Foster Care: HHS Needs to Improve Oversight of Fostering Connections Act Implementation
Highlights
What GAO Found
To implement the Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections Act), many states GAO surveyed (which included the District of Columbia and Puerto Rico) reported requiring caseworkers to employ multiple practices to improve outcomes for children in foster care; however, states continue to face challenges that can undermine progress. Among the practices that the Department of Health and Human Services (HHS) and others suggested states use, survey respondents reported requiring caseworkers to use group decision-making to maintain family connections, consult with schools, and facilitate adult connections for older youth. At the same time, a majority of surveyed states reported facing challenges, especially related to foster placements (see fig. below).
Major Challenges Reported by States in GAO Survey Regarding Foster Placements
Note: Responses do not sum to 52 if states selected “do not know/not applicable” or did not respond.
Further, the Fostering Connections Act made additional children eligible for federal adoption assistance payments thereby potentially freeing up state funds previously used for this purpose. Although states are required to spend any resulting savings on child welfare services, only 21 states reported calculating these savings for fiscal year 2012, and 20 states reported difficulties performing the calculations. HHS has not provided states guidance in this area, and without it states may continue to struggle with the calculations, leading to potential lost program funding.
HHS approved states' plans to implement the Fostering Connections Act; however, the agency has not yet monitored states' actions. HHS regulations specify that states must undergo a complete review of child welfare programs every 5 years, yet HHS's last review cycle began in 2007—using a tool developed before the act was passed. Internal control standards emphasize using timely data for effective monitoring, but data collected by HHS do not reflect the act's provisions. In March 2014, HHS announced plans to begin a review cycle in fiscal year 2015, but details about how it would address changes from the act were unavailable. Without adequate monitoring or updated data, HHS lacks information about the implementation of the act and the effectiveness of states' actions.
Why GAO Did This Study
Approximately 400,000 children were living in foster care in fiscal year 2012, according to the most recent data available. HHS oversees states' implementation of federal child welfare requirements under title IV-E of the Social Security Act. In 2008, the Fostering Connections Act amended title IV-E to improve the outcomes for children in foster care, such as maintaining family and school connections. GAO was asked to review implementation of the act.
GAO examined (1) steps states have taken to implement selected provisions of the act and challenges they have faced, and (2) the extent to which HHS has monitored states' efforts. GAO reviewed relevant federal laws, regulations, and guidance and surveyed 52 state child welfare agencies, achieving a 100 percent response rate. GAO also interviewed HHS officials and state and local child welfare and educational agency officials; caseworkers; court officials, and foster youth and parents in four states, selected to ensure variety of program characteristics and geographic dispersion.
Recommendations
GAO recommends that HHS (1) provide guidance on how states could calculate savings resulting from changes to federal adoption assistance eligibility criteria, (2) systematically monitor states' implementation of the act, and (3) update data reporting requirements related to the act. HHS concurred with our recommendations. HHS also provided technical comments that were incorporated, as appropriate. The Department of Education had no comments.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | To ensure implementation of the Fostering Connections Act, improve outcomes for children in foster care, and to maximize the amount of funds states are reinvesting into child welfare services, the Secretary of Health and Human Services should provide guidance on how states could calculate savings from the changes to the federal adoption assistance income eligibility criteria. |
The provision relating to calculation of adoption savings was amended by Public Law 113-183, the Preventing Sex Trafficking and Strengthening Families Act, enacted September 29, 2014. As amended, this section of the law requires Title IV-E agencies to calculate and report annually the agency savings from applying the differing Title IV-E Adoption Assistance eligibility criteria, the methodology used to calculate the savings, the amount of any savings, and how savings are spent. Title IV-E agencies must use a methodology specified by the Department of Health and Human Services (HHS) or may propose an alternative for the Secretary's approval. On June 8, 2015 HHS published guidance outlining a methodology for calculating savings and procedures for requesting approval of an alternative methodology, and indicated that a standard reporting form for Title IV-E agencies to use in reporting the information was still under development. On December 2, 2015, HHS issued Program Instruction 15-09 which announced a new section for the financial reporting form CB-496 called "Annual Adoption Savings Calculation and Accounting Report" for states to report any adoption savings annually.
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| Department of Health and Human Services | To ensure implementation of the Fostering Connections Act, improve outcomes for children in foster care, and to help identify areas where states may need additional support or guidance in their efforts to provide children in foster care with services and assistance under title IV-E, as amended by the Fostering Connections Act, the Secretary of Health and Human Services should proceed with and expeditiously finalize plans to update the Adoption and Foster Care Analysis and Reporting System to collect relevant data from states about provisions established by the Fostering Connections Act. |
On December 14, 2016, HHS published a final rule that replaced the existing AFCARS regulations. The new regulations require title IV-E agencies to collect and report data to the HHS Administration for Children and Families including relating to provisions established in the Fostering Connections Act, such as sibling placement, educational stability, Title IV-E guardianship assistance, and transition plans.
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| Department of Health and Human Services | To ensure implementation of the Fostering Connections Act, improve outcomes for children in foster care, and to help identify areas where states may need additional support or guidance in their efforts to provide children in foster care with services and assistance under part E of title IV (title IV-E), as amended by the Fostering Connections Act, the Secretary of Health and Human Services should proceed with and expeditiously finalize plans to systematically monitor state practices for compliance with policies outlined in their title IV-E plans that cover the new provisions established by the Fostering Connections Act. |
In June 2015, HHS reported that it had finalized the review instruments and statewide data indicators that will be used in the Child and Family Service Reviews that will in part monitor states' implementation of the Fostering Connections Act. HHS demonstrated where provisions related to the Fostering Connections Act have been integrated into the review instruments, and indicated that additional agency guidance and monitoring occurs via the Children Bureau's joint planning process with states on an annual basis. In May 2017, HHS reported that the third round of Child and Family Service Reviews were completed and reports were posted on their website. Our review of the instruments found that HHS has taken steps to monitor several provisions in the Fostering Connections Act. For example, the Onsite Review Instrument instructs reviewers to determine whether efforts were made to maintain the child in the same school the child was in before placement in foster care, if remaining in the same school was in the child's best interest, and whether concerted efforts were made to ensure that siblings in foster care are placed together unless a separation was necessary to meet the needs of one of the siblings. Nevertheless, we encourage HHS to follow up with states in the joint planning process or in future monitoring efforts on other provisions that were not clearly incorporated into the monitoring materials. For example, these might include efforts to identify and notify all adult relatives of a child within 30 days of the child's removal or the development of a personalized transition plan during the 90-day period prior to a child aging out of foster care.
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