Foster Youth: HHS Actions Could Improve Coordination of Services and Monitoring of States' Independent Living Programs
Released: 2004-12-20T00:00:00

Letter

Background

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.

Foster Care Independence Act and the Chafee Program

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.

State Responsibilities under FCIA

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.

Federal Oversight

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.

FCIA Increased Independent Living Allocations for Most States, but Some States Had Difficulty Absorbing Large Increases in Funds

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.

States Expanded and Improved Services for Youth after FCIA, but Gaps in Critical Services Remain

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.

FCIA Allowed States to Serve Younger and Emancipated Youth and to Improve Services for All Youth in Independent Living Programs

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.

Education and Training Vouchers

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.

Medicaid Health Insurance

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.

Improving Existing Services

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.

Serving Youth Remains Challenging because of Gaps in Services and Difficulties Engaging Youth and Foster Parents

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.

Mental Health Services

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.

Mentoring Services

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.

Securing Safe and Suitable Housing

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.

States Reported Increased Coordination with Federal and State Programs to Provide Independent Living Services to Youth, but Barriers Hinder Linkages across Programs

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.

States Reported Accessing Federal and State Programs More after FCIA to Provide Independent Living Services

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.

States Reported Barriers to Establishing Linkages between the Independent Living Programs and Other Youth-Serving Programs

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.

States’ and HHS’s Actions in Response to FCIA Requirements Have Not Yet Established Accountability for Independent Living Programs

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.

States Submitted Plans and Annual Reports to Comply with Federal Requirements, but the Documents Do Not Provide Information Necessary to Assess Progress

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.

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

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.

HHS Has Begun Multiyear Evaluation of Four Approaches to Delivering Independent Living Services

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.

Conclusions

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.

Recommendations

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.

Agency Comments

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.

Appendix I: Scope and Methodology

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.

Appendix II: Selected Federal Youth Programs and Services That Target Current and Former Foster Youth

Department of Health and Human Services

Appendix III: Comments from the Department of Health and Human Services

Appendix IV: GAO Contacts and Acknowledgments

GAO Contacts

Staff Acknowledgments

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.

Bibliography

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.

Related GAO Products

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.