were emancipated from foster care after the passage of FCIA  (see fig. 2).
Many states also began to offer the new services under FCIA that would  allow them to meet the unique needs of youth that emancipated from  foster care. These services include the Education and Training Vouchers,  Medicaid health insurance, and assistance with room and board.
subsections: section_title: Education and Training Vouchers
paragraphs: All states, the District of Columbia, and Puerto Rico were allocated funds  under the ETV program to assist youth seeking postsecondary education.  The 4 states we visited had started to implement their ETV programs at the  time of our site visits and had plans to use the funds in different ways.
Texas officials said that youth would be able to use ETV funds for  educational expenses, housing, food, clothing, or day care, so that the  funds would provide relief for youth who want to continue their education  but are concerned about paying bills while attending postsecondary school  full-time.
Connecticut officials said they would use ETV funds to provide computers  to youth in postsecondary education and training programs and to  establish an additional liaison between the independent living program  and the Job Corps program.
Florida officials said they would use ETV funds for educational expenses  for youth receiving the state’s independent living scholarship.
Washington plans to use ETV funds to expand and enhance service  delivery for education and training, and service providers will be evaluated  on their success in helping youth reach desired educational outcomes.
section_title: Medicaid Health Insurance
paragraphs: Of the 50 states responding to our 2004 survey, 31 reported offering  Medicaid benefits to at least some emancipated youth to help them  maintain access to health care benefits while they transitioned to  independence (see fig. 3). Some states may limit coverage to specific  subpopulations of emancipated youth. For example, according to officials  in Florida, the state limits Medicaid access to emancipated youth who  meet minimum academic requirements to qualify for the state’s  independent living scholarship program.
In our 2004 survey, 46 states reported that they offered assistance with  room and board to youth that had been emancipated from foster care, and  the states we visited reported offering a range of housing supports to  assist youth. Connecticut provided several housing options to meet the  needs of youth at varying levels of independence, including group homes,  supervised apartment sites, and unsupervised apartment sites with  periodic visits from case managers. While other states we visited offered a  more limited supply of housing options, all provided some type of housing  subsidy or placement. For example, Texas and Washington provided youth  with a monthly stipend for rent as well as a onetime stipend for household  supplies.
section_title: Improving Existing Services
paragraphs: Chafee Program funds were also used to improve the quality of existing  independent living services, refocus the attention of their programs, or  develop new services to assist youth of all ages in independent living  programs, according to state officials we visited.
Local officials in Florida said that prior to FCIA, training in daily living  skills was provided haphazardly, and in many cases unqualified staff  taught classes even though such training was considered a core  component of their independent living program. After FCIA, Florida  officials said that the state redesigned staff training, improved instructor  quality, and was better prepared to provide youth with the skills necessary  to live independently outside of the foster care system.
In Texas, a service provider reported that FCIA encouraged the state to  incorporate more experiential learning opportunities in the daily living  skills curriculum. For example, the curriculum in one locality included  taking the youth on a shopping trip to the grocery store while working  within a set budget. Similarly, in one local area in Florida, youth in the  independent living program described a scavenger hunt in which they  were required to take public transportation around the city and conduct  certain activities that emphasized their daily living skills training, such as  going to the bank and opening a checking account.
Washington officials reported that FCIA was instrumental in shifting the  emphasis of the state’s independent living program to focus on  educational achievement, and some regions in the state developed summer  enrichment programs to provide youth with year-round opportunities to  keep up with their peers academically or to further their educational  development.
Officials in Connecticut reported using additional funds to develop  mentoring programs and to establish adolescent specialist positions in  each local child welfare office.
section_title: Serving Youth Remains Challenging because of Gaps in Services and Difficulties Engaging Youth and Foster Parents
paragraphs: States differed in the proportion of eligible youth served under their  respective independent living programs, and officials in the 4 states we  visited reported gaps in providing critical services, as well as challenges in  engaging youth and parents in the services offered. Complete data that  show how many youth states are serving through the independent living  programs are not available, and while these programs serve both youth in  foster care and emancipated youth, data we were able to collect from  some states were limited to youth in care. Data from our 2004 state survey  showed that 40 states responding to our survey reported serving about  56,000 youth—or approximately 44 percent of youth in foster care who  were eligible for independent living services in these states. However,  there were substantial differences among states in the proportion of youth  served, ranging from a low of 10 percent up to 100 percent of the state’s  eligible foster care population. As shown in figure 4, about one-third of  reporting states were serving less than half of their eligible foster care  youth population, while an equal percentage of states were serving three- fourths or more. The extent to which these differences were related to  whether the states served higher or lower numbers of youth who  emancipated from foster care is unknown.
While states expanded eligibility to younger youth, most services  continued to be directed at youth age 16 and older in most of the states we  visited. For example, Texas officials told us that although the state  lowered the age that youth are eligible for independent living services to  14 years, serving youth age 16 years and older is the highest priority, and  serving younger youth within the various regions is dependent on available  funding. In addition, while Washington expanded eligibility to serve youth  as young as 13 years, state officials reported that the state has yet to  develop a contract for providers to offer services to youth 13 to 15 years  old and few regions have developed services for youth in this age range.
subsections: section_title: Mental Health Services
paragraphs: Youth in foster care often require mental health services continuing  beyond emancipation, but 3 states we visited cited challenges in providing  youth with a smooth transition between the youth and adult mental health  systems. Officials in Connecticut reported that it is critical for youth to  receive mental health services because mental well-being affects every  aspect of the youths’ lives, including learning life skills, locating and  maintaining employment, succeeding in school, and the ability to  transition to a more independent setting. However, state officials reported  that youth who did not qualify for the adult mental health system were left  without critical services. In Florida, many individuals who had been  served by the youth mental health system did not qualify for adult services  because of more stringent eligibility requirements, possibly losing access  to important treatments and therapies. In Washington, caseworkers  reported that the adult mental health system did not provide the same  level of services as the youth system, and long waiting lists sometimes  prevented youth from accessing critical services.
section_title: Mentoring Services
paragraphs: Research studies indicate that the presence of positive adult role models is  critical for youth in foster care because family separations and placement  disruptions have been found to hinder the development of enduring bonds,  but officials in the states we visited cited challenges in providing all youth  with access to mentoring programs to establish and maintain such  relationships. Although the majority of states reported in our 2004 survey  that they offered mentoring programs to youth, officials in Texas and  Florida reported that formal mentoring programs were not available  throughout the state. Connecticut officials said they used FCIA funding to  develop a statewide mentoring program, but the state is still working to  expand program availability to youth in all regions. In addition, one  program director reported challenges recruiting adults to serve as  mentors, especially men willing to make a 1-year commitment to an  adolescent boy. Some state and local officials and service providers  seemed unclear on what should be included in a quality mentoring  program and how to identify qualified service providers. For example, a  nonprofit service provider delivering independent living services in an  urban county in Washington reported being unfamiliar with how a  mentoring program should be run and said that guidance on how to  identify and train mentors would be helpful.
section_title: Securing Safe and Suitable Housing
paragraphs: Youth we spoke with across the 4 states we visited said that locating safe  and stable housing after leaving foster care was one of their primary  concerns in their transition to independence, but state officials reported  challenges meeting youths’ housing needs. Youth reported difficulties  renting housing because of a lack of an employment history, a credit  history, or a co-signer. State and local officials in the states we visited said  the availability of housing resources for foster youth during their initial  transition from foster care depended on where they lived, and in some  cases the benefits provided did not completely meet the needs of youth, or  were available only to certain youth. For example, in Washington, local  officials reported that housing subsidies may not completely offset  expenses for youth in expensive urban areas like Seattle and that rental  housing in some rural areas is scarce. In Florida, youth must be full-time  students to receive full housing benefits.
In addition to reporting these service gaps, youth said during our site visits  that living in rural areas made it difficult to access independent living  services, and state and local officials concurred that services for youth in  rural areas were sometimes limited. Difficulties are often related to a lack  of transportation or providers willing to provide services in remote areas.  In large states such as Texas and Florida, the long distances separating  some youth from available service providers made it difficult for youth to  access services on a regular basis. Additional challenges include the lack  of employment opportunities and transitional housing for youth living in  some regions.
Finally, state and local officials, as well as service providers in the 4 states  we visited said that it was difficult to get some youth to participate in the  independent living programs and that foster parents were sometimes  reluctant partners. While youth were generally offered incentives, such as  cash stipends, to participate in daily living skills training or other  activities, officials emphasized that participation is voluntary and it is  critical for foster parents to support and encourage youth participation in  the program. Florida and Washington officials said that some foster  parents were reluctant to transport youth to classes or meetings because  of scheduling conflicts or long distances from training locations and did  not always reinforce classroom training in daily living skills by allowing  youth to practice skills such as cooking or financial management. FCIA  emphasized the need to provide training to help foster parents understand  and address the issues confronting adolescents preparing for  independence, and nearly all states reported in our 2004 survey that they  provided some training to foster parents in this regard. However, the  number of parents trained differed across 34 states reporting data—while  some states reported training 1,100 or more, others reported training as  few as 24.
section_title: States Reported Increased Coordination with Federal and State Programs to Provide Independent Living Services to Youth, but Barriers Hinder Linkages across Programs
paragraphs: After FCIA, 49 states reported increased coordination with a number of  federal, state, and local programs that can provide or supplement  independent living services, but officials from the 4 states we visited  reported several barriers in developing the linkages necessary to access  services under these programs across local areas. These barriers include a  lack of information on the array of programs available in each state and in  local areas, as well as differences in performance measures between  programs. Many child welfare caseworkers, foster parents, and youth we  spoke with during our site visits were unaware of the full array of youth  and adult support services available to youth while in foster care and after  emancipation.
subsections: section_title: States Reported Accessing Federal and State Programs More after FCIA to Provide Independent Living Services
paragraphs: Federal, state, and local agencies oversee a wide range of programs  providing services that may assist youth in their transition to adult life and  that include current and former foster youth among their target  populations. In our 2004 survey, 49 states reported increased  coordination with federal, state, and local agencies and private  organizations that provide services to youth since the passage of FCIA to  provide a wide variety of services. Table 3 displays selected key  independent living services and the most prevalent service providers.
States we visited used different strategies to develop linkages among state  youth programs. Three of the states we visited reported establishing state- level work groups that included representatives from the independent  living program and other state agencies to bring agency officials together  to discuss the needs of youth in foster care and possible strategies for  improving service delivery. For example, Florida’s legislature mandated a  state-level work group to facilitate information sharing at the state level  among various agencies, such as the State Departments of Children and  Families and Education, the Agency for Workforce Innovation, and the  Agency for Health Care Administration. Texas was developing a strategy  to redesign the provision of social services in the state, including services  to youth in the independent living program. The goals of this effort  included establishing a local, cross-system network composed of youth in  foster care, emancipated youth, caregivers, and professionals to facilitate  linkages between stakeholders and improve the delivery of services to  youth transitioning out of foster care.
Additional strategies states developed to establish linkages with other  federal, state, or local programs included establishing liaisons between  agencies or programs or through less formal collaborative arrangements.
In Connecticut, the child welfare agency established a liaison position with  the Job Corps program to meet with foster care youth to determine  whether they were appropriate candidates for the program, and to monitor  their progress, address any obstacles or concerns, and help youth plan for  the future. In addition, a liaison between the independent living program  and Connecticut’s mental health agency assists youth in their transition to  the adult mental health system to ensure that youth who need the  continued support maintain access to medication and services after youth  leave the foster care system.
In local areas in Texas and Florida, child welfare officials worked with  local housing authorities to assist youth in accessing federal housing  vouchers provided by HUD. For example, in Tallahassee, Florida, the local  housing authority secured 30 of 100 available housing vouchers for youth  emancipating from foster care and established a case manager position  especially for the youth in the program.
In Florida, the independent living program officials worked with the state’s  youth mental health department to access the Assertive Community  Treatment for Teens Program. The program consisted of community-based  teams—nurses, job developers, housing and education officials, and other  relevant stakeholders—who worked together to develop integrated service  plans for youth with serious and persistent mental illness.
In addition, officials reported developing linkages with other private  resources in their communities, such as business owners, to provide  services to youth in the independent living program.
Connecticut independent living officials collaborated with business  owners, nonprofit organizations, and other state agencies to develop an  experiential employment training program that gave youth 16 and older  the opportunity to learn skills through participation in workshops covering  all aspects of a local business. For example, some youth worked in a boat- building business and learned skills ranging from carpentry and  construction to sales and financial management.
In one Florida county, independent living staff utilized a community  resource know as the speakers’ bureau—a service that links members of  the community with youth to talk about a wide range of professions and  activities. Caseworkers said as youth moved through their daily living  skills curriculum they were asked to decide whom they wanted as guest  speakers.
In Texas, the child welfare agency worked with the Orphan Foundation of  America—a nonprofit organization—so youth could access a Web-based  mentoring program. Youth participating in the program were matched  with online mentors based on mutual interests, and they communicated  regularly via e-mail or by phone.
section_title: States Reported Barriers to Establishing Linkages between the Independent Living Programs and Other Youth-Serving Programs
paragraphs: While table 3 shows that states are using a wide variety of programs to  provide independent living services, officials in the 4 states we visited  reported several barriers that hinder their ability to establish linkages with  other agencies and programs, including the lack of information on the  array of programs available in each state or local area and differences in  program priorities. Officials from 3 states we visited said that they relied  on local officials to identify potential partners and initiate and maintain  coordination efforts; and while individuals in some local areas may have  developed successful collaborations with service providers in their area,  these relationships have not always been expanded statewide. To some  extent, this has been due to the fact that state and local child welfare  officials differ in their awareness of resources available from various  federal and state agencies.
Local officials in one area of Florida were working with a U.S. Department  of Labor workforce program, while officials in another local area of the  state were not familiar with this program to train and find employment for  youth.
In one local area in Washington, independent living coordinators and  caseworkers expressed concern about access to affordable health care for  youth emancipating from foster care and were not aware of a federal  health center located nearby that was required to provide medical and  mental health services on a sliding fee scale.
These gaps in awareness may be partly due to turnover rates for  caseworkers reported by the states we visited. Caseworkers’ lack of  knowledge about available programs may have contributed to foster  parents and youth reporting that they were unaware of the array of  services available from other federal, state, or local programs.
Officials in the independent living programs in the states we visited also  cited barriers to establishing linkages with other federal and state  programs because of different program priorities.
Difference in performance goals among programs can affect the ability of  independent living staff to obtain services for foster youth from other  agencies. For example, child welfare and workforce officials in Florida  reported that performance goals for workforce programs may act as  barriers to serving youth in the child welfare system who may be more  difficult to place in employment and might not maintain the jobs once  placed, potentially bringing down workforce program performance  measures. As a result, the officials reported that local workforce  programs may target those individuals with whom they can most easily  achieve successful outcomes and foster youth may be unable to access  services they need to achieve positive employment outcomes.
According to independent living service providers in one local area in  Washington, privacy concerns were a barrier to developing linkages with  education programs. For example, schools in one area we visited would  not allow anyone besides biological parents—including caseworkers and  foster parents—access to youths’ individualized education programs. Yet  according to caseworkers, foster parents, and service providers, lack of  access to these plans made it difficult to align the individualized education  programs with the youths’ independent living plans.
section_title: States’ and HHS’s Actions in Response to FCIA Requirements Have Not Yet Established Accountability for Independent Living Programs
paragraphs: All states developed multiyear plans as required under FCIA and  submitted annual progress reports to ACF for their independent living  programs, but the absence of standard comprehensive information within  and across state plans and reports precludes using them at the state and  federal level to monitor how well the programs are working to serve foster  youth. HHS has not yet implemented its plan to collect information to  measure states’ program performance, and while some states reported  collecting some data, states have experienced difficulties in contacting  youth to determine their outcomes. HHS has begun to evaluate selected  independent living programs, and officials reported that the results of this  evaluation should be available in 2007.
subsections: section_title: States Submitted Plans and Annual Reports to Comply with Federal Requirements, but the Documents Do Not Provide Information Necessary to Assess Progress
paragraphs: All states developed state plans as required by FCIA that described  independent living services they planned to provide to foster youth and  submitted annual reports to ACF, but for several reasons, these plans and  reports cannot be used to assess states’ independent living programs. To  assist states in preparing these documents, ACF developed guidance that  set out broad expectations for the plans and reports that would meet the  FCIA requirements. However, while ACF officials stated that the plans and  annual reports served as the primary method the agency used to monitor  states’ use of the Chafee Program funds, ACF did not require states to use  a uniform reporting format, set specific baselines for measuring progress,  or report on youths’ outcomes. As a result, each state developed plans and  reports that varied in their scope and level of detail, making it difficult to  determine whether states had made progress in preparing foster youth to  live self-sufficiently. Our review of plans from 51 states covering federal  fiscal years 2001 through 2004, and annual reports for 45 states from  federal fiscal years 2001 and 2002 showed that    Few states both organized the information in their plans to address the  purposes of FCIA and presented specific strategies they would use to  meet these purposes. For example, Nebraska’s plan was aligned according  to the five purposes of FCIA, but when describing how the state would  help youth receive the education, training, and services necessary to  obtain employment, the plan provided only a broad statement about the  collaborative efforts between state agencies without mention of specific  strategies to deliver the services. In contrast, New Hampshire submitted a  comprehensive state plan that described the state’s holistic approach to  providing services to youth transitioning out of care, such as specialized  trainings for youth, foster parents, and independent living staff; programs  offered through community resources; and resources available for youth  with emotional and physical challenges, but these services were not  attached to any one purpose of FCIA.
The plans vary in their usefulness in establishing outcomes the states  intended to achieve for youth. For example, the District of Columbia  indicated that it will use Chafee Program funds to establish a computer lab  where current and former foster care youth can search for jobs, but the  plan does not establish any outcomes the District hoped to achieve with  this service, such as the percentage of youth that find employment over a  period of time. In contrast, the Nevada plan identified 2001 and 2002 as the  baseline years for the number of foster youth who graduate or receive a  general equivalency diploma (GED) and planned to increase by 3 percent  each year the number of youth who receive a high school diploma or GED  until the youth are within the overall state average.
Annual reports for all 45 states contained information that did not  directly relate to information in their state plan making it unclear  whether the differences were due to service changes or missing  information. For example, in Hawaii’s plan, the state listed several  services and supports provided to youth, including employment services,  such as career exploration and job placement and retention. However, in  each of the annual reports, the state does not mention offering or  providing any employment-related services.
Of the 90 annual progress reports we reviewed, 52 reports did not  include clear data that could be used to determine progress toward  meeting the goals of the states’ independent living program. For  example, Arkansas’ report for federal fiscal year 2002 listed several  workshops provided to youth, such as money management and college  preparation, and a count of the number of youth who participated in the  workshops. In contrast, Nevada consistently reported data on youths’  participation in different independent living activities, including the  changes between each year, progress towards meeting the goals  established in their plan, and reasons for not yet meeting the goals.
ACF officials said that they recognize the limitations of these documents  as tools to monitor states’ use of independent living program funds, but  explained that they rely on states’ to self-certify that their independent  living programs adhere to FCIA requirements. Staff in ACF’s 10 regional  offices conduct direct oversight of the program by reviewing the multiyear  plans and annual reports, interpreting program guidance, and  communicating with states when clarification about their plans or reports  is needed. However, officials in three offices said that their review of the  documents was cursory and that the plans and annual reports do not serve  as effective monitoring tools. Only three regions reported that they  conducted site visits to observe independent living programs in at least  some states in their regions. The other regions reported that they do not  have the funds to travel or when they do, the review is focused on other  programs or planning efforts. One region commented that even if it had  funds, ACF had not developed a standard mechanism for regional offices  to use in monitoring states’ use of FCIA funds.
Alternatively, ACF officials reported that the Child and Family Services  Review used to evaluate the states’ overall child welfare systems could  serve as a tool to monitor independent living programs, but the CFSR is  limited in the type and amount of data collected on youth receiving  independent living services. While states evaluated under the first year of  the CFSR were rated on the provision of independent living services to  youth in care, this item was removed in subsequent reviews. ACF  redesigned its review instrument with the intent of focusing on setting and  achieving appropriate permanency goals for children rather than  evaluating specific services. Despite the fact that independent living  services are no longer a specific focus of the CFSR, ACF officials believe  that two broader measures used in the review will provide opportunities to  evaluate states’ performance in assisting youth: the measurement of the  stability of foster care placements and the review of permanency goals of  other planned permanent living arrangements, such as the goal of  emancipation. However, some regional officials performing these reviews  reported that the on-site portion of the CFSR is limited in scope and does  not present an opportunity to determine if states are delivering  independent living services to youth and if youth receiving such services  are achieving better outcomes than their peers. Further, the CFSR  includes a review of a small number of foster care case files and does not  include a review of emancipated youth.
section_title: HHS Has Not Yet Complied with Requirements to Collect Program Data to Assess States’ Programs, and Some States Collecting Information on Youth Are Experiencing Difficulties
paragraphs: ACF has not completed efforts to develop a plan to collect data on youths’  characteristics, services, and outcomes in response to the FCIA  requirement, and some states that are attempting to collect information on  youths’ outcomes are experiencing difficulties. In 2000, ACF started to  develop the National Youth in Transition Database (NYTD) to collect  information needed to effectively monitor and measure states’  performance in operating independent living programs. However, HHS  officials stated that as of August 2004, implementation had not yet  occurred.  The agency has completed many of the steps laid out in its  original plan dated September 2001, including consulting with child  welfare and information technology professionals, developing a set of  preliminary data elements and outcomes measures, and pilot testing the  data collection instruments with 7 states. However, HHS reported that it  had not taken the next step of publishing the notice for proposed rule  making because the agency decided to develop regulations for the data  collection system in order to fulfill a statutory requirement to assess  penalties on states for noncompliance. As a result, the proposal has been  under internal review since the conclusion of the pilot test process in  November 2001. HHS reported that it expects to issue guidance in the form  of a proposed regulation in 2005.
Officials in all the states we visited supported the idea of having data on  former foster youth, and 26 states reported in our 2004 survey that they  have begun to plan for the impending data reporting requirements despite  the federal delays. Many states reported in our 2004 survey that they  already collect many of the data elements HHS had developed as part of  the consultation and pilot testing process (see table 4).
In addition, some states are attempting to collect outcome information on  former foster care youth but have experienced difficulties. According to  results from our survey, in federal fiscal year 2003, 30 states attempted to  contact youth who had been emancipated from foster care for initial  information to determine their status, including education and  employment outcomes. Of those states, most reported that they were  unsuccessful in contacting more than half of the youth. Further, 21 states  reported attempting to follow up with emancipated youth after a longer  period of time had elapsed but had trouble reaching all the youth.
Officials in the states we visited reported that collecting outcome data is  especially challenging since there is little they can do to find youth unless  the youth themselves initiate the contact. Further, some officials were  concerned about the value of the outcome data since they believe that  youth who are doing well are more likely to participate in the follow-up  interviews, thus skewing the results. Similarly, an ACF regional official  reported that the value of the NYTD would be determined by the resources  available to states to support the follow-up component. Some state  officials, caseworkers, and youth we interviewed suggested strategies  states may need to develop to maintain contact with former foster care  youth, including offering incentives to the youth to stay in touch;  establishing a toll-free telephone line that will make the process of staying  in touch as easy as possible; or using other resources that may help locate  the youth or provide the necessary data, such as other service providers or  other social services information systems.
section_title: HHS Has Begun Multiyear Evaluation of Four Approaches to Delivering Independent Living Services
paragraphs: By December 2007, ACF expects to complete the evaluations of four  approaches to delivering independent living services. As required by FCIA,  these evaluations will use rigorous scientific standards, such as an  experimental research design that randomly assigns youth in independent  living programs to different groups: one that is administered the  experimental treatment and one that is not. HHS initiated this effort in  2001 with a nationwide review of potentially promising approaches to  delivering independent living services. HHS contracted with a research  institute to conduct a nationwide search to identify independent living  programs that meet the criteria of the evaluation and to conduct 5-year  evaluations of the selected programs. On the basis of the search and the  established criteria, HHS selected four programs for the evaluation (see  table 7).
The study is designed to answer the following questions: (1) How do the  outcomes of youth randomly assigned to the identified interventions  compare with those of youth who are assigned to “services as usual”?   (2) For the identified programs, what are the features of these programs  that are likely to influence their impact on youth clients? (3) How are  these services implemented? (4) To what extent might these programs be  adapted to other locales? (5) What are the barriers to implementation?  Each program will be evaluated using similar techniques: in-person  structured interviews to establish a baseline and to follow up with youth in  the treatment and control groups; a Web-based survey of caseworkers; and  program site visits including semistructured interviews with  administrators, staff, and youth. All youth will be interviewed shortly  following referral and random assignment, and 1 year and 2 years later. As  of August 2004, all evaluation studies were in the early stages. Baseline  interviews with the youth had begun or were completed in three sites and  the process was starting in the fourth site.
section_title: Conclusions
paragraphs: Many youth in the foster care system need additional services and support  throughout and beyond their adolescence to make the transition to self- sufficiency. States have generally expanded their independent living  programs to provide new and enhanced services to a wider age range of  youth, but some states have been slower to implement the program, and  foster youth across the nation may not have access to the full array of  services they may need to lead independent and successful lives. While  many other federal, state, and private resources exist to cover some  shortfalls in service, the absence of information on resources available in  local areas may continue to hinder efforts to establish needed linkages  among programs. Similarly, while ACF provides some assistance to states,  there is still a lack of awareness about available resources among  caseworkers, foster parents, and youth that may further limit youths’  ability to access needed services once emancipated from the foster care  system.
While the Chafee Program funding is small compared with that of other  child welfare programs, effective federal oversight requires reliable  information on states’ implementation efforts and results. At a minimum,  information from state plans and annual reports could be useful in federal  oversight and monitoring. However, the ability of ACF to monitor state  performance continues to be hindered by an absence of standard,  comprehensive information within and across state plans on each state’s  goals, services, and youth outcomes as measured against baselines of past  achievement. Oversight is similarly hindered by a lack of standard  monitoring practices across ACF regional offices. While ACF is developing  an information system that may address some of these limitations, it may  be unavailable for several years. In the meantime, additional actions to  strengthen federal monitoring of state programs may serve to provide  greater assurance of program accountability at the state and federal level.
section_title: Recommendations
paragraphs: To improve access to the array of services available to youth transitioning  out of foster care and assist states in leveraging available resources, HHS  should make information available to states and local areas about other  federal programs that may assist youth in their transition to self- sufficiency and provide guidance on how to access services under these  programs.
To improve HHS’s ability to monitor implementation of the Chafee  Program, HHS should develop a standard reporting format for state plans  and progress reports and implement a uniform process regional offices  can use to assess states’ progress in meeting the needs of youth in foster  care and those recently emancipated from care.
section_title: Agency Comments
paragraphs: We provided a draft copy of this report to the following agencies for  comment: the Departments of Health and Human Services, Education,  Labor, Housing and Urban Development, and Justice, and the Social  Security Administration.  We obtained comments from the Department of  Health and Human Services, which are reproduced in appendix III. HHS  also provided technical comments, which we incorporated as appropriate.   All other agencies did not have any comments on this report.
HHS did not comment on our recommendation to make information  available to states and local areas about other federal programs that may  assist youth in their transition to self-sufficiency and to provide guidance  on how to access services under these programs.  HHS listed several  efforts that they had undertaken to collaborate with other related federal  agencies, such as Labor, Justice, and Education, to expand services to  youth.  While these efforts will help strengthen the relationships among  federal agencies and better inform the states, we believe that  implementing our recommendation to develop ways to better disseminate  such information to state and local child welfare agencies and to provide  assistance on ways to leverage these resources can improve services to  youth both in and recently emancipated from foster care.
HHS disagreed with our recommendation to develop a standard reporting  format for state plans and progress reports but said it was taking action to  implement a uniform process that its regional offices can use to assess  states’ progress in meeting the needs of youth in foster care and those  recently emancipated from care.  HHS stated that taking action to  standardize the reporting format for state plans and annual reports would  be overly prescriptive and impose an unnecessary burden on states.  HHS  added that a significant change under the law was to require states to self- certify their compliance with statutory requirements in their state plan,  and that rather than report on performance outcomes, the plan was  intended to be a narrative to ensure state adherence to plan requirements  and assurances.  In addition, HHS reported that when standard data are  available through the National Youth in Transition Database, the agency  would be better positioned to determine how best to assess state  performance.  HHS further reported that ACF did provide regional office  staff with a checklist to review and approve the first state plan and that in  fiscal year 2005, ACF will develop and provide a review protocol to be  used in regional office desk reviews of states’ annual progress reports.
We continue to believe that strengthening the state reporting process is  needed to provide assurance of program accountability at the state and  federal level.  HHS officials stated that they consider their review of the  state plans and annual reports as the primary method the agency uses to  monitor states’ use of Chafee Program funds. However, comments by ACF  regional officials conducting the oversight reviews—as well as our own  review—have shown that the diverse format and content of these  documents are insufficient for this purpose. Developing a standard  reporting format that states can use for their plans and annual reports  would help HHS improve the efficiency of the reporting process by  clarifying the broad guidance ACF provides to the states, allowing ACF  reviewers to quickly identify states’ progress toward meeting program  goals, and thereby reduce the burden of the reporting process currently in  place. As we reported, some states have already taken action to establish  baselines and goals as well as strategies for action in their state plan that  can be linked with information in the annual progress reports to identify  areas of strength and needed improvement.  HHS should consider these  efforts undertaken by states and take a cooperative approach in working  with them and cognizant national organizations in developing a standard  report format to garner support and reduce perceptions of burden. HHS  could, for example, continue its partnership with the workgroup that  contributed to the NYTD proposal or convene a session at the annual  conference with state independent living coordinators. HHS action to  implement our recommendation may also serve to strengthen the  usefulness of uniform review protocols that ACF plans to develop for use  by regional staff in evaluating state progress during their annual desk  reviews of state performance.
As agreed with your offices, unless you publicly announce its contents or  authorize its release earlier, we plan no further distribution of this report  until 30 days after its issue date.  At that time, we will send copies of this  report to the Secretaries of Health and Human Services, Education,  Housing and Urban Development, Labor, and Justice; relevant  congressional committees; and other interested parties. Copies will be  made available to others upon request. In addition, the report will be  available at no charge on GAO’s Web site at http://www.gao.gov. Please  contact me at (415) 904-2272 if you or your staff have any questions about  this report. Other major contributors to this report are listed in appendix  IV.
section_title: Appendix I: Scope and Methodology
paragraphs: To determine how states’ funding allocations changed to serve youth after  the Foster Care Independence Act of 1999 (FCIA), we analyzed federal  funding to the 50 states, the District of Columbia, and Puerto Rico for  independent living programs before and after the passage of FCIA. We  compared state allocations after the passage of FCIA with the numbers of  eligible youth in foster care in each state to determine available funding  per eligible youth across states. To perform this comparison, we used data  reported by states to the Department of Health and Human Services (HHS)  in the Adoption and Foster Care Analysis and Reporting System (AFCARS)  on the numbers of eligible youth in foster care within each state in federal  fiscal year 2002. Since states’ funding allocation are based on AFCARS  data, we determined that these data were the best available information  for the purposes of this analysis. The procedures the agency uses to assess  data quality, which includes identifying out-of-range or missing data, were  sufficient for our purposes. To determine the age ranges of youth in foster  care eligible for independent living services within each state, we used  data reported by states in our 2004 survey of state independent living  coordinators. In addition to reviewing these data, we interviewed HHS  staff in headquarters and each of the 10 regional offices.
To determine the extent to which states expanded independent living  services and age groups of foster youth served since the passage of FCIA,  as well as what challenges remain, we surveyed all 50 states, the District of  Columbia, and Puerto Rico through a Web-based questionnaire. We  pretested the survey instrument with administrators of the independent  living program in Texas, Florida, Washington, Maryland, and Connecticut.  On the basis of the feedback from the pretests, we modified the questions  as appropriate. Information about accessing the questionnaire was  provided via e-mail. To ensure security and data integrity, we provided  each official with a password that allowed him or her to access and  complete the questionnaire for his or her state. We received responses  from all 50 states and the District of Columbia for a response rate of about  98 percent. Our survey collected a variety of state data, including  information on services provided to youth, numbers of youth eligible and  served with independent living services, funding for independent living  programs, and changes since the passage of FCIA. We designed the survey  to parallel several questions from a 1999 GAO survey of states regarding  their independent living programs prior to the passage of FCIA in fiscal  year 1998. We compared responses between the surveys to identify  changes with state independent living programs since the passage of FCIA.
The practical difficulties of conducting any survey may introduce errors,  known as nonsampling errors. For example, differences in how a  particular question is interpreted, the sources of information available to  respondents, or the types of people who do not respond can introduce  unwanted variability into the survey results. We included steps in both the  data collection and data analysis stages for the purpose of minimizing such  nonsampling errors.
In addition to conducting the survey, we visited independent living  programs in 4 states (Texas, Florida, Washington, and Connecticut) to  obtain more detailed information regarding the provision of independent  living services and changes to state independent living programs since the  passage of FCIA in 1999. We selected these states to represent a range in  size of foster care populations, approaches to the provision of independent  living services, federal allocations of independent living funds, and  geographic locations. During our state visits, we interviewed state and  local child welfare officials, caseworkers, contracted service providers,  foster parents, and youth. We also spoke with HHS staff in the central  office and each of the 10 regional offices; National Resource Center for  Youth Development officials; and child welfare experts from various  organizations including the National Independent Living Association, the  Chapin Hall Center for Children, and the Casey organizations.
To determine to what extent states used other federal and state programs  to coordinate the delivery of independent living services to foster youth,  we surveyed states using the above-mentioned survey instrument. In  addition, during our site visits we interviewed state and local child welfare  officials; officials from other state agencies that provide services that may  assist youth in their transition to self-sufficiency; as well as contracted  service providers, caseworkers, foster parents, and youth. We also spoke  with HHS officials in the central and regional offices and officials at a  number of federal agencies that are responsible for programs that may  benefit transitioning youth. These included the U.S. Departments of  Education, Labor, Housing and Urban Development, and Justice; the  Social Security Administration; and the Substance Abuse and Mental  Health Services Administration.
To determine how states and HHS fulfilled the accountability provisions of  FCIA, we analyzed Chafee Foster Care Independence Program state plans  for 49 states, the District of Columbia, and Puerto Rico for fiscal years  2001-2004 to determine each state’s program goals and strategies. We also  analyzed 90 annual progress and services reports (annual reports) that  states submitted regarding the progress made in implementing their  Chafee plans for fiscal years 2001 and 2002. We obtained the plans and  progress reports from the Administration of Children and Families (ACF)  regional offices after consulting with ACF’s central office and the National  Resource Center for Youth Development. One regional office could not  provide us with the state plan for Wyoming and the annual reports for  Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming in  the time requested. Therefore, these states are not included in our  analysis. In addition, we received only one report for Tennessee (federal  fiscal year 2001) and Puerto Rico (federal fiscal year 2002). We developed  a data collection instrument (DCI) based on the federal guidance provided  that described how states were expected to develop their plans and  reports. A DCI was completed for each state plan and annual report, and  another staff person reviewed each record for clarity and accuracy. We  supplemented this analysis with discussions with state officials and ACF  central and regional office officials. In addition, we reviewed ACF’s draft  proposals for the National Youth in Transition Database (NYTD) and  talked with the contractor staff responsible for development of this system  and the multisite evaluation of promising independent living programs. We  were not able to obtain the most current information on the NYTD  proposals. Therefore, we only have information as recent as August 2003,  and our description of NYTD may not accurately describe the final  proposal when it becomes available.
section_title: Appendix II: Selected Federal Youth Programs and Services That Target Current and Former Foster Youth
subsections: section_title: Department of Health and Human Services
section_title: Appendix III: Comments from the Department of Health and Human Services
section_title: Appendix IV: GAO Contacts and Acknowledgments
subsections: section_title: GAO Contacts
section_title: Staff Acknowledgments
paragraphs: In addition to those named above, Adam Roye, Catherine Roark, and   R. Jerry Aiken made key contributions to this report. Diana Pietrowiak,  Luann Moy, Catherine M. Hurley, and Amy Buck also provided key  technical assistance.
section_title: Bibliography
paragraphs: Casey Family Programs. Providing Education Related Supports and  Services under the Chafee Independence Act of 1999: Selected State  Activities, and Postsecondary Education and Training Voucher  Information. Seattle, Washington, May 2003.  ——-. Assessing the Effects of Foster Care: Early Results from the Casey  National Alumni Study. Seattle, Washington, October 2003.
Chapin Hall Center for Children, University of Chicago. Midwest  Evaluation of the Adult Functioning of Former Foster Youth: Conditions  of Youth Preparing to Leave State Care. February 2004.
U.S. Department of Health and Human Services, Administration for  Children and Families; Administration on Children, Youth, and Families;  Children’s Bureau. Title IV-E Independent Living Programs: A Decade in  Review. Washington, D.C., November 1999.
Wald, M., and T. Martinez. Connected by 25: Improving the Life Chances  of the Country’s Most Vulnerable 14-24 Year Olds. William and Flora  Hewlett Foundation Working Paper. Menlo Park, CA: William and Flora  Hewlett Foundation, November, 2003.
White House Task Force for Disadvantaged Youth Final Report.  Washington, D.C., October 2003.
section_title: Related GAO Products
paragraphs: D.C. Child and Family Services Agency: More Focus Needed on Human  Capital Management Issues for Caseworkers and Foster Parent  Recruitment and Retention. GAO-04-1017. Washington, D.C.: September  24, 2004.
Child and Family Services Reviews: Better Use of Data and Improved  Guidance Could Enhance HHS’s Oversight of State Performance.   GAO-04-333 Washington, D.C.: April 20, 2004.
Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide  States Additional Information to Improve Services. GAO-03-956.  Washington, D.C.: September 12, 2003.
Child Welfare: Most States Are Developing Statewide Information  Systems, but the Reliability of Child Welfare Data Could Be Improved.  GAO-03-809. Washington, D.C.: July 31, 2003.
Child Welfare and Juvenile Justice: Federal Agencies Could Play a  Stronger Role in Helping States Reduce the Number of Children Placed  Solely to Obtain Mental Health Services. GAO-03-397. Washington, D.C.:  April 21, 2003.
Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare  Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March  31, 2003.
Foster Care: Recent Legislation Helps States Focus on Finding  Permanent Homes for Children, but Long-Standing Barriers Remain.  GAO-02-585. Washington, D.C.: June 28, 2002.
Workforce Investment Act: Improvements Needed in Performance  Measures to Provide a More Accurate Picture of WIA’s Effectiveness.  GAO-02-275. Washington, D.C.: February 1, 2002.
Child Welfare: New Financing and Service Strategies Hold Promise, but  Effects Unknown. GAO/T-HEHS-00-158. Washington, D.C.: July 20, 2000.
Foster Care: States’ Early Experiences Implementing the Adoption and  Safe Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999.
Foster Care: HHS Could Better Facilitate the Interjurisdictional  Adoption Process. GAO/HEHS-00-12. Washington, D.C.: November 19,  1999.
Foster Care: Effectiveness of Independent Living Services Unknown.  GAO/HEHS-00-13. Washington, D.C.: November 10, 1999.
Foster Care: Kinship Care Quality and Permanency Issues.   GAO/HEHS-99-32. Washington, D.C.: May 6, 1999.
Juvenile Courts: Reforms Aim to Better Serve Maltreated Children.  GAO/HEHS-99-13. Washington, D.C.: January 11, 1999.
Child Welfare: Early Experiences Implementing a Managed Care  Approach. GAO/HEHS-99-8. Washington, D.C.: October 21, 1998.
Foster Care: Agencies Face Challenges Securing Stable Homes for  Children of Substance Abusers. GAO/HEHS-98-182. Washington, D.C.:  September 30, 1998.