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entitled 'African American Children in Foster care: Additional HHS 
Assistance Needed to Help States Reduce the Proportion in Care' which 
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Report to the Chairman, Committee on Ways and Means, House of 
Representatives: 

United States Government Accountability Office: 

GAO: 

July 2007: 

African American Children In Foster Care: 

Additional HHS Assistance Needed to Help States Reduce the Proportion 
in Care: 

GAO-07-816: 

GAO Highlights: 

Highlights of GAO-07-816, a report to the Chairman, Committee on Ways 
and Means, House of Representatives 

Why GAO Did This Study: 

A significantly greater proportion of African American children are in 
foster care than children of other races and ethnicities, according to 
HHS and other research. Given this situation, GAO was asked to analyze 
the (1) major factors influencing the proportion of African American 
children in foster care, (2) extent that states and localities have 
implemented promising strategies, and (3) ways in which federal 
policies may have influenced African American representation in foster 
care. GAO’s methodologies included a nationwide survey; a review of 
research and federal policies; state site visits; analyses of child 
welfare data; and interviews with researchers, HHS officials, and other 
experts. 

What GAO Found: 

A higher rate of poverty is among several factors contributing to the 
higher proportion of African American children entering and remaining 
in foster care. Families living in poverty have greater difficulty 
accessing housing, mental health, and other services needed to keep 
families stable and children safely at home. Bias or cultural 
misunderstandings and distrust between child welfare decision makers 
and the families they serve are also viewed as contributing to 
children’s removal from their homes into foster care. African American 
children also stay in foster care longer because of difficulties in 
recruiting adoptive parents and a greater reliance on relatives to 
provide foster care who may be unwilling to terminate the parental 
rights of the child’s parent—as required in adoption—or who need the 
financial subsidy they receive while the child is in foster care. 

Most states we surveyed reported using strategies intended to address 
these issues, such as involving families in decisions, building 
community supports, and broadening the search for relatives to care for 
children. HHS provides information and technical assistance, but states 
reported that they had limited capacity to analyze data and formulate 
strategies, and states we visited told us they relied on assistance 
from universities or others. 

States reported that the ability to use federal funding for family 
support services was helpful in keeping African American children 
safely at home and that federal subsidies for adoptive parents helped 
move children out of foster care. However, they also expressed concerns 
about the inability to use federal child welfare funds to provide 
subsidies to legal guardians. As an alternative to adoption, subsidized 
guardianship is considered particularly promising for helping African 
American children exit from foster care. States were also concerned 
about the lack of flexibility to use federal foster care funds to 
provide services for families, although states can use other federal 
funds for this purpose if they consider it a priority. 

Figure: Proportion of Children in Foster Care Settings, End of Fiscal 
Year 2004: 

[See PDF for Image] 

Source: GAO analysis of AFCARS and Census data. 

[End of figure] 

What GAO Recommends: 

GAO suggests that Congress consider amending current law to allow 
subsidies for legal guardianships. HHS believes its proposal for 
restructuring child welfare funding would give states the option to do 
this, but the viability of this proposal is uncertain. GAO also 
recommends that HHS further assist states in addressing 
disproportionality. In its comments, HHS noted that GAO’s 
recommendation was consistent with its efforts to provide technical 
assistance to states, but did not address the specific actions GAO 
recommended. GAO continues to believe that further assistance is 
important for helping states address disproportionality. 

[Hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-07-816]. 

To view the full product, including the scope and methodology, click on 
the link above. For more information, contact Denise M. Fantone at 
(202) 512-7215 or fantoned@gao.gov. 

[End of section] 

Contents: 

Letter: 

Results in Brief: 

Background: 

States Report Poverty and Difficulty in Finding Permanent Homes Are 
among Major Factors Influencing African Americans' Entry and Length of 
Stay: 

States Implemented a Range of Strategies Considering Promising for 
Addressing Disproportionality, but Fewer States Specifically Focus 
Attention on Issue: 

States Reported That Some Current Federal Policies May Reduce the 
Disproportion of African American Children in Care, While Other 
Policies May Increase It: 

Conclusions: 

Matter for Congressional Consideration: 

Recommendation for Executive Action: 

Agency Comments and Our Response: 

Appendix I: Objectives, Scope, and Methodology: 

Appendix II: Disproportionality Indexes of Children in Foster Care by 
Race and State: 

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

Appendix IV: GAO Contact and Staff Acknowledgments: 

Tables: 

Table 1: Types of Temporary and Permanent Homes for Children in Child 
Welfare: 

Table 2: Key Federal Legislation Affecting Foster Care Programs: 

Table 3: Strategies Used by States That Address Factors Contributing to 
Disproportionality: 

Table 4: Disproportionality Index by State of Children Ages 17 Years of 
Age or Under in Foster Care as of Last Day of Fiscal Year 2004: 

Figures: 

Figure 1: Proportion of Children by Race in Foster Care Settings, End 
of Fiscal Year 2004: 

Figure 2: Federal Child Welfare Funding by Funding Source, FY 2004: 

Figure 3: State Views on Poverty-Related Factors Affecting Higher Entry 
of African American Children to Foster Care: 

Figure 4: State Views on Support and Preventive Services Affecting 
African American Children's Higher Entry into Foster Care: 

Figure 5: State Views on Issues of Distrust and Bias or Cultural 
Misunderstanding Affecting African American Children's Greater Entry to 
Foster Care: 

Figure 6: State Views on Factors Affecting Longer Time in Foster Care 
for African American Children --Difficulty in Finding Permanent Homes: 

Figure 7: State Views on Factors Affecting Greater Time in Foster Care 
for African American Children --Difficulties in Achieving 
Reunification: 

Figure 8: Strategies Intended to Improve Decisions by Reducing Bias: 

Figure 9: Strategies to Improve Access to Support Services: 

Figure 10: Strategies to Reduce Length of Stay in Foster Care: 

Figure 11: Children Entering Foster Care in California in 2005: 

Figure 12: Children in Foster Care in California in 2005: 

Figure 13: States' Views on Impact of Funding Policies on 
Disproportionality: 

Figure 14: States' Views on Impact of Adoption and Guardianship 
Policies on Disproportionality: 

Figure 15: Adoption Rates for All Children, 2001 through 2005: 

Figure 16: States' Views on Impact of Federal Policies on Licensing and 
Time Frames for Making Permanency Decisions on Disproportionality: 

Abbreviations: 

ACF: Administration for Children and Families: 

ASFA: Adoption and Safe Families Act: 

CFSR: Child and Family Services Reviews: 

CWLA: Child Welfare League of America: 

HHS: Health and Human Services: 

IEP: Interethnic Placement Act: 

MEPA: Multiethnic Placement Act: 

NRC: national resource center: 

OJJDP: Office of Juvenile Justice and Delinquency Prevention: 

SSBG: Social Security Block Grant: 

TANF: Temporary Assistance for Needy Families: 

United States Government Accountability Office: 
Washington, DC 20548: 

July 11, 2007: 

The Honorable Charles B. Rangel: 
Chairman: 
Committee on Ways and Means: 
House of Representatives: 

Children of all races are equally as likely to suffer from abuse and 
neglect, according to the Department of Health and Human Services' 
(HHS) National Incidence Study of Child Abuse and Neglect (NIS); 
however, HHS data show that a significantly greater proportion of 
African American children enter and remain in foster care than children 
of other races and ethnicities. African-American children across the 
nation were more than twice as likely to enter foster care compared 
with White children in 2004, and African American children remained in 
foster care about 9 months longer. On the last day of fiscal year 2004, 
African American children totaled 162,911--or 34 percent--of the 
482,541 children in foster care, according to HHS data--about twice 
their proportions in the general child population. Although there is 
great variability among and within the states, data from nearly all 
states show some disproportionate representation of African American 
children in foster care. State data also show patterns of 
disproportionate representation in foster care for Native American 
children and, in certain localities, Hispanics and Asian subgroups are 
also disproportionately represented to some extent.[Footnote 1] 

About 60 percent of children who enter foster care do so through 
reports of child abuse or neglect provided to a state's child welfare 
system.[Footnote 2] Child welfare staff screen and investigate reports 
of child maltreatment, and make decisions about whether a child can 
remain safely at home, with or without family support services, or must 
be immediately removed and placed in foster care. The decision to place 
a child in foster care is subsequently presented before a judge who 
evaluates the evidence for removal from home and either corroborates or 
overturns the decision. After entering a child in foster care, child 
welfare staff develop case plans that are approved by the courts 
outlining steps parents must take before a child can return home or, 
for children the courts decide cannot safely be returned home, 
establishing other permanency goals for them, such as adoption or legal 
guardianship. States have the primary responsibility for establishing 
the legal and administrative structures and programs of their child 
welfare services; however, federal legislation and regulations 
establish a framework within which states make their programmatic and 
fiscal decisions. The Department of Health and Human Services (HHS) is 
the principal federal agency that provides federal oversight of states' 
child welfare systems. HHS administers about $8 billion in funds each 
year that are dedicated to support states' child welfare systems. HHS 
also administers social services block grant programs, such as 
Temporary Assistance for Needy Families (TANF), and states generally 
spend about $12 billion of these funds to provide direct social 
services. States use these block grant funds to benefit various 
populations, including child welfare families. 

Concerned about why African American children are overrepresented in 
foster care, you asked us to analyze: 

(1) The major factors that have been identified as influencing the 
proportion of African American children entering and remaining in 
foster care compared to children of other races and ethnicities; 

(2) The extent that states and localities have implemented strategies 
that appear promising in addressing African American representation in 
foster care; and: 

(3) The ways in which key federal child welfare policies[Footnote 3] 
may have influenced African American representation in foster care. 

To address these three objectives, we used multiple methodologies, 
including administering a state survey; conducting site visits; 
interviewing researchers and federal agency officials; conducting a 
literature review; and analyzing federal legislation and policies. 
Although we focused on African American children in this report, we 
also noted points of similarity or difference with children of other 
races and ethnicities as appropriate.[Footnote 4] Specifically, we 
conducted a nationwide Web-based survey of state child welfare 
administrators in 50 states and the District of Columbia between 
November 2006 and January 2007 and received responses from 48 
states.[Footnote 5] In developing the survey, we relied upon a 
literature review to identify issues, such as factors that contribute 
to disproportionality, as well as interviews with child welfare 
researchers and others. To obtain a more in-depth understanding of 
issues, we conducted site visits to California, Illinois, Minnesota, 
New York, and North Carolina, where we interviewed state and local 
child welfare officials, juvenile court judges, and others involved in 
the child welfare systems. In addition we conducted telephone 
interviews with Texas state and local child welfare officials, service 
providers, and a judge. When viewed as a group, the states we visited 
reflected diversity in their rates of African American representation 
in foster care, strategies and initiatives used to address this 
disproportionality, program administration (state administered and 
county administered), and geographic location. In addition, the states 
we selected collectively covered nearly one-third of children in foster 
care across the nation. To extend our understanding, we interviewed 
child welfare researchers identified through our literature review and 
through recommendations from child welfare officials and stakeholders 
for their knowledge on issues of racial disproportionality in foster 
care. We also interviewed HHS officials responsible for foster care 
programs and related data, as well as federal officials at the Justice 
Department, Office of Juvenile Justice and Delinquency Prevention 
(OJJDP), which is required by law to address racial disproportionality 
in the juvenile justice systems. In addition, we conducted an extensive 
literature review of research on racial disproportionality in foster 
care and strategies used by states and others to address this issue. In 
reporting our findings, we drew upon research publications our 
methodologists considered generally reliable and methodologically 
sound. We analyzed federal child welfare legislation and policies 
relevant to foster care that our literature review and interviews had 
indicated might have an impact on racial disproportionality. Finally, 
we also analyzed HHS data on foster care and adoptive children that 
state child welfare agencies submit biannually to the agency under its 
foster care and adoption reporting system. We also confirmed the 
reliability of these data for our purposes. We conducted our work 
between June 2006 and June 2007 in accordance with generally accepted 
government auditing standards. 

Results in Brief: 

A higher rate of poverty and challenges in accessing support services, 
as well as racial bias and difficulties in finding appropriate 
permanent homes, were identified in our review as the main factors 
influencing the proportion of African American children in foster care. 
Thirty-three states in our survey cited high rates of poverty among 
African Americans as a factor influencing children's entry into foster 
care. Nationally, African Americans are nearly four times more likely 
than others to live in poverty. Studies have shown that families living 
in poverty have difficulty accessing needed services that can help 
support families and keep children who may be vulnerable to abuse and 
neglect safely at home. However, research suggests that poverty does 
not fully account for differing rates of entry into foster care. State 
child welfare directors we surveyed also responded that bias or 
cultural misunderstanding and distrust between child welfare decision 
makers and the families they serve also contribute to the removal of 
children from their homes. Once African American children are removed 
from their homes, their lengths of stay in foster care average 9 months 
longer than those of White children. The challenges in accessing 
services, such as substance abuse treatment and subsidized housing, 
also contributed to longer lengths of stay for children whose goal is 
to reunify with their families. For children who cannot be reunified 
with their families, state officials reported difficulties in finding 
them appropriate permanent homes, in part because of the challenges in 
recruiting adoptive parents, especially for youth who are older or have 
special needs. An additional factor is that African Americans are more 
likely to rely on relatives to provide foster care. Although this type 
of foster care placement, known as kinship care, can be less traumatic 
for children and reduce the number of placements and chance of their re-
entry into foster care, it is also associated with longer lengths of 
stay. 

Most states in our survey reported implementing some strategies that 
experts have identified as promising for African American children and 
noted several factors they considered fundamental to any attempt to 
address racial disproportionality. Researchers and officials stressed 
that no single strategy would fully address the issue, but that 
strategies to increase access to support services, reduce bias, and 
increase the availability of permanent homes all hold some promise for 
reducing disproportionality. For example, 38 states reported 
collaborating with neighborhood-based organizations to expand the 
availability of support services. Most states sought to reduce bias by 
including the family in making key decisions and by recruiting and 
training staff with the skills to work with people of all ethnicities. 
To move children more quickly from foster care to permanent homes, more 
than half of states performed a diligent search for relatives of 
children in foster care who might be willing to provide permanent 
homes, recruited African American adoptive families, and offered 
subsidies to guardians who were not willing to adopt, as is currently 
allowed for adoptive families. However, fewer states reported focusing 
attention on disproportionality itself by, for example, enacting state 
legislation or establishing councils on racial disproportionality. 
Although research on the effectiveness of strategies has been limited, 
public and private officials in the forefront of research and 
implementation said that the ability to analyze data, work across 
social service agencies, and sustain leadership was fundamental to any 
attempt to address racial disproportionality. HHS has taken steps to 
help states in their efforts to address disproportionality through 
outreach and technical assistance. However, state child welfare 
directors generally reported in our survey that additional support in 
analyzing data on disproportionality and disseminating strategies is 
needed. Child welfare officials in states considered to be at the 
forefront of addressing disproportionality told us they relied on 
technical assistance in analyzing data from universities and funds from 
a private foundation to help them devise strategies to address 
disproportionality. 

According to our survey results, federal policies that provide for 
family support services and promote adoption were generally considered 
helpful in reducing the proportion of African Americans in foster care, 
but policies that limit the use of foster care funding for family 
support services and legal guardianship were reported to have a 
negative effect. Half of the state child welfare directors we surveyed 
reported that federal block grants used to provide services to 
families, such as substance abuse treatment, contribute to reducing the 
proportion of African American children in foster care. However, even 
more child welfare directors in our survey reported that policies 
governing the use of funds specifically intended for children in foster 
care increase the proportion of African American children in foster 
care. More specifically, many state child welfare directors expressed 
concerns about the cap on funds for preventive services and the lack of 
flexibility to use funds meant for foster care and adoption for other 
purposes, including services to families at-risk of having their 
children removed, such as parenting classes. Among policies that affect 
states' ability to find permanent homes for children, states generally 
reported that adoption policies have been helpful, such as the 
requirement to recruit minority adoptive parents and providing 
subsidies to families adopting children that states have identified as 
having special needs. However, states still face challenges in 
recruiting sufficient numbers of willing and qualified adoptive 
families for African American children. In addition, state and local 
officials also reported wanting federal support for legal guardianship. 
States responding to our survey considered the federal policy 
recognizing legal guardianship as helpful in enabling children to exit 
foster care, but policies limiting the use of federal funds to pay 
subsidies to guardians, similar to those provided to adoptive parents, 
as a barrier. States were less definitive about the impact of federal 
policies that impose time frames on permanency decisions. These time 
frames may shorten the time children remain in care but may also impede 
states' ability to reunify children with their parents. 

Our draft report recommended that HHS pursue specific measures to allow 
adoption assistance payments to be used for subsidizing legal 
guardianship. In commenting on the draft report, HHS disagreed, stating 
that the administration had already proposed an alternative funding 
approach, known as the Child Welfare Program Option. Under this 
proposal, states could choose to remain under the current foster care 
funding structure or instead receive a flexible capped grant that they 
could use for a wide range of child welfare services and supports, 
including subsidizing guardianships. The current adoption assistance 
program would remain the same under this proposed option. However, 
although HHS has presented this broad restructuring of child welfare 
funding in its budget proposals each year since 2004, no legislation 
has been offered to date to authorize it. Moreover, if enacted, it is 
unknown how many states would choose a capped grant that would allow 
greater program flexibility instead of the current title IV-E foster 
care entitlement funding. Therefore, in light of these factors, we have 
deleted our recommendation to HHS and are instead suggesting that 
Congress consider amending current law to allow subsidies for legal 
guardianships, as is currently allowed for adoption. Current evidence 
indicates that allowing such subsidies could help states increase the 
number of permanent homes available for African American and other 
children in foster care. We are also making a recommendation that the 
Secretary of the HHS provide states with additional technical 
assistance and tools to develop strategies to address 
disproportionality. In its comments, HHS noted that our recommendation 
was consistent with its efforts to provide technical assistance to 
states for addressing disproportionality, but the department did not 
address the specific actions we recommended. We continue to believe 
that it is important for HHS to take these actions to help states 
address this complex issue. 

Background: 

The HHS National Incidence Study has shown since the early 1980s that 
children of all races and ethnicities are equally likely to be abused 
or neglected; however, African American children, and to some extent 
other minority children, have been significantly more likely to be 
represented in foster care, according to HHS data and other 
research.[Footnote 6] Nationally, African American children made up 
less than 15 percent of the overall child population in the 2000 
Census, but they represented 27 percent of the children who entered 
foster care during fiscal year 2004, and they represented 34 percent of 
the children remaining in foster care at the end of that year, as shown 
in figure 1.[Footnote 7] 

Figure 1: Proportion of Children by Race in Foster Care Settings, End 
of Fiscal Year 2004: 

[See PDF for image] 

Source: GAO analysis of AFCARS and Census data. 

[End of figure] 

African American children were more likely to be placed in foster care 
than White or Hispanic children, and at each decision point in the 
child welfare process the disproportionality of African American 
children grows. Although racial disproportionality is most severe and 
pervasive for African American children, Native American children also 
experience higher rates of representation in foster care than children 
of other races or ethnicities. Just over 2 percent of children in 
foster care at the end of fiscal year 2004 were Native Americans, while 
they represented less than 1 percent of children in the United 
States.[Footnote 8] However, there can be significant variation by 
state and county. It is especially important to understand local 
variations for Hispanic and Asian children, since they are 
underrepresented in foster care nationally and in most states, but are 
overrepresented in some counties and states. For example, in a single 
county in California, Hispanic children represented 30 percent of the 
population but 52 percent of the county's child welfare cases. 

There are various options for placing children in temporary and 
permanent homes through the child welfare system. Temporary options 
include foster care with relatives or non-relatives--whether licensed 
or unlicensed--and group residential settings. According to HHS, 
approximately one-fourth of the children in out-of-home care are living 
with relatives, and this proportion is higher for Hispanic and African 
American families. For permanent placements, adoption and guardianship 
are options under federal law in addition to the child's reunification 
with their parents. One important difference is that adoption entails 
terminating parental rights, while guardianship does not. (See table 
1.) 

Table 1: Types of Temporary and Permanent Homes for Children in Child 
Welfare: 

Type of temporary placement: Foster parents; 
Definition: Non-related adults who have been trained and 
licensed/certified to provide shelter and care to a child. 

Type of temporary placement: Kinship Care[A] - Licensed Foster; 
Definition: Relative or close family friend who provides shelter and 
care. Licensed kinship care may involve a training and licensure 
process for the caregivers and support services. 

Type of temporary placement: Kinship Care - Unlicensed Foster; 
Definition: Relative or close family friend who provides shelter and 
care. Unlicensed kinship care may involve only an assessment process to 
ensure the safety and suitability of the home along with supportive 
services for the child and caregivers. 

Type of temporary placement: Congregate Care; 
Definition: These settings include community-based group homes, campus-
style residential facilities, and secure facilities. Residential 
programs, and the staff who work in them, are generally focused on 
working with children who have certain special physical or behavioral 
needs. 

Type of permanent placement[B]: Reunification; 
Definition: Parents reassume their role as the principle caretaker for 
their children if the courts determine that parents have successfully 
completed the action required in their case plan. 

Type of permanent placement[B]: Adoption; 
Definition: Caretakers who assume legal guardianship of the child 
through the termination of parental rights. 

Type of permanent placement[B]: Guardianship; 
Definition: Caretakers who assume legal guardianship without the 
termination of a child's parent's rights. Legal guardianship is more 
durable than a simple transfer of custody to caretakers. 

Source: HHS, Child Welfare Information Gateway. 

[A] Kinship care exists both as formal arrangements made through the 
child welfare system and as informal arrangements made by families 
outside of child welfare. In this study, we are only referring to 
formal kinship care through child welfare, either as a temporary 
placement for a child or a permanent placement that allows the child to 
exit foster care. 

[B] Children can also exit foster care through emancipation when they 
turn 18 years old. This is sometimes referred to as "aging out" of the 
foster care system. 

[End of table] 

Federal Foster Care and Adoption Legislation: 

In the last decade, several federal laws have been enacted to help 
states reduce the number of children who enter and remain in foster 
care. These laws include the Multi-Ethnic Placement Act of 
1994,[Footnote 9] as amended in 1996 by the Interethnic Adoption 
Provisions included in the Small Business Job Protection Act[Footnote 
10] (MEPA-IEP). MEPA-IEP is intended to eliminate race-related barriers 
to adoption by prohibiting foster care and adoption agencies that 
receive federal funds from delaying or denying placement decisions on 
the basis of race, color, or national origin of either the adoptive or 
foster parent or child. MEPA-IEP also required states to diligently 
recruit potential foster and adoptive families that reflect the ethnic 
and racial diversity of children in the state who need foster care and 
adoptive homes. MEPA-IEP was followed by the Adoption and Safe Families 
Act of 1997 (ASFA),[Footnote 11] which established expedited time 
frames to place children in permanent homes through reunification, 
adoption, or guardianship and for terminating parental rights. ASFA 
recognized that guardianship may be an appropriate permanency option 
for some children in foster care and it encouraged adoption by 
establishing adoption incentive payments for states. The Promoting Safe 
and Stable Families (PSSF) program also created under ASFA supported 
the need to strengthen and reunify families. This program expanded 
dedicated funding for services that could help prevent the removal of 
children from their homes or could expedite children's return home from 
foster care. In addition to family preservation and community-based 
support services, PSSF services include time-limited reunification 
services and adoption promotion and support services. States are 
required to allocate "significant portions" of their funding for each 
of these four service categories. (See table 2.) 

Table 2: Key Federal Legislation Affecting Foster Care Programs: 

Multi-Ethnic Placement Act of 1994 (MEPA-IEP). 

Legislation: Prohibition against adoption placements on basis of race; 
Description: 
* Prohibited states and other entities that receive federal funding 
assistance from delaying or denying a child's foster care or adoption 
placement on the basis of the child or prospective parent's race, 
color, or national origin. 

Legislation: Recruiting foster and adoptive parents; 
Description: 
* Required that states diligently recruit foster and adoptive parents 
who reflect the racial and ethnic diversity of the foster care 
population for a state to remain eligible for federal assistance for 
child welfare programs. 

Adoption and Safe Families Act of 1997 (ASFA). 

Legislation: Expediting decisions about permanent homes for children; 
Description: 
* Required that states hold a permanency hearing no later than 12 
months after the date a child enters foster care. This requirement was 
shortened from 18 months in prior law; 
* Required that states file a petition to terminate parental rights for 
children who have been in foster care for 15 of the most recent 22 
months. States may exempt children from this requirement for multiple 
reasons, including if the child is placed with a relative. 

Legislation: Providing incentives to states for increasing adoptions; 
Description: 
* Provided financial rewards to states for increasing numbers of 
finalized adoptions through the adoption incentive payment program. 
States have the flexibility to use the incentive payment funds for any 
child welfare related initiative; 
* Required that in order to receive incentive payments, states must 
exceed adoption baselines established for their state. States receive a 
fixed payment of $4,000 for each foster child who is adopted over the 
baseline, an extra $2,000 for the adoption of each special needs child 
younger than age 9, and $4,000 for the adoption of each child aged 9 or 
older. 

Source: GAO analysis of federal legislation. 

[End of table] 

One of the prerequisites to finding children temporary and permanent 
homes is for states to ensure that criminal background checks have been 
conducted for prospective foster care and adoptive parents. Congress 
had prohibited states from receiving federal foster care or adoption 
assistance support on behalf of eligible children who are placed in the 
home of a foster or adoptive parent who had certain types of 
convictions.[Footnote 12] States had been allowed to opt out of certain 
federal criminal background requirements by providing alternative plans 
to ensure children's safety, which were assessed as part of an HHS 
review process. According to HHS, eight states had been approved to use 
alternative plans.[Footnote 13] However, requirements for conducting 
federal background checks have recently changed: a provision of the 
Adam Walsh Safety and Protection Act of 2006,[Footnote 14] which was 
developed in response to concerns about child predators, establishes 
additional federal requirements for criminal background checks of 
prospective foster or adoptive parents[Footnote 15] and eliminates 
states' ability to opt out of the federal requirements, effective 
October 2008. 

Foster Care Financing: 

Federal funds account for approximately half of states' total reported 
spending for child welfare services, with the rest of funding coming 
from states and localities. In fiscal year 2004, total federal spending 
on child welfare was estimated to be $11.7 billion based on analysis of 
data from over 40 states.[Footnote 16] These federal funds come from 
sources that are dedicated to child welfare as well as those that are 
provided to states under the federal block grant structure for broader 
purposes. 

Titles IV-E and IV-B of the Social Security Act are the principal 
sources of federal funds dedicated for child welfare activities. Title 
IV-E provides the majority of dedicated federal funds for support 
payments to foster families, adoption assistance, and related 
administrative costs on behalf of children who meet certain federal 
eligibility criteria.[Footnote 17] Title IV-E foster care maintenance 
and adoption assistance payments are authorized as open-ended 
entitlements. States may claim federal reimbursement for a specified 
amount of the costs for every eligible child who is placed in a 
licensed foster home. In addition, Title IV-E established subsidies 
paid to families who provide adoptive homes to children who states 
identify as having special needs that make placement 
difficult.[Footnote 18] In 2003, 2004, and 2005, states designated more 
than 80 percent of adoptions as special needs adoptions enabling 
families to receive federal financial subsidies, according to HHS data. 
Total federal expenditures, including administrative costs, for Title 
IV-E programs were about $6.8 billion in fiscal year 2006. Title IV-B 
authorizes funds to states for broad child welfare purposes, including 
child protection, family preservation, and adoption services. In 
contrast to Title IV-E funds, Title IV-B funds are appropriated 
annually and totaled about $700 million in 2006.[Footnote 19] 

Federal block grants such as the Temporary Assistance for Needy 
Families (TANF) and the Social Services Block Grant (SSBG) provide 
additional sources of funds that states can use for child welfare 
purposes. Block grants and other sources of non-dedicated funds made up 
about 44 percent of total federal funds spent on child welfare in 2004, 
or about $5.2 billion, according to the most recent research 
available.[Footnote 20] Under these block grants, states have 
discretion to provide direct social services for various populations, 
including child welfare families, the elderly, and people with 
disabilities. (See fig. 2.) 

Figure 2: Federal Child Welfare Funding by Funding Source, FY 2004: 

[See PDF for image] 

Source: Urban Institute 2005 Child Welfare Survey reported in May 2006. 

Note: This funding analysis is the most recent available that shows 
federal funding used specifically for child welfare. Total federal 
spending on child welfare was estimated to be $11.7 billion in state 
fiscal year 2004. Percentages may not total to 100 due to rounding. 

[End of figure] 

In 1994, the Congress authorized the use of flexible funding 
demonstration waivers to encourage innovative and effective child 
welfare practices. These waivers, typically authorized for 5 years, 
allowed states to use Title IV-E funds to provide services and supports 
other than foster care maintenance payments. For example, states could 
use waivers to provide subsidies to legal guardians or services to 
caregivers with substance abuse problems. Waiver demonstrations must 
remain cost-neutral to the federal government and they must undergo 
rigorous program evaluation to determine their effectiveness. As of May 
2007, according to HHS, 14 states have one or more approved Title IV-E 
child welfare waiver demonstration projects, involving one or more 
programmatic components, such as subsidized guardianship. With regard 
to guardianship specifically, four states have completed demonstrations 
that involved subsidized guardianships as of May 2007, seven states 
have active guardianship demonstrations, and one state has not yet 
implemented its guardianship demonstration. HHS's ability to approve 
new Title IV-E waivers expired in 2006, however, and Congress has not 
reauthorized this program. 

The Administration's fiscal year 2008 budget proposes, for the fifth 
consecutive year, to implement a "Child Welfare Program Option," which 
would restructure the Title IV-E foster care program. Under this 
proposal, states could forego open-ended entitlement foster care 
funding in exchange for a pre-determined grant. Unlike the open-ended 
funds, the grant could be spent on the entire range of child welfare 
purposes and for any child (regardless of the child's federal foster 
care eligibility status). States taking this option would need to 
continue to ensure child safety protections, maintain existing state 
funding for child welfare, and participate in federal assessments of 
state child welfare programs, known as Child and Family Services 
Reviews. Under this proposal, the Title IV-E Adoption Assistance 
program would continue as an entitlement program, according to an HHS 
official. In 2006, HHS approved two states to pilot the program option 
over the next 5 years under its Title IV-E waiver demonstration 
authority, which expired in that year.[Footnote 21] Final evaluation 
results for these pilots will not be available for at least 5 years. 

HHS Assessments of State Programs and Technical Assistance to States: 

States are required to enact policies and meet certain federal 
standards related to child welfare programs, and HHS evaluates how well 
state child welfare systems achieve these federal standards through its 
Child and Family Services Reviews (CFSR). Implemented in 2001, these 
reviews focus on states' performance in ensuring children's safety, 
permanency, and well-being over a range of child welfare services, 
using various outcome measures.[Footnote 22] To address any areas 
identified as not in substantial conformity with these outcome 
measures, the state develops a program improvement plan.[Footnote 23] 
To evaluate states' performance on these measures, HHS also relies, in 
part, on its Adoption and Foster Care Analysis and Reporting System 
(AFCARS) to capture, report, and analyze information collected by the 
states.[Footnote 24] In addition, AFCARS is used to generate annual 
reports on foster care and adoption programs nationwide. 

HHS provides states with training and technical assistance to help them 
develop and implement their CFSR performance improvement plans, build 
state agency capacity, and improve the state child welfare system. 
Technical assistance providers in this network include HHS's Children's 
Bureau, 10 regional offices, and various National Resource Centers. An 
additional resource is the department's Child Welfare Information 
Gateway, a Web site that provides access to information and resources 
to help protect children and strengthen families.[Footnote 25] 

States Report Poverty and Difficulty in Finding Permanent Homes Are 
among Major Factors Influencing African Americans' Entry and Length of 
Stay: 

A complex set of interrelated factors influence the disproportionate 
number of African American children who enter foster care as well as 
their longer lengths of stay, and our review found that poverty and the 
lack of appropriate homes are particularly influential. Major factors 
affecting children's entry into foster care included African American 
families' higher rates of poverty, families' difficulties in accessing 
support services so that they can provide a safe home for vulnerable 
children and prevent their removal, and racial bias and cultural 
misunderstanding among child welfare decision makers. Factors often 
cited as affecting African American children's length of stay in foster 
care included the lack of appropriate adoptive homes for children, 
greater use of kinship care among African Americans, and parents' lack 
of access to supportive services needed for reunification with their 
children. 

Higher Rates of Poverty, Lack of Support Services, and Racial Bias 
Viewed as Increasing African American Children's Entry into Foster 
Care: 

In responding to our survey, states considered three main groups of 
factors as contributing to African American children's entry into 
foster care: These groups included high rates of poverty and other 
poverty-related issues, challenges in accessing supports and services 
in impoverished communities, and racial bias or cultural 
misunderstanding among decision makers. 

Higher Rates of Poverty: 

Of the many factors that have been found to influence African American 
children's disproportionate entry into foster care, the most often 
cited factors that emerged in our survey were African American 
families' higher rates of poverty and issues related to living in 
poverty. Poverty-related factors included the large number of single 
parents among African American households, a high rate of substance 
abuse, and greater contact with public officials who have mandatory 
responsibilities to report incidents of abuse and neglect.[Footnote 26] 
(See fig. 3.) 

Figure 3: State Views on Poverty-Related Factors Affecting Higher Entry 
of African American Children to Foster Care: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

In our survey, poverty was cited as a key factor for entry: 33 states 
reported that high rates of poverty in African American communities may 
increase the disproportionate number of African American children 
entering foster care compared to children of other races and 
ethnicities. Researchers and child welfare officials in states we 
visited also noted the importance of poverty as a contributing factor. 
Across the nation, an estimated 23 percent of all African American 
families lived below the poverty level compared to only 6 percent of 
Whites, making African Americans nearly four times more likely to live 
in poverty, according to U.S. Census data.[Footnote 27] Since foster 
care programs primarily serve children from low-income families, this 
could account for some of the disproportionate number of African 
American children in the foster care system. However, our review of our 
survey results, interviews, and studies indicate that factors unrelated 
to poverty are also at play in foster care placements. 

In addition, child welfare directors in 25 states reported that the 
greater number of African American single-parent households was also a 
factor contributing to African American children's entry into foster 
care to at least a moderate extent.[Footnote 28] According to the most 
recent National Incidence Study, children of single parents had a 77 to 
87 percent greater risk of harm than children from two-parent 
families.[Footnote 29] Across the nation, 35 percent of African 
American family households were headed by single females with children 
under 18 years of age compared to 9 percent for Whites and 19 percent 
for Hispanics, according to U.S. Census data.[Footnote 30] In addition, 
nearly half of the child welfare directors responding to our survey 
considered higher rates of substance abuse in African American 
households as contributing to the proportion of African American 
children in foster care. (See fig. 3.) Despite this perception, 
national data show that African Americans have nearly the same rate of 
substance abuse as Whites.[Footnote 31] However, 65 percent of African 
American children were removed from their homes because of parental 
substance abuse and placed in foster care, compared to 58 percent of 
White children, according to our analysis of AFCARS fiscal year 2004 
data.[Footnote 32] Finally, child welfare directors in 14 states 
responded that African American children's greater contact with 
officials mandated to report child abuse and neglect played a role in 
the children's entry to foster care. Several researchers we interviewed 
noted that low-income families come into contact with a greater number 
of mandated reporters because they have more interaction with some 
public services. In fact, as noted in an HHS report, the top three 
sources of reports to child protective services hotlines in 2003 were 
educational staff, law enforcement officials, and social services 
personnel, of which the latter two disproportionately interact with low-
income individuals. 

Challenges in Accessing Supports and Services: 

In our survey, African American families' challenges in accessing 
supports and social services was also viewed as influencing African 
American children's entry to foster care. African American and other 
families living in impoverished neighborhoods often do not have access 
to the kinds of supports and services that can prevent problems in the 
home from leading to abuse or neglect. Such supports and services 
include affordable and adequate housing, substance abuse treatment, and 
family services such as parenting skills and counseling. Access to 
legal representation in courts responsible for making decisions about 
children reported to have been abused or neglected was also as a factor 
as influencing African American children's entry into foster care. (See 
fig. 4.) 

Figure 4: State Views on Support and Preventive Services Affecting 
African American Children's Higher Entry into Foster Care: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

According to our survey, child welfare directors in 25 states reported 
that the lack of affordable housing options was a factor that may 
increase the proportion of African American children entering foster 
care to at least a moderate extent. For low-income families, affordable 
public housing is a critical support that can help families stay 
together and allow for in-home services, thereby decreasing the chances 
of children being removed from their families, but in some areas, there 
is a shortage. For example, child welfare officials in a California 
county told us they have a waiting list estimated at around 20,000 
applicants for public housing.[Footnote 33] Families involved in the 
child welfare system often live in communities that lack resources and 
services, including drug treatment services and job training, which 
they either do not receive or must travel long distances to obtain, 
according to an HHS study.[Footnote 34] In our survey, 25 states 
reported that the lack of substance abuse treatment and 24 states 
reported that the limited access to preventive services were factors 
that may increase the proportion of African American children entering 
foster care to at least a moderate extent. The state survey responses 
may reflect the fact that a higher percentage of African American 
families live in impoverished neighborhoods that lack such resources. 
Child welfare officials in all of the states we visited as well as 
researchers noted that lack of adequate supportive services contributed 
to disproportionality. For example, during a site visit, a Minnesota 
child welfare official noted that wealthier families may be able to 
draw upon support services, like family and substance abuse counseling, 
that can help keep the children with their families. However, poorer 
families, without access to supportive services, may have a more 
difficult time weathering a problem such as substance abuse or 
emotional issues.[Footnote 35] Even after they are reported to child 
welfare, families can have difficulty in gaining access to the types of 
services that would allow a child to remain with the family and risk 
being removed to foster care. According to HHS's 2005 Child 
Maltreatment report, about 40 percent of children identified as victims 
of maltreatment do not receive services such as counseling and family 
support services.[Footnote 36] With regard to substance abuse treatment 
services, one study found significant gaps in services for families 
involved with the child welfare system, with only 31 percent of at-risk 
children and families with substance abuse problems receiving 
treatment.[Footnote 37] There is also some evidence that African 
American families, in particular, are not offered the same amount of 
support services when they are brought to the attention of the child 
welfare system. As one study found, race was a significant factor in 
whether families received mental health related services, even after 
controlling for age, type of maltreatment, behavior of the child, and 
gender.[Footnote 38] A Texas state child welfare official reiterated 
this point, telling us that in her experience, African American 
children are less likely than children of other races or ethnicities to 
receive in-home services. 

According to 20 states responding to our survey, once African American 
families come into contact with the child welfare system, they often 
have difficulties obtaining adequate legal representation in court, and 
this contributed to their disproportionate numbers in foster care. 
Local court officials and others we interviewed observed that higher 
income families can afford private legal representation, which can help 
prevent their child's removal to foster care, but lower-income parents 
usually do not have this option. In one state we visited, we were told 
that public attorneys assigned to child welfare families often do not 
meet parents before they appear in court and have little time to review 
case files, putting parents at a disadvantage in unfamiliar legal 
settings. In addition, the Pew Commission on Children in Foster Care 
found that parents in dependency hearings were often inadequately 
represented because of a lack of time, preparation, and resources, 
including attorney compensation.[Footnote 39] 

Distrust and Racial Bias or Cultural Misunderstanding: 

Coupled with African American parents' greater distrust of the child 
welfare system, racial bias or cultural misunderstanding among decision 
makers also emerged in our survey as major factors contributing to the 
disproportionate number of African American children entering foster 
care. These decision makers include mandated reporters, child welfare 
caseworkers, and those involved in judicial rulings about these 
children. (See fig. 5.) 

Figure 5: State Views on Issues of Distrust and Bias or Cultural 
Misunderstanding Affecting African American Children's Greater Entry to 
Foster Care: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

Families' distrust of the child welfare system was cited by child 
welfare directors in 28 states as a factor contributing to the entry of 
African American children into foster care to at least a moderate 
extent. According to state child welfare officials and some researchers 
we interviewed, African American families' distrust of the child 
welfare system stems from their perception that the system is 
unresponsive to their needs and racially biased against them. Child 
welfare officials and researchers said that many African Americans in 
poor communities perceive child welfare caseworkers as more intent on 
separating African American parents from their children than on working 
within their communities to address child safety issues. As an example 
of how this dynamic might occur, a neighborhood-based service provider 
we interviewed in California described a situation in which a mother 
fleeing domestic violence at home did not seek public services for 
herself and her children--despite the evident need for clothing and 
therapy--because child welfare had once before removed her children and 
she did not trust the system to be helpful. These experiences in turn 
can shape the families' dynamics in their initial contacts with 
mandated reporters, caseworkers, and judges. Casey Family 
Programs[Footnote 40] staff in an interview noted that African American 
families in such circumstances may not seek services because of such 
distrust, which in turn increases the risk of a child's removal. 

In our survey, 23 state child welfare directors reported that they 
considered racial bias or cultural misunderstanding on the part of 
those reporting abuse or neglect, such as teachers, medical 
professionals, or police officers, as a factor in the disproportionate 
representation of African American children entering foster care to at 
least a moderate extent. In support of this view, some studies have 
found that medical professionals are more likely to report low-income 
or minority children to child protective services, even controlling for 
other factors, such as type of abuse.[Footnote 41] In addition, bias or 
cultural misunderstanding on the part of child welfare caseworkers and 
juvenile and family court judges are viewed as playing a role in the 
proportion of African American children entering foster care. In our 
survey, child welfare directors in 21 states reported that caseworker 
bias, cultural misunderstanding, or inadequate training was a factor 
that contributes to entry. To a lesser extent, bias or cultural 
misunderstanding was considered a factor in judicial rulings as well. 
HHS and a few state child welfare officials we interviewed also noted 
that class and educational differences between caseworkers and families 
also contributed to cultural misunderstandings. As one researcher 
noted, even well-meaning decision makers at any stage of the child 
welfare process may have faulty assumptions about racial, ethnic, or 
socio-economic groups. 

Studies that have tried to control for other factors to determine if 
race or racial bias was a predictor for entry into foster care have 
produced varied results. One study using California data found that, 
after controlling for poverty and maltreatment, African American 
children were more likely to be removed from their homes and placed in 
foster care compared to White children, when income was accounted 
for.[Footnote 42] However, another study using Baltimore, Maryland, 
data found African American children did not have an increased 
likelihood of being removed from their homes and placed in foster 
care.[Footnote 43] Although research on racial bias or race as a 
predictor for entry into foster care is not always consistent, a recent 
review of the current literature by the Casey-Center for the Study of 
Social Policy Alliance for Racial Equity in the Child Welfare System 
concluded that race is an important factor that affects the decision to 
place children into foster care.[Footnote 44] 

Difficulties in Finding Permanent Homes and Achieving Reunification May 
Increase Time in Foster Care for African American Children: 

In responding to our survey, states considered certain groups of 
factors as contributing to African American children's length of stay 
in foster care, thereby increasing their disproportionality: These 
included challenges in finding appropriate adoptive homes for those 
unable to be reunified with their families, the impact of kinship 
foster care on length of stay, and other challenges affecting 
children's ability to exit foster care to be reunified with their 
families. 

Challenges in Finding Appropriate Adoptive Homes: 

Certain factors made finding permanent homes for African American 
children more challenging, according to states responding to our 
survey, thereby contributing to longer lengths of stay for African 
American children. These factors included an insufficient number of 
appropriate adoptive homes, difficulties in finding families that will 
adopt older African American children, and the belief that African 
American children are more likely to be diagnosed as having special 
needs. (See fig. 6.) 

Figure 6: State Views on Factors Affecting Longer Time in Foster Care 
for African American Children --Difficulty in Finding Permanent Homes: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

State officials from 29 states cited the insufficient number of 
appropriate adoptive homes as a factor that may increase African 
American children's length of stay in foster care to at least a 
moderate extent. For African American children, lengths of stays in 
foster care averaged 9 months longer compared to White children in 
2004, according to our analysis of AFCARS data. This is partly due to 
the fact that African American children constituted nearly half of the 
children legally available for adoption in 2004 and waited 
significantly longer than other children for an adoptive placement. 
State officials we interviewed described challenges in recruiting 
appropriate adoptive families for African American children. These 
challenges include the difficulty many states have in recruiting 
adoptive families of the same race and ethnicity of the children 
waiting for adoption and the unwillingness of some families to adopt a 
child of another race. An additional challenge was finding adoptive 
African American families who are able to meet state licensing 
requirements, including housing and background checks, for an 
appropriate adoptive home. In New York, for example, local officials 
explained that state requirements for a certain number of bedrooms can 
prevent poor African American families from being able to meet 
licensing requirements needed for adoption--this can be especially an 
issue in high-cost urban areas in which there is limited affordable 
housing. In three states we visited, child welfare officials also told 
us that African American families who were interested in adopting were 
sometimes prevented from doing so because a member of the household had 
a prior criminal record, even though child welfare officials had 
determined that the person would not be a risk to the child.[Footnote 
45] 

The age of foster children awaiting adoption also contributes to the 
challenges in finding appropriate adoptive families, with greater 
difficulties in placing older children. According to research, 
prospective adoptive parents are more inclined to adopt younger 
children, and older children may also have less interest in being 
adopted. In our survey, 21 states reported that a factor accounting for 
the longer lengths of stay for African American children waiting to be 
adopted was that many of them were also older.[Footnote 46] According 
to a 2003 study comparing a cohort of children whose parents' rights 
were terminated at the same time, children who were both older and 
African American had longer wait times between the termination of 
parental rights and adoption.[Footnote 47] State officials we visited 
echoed this finding, noting that child welfare agencies have a 
difficult time trying to find adoptive homes, particularly for older 
African American children. 

In our survey, 16 states also considered the greater likelihood of 
African American children being diagnosed as having medical and other 
special needs as a factor affecting African American's length of stay 
to at least a moderate extent. According to HHS data, African American 
children in foster care in 2004 were only slightly more likely to have 
been diagnosed as having medical conditions or other disabilities (28 
percent) than White children in foster care (26 percent). Children with 
special needs may require additional support services, and some African 
American families may have less access to support services that would 
enable them to take on this extra responsibility. The impact on African 
American children is supported by HHS adoption data that shows that 23 
percent of African American children who were adopted out of foster 
care had a medical condition or disability, compared to 31 percent of 
White children in the same category. 

Kinship Care: 

African American children are more likely than White and Asian children 
to enter into the care of relatives.[Footnote 48] Although kinship care 
is associated with longer lengths of stay, child welfare researchers 
and officials we interviewed consider these placements to be positive 
options for African American children because they are less stressful 
to the child and maintain familial ties. In addition, some researchers 
associate the use of kinship care with fewer foster care placements and 
lower rates of re-entry.[Footnote 49] Kinship care also has some 
drawbacks. For example, a 1999 GAO study found that kinship care might 
increase a child's risk of harm because caregivers may be unwilling to 
enforce court-ordered restrictions on parental visits.[Footnote 50] In 
responding to our survey, 18 states reported that the use of kinship 
care was a factor contributing to longer lengths of stay in foster care 
for African American children to at least a moderate extent. This view 
is supported by research findings indicating that children living with 
relatives generally spend more time in foster care than children living 
with non-relatives. For example, a study cited in a HHS report showed 
that 42 percent of children in foster kinship care remain there for 
more than 2 years compared to 36 percent of children in non-kin foster 
care.[Footnote 51] 

Moving a child from kinship foster care to adoption can be difficult 
for caregivers who need financial assistance or wish to retain family 
ties. Several child welfare officials said that there is a financial 
disincentive to adopt children who are only eligible for financial 
subsidies and services while they are in foster care, especially for 
grandparents and others living on a fixed income. Even when states 
offer financial subsidies to help families adopt these children, 
relatives may be reluctant to terminate their relatives' rights. An 
alternative is for these caregivers to provide a permanent home for 
their relative's children through legal guardianship in which 
caregivers are afforded legal decision-making authority over the child 
without terminating the birth parent's rights.[Footnote 52] 

Difficulty in Achieving Reunification: 

Some of the same factors that states view as contributing to African 
American children's entry also contribute to their difficulties in 
exiting foster care and being reunified with their families. In our 
survey, nearly half of the states considered the lack of affordable 
housing, distrust of the child welfare system, and lack of substance 
abuse treatment as factors contributing to African American children's 
longer lengths of stay. The lack of such supports and other services in 
many poor African American neighborhoods contributes to children's 
longer stays in foster care because services can influence a parent's 
ability to reunify with their child in a timely manner, according to 
our survey, interviews, and research. (See fig. 7.) 

Figure 7: State Views on Factors Affecting Greater Time in Foster Care 
for African American Children --Difficulties in Achieving 
Reunification: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

In our survey, nearly half of the states reported a lack of affordable 
housing options for African American parents, and state and county 
child welfare officials said that housing issues often delay family 
reunification, resulting in longer lengths of stay in foster care. 
According to child welfare officials and researchers we interviewed, 
poor families can lose their housing once their children have been 
removed because the TANF program requires children to be living with 
caregivers for them to qualify for TANF child-only benefits. For 
example, a county official in California noted that about 70 percent of 
families in that county experience a housing crisis when their children 
are removed. If families cannot afford to remain in their homes without 
TANF benefits, then they must seek other alternatives to create homes 
suitable for reunification with their children. Furthermore, if 
families do maintain their housing or find other housing they can 
afford, the standards that parents must meet before their children can 
be returned home from foster care are often higher than when the 
children were removed. According to a private foundation that assists 
13 state and local child welfare agencies around the country in 
addressing disproportionality, a parent living in poverty might be 
unable to meet housing requirements needed for reunification, such as 
having a bedroom for each child, even though the appropriateness of the 
parent's housing had not been the original basis for a child's removal. 

According to 25 states in our survey, parents' distrust of the child 
welfare system was also a factor contributing to African American 
children's longer length of stay in foster care to at least a moderate 
extent. We were told that African American families in some communities 
do not trust child welfare agencies because families in their 
communities have had adversarial relationships with various public 
organizations, including schools, public health, and criminal justice 
systems. 

The lack of substance abuse treatment, mental health services, and 
other support services in African American communities are additional 
factors that can slow African American children's reunification with 
their parents, thereby contributing to longer stays in foster care. 
According to our survey, 23 state child welfare administrators reported 
the lack of substance abuse treatment services as factors contributing 
to African American children's longer stays in foster care to at least 
a moderate extent. An HHS study found that state officials lack the 
resources to provide substance abuse and other types of treatment 
services sufficient to help African American families and those of 
other racial and ethnic minorities move toward reunification and 
adoption.[Footnote 53] Court officials in California said that 
initiatives to refer drug offenders to treatment programs instead of 
incarceration have increased competition for accessing publicly funded 
substance abuse programs, adding to the difficulties families may face 
in making changes needed for reunification. In addition, when services 
are available, it may take 2 years for a parent to complete a substance 
abuse treatment program, and entry into such programs may be delayed if 
there are waiting lists for services. 

States Implemented a Range of Strategies Considering Promising for 
Addressing Disproportionality, but Fewer States Specifically Focus 
Attention on Issue: 

Most states we surveyed reported implementing a range of child welfare 
strategies-often good practices generally-that researchers and experts 
believe may also be promising for reducing the number of African 
American children in foster care. These strategies are intended to 
reduce bias in decision making and increase access to supportive 
services for families and the availability of permanent homes for 
foster children. Fewer states reported focusing attention on 
disproportionality through such actions as convening task forces or 
passing state legislation to study the issue. States that did more 
directly address disproportionality agreed that certain key elements 
were central to their efforts: these elements were data analysis to 
identify problems and strategies to address them, leadership to sustain 
change across time, and collaboration with different social services 
agencies to access programs and resources needed outside the child 
welfare system. HHS has provided some support to states for reducing 
the proportion of African American children in foster care through 
conferences, workshops and various Web sites, but states reported that 
they would benefit from having additional guidance in analyzing 
information and from the dissemination of strategies that other states 
have found promising. 

States Implement a Range of Strategies Expected to Have an Impact on 
Disproportionality: 

Researchers and child welfare administrators stressed that no single 
strategy was sufficient to fully address disproportionality. Some 
strategies states reported on have the potential to reduce bias or 
improve decision making. Other strategies are intended to improve 
access to support services for parents, and still others could increase 
the availability of permanent homes for children waiting in foster care 
(see table 3). 

Table 3: Strategies Used by States That Address Factors Contributing to 
Disproportionality: 

Factor: Bias in decision making; 
Type of Strategy States Are Using: Involving family in planning 
decisions about children. 

Factor: Bias in decision making; 
Type of Strategy States Are Using: Training caseworkers to strengthen 
their ability to work across cultures. 

Factor: Bias in decision making; 
Type of Strategy States Are Using: Conducting outreach or education to 
mandated reporters on criteria or standards for reporting abuse and 
neglect. 

Factor: Bias in decision making; 
Type of Strategy States Are Using: Recruiting, retaining, and promoting 
culturally competent staff. 

Factor: Bias in decision making; 
Type of Strategy States Are Using: Using risk assessment tools that are 
considered culturally competent or validated. 

Factor: Lack of access to support services; 
Type of Strategy States Are Using: Collaborating with neighborhood-
based organizations to provide services. 

Factor: Lack of access to support services; 
Type of Strategy States Are Using: Using interagency agreements with 
other social service agencies to improve families' access to services 
across programs. 

Factor: Lack of access to support services; 
Type of Strategy States Are Using: Providing supports for families 
judged to be a at lower risk of abusing or neglecting their children 
instead of removing them from their families through an approach known 
as Alternative, Dual or Differential Response. 

Factor: Challenges in finding permanent homes; 
Type of Strategy States Are Using: Searching for fathers or paternal 
kin of foster children. 

Factor: Challenges in finding permanent homes; 
Type of Strategy States Are Using: Recruiting more African American 
adoptive families. 

Factor: Challenges in finding permanent homes; 
Type of Strategy States Are Using: Providing financial subsidies to 
guardians willing to permanently parent foster children. 

Factor: Lack of focused attention; 
Type of Strategy States Are Using: Establishing councils or advisory 
committees on disproportionality. 

Factor: Lack of focused attention; 
Type of Strategy States Are Using: Providing preventive services 
targeted at African American families. 

Factor: Lack of focused attention; 
Type of Strategy States Are Using: Establishing requirements in 
contracts to address disproportionality. 

Source: GAO survey of state child welfare administrators. 

[End of table] 

States' Strategies to Address Racial Bias in Decision Making: 

To help mitigate the influence of racial and other forms of bias in 
child welfare decision making processes, states implemented a range of 
strategies such as including family members in discussions of placement 
options, providing training for case workers to strengthen their 
cultural competency, implementing tools to help caseworkers make more 
systematic decisions, and reaching out to educate mandated reporters 
about reporting requirements. (See fig. 8.) Among these strategies, 
states expected that including families in the decision making process 
and training culturally competent staff would most reduce 
disproportionality. 

Figure 8: Strategies Intended to Improve Decisions by Reducing Bias: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

All states we surveyed had implemented strategies to include families 
in the decision making process to some degree, and every state we 
visited told us they were using this method to help address 
disproportionality. There may be differences in the extent to which 
states involved families, ranging from occasional discussions with 
family members to more formal approaches of "family group 
conferencing," which follows a specific model of engaging family 
members in decisions about the child's placement through three phases 
including monitoring and follow up. This approach can help address 
caseworker bias, as one researcher explained, because it increases 
caseworkers' exposure to the lifestyles of the community they are 
serving and helps bridge misunderstandings. Some studies of this 
strategy show that it holds promise for African American families. 
According to an evaluation in Texas, family group decision making led 
to a reduction in foster care placements and an increase in placements 
with relatives for all children; these findings were especially 
pronounced for African American and Hispanic children. Specifically, 32 
percent of African American children whose families attended such a 
conference returned home compared to 14 percent whose families received 
traditional services. 

Almost all states (45) reported conducting training for caseworkers to 
strengthen their understanding of different cultures, known as cultural 
competency training. Such training could include workshops on cultural 
differences to enable caseworkers to better interpret behaviors and 
interactions with their clients. Somewhat fewer states (36) reported 
using initiatives to recruit and retain culturally competent staff. To 
address bias among caseworkers, some of the states we visited required 
that their child welfare workers take an intensive program called 
"Undoing Racism."[Footnote 54] This program has participants analyze 
the ways in which structural racism may affect their decisions through 
dialogue, reflection, role-playing, and presentations.[Footnote 55] In 
addition, officials pointed out that, beyond cultural understanding, 
caseworkers need to understand the challenges of living with economic 
disadvantages so that they can work effectively with their clients. For 
example, one county agency in Iowa required its child welfare workers 
to spend 1 day using public transportation to get to social service 
appointments their clients must attend to better understand the time 
and transportation constraints some people face. Although most survey 
respondents expected cultural competency training to have an impact on 
disproportionality, there is little research linking cultural 
competency training programs to improved outcomes for African American 
children. However, one 3-year evaluation of a comprehensive cultural 
competency program in Washington state, which was initiated 
specifically to address the causes of disproportionality, found that 
families served by staff trained in this approach had a higher rate of 
children returning home than African American children in other areas. 

Because some state data have shown that disproportionality in foster 
care starts with the differing rates of reporting among races, most 
states (37) are also conducting educational outreach for those who work 
with children, such as teachers, health care providers, and social 
workers, who are required to report suspected abuse and neglect. These 
efforts may help ensure that mandated reporters are not inappropriately 
referring families to child welfare. Illinois conducted a widespread 
public awareness campaign for mandated reporters about how to identify 
abuse and neglect. Although some child welfare officials expect this 
outreach strategy to reduce disproportionality, none of the studies we 
examined assessed its effectiveness in that regard. 

Over half of states (29) reported using risk assessment tools, which 
can help caseworkers make more systematic decisions about a child's 
safety and the need to remove a child from the home. Caseworkers use 
these tools when investigating an allegation of child maltreatment to 
systematically collect information about a family and, based on this 
information, more objectively assess the level of risk in keeping the 
child at home. Without such tools, workers may err on the side of 
unnecessarily removing a child from its family, according to some child 
welfare officials. Two studies found particular risk assessment tools 
to be both race-neutral and more accurate predictors of future harm 
than caseworker judgment alone. A 2004 study of five counties in 
California found that minority groups often showed a lower risk than 
Whites when the assessment tool was applied, which means it could help 
to reduce the representation of some groups in the child welfare 
system, according to the author.[Footnote 56] However, some researchers 
express concern that other risk assessments that rely too heavily on 
information related to social conditions and poverty might actually 
contribute to racial bias. Despite the promising research about the 
value of specific risk assessment tools, only about one-third of the 
child welfare administrators surveyed who were using this strategy 
expected it to reduce disproportionality. 

States' Strategies to Improve Families' Access to Services: 

Child welfare agencies are taking action to improve access to services, 
such as providing or arranging for mental health treatment, medical 
care, and housing assistance for low-income people. The strategies 
states are using for this purpose include collaborating with 
neighborhood-based services, establishing interagency agreements to 
improve access to these services, and implementing an alternative 
approach to the removal of children--known as alternative, dual, or 
differential response. Just over half of the states who used each 
strategy reported in the survey that they expected it to reduce 
disproportionality. (See fig. 9.) 

Figure 9: Strategies to Improve Access to Support Services: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

Thirty-eight states reported using neighborhood-based support 
organizations to improve access to and use of support services. 
Neighborhood-based services can improve access to supports for parents 
because they are often more conveniently located to parents' homes and 
more likely to be staffed by people familiar with issues particular to 
their ethnic community. For example, child welfare officials in Los 
Angeles County told us that they went door to door in minority 
neighborhoods to find service providers beyond those with whom they 
have historically contracted. They subsequently heard that this 
collaboration helped to increase trust between the community and the 
child welfare system and increased use of these services. Similarly, 
one county in North Carolina convened a task force of schools, police, 
and community groups to examine and identify what support services were 
available to families. An HHS report synthesizing the views of child 
welfare workers in eight states noted that working with community-based 
services holds promise for reducing disproportionality because they are 
more accessible and provide services in a culturally appropriate 
context.[Footnote 57] 

Interagency agreements, used by 34 states, may improve families' 
ability to obtain services and supports they need from agencies outside 
of child welfare, which are primarily provided and funded through other 
state agencies. To address gaps in the provision of services like 
substance abuse treatment and financial supports,[Footnote 58] agencies 
can work with one another in any of the following ways: training staff 
jointly, sharing information and tracking systems, using common intake 
and assessment forms, coordinating case management, and placing staff 
from multiple agencies in the same office. Some child welfare officials 
told us they were reluctant to share information about overlapping 
clients because of federal privacy laws,[Footnote 59] while other local 
officials described methods they use to share information across 
systems. For example, the child welfare agency in San Francisco uses 
court agreements with other agencies, such as juvenile justice and 
mental health, to share information about families who are involved in 
multiple systems, and county officials report that these agreements 
enable them to better serve these families. Although we found no 
studies on the effectiveness of inter-agency agreements in reducing 
disproportionality, many child welfare officials expected that this 
strategy could have an impact. 

Another approach used by slightly more than half of states is 
differential or alternative response, which is a way for states to 
provide services to families when the risk of abuse and neglect is 
judged to be lower in lieu of removing children from their homes. 
Differential response can be used when maltreatment is not related to 
physical and sexual abuse, but instead to conditions of chronic 
poverty, chemical abuse, or domestic violence. For example, some 
California counties have three tracks for assessing families, depending 
on a family's situation. In the first track, if the case involves abuse 
and neglect and the risk is considered moderate to high for continued 
abuse, the caseworker may take action to remove the child with or 
without the family's consent, court orders may be involved, and 
criminal charges may be filed. In the second track, if the risk of 
continued abuse and neglect is lower, families work with 
representatives of county child welfare agencies to identify services 
for improving child and family well-being. In the third track, if an 
allegation is not considered abuse, the family is linked to services in 
the community through expanded partnerships with local organizations. 
Evaluations of alternative response in some states have shown this 
strategy to have promise for addressing the factors that may lead to 
the disproportionate number of African American children in care. 
Evaluations in Missouri and Minnesota[Footnote 60] found that use of 
alternative response increased cooperation between families and the 
child welfare agency. The Minnesota study also found that families who 
participated in the alternative response system received significantly 
greater access to support services and also a lower rate of new 
maltreatment reports than families in a control group. 

States' Strategies for Increasing the Availability of Permanent Homes: 

States are also devising strategies to increase the number of permanent 
homes for African American children who cannot be reunified with their 
parents so as to reduce the length of time they remain in foster care 
and increase the likelihood that they will be adopted. To do this, many 
states are increasing the search for fathers and paternal kin, making 
efforts to recruit more African American adoptive parents, and 
providing financial subsidies for caregivers (often relatives) who are 
willing to act as permanent guardians for foster children. (See fig. 
10.) 

Figure 10: Strategies to Reduce Length of Stay in Foster Care: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

Almost all states surveyed reported that they take action to search for 
paternal kin when making decisions on where to place a child. Until 
recently, caseworkers did not routinely gather information on fathers, 
according to child welfare workers we spoke with. As foster care 
agencies have placed greater reliance on placing children with 
relatives, however, fathers and paternal relatives are increasingly 
being viewed as potential caregivers. Greater efforts to locate fathers 
and paternal kin are particularly relevant for African American 
families who are less likely to have a father living with the family at 
the time of their involvement with the child welfare agency. Officials 
we visited in Illinois, North Carolina, and New York told us that they 
had instituted changes so that searching for paternal kin was routine. 
One county in North Carolina requires social workers to use a 
structured protocol in contacting and gathering information from the 
father about family members as potential resources. This approach can 
allow fathers and other paternal relatives to take a much more active 
role in their child's life to prevent out-of-home placements. About two-
thirds of states using this strategy expected it to reduce 
disproportionality, but there is relatively little research on the role 
of fathers in child welfare cases in general. 

Although 38 states reported that, to some extent, they are recruiting 
African American adoptive families, states still face challenges. 
States are required by law to diligently recruit foster and adoptive 
parents who reflect the racial and ethnic backgrounds of children. 
States have adopted various strategies, such as contracting with faith- 
based organizations and convening adoption support teams, to recruit 
greater numbers of African American adoptive parents. However, despite 
these efforts the overall number of African American children adopted 
by African American parents has not substantially increased in the past 
8 years. In addition, HHS's 2001-2004 review found that only 21 of 52 
states were sufficiently recruiting minority families, and a recent 
report found that the recruitment of minority families was one of the 
greatest challenges for nearly all states. 

Using subsidized guardianship as an alternative to adoption may hold 
particular promise for reducing disproportionality, and more than half 
of the states surveyed (30) reported using this strategy.[Footnote 61] 
African Americans are more likely than White children to be placed with 
relatives for foster care, and relative foster care is generally longer 
term.[Footnote 62] These relative caregivers are also more likely than 
non-relative foster parents to be low-income.[Footnote 63] They may be 
unwilling to adopt because they may find it difficult financially to 
forego foster care payments or because adoption entails terminating the 
parental rights of their kin. However, states can provide a way for 
foster children living with relatives to convert this to a more 
permanent arrangement by creating subsidized guardianship programs. 
These programs provide financial subsidies for foster parents (often 
relatives) who agree to become legally responsible for children, but 
are unable or willing to adopt. When Illinois and California 
implemented two of the largest of such programs, they subsequently saw 
an increase in permanent placements for all children.[Footnote 64] 
After instituting their subsidized guardianship programs, over 40 
percent of children who were in long-term relative foster care in both 
states found permanency. In Illinois, this decrease also coincided with 
a reduction in disproportionate numbers of African American children in 
foster care.[Footnote 65] HHS officials also pointed out that these 
programs can be cost-neutral because the administrative costs 
associated with maintaining a child in foster care are no longer 
incurred with permanent legal guardianships. All seven states that used 
federal waivers to subsidize their guardianship programs with Title IV- 
E funds did so in a cost-neutral manner, as required by the waivers. 

Fewer States Implemented Strategies That Focused Attention Specifically 
on Disproportionality: 

Although many states we surveyed are employing the types of strategies 
that hold promise for reducing the proportion of African American 
children in foster care, fewer states were focusing attention 
specifically on disproportionality as a policy issue.[Footnote 66] Such 
strategies included establishing councils on disproportionality, 
requiring child welfare contractors to address disproportionality, and 
targeting preventive services to African American families.[Footnote 
67] While these strategies may not necessarily be more effective than 
other strategies, they do represent a public acknowledgment of the 
issue and may be considered a starting point for further activity. 
States were much less likely to use these strategies compared with 
other strategies in our survey. A total of 15 states had established 
disproportionality councils or commissions that can provide leadership 
in addressing the issues. According to a report by the National Council 
of State Legislatures, the Illinois African-American Family Commission 
has the broad mandate to monitor legislation and programs, and assist 
in designing new programs on behalf of African American families, as 
well as facilitate the participation of African Americans in 
establishing community-based services. In addition, 13 states reported 
in our survey that they were targeting preventative services to African 
American families, and 11 states had some requirements for contracted 
agencies to address disproportionality. For example, child welfare 
officials in Kentucky reported that they were making a concerted effort 
to contract with service providers that can demonstrate their knowledge 
or understanding of the issue of disproportionality. 

Data, Leadership, and Working across Social Service Systems Are Key 
Elements to Address Disproportionality: 

Collecting, analyzing, and disseminating data were considered 
fundamental aspects of states' efforts to address disproportionality. 
These data can include not only disproportionality rates (as described 
in appendix II), but also information that identifies the extent to 
which disproportionality occurs, among ages, along the child welfare 
process, and geographically. For example, a researcher at the 
University of California at Berkeley has used state data to show that 
African American infants enter at a much higher rate than other 
children (see fig. 11). However, this disproportionality grows as 
children get older, because African American children are also less 
likely to exit foster care; and the foster care population for all ages 
then becomes disproportionally African American (see fig. 12). Child 
welfare officials in most of the states we visited used their data to 
show that as a child moved through the child welfare process from 
having a case reported, then investigated, then being removed from the 
home, disproportionality increased at each decision point. Lastly, 
researchers in Illinois learned that disproportionality rates were 
actually higher in the rest of the state than in Cook County, the main 
urban county containing Chicago and over half of the state's foster 
care population. 

Figure 11: Children Entering Foster Care in California in 2005: 

[See PDF for image] 

Source: Center for Social Services Research, University of California 
at Berkeley. 

[End of figure] 

Figure 12: Children in Foster Care in California in 2005: 

[See PDF for image] 

Source: Center for Social Services Research, University of California 
at Berkeley. 

[End of figure] 

Using data is considered crucial in identifying where 
disproportionality occurs in the child welfare process in order to 
devise strategies to most effectively address the issue. For example, 
when they analyzed state-level data, Texas officials realized that it 
was difficult to find foster care placements in close proximity to the 
birth family, making it difficult for African American children to be 
reunified with their families. To address this problem, Texas provided 
automated support for tracking the vacancies of foster homes and 
facilities. Data can also be useful for building consensus among 
community leaders, practitioners and policy-makers. Researchers in 
Illinois shared data on disproportionality with child welfare 
supervisors and caseworkers to increase their awareness that once an 
African American child is removed from the home, they are more likely 
to spend longer time in foster care. In Guilford County, North 
Carolina, child welfare officials shared data to show teachers, who are 
also mandated reporters, how disproportionality increases as a child 
moves from being referred, to investigated, to placed into foster care. 
Despite the importance of data collection, 18 states we surveyed 
reported that they were not regularly using data in their efforts to 
address disproportionality. 

In states we visited, child welfare officials also agreed that 
sustained leadership was fundamental to the process of identifying and 
addressing disproportionality. Members of the Child Welfare League of 
America's Cultural Competence and Racial Disproportionality and 
Disparity of Outcomes Committee told us that initiatives generally take 
root through the efforts of a person or organizations that champion the 
issue. All of the states we visited had some support from the Casey 
Foundation, and four states were involved with Casey's Breakthrough 
Series Collaborative, which focuses specifically on having child 
welfare professionals test new ideas and strategies to address racial 
disproportionality.[Footnote 68] Without such leadership, officials who 
have many competing priorities may be reluctant to tackle a politically 
sensitive issue. For example, child welfare workers in one county 
expressed concern that their efforts to address disproportionality 
would diminish when their Social Services Director -
-who was highly committed to addressing disproportionality--retired. 
According to the National Conference of State Legislatures, six states 
have enacted state legislation to address disproportionality. These 
laws generally create commissions or task forces, require a study of 
the issue, or fund special projects to address disproportionality. For 
example, a Texas law required an analysis of data to determine whether 
child welfare enforcement actions were disproportionately initiated 
against any racial or ethnic group.[Footnote 69] In addition, some 
states included some discussion of African American disproportionality 
in their state child welfare plans. California, for example, pledged to 
meet the target of increasing the service provisions specifically for 
Native American and African American children. 

Finally, state child welfare officials, researchers, and other experts 
stressed the need to work across different social service systems 
because many of the factors that contribute to disproportionality lay 
outside the child welfare system. For example, one child welfare 
official we interviewed observed that efforts to address 
disproportionality in one system (e.g., child welfare) can be undone by 
lack of diligence in another (e.g., housing). Additionally, some state 
officials said that there was a need for collaboration among social 
service agencies, such as juvenile justice and education, because 
disproportionality in child welfare often results when families have 
not had their service and support needs met by other agencies. 

Although HHS Has Provided Assistance and Guidance, States Report That 
More Information and Technical Assistance Is Needed: 

HHS has made available technical assistance, guidance, and information 
to states on disproportionality at conferences, workshops and through 
various HHS Web sites. Since 2004, disproportionality and cultural 
competency have been discussed at training and technical assistance 
meetings attended by members of HHS's network of National Resource 
Centers, and since 2006 these issues have been a priority area for the 
network, according to HHS officials. Currently, HHS provides states and 
localities with information on disproportionality through various 
National Resource Center Web sites and the Children's Bureau 
Information Gateway Web site, such as links to literature examining 
various strategies and audio files of past teleconferences discussing 
disproportionality. HHS also provides guidance and information on 
promising approaches as well as technical assistance and training to 
improve states' efforts to find minority foster care and adoptive 
parents through its AdoptUsKids initiative and Web site. In 2003, HHS's 
Children's Bureau also published a study examining 
disproportionality[Footnote 70] and the Office of Planning, Research 
and Evaluation summarizes other published and unpublished research 
findings on disproportionality on its Web site. 

Although HHS does not require states to collect or report information 
on disproportionality, the agency has included state-based data on 
disproportionality in its Annual Child Welfare Outcomes Report to 
Congress. In addition, through an initiative known as the Culturally 
Competent Practice Knowledge Management Initiative, the agency is 
compiling an inventory of tools and best practices for addressing 
disproportionality. According to HHS officials, the agency plans to 
make this information available to consultants within its network of 
National Resource Centers to use in providing training and technical 
assistance to states and localities, but as of April 2007, HHS had not 
determined whether or how to make this information publicly available. 

As a whole, child welfare administrators we surveyed reported that in 
their view, their own states should be doing more to address 
disproportionality but added that having additional resources, 
including information on promising practices and technical assistance, 
would be useful in their efforts. Forty-two states reported that 
additional resources were needed to apply known strategies to reduce 
the disproportionality of African American children. All six states we 
visited were using funds from a private foundation, Casey Foundation, 
to support their initiatives. Similarly, 41 states reported that having 
information on best practices to address racial disproportionality 
would be at least moderately helpful to them. In responding to the 
survey, officials from one state noted that Casey Family Programs had 
developed helpful strategies to address the issue, and officials from 
another state noted that having a central federal repository to share 
information across states, including descriptions and evaluations of 
promising strategies, would help them more effectively address 
disproportionality. 

Twenty-five states also reported that receiving technical assistance 
from HHS in calculating disproportionality and tracking it over time 
would be useful.[Footnote 71] Some of these states volunteered through 
written comments that this additional assistance would be useful 
because state and local agencies have limited capacity to analyze or 
track disproportionality-related data. Nearly all of the states we 
visited had assistance from local universities or research institutes 
in analyzing data on disproportionality. California state child welfare 
officials told us that without the aid of a university researcher, they 
would not have the ability to help counties that lack the capacity to 
collect and analyze their data. At the time of our survey, eighteen 
states reported that they were not regularly analyzing or using data in 
their efforts to address disproportionality. 

Some child welfare officials and researchers we interviewed reported 
that the leadership and efforts made by the Department of Justice, 
Office of Juvenile Justice and Delinquency Prevention (OJJDP), to 
address the disproportionate representation of minorities in the 
juvenile justice system could serve as a model for child welfare. In 
response to similar issues with racial disproportionality, the Justice 
Department has overseen states' efforts in addressing 
disproportionality in the juvenile justice system, as mandated. To 
carry out its mission, OJJDP has established reporting requirements for 
states; provided guidance, technical assistance, and information on 
promising practices through a centralized location on the OJJDP Web 
site; and conducted regular conferences and training sessions for over 
a decade on the issue. According to a key official from OJJDP and a few 
state juvenile justice coordinators we interviewed, because of the 
legal mandate and federal funding provided over time, OJJDP's efforts 
have helped states implement strategies intended to reduce 
disproportionate minority contact in the juvenile justice system. As of 
2005, nearly all eligible states and territories have devised plans to 
address disproportionality and regularly submit reports to OJJDP. 

States Reported That Some Current Federal Policies May Reduce the 
Disproportion of African American Children in Care, While Other 
Policies May Increase It: 

Federal policies that support services to families and adoption were 
generally considered helpful in reducing the proportion of African 
Americans in foster care, but policies that limit funds for prevention 
and legal guardianship were reported to have a negative effect, 
according to our review. Although it is difficult to isolate the effect 
of any one policy,[Footnote 72] many states reported that federal block 
grants that can be used to provide services to families help reduce 
disproportionality. At the same time, even more states reported that 
other policies constraining the use of federal child welfare funds work 
against this goal. States generally reported that policies promoting 
adoption-such as subsidies to families adopting children with special 
needs and the requirement to recruit minority adoptive parents-have 
been helpful, but wanted more support for legal guardianship. In 
particular, states considered the federal policy recognizing legal 
guardianship as helpful in enabling children to exit foster care, but 
policies limiting the use of federal funds to pay subsidies to 
guardians as a barrier. Federal policies that impose time frames on 
caseworkers for making permanency decisions may shorten the time 
children remain in care but may also impede states' ability to reunify 
children with their parents. 

Policies That Support Services to Families Were Considered Helpful, but 
Some Funding Policies Constrain States' Ability to Reduce 
Disproportionality: 

According to states we surveyed, having federal block grant funds 
available to provide services to families contributes to reducing the 
proportion of African American children in foster care compared to 
children of other races and ethnicities. However, policies that limit 
federal child welfare funds for preventive services or other purposes 
besides maintenance payments to foster care families are viewed as 
having a negative effect. (See fig. 13.) 

Figure 13: States' Views on Impact of Funding Policies on 
Disproportionality: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

In our survey, 23 states reported that the ability to use TANF block 
grant funds to provide parenting classes, substance abuse treatment 
programs, and payments to guardians who are relatives contributes to a 
reduction in the proportion of African American children in care in 
their states.[Footnote 73] Many officials and researchers we 
interviewed told us that having an adequate level of preventive 
services and family supports was particularly relevant for African 
American families living in poverty. However, as with all block grants, 
state officials determine the use of these funds and their program 
priorities. TANF funds used for child welfare in 2004 ranged from zero 
percent in eight states to 51 percent of Connecticut's total federal 
funds for such purposes, according to an Urban Institute 
report.[Footnote 74] Some officials from local child welfare agencies 
we interviewed also noted that because they did not have a steady 
source of funds for child welfare activities, it was difficult to plan 
for and provide preventive and family support services to these 
families. In a recent GAO report, states cited such services as the 
ones most in need of greater federal, state or local 
resources.[Footnote 75] 

Other policies constrain the amount of federal child welfare funds 
states can spend on services to support families, and states reported 
that these policies contributed to the disproportion of African 
American children in foster care. Of particular concern to 28 states 
were limitations on the use of federal funds under Title IV-B, which 
funds preventative and family support services. Under this part of the 
law, states are entitled to no more than their specified share of 
annual funding regardless of the number of families they serve in a 
year. These IV-B prevention funds can help divert children from foster 
care by providing services to their families and also help children 
exit foster care by providing supports to adoptive families and 
guardians. Yet the majority of federal funding for child welfare is 
distributed as payments for maintaining children already in foster care 
homes under another part of the law, Title IV-E. [Footnote 76] 

Twenty-five states we surveyed reported that the limited use of Title 
IV-E funds for other purposes besides making maintenance payments to 
foster care families, such as providing services to families, 
contribute to the proportion of African American children in care. 
According to California and Minnesota officials, because the majority 
of federal child welfare funds are used for foster care payments 
instead of preventive services, federal funding policies did not align 
with states' efforts to reduce the number of children entering foster 
care by serving at-risk children safely in their homes.[Footnote 77] 
Previous GAO work as well as other research has noted that federal 
child welfare funding favors reimbursement for foster care placements, 
while providing less support for services to prevent such 
placements.[Footnote 78] Every year since fiscal year 2004, the 
administration has proposed in its budget the creation of a Child 
Welfare Program Option under which states would have the option to 
receive federal foster care funds in the form of flexible grants, which 
they could use to fund a range of child welfare services and 
activities.[Footnote 79] This proposal has not been introduced as 
legislation. 

States Generally Viewed Federal Policies on Adoption as Helpful, but 
Other Policies Limit State Efforts to Find Alternate Placements or 
Reunify Families: 

In responding to our survey, states considered certain federal policies 
as helpful in reducing disproportionality, especially adoption policies 
and the recognition of guardianship. However, states viewed the lack of 
subsidies for guardianship and policies affecting the licensing of 
foster care and adoptive families as contributing to 
disproportionality. Views were mixed on federal policies that impose 
time frames for making permanency decisions. 

Adoption and Guardianship: 

Among federal policies that affect states' ability to find permanent 
homes for children, those that promote adoption were believed to reduce 
the proportion of African American children in foster care, according 
to our survey results. Although the recognition of guardianship as a 
placement option under federal law was also considered helpful, state 
and local officials reported that the lack of federal reimbursement for 
subsidies to guardians constrained their ability to place children in 
such arrangements. (See fig. 14.) 

Figure 14: States' Views on Impact of Adoption and Guardianship 
Policies on Disproportionality: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

In our survey, 22 states reported that the requirement to diligently 
recruit minority families contributes to a decrease in the proportion 
of African American children in care. According to officials from 
Illinois, New York, and North Carolina, the requirement to diligently 
recruit minority families has had a positive impact on moving African 
American children into permanent homes. For example, this requirement 
broadened the role and use of extended family as possible caregivers 
for children, according to an HHS survey of child welfare 
workers.[Footnote 80] 

State officials told us that it was a challenge to recruit a racially 
and ethnically diverse pool of potential foster and adoptive parents, 
as evidenced by the fact that more than half of states are not meeting 
HHS performance goals for recruitment.[Footnote 81] State officials 
noted the shortage of willing, appropriate, and qualified parents to 
adopt African American children, particularly older children, and 
researchers also cited a lack of resources among state and local 
agencies and federal guidance to implement new recruiting and training 
initiatives.[Footnote 82] Perhaps because of these challenges, 9 states 
in our survey reported that the policy requiring diligent recruitment 
had no effect on the proportion of African American children in care, 
and 15 states reported that they were unable to tell. Over the last 5 
years, African American children as well as Native American children 
have consistently experienced lower rates of adoption than children of 
other races and ethnicities, according to HHS adoption data. (See fig. 
15.) 

Figure 15: Adoption Rates for All Children, 2001 through 2005: 

[See PDF for image] 

Source: GAO analysis of HHS reported AFCARS data. 

Note: Adoption rates are calculated as total estimated count of 
adoptions with public agency involvement finalized during the year of 
interest divided by the number of children waiting to be adopted on the 
last day of the prior year. Children waiting to be adopted are defined 
by HHS as those children who have goal of adoption and/or have parental 
rights terminated, excluding children with termination of parental 
rights who are 16 and older and have the goal of emancipation. 

[End of figure] 

Providing adoption incentive payments to states generally helps reduce 
the proportion of African American children in care, according to our 
survey; however, these benefits may not be sustainable over time. In 
our survey, 20 states reported that these federal incentive payments 
provided to states for increasing adoptions contributes to reducing the 
proportion of African American children in care. A state official from 
Texas's child welfare agency told us that in 2005 the state received 
the highest adoption incentive payments among all states and that the 
number of African American children adopted has increased each year 
since 2004. However, states face challenges under this program because 
they must reach higher benchmarks each year to continue to earn 
adoption incentive payments. While the total number of adoptions 
nationally increased significantly in the late 1990s, since 2000 
adoption rates have reached a plateau, according to HHS data and other 
research. 

Twenty states reported that the federal policy that provides subsidies 
to parents who adopt a child considered as having special needs 
contributes positively to reducing the proportion of African American 
children in foster care.[Footnote 83] Of African American children who 
were adopted from foster care in 2004 who states classified as having 
special needs, the child's race provided the basis for the 
classification in 20 percent of cases. In contrast, race was the basis 
for the classification of about 10 percent of Hispanic, Asian, and 
Native American adopted children who were determined to have special 
needs in that year. 

The federal policy encouraging race-neutral adoptions was believed to 
have less effect than other policies on the proportion of African 
American children in foster care.[Footnote 84] Intended to eliminate 
race-related barriers to adoption, MEPA-IEP prohibits foster care and 
adoption agencies that receive federal funds from delaying or denying 
placement decisions on the basis of race, color or national origin. 
Although 15 states reported that encouraging race-neutral adoptions 
would help reduce disproportionality, 18 states responded that this 
policy had no effect, and an additional 12 states reported that they 
were unable to tell. An HHS 2003 study of child welfare agencies, 
staff, and partner agencies noted that confusion and a general lack of 
knowledge regarding what the law allowed or prohibited hindered its 
implementation. In support of this finding, child welfare officials we 
spoke with in Illinois and Texas also noted that child welfare workers 
may misunderstand or fear that they are not complying with the law's 
prohibition. These officials stated that in some cases child welfare 
workers may be less likely to place African American children with 
relatives or in African American adoptive homes because they mistakenly 
believe that the law prohibits or discourages same-race adoptions. 
Other researchers and officials told us they opposed the law's intent 
and were concerned about the detrimental effects of placing children 
with parents of another race on a child's well being.[Footnote 85] Some 
officials we interviewed stated that race should be given first 
priority in placing African American children in families for care as 
is done for Native American children under the Indian Child Welfare Act 
of 1978 (ICWA).[Footnote 86] According to a judge we interviewed in 
North Carolina, the encouragement of race-neutral adoptions led in some 
cases to African American children being placed in cross-racial homes 
in which they felt disconnected from their heritage. 

In addition to adoption, many child welfare officials and researchers 
we interviewed considered legal guardianship a particularly important 
way to help African American children exit foster care. Legal 
guardianship was formally recognized under federal law as another 
option for placing children in permanent homes.[Footnote 87] Some 
African American families, especially relatives, are reluctant to adopt 
because they do not want to terminate the parental rights of the 
child's parent, according to officials and researchers we interviewed. 
Legal guardianship allows a household to establish a permanent home for 
a child without terminating the parental rights of the birth parents. 
Seventeen states in our survey reported that this federal policy was 
believed to help decrease the proportion of African American children 
in their states' foster care systems. In California and Illinois, 
subsidized guardianships have been found to reduce the number of 
children in foster care, including African American children. In 
California about 16,000 children exited the state foster care system 
between 2000 and 2005 through their kinship guardianship program, and 
about 43 percent of these children were African American, according to 
data from state officials. Based on the results of the Illinois waiver 
and other states with waivers, subsidized guardianships have also been 
found to be at least cost neutral. 

However, according to state child welfare directors we surveyed and 
interviewed, the lack of federal reimbursement for subsidies to 
guardians constrained states' ability to place African American 
children in guardianship arrangements. In many cases, families that 
could otherwise serve as guardians lack the financial stability to 
permanently care for children without support, according to officials 
and researchers we interviewed. However, unless states are one of the 
seven that have a current federal demonstration waiver for assisted 
guardianship or kinship permanency programs, states cannot use federal 
child welfare funds to provide subsidies to legal guardians.[Footnote 
88] 

According to state and local child welfare officials, states would like 
to have more flexibility to use Title IV-E funds for supporting 
guardianship placements, as is done with adoption. In discussions with 
us, HHS officials stated that the Administration's proposed Child 
Welfare Program Option would provide states with the flexibility to use 
Title IV-E funds for the entire range of child welfare purposes, 
including assisted guardianship. However, although an HHS official said 
that guardianship was not considered as permanent as adoption, the 
results for the child have been found to be essentially the same. In 
the Illinois evaluation, guardianship and adoption both provide 
comparable levels of stability for the child and showed similar 
outcomes in terms of children's emotional and physical health. 

Licensing and Time Frames: 

Federal policies regarding licensing, such as those that limit 
reimbursement for costs associated with the use of unlicensed relative 
caregivers and require criminal background checks on prospective 
caregivers, contribute to the disproportionality of African American 
children in foster care, according to states we surveyed. To a lesser 
extent, state officials reported that federally mandated time frames 
determining a child's permanency plan and whether parental rights 
should be terminated also had a negative effect. (See fig. 16.) 

Figure 16: States' Views on Impact of Federal Policies on Licensing and 
Time Frames for Making Permanency Decisions on Disproportionality: 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

States considered federal policies on the licensing and the use of 
relatives to provide foster care as increasing the proportion of 
African American children in foster care. In some cases, states 
permanently place children with unlicensed relatives who are neither 
adoptive parents nor guardians; however, states cannot claim federal 
reimbursement for such kinship care.[Footnote 89] In our survey, 20 
states reported that this policy limiting reimbursement for costs 
associated with the use of unlicensed relative caregivers contributed 
to the disproportionality of African American children by hindering 
their ability to place children with relatives. According to 
researchers and state officials we interviewed, such policies have a 
disproportionate impact on African American children because they are 
more likely to live with unlicensed relatives. These relatives may be 
able to provide safe homes for children but may also be more likely 
have lower incomes and have difficulty meeting foster care licensing 
requirements, such as having a certain number of bedrooms. 

Eighteen states reported that federal policies requiring states to 
perform criminal background checks on prospective caregivers, including 
relatives, contributes to disproportionality, while other states 
reported that these policies had no effect. Among child welfare 
officials and others we interviewed, some were concerned that federal 
law requiring states to conduct fingerprinting checks for prospective 
parents or other types of background checks on all adults in the 
household may deter some African American relatives from stepping 
forward as caregivers. However, 16 states saw federal policy on 
criminal checks as having no effect. This may be in part due to the 
fact that most states have their own requirements regarding background 
checks that are similar to or more stringent than federal 
requirements.[Footnote 90] 

Until recently, states could opt out of federal requirements for 
criminal background checks on prospective foster care and adoptive 
parents, but that provision was eliminated by the recently enacted Adam 
Walsh Child Safety and Protection Act. For the eight states that opted 
out of the federal requirements, federal regulations require them to 
verify that safety considerations with respect to the prospective 
foster or adoptive parents have been addressed.[Footnote 91] Some 
officials were concerned that the federal policy would limit their 
ability under previous policy to place African American and other 
children with relatives and other families. California and New York 
officials told us that their alternative plans allow them the 
flexibility to make exemptions case-by-case for foster care, adoptive, 
or guardianship families, typically relatives, that have past 
convictions that would otherwise be automatically prohibited by federal 
law.[Footnote 92] Although such exemptions make up a comparatively 
small proportion of total placements for children,[Footnote 93] state 
and county officials in California told us that their inability to make 
these exemptions beginning October 2008--when the prohibition on 
states' ability to opt out of federal requirements goes into effect-- 
may have a disproportionate impact in the placement of African American 
children with relatives or other families who they consider safe and 
appropriate for children. 

State officials had mixed views on federal policies that impose time 
frames on permanency decisions that affect whether children will be 
reunified with their parents or placed in an alternative home.[Footnote 
94] About a third of states reported that federal policy requiring that 
states adhere to certain time frames for initiating plans to place 
children in permanent arrangements and for terminating parental rights 
contributed to an increase in the proportion of African American 
children in care. Some state officials and researchers we interviewed 
said that these time frames were not reasonable for some African 
American parents who have complex problems, such as substance abuse and 
mental health issues, that require more time to resolve or if they have 
difficulty in accessing services.[Footnote 95] When parental rights are 
terminated, some children become "legal orphans" and remain in foster 
care longer than if parents had been given more time to complete their 
reunification plans.[Footnote 96] According to an HHS official's 
analysis of AFCARS data, the percentage of children who have had their 
parental rights terminated but who did not find a permanent home and 
ultimately emancipated out of the foster care system increased from 3.3 
percent in 2000 to 6.7 percent in 2005.[Footnote 97] On the other hand, 
some child welfare officials reported that the ASFA time frames have 
been helpful in ensuring that children do not languish in care and have 
helped reduce the proportion of African American children in care. 

Conclusions: 

Issues surrounding the disproportionate representation of African- 
American children in foster care are pervasive, continuing, and 
complex. They cut across different points in the child welfare process-
-from before entry to exit from foster care--and they affect nearly all 
states in this nation to varying degrees. 

In efforts to reduce African American representation in foster care, 
state and local child welfare agencies face numerous challenges. These 
challenges include ensuring that decisions to place a child in foster 
care are not influenced by bias or cultural misconceptions about 
families or communities, and that parent's difficulties in accessing 
support services do not prevent a child from returning home. Adding to 
these challenges is the fact that many supports and services are 
provided through multiple social service systems and require actions 
outside the responsibility of child welfare agencies, such as the 
ability to obtain timely substance abuse treatment for parents or the 
availability of affordable housing. To facilitate access to services, 
state and local agencies bear the primary responsibility for 
coordinating and administering these services. 

To some extent, federal policies on adoption have supported states' 
efforts to reduce the foster care population, but among policies aimed 
at reducing the number of minority children in foster care, many states 
experienced challenges recruiting sufficient minority families that 
reflect the foster care population. African American children have 
generally seen lower adoption rates than children of other races, and 
in recent years the adoption rate for all children has reached a 
plateau. States report being constrained by the lack of federal 
subsidies for legal guardianship similar to those provided for 
adoption. Many consider legal guardianship to be more reflective of the 
cultural values held by some African Americans and other families of 
color and better suited to the needs of African American and Hispanic 
families who want to permanently care for related children without 
necessarily adopting them. As a strategy, subsidizing guardianships has 
demonstrated its value in providing permanent families for children and 
in reducing the number of African American children in foster care. It 
may also be cost-effective, given the experiences of the states that 
implemented this strategy using federal waivers. This may therefore be 
the time to reconsider the current distinctions that provide subsidies 
for adoption but not for guardianship. 

The importance of collecting and analyzing data by race is considered a 
crucial first step for addressing racial disparity within child welfare 
and other systems. Yet some states and localities report a lack of 
capacity to collect or analyze data that would better allow them to 
identify the strategies that would be most useful in addressing the 
problems in their state. HHS provides assistance to states on data 
analysis and practices through its technical assistance network and 
related Web sites, although the agency lacks the directive and funding 
that Department of Justice officials said were instrumental to their 
efforts to analyze data by race and provide guidance on promising 
practices. In response to this directive, states that have identified 
disproportionality in juvenile justice as an issue have regularly 
submitted reports to OJJDP and have devised plans to address the issue. 
In child welfare, states identified as being in the forefront of 
efforts to address disproportionality are relying on private 
organizations to provide financial and technical assistance. In the 
absence of research-based evidence on strategies that work for 
addressing disproportionality, states are seeking out promising 
practices used in other states. Despite the steps that HHS has taken to 
disseminate information about these strategies, states report that they 
need further information and technical assistance to strengthen their 
current efforts in addressing disproportionality. 

Matter for Congressional Consideration: 

To assist states in increasing the number of homes available for the 
permanent placement of African American and other children from foster 
care, we suggest that Congress consider amending federal law to allow 
federal reimbursement for legal guardianship similar to that currently 
provided for adoption. 

Recommendation for Executive Action: 

To enhance states' ability to reduce the proportion of African American 
children in foster care, the Secretary of HHS should further assist 
states in understanding the nature and extent of disproportionality in 
their child welfare systems and in taking steps to address the issue. 
These actions should include: 

* Encouraging states to regularly track state and local data on the 
racial disproportionality of children in foster care and use these data 
to develop strategies that can better enable them to prevent children's 
entry into foster care and speed their exit into permanent homes. HHS 
should also encourage states to make increased use of HHS's National 
Resource Centers as a source of technical assistance on this issue. 

* Completing and making publicly available information on 
disproportionality that the agency is developing under its Culturally 
Competent Practice Knowledge Initiative so that states have easier 
access to tools and strategies useful for addressing the issue. 

Agency Comments and Our Response: 

We provided a draft of this report to HHS for review and comment. HHS's 
written comments are provided in appendix III of this report. 

Our draft report included a recommendation that HHS pursue specific 
measures to allow federal reimbursement for legal guardianship. In 
commenting on the draft report, HHS disagreed with the recommendation, 
stating that the administration had already proposed a broad 
restructuring of child welfare funding, known as the Child Welfare 
Program Option, which would allow states to use federal funds for legal 
guardianship. Under this proposed restructuring of child welfare, 
states could choose to remain under the current foster care funding 
structure or they could instead receive a capped grant for a period of 
5 years. States choosing the grant option would have the flexibility to 
use these funds for a wide range of child welfare purposes, including 
subsidizing guardianships. The current adoption assistance program 
would remain the same under this proposal. However, HHS has presented 
this option in its budget proposals each year since 2004, but no 
legislation has been offered to date to authorize it. Moreover, if 
enacted, it is unknown how many states would choose a capped grant that 
would allow greater program flexibility instead of the current title IV-
E foster care entitlement funding. In light of these factors, we 
suggest that Congress consider taking action to allow adoption 
assistance payments to be used for legal guardianship. Current evidence 
indicates that such a change could help states increase the number of 
permanent homes available for African American and other children in 
foster care. Furthermore, some states have demonstrated this change can 
be achieved without increasing program costs. We have changed the final 
report to delete our recommendation to HHS and to include instead this 
matter for congressional consideration. 

In response to our recommendation that HHS take certain actions to 
further assist states in understanding and addressing the nature and 
extent of racial disproportionality in their child welfare systems, HHS 
stated that these actions were consistent with their current technical 
assistance efforts to encourage and assist states in addressing racial 
disproportionality. For example, HHS cited the variety of technical 
assistance available to states in areas such as data analysis and 
cultural competency. However, HHS did not address the specific actions 
that we recommended related to encouraging states to regularly track 
and use child welfare data on racial disproportionality and completing 
and making publicly available the information on disproportionality 
that it is developing through its Culturally Competent Practice 
Knowledge Initiative. We continue to believe that it is important for 
HHS to take these actions to further equip states to address this 
complex issue. 

As agreed with your office, unless you publicly announce its contents 
earlier, we plan no further distribution of this report until 30 days 
from its issue date. At that time, copies of this report will be sent 
to the Secretary of HHS, relevant congressional committees, and other 
interested parties. We will also make copies available to others upon 
request. In addition, the report will be made available at no charge on 
GAO's Web site at http://www.gao.gov. 

Please contact me at (202) 512-7215 if you or your staff have any 
questions about this report. Contact points for our Offices of 
Congressional Relations and Public Affairs may be found on the last 
page of this report. GAO staff who made major contributions to this 
report are listed in appendix IV. 

Signed by: 

Denise M. Fantone, Acting Director: 
Education, Workforce, and Income Security Issues: 

[End of section] 

Appendix I: Objectives, Scope, and Methodology: 

Objectives: 

For this study, we were asked to analyze (1) the major factors that 
have been identified as influencing the proportion of African American 
children entering and remaining in foster care compared to children of 
other races and ethnicities; (2) the extent that states and localities 
have implemented strategies that appear promising in addressing African 
American representation in foster care; and (3) the ways in which key 
federal child welfare policies may have influenced African American 
representation in foster care. Although we focused on African American 
children in this report, we also noted points of similarity or 
difference with children of other races and ethnicities as appropriate. 

Scope and Methodology: 

Overall, to address these three objectives, we used multiple 
methodologies, including administering a state survey; conducting site 
visits; interviewing researchers and federal agency officials; 
conducting a literature review using various criteria; and analyzing 
federal legislation and policies. More specifically, we conducted a 
nationwide Web-based survey of state child welfare administrators in 50 
states and the District of Columbia between November 2006 and January 
2007. To obtain a more in-depth understanding of the issues, especially 
of any promising strategies to address disproportionality of African 
American children, we conducted site visits to California, Illinois, 
Minnesota, New York, and North Carolina, and in addition, conducted 
telephone interviews with state and local child welfare officials, 
service providers, and court officials in Texas. These states were 
selected in accordance with various criteria discussed below. To extend 
our understanding, we interviewed child welfare researchers identified 
by others as knowledgeable on issues of racial disproportionality in 
foster care as well as representatives from national child welfare 
organizations, such as the Casey Family Programs; the Child Welfare 
League of America; Black Administrators in Child Welfare, Inc; and the 
Center for the Study of Social Policy, on these matters. In addition, 
we participated in child welfare-related conferences with sessions 
relevant to these objectives. We also conducted an extensive literature 
review and analyzed published research on racial disproportionality in 
foster care and strategies used by states and others to address this 
issue, and selected the research for this review based on particular 
criteria described below. At the federal level, we interviewed HHS 
officials responsible for foster care programs and related data, as 
well as officials at the Department of Juvenile Justice, which is 
required by law to address racial disproportionality in the juvenile 
justice systems. Finally, we analyzed federal child welfare 
legislation, agency documentation, and policies relevant to foster care 
that may have an impact on racial disproportionality. We conducted our 
work between June 2006 and June 2007 in accordance with generally 
accepted government auditing standards. 

Web-Based Survey: 

To obtain state perspectives on our objectives and the relative 
priority state child welfare agencies place on the challenges they 
face, we conducted a Web-based survey of child welfare directors in the 
50 states and the District of Columbia. The survey was conducted using 
a self-administered electronic questionnaire posted on the Web. We 
contacted directors via e-mail announcing the survey and sent follow-up 
e-mails and made telephone calls as well to encourage responses. The 
survey data were collected between November 2006 and January 2007. We 
received completed surveys from 47 states and the District of Columbia 
(a 92 percent response rate). The states of New Jersey, Maryland, and 
Rhode Island did not return completed surveys. 

To develop the survey questions, we relied on information gathered 
through interviews with researchers, professional associations, and our 
literature review (see criteria for selecting literature). In addition, 
in July 2006, we solicited comments from various researchers and other 
experts on elements used in our survey to ensure their completeness. 
These elements included a list of factors that contribute to, 
strategies to address, and federal policies that may affect the 
disproportionality of African American children in foster care. We 
received comments on these elements from the Center for the Study of 
Social Policy, the Black Administrators in Child Welfare, and Westat, 
and made modifications accordingly. We worked closely with social 
science survey specialists to develop and pretest the questionnaire. 
Because these were not sample surveys, there are no sampling errors. 
However, the practical difficulties of conducting any survey may 
introduce errors, commonly referred to as nonsampling errors. For 
example, differences in how a particular question is interpreted, in 
the sources of information that are available to respondents, or how 
the data are entered into a database can introduce unwanted variability 
into the survey results. We took steps in the development of the 
questionnaires, the data collection, and data analysis to minimize 
these nonsampling errors. For example, prior to administering the 
survey, we pretested the content and format of the questionnaire with 
five states to determine whether (1) the survey questions were clear, 
(2) the terms used were precise, (3) respondents were able to provide 
the information we were seeking, and (4) the questions were unbiased. 
We made changes to the content and format of the final questionnaire 
based on pretest results. Because these were Web-based surveys in which 
respondents entered their responses directly into our database, there 
was a reduced possibility of data entry error. We also performed 
computer analyses to identify inconsistencies in responses and other 
indications of error. In addition, an independent analyst verified that 
the computer programs used to analyze the data were written correctly. 

Site Visits: 

To obtain a more in-depth understanding of issues, we conducted site 
visits to California, Illinois, Minnesota, New York, and North 
Carolina. In addition we conducted telephone interviews with Texas 
state child welfare officials, a researcher a service provider, and a 
judge in Texas. When viewed as a group, the states we visited reflected 
diversity in geographic location, rates of African American 
representation in foster care, strategies and initiatives used to 
address this disproportion, and program administration (state 
administered and county administered). In addition, the states we 
selected collectively covered nearly one-third of children in foster 
care across the nation. During these visits, we interviewed state and 
local child welfare officials; juvenile court judges and other child 
welfare-related legal representatives, such as attorneys and public 
guardians; community service providers; and others involved in the 
child welfare systems, such as academic researchers. We also collected 
information, reports, and data on disproportionality and initiatives to 
address this issue from state and local child welfare agencies and 
others during these visits. We cannot generalize our findings beyond 
the states we visited. 

Literature Review of Published Research on Disproportionality: 

To learn more about the major factors, strategies, and federal policies 
influencing whether African American children enter and remain in 
foster care compared to children of other races and ethnicities, we 
conducted a literature review. The literature we reviewed included 
research articles we identified through databases, such as Lexis-Nexis, 
J-STOR, and the National Clearinghouse on the Child Abuse and Neglect 
Information. We used various search terms, such as disproportionality, 
African American, foster care, child welfare system, and over- 
representation in searching these databases. We also reviewed 
literature cited in these studies and those we found on Web sites 
related to child welfare and disproportionality, as well as literature 
recommended to us from our interviews. In addition, we conducted a more 
intensive review about 50 studies identified through these methods that 
focused on factors affecting entry and length of stay in foster care. 
For each selected study, we determined whether the study's findings 
were generally reliable. Two GAO social science analysts assessed each 
study's research methodology, including its research design, sampling 
frame, selection of measure, data quality, limitation, and analytic 
techniques for its methodological soundness and the validity of the 
results and conclusions that were drawn. 

Interviews with Researchers and Child Welfare Organizations: 

For all three objectives we also conducted interviews with academic 
researchers and other experts on disproportionality issues, such as 
child welfare-related organizations. We identified child welfare 
researchers for our interviews through our literature review and 
through recommendations from child welfare officials and stakeholders 
as knowledgeable on issues of racial disproportionality in foster care. 
For this study we interviewed academic researchers affiliated with the 
following universities and research centers: Chapin Hall at the 
University of Chicago, Children and Family Research Center at the 
University of Illinois School of Social Work, Jordan Institute for 
Families at the University of North Carolina, School of Social Welfare 
at the University of California at Berkeley, University of Minnesota 
School of Social Work, University of Texas School of Social Work, and 
Hunter College School of Social Work of the City University of New 
York. We also interviewed researchers and other staff at the following 
organizations: Black Administrators in Child Welfare, Casey Family 
Programs, Center for the Study of Social Policy, Child Welfare League 
of America, National Association of Public Child Welfare 
Administrators, National Council of Juvenile and Family Court Judges, 
Nestor Associates, and Westat. To obtain clarification on the findings 
of the National Incidence Surveys, we also interviewed the principal 
investigator of these studies for HHS, also at Westat. 

Adoption and Foster Care Analysis and Reporting System (AFCARS): 

To obtain children welfare data we requested and analyzed the U.S. 
Children's Bureau AFCARS data from the National Data Archive on Child 
Abuse and Neglect at Cornell University (NDACAN). AFCARS is a federal 
database that provides case level data on all children covered by Title 
IV-B and Title IV-E of the Social Security Act. On a bi-annual basis, 
all states submit data to the Children's Bureau concerning each child 
in foster care and each child who has been adopted under the authority 
of the state's child welfare agency. To confirm the reliability of the 
data, social science methodologists at GAO conducted electronic data 
testing, comparing our figures with HHS and others who have reported 
similar data. We also interviewed several officials with NDACAN and HHS 
who were responsible for the data. We found the data to be sufficiently 
reliable for the purposes of this report. 

In calculating the adoption rates reported in figure 15, we used 
estimates from HHS's Web site of the total estimated count of adoptions 
with public agency involvement finalized at year end divided by the 
number of children waiting to be adopted on the last day of the prior 
year. Children waiting to be adopted are defined by HHS as those 
children who have the case goal of adoption and/or have parental rights 
terminated.[Footnote 98] According to an HHS official familiar with 
AFCARS data, the HHS reported numbers of children waiting to be adopted 
may be imprecise because of variations among states and over 
time.[Footnote 99] Accordingly, we also calculated the adoption rate by 
using the number of children in foster care on the last day of the 
prior year as the denominator. Under both analyses, African American 
and Native American children had lower adoption rates between 2001 and 
2005 than children of other races and ethnicities. We chose not to 
report the findings under the second method of analysis because the 
numbers of children in foster care on the last day of the prior year 
include many children who are not waiting to be adopted, such as 
children who have a case goal of reunification and later reunify with 
their parents, which would greatly underestimate adoption 
rates.[Footnote 100] 

[End of section] 

Appendix II: Disproportionality Indexes of Children in Foster Care by 
Race and State: 

Among researchers and others, disproportionality indexes or ratios are 
used to characterize the extent of disproportionality in a particular 
area, whether nationwide, within a state, or within a county or 
metropolitan area. Table 4 represents the proportion of African 
American, White, Hispanic, Asian, and Native American children in the 
foster care system in each state when compared to the overall 
population of each racial category of children in that state. (See 
table 4.) In the table, we present disproportionality indexes by state 
for children in foster care on the last day of fiscal year 2004. In 
this table, for example, an index number of below 1.00 indicates an 
under-representation of African American in foster care in a state 
compared to African American children's proportions in the general 
child population in that state, while a number above 1.00 indicates an 
over-representation of African American children in foster care in a 
state compared to African American children's proportions in the 
general child population in that state. This table also displays this 
indexing methodology for the other four racial and ethnic 
categories.[Footnote 101] 

Overall, the disproportionality index nationwide for African American 
children is 2.26, which means that African American children were over- 
represented in foster care nationally in 2004 at a rate of more than 
twice their proportions in the U.S. child population. In fiscal year 
2004, a total of 36 states had disproportionality indexes of 2.0 or 
more, and 16 states had disproportionality indexes of 3.0 or more for 
the number of African American children in foster care at the end of 
the fiscal year (indexes of 2.0 or more are bolded in the table 4). 
Within states, disproportionality rates may vary considerably, as noted 
earlier. 

Table 4: Disproportionality Index by State of Children Ages 17 Years of 
Age or Under in Foster Care as of Last Day of Fiscal Year 2004: 

State: Alabama; 
African American children[A]: 1.52; 
White children[B]: 0.77; 
Hispanic children[C]: 0.63; 
Asian children[D]: 0.05; Native American children[E]: 0.54. 

State: Alaska; 
African American children[A]: 2.23; 
White children[B]: 0.48; 
Hispanic children[C]: 0.25; 
Asian children[D]: 0.04; 
Native American children[E]: 3.07. 

State: Arizona; 
African American children[A]: 2.36; 
White children[B]: 0.95; 
Hispanic children[C]: 0.95; 
Asian children[D]: 0.13; 
Native American children[E]: 0.39. 

State: Arkansas; 
African American children[A]: 1.39; 
White children[B]: 0.84; 
Hispanic children[C]: 0.64; 
Asian children[D]: 0.30; 
Native American children[E]: 0.05. 

State: California; 
African American children[A]: 4.05; 
White children[B]: 0.75; 
Hispanic children[C]: 0.89; 
Asian children[D]: 0.17; 
Native American children[E]: 1.80. 

State: Colorado; 
African American children[A]: 2.78; 
White children[B]: 0.78; 
Hispanic children[C]: 1.27; 
Asian children[D]: 0.28; 
Native American children[E]: 1.94. 

State: Connecticut; 
African American children[A]: 2.76; 
White children[B]: 0.49; 
Hispanic children[C]: 2.02; 
Asian children[D]: 0.08; 
Native American children[E]: 0.58. 

State: Delaware; 
African American children[A]: 2.30; 
White children[B]: 0.58; 
Hispanic children[C]: 0.83; 
Asian children[D]: 0.05; 
Native American children[E]: 0.51. 

State: District of Columbia; 
African American children[A]: 1.30; 
White children[B]: 0.01; 
Hispanic children[C]: 0.31; 
Asian children[D]: 0.17; 
Native American children[E]: 0.00. 

State: Florida; 
African American children[A]: 1.93; 
White children[B]: 0.89; 
Hispanic children[C]: 0.42; 
Asian children[D]: 0.12; 
Native American children[E]: 0.88. 

State: Georgia; 
African American children[A]: 1.44; 
White children[B]: 0.80; 
Hispanic children[C]: 0.54; 
Asian children[D]: 0.07; 
Native American children[E]: 0.12. 

State: Hawaii; 
African American children[A]: 0.44; 
White children[B]: 0.58; 
Hispanic children[C]: 0.19; 
Asian children[D]: 1.01; 
Native American children[E]: 1.80. 

State: Idaho; 
African American children[A]: 3.37; 
White children[B]: 0.89; 
Hispanic children[C]: 1.12; 
Asian children[D]: 0.24; 
Native American children[E]: 5.86. 

State: Illinois; 
African American children[A]: 3.48; 
White children[B]: 0.50; 
Hispanic children[C]: 0.29; 
Asian children[D]: 0.02; 
Native American children[E]: 0.53. 

State: Indiana; 
African American children[A]: 3.01; 
White children[B]: 0.72; 
Hispanic children[C]: 0.87; 
Asian children[D]: 0.09; 
Native American children[E]: 1.36. 

State: Iowa; 
African American children[A]: 4.45; 
White children[B]: 0.86; 
Hispanic children[C]: 0.91; 
Asian children[D]: 0.79; 
Native American children[E]: 5.41. 

State: Kansas; 
African American children[A]: 2.93; 
White children[B]: 0.88; 
Hispanic children[C]: 0.47; 
Asian children[D]: 0.16; 
Native American children[E]: 1.22. 

State: Kentucky; 
African American children[A]: 2.02; 
White children[B]: 0.87; 
Hispanic children[C]: 0.26; 
Asian children[D]: 0.19; 
Native American children[E]: 0.68. 

State: Louisiana; 
African American children[A]: 1.40; 
White children[B]: 0.76; 
Hispanic children[C]: 0.28; 
Asian children[D]: 0.12; 
Native American children[E]: 0.64. 

State: Maine; 
African American children[A]: 1.74; 
White children[B]: 0.88; 
Hispanic children[C]: 2.15; 
Asian children[D]: 0.43; 
Native American children[E]: 1.52. 

State: Maryland; 
African American children[A]: 2.27; 
White children[B]: 0.39; 
Hispanic children[C]: 0.23; 
Asian children[D]: 0.08; 
Native American children[E]: 0.78. 

State: Massachusetts; 
African American children[A]: 2.23; 
White children[B]: 0.67; 
Hispanic children[C]: 2.18; 
Asian children[D]: 0.39; 
Native American children[E]: 0.89. 

State: Michigan; 
African American children[A]: 2.90; 
White children[B]: 0.56; 
Hispanic children[C]: 0.78; 
Asian children[D]: 0.13; 
Native American children[E]: 1.83. 

State: Minnesota; 
African American children[A]: 3.63; 
White children[B]: 0.63; 
Hispanic children[C]: 1.39; 
Asian children[D]: 0.37; 
Native American children[E]: 7.31. 

State: Mississippi; 
African American children[A]: 1.10; 
White children[B]: 0.92; 
Hispanic children[C]: 0.73; 
Asian children[D]: 0.54; 
Native American children[E]: 0.14. 

State: Missouri; 
African American children[A]: 2.15; 
White children[B]: 0.84; 
Hispanic children[C]: 0.62; 
Asian children[D]: 0.13; 
Native American children[E]: 1.04. 

State: Montana; 
African American children[A]: 2.68; 
White children[B]: 0.63; 
Hispanic children[C]: 1.62; 
Asian children[D]: 0.56; 
Native American children[E]: 3.44. 

State: Nebraska; 
African American children[A]: 2.76; 
White children[B]: 0.80; 
Hispanic children[C]: 0.98; 
Asian children[D]: 0.27; 
Native American children[E]: 6.54. 

State: Nevada; 
African American children[A]: 2.67; 
White children[B]: 1.07; 
Hispanic children[C]: 0.53; 
Asian children[D]: 0.36; 
Native American children[E]: 0.39. 

State: New Hampshire; 
African American children[A]: 4.37; 
White children[B]: 0.91; 
Hispanic children[C]: 1.79; 
Asian children[D]: 0.15; 
Native American children[E]: 0.90. 

State: New Jersey; 
African American children[A]: 3.81; 
White children[B]: 0.41; 
Hispanic children[C]: 0.35; 
Asian children[D]: 0.03; 
Native American children[E]: 1.27. 

State: New Mexico; 
African American children[A]: 2.81; 
White children[B]: 1.02; 
Hispanic children[C]: 1.06; 
Asian children[D]: 0.20; 
Native American children[E]: 0.40. 

State: New York; 
African American children[A]: 2.63; 
White children[B]: 0.37; 
Hispanic children[C]: 0.97; 
Asian children[D]: 0.08; 
Native American children[E]: 0.90. 

State: North Carolina; 
African American children[A]: 1.67; 
White children[B]: 0.74; 
Hispanic children[C]: 0.79; 
Asian children[D]: 0.27; 
Native American children[E]: 1.53. 

State: North Dakota; 
African American children[A]: 3.26; 
White children[B]: 0.69; 
Hispanic children[C]: 1.90; 
Asian children[D]: 2.98; 
Native American children[E]: 3.09. 

State: Ohio; 
African American children[A]: 2.87; 
White children[B]: 0.65; 
Hispanic children[C]: 0.98; 
Asian children[D]: 0.08; 
Native American children[E]: 0.96. 

State: Oklahoma; 
African American children[A]: 1.76; 
White children[B]: 0.70; 
Hispanic children[C]: 1.10; 
Asian children[D]: 0.12; 
Native American children[E]: 1.12. 

State: Oregon; 
African American children[A]: 3.27; 
White children[B]: 0.75; 
Hispanic children[C]: 0.70; 
Asian children[D]: 0.24; 
Native American children[E]: 8.68. 

State: Pennsylvania; 
African American children[A]: 3.56; 
White children[B]: 0.53; 
Hispanic children[C]: 1.38; 
Asian children[D]: 0.21; 
Native American children[E]: 1.10. 

State: Rhode Island; 
African American children[A]: 2.68; 
White children[B]: 0.76; 
Hispanic children[C]: 1.14; 
Asian children[D]: 0.47; 
Native American children[E]: 2.11. 

State: South Carolina; 
African American children[A]: 1.43; 
White children[B]: 0.74; 
Hispanic children[C]: 0.69; 
Asian children[D]: 0.19; 
Native American children[E]: 0.48. 

State: South Dakota; 
African American children[A]: 1.67; 
White children[B]: 0.41; 
Hispanic children[C]: 2.33; 
Asian children[D]: 0.28; 
Native American children[E]: 3.71. 

State: Tennessee; 
African American children[A]: 1.52; 
White children[B]: 0.84; 
Hispanic children[C]: 0.91; 
Asian children[D]: 0.16; 
Native American children[E]: 0.36. 

State: Texas; 
African American children[A]: 2.02; 
White children[B]: 0.81; 
Hispanic children[C]: 0.89; 
Asian children[D]: 0.09; 
Native American children[E]: 0.73. 

State: Utah; 
African American children[A]: 6.06; 
White children[B]: 0.82; 
Hispanic children[C]: 1.63; 
Asian children[D]: 0.91; 
Native American children[E]: 3.97. 

State: Vermont; 
African American children[A]: 3.24; 
White children[B]: 1.01; 
Hispanic children[C]: 0.45; 
Asian children[D]: 0.13; 
Native American children[E]: 0.70. 

State: Virginia; 
African American children[A]: 1.89; 
White children[B]: 0.72; 
Hispanic children[C]: 0.76; 
Asian children[D]: 0.06; 
Native American children[E]: 0.28. 

State: Washington; 
African American children[A]: 3.07; 
White children[B]: 0.80; 
Hispanic children[C]: 1.03; 
Asian children[D]: 0.19; 
Native American children[E]: 4.99. 

State: West Virginia; 
African American children[A]: 2.04; 
White children[B]: 0.92; 
Hispanic children[C]: 1.19; 
Asian children[D]: 0.00; 
Native American children[E]: 0.19. 

State: Wisconsin; 
African American children[A]: 4.69; 
White children[B]: 0.54; 
Hispanic children[C]: 1.26; 
Asian children[D]: 0.34; 
Native American children[E]: 2.48. 

State: Wyoming; 
African American children[A]: 4.28; 
White children[B]: 0.96; 
Hispanic children[C]: 1.06; 
Asian children[D]: 0.17; 
Native American children[E]: 0.24. 

State: United States; 
African American children[A]: 2.26; 
White children[B]: 0.68; 
Hispanic children[C]: 0.87; 
Asian children[D]: 0.22; 
Native American children[E]: 2.25. 

Source: GAO analysis using Census Population Estimates from 2004 and 
Adoption and Foster Care Analysis and Reporting System (AFCARS) for 
fiscal year 2004, which was made available to us by the National Data 
Archive on Child Abuse and Neglect (NDACAN), Cornell University, 
Ithaca, New York. Children identified by the child welfare system with 
two or more racial categories were not included. 

Note: Children who were identified by the child welfare system with two 
or more racial categories or who were unknown were not presented in 
this table. 

[A] Children identified by the child welfare system as African 
American, non-Hispanic, and with only one race category. 

[B] Children identified by the child welfare system as White, non- 
Hispanic, and with only one race category. 

[C] Children identified by the child welfare system as having Hispanic 
origins; not a racial category. 

[D] Children identified by the child welfare system as Asian, which 
includes Hawaiian and Pacific Islander, non-Hispanic and with only one 
race category. 

[E] Children identified by the child welfare system as Native American, 
non-Hispanic, and with only one race category. 

[End of table] 

To derive each state's disproportionality index, for example, we 
divided the proportion of African American children in foster care (the 
number of African American children in foster care divided by the total 
number of children in child foster care) by the proportion of the 
African American children in the general population (the number of 
African American children in the population divided by the total number 
in the general population).[Footnote 102] According to HHS AFCARS data 
from fiscal year 2004, there were 498,981 children ages 17 years and 
under in foster care in the United States on September 30, 2004. Of 
these children, 162,991 were African American. Census population 
estimates for 2004 show there were 73,258,205 children 17 years old and 
under in the general population, of which 10,805,487 children were 
African American. Using the methodology described, we obtained a 
disproportionality index of 2.26 nationally for African American 
children in foster care at the end of the fiscal year for 2004. This 
methodology was used for the other four racial categories. 

[End of section] 

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

Department Of Health And Human Services: 
Office of the Assistant Secretary for Legislation: 
Washington, D.C. 20201: 

Jun 18 2007: 

Denise Fantone, Acting Director: 
Education, Workforce, and Income Security Issues: 
U.S. Government Accountability Office" 
Washington, DC 20548: 

Dear Ms. Fantone: 

Enclosed are the Department's comments on the U.S. Government 
Accountability Office's (GAO) draft report entitled, "African American 
Children in Foster Care: Additional HHS Assistance Needed to Help 
States Reduce the Proportion in Care " (GAO-07-816), before its 
publication. 

The Department appreciates the opportunity to comment on this draft 
before its publication. 

Sincerely, 

Signed for: 

Vincent J. Ventimiglia: 
Assistant Secretary for Legislation: 

Comments Of The Department Of Health And Human Services On The 
Government Accountability Office Draft Report Entitled. "African 
American Children In Foster Care: Additional HHS Assistance Needed To 
Help States Reduce The Proportion In Care" (GAO-07-816): 

GAO Recommendations: 

(1) To assist states in increasing the number of homes available for 
permanent placement of African American and other children from foster 
care, the Secretary of HHS should conduct a study to determine the 
feasibility of allowing adoption assistance payments to also be used 
for legal guardianship. Such a study should begin with the promising 
waiver results and examine whether subsidized guardianship can be 
implemented more broadly with similar results. Depending on the 
results, HHS should consider submitting a legislative proposal to 
reauthorize the use of federal demonstration waivers to subsidize legal 
guardianships, or alternatively, to amend current law to allow federal 
reimbursement for legal guardianship. 

(2) To enhance states' ability to reduce the proportion of African 
American children in foster care, the Secretary of HHS should further 
assist states in understanding the nature and extent of 
disproportionality in their child welfare systems and in taking steps 
to address the issue. These actions should include: 

* Encouraging states to regularly track state and local data on the 
racial. disproportionality of children in foster care and use the data 
to develop strategies that can better enable them to prevent children's 
entry into foster care and speed their exit into permanent homes. HHS 
should also encourage states to make increased use of HHS's National 
Resource Centers as a source of technical assistance on this issue. 

* Completing and making publicly available information on 
disproportionality that the agency is developing under its Culturally 
Competent Practice Knowledge Initiative so that states have easier 
access to tools and strategies useful for addressing the issue. 

HHS Comments: 

We do not concur with recommendation (1). As noted in the body of the 
report, the Administration has already identified in the Child Welfare 
Program Option a proposal to allow States the option to receive their 
foster care funding as a flexible grant for a period of five years or 
to maintain the program as it is currently funded. The option would 
provide States with the flexibility to develop a seamless child welfare 
system that supports a continuum of services to families in crisis and 
children at risk from the provision of prevention services to the 
provision of subsidies for guardianships. 

States that choose the grant option will be able to use the funds for 
foster care payments, prevention activities, permanency efforts 
(including searching for relatives and subsidized guardianships), case 
management, administrative activities, such as data analysis of the 
level of representation of specific populations, training for child 
welfare staff in cultural competence, and other such services related 
to child welfare activities. States would be able to develop innovative 
and effective systems for preventing child abuse and neglect, keeping 
families and children of all backgrounds safely together, and moving 
children toward adoption and permanency, quickly. 

Flexibility was built into the Child Welfare Program Option based on 
knowledge developed from the previous and existing Federal Title IV-E 
waivers. The grant would encompass Federal funding for the existing 
Title IV-E foster care maintenance payments program and the associated 
administrative costs, including Statewide Automated Child Welfare 
Information Systems and training. State allocations would be based on 
historical expenditures in consultation with the States. States that 
choose the option must maintain their existing level of financial 
investment in child welfare programs. The Administration is committed 
to addressing the fundamental flaws of the program through the Child 
Welfare Program Option, thereby providing States that take it the 
flexibility to address the causes of disproportional representation, 
creatively and actively. 

Recommendation (2) is consistent with the Children's Bureau current 
technical assistance efforts to encourage and assist States in 
addressing disproportionality through multiple avenues. Technical 
assistance is available to States in a variety of forms, including data 
analysis to determine the extent of concerns at the State and local 
levels, development of effective case practice models sensitive to 
various cultural populations, and design of service systems that can be 
individualized to the specific needs of children and families. Cultural 
competence in child welfare is a topic that has been discussed for many 
years without an identifiable national model or working solution for 
implementation in States. 

As part of its work with States, Tribes, localities, and courts, the 
Children's Bureau has created a Training and Technical Assistance (TTA) 
Network to assist States, Tribes, localities, and courts implement 
system changes necessary to produce better outcomes for children, 
youth, and families involved in the child welfare system. Over several 
years of discussions with the TTA Network, ongoing concern has been 
raised about the over-representation of children and families of color 
in the public child welfare system-a negative consequence when practice 
lacks cultural competence. 

The Children's Bureau has highlighted for each member of its technical 
assistance network the importance of developing and providing 
leadership activities to identify and classify issues and barriers 
related to culturally competent practices and disseminating positive 
results and strategies for implementation across the country. The 
Children's Bureau applauds GAO for recognizing the importance of these 
existing efforts and for GAO's support of ACF's continuing focus on 
reducing disproportional representation of specific populations both at 
entry into foster care and in reducing the longer stay while in foster 
care. By highlighting the availability of these services, GAO is 
assisting ACF in publicizing the availability of technical assistance 
in this area. 

Additionally, GAO reported that most States are using strategies to 
address the over-representation of specific populations in foster care, 
such as involving families in decision making, building community 
supports, and broadening the search for relatives to care for children. 
It should be noted that ACF reviews States and provides feedback on 
performance of these strategies as part of the Child and Family 
Services Reviews (CFSRs). ACF makes separate determinations regarding 
substantial conformity for each of the seven outcomes and each of the 
seven systemic factors reviewed. 

All States reviewed during the first round of CFSRs were found to be in 
substantial conformity on some of these areas and not in substantial 
conformity on others. The design of the reviews provides an opportunity 
for States to enter into program improvement plans to move towards 
improving performance in identified outcomes and systemic factors. It 
is by focusing States on long-term strategic and active program 
improvement that the reviews achieve the objective of enhancing service 
to children and families. 

The Children's Bureau has begun the second round of reviews and has 
developed specific technical assistance strategies to help States 
prepare for the CFSRs and maximize the benefit derived from the program 
improvement planning process. The National Child Welfare Resource 
Center for Organizational Improvement (NRCOI) has worked with other 
national resource centers to develop a CFSR training and technical 
assistance package. This material will help agencies successfully 
prepare for the second round of the CFSR, enhance leadership and 
management capacity, and achieve better outcomes through systemic 
change. Information on the technical assistance can be found on the 
NRCOI website at hyperlink, 
http://muskie.usm.maine.edu/helpkids/cfsrta.htm. 

The Children's Bureau also funds the Child Welfare Information Gateway, 
which has information available for readers who wish to learn more 
about disproportionality and cultural competence (see hyperlink, 
http://www.childwelfare.gov/systemwide/cultural/disporp/related.cfm). 

[End of section] 

Appendix IV: GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Denise M. Fantone, Acting Director (202) 512-7215 or fantoned@gao.gov: 

Acknowledgments: 

Cindy Ayers (Assistant Director) and Deborah A. Signer (Analyst-in- 
Charge) managed all aspects of the assignment. Christopher T. Langford, 
Theresa Lo, and Kimberly Siegal made significant contributions to this 
report, in all aspects of the work. Interns Lisa McMillen and Ashley 
Gilbert also contributed with data collection and analysis. In 
addition, Charles Willson assisted in the message and report 
development; Jay Smale contributed to the initial design of the 
engagement and, together with Luann Moy, assessed studies for the 
literature review; William R. Chatlos provided technical assistance in 
the development and pre-testing of the Web-based survey; Carolyn Boyce 
provided technical support in survey research and statistical analysis; 
George Quinn provided data analytic support; and James Rebbe, Attorney, 
provided legal support. 

FOOTNOTES 

[1] Racial disproportionality refers to the extent that children of a 
certain race or ethnic group are over-or underrepresented in foster 
care relative to their proportion in the population. (See app. II for 
disproportionality rates for African American, White, Hispanic, Asian, 
and Native American children by state in fiscal year 2004.) 

[2] Children also enter foster care for other reasons, such as their 
parents' illness, death, or disability or because of the children's 
delinquent behavior and truancy. 

[3] We are using the term "policy" in this report to include federal 
laws, regulations, and informal agency guidance. 

[4] Native Americans are also overrepresented nationally, but some are 
affected by different child welfare laws and oversight authority than 
African Americans, making comparisons challenging. 

[5] For more detail on our methodology for conducting our work, see 
appendix I. 

[6] The National Incidence Study (NIS) is a congressionally mandated, 
periodic effort of the National Center on Child Abuse and Neglect to 
obtain information about the current incidence of child abuse and 
neglect in the United States. NIS-1 was published in 1981, NIS-2 was 
published in 1988, and NIS-3 was published in 1996. The NIS-3 findings 
are based on a nationally representative sample of over 5,600 
professionals in 842 agencies serving 42 counties in the United States. 

[7] For disproportionality rates for African American, White, Hispanic, 
Asian, and Native American children by state in fiscal year 2004, see 
appendix II. 

[8] These data are based on our analysis of HHS's AFCARS data for 2004 
and U.S. Census population estimates for that year. 

[9] Pub. L. No. 103-382, §§ 551-553. 

[10] Pub. L. No. 104-188, § 1808. 

[11] Pub. L. No. 105-89. 

[12] These convictions include situations in which the prospective 
foster or adoptive parent was, at any time, convicted of felony child 
abuse or neglect, spousal abuse, a crime involving children (including 
child pornography), or a crime involving violence (including rape, 
sexual assault, or homicide, but not including other physical assault 
or battery); or if the record check shows a felony conviction for 
physical assault, battery, or a drug-related offense that was committed 
in the last 5 years. 

[13] As of July 2006, eight states were using alternative background 
check processes approved by HHS instead of specified federal background 
check requirements for prospective foster care and adoptive parents: 
California, New York, Idaho, Oklahoma, Oregon, Massachusetts, Ohio, and 
Arizona. 

[14] Pub. L. No. 109-248. 

[15] Under prior law, the type of criminal record check was not 
specified. Under this act, states are required to perform a fingerprint-
based check. 

[16] Urban Institute 2005 Child Welfare Survey reported in May 2006. 
This funding analysis is the most recent available that shows federal 
funding used specifically for child welfare. 

[17] States are entitled to Title IV-E reimbursement on behalf of 
children who would have been eligible for Aid to Families with 
Dependent Children (AFDC) (as AFDC existed on July 16, 1996), but for 
the fact that they were removed from the home of certain specified 
relatives. Although the AFDC program was replaced by the Temporary 
Assistance for Needy Families program in 1996, eligibility for Title IV-
E payments remains tied to the income eligibility requirements of the 
now-defunct AFDC program. 

[18] The term "special needs" is used in a distinct way in Title IV-E 
programs. In order to be considered a child with special needs for the 
purpose of providing adoption assistance payments, states must 
determine that the child should not return home and have a factor or 
condition that would make the child difficult to place for adoption 
without such payments. States are provided discretion under federal law 
to determine what these factors or conditions are and may include age, 
membership in a sibling or minority group, or having a medical or 
developmental disability that would make placement difficult. There are 
additional eligibility requirements to obtain adoption assistance 
subsidies as well. 

[19] For further information on Title IV-B funds, see GAO, Child 
Welfare: Enhanced Federal Oversight of Title IV-B Could Provide States 
Additional Information to Improve Services, GAO 03-956 (Washington, 
D.C.: Sept. 12, 2003). 

[20] Data as reported by the Urban Institute in 2006, based on its 2005 
survey of state child welfare agencies. This survey asked states to 
estimate their amount of funds spent on child welfare activities for 
state fiscal year 2004, and over 40 states provided data for federal, 
state and local funds. Federal funding included Title IV-E and IV-B, 
TANF, SSBG, Medicaid, and "other." SSBG includes funding transferred 
from TANF. Medicaid funds reported here include expenditures for 
transportation, rehabilitative services, targeted case management, and 
mental health services in residential treatment facilities and exclude 
expenditures for routine health care services for children in foster 
care. "Other federal funds" include Social Security Income and 
Survivor's Benefits. 

[21] These two states are California (Los Angeles County) and Florida. 
Florida began its waiver project in October 2006, while California's 
project has not yet begun. 

[22] The CFSR outcomes include protecting children from abuse and 
neglect, fostering permanency and stability in children's living 
conditions, preserving the continuity of children's family 
relationships and connections, enhancing families' capacity to provide 
for their children's needs, and ensuring that children receive 
appropriate services to meet their educational needs. 

[23] For additional information regarding HHS's oversight and states' 
implementation of the CFSR process, see GAO, Child and Family Services 
Reviews: Better Use of Data and Improved Guidance Could Enhance HHS's 
Oversight of State Performance, GAO-04-333 (Washington, D.C.: Apr. 20, 
2004). 

[24] On a semiannual basis, all states submit data to HHS concerning 
all children in foster care for whom state child welfare agencies have 
responsibility for placement, care, or supervision and on children who 
are adopted under the auspices of the state's public child welfare 
agency. AFCARS also includes information on foster and adoptive 
parents. 

[25] The Information Gateway was formerly the National Clearinghouse on 
Child Abuse and Neglect Information and the National Adoption 
Information Clearinghouse. 

[26] Mandated reporters are individuals required by law to report cases 
of children's abuse and neglect. They are usually professionals who 
have frequent contact with children, such as health care workers, 
teachers, social workers, and law enforcers. 

[27] U.S. Census American Community Survey, 2005. The next highest 
percentages of families living below the poverty level were Hispanic 
and Native American families, both at 21 percent. 

[28] Hispanic families are less likely than African American families 
to be headed by single parents, a cultural difference that has been 
cited as a protective factor for Hispanic families that reduces the 
potential for children's removal from their families for neglect or 
abuse, despite similar rates of poverty. 

[29] A. Sedlak and D. Broadhurst, Executive Summary of the Third 
National Incidence Study of Child Abuse and Neglect. (U.S. Department 
of Health and Human Services, Washington, D.C.: 1996). 

[30] U.S. Census American Community Survey data from 2005. Females make 
up the majority of single parent households. 

[31] U.S. Department of Health and Human Services, Substance Abuse and 
Mental Health Services Administration, Results from the 2005 National 
Survey on Drug Use and Health: National Findings (HHS, SAMHSA, Office 
of Applied Studies, Rockville, MD: 2006). 

[32] All AFCARS data cited in this report comes from our analysis of 
the AFCARS database, which was made available to us by the National 
Data Archive on Child Abuse and Neglect , Cornell University, Ithaca, 
New York, unless otherwise stated. NDACAN's funding is provided by 
grant 90-CA-1667 from the Children's Bureau, U. S. Department of Health 
and Human Services. 

[33] This number was not associated with a particular racial or ethnic 
group. 

[34] U.S. Department of Health and Human Services, Children of Color in 
the Child Welfare System: Perspectives from the Child Welfare Community 
(HHS, Administration for Children and Families, Children's Bureau, 
Washington, D.C.: 2003). 

[35] Some child welfare officials also pointed out that lower income 
families may even be referred to the child welfare system in order to 
gain access to services. 

[36] U.S. Department of Health and Human Services, Child Maltreatment 
2005 (HHS, Administration on Children, Youth and Families, Washington, 
D.C.: 2007). 

[37] Cited by Christianne Lind, "Developing and Supporting a Continuum 
of Child Welfare Services," (The Finance Project), 2004. The Finance 
Project is a non-profit organization that provides research, 
consulting, and technical assistant to public and private leaders on 
investing and making financial decisions with regard to children, 
families, and local communities. 

[38] Ann F. Garland et al., "Racial and Ethnic Variations in Mental 
Health Care Utilization Among Children in Foster Care," Children's 
Services: Social Policy, Research and Practice, 3(3): 133-146 (2000). 

[39] Astra Outley, Representation for Children and Parents in 
Dependency Proceedings (The Pew Commission on Children in Foster Care, 
May 2004). 

[40] Casey Family Programs is a foundation that works nationally with 
state and local child welfare agencies and families to provide direct 
services, as well as child welfare practice and policy suggestions. 

[41] For example: R. L. Hampton and E. Newberger, "Child Abuse 
Incidence and Reporting by Hospitals: Significance of Severity, Class 
and Race," American Journal of Public Health (75) 1: 56-60 (1985). For 
information on other studies, see R. Hill, Synthesis of Research on 
Disproportionality in Child Welfare: An Update (Casey-Center for the 
Study of Social Policy Alliance for Racial Equity in the Child Welfare 
System, 2006). 

[42] Barbara Needell et al., "Black Children and Foster Care Placement 
in California" (Children and Youth Services Review, 25(5/6): 393-408 
(2003). 

[43] S. Zuravin et al., "Predictors of Child Protective Service Intake 
Decisions: Case Closure, Referral to Continuing Services, or Foster 
Care Placement," in P.A. Curtis, G. Dale, Jr., and J.C. Kendall (eds.), 
The Foster Care Crisis ( Lincoln, Nebr.: University of Nebraska, 1999), 
pp. 63-83). 

[44] Robert B. Hill, Synthesis of Research on Disproportionality in 
Child Welfare: An Update (Casey-CSSP Alliance for Racial Equity in the 
Child Welfare System, 2006). 

[45] According to statistics from the Bureau of Justice, African 
American men were over two times more likely to have been in prison on 
December 31, 2005, than Hispanic men and over six times more likely 
than White men. Female incarceration rates, though substantially lower 
than male incarceration rates, reveal similar racial and ethnic 
differences. African American neighborhoods with highly concentrated 
poverty tend to have both high levels of foster care involvement as 
well as involvement in the criminal justice system, according to child 
welfare officials we spoke with and research we reviewed. 

[46] According to our analysis of AFCARS fiscal year 2004 data, African 
American children are even more disproportionally represented in foster 
care at older ages than other children. 

[47] Brenda D. Smith, "After Parental Rights Are Terminated: Factors 
Associated with Exiting Foster Care," Children and Youth Services 
Review, 25(12): 965-985 (2003). 

[48] Hispanic children were also more likely to use kinship care than 
Whites, according to our analysis of AFCARS fiscal year 2004 data. 

[49] For example see: R. Barth, "Family Reunification," Child Welfare 
Research Review, 2 (1997): 109-122. 

[50] GAO, Foster Care: Kinship Care Quality and Permanency Issues, GAO-
99-32 (Washington, D.C.: May, 1999). 

[51] R. Cook et al., Unpublished Analysis of Kinship Care Data, (1998), 
quoted in U. S. Department of Health and Human Services (HHS), 
Administration for Children and Families, Children's Bureau, Report to 
the Congress on Kinship Foster Care: Part I: Research Review, Part II: 
Secretary's Report to the Congress (Washington, D.C.: 2000). 

[52] Kinship care refers to situations in which a relative or a close 
family friend provides shelter and cares for a child who is still in 
the foster care system. Legal guardianship refers to situations in 
which a relative or caregiver has taken permanent legal custody of the 
child without terminating parental rights; with legal guardianship, the 
child has exited foster care. 

[53] HHS, Children of Color in the Child Welfare System: Perspectives 
from the Child Welfare Community (HHS, Administration for Children and 
Families, Children's Bureau, Washington, D.C.: 2003). 

[54] Sponsored by the People's Institute for Survival and Beyond and 
promoted by Casey Family Programs. 

[55] According to academic researchers and others, structural or 
institutional racism is defined as the historical, cultural, political, 
ideological, and economic practices that have produced disparities and 
disproportionality between the different racial groups. Under this 
conceptualization of racism, the focus is not on individual behavior 
but instead on systems that distribute resources along lines by race or 
ethnicity. 

[56] Will Johnson, "Effectiveness of California's Child Welfare 
Structured Decision Making Model: A Prospective Study of the Validity 
of the California Family Risk Assessment," (California Child Welfare 
Structured Decision Making Project, for the California Department of 
Social Services, Feb. 2004). See also L. Anthony Loman and Gary L. 
Siegel, "An Evaluation of the Minnesota SDM Family Risk Assessment: 
Final Report," (Institute of Applied Research, St. Louis, Missouri, 
conducted for the Department of Human Services, Minnesota: Dec. 2004). 

[57] HHS, Children of Color in the Child Welfare System: Perspectives 
from the Child Welfare Community (HHS, Administration for Children and 
Families, Children's Bureau, Washington, D.C.: 2003). 

[58] See GAO, Child Welfare and Juvenile Justice: Federal Agencies 
Could Play a Stronger Role in Helping States Reduce the Number of 
Children Placed Solely to Obtain Mental Health Service, GAO-03-397 
(Washington, D.C.: Aug. 2003), for gaps in access to mental health 
service and see GAO, HHS Actions Could Improve Coordination of Services 
and Monitoring of States' Independent Living Programs, GAO-05-25 
(Washington, D.C.: Nov. 2004) for gaps in supportive services for 
children transitioning out of foster care. 

[59] In response to the Health Insurance Portability and Accountability 
Act of 1996 (Pub. L. No. 104-191), known as HIPPA, the Secretary of HHS 
issued regulations covering the use and disclosure of protected health 
information. The Family Education Rights and Privacy Act (Pub. L. No. 
93-380) governs access to student education records. 

[60] This study was based on data from 14 counties. 

[61] A 2006 report by Generations United found that a total of 35 
states and the District of Columbia were subsidizing legal 
guardianships. (See hyperlink, http://ipath.gu.org/documents/A0/GU-
GeneralFactSheetJune.pdf.) Three of these states, Maryland, New Jersey, 
and Rhode Island, did not respond to our survey on disproportionality. 
Other states may subsidize guardianships, but not limit these subsidies 
to families involved in the state child welfare system. 

[62] This may be in part because relative foster care homes can be 
exempt from federal timeline requirements. 

[63] Jill Duerr Berrick, "When Children Cannot Remain Home: Foster 
Family Care and Kinship Care," The Future of Children: Protecting 
Children from Abuse and Neglect, 8, no.1 (1998). 

[64] In 2003, the University of Illinois and Westat conducted an 
evaluation of Illinois' subsidized guardianship program, the largest of 
all programs funded by Title IV-E waivers, reaching 6,800 guardians. 
The study used an experimental design with random assignment of 
families into treatment and control groups. The study found that 
Illinois' subsidized guardianship waiver resulted in fewer children 
remaining in long-term foster care with ongoing administrative 
oversight, that home stability increased, and that the withdrawal of 
regular administrative oversight and casework services from the 
families did not result in higher rates of indicated subsequent reports 
of abuse and neglect. 

[65] Illinois' guardianship program was funded through a federal Title 
IV-E waiver. 

[66] States like Alaska, Hawaii, Utah, and Montana all reported in 
their survey comments that they were concentrating their efforts on 
disproportionality of other populations such as Native Americans and 
Hispanics because the number of African Americans in their foster care 
systems was comparatively small. 

[67] Diligent recruitment of African American foster and adoptive 
parents might be considered a more targeted strategy. However, we 
grouped this under strategies to increase the number of permanent homes 
because states are required by law to engage in this activity, and it 
is not necessarily an indication of their efforts to target efforts to 
address disproportionality. 

[68] Called the Breakthrough Series Collaborative (BSC), this program 
encourages participating jurisdictions to develop child welfare systems 
that are free of structural racism and benefit all children by engaging 
with other jurisdictions, developing leaders and disseminating lessons 
learned. 

[69] When this report was completed, the Texas Health and Human 
Services Commission and the Department of Family and Protective 
Services, as required by the law (Tex. Fam. Code Ann. Sec. 264.2041) 
also devised a remediation plan to prevent racial or ethnic disparities 
and an evaluation of policies and procedures should the results 
indicate disparate treatment of racial or ethnic groups. 

[70] HHS, Children of Color in the Child Welfare System: Perspectives 
from the Child Welfare Community (HHS, Administration for Children and 
Families, Children's Bureau, Washington, D.C.: 2003). 

[71] Although 18 states in our survey believed that having reporting 
requirements on disproportionality rates in the CFSR would be useful, 
nearly as many responded that it would not be useful, and HHS officials 
told us that the CFSR process was governed by statute and that they 
could not add such a requirement. In addition, some child welfare 
officials we interviewed believed that outcomes should be recorded by 
race. These would be similar to educational outcome requirements under 
the No Child Left Behind Act. It requires states to create an 
accountability system of assessments, graduation rates, and other 
indicators. Schools have to make adequate yearly progress to a state- 
determined level of proficiency. 

[72] Because policies are often implemented around the same time and 
overlap, changes in outcomes, such as adoption rates, may reflect the 
influence of multiple policies. 

[73] In addition to block grant funds, federal funds for prevention and 
family support services under Title IV-B have been useful in states' 
efforts to address disproportionality, according to some officials we 
interviewed. 

[74] See Cynthia Andrews Scarcella, Roseanna Bess, Erica Hecht 
Zielewski, and Rob Geen, The Cost of Protecting Vulnerable Children V 
(Washington, D.C.: Urban Institute, 2006). According to the Urban 
Institute survey, states' allocation of TANF and SSBG block grants 
constituted 32 percent of federal child welfare spending in fiscal year 
2004. 

[75] See GAO 07-75. 

[76] States may claim federal reimbursement under Title IV-E for every 
eligible child who is placed in a licensed foster care homes, and 
states may seek reimbursement from the federal government for specified 
percentages of these costs. Of total federal child welfare expenditures 
for 2004, Title IV-E claims represented about 50 percent, while Title 
IV-B funds represented about 5 percent, according to data from the 
Urban Institute. 

[77] Although many officials we interviewed indicated that more funds 
should be placed in prevention, family preservation and family support 
services, findings from large-scale evaluations conducted by HHS showed 
that provision of these services provided no or little effect in 
reducing out-of-home placement, maltreatment recurrence, or improved 
family functioning beyond what normal casework services achieved. See 
HHS, Evaluation of Family Preservation and Reunification Programs, 
Final Report, Volumes 1 and 2 (Dec. 2002). 

[78] See GAO-06-787T; GAO 07-75; Fostering the Future: Safety, 
Permanence and Well-Being for Children in Foster Care, Pew Commission 
on Children in Foster Care (May 2004); and C. Lind, Developing and 
Supporting a Continuum of Child Welfare Services, Welfare Information 
Network, The Finance Project (Dec. 2004). 

[79] HHS discussed the current funding structure and the 
administration's proposed child welfare program option in its 
publication, Federal Foster Care Financing: How and Why the Current 
Funding Structure Fails to Meet the Needs of the Child Welfare Field, 
ASPE Issue Brief, (U.S. Department of Health and Human Services, 
Assistant Secretary for Planning and Evaluation, Washington, D.C.: Aug. 
2005). 

[80] HHS, Children of Color in the Child Welfare System: Perspectives 
from the Child Welfare Community (HHS, Administration for Children and 
Families, Children's Bureau, Washington, D.C.: 2003). 

[81] This is based on HHS CFSR results between 2001 and 2004. 
Challenges in recruiting are consistent with survey responses in an 
earlier GAO study as well. See GAO, Child Welfare: Improving Social 
Service program, Training, and Technical Assistance Information Would 
Help Address Long-standing Service-level and Workforce Challenges, GAO-
07-75 (Washington, D.C.: Oct. 6, 2006). 

[82] Lorelei B. Mitchell, Richard P. Barth, Rebecca Green, Ariana Wall, 
et al., "Child Welfare Reform in the United States: Findings from a 
Local Agency Survey," Child Welfare, 84, no. 1 (Jan.-Feb. 2005). 

[83] As noted earlier, federal policy allows states to classify 
children as special needs if they have characteristics that make them 
difficult to place with adoptive families without adoption assistance, 
such as belonging to a sibling or minority group, or having a 
disability. 

[84] Most African American children were adopted by African American 
parents from 2000 to 2004, according to our analysis of HHS data, and 
the percentage of African American children in foster care adopted by 
single or married African American parents remained relatively steady 
at around 70 percent. 

[85] This concern was also expressed in a previous GAO report. See GAO, 
Foster Care Implementation of the Multiethnic Placement Act Poses 
Difficult Challenges, GAO-98-204 (Washington, D.C.: Sept. 14, 1998). 

[86] Pub. L. No. 95-608. ICWA requires that efforts be made to place 
Native American children with relatives or tribal families, unless a 
good reason exists not to follow these placement preferences. 

[87] Prior to ASFA's enactment, children's options for exiting foster 
care included being reunified with their parents, adopted by a relative 
or nonrelative, or achieving emancipation from foster care when they 
reached a certain age, usually 18. 

[88] According to HHS officials, as of May 2007, seven states have 
active demonstrations testing the use of subsidized guardianship as an 
alternative permanency option, and one state has not yet implemented 
its guardianship demonstration. 

[89] In the preamble to its 2000 regulations implementing ASFA, HHS 
clarified that relative caregivers must be fully licensed and meet the 
same licensing requirements as nonkin in order for the state to receive 
IV-E reimbursements for those families. 65 Fed. Reg. 4020 Except for 
background checks related to criminal convictions, states determine 
their own licensing requirements for prospective foster care, adoptive, 
and guardian parents, but must meet national safety standards as 
overseen through the CFSR process. 

[90] For example, according to information from HHS's Children's 
Bureau, 24 states as of August 2006 require federal criminal record 
checks for prospective adoptive parents and 23 states require 
fingerprinting checks. 

[91] 45 C.F.R. 1356.30(e). 

[92] For example, officials in California told us that county child 
welfare officials made an exemption for an uncle who, 3 years ago, had 
a felony drug conviction for being under the influence of marijuana and 
alcohol. The county welfare agency determined that he had since 
rehabilitated and would, along with the aunt, make an appropriate 
caregiver of three children. 

[93] For example, state officials from California estimated that local 
child welfare agencies made about 360 exemptions in California between 
2005 and 2006 for relative caregivers who otherwise would have been 
automatically disqualified as caregivers under federal law. These 
exemptions accounted for 2 to 3 percent of all placements that were 
approved for foster care, some of whom later became guardians or 
adoptive parents, according to officials. 

[94] ASFA shortened the time frame in which a permanency hearing must 
be held for children when they first enter foster care from 18 months 
to 12 months and required states to file a petition to terminate 
parental rights for children who have been in foster care for 15 of the 
past 22 months. States may exempt children from the requirement to 
terminate parental rights if a child is placed with a relative. 

[95] However, timelines were often extended because of parents' 
difficulties in accessing services they needed to comply with 
requirements for reunifying with their children. See GAO, Foster Care: 
Recent Legislation Helps States Focus on Finding Permanent Homes for 
Children, but Long-Standing Barriers Remain, GAO-02-585 (Washington, 
D.C.: June 28, 2002). 

[96] To mitigate this situation, California passed legislation in 2005 
permitting a child who has not been adopted after the passage of 3 
years from termination of parental rights to petition the juvenile 
court for reinstatement of parental rights (Cal. Stats., AB 519, Chap. 
634). 

[97] Some of the increase also represented better data reporting, as 
cited in Penelope L. Maza, "Children Who Fall Through the Cracks," The 
Roundtable, National Child Welfare Research Center, 21, no. 1 (2007). 

[98] This excluded children with termination of parental rights who are 
16 and older and have the goal of emancipation. 

[99] According to this HHS official, until the last few years, some 
states may have been under-reporting cases in which termination of 
parental rights has occurred, and states vary in how they determine 
adoption as a case goal for children in foster care. HHS has been 
revising how it generates this estimate over the years. 

[100] For example, in 2005, reunification was the case goal for 50 
percent of children, and 54 percent of children who exited foster care 
that year were reunified with their parent or primary caretaker. 

[101] Another method, used by child welfare researchers at the 
University of California at Berkeley to characterize differences among 
populations, is called a "disparity index." This index compares the 
levels of disproportionality between various racial and ethnic groups. 
For example, the disparity index for New York's African American 
children when compared to White children is 7.11--more than double the 
state's disproportionality rate for African American children of 2.63, 
as shown in table 4. (OJJDP also uses a similar index, which it terms 
the "relative rate index," in analyzing disproportionate minority 
contact.) 

[102] The methodology we used for our disproportionality calculations 
is based on the University of California at Berkeley Center for Social 
Services Research's Foster Care Dynamics Disproportionality and 
Disparity Index Web site. URL: < hyperlink, 
http://cssr.berkeley.edu/CWSCMSreports/dynamics/disprop/> 

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