Improving the Well-Being of Children and Families

HHS faces challenges in its oversight of a number of highly varied programs that promote the well-being and economic independence of children and families. In general, HHS is challenged to balance the quality of services, program participation, and integrity of these programs, many of which are implemented in partnership with states and other grantees.

• For example, HHS must continue to ensure that states and other grantees implement the $17 billion Temporary Assistance for Needy Families program and the $5 billion Child Care and Development Fund in ways that support families' efforts to work and attain self-sufficiency, while also ensuring that the programs provide funds only to those who are eligible.

  Highlights of GAO-06-942 (PDF)

• In addition, HHS's oversight of the states' implementation of these and other social service programs has been encumbered by limitations in states' data systems, deficiencies in program performance measures, and other factors. For example, some youth placed in residential facilities because of behavioral and emotional problems have experienced maltreatment or death; however, the extent of this problem is unknown because of gaps in reported data.

  Highlights of GAO-08-346 (PDF)

• HHS also faces the challenge of learning from past difficulties as the agency begins developing and implementing a new disaster case management effort in collaboration with the Federal Emergency Management Agency (FEMA). As a result of the damage caused by Hurricanes Katrina and Rita in 2005, the federal government funded several disaster case management programs; however, federal agencies and case management agencies faced coordination challenges, potentially leaving some victims without access to disaster case management services

  Highlights of GAO-09-561 (PDF), Highlights of GAO-10-278T (PDF)

• In the area of child welfare, no state has been able to meet all of the expected outcomes as defined and measured by HHS. HHS challenges to helping states meet those outcomes include a patchwork of federal legislation, a lack of interagency coordination and services, and a lack of reliable and timely data.

  Highlights of GAO-09-26 (PDF), Highlights of GAO-08-678, (PDF), Highlights of GAO-07-816 (PDF), Highlights of GAO-07-75 (PDF)

• Further, HHS also lacks reliable data to effectively monitor Head Start enrollment and teacher qualifications for the roughly 1,600 recipients of Head Start grants.

  Highlights of GAO-08-221 (PDF)

• HHS lacks performance outcome measures for its programs intended to promote healthy marriage and responsible fatherhood, making it difficult to monitor program results.

  Highlights of GAO-08-1002 (PDF)

• HHS faces the added challenge of potentially rising numbers of applicants to many of its programs in light of recent declining economic conditions and job losses.

^ Back to topWhat Needs to Be Done

HHS should take action to improve the effectiveness and integrity of programs that promote the economic and social well-being of children and families. Such actions include

• safeguarding the well-being of youth in residential facilities through improved data and enhanced oversight of state accountability;

  Highlights of GAO-08-346 (PDF)

• working with FEMA to develop and implement a new disaster case management program;

  Highlights of GAO-09-561 (PDF)

• improving awareness of and access to various child welfare services by centralizing information on available federal assistance programs for use by state and local child welfare staff and providers;

  Highlights of GAO-07-75 (PDF)

• implementing uniform performance indicators for Healthy Marriage and Responsible Fatherhood grantees and improving grantee monitoring; and

  Highlights of GAO-08-1002 (PDF)

• strengthening oversight of the Head Start program through a more comprehensive risk management strategy and data improvements.

  Highlights of GAO-08-221 (PDF)

^ Back to topKey Reports

Temporary Assistance for Needy Families

Disaster Assistance

Sponsored Noncitizens and Public Benefits

Healthy Marriage and Responsible Fatherhood Initiative

Young Adults With Serious Mental Illness

Residential Facilities

Head Start

African American Children In Foster Care

Child Welfare

More Reports