Child Welfare: Federal Oversight of State IV-B Activities Could Inform Action Needed to Improve Services to Families and Statutory Compliance
Published: 2006-05-23T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: For federal fiscal year 2004, state and local child protective services staff determined that an estimated 872,000 children have been victims of abuse or neglect. Title IV-B subparts 1 and 2 authorize a wide array of child welfare services with some restrictions on states' use of funds. This testimony discusses: (1) how states used Title IV-B dollars to serve families under subparts 1 and 2; (2) the extent that federal oversight ensured state compliance with spending requirements under subpart 1; and (3) what the research said about the effectiveness of service states have provided to families using Title IV-B funds. This testimony was primarily based on a 2003 report (GAO-03-956).
section_title: What GAO Found
paragraphs: States used Title IV-B funds to provide a broad range of services to prevent the occurrence of abuse, neglect, and foster care placements in addition to other child welfare services. While there was some overlap, states reported using Title IV-B subpart 1 funds primarily to operate child welfare programs and serve families in the foster care system, while states reported using subpart 2 funds primarily for family services targeted to families at risk of child removal due to abuse or neglect. For example, nearly half of subpart 1 staff costs paid salaries for social worker positions in child protective services. Family services under subpart 2 included those to support, preserve, and reunify families by providing mentoring programs, financial assistance to help with rent and utilities, parenting classes, child care, and support groups. HHS provided relatively little oversight specific to state spending under subpart 1. HHS did not collect data on subpart 1 expenditures and regional officials paid little attention to statutory limits in states' planned use of funds. In response to GAO's survey, 10 states reported actual 2002 subpart 1 expenditures that exceeded the sending limits by over $15 million in total. Research is limited assessing the effectiveness of services provided under Title IV-B. In GAO's survey, 22 states reported providing services other than foster care and adoption assistance payments, staff salaries, or administration under subpart 1; however, none of these states had sufficiently evaluated the outcomes of these services. Similarly, GAO's literature review showed that few evaluations had been conducted, and evaluations that had been conducted showed mixed results. HHS evaluations of subpart 2 services also have shown no or little effect in reducing out-of-home placement, maltreatment recurrence, or improved family functioning beyond what normal casework services achieved.

section_title: Letter
paragraphs: I am pleased to be here today to present information from our 2003 report  on how states used funds authorized under Title IV-B of the Social  Security Act to help families address problems that lead to child abuse and  neglect and subsequent separation of children from their families. For  federal fiscal year 2004, child protective services (CPS) staff in state and  local child welfare agencies reported investigating or assessing an  estimated 3 million allegations of child maltreatment and determined that  approximately 872,000 children had been the victims of child abuse or  neglect by their parents or other caregivers. Established in 1935, Title IV-B  first authorized funds to states that could be used to provide a wide array  of child welfare services including those necessary to investigate reports  of child maltreatment, remove children from their home and place them  with a temporary foster family, help preserve or reunify families, and place  children who cannot be safely reunified with their families in an adoptive  home.
The Congress has passed various laws over the years emphasizing the  need for states to use Title IV-B funding to provide supportive services to  preserve and reunify families. In 1980, for example, the Adoption  Assistance and Child Welfare Act established a dollar cap on the amount  of child welfare funds that states could use under Title IV-B for foster care  and certain other activities to encourage states to use additional funding  for services to families. In 1993, the Congress established the family  preservation and family support services program under Title IV-B subpart  2, authorizing funding to states for family preservation and community- based family support services. The Adoption and Safe Families Act of 1997  further encouraged spending on family support services by reauthorizing  subpart 2, renaming it Promoting Safe and Stable Families, and expanding  the types of programs on which states were authorized to spend Title IV-B  funds to include adoption promotion and support services and time- limited family reunification services. In fiscal year 2006, the Congress  appropriated $287 million for child welfare services under subpart 1 and  $394 million for family support services under subpart 2. These funds are  administered to states by the Department of Health and Human Services’  (HHS) Administration for Children and Families (ACF).
My testimony today is primarily based on information included in our 2003  report. Specifically, I will be discussing: (1) how states used Title IV-B  dollars to serve families under subparts 1 and 2; (2) the extent that federal  oversight ensured state compliance with spending requirements under  subpart 1; and (3) what the research said about the effectiveness of  services states have provided to families using Title IV-B funds.
In summary, while overlap exists, states reported using Title IV-B subpart  1 funds primarily to staff and administer child welfare programs and serve  families in the foster care system, while states reported using subpart   2 funds primarily for prevention and support services for families at risk of  child abuse and neglect. It is difficult, however, to clearly differentiate  among the various service categories and populations served. HHS  provided relatively little oversight in how states spent federal funds under  subpart 1, and at least 10 states spent a total of over $15 million over the  legislated cap for foster care and adoption assistance payments. Although  the predominance of federal funding spent for foster care and adoption  assistance has long been cited as providing a disincentive to preserve and  reunify families, little research is available on the effectiveness of the  services subpart 1 funds provide and HHS evaluations of services funded  under subpart 2 have generally shown no or little effect.  Similarly, the  extent that differences in how states spent funds to support children and  families resulted in better or worse outcomes for children is unknown.
To help address this information gap, our 2003 report recommended that  the Secretary of HHS consider the feasibility of collecting and using data  on states’ use of Title IV-B subpart 1 funds. We made this recommendation  not only to facilitate federal oversight and analysis of how states’ spending  patterns correlate to child outcomes, but also so that HHS could use this  data to inform the design of alternative funding proposals that would give  states more flexibility in spending federal child welfare funds. We also  recommended that the Secretary provide the necessary guidance to ensure  compliance with statutory restrictions on the use of Title IV-B subpart  1funds.  ACF agreed with our findings and implemented guidance to states  reminding them of the statutory requirements for subpart 1 spending.   However, ACF disagreed with our recommendation to consider collecting  data on subpart 1 expenditures. ACF believed that its level of oversight  was commensurate with the scope and intent of subpart 1, noting that its  oversight efforts were more appropriately focused on reviews of the  states’ overall child welfare systems. ACF did not comment on our  recommendation to use such data to inform the design of an alternative  financing option.
Our review was based on two surveys to child welfare directors to obtain  information on how they use Title IV-B funds. We also visited four states— California, New Jersey, Ohio, and Washington—where we interviewed  state and local officials and service providers. We also held discussions  with HHS headquarters and regional office officials and child welfare  experts. We reviewed results from HHS’s assessments of state child  welfare agencies as well as the literature assessing the effectiveness of  various child welfare services.
subsections: section_title: Background
paragraphs: Title IV-B of the Social Security Act authorizes funds to states to provide  an array of child welfare services to prevent the occurrence of abuse,  neglect, and need to place children in foster care. The Administration for  Children and Families within HHS is responsible for the administration  and oversight of federal funding to states for child welfare services under  Title IV-B. HHS headquarters staff are responsible for developing  appropriate policies and procedures for states to follow in obtaining and  using federal child welfare funds, while staff in HHS’s 10 regional offices  are responsible for providing direct oversight of state child welfare  systems. No federal eligibility criteria apply to the children and families  receiving services funded under Title IV-B. The amount of subpart 1 funds  a state receives is based on its population under the age of 21 and the state  per capita income, while subpart 2 funding is determined by the  percentage of children in a state whose families receive food stamps.
Subpart 1 provides grants to states for child welfare services, that are  broadly defined. Subpart 1 funds are intended for services that are  directed toward the accomplishment of the following purposes:    protect and promote the welfare of all children;    prevent or remedy problems that may result in the abuse or neglect    prevent the unnecessary separation of children from their families  by helping families address problems that can lead to out-of-home  placements;  reunite children with their families;    place children in appropriate adoptive homes when reunification is  not possible; and    ensure adequate care to children away from their homes in cases in  which the child cannot be returned home or cannot be placed for  adoption.
Subpart 2 services are similar to those allowed under subpart 1, although  the range of services allowed under subpart 2 is more limited in some  cases. For example, time-limited family reunification services can only be  provided during a child’s first 15 months in foster care, while no such  restriction is placed on the use of subpart 1 funds. In addition, states must  spend a “significant portion” of their subpart 2 funds on each of four  service categories:    Family preservation service. Services designed to help families at  risk or in crisis, including services to (1) help reunify children with  their families when safe and appropriate; (2) place children in  permanent homes through adoption, guardianship, or some other  permanent living arrangement; (3) help children at risk of foster  care placement remain safely with their families; (4) provide follow- up assistance to families when a child has been returned after a  foster care placement; (5) provide temporary respite care; and   (6) improve parenting skills.
Family support services. Community-based services to promote  the safety and well-being of children and families designed to  increase the strength and stability of families, to increase parental  competence, to provide children a safe and supportive family  environment, to strengthen parental relationships, and to enhance  child development. Examples of such services include parenting  skills training and home visiting programs for first time parents of  newborns.
Time-limited family reunification services. Services provided to a  child placed in foster care and to the parents of the child in order to  facilitate the safe reunification of the child within 15 months of  placement. These services include counseling, substance abuse  treatment services, mental health services, and assistance to  address domestic violence.
Adoption promotion and support services: Services designed to  encourage more adoptions of children in foster care when adoption  is in the best interest of the child, including services to expedite the  adoption process and support adoptive families.
Federal child welfare funding has long been criticized for entitling states  to reimbursement for foster care placements, while providing little funding  for services to prevent such placements. When the Congress enacted the  Adoption Assistance and Child Welfare Act of 1980, it created a new  funding source for foster care and adoption assistance under Title IV-E of  the Social Security Act. Title IV-E provides an open-ended entitlement for  foster care maintenance payments to cover a portion of the food, housing,  and incidental expenses for all foster children whose parents meet certain  federal eligibility criteria. Title IV-E also provides payments to adoptive  parents of eligible foster children with special needs. While states could  still use Title IV-B funding for foster care and adoption assistance for  children ineligible under Title IV-E, the law established a dollar cap on the  amount of Title IV-B funds that states could use for three categories of  service: foster care maintenance payments, adoption assistance payments,  and child care related to a parent’s employment or training. The law  requires that the total of subpart 1 funds used for these categories cannot  exceed a state’s total 1979 subpart 1 expenditures for all types of services.  The intent of this restriction, according to a congressional document, was  to encourage states to devote increases in subpart 1 funding as much as  possible to supportive services that could prevent the need for out-of- home placements. However, this restriction applies only to the federal  portion of subpart 1 expenditures, as the law provides that states may use  any or all of their state matching funds for foster care maintenance  payments.
For the fourth consecutive year, the President’s budget proposes a Child  Welfare Program Option. HHS developed the proposal to give states more  flexibility in using Title IV-E foster care funds for preventive services such  as those under Title IV-B. Under this proposal, states could voluntarily  choose to receive a fixed IV-E foster care allocation (based on historic  expenditure rates) over a 5-year period, rather than receiving a per child  allocation. States could use this allocation for any services provided under  Titles IV-B and IV-E, but would also have to fund any foster care  maintenance payments and associated administrative costs from this fixed  grant or use state funds. No legislation to enact this option has been  introduced.
section_title: States Used Subparts 1 and 2 to Support Similar Services and Populations, but Funding Emphasis Differed
subsections: section_title: States Emphasized Different Services under Subparts 1 and 2
paragraphs: While states funded similar services under subparts 1 and 2, most states  reported using subpart 1 funds primarily to pay for costs associated with  operating child welfare programs, while most states reported using  subpart 2 funds for family services as shown in table 1. For example,  states used over 44 percent of subpart 1 funds to pay for staff salaries and  costs to administer and manage programs. In contrast, states spent over   71 percent of subpart 2 funds for services to support, preserve, and reunify  families.
The majority of subpart 1 funds were spent on staff salaries, and  Washington officials said that in their state, over half of these costs paid  for staff providing direct services to children and families. Overall, states  reported that nearly half of Title IV-B funds used for staff salaries  supported social worker positions in child protective services. Another 20  percent of funds supported positions for other social workers. The  remaining costs supported other staff including those providing  supervision of caseworkers and legal services. (See fig. 1.)
Percentages do not total to 100 due to rounding.
The remaining subpart 1 funds were split fairly evenly among  administration and management, child protective services, and foster care  maintenance payments:    Administration and management comprised the second largest  category of subpart 1 expenditures, accounting for almost 17  percent of subpart 1 dollars. These services included rent and  utilities for office space, travel expenses for agency staff, and staff  training.
Child protective services represent the third largest category of  subpart 1 expenditures. States reported using about 16 percent of  their subpart 1 funds to provide a variety of CPS services, such as  telephone hotlines for the public to report instances of child abuse  and neglect, emergency shelters for children who needed to be  removed from their homes, and investigative services.
States reported using nearly 11 percent of their subpart 1 funds to  make recurring payments for the room and board of foster children  who were not otherwise eligible for federal reimbursement. For  example, New Jersey officials reported spending over half of the  state’s subpart 1 funds on foster care maintenance payments.
subsections: section_title: Subpart 2 Services
paragraphs: States reported using over 70 percent of their subpart 2 dollars on serving  families, with nearly half of these funds used to fund family support and  prevention services. These services included mentoring programs to help  pregnant adolescents learn to be self-sufficient, financial assistance to low- income families to help with rent and utilities, parenting classes, child  care, and support groups provided by community-based resource centers.
The remaining subpart 2 funds were split fairly evenly among family  preservation, family reunification, and services to support and preserve  adoptive families.
Family preservation services accounted for nearly 12 percent of  subpart 2 dollars. Services provided by Washington state in this  category included counseling and parent training services for up to  6 months for families with children who were at risk of being placed  in foster care.
Adoption support and preservation services accounted for over 11  percent of subpart 2 dollars. With these funds, states provided  services such as counseling for children who were going to be  adopted, family preservation services to adoptive families, and  respite care for adoptive families. Officials in Ohio reported using  almost half of its subpart 2 dollars for adoption services, including  post adoption services and services to recruit families for children  in need of homes.
Family reunification services accounted for over 9 percent of  subpart 2 funds. These services included supervised visitation  centers for parents to visit with their children who were in foster  care and coordinators for alcohol and drug treatment services for  families whose primary barrier to reunification was substance  abuse. New Jersey funded a supervised visitation program that  offered parenting education, counseling, transportation, and  support groups and was located in a private home, allowing families  to visit together in a homelike setting and engage in more natural  interactions.
section_title: States Emphasized Different Populations Served Under Subparts 1 and 2
paragraphs: States served similar populations under subparts 1 and 2; however, states  reported using most subpart 1 funds primarily to serve families whose  children had been removed from the home, while most subpart 2 funds  were reported to serve families with children at risk of removal due to  child abuse or neglect, as shown in table 2. For example, states used 42  percent of subpart 1 funds to serve children in foster care and/or their  parents. In contrast, states used 44 percent of subpart 2 funds for children  at risk of child abuse and neglect and/or their parents.
In our survey, we asked states for more detailed information about the  populations served by programs under subparts 1 and 2, such as  demographic and socioeconomic characteristics. However, few states  were able to provide this data. For selected subpart 1 services, 10 states  were able to estimate the extent to which the same children and families  also received services under subpart 2:  four states reported that generally none or almost none of the  recipients also received a service funded by subpart 2,  three states reported that generally less than half of the recipients  received subpart 2 services,   one state reported that all or almost all recipients received subpart  two states provided varying estimates for different subpart 1  services.
section_title: HHS Officials and States Supported Flexibility of Title IV-B Funding
paragraphs: Officials in almost all of HHS’s regional offices supported retaining the  current balance between allowing states some flexibility in use of funds  and targeting some resources toward prevention, regardless of whether  federal funding sources are combined under alternative financing options.  One regional official noted that the current financing structure of subpart  1 gives states the flexibility to address unexpected circumstances affecting  the child welfare system—for example, the need to develop substance  abuse treatment programs for parents affected by the cocaine epidemic of  the 1980s. Other regional officials noted that the spending requirements  under subpart 2 helped ensure that states used some funds on family  support services and prevention activities to help preserve families and  keep children from entering foster care.
States reported in our survey that flexibility was important to meet the  needs of their child welfare systems, and thus generally preferred the  financing structure of subpart 1 over subpart 2, as shown in figure 2.
section_title: Federal Oversight Insufficient to Ensure State Compliance with Title IV-B Spending Requirements under Subpart 1
paragraphs: HHS provided relatively little oversight specific to state spending under  subpart 1. HHS does not collect data on subpart 1 expenditures, relying  instead on cursory reviews of plans submitted by states that discuss how  they intend to use their subpart 1 funds in the coming year. HHS regional  officials reported that they review these plans for relatively limited  purposes because there are few restrictions on how states can spend  subpart 1 dollars. We also found that HHS regional offices had paid little  attention to statutory limits in states’ planned use of subpart 1 funds. In  response to our survey, 10 states reported actual 2002 subpart 1  expenditures that exceeded the spending limits by over $15 million in  total.
subsections: section_title: HHS Had Little Information about States’ Use of Subpart 1 Funds
paragraphs: HHS received forms from states each year that showed how they planned  to spend subpart 1 funds, but had little information on how states actually  spent these funds. Officials from four HHS regional offices said that they  generally reviewed the forms to ensure that states were requesting the  total amount of subpart 1 funds to which they were entitled, and that they  complied with the requirement to match 25 percent of subpart 1 funds  with state funds. Most regional offices indicated that their review of the  state submitted forms focused more on subpart 2 than subpart 1. For  example, they reported reviewing planned subpart 2 spending to ensure  that states complied with the requirement to spend at least 20 percent of  funds on each of the service categories and spend no more than 10 percent  of funds for administrative purposes. Several HHS officials said that they  did not monitor subpart 1 funds as closely as other federal child welfare  funds due to the relatively small funding amount and the lack of detailed  requirements about how these funds could be spent.
Oversight of subpart 1 was further limited because spending plans states  provided on the annual forms may not reliably show how states actually  spent Title IV-B funds. HHS officials explained that states’ actual  expenditures may vary from planned expenditures as states address  unforeseen circumstances. The timing for submitting the annual forms  also affected how well states could plan Title IV-B spending. HHS required  states to submit their initial spending plans for the upcoming year by June  30, prior to states receiving information on program appropriations for the  upcoming year. While we did not conduct a review comparing state  submitted planned expenditures to actual expenditures for previous years,  we did identify instances that suggested differences in planned and actual  expenditures as well as data on actual expenditures that were not always  accurate. For example, two states with county-administered child welfare  systems said they could not reliably estimate planned spending by service  category because the states did not collect expenditure data from county  child welfare agencies that administer Title IV-B funds.
One regional official explained that the only way to determine how a state  actually used its Title IV-B funds was to review its financial accounts. At  the time of our review, three regional offices had indicated that they had  begun asking states to provide Title IV-B expenditure data.
section_title: HHS Regional Offices Were Unaware of Spending Limits or Did Not Enforce Them
paragraphs: HHS regional offices paid little attention to the statutory limits on the use  of subpart 1 funds for foster care maintenance and adoption assistance.  Officials in only 1 of HHS’s 10 regional offices said that they ensured state  plans complied with statutory spending limits for subpart 1. In contrast, 5  regional offices were unaware that any limits on the use of subpart 1 funds  existed. Four other regional offices were aware that some limitations  existed, but did not ensure state compliance with them.
Two regional offices said they did not monitor planned expenditures for  subpart 1 because they had no data to calculate the spending limit for each  state, and HHS had not provided guidance on how to enforce the limits.  Officials in another region said that their office discontinued subpart 1  compliance reviews because they considered the limits to be meaningless  because state and federal funds are fungible and state funds spent on child  welfare services greatly exceeded subpart 1federal funds. In other words,  any attempt to enforce the limits, according to these officials, would only  lead to changes in how states accounted for state and federal funds.
Some states reported in our survey that they spent 2002 subpart 1 funds in  excess of the statutory authority for foster care maintenance and adoption  assistance payments. (See fig. 4.) While spending excesses were small in  some states, they were large in others, ranging from a low of $27,000 in  New Hampshire to nearly $4 million in Michigan. In total, reported actual  spending by the 10 states exceeded the statutory limit by over $15 million.
Subsequent to our review, ACF issued guidance to states reminding them  of the statutory spending limits for Title IV-B subpart 1 funds in November  2003. This guidance included information needed by each state to  calculate its spending limit for foster care and adoption assistance  payments, and day care related to employment or training.
section_title: Little Research Existed on the Effectiveness of Title IV-B Services
paragraphs: Research on the effectiveness of services provided under subpart 1of Title  IV-B was limited, and HHS evaluations of subpart 2 services showed no or  little effect on children’s outcomes. In our survey, 22 states reported  providing services other than maintenance payments, staff salaries, or  administration under subpart 1; however, none of these states had  evaluated the outcomes of these services. One state official said that few  states could afford to divert resources away from direct services to  families in order to conduct formal program evaluations, given the  tremendous service needs of families involved in the child welfare system.
Similarly, our literature review showed that few evaluations had been  conducted, and evaluations that had been conducted produced mixed  results. For example, one study evaluating a program in Texas to increase  family literacy and prevent child abuse by enhancing parent-child  interactions cited results showing positive effects on children’s measured  competence and classroom behavior. However, evaluation of the same  program in New York did not consistently show differences in outcomes  for children and parents in the program compared to those in a control  group.
HHS evaluations of subpart 2 services also have shown no or little effect,  as reported by the Congressional Research Service. The Congress  required HHS to evaluate the effectiveness of programs funded under  subpart 2 as part of its initial approval of funding for family preservation  and family support services. HHS focused on the use of subpart 2 funds in  three large-scale evaluations. One looked at overall implementation issues  for the program, the second looked at the effectiveness of two models of  family preservation services (both providing relatively intensive  casework), and the third looked at the effectiveness of a wide range of  family support services. Overall, the findings were similar across all  evaluation sites showing subpart 2 services provided no or little effect in   reducing out-of-home placement, maltreatment recurrence, or improved  family functioning beyond what normal casework services achieved. No  similar large scale evaluations of time-limited reunification services or of  adoption promotion and support services have been made.
section_title: Prior Recommendations
paragraphs: Our 2003 report recommended that the Secretary of HHS provide the  necessary guidance to ensure that HHS regional offices are providing  appropriate oversight of subpart 1, consider the feasibility of collecting  data on states’ use of these funds to facilitate program oversight and  guidance to states, and use the information gained through enhanced  oversight of subpart 1 to inform its design of alternative child welfare  financing options. ACF agreed with our findings and implemented  guidance to states reminding them of the statutory requirements for  subpart 1 spending. ACF disagreed with our recommendation to consider  collecting data on subpart 1 expenditures. ACF believed that its level of  oversight was commensurate with the scope and intent of subpart 1,  noting that its oversight efforts are more appropriately focused on reviews  of the states’ overall child welfare systems. ACF did not comment on our  recommendation to use such data to inform the design of an alternative  financing option.
Mr. Chairman, this completes my prepared statement. I would be happy to  respond to any questions you or other Members of the Subcommittee may  have.
section_title: Appendix I: GAO Contact and Acknowledgments
paragraphs: For further information regarding this testimony, please contact me at  (202) 512-8403. Individuals making key contributions to this testimony  include Lacinda Ayers, Diana Pietrowiak, and Michelle St. Pierre.
section_title: Appendix II: Related GAO Products
paragraphs: Lessons Learned for Protecting and Educating Children after the Gulf  Coast Hurricanes. GAO-06-680R. Washington, D.C.: May 11, 2006.
District of Columbia: Federal Funds for Foster Care Improvements Used  to Implement New Programs, but Challenges Remain. GAO-05-787.  Washington, D.C.: July 22, 2005.
Child Welfare: Better Data and Evaluations Could Improve Processes  and Programs for Adopting Children with Special Needs. GAO-05-292.  Washington, D.C.: June 13, 2005.
Indian Child Welfare Act: Existing Information on Implementation  Issues Could Be Used to Target Guidance and Assistance to States.   GAO-05-290. Washington, D.C.: April 4, 2005.
Foster Youth: HHS Actions Could Improve Coordination of Services and  Monitoring of States’ Independent Living Programs. GAO-05-25.  Washington, D.C.: November 18, 2004.
D.C. Child And Family Services Agency: More Focus Needed on Human  Capital Management Issues for Caseworkers and Foster Parent  Recruitment and Retention. GAO-04-1017. Washington, D.C.: September  24, 2004.
Child And Family Services Reviews: States and HHS Face Challenges in  Assessing and Improving State Performance. GAO-04-781T. Washington,  D.C.: May 13, 2004.
D.C. Family Court: Operations and Case Management Have Improved,  but Critical Issues Remain. GAO-04-685T. Washington, D.C.: April 23,  2004.
Child and Family Services Reviews: Better Use of Data and Improved  Guidance Could Enhance HHS’s Oversight of State Performance.   GAO-04-333. Washington, D.C.: April 20, 2004.
Child Welfare: Improved Federal Oversight Could Assist States in  Overcoming Key Challenges. GAO-04-418T. Washington, D.C.: January 28,  2004.
D.C. Family Court: Progress Has Been Made in Implementing Its  Transition. GAO-04-234. Washington, D.C.: January 6, 2004.
Child Welfare: States Face Challenges in Developing Information  Systems and Reporting Reliable Child Welfare Data. GAO-04-267T.  Washington, D.C.: November 19, 2003.
Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide  States Additional Information to Improve Services. GAO-03-956.  Washington, D.C.: September 12, 2003.
Child Welfare: Most States Are Developing Statewide Information  Systems, but the Reliability of Child Welfare Data Could be Improved.  GAO-03-809. Washington, D.C.: July 31, 2003.
D.C. Child and Family Services: Key Issues Affecting the Management of  Its Foster Care Cases. GAO-03-758T. Washington, D.C.: May 16, 2003.
Child Welfare and Juvenile Justice: Federal Agencies Could Play a  Stronger Role in Helping States Reduce the Number of Children Placed  Solely to Obtain Mental Health Services. GAO-03-397. Washington, D.C.:  April 21, 2003.
Foster Care: States Focusing on Finding Permanent Homes for Children,  but Long-Standing Barriers Remain. GAO-03-626T. Washington, D.C.:  April 8, 2003.
Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare  Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March  31, 2003.
Foster Care: Recent Legislation Helps States Focus on Finding  Permanent Homes for Children, but Long-Standing Barriers Remain.  GAO-02-585. Washington, D.C.: June 28, 2002.
District of Columbia Child Welfare: Long-Term Challenges to Ensuring  Children’s Well-Being. GAO-01-191. Washington, D.C.: December 29, 2000.
Foster Care: HHS Should Ensure That Juvenile Justice Placements Are  Reviewed. GAO/HEHS-00-42. Washington, D.C.: June 9, 2000.
Juvenile Courts: Reforms Aim to Better Serve Maltreated Children.  GAO/HEHS-99-13. Washington, D.C.: January 11, 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 5, 1999.
Child Welfare: States’ Progress in Implementing Family Preservation  and Support Services. GAO/HEHS-97-34. Washington, D.C.: February 18,  1997.
Child Welfare: Opportunities to Further Enhance Family Preservation  and Support Activities. GAO/HEHS-95-112. Washington, D.C.: June 15,  1995.
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