Foster Care:

HHS Needs to Improve Oversight of Fostering Connections Act Implementation

GAO-14-347: Published: May 29, 2014. Publicly Released: May 29, 2014.

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What GAO Found

To implement the Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections Act), many states GAO surveyed (which included the District of Columbia and Puerto Rico) reported requiring caseworkers to employ multiple practices to improve outcomes for children in foster care; however, states continue to face challenges that can undermine progress. Among the practices that the Department of Health and Human Services (HHS) and others suggested states use, survey respondents reported requiring caseworkers to use group decision-making to maintain family connections, consult with schools, and facilitate adult connections for older youth. At the same time, a majority of surveyed states reported facing challenges, especially related to foster placements (see fig. below).

Major Challenges Reported by States in GAO Survey Regarding Foster Placements

Major Challenges Reported by States in GAO Survey Regarding Foster Placements

Note: Responses do not sum to 52 if states selected “do not know/not applicable” or did not respond.

Further, the Fostering Connections Act made additional children eligible for federal adoption assistance payments thereby potentially freeing up state funds previously used for this purpose. Although states are required to spend any resulting savings on child welfare services, only 21 states reported calculating these savings for fiscal year 2012, and 20 states reported difficulties performing the calculations. HHS has not provided states guidance in this area, and without it states may continue to struggle with the calculations, leading to potential lost program funding.

HHS approved states' plans to implement the Fostering Connections Act; however, the agency has not yet monitored states' actions. HHS regulations specify that states must undergo a complete review of child welfare programs every 5 years, yet HHS's last review cycle began in 2007—using a tool developed before the act was passed. Internal control standards emphasize using timely data for effective monitoring, but data collected by HHS do not reflect the act's provisions. In March 2014, HHS announced plans to begin a review cycle in fiscal year 2015, but details about how it would address changes from the act were unavailable. Without adequate monitoring or updated data, HHS lacks information about the implementation of the act and the effectiveness of states' actions.

Why GAO Did This Study

Approximately 400,000 children were living in foster care in fiscal year 2012, according to the most recent data available. HHS oversees states' implementation of federal child welfare requirements under title IV-E of the Social Security Act. In 2008, the Fostering Connections Act amended title IV-E to improve the outcomes for children in foster care, such as maintaining family and school connections. GAO was asked to review implementation of the act.

GAO examined (1) steps states have taken to implement selected provisions of the act and challenges they have faced, and (2) the extent to which HHS has monitored states' efforts. GAO reviewed relevant federal laws, regulations, and guidance and surveyed 52 state child welfare agencies, achieving a 100 percent response rate. GAO also interviewed HHS officials and state and local child welfare and educational agency officials; caseworkers; court officials, and foster youth and parents in four states, selected to ensure variety of program characteristics and geographic dispersion.

What GAO Recommends

GAO recommends that HHS (1) provide guidance on how states could calculate savings resulting from changes to federal adoption assistance eligibility criteria, (2) systematically monitor states' implementation of the act, and (3) update data reporting requirements related to the act. HHS concurred with our recommendations. HHS also provided technical comments that were incorporated, as appropriate. The Department of Education had no comments.

For more information, contact Kay Brown at (202) 512-7215 or brownke@gao.gov.

Recommendations for Executive Action

  1. Status: Open

    Comments: HHS concurred with this recommendation and said it will gather examples of how savings are being calculated and documented by some states and develop a document to provide as technical assistance to other states. HHS noted that its implementation of this provision has been driven by a desire to avoid imposing an undue administrative burden on states and the challenge of specifying a methodology for calculating savings that would work in all state settings. State officials have signed assurances as part of their title IV-E plan submissions to calculate and reinvest these savings. In addition, the agency noted that independent auditors are responsible for identifying an appropriate finding in single audit reports for any states that have not taken steps to calculate and account for these savings. HHS said it will work to assure that all needed corrective actions are taken to resolve any such finding in a state's single audit. GAO will monitor these efforts to see if they are fully implemented.

    Recommendation: To ensure implementation of the Fostering Connections Act, improve outcomes for children in foster care, and to maximize the amount of funds states are reinvesting into child welfare services, the Secretary of Health and Human Services should provide guidance on how states could calculate savings from the changes to the federal adoption assistance income eligibility criteria.

    Agency Affected: Department of Health and Human Services

  2. Status: Open

    Comments: HHS agreed with this recommendation and announced its intent to begin the regulatory process to make changes to the Adoption and Foster Care Analysis and Reporting System (AFCARS) by issuing a Notice of Proposed Rulemaking, projected to be published in Spring 2014. HHS did not discuss how these changes would incorporate the provisions in the Fostering Connections Act nor provide an estimate as to when these changes will be completed. We encourage HHS to expedite these changes within the rulemaking process. As it is, the next round of CFSRs will proceed without the benefit of updated data from AFCARS relevant to the amendments made by the Fostering Connections Act. Without these data, it will be difficult for HHS to have adequate information to assess states' progress in implementing the Fostering Connections Act.

    Recommendation: To ensure implementation of the Fostering Connections Act, improve outcomes for children in foster care, and to help identify areas where states may need additional support or guidance in their efforts to provide children in foster care with services and assistance under title IV-E, as amended by the Fostering Connections Act, the Secretary of Health and Human Services should proceed with and expeditiously finalize plans to update the Adoption and Foster Care Analysis and Reporting System to collect relevant data from states about provisions established by the Fostering Connections Act.

    Agency Affected: Department of Health and Human Services

  3. Status: Open

    Comments: HHS agreed with this recommendation. The agency stated that the Child and Family Services Reviews (CFSR) process is designed to provide federal oversight of states' compliance with provisions of titles IV-B and IV-E, and the amendments made by the Fostering Connections Act to titles IV-B and IV-E will be reflected in the revised CFSR protocol. HHS said it is in the process of finalizing the instruments and measures that will be used during the round of reviews expected to begin in fiscal year 2015 and they will be shared with the public when finalized. We will monitor these efforts to see whether the new provisions introduced by the Fostering Connections Act are incorporated into these instruments and measures and that the department moves quickly to complete the instruments and begin the third round of CFSR reviews.

    Recommendation: To ensure implementation of the Fostering Connections Act, improve outcomes for children in foster care, and to help identify areas where states may need additional support or guidance in their efforts to provide children in foster care with services and assistance under part E of title IV (title IV-E), as amended by the Fostering Connections Act, the Secretary of Health and Human Services should proceed with and expeditiously finalize plans to systematically monitor state practices for compliance with policies outlined in their title IV-E plans that cover the new provisions established by the Fostering Connections Act.

    Agency Affected: Department of Health and Human Services

 

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