The Department of Health and Human Services (HHS) is responsible for the administration and oversight of federal funding to states for services to foster children under title IV-E of the Social Security Act. The states are responsible for administering foster care programs, which are supported in part with federal funds. These funds reimburse the states for a portion of the cost of maintaining foster children whose parents meet federal eligibility criteria for the funds. The criteria are based in part on the income level of the parents. Federal expenditures for the administration and maintenance of foster care cases eligible for title IV-E were $3.2 billion in 1997. When foster children are not eligible for title IV-E funding, they may be eligible for child-only benefits under the Temporary Assistance for Needy Families (TANF) program, which are partially funded by the federal government. Otherwise, states and counties must bear the full cost of caring for foster children. Within the foster care system, children can be placed in any of a number of temporary settings, including kinship care, family foster care, private for-profit or nonprofit child care facilities, or public child care institutional care. In the kinship care setting, foster children are placed with their relatives. While the definition of “relatives” varies somewhat by state, relatives are typically adults who are related to a foster child by blood or marriage. They may also be family friends, neighbors, or other adults with whom the child is familiar. In this report, kinship care refers to the formal placement of children in the foster care system with their relatives. It does not include informal arrangements for relatives to care for children who are outside the child welfare system and the purview of the courts. Since at least the 1980s, some portion of foster children in this country have been placed with relatives. Some studies contend that the increase in the number of foster children being placed with relatives may have been, at least initially, the result of a shortage of traditional foster homes.Others suggest that kinship care increased as a result of the Adoption Assistance and Child Welfare Act of 1980. This act required states to place children in the “least restrictive (most family like) setting available,” a requirement that has been interpreted by many states as implying a preference for placing foster children with their relatives. The increase in kinship care may also stem in part from litigation (Matter of Eugene F. v. Gross, Sup. Ct., NY County, Index No. 1125/86) that resulted in New York City’s bringing certain children being cared for by relatives into the formal foster care system and making them eligible for publicly funded services. Regardless of the historical impetus behind the growth in kinship care, section 505 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 amended federal law to require that the states consider giving priority to relatives when deciding with whom to place children while they are in the foster care system. Kinship care cases are eligible for federal title IV-E funding if, in addition to other criteria, the caregivers meet state licensing requirements for foster homes and the child’s parents meet the income eligibility criteria.In 1996, in about 60 percent of the kinship care cases in California and about 50 percent of such cases in Illinois, the caregiver received title IV-E funding. In the remaining kinship care cases in these states, the caregiver may have received an Aid to Families with Dependent Children (AFDC) grant, which may have been a child-only grant. Thirty-nine states reported in a 1996 survey conducted by the Child Welfare League of America (CWLA) that in 1995 they had a total of about 107,000 foster children in kinship care, or about one-quarter of all foster children in the United States. In 1995, the proportion of all foster children in each state who were in kinship care ranged from 0.4 to 52 percent. As time passes, states appear to be relying more on kinship care. CWLA has reported that between 1990 and 1995, the number of children in foster care increased by 21 percent (from 400,398 in 1990 to 483,629 in 1995), while the number of kinship care children increased by 29 percent. In 1995, the foster care population in California was 87,010, or about 27 percent larger than it had been in 1990, while the kinship care population was about 36 percent larger. According to our survey, as of September 15, 1997, 51 percent of the 74,133 foster children in California who had been in the system since at least March 1, 1997, were in kinship care. In 1997, the foster care population in Illinois was 50,721, or about 159 percent larger than it had been in 1990, while the kinship care population was about 250 percent larger. Up until July 1995, children whose parents were absent and who were living safely with a relative were considered “neglected” under Illinois state law, and the state generally assumed custody of such children. In these cases, the relative’s home at the time was frequently converted into kinship care within the foster care system. This may have accounted for the growth of the kinship care population in Illinois up until that time. Illinois amended the definition of “neglected child,” effective July 1, 1995, and as a result, such children are no longer considered neglected and the state no longer assumes custody.According to our survey, as of September 15, 1997, 55 percent of the 48,745 foster children in Illinois who had been in the system since at least March 1, 1997, were in kinship care. Federal foster care statutes and regulations, which emphasize the importance of both reunifying families and achieving permanency for children in a timely manner, apply to all foster care cases, whether a child is in kinship care or another foster care setting. Outcomes in foster care cases include (1) family reunification, (2) adoption, (3) legal guardianship, and (4) independent living or aging out of the foster care system, usually at age 18. In emphasizing the goal of family reunification, for example, federal law requires that the states make “reasonable efforts” to reunify foster children with their parents. The law requires that the states develop case plans that among other things describe the services that are to be provided to help parents, children, and foster parents facilitate the children’s return to their own safe home or their permanent placement elsewhere. The states are required to review foster care cases at least every 6 months and must hold permanency planning hearings at least every 12 months, during which a judge or a hearing officer determines whether a state should continue to pursue the current goal or begin to pursue some other permanency goal. When foster children cannot be safely returned to their parents in a timely manner, the Adoption and Safe Families Act of 1997 (enacted after the period covered by our survey) includes a provision requiring the states to begin the process to file a petition to terminate parental rights if a child has been in foster care for 15 of the most recent 22 months, unless (1) required reasonable efforts and services to reunify the family have not been made in accordance with the case plan, (2) a “compelling reason” is documented in the case plan indicating why it would not be in the best interest of the child to terminate parental rights at that time, or (3) at the option of the state, the child is being cared for by a relative. At the same time that the states are required to initiate termination procedures, they must also identify and recruit qualified families for adoption. Thus, if none of the exceptions apply, the law attempts to achieve permanency through adoption. Most research on the quality of kinship care has used the demographic characteristics of the caregivers as indirect indicators of the quality of foster care they provide. Although the studies’ results have varied somewhat, many studies have found that kinship caregivers tend to be older, have less formal education and lower incomes, are less often married, and are less healthy than other foster caregivers. On the basis of these characteristics, child welfare researchers and practitioners have inferred that the quality of kinship care may be lower than the quality of care in other foster care settings. Our analysis of the caseworkers’ responses to our survey of open foster care cases in California and Illinois showed that, overall, the quality of both kinship care and other foster care was good and that in most respects the experiences of children in kinship care and in other foster care settings were comparable. In both states, most caregivers in kinship as well as foster care settings received high scores from their caseworkers when it came to performing parenting tasks. We also found that, in general, children in kinship care in these states experienced significantly more continuity in their lives—that is, continued contact with family, friends, and the neighborhood they lived in before entering foster care—than other foster children. However, we also found that while the caseworker in most kinship as well as other foster care cases believed that the caregivers were likely to enforce court-ordered restrictions on parental visits, the proportion of cases in which this view was held was smaller for kinship care cases than other foster care cases. Moreover, requirements such as standards or approval criteria for becoming a caregiver and training for caregivers were less stringent for kinship care in California and Illinois than for other foster care. In both California and Illinois, most kinship and other foster caregivers received comparably high scores from their caseworker in performing nearly all the parenting tasks we asked about in our survey. These tasks covered three areas: (1) providing day-to-day care, such as providing supervision and emotional support to a child, setting and enforcing limits on the child’s behavior, and making sure the child attends school; (2) ensuring that the child is up-to-date on routine medical examinations; and (3) interacting with medical, mental health, and educational professionals. We found no research that directly measured foster parents’ ability to perform such tasks. For nearly all the parenting tasks we asked about, the caseworkers in more than 90 percent of kinship care and other foster care cases in the two states responded that the caregivers performed those tasks either adequately or very adequately. A smaller percentage—about 80 percent—of the children in kinship care in Illinois, however, were up-to-date on their routine vision and dental examinations, compared with 90 percent of other foster children. State officials in Illinois speculated that this was because kinship caregivers are more likely than other foster caregivers to seek vision and dental care for their foster children only as often as they do for themselves, which is less frequently than state standards and guidelines call for. Those officials believed that other foster caregivers are more likely to follow state standards and guidelines when it comes to their foster children. In both California and Illinois, responses to our survey questions indicated that there was significantly more continuity in the lives of children in kinship care than in other foster care settings. While many mental health professionals agree that continuity in relationships is good for children in general, there is less agreement about the merits of continuity in the lives of abused or neglected children. Experts do agree that contact with siblings, and especially living with siblings, is beneficial for a child and that parental visits with foster children are needed to achieve reunification when this is an appropriate goal. Experts also report that a child’s familiarity with the caregiver lessens the trauma of separation from the family, at least in the short run. Advocates of kinship care further assert that placing a foster child with relatives or friends may help maintain continuity in the child’s life by maintaining ties with the child’s community, school, and church. Many believe, however, that parents who neglect or abuse their children learn this behavior from members of a dysfunctional immediate or extended family. So, living with relatives and continued contact with the community may not be in the best interest of the child because the child continues to live in the environment that may have led to the abuse or neglect. Our survey asked for information about three types of continuity in foster children’s lives: (1) their previous familiarity with the person who became their foster parent; (2) their contact while in foster care with their parents, other relatives, and friends; and (3) their involvement, while in foster care, with the community they lived in before they entered the system. Our analysis showed that there was significantly more continuity in the lives of children in kinship care than in other foster care settings with respect to nearly all the indicators we used to measure these three categories of continuity. In general, our findings were consistent with the results of other research about the relationship of kinship care and continuity in foster children’s lives. In measuring children’s familiarity with the persons who became their foster parents, the results of our survey in both California and Illinois indicated that a significantly larger proportion of children in kinship care than other foster care knew their caregivers before entering the system. In addition, a significantly larger proportion of kinship care children had resided with their caregivers previously. (See fig. 1.) In measuring the extent to which foster children were in contact with their parents, other relatives, and friends in California and Illinois, in significantly more kinship care than other foster cases the caseworkers reported that the children were in contact with family and friends. For example, the caseworkers’ responses to our survey showed that mothers with children in kinship care (24 percent in California, 39 percent in Illinois) visited their children more often than specified in their case plans than did mothers with children in other foster care settings (6 percent in California, 11 percent in Illinois). To put this into perspective, however, in both kinship care and other foster care settings, less than 50 percent of mothers visited their children as often as specified in their case plans. Other research has also shown that parents of children in kinship care are more likely to visit their children at least once a year, and visit them more often per year, than parents of other foster children. In both California and Illinois, in a significantly larger proportion of kinship than other foster care cases the caseworkers noted that one or more of a child’s siblings were living in the same foster home. According to our survey, children in kinship care also had more contact with their friends and relatives other than parents, foster parents, or siblings. (See fig. 2.) Other studies reported similar findings. For example, surveys of foster children in Baltimore County, Maryland, in 1993 and in California from 1988 through 1991 have shown that children in kinship care were more likely to live with siblings than were other foster children. Finally, in measuring children’s contact with the communities they lived in before they entered the system, in significantly more kinship care than other foster care cases in California and Illinois caseworkers indicated that children had contact with their established community. More specifically, in both California and Illinois a larger proportion of children in kinship care than in other foster care settings lived in the same neighborhood they had lived in before entering foster care. (See fig. 3.) This is consistent with other studies of foster children in Illinois.Furthermore, according to our survey, a larger proportion of children in kinship care in each state were attending the school they would have attended had they not entered the system. The number of times caregivers changed during a foster care episode has also been used as an indication of continuity in a child’s life. Previous research in California has shown that foster caregivers changed fewer times per foster care episode in kinship care than other foster care cases; the lives of children in kinship care tended to be more stable while they were in foster care. Our survey suggests that the safety of a somewhat larger proportion of children in kinship care than other foster care in California and Illinois may be at risk because their caregivers may be unwilling to enforce court-ordered restrictions on parental visits. Specifically, in 72 percent of the California kinship care cases and 68 percent of the Illinois kinship care cases in which the parents’ visits with their children were restricted, the caseworkers believed that the caregivers were likely to take the necessary action to enforce the restrictions. In contrast, 92 percent of the caseworkers in other foster care cases in California and 80 percent in other foster care cases in Illinois believed that the caregivers were likely to enforce parental visitation restrictions. (See fig. 4.) As noted earlier, parental visits provide stability for children while they are in foster care. In some cases, however, the court may restrict visits by the parents because it believes the child might be harmed by these visits. In more than 85 percent of our survey cases, the court had restricted visits by the parents. Certain elements of California’s and Illinois’s quality assurance systems are less rigorous for kinship care than for other foster care settings. Both California and Illinois have less stringent requirements for becoming a caregiver and provide less training and support to kinship caregivers. States sometimes treat kinship caregivers differently because of the family bond that is assumed to be present between children and their relatives. They believe this bond mitigates the need for more intrusive state oversight in these cases. While some experts in child welfare believe that this exception for kinship caregivers is reasonable, others believe that while a state has custody of a child, all caregivers should be held to the same standards. To become foster caregivers in California or Illinois, a child’s relatives must meet certain criteria specifically designed for kinship care that are less stringent than the licensing requirements that apply to other foster caregivers. For example, since Illinois does not require kinship caregivers to be licensed, they do not have to meet licensing requirements regarding the number of bedrooms or the square footage in the home. Furthermore, they are exempt from some specific requirements designed to ensure a foster child’s safety in the home. Even though kinship caregivers are not required to meet the same requirements as other caregivers, in California if a foster child is eligible for title IV-E funds, the kinship caregivers receive the same maintenance payment as licensed caregivers would. Unlike in California, kinship caregivers in Illinois can receive the same maintenance payment as other caregivers only if they choose to meet the licensing requirements of other foster caregivers and thereby become licensed. Otherwise, relatives must meet less stringent requirements to provide foster care, which results in a lower maintenance payment. State child welfare officials in Illinois indicated that about 50 percent of the kinship caregivers in the state are licensed to provide foster care. Both California and Illinois require caseworkers to periodically visit all foster children. Caseworkers are required to visit foster children in order to, among other things, monitor the quality of the care they are receiving and determine whether the children or caregivers have any unmet service needs. Generally, in California, caseworkers are required to visit foster children at least once a month. When the goal is something other than family reunification, caseworkers are required to visit at least once every 6 months, because in these cases the children are considered to be in a more stable setting. Illinois requires caseworkers to visit foster children at least once a month, regardless of the permanency goal. According to our survey, caseworkers in California and Illinois visited both foster children in kinship care and those in other settings more often on average than formally required, but they visited children in kinship care less often on average than children in other foster care settings. Eighty-five percent of our cases in California were past family reunification so were required to be visited once every 6 months. In California, caseworkers visited kinship care children an average of 3.8 times in 6 months compared with an average of 5.3 visits to other foster children. Similarly, in Illinois caseworkers visited kinship care children an average of 8 times in 6 months compared with an average of 11.3 visits to other foster children.Our survey results were consistent with other research that has also found that caseworkers tend to visit children in kinship care less frequently than other foster children. California and Illinois provide fewer kinship caregivers with training than other foster caregivers. To help ensure good quality foster care, both states require licensed foster caregivers to receive training in topics such as the child welfare system and procedures and caring for children who have been abused or neglected. Since kinship caregivers are not required to be licensed in either California or Illinois, a smaller proportion of kinship caregivers than other foster caregivers in these states receive such training. Because of funding constraints, California has historically precluded kinship caregivers from receiving such training unless they pay for it themselves. Nonetheless, California state officials believe that kinship caregivers should receive training that is specifically designed for them. The Child Welfare Research Center (CWRC) has found that both kinship caregivers and other foster caregivers in California would like more training on subjects such as foster parent licensing, prenatal drug exposure, and how to interact more effectively with social service agencies. CWRC has also found that kinship caregivers in California want more information about court proceedings related to foster care and how to navigate the child welfare system in order to receive needed services. Some states provide fewer kinship caregivers with support services than other foster caregivers. Services such as respite care, housing support, counseling, transportation, child care, legal services, and access to support groups are designed to help foster caregivers successfully perform their role. Research conducted in California found that a smaller proportion of kinship caregivers received such services than other foster caregivers.This research also found that kinship caregivers in California, reacting to the emotional demands of caring for an abused or neglected relative, also wanted to know more about community resources and mental health services that were available to them. Previous research on children who have left the foster care system has shown that children who had been in kinship care were less likely to be adopted and stayed longer in foster care than other foster children. However, we found no consistent pattern between California and Illinois. In California, we found a pattern similar to the research regarding permanency goals among foster care cases in which a child is still in the system. Specifically, kinship care cases in California less often had the goal of adoption or guardianship (and more often had the goal of long-term foster care) than did other foster care cases. In California, there was no difference between kinship care and other foster care in the length of time children spent in foster care. However, in Illinois, in foster care cases in which a child was still in the system, a larger proportion of kinship care than other foster care cases had the goal of adoption and guardianship, and kinship care cases had been in the system a shorter, not longer, period of time. Because outcomes for kinship care cases differed in these two states, it is likely that state foster care policies and practices rather than the type of foster care setting in which children were placed had the greatest influence over a foster child’s permanency goal and length of time in care. It should also be noted that, in both states, we found that most children, regardless of foster care setting, had been in the system much longer than they should have been if the Adoption and Safe Families Act had been in effect at the time of our survey. Several research studies have looked at foster care outcomes and length of stay. Many of these examined the experiences of a group of children who entered the system in the same year. Most have shown that children in kinship care were less likely than other foster children to be adopted. Most have also shown that children in kinship care spent more time than other foster children in the foster care system. In California, our analysis of the survey data indicated that kinship care cases in the foster care system as of September 15, 1997, were more likely to have the goal of long-term foster care than other foster care cases in the system at that time. Where reunification was no longer considered feasible, our survey showed that 67 percent of the cases in kinship care had a goal of long-term foster care compared with 53 percent of cases in other foster care settings. (See fig. 5.) The large number of children in kinship care with the goal of long-term foster care is not surprising given that according to California officials, the state had only recently begun to offer adoption and guardianship options specifically designed for a foster child’s relatives. Survey responses confirmed this belief. In 74 percent of kinship care cases with a goal of long-term foster care, the caseworkers responded that the primary reason why the children did not have adoption as the goal was that they were being cared for by relatives who did not want to adopt and that moving the children to another home would be detrimental to them. State officials in California pointed out several disincentives for adoption and guardianship in kinship care cases. Certain benefits for foster children in California, such as special priority for assistance in schools and financial assistance for college, are no longer available when they have been adopted. Similarly, title IV-E maintenance payments are not authorized for children who leave the foster care system because of legal guardianship. Guardians who are related to a child could receive a TANF child-only grant on behalf of the child instead of title IV-E payments, but this grant is much lower than the title IV-E maintenance payments. In addition, to qualify for a TANF child-only grant, the guardian would have to provide proof that the child attends school and receives medical examinations. According to our survey, more than half of the open kinship care cases in California with the goal of guardianship had a guardian appointed but remained in the foster care system. This may be because guardians can receive the foster care maintenance payment, which is higher than a TANF child-only grant, if the case remains in the foster care system. While our survey found that, of all foster care children in California, 11.3 percent of children in kinship care and 19.1 percent of other foster children had adoption as the goal, in fact, only 2 percent of the children in foster care were adopted in 1997. Therefore, the state foster care agency has set the goal of adoption for many more foster children than are likely to be adopted, given recent experience. According to our survey in California, as of September 15, 1997, children in kinship care had been in the system about as long as those in other foster care settings. A multivariate analysis of cases in California confirmed that the type of foster care setting was not associated with the time foster children had spent in the system. Both children in kinship care and those in other foster care settings as of September 15, 1997, had already spent more than 60 months on average in foster care. This is 45 months longer than the time now allowed under the Adoption and Safe Families Act before the states are required to file a petition to terminate parental rights. Furthermore, we estimate that of the 37,881 children in kinship care in California as of September 15, 1997, who had been in the system since at least March 1, 1997, nearly 82 percent, or 31,025, had been in the system for 17 months or more. Under federal law, however, children in kinship care may be excluded from the requirement to terminate parental rights once a child has been in foster care for 15 of the past 22 months. In contrast to our findings in California, data from our survey in Illinois indicated that children in kinship care as of September 15, 1997, were more likely to have the goal of adoption or guardianship than other foster children in the system at that time. Specifically, 66 percent of kinship care cases had the goal of adoption or guardianship compared with 47 percent of cases in other foster care settings. (See fig. 6.) According to state officials, Illinois has found that kinship caregivers, contrary to popular belief, are willing to adopt, and Illinois is actively pursuing adoption in these cases. While our survey found that in Illinois 41.3 percent of children in kinship care and 37.9 percent of other foster children had adoption as a goal, in fact, only 4 percent of all foster children were estimated to have been adopted in 1997. Therefore, as in California, the state foster care agency has set the goal of adoption for many more children than are likely to be adopted, given recent experience. Our survey in Illinois indicated that foster children in kinship care as of September 15, 1997, had spent 43 months, on average, in the system. Other foster children had been in care for 53 months, on average, as of that date. A multivariate analysis of cases in Illinois also indicated that the type of foster care setting was associated with the time children had already spent in the system. Children in kinship care had been in the system about 10 fewer months, on average, than other foster children. Although children in other foster care settings in Illinois had spent more months in the system, as of September 15, 1997, than children in kinship care, foster children in general had spent much more time, on average, in the system as of that date than the 15 months allowed with the enactment of the Adoption and Safe Families Act before states are required to file a petition to terminate parental rights. Furthermore, we estimated that of the 26,712 children in kinship care in Illinois as of September 15, 1997, who had been in the system since at least March 1, 1997, 87 percent, or 23,213, had been in the system for 17 months or more. As we noted earlier, however, the law allows the states to exclude children in kinship care from the federal requirement to terminate parental rights in cases in which they have been in care 15 of the past 22 months. Since the fall of 1997, both California and Illinois have been instituting new programs and practices that are designed to (1) increase the likelihood that permanent living arrangements will be found for children in kinship care, as well as other foster care settings, who cannot return to their parents and (2) continue to ensure that kinship care is of good quality. They are pursuing efforts to choose the best kinship caregivers by identifying and locating a larger pool of relatives to draw from when deciding with whom to place foster children. To help ensure that children who cannot return to their parents do not remain in the foster care system indefinitely, California and Illinois recently enacted laws and are developing programs that encourage kinship caregivers and other relatives of foster children to provide permanent homes for them when necessary. Both states also support adoption and subsidized guardianship for children in kinship care as pathways out of the foster care system. Both California and Illinois have stepped up their efforts to identify as many of a foster child’s relatives as possible before deciding with whom to place that child. By expanding the pool of potential foster caregivers, the states hope to help ensure a foster child is placed with the relative who is capable of providing good quality foster care in the short term and who is willing to provide a long-term home if reunification with the parents is not feasible. Illinois requires that a “diligent” search for the parents when a child enters foster care include a search for other relatives, as well. The state is contracting with a firm that specializes in identifying and locating relatives and will conduct such searches routinely in foster care cases statewide. Since January 1, 1998, courts in California have had the authority to order the parents of foster children to disclose the names and residences of all the children’s maternal and paternal relatives. According to California officials, parents before then typically provided the names of only one or two relatives, usually the ones with whom they preferred their child to be placed. In addition, before a foster child is placed with a relative, California now applies an expanded assessment requiring that (1) a detailed background check be conducted; (2) the relative’s capacity to help implement the case plan, including family reunification efforts, be considered; and (3) the relative’s ability and willingness to provide a permanent home for the child also be considered. Recent legislation in California has also created the Kinship Support Services Program, one of whose objectives is to help ensure the good quality of kinship care. Services this program provides include case management; social services referral and intervention aimed at maintaining the kinship family unit—for example, housing, homemaker services, respite care, legal services, and day care; transportation for medical care and educational and recreational activities; individual and group counseling in parent-child relationships and group conflict; counseling and referral services aimed at promoting permanency, including kinship adoption and guardianship; and tutoring and mentoring for the children. Both California and Illinois are attempting to help ensure that children in kinship care spend as little time in the foster care system as possible. Anticipating federal and state legislation requiring the states to move more quickly to secure permanent homes for foster children, including those in kinship care, in 1998 the Illinois Department of Children’s and Family Services instituted new policies and programs related to kinship care to meet this requirement. In California, the move to encourage relatives to provide permanent homes for foster children began with the Governor’s Adoption Initiative of 1996, which is a 5-year plan to “identify and implement strategies to maximize adoption opportunities for children in long-term foster care.” In 1996, the state held a policy summit on kinship care that found that current “permanency options present significant cultural and financial barriers to kin to achieve permanency.” Following is an overview of the activities these states are undertaking to take better advantage of opportunities for permanently placing foster children with their relatives. On January 1, 1998, California instituted a kinship adoption program to remove barriers to adoption by current kinship caregivers and other relatives of foster children. In a kinship adoption, caregivers and relatives are permitted to enter into a kinship adoption agreement, a provision that is not typical in traditional adoptions. This agreement can address visitation rights for parents and other family members, as well as how information about a child is to be shared. The law authorizing the program sets out procedures for the agreement’s enforcement, modification, and termination. Under the terms of kinship adoption, parents may voluntarily relinquish their parental rights and designate the relative who will adopt the child, a provision that is also unique to kinship adoption. Concurrent planning allows for planning for the ultimate return of foster children to their parents, as well as another permanency outcome should family reunification prove infeasible. This process is intended to shorten the length of time it takes to secure another permanent home for children once the court decides that they cannot return to their parents. Illinois has recently begun concurrent planning; it is particularly useful when parents have previously been unwilling or unable to provide a safe home for their children or when repeated clinical interventions have failed. “A successful concurrent planning program is one in which the number of children who enter long-term foster care is significantly reduced (ideally, eliminated), the time the typical child spends in the system is reduced, virtually all young children who do not reunify are adopted rather than placed with legal guardians, the number of children replaced is reduced significantly, the proportion of relinquishments increases, and social workers’ comfort with the quality of adoptive families increases.” HHS has granted both Illinois and California a 5-year waiver of the restriction the Social Security Act places on providing title IV-E maintenance payments to legal guardians. This waiver enables the states to subsidize guardianships using title IV-E funds, thus eliminating the financial disincentive for kinship caregivers to become their foster child’s legal guardian. In its first year, the waiver for California applies only to children 13 years of age or older. In each subsequent year, the minimum eligibility age increases by 1 year. When the waiver period ends in 5 years, all children who were covered by the waiver will have reached the age of 18, so they will no longer require title IV-E foster care payments. Thus, California will not be responsible for any further subsidized guardianship payments for these children once the waiver period has ended. California recently notified HHS that it would like to delay the implementation of this waiver until it has fully analyzed recently passed state legislation that also provides for subsidized guardianship. Illinois has received a title IV-E waiver from HHS enabling it to use title IV-E funds for subsidies to kinship caregivers who agree to assume legal guardianship of their foster children. Unlike California, Illinois’s subsidy is available for children of any age. Thus, when this 5-year waiver expires, Illinois will fund the subsidies for children in this program from state revenues until they reach the age of 18. Although there are no age limits under Illinois’s waiver, to be eligible a child must have been in foster care for 1 year and must have lived with the potential guardian for at least 1 year before that guardian can apply for payments under this waiver. California’s Kinship Support Services Program, described earlier, also provides an incentive for kinship caregivers to adopt or assume legal guardianship of their foster children by continuing to make the program’s support services available to them after their foster children leave the system. Thus, these services are available to relatives, whether or not the child in their care is under the jurisdiction of the juvenile court or in the child welfare system. In 1998, California enacted legislation requiring that a plan be developed for a Kinship Care Program that will be separate and distinct from the existing foster care program and will provide services uniquely suited to the needs of children being cared for by their relatives. The Department of Social Services is currently developing a plan for a separate kinship care program. California also enacted legislation in 1998 that set up the Kinship Guardianship Assistance Payment program known as Kin-GAP. According to California officials, the Kin-GAP program allows children in kinship foster care to leave the foster care system by having their kinship caregivers become their legal guardians. This program allows children who have been assessed as being in a long-term stable home to exit the foster care system. Until they reach the age of 18, children in this program have medical coverage and maintenance payments are made for each child. The law limits this payment to no more than 85 percent of the title IV-E foster care maintenance payment. By July 1, 1999, the Department of Social Services must determine what the dollar amount of the payment will be. In order to reaffirm the priority Illinois places on securing permanent homes for foster children, it has established new permanency goals. It has eliminated “long-term relative care” as a permanency goal. Illinois officials noted that caseworkers will thus be forced to more actively seek permanent homes for children in kinship care and thereby prevent them from remaining indefinitely in the foster care system simply because they are being cared for by relatives. New permanency goals include “return home within 5 months,” “return home within a year,” “substitute care pending termination of parental rights,” “adoption,” “guardianship,” “substitute care pending independence,” and “substitute care due to the child’s disabilities or mental illness.” Despite a number of concerns expressed by some child welfare experts about the quality and outcomes of kinship care (the setting in which about one-quarter of the nation’s foster children are placed), the results of our survey of foster care cases in California and Illinois revealed a positive picture but not without some cautionary notes. Parenting-skill assessments by caseworkers in kinship care cases were comparable to parenting-skill assessments by caseworkers in other foster care cases. This was not true for other dimensions of quality. Information from our survey suggests some areas where improvements in kinship care may be needed. Specifically, there may be cause for concern about health and safety, especially with regard to observance of the need for routine dental and eye exams, and about potentially unsafe visits by abusing parents. While California and Illinois apply less stringent standards or approval criteria for kinship caregivers, both states are taking steps to better ensure good quality kinship care. They are raising standards for kinship caregivers and widening the pool of potential kinship caregivers to increase the chances of locating relatives capable of providing good quality care. Since the ultimate goal for foster children is a safe and permanent home, the permanency plan in foster care cases is of paramount concern. Previous research shows that children in kinship care cases stay longer in the system and are less likely to be adopted. In our survey, in California children in kinship care stayed in the system as long as children in other foster care settings and less often had a goal of adoption or guardianship. In contrast, in Illinois children in kinship care stayed in the system a shorter period of time and more often had a goal of adoption or guardianship than children in other foster care settings. Differences in permanency goals and time in foster care, therefore, may depend more on state policies and practices than on foster care setting. Moreover, both states have taken initiatives either to make homes with relatives a viable permanency option or to facilitate permanency planning. We provided a draft of this report to HHS and state child welfare officials in California and Illinois for their review. HHS generally agreed with the report and also described a number of activities of its Administration for Children and Families that it believes will help inform both policy and the child welfare field. HHS also provided technical comments, which we incorporated where appropriate. HHS’s response is in appendix VI. California did not provide official comments. However, California child welfare officials provided oral comments, limited to technical issues related to information about their programs. We incorporated their comments where appropriate. Illinois generally agreed with our report. However, state officials believed that the standards applied to other foster care cases with respect to (1) frequency of caseworkers’ visits, (2) criteria for becoming a caregiver, and (3) caregivers’ willingness to enforce parental visitation restrictions should not be applied to kinship care cases. We believe that it is valid to apply the same standards in both kinship and other foster care cases as far as the number of caseworker visits and a caregiver’s willingness to enforce restrictions on parental visits are concerned. Regarding the number of caseworker visits, we applied the standards that California and Illinois have already set, which in both states are the same for kinship and other foster care cases. Protecting a child’s safety should be the overriding concern of both kinship and other foster caregivers. Therefore, when a restriction is placed on parental visits in the interest of a child’s safety, it seems reasonable to expect kinship caregivers to be as willing as other foster caregivers to enforce that restriction. Although we report that the states apply less stringent requirements for becoming a kinship caregiver, we have taken no position on whether the criteria for kinship and other foster caregivers should be equal. We have modified the report to clarify this. We will send copies of this report to the Secretary of HHS and program officials in California and Illinois. We will also send copies to child welfare program directors in all other states and make copies available to others upon request. Major contributors to this report are listed in appendix VII. If you or your staff have any questions, please contact me at (202) 512-7215 or Clarita A. Mrena, Assistant Director, at (415) 904-2245 or Ann T. Walker, Evaluator-in-Charge, at (415) 904-2169. This appendix contains a detailed description of our review of existing research, interviews with child welfare experts, and survey of open foster care cases in California and Illinois. We conducted this review from April 1997 to December 1998 in accordance with generally accepted government auditing standards. In order to determine what research had been done on kinship care, we conducted a literature search to identify journal articles, reports, dissertations, and theses written between the beginning of 1990 and the fall of 1998 that addressed at least one of the following two research questions: (1) Does the foster care setting affect the quality of care a child receives? and (2) Does the foster care setting affect time in the system and permanency for the child? We began our search by reviewing the bibliographies of three major publications addressing the subject of kinship care: (1) Child Welfare League of America, Selected References on Kinship Care 1962-1994; (2) the Transamerica Systems, Inc., 1997 draft “Study of Outcomes for Children Placed in Foster Care with Relatives”; and (3) Child Welfare League of America, Kinship Care: A Natural Bridge, issued in 1994. We also conducted a computerized search for articles written about kinship care after 1994, the latest year covered in two of these bibliographies. To ensure that we omitted no major articles on kinship care, we sent copies of the three bibliographies and the results of the computerized search to child welfare experts both inside and outside GAO for their review. These experts suggested several additional articles. To identify recently published articles while drafting the report, we updated our computerized search and sent our bibliography to two additional experts outside GAO for their review. As a result of this process, we identified more than 150 documents for preliminary review. We reviewed these documents to determine whether they met our criteria for inclusion in our study and whether they reported any findings related to our research questions. We excluded a number of documents identified in our preliminary review from our final compilation of the research, most often because they (1) did not contain any research results, (2) did not describe original research but instead summarized others’ research, (3) did not differentiate between kinship and other foster care settings, (4) did not differentiate between children in the child welfare system and children being cared for by relatives outside the child welfare system, (5) did not include new data that had not already been summarized in another document written in whole or part by the same authors, and (6) did not address either of our two research questions. Tables I.1 and I.2 list the subquestions we used in the literature search and the tables in appendix III that show the research results for each subquestion. Does the foster child live with siblings who are in foster care? Does the foster child maintain contact with siblings? Does the foster child maintain contact with parents? Does the foster child remain in the same community or neighborhood he or she lived in before entering foster care? Does the foster child feel that he or she is part of the foster family? What is the foster caregiver’s age? What is the foster caregiver’s marital status? What is the foster caregiver’s education? What is the foster caregiver’s health? What is the foster caregiver’s income? What training or preparation did the foster caregiver receive? What required health services does the foster child receive? How often does the caseworker visit the foster child? To what extent does the foster caregiver receive services? How long did the foster child stay in foster care? How many placements in foster care has the foster child had? How long was the foster child in care before adoption, the goal changed to adoption, the child was placed with an adoptive family, or the child was freed for adoption? How long was the foster child in care before reunification with his or her parents? What permanency goals are pursued? To obtain a broader perspective on the issues surrounding kinship care, we interviewed researchers, public policy advisers, physicians, attorneys, family court judges, social workers, adoption caseworkers, and representatives of organizations that have an interest in foster care or child welfare in general. We asked for their opinions about the strengths and weaknesses of kinship care, the quality of kinship care, additional safeguards needed in the system, if any, and the effect of kinship care on foster care outcomes. We also interviewed state program officials to obtain information about kinship care in their state and their opinions about kinship care in general. We surveyed open foster care cases in California and Illinois to obtain information about the quality of care that children in kinship care receive relative to that of foster children in other foster care settings, as well as information about the effect of kinship care on permanency goals and the time children spend in foster care. Each state selected a simple random sample of open foster care cases for our survey, from all cases that were in its foster care system on June 1, 1997, and had been there continuously since at least March 1, 1997. Each sample was intended to represent the entire population of open foster care cases in the state during that time. The samples allowed us to make statements about the experiences of the foster children who made up the foster care population during that time. Because these samples were not drawn from a population of all children who entered the foster care system in a state, however, they do not represent the experiences of all foster children who entered the system. Foster children who spend a relatively short time in the system may be underrepresented in our samples, while children who spend more time in foster care may be overrepresented. Furthermore, while the survey results based on these samples can be generalized to the population of open foster care cases during the specified time in each state, they do not represent the foster care population nationally or in any other state. The foster care cases in California and Illinois combined account for about one-quarter of the entire foster care population nationwide and about half of all kinship care cases. After our samples were drawn, we learned that 22 of the sampled cases from California and 2 from Illinois had not been in foster care continuously from March 1, 1997, through June 1, 1997, and we excluded them from our study. We excluded an additional 57 cases in the California sample and 17 in the Illinois sample because information provided in the questionnaire indicated that they had not been in the foster care system continuously from June 1, 1997, through September 15, 1997—the date in the questionnaire for which caseworkers were asked to provide information about their cases. We assumed that, if all the questionnaires for the cases in each of the initial samples had been returned to us, additional cases would have fallen into these two categories. We used the proportions of each of these types of cases among respondents to estimate how many nonrespondents would have fallen into these two categories. Thus, we reduced our initial samples by 25 cases in California and 6 cases in Illinois. We also adjusted each state’s initial population size by the same proportions. The initial and adjusted population and sample sizes and survey response rates are shown by state in table I.3. The adjusted populations are our best estimates of the number of foster care cases that were in the system continuously from March 1, 1997, through September 15, 1997. We designed a mail questionnaire that asked caseworkers for information, as of September 15, 1997, about the individual foster care cases they were assigned to. We chose this date because it fell just before the date the questionnaires were scheduled to be mailed out, so when caseworkers received the questionnaire they were likely to still recall the facts in a case as of September 15, 1997. Our survey objectives were to collect (1) data not in other research, (2) data more directly related to and thus a better indication of the quality of foster care than the information in other research, and (3) some of the same data as in other research because the foster care population we surveyed and the time covered by our survey were not the same as those in other research. Examples of information our questionnaire collected that we did not find in existing research include foster children’s knowledge of their foster caregivers before entering foster care; foster caregivers’ history of child abuse or neglect, domestic violence, or drug abuse; foster caregivers’ parenting skills; health services foster children received; and the likelihood that foster caregivers would enforce restrictions on parental visits and thus protect children from abusing parents. We pretested the questionnaire with a number of foster care caseworkers in California and Illinois and revised it on the basis of the pretest results.We mailed a questionnaire for each case in our samples to the manager in the office handling that case, who was instructed to give it to the caseworker assigned to that case. The caseworker was asked to respond to the questionnaire with regard to that case. We conducted multiple follow-ups with office managers and caseworkers, by both mail and telephone, encouraging them to respond. In addition to using a mail questionnaire to collect information about foster care cases in our samples, we received an automated file from each state that contained administrative data on each sampled case from that state. The states rely on these data in managing their foster care programs. We did not evaluate the validity of these databases. Our estimates of the number of foster care cases in each state that would be subject to the requirement in the Adoption and Safe Families Act of 1997 to file a petition to terminate parental rights were based on the number of cases in our samples in which a child had been in foster care for at least 17 months as of September 15, 1997. We used 17 months, rather than 15 months as specified in the law, because the clock for determining whether a case is subject to the termination of parental rights requirement begins running on the date the child was adjudicated abused or neglected or 60 days after the date the child was actually removed from the parents’ custody, whichever came first. Since we did not know the adjudication date of the cases in our surveys, we used 17 months as a conservative estimate of the time the case would be subject to the requirement. Most of the conclusions we drew from this survey were based on a comparison within each state of survey responses for cases in kinship care and cases in other foster care settings. In each state, we placed each case in one of these two groups, depending on the caseworker’s response to a question about the type of foster care setting in that case. We placed cases in the kinship care category only when the caseworkers responded that the foster children were in settings that “your state classifies as kinship or relative care.” We placed all other cases in the “other foster care setting” category. About half the cases fell into the kinship care group in each state. The “other foster care setting” category contained cases in settings such as substitute care, specialized care, institutional care, group homes, and traditional foster family homes. The results of these analyses are contained in appendix V. We examined the relationship between type of setting and other variables in the questionnaire by generating crosstabular tables and statistically testing to determine whether any differences between two variables in a table were significant at the .05 level. We calculated most of the percentage estimates we reported in the body of this report and in appendix V using as the base the number of cases for which there was a response to a variable other than “don’t know.” For analyses that involved a child’s date of entry into foster care, we used the date that was recorded in the state’s administrative data file. Thus, our calculation of the average length of time our cross-section of foster children in each state spent in foster care up until September 15, 1997, was based on administrative rather than survey data. In addition to using crosstabulations to identify the relationship, if any, between two variables, we performed multivariate analyses. These analyses tested for associations, at the .05 significance level, between foster care setting—that is, kinship care versus other foster care setting—and permanency goal, as well as the time children spent in foster care, while taking into account other variables—namely, a foster child’s age at entry into foster care, gender, and race and the parents’ history of drug or alcohol abuse—that might also influence the permanency goal or time in the system. For our multivariate analyses of the relationship between foster care setting and permanency goal, we constructed a permanency goal variable by ranking long-term foster care, guardianship, and adoption according to the extent to which each goal allowed children and their families to be independent of the foster care system. Long-term foster care was considered least independent and assigned a value of “0,” guardianship more independent and assigned a value of “1,” and adoption most independent and assigned a value of “2.” We used linear regression—specifically the ordinary least squares method—to examine the relationship between foster care setting and permanency goal in foster care cases in each state, while taking into account the influence other variables may have had on a permanency goal. We found that there was no significant relationship between a child’s race or gender and his or her permanency goal in either state. Therefore, we excluded race and gender from the additional multivariate analyses we conducted. A regression analysis for cases in California indicated that foster care setting and a child’s age at entry into foster care were both related to permanency goal. Specifically, children in kinship care in California were more likely to have long-term foster care as the goal, and children in other settings were more likely to have guardianship or adoption as the goal. Our analyses also indicated that children who entered foster care in California at an early age were more likely than those who entered at a later age to have guardianship or adoption as the goal. A regression analysis for cases in Illinois indicated that foster care setting, child’s age at entry into foster care, and having a parent with a history of drug or alcohol abuse were all related to permanency goal. Specifically, in Illinois, children in kinship care and children who had entered foster care at an early age were more likely to have guardianship or adoption as the goal than children in other foster care settings. We also found that children who had a parent with a history of drug or alcohol abuse were more likely to have the goal of guardianship or adoption than children who had parents with no history of drug or alcohol abuse. See table I.4 for a summary of the results of our regression analyses related to permanency goals. Variation explained (r contributed) Total variation explained (r) We also performed a regression analysis to determine the relationship, if any, between foster care setting and time in foster care, taking into account the influence of permanency goal, a child’s age at entry into foster care, race, gender, and parents’ history of drug or alcohol abuse. We found that there was no significant relationship between a child’s race, gender, or having a parent with a history of drug or alcohol abuse and time in foster care in either state. Therefore, we excluded these variables from the additional multivariate analyses we conducted regarding time in foster care. Our regression analysis for cases in California indicated that there was no relationship between foster care setting and time in foster care. The goal of adoption and a child’s age at entry into foster care, however, were both related to time in the system. Specifically, adoption as the goal explained more than 12 percent of the variation in the length of time children spent in foster care. Children with adoption as the goal spent 47 fewer months, on average, in foster care than children with some other goal. A child’s age at entry explained almost 6 percent of the variation in the length of time spent in foster care. For each additional year of age, children spent an average of 2.4 fewer months in foster care. Among foster care cases in Illinois, we found that both foster care setting and the goal of adoption were related to the length of time children spent in foster care. Specifically, kinship care and adoption explained 3 percent and 1.4 percent of the variation in the amount of time children spent in foster care, respectively. Children in kinship care spent about 9 fewer months in foster care, on average, than children in other foster care settings. Similarly, children with the goal of adoption spent about 10 fewer months in the system, on average, than children with some other goal. See table I.5 for a summary of the results of our regression analyses related to the length of time in foster care. Total variation explained (r) Because the estimates we reported from our survey were based on samples of foster care cases, a margin of error or imprecision surrounds them. This imprecision is usually expressed as a sampling error at a given confidence level. We calculated sampling errors for estimates based on our survey at the 95-percent confidence level. The sampling errors for percentage estimates we cited in this report varied but did not exceed plus or minus 15 percentage points. This means that if we drew 100 independent samples from each of our populations—samples with the same specifications as those we used in this study—in 95 of these samples the actual value in the population would fall within no more than plus or minus 15 percentage points of our estimate. The sampling error for our estimates of the average number of visits by caseworkers in each state never exceeded plus or minus 1.3 visits. Sampling errors for our estimates of the average length of time foster children in each state spent in the system did not exceed plus or minus 8.7 months. Sampling errors for our estimates of the number of foster care children in each state who spent 17 months or more in the system did not exceed plus or minus 2,650 children. Finally, in appendix V, the sampling error for estimates in each state of the (1) average number of a foster child’s siblings never exceeded plus or minus 0.5 siblings, (2) average age at which a child entered foster care never exceeded plus or minus 0.84 years, and (3) average age of children in foster care never exceeded plus or minus 0.92 years. Because of the relatively small number of responses in some of the tables in appendix V, and the resulting imprecision of any population estimates that would be based on those responses, tables in appendix V with fewer than 41 cases present only the number of sample cases for which each response was given. We made no population estimates concerning those responses. This appendix contains studies we identified that compare kinship care and other foster care. A brief description of study design and methodology follows each item. Appendix I describes how we identified research in this area and our criteria for including a study in this bibliography. Appendix III contains the results of analyses from the studies listed here. Benedict, Mary I., and R.B. White. “Factors Associated with Foster Care Length of Stay.” Child Welfare, Vol. 70, No. 1 (1991), pp. 45-58. This article contains the results of a longitudinal study of children in three urban and suburban jurisdictions in Maryland who entered foster care for the first time between January 1, 1980, and December 31, 1983. Data were obtained from the case records of a random sample of 689 of these children and covered a period that began the month a child entered foster care and ended in June 1986. A number of factors, such as the parents’ ability to care for and raise children and foster care placement with relatives, were examined to identify any relationship between them and the amount of time children spent in foster care. Berrick, J.D., R.P. Barth, and B. Needell. “A Comparison of Kinship Foster Homes and Foster Family Homes: Implications for Kinship Foster Care as Family Preservation.” Children and Youth Services Review, Vol. 16, Nos. 1-2 (1994), pp. 33-63. The researchers described the characteristics of a two-stage, random sample of the 88,000 children in foster care in California between January 1988 and the date when the article was written in 1991. A screening questionnaire was mailed to the foster parents of each of the 4,234 children in the initial sample. This sample was split evenly between traditional and relative foster care placements. For the screening questionnaire, foster parents responded in 1,178 (28 percent) of the cases sampled. In 600 of these cases (246 relative foster care placements and 354 traditional foster care placements), the foster parents completed a second questionnaire by either telephone or mail. If they cared for more than one foster child, they were asked to answer the questions for one child older than 2 who had resided in their home for at least 6 months. They provided information about the child’s physical and mental health, the types of services the child received, and their own perceptions of the child welfare agency and caseworkers. Although the gender, age, and ethnicity of children in the ultimate sample were similar to those of children in the total population, the researchers acknowledged that there was no way to determine the representativeness of the sample of providers. Berrick, J.D., and others. Assessment, Support, and Training for Kinship Care and Foster Care: An Empirically-Based Curriculum. Berkeley, Calif.: University of California at Berkeley, Child Welfare Research Center, 1998. A chapter in this curriculum reported the results of a study in which a sample of 161 kin and 96 nonkin caregivers living in the San Francisco Bay Area were interviewed in their homes. The study compared the two groups of caregivers on demographics, the quality of the relationship between caregiver and child, home safety, neighborhood safety, and other factors related to the quality of care the children received. Courtney, M.E. “Factors Associated with the Reunification of Foster Children with Their Families.” Social Service Review, March 1994, pp. 81-108. This study examined the relationship between factors such as a child’s age, type of foster care placement (kinship or nonkinship), reason for removal, and the probability that the child would return to his or her parents. The results were based on statewide administrative data on a random sample of 8,748 of the approximately 88,000 children who entered the foster care system in California for the first time between January 1988 and May 1991. The author cited as study limitations the short time period covered by the data, the limited amount of data recorded for each case, and the quality of items recorded in the database. Gebel, Timothy J. “Kinship Care and Non-Relative Family Foster Care: A Comparison of Caregiver Attributes and Attitudes.” Child Welfare, Vol. 75, No. 1 (1996), pp. 5-18. This study compared the demographics, attitudes, and perceptions of relative and nonrelative foster parents in one urban county in a southeastern state in 1993. The results were based on responses to a questionnaire mailed to the foster parents in random samples of 140 of the 450 relative foster care cases and 140 of the approximately 300 nonrelative foster care cases in that county at that time. Foster parents were asked about their attitudes toward the use of corporal punishment and their perceptions regarding children in their care, the behavior of these children, and the support they received from child welfare agencies. Foster parents in 111 of the traditional placements and 82 of the placements with relatives responded to the survey. Iglehart, Alfreda P. “Kinship Foster Care: Placement Service and Outcome Issues.” Children and Youth Services Review, Vol. 16, Nos. 1-2 (1994), pp. 107-22. This article described the results of a study that compared selected characteristics of adolescents in kinship care to those of adolescents not in kinship foster care. Between February and July 1988, caseworkers in Los Angeles County extracted this information from the case files of all 1,642 children aged 16 or older who were in foster care during that period. Data for about 990 adolescents—352 in kinship care and 638 in traditional foster care—were analyzed for this study. Among the characteristics compared were gender, race and ethnicity, reason for removal, total number of placements, length of time in current placement, and degree of agency case monitoring. Le Prohn, Nicole S. “Relative Foster Parents: Role Perceptions, Motivation and Agency Satisfaction.” Ph.D. dissertation, University of Washington, Seattle, Washington, 1993. This researcher examined the relationship between relative and nonrelative placement with respect to what foster parents believed their role to be, what motivated them to become foster parents, and how satisfied they were with the foster care agency. Associations between foster placement type and the children’s behavior and amount of contact with their parents were also examined. The foster families selected for the study were families in the Casey Family Program, a long-term foster care program with offices in 13 states for children who are unable to be reunited with their birth parents and are unlikely to be adopted. Results were based on a random sample of about 175 nonrelative foster homes selected from all nonrelative foster homes in the Casey program in 1992. That group was compared with the entire population of about 130 relative foster homes in the Casey program during 1992. Data were collected from foster parents using a mail questionnaire and a telephone interview. Eighty-two relative foster homes and 98 nonrelative homes were included in the analysis. Le Prohn, Nicole S., and Peter J. Pecora. Research Report Series: The Casey Foster Parent Study Research Summary. Seattle, Wash.: Casey Family Program, 1994. Same description as for Le Prohn dissertation above. Magruder, Joseph. “Characteristics of Relative and Non-Relative Adoptions by California Public Adoption Agencies.” Children and Youth Services Review, Vol. 16, Nos. 1-2 (1994), pp. 123-31. The author compared adoptions in California by relatives and nonrelatives with respect to children’s gender, ethnicity, and time in placement before adoption and the characteristics of the adoptive parents and their households. Study results were based on the 3,214 public adoptions that took place during that state’s fiscal year 1992, for which data were available. Needell, B. “Placement Stability and Permanence for Children Entering Foster Care as Infants.” Ph.D. dissertation, University of California at Berkeley, Berkeley, California, 1996. A number of samples were drawn for this study from a longitudinal database containing all cases in the California Foster Care Information System from 1988 through 1994. The primary sample consisted of all 43,066 children in California who entered foster care before their first birthday and between 1988 and 1994. Analysis examined the types of placement, length of stay, reasons for infants’ reentry into foster care after reunification, and factors that may have led to an infant’s adoption or reunification. Needell B., and others. Performance Indicators for Child Welfare Services in California: 1994. Berkeley, Calif.: University of California at Berkeley, School of Social Welfare, Child Welfare Research Center, 1995. The results of this study were based on a longitudinal database of 233,000 cases in the California Foster Care Information System. These children were in foster care during 1988 or had entered care before the beginning of 1995. The percentage of children in different types of placements who exited the system by reunification, adoption, guardianship, and emancipation was reported, as well as the median length of the children’s first stay in foster care by foster care placement type. The authors also examined the effect of ethnicity, age at time of entry, and reasons for removal from the home on the relationships between placement type and foster care outcome and between placement type and length of stay. Needell B., and others. Performance Indicators for Child Welfare Services in California: 1996. Berkeley, Calif.: University of California at Berkeley, School of Social Welfare, Child Welfare Research Center, 1997. In this study, the longitudinal database used in the 1995 Needell and others study cited above was expanded to 300,000 children who were in foster care during 1988 or had entered care before 1997. The analyses were similar to those in the 1995 study. Poindexter, Garthia M. “Services Utilization by Foster Parents and Relatives.” Master of Social Work thesis, California State University, Long Beach, California, 1996. The author reported on the use of social services by relative and nonrelative foster parents in Los Angeles County based on 40 foster care cases selected at random from the population of children who entered foster care in that county during 1994. Of the 40 cases, 22 were relative foster care placements and 18 were nonrelative foster care placements. Scannapieco, Maria, Rebecca L. Hegar, and Catherine McAlpine. “Kinship Care and Foster Care: A Comparison of Characteristics and Outcomes.” Families in Societies, Vol. 78, No. 5 (1997), pp. 480-88. From case file information for a cross-section of children in foster care in Baltimore County on March 23, 1993, the researchers attempted to determine whether there were differences between kinship and other foster care placements in terms of permanency planning goals. Of the 106 children sampled, 47 were in kinship care and 59 were in other types of placements. Testa, Mark F. Home of Relative (HMR) Program in Illinois Interim Report. Chicago, Ill.: University of Chicago, School of Social Service Administration, 1993. The author used a database that included information about all children in foster care in Illinois between fiscal years 1965 and 1992 to establish trends in kinship care placements in Illinois and to describe various characteristics of foster children and their foster care outcomes. Testa, Mark F. “Kinship Care in Illinois.” In J.D. Berrick, R.P. Barth, and N. Gilbert (eds.), Child Welfare Research Review, Vol. 2. New York: Columbia University Press, 1997. Pp. 101-29. Focusing on reunification and discharge rates among children in foster care in Illinois between fiscal years 1976 and 1992, the researcher examined the effect of selected factors such as age, race, and type of foster care placement on the likelihood of reunification or discharge. Testa, Mark F. “Professional Foster Care: A Future Worth Pursuing?” Child Welfare: Special Edition on Family Foster Care in the 21st Century. Forthcoming. This study examined the relationship between children’s placement type and whether or not they (1) remained close to their community of origin, (2) were placed with other siblings in the same household, and (3) achieved permanency or stayed in the same foster care setting. The researcher used administrative data from Cook County, Illinois, for three different foster care recruitment programs and two random samples, one of 995 kinship care and one of 852 traditional foster care placements. The samples included only placements between December 1, 1994, and September 30, 1996. Administrative data through September 30, 1997, were used to determine whether or not the children stayed in one foster care setting or left the foster care system. Thornton, Jesse L. “Permanency Planning for Children in Kinship Foster Homes.” Child Welfare, Vol. 70, No. 5 (1991), pp. 593-601. Three surveys were conducted in this study. Semi-structured interviews were administered to a random sample of 20 kinship caregivers in New York City to determine their attitudes toward adoption. Eighty-six foster care caseworkers in New York City completed questionnaires that asked for their perceptions about kinship caregivers’ willingness to adopt. Finally, to compare permanency goals for children in kinship care to those for children in traditional care, the records from 95 active kinship foster care cases in April 1985 were examined along with statistics from an administrative database. U.S. General Accounting Office. Foster Care: Children’s Experiences Linked to Various Factors; Better Data Needed, GAO/HRD-91-64. Washington, D.C.: Sept. 11, 1991. Data on children who entered or left foster care in 1986 in Georgia, Illinois, New York, Oregon, South Carolina, and Texas and Los Angeles County and New York City were analyzed for the relationship of age, ethnicity, gender, location, reason for entry, and foster care placement type to length of stay. For Georgia, Oregon, South Carolina, and Texas, computerized data files of the case records for all children entering or leaving foster care during 1986 were used. For New York, Illinois, Los Angeles County, and New York City, random samples of children who had been discharged from foster care during 1986 were used; the New York and Illinois samples each contained 1,488 children, the sample for Los Angeles County contained 209 children, and the sample for New York City contained 130 children. U.S. General Accounting Office. Foster Care: Health Needs of Many Young Children Are Unknown and Unmet, GAO/HEHS-95-114. Washington, D.C.: May 26, 1995. A random sample of 137 case records of foster children who had been in either kinship or traditional care exclusively was selected from the case records of all foster children younger than 3 years old in Los Angeles County and New York City during 1991 to examine the relationship between placement type and the receipt of health services by foster children in this age group. U.S. General Accounting Office. Foster Care: Services to Prevent Out-of-Home Placements Are Limited by Funding Barriers, GAO/HRD-93-76. Washington, D.C.: June 29, 1993. In this study of the statutory and fiscal barriers the states faced in delivering child welfare services, the researchers used caseload data for the last day of either calendar or fiscal year 1992 in California, Michigan, and New York to describe trends in foster care and child welfare services. Wulczyn, F.H., and R.M. George. “Foster Care in New York and Illinois: The Challenge of Rapid Change.” Social Service Review, June 1992, pp. 278-94. Aggregated administrative data on all children in New York’s child welfare system and similar data from Illinois were used to compare child welfare trends in these two states from 1983 through 1989. Shifts in total caseload size, average age of children entering foster care, and the number of relative foster care placements were examined. The researchers also determined the proportion of children admitted to foster care during 1988 in each state who were (1) discharged within 12 months, (2) discharged between 12 and 24 months, and (3) still in the system after 24 months. They compared the proportions in kinship care placements with those in nonkinship care placements. This appendix contains the results of analyses from the studies we identified that compared kinship care and other foster care. These results are presented in tables organized by research question. Sources are noted after each table. In some instances, the results in the tables were based on data from entire populations of foster children. When they were based on data from samples of foster children, if the researcher reported that a difference between kinship and other foster care was statistically significant, the significance level is noted in parentheses in the table. Appendix II contains a description of the design and methodology of the studies in this appendix. Table III.1: Did the Foster Child Remain in the Same Community or Neighborhood He or She Lived in Before Entering Foster Care? Of nonemergency first placements in Chicago, percentage located in the same community or neighborhood in which the parents or guardians residedPercentage of cases in which the interviewer thought the foster caregiver’s neighborhood was dangerous(.001) Average number of times foster child visited parents in the past yearMother (.001) Percentage of children who had contact with their mothers (.01) or fathersDid not see parents in past 12 months Saw parents at least once in the past 12 months Parents’ whereabouts were unknown Percentage of foster children who saw their parentsAt least once a month More than four times a month (.01) Percentage of foster children placed with siblings also in foster care (.01) Of the foster families with more than one foster child, percentage in which siblings were placed togetherFour or more siblings (.05) At least two siblings (.001) Percentage of children placed with siblingsAverage number of times foster children visited their siblings in the past year (.001) Table III.6: How Many Placements in Foster Care Did the Foster Child Have? In care less than 30 days In care 30 days or more (.001) Total placements (.01) Percentage of foster children with (.01) Percentage of foster children who entered care between 1988 and 1990 in California and had placements within 4 years after entry(continued) Percentage of foster children who had at least one placement before current placement (.001) Percentage of foster children with different degrees of integration according to foster parents (.001) and social workers (.001) Children who felt that they were very much part of the foster family Children who felt somewhat like a foster child Children who felt very much like a foster child Average age of foster caregivers in years Foster mothers (.01) Male foster caregivers (.05) Female foster caregivers (.05) Percentage of female foster caregivers 55 years of age or older (.01) Percentage of primary female foster caregivers by age (.005) Percentage of married foster caregivers (.05) Percentage of single foster caregivers (.001) Percentage of married foster caregivers by genderFoster mothers (.01) Percentage of foster caregivers who had completed high schoolMean number of years of school completedFoster fathers (.05) Foster mothers (.001) Percentage of foster caregivers who did not have a high school diplomaFemale (.001) Male (.01) Percentage of primary female foster caregivers with education by category (.00001) Percentage of foster caregivers in fair or poor healthMale (.001) Female (.001) Percentage of foster caregivers whose income was less than $15,000 a yearPercentage of foster families with income by category (.01) Average annual gross income, including foster care payments (.001) Average annual income, disregarding money received from either Aid to Families with Dependent Children (AFDC)-Family Grant or AFDC–Foster Care Percentage of primary female caregivers with household income by category (.000005) Percentage of foster caregivers whoHad a fire extinguisher (.001) Had a complete first aid kit (.001) Knew cardiopulmonary resuscitation (.001) Percentage who felt that training adequately prepared them to be a foster parent (.01) Percentage who received training (.001) Percentage of foster caregivers who received servicesSpecialized training (.001) Support group (.001) Respite care (.001) Mean number of services foster caregivers received (.001) Percentage of foster children who were not well known to the caseworker (.0001) Mean number of caseworkers’ visits with foster children during a 6-month period (.05) Mean number of caseworkers’ visits with foster children in past 12 monthsAverage number of hours per month foster children spent with a caseworker (.01) Table III.17: What Required Health Services Did the Foster Child Receive? Percentage of foster children up to 3 years old who received health-related servicesNo services (.10) Mean number of days (.05) 1994 study (.001) Percentage of first admissions in 1988 by length of stayStill in care as of June 1990 Still in care as of June 1990 Percentage of foster children entering care in 1986 in foster care for 1 year or longerPercentage of foster children who were in care as of June 30, 1992, by 2-year fiscal period in which they enteredLikelihood of being in care for 1 year or longer (explained in footnote g) Kinship care associated with longer length of stay when controlling for other factors (.007) Percentage difference between the likelihood that foster children who entered in a 2-year fiscal period would be discharged and the likelihood that children in other foster care settings who entered the system before 1977 would be discharged (explained in footnote i) (continued) For example, in Georgia a child in kinship care is almost three times as likely as a child in other foster care settings to remain in care for 1 year or longer. U.S. General Accounting Office, Foster Care: Children’s Experiences Linked to Various Factors; Better Data Needed, GAO/HRD-91-64 (Washington, D.C.: Sept. 11, 1991). For example, children who entered kinship care in fiscal years 1979 to 1980 were 25-percent less likely to be discharged than children who entered other foster care settings before fiscal year 1977, and children who entered other foster care settings in fiscal years 1979 to 1980 were 14-percent more likely to be discharged than children who entered other foster care settings before fiscal year 1977. Discharge includes return to parental custody, placement in private guardianship, adoption, or staying in the child welfare system until age 18. Mark F. Testa, “Kinship Care in Illinois,” in J.D. Berrick, R.P. Barth, and N. Gilbert (eds.), Child Welfare Research Review, Vol. 2 (New York: Columbia University Press, 1997), pp. 101-29. Percentage who were reunified with their parents within 4 years by year enteredPercentage who were adopted within 4 years by year enteredPercentage who exited within 4 years by year enteredPercentage who were emancipated within 4 years by year enteredCumulative percentage who entered care between January and July 1988 who were reunified with their parents afterPercentage who entered care in a 2-year period who were reunified with their parents withinPercentage attaining a permanency outcome by the end of the study period(continued) Entered subsidized guardianship (.0001) This appendix displays the frequency distributions of responses to questions in our survey of foster care cases in California and Illinois. Means and medians are provided for some items. In addition, selected information from the states’ administrative records is provided about these cases. Appendix I includes a detailed description of our survey methodology, and the questionnaire for this survey is in appendix IV. The percentage given for each response category constitutes our estimate of the proportion of all foster care cases in each state’s system as of September 15, 1997, that had been in the system since at least March 1, 1997. Because of the relatively small number of responses in some of the tables in this appendix and the resulting imprecision of any population estimates that might be based on those responses, tables with fewer than 41 cases present only the number of sample cases for which each response was given. No population estimates are given for those responses. The sampling errors for the percentage estimates vary. No sampling error for any of the percentage estimates exceeds plus or minus 15 percentage points. Table V.1 provides a more specific breakdown of sampling errors for the percentage estimates by number of cases for which there was a response. The sampling error for our estimates of the average number of caseworker visits in each state never exceeds plus or minus 1.3 visits. The sampling error for estimates in each state of the average number of a foster child’s siblings never exceeds plus or minus 0.5 siblings. The sampling error for estimates of the (1) average length of time all foster children in each state had spent in the system up until September 15, 1997, never exceeds plus or minus 8.7 months, (2) average age at which children entered foster care never exceeds plus or minus 0.84 years, and (3) average age of children in foster care never exceeds plus or minus 0.92 years. In tables V.9 through V.12, we provide the results of these three calculations for subpopulations of all foster children. Because some of these calculations are based on a relatively small sample of cases in each subpopulation, they do not constitute very precise estimates of the actual averages in the entire subpopulation in each state. These calculations refer to only the cases in our sample. Each category versus the rest combined (continued) Each category versus the rest combined n=88 No, first 3 n=115 No, first 3 categories combined versus the rest combined categories combined versus the rest combined (continued) While the question allowed answers about each of a pair of caregivers, the table shows the answers for only the younger one. While the question allowed answers about each of a pair of caregivers, the table shows the answers for the one in better health. (continued) Table V.5: Caregiver’s Performance of Parenting Tasks n=88 No, first 2 n=114 No, first 2 categories combined versus the rest combined categories combined versus the rest combined (continued) Yes, first 2 categories combined versus the rest combined n=114 No, first 2 categories combined versus the rest combined n=88 No, first 2 n=115 No, first 2 categories combined versus the rest combined categories combined versus the rest combined (continued) n=88 No, first 2 n=115 No, first 2 categories combined versus the rest combined categories combined versus the rest combined n=88 No, first 2 n=114 No, first 2 categories combined versus the rest combined categories combined versus the rest combined n=87 No, first 2 n=115 No, first 2 categories combined versus the rest combined categories combined versus the rest combined n=82 No, first 2 n=98 No, first 2 categories combined versus the rest combined categories combined versus the rest combined (continued) n=83 No, first 2 n=112 No, first 2 categories combined versus the rest combined categories combined versus the rest combined n=86 No, first 2 n=113 No, first 2 categories combined versus the rest combined categories combined versus the rest combined (continued) Yes, first 2 categories combined versus the rest combined n=87 No, first 2 n=114 No, first 2 categories combined versus the rest combined categories combined versus the rest combined n=87 No, first 2 n=111 No, first 2 categories combined versus the rest combined categories combined versus the rest combined (continued) Yes, first 2 categories combined versus the rest combined (continued) Yes, first category versus the rest combined category versus the rest combined n=50 No, first 3 n=82 No, first 3 categories versus the rest combined categories versus the rest combined n=50 No, first 3 n=82 No, first 3 categories versus the rest combined categories versus the rest combined (continued) Yes, first 3 categories versus the rest combined n=131 No, first 3 categories versus the rest combined category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test (continued) Yes, first 2 categories combined versus rest combined n=99 No, first 2 category is too small to perform the test categories combined versus rest combined n=98 No, first 3 category is too small to perform the test categories combined versus rest combined (continued) category is too small to perform the test category is too small to perform the test (continued) While the question allowed answers about each of a pair of caregivers, the table shows the answers for only the one whom the child knew best. While the questions allow answers about each parent, the table shows answers for the parent whose visitation restrictions are least likely to be enforced. Table V.9: Cases With the Goal of Reunification category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test (continued) Table V.10: Cases With the Goal of Adoption category is too small to perform the test category is too small to perform the test category is too small to perform the test (continued) category is too small to perform the test category versus the rest combined n=50 No, first 2 category is too small to perform the test categories combined versus the rest combined category is too small to perform the test category is too small to perform the test category is too small to perform the test (continued) Table V.11: Cases With the Goal of Guardianship category is too small to perform the test category is too small to perform the test (continued) category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test category is too small to perform the test (continued) Table V.12: Cases With the Goal of Long-Term Foster Care (continued) Juvenile Courts: Reforms Aimed to Better Serve Maltreated Children (GAO/HEHS-99-13, Jan. 11, 1999). Foster Care: Agencies Face Challenges Securing Stable Homes for Children of Substance Abusers (GAO/HEHS-98-182, Sept. 30, 1998). Child Protective Services: Complex Challenges Require New Strategies (GAO/HEHS-97-115, July 21, 1997). Foster Care: State Efforts to Improve the Permanency Planning Process Show Some Promise (GAO/HEHS-97-73, May 7, 1997). Child Welfare: Complex Needs Strain Capacity to Provide Services (GAO/HEHS-95-208, Sept. 26, 1995). Foster Care: Health Needs of Many Young Children Are Unknown and Unmet (GAO/HEHS-95-114, May 26, 1995). Foster Care: Parental Drug Abuse Has Alarming Impact on Young Children (GAO/HEHS-94-89, Apr. 4, 1994). The first copy of each GAO report and testimony is free. Additional copies are $2 each. Orders should be sent to the following address, accompanied by a check or money order made out to the Superintendent of Documents, when necessary. VISA and MasterCard credit cards are accepted, also. 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Summary: Pursuant to a congressional request, GAO reviewed how well kinship care is serving foster children, focusing on the: (1) quality of care that children in kinship care receive compared with that received by other foster children, as measured by a caseworker's assessment of a caregiver's parenting skills, the extent to which a foster child is able to maintain contact with familiar people and surroundings, and a caregiver's willingness to enforce court-ordered restrictions on parental visits; (2) frequency with which state child welfare agencies pursue various permanent living arrangements and the time children in kinship care have spent in the system compared with other foster children; and (3) recent state initiatives intended to help ensure that children in kinship care receive good quality foster care and are placed in permanent homes in a timely manner. GAO noted that: (1) GAO's survey of open foster care cases in California and Illinois showed that in most respects the quality of both kinship and other foster care was good and that the experiences of children in kinship care and children in other foster care settings were comparable; (2) GAO found that caregivers both in kinship care and in other foster care settings demonstrated good parenting skills overall; (3) GAO also confirmed the belief that there is more continuity in the lives of children in kinship care before and after they enter foster care than there is in other foster children's lives; (4) in cases in which the courts have restricted parental visits with foster children to ensure the children's safety, the proportion of cases in which the caseworker believed that the caregiver was likely to enforce the restrictions was somewhat smaller among kinship care cases than among other foster care cases; (5) some of the standards that California and Illinois use to ensure good quality foster care and the level of support each state provides to foster caregivers are lower for kinship care than other types of foster care; (6) previous research on children who have left foster care has shown that children who had been in kinship care were less likely to be adopted and stayed longer in foster care than other foster children; (7) between California and Illinois, GAO's survey showed no consistent findings regarding the relationship between kinship care and permanency goals or the time foster children had spent in the system; (8) in Illinois, kinship care cases were more likely to have a permanency goal of adoption or guardianship than other foster care cases; (9) Illinois has found that kinship caregivers are willing to adopt, and Illinois is actively pursuing adoption in kinship care cases; (10) in California, kinship care cases were less likely than other foster care cases to have adoption or guardianship as a goal; (11) according to California officials, this may be because, at the time of GAO's survey, the state had only recently begun to offer adoption and guardianship options specifically designed for a foster child's relatives; (12) in California, there was no significant difference between the average length of time that children in kinship care and children in other settings had spent in the system; (13) in Illinois, children in kinship care had spent significantly less time in the system than other foster children; and (14) both California and Illinois are now taking steps to better ensure the good quality of kinship care and to encourage kinship caregivers to provide permanent homes for foster children who cannot return to their parents.