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Testimony

:



Before the Subcommittee on Human Resources Committee on Ways and Means

House of Representatives:



United States General Accounting Office:



GAO:



For Release on Delivery Expected at 3:00 p.m. EST:



Tuesday, April 8, 2003:



Foster Care:



States Focusing on Finding Permanent Homes for Children, but Long-

Standing Barriers Remain:



Statement of Cornelia M. Ashby, Director

Education, Workforce, and Income Security Issues:



GAO-03-626T:



This is a work of the U.S. government and is not subject to copyright 

protection in the United States. It may be reproduced and distributed 

in its entirety without further permission from GAO. However, because 

this work may contain copyrighted images or other material, permission 

from the copyright holder may be necessary if you wish to

reproduce this material separately.



GAO Highlights:



Highlights of GAO-03-626T, a testimony for the Subcommittee on Human 

Resources, Committee on Ways and Means, House of Representatives 





Why GAO Did This Study:



In response to concerns that some children were languishing in 

temporary foster care, Congress enacted the Adoption and Safe Families 

Act of 1997 (ASFA) to help states move children in foster care more 

quickly to safe and permanent homes.  ASFA contained two key 
provisions:



(1) the “fast track” provision allows states to bypass efforts to 

reunify families in certain egregious situations and (2) the “15 of 22” 

provision requires states, with a few exceptions, to file a petition to 

terminate parental rights (TPR) when a child has been in foster care 

for 15 of the most recent 22 months.  Representative Wally Herger, 

Chairman of the House Ways and Means Subcommittee on Human Resources 

asked GAO to review (1) changes in outcomes for children in foster care 

since ASFA was enacted, (2) states’ implementation of ASFA’s fast track 

and 15 of 22 provisions, (3) states’ use of two new adoption-related 

funds provided by ASFA, and (4) states’ initiatives to address barriers 

to achieving permanency.  



What GAO Found:



ASFA’s goal was to increase permanent placements, such as adoption, for

children in foster care, but determining ASFA’s impact is difficult.  

The annual number of adoptions have increased by 57 percent from the 

time ASFA was enacted through fiscal year 2000; however, the lack of 

comparable pre- and post-ASFA data make it difficult to determine 

ASFA’s role in this increase.  In addition, states have improved their 

foster care data since ASFA, making it difficult to determine whether 

observed changes in outcomes are due to changes in data quality or 

changes in state performance.  States have also pursued other child 

welfare reform efforts that may be contributing to outcome changes.  

HHS data on children who left foster care between 1998 and 2000 

indicate that most were reunified with their families after spending a 

median of 1 year in care (although about 33 percent returned to foster 

care within 2 years). Children who were adopted spent a median of 39 

months in care.



In response to a GAO survey, very few states were able to provide data 

on the number of children affected by ASFA’s fast track and 15 of 22 

provisions.  Survey data, as well as information gathered from the six 

states GAO visited, suggest that states use the fast track provision 

infrequently and exempt a number of children from the 15 of 22 

provision. During GAO’s site visits, state and local officials 

described circumstances, such as the reluctance on the part of some 

judges to allow a state to bypass reunification efforts, which made it 

difficult for these states to use fast track for more cases.  In 

addition, these officials said that difficulties finding adoptive homes 

for certain children, such as adolescents, discouraged states from 

using the 15 of 22 provision for these children.  States reported 

exempting children placed with relatives and children who were expected 

to reunify shortly with their families.



States are most frequently using ASFA’s two new adoption-related funds 

to recruit adoptive parents and provide post adoption services.  

Examples include purchasing advertisements on Spanish language 

television to recruit adoptive families for older Hispanic children and 

creating a statewide adoption resource center to provide support to 

adoptive families.



The states GAO visited have implemented a variety of practices to 

address long-standing barriers—such as court delays and difficulties in 

recruiting adoptive families for children with special needs—to 

achieving permanency for foster children. To help address court delays, 

for example, Massachusetts has developed a mediation program to help 

birth families and potential adoptive parents agree on the permanent 

plan for a child.  However, limited data are available on the 

effectiveness of these practices.



In a related report, GAO recommended that the Secretary of Health and 

Human Services review the feasibility of collecting data on states’ use 

of ASFA’s fast track and 15 of 22 provisions.



www.gao.gov/cgi-bin/getrpt?GAO-03-626T.



To view this testimony, click on the link above.

For more information, contact Cornelia M. Ashby at (202) 512-8403 or 

ashbyc@gao.gov.



[End of section]



Mr. Chairman and Members of the Subcommittee:



Thank you for inviting me here today to discuss the implementation of 

the Adoption and Safe Families Act of 1997 (ASFA). As you are aware, 

this legislation was enacted in response to concerns that some children 

were languishing in temporary foster care while prolonged attempts were 

made to reunify them with their birth families. ASFA contained two key 

provisions that were intended to help states move children in foster 

care more quickly to safe and permanent homes. One of these provisions, 

referred to as “fast track,” allows states to bypass efforts to reunify 

families in certain egregious situations. The other provision, 

informally called “15 of 22,” requires states, with a few exceptions, 

to file a petition to terminate parental rights (TPR) when a child has 

been in foster care for 15 of the most recent 22 months. In addition, 

ASFA emphasized the importance of adoption when foster children cannot 

safely and quickly return to the care of their birth parents. Toward 

that end, ASFA established incentive payments for states that increase 

their adoptions. In addition, the law provided a new source of funds 

for states to use to promote and support adoptions through the 

Promoting Safe and Stable Families (PSSF) Program.



My testimony today will focus on four key issues: (1) changes in the 

outcomes and characteristics of children in foster care from the time 

ASFA was enacted through fiscal year 2000, (2) states’ implementation 

of ASFA’s fast track and 15 of 22 provisions, (3) states’ use of 

adoption-related funds provided by ASFA, and (4) practices states are 

using to address barriers to achieving permanency for children in 

foster care. My comments are based on the findings from our June 2002 

report, Foster Care: Recent Legislation Helps States Focus on Finding 

Permanent Homes for Children, but Long-Standing Barriers Remain (GAO-

02-585, June 28, 2002). Those findings were based on our analyses of 

national foster care and adoption data from the U.S. Department of 

Health and Human Services (HHS) for fiscal years 1998 through 

2000;[Footnote 1] site visits to Illinois, Maryland, Massachusetts, 

North Carolina, Oregon, and Texas; and interviews with federal 

officials and child welfare experts. In addition, we conducted a survey 

of child welfare directors in the 50 states and the District of 

Columbia.[Footnote 2] We received responses from 46 states, although 

they did not all respond to every question.[Footnote 3]



In summary, while the annual number of adoptions has increased by 57 

percent from the time ASFA was enacted through fiscal year 2000, the 

lack of comparable pre-and post-ASFA data makes it difficult to 

determine ASFA’s role in this increase or changes in other foster care 

outcomes. However, HHS data on children who left foster care between 

1998 and 2000 provide some insight into the experiences of children in 

foster care. For example, children who left foster care during this 

time spent a median of nearly 1 year in care. Of these children, those 

who were adopted spent a median of approximately 3-½ years in foster 

care. Recent improvements in the quality of HHS data, however, make it 

difficult to determine if changes observed after 1998 are the result of 

changes in data quality or actual changes in the outcomes and 

characteristics of foster children. Similarly, data on states’ use of 

ASFA’s two key permanency provisions--fast track and 15 of 22--are 

limited, although some states described circumstances that hindered the 

broader use of these provisions. For example, state officials described 

several court-related issues, such as reluctance on the part of some 

judges to allow a state to bypass reunification efforts, which made it 

difficult for these states to use the fast track provision for more 

cases.



In general, states are most frequently using the new adoption-related 

funds provided by ASFA to recruit adoptive parents and provide post 

adoption services. For example, Connecticut used its adoption incentive 

funds to buy advertisements on Spanish language television to recruit 

adoptive families for older Hispanic children and sibling groups to 

address a shortage of families for these children. Oregon used its PSSF 

funds to create a new, statewide resource center to provide information 

and referral services, support groups, and educational workshops to 

adoptive families. The states we visited have implemented a variety of 

practices to address long-standing barriers--such as court delays and 

difficulties in recruiting adoptive families for children with special 

needs--to achieving permanency for foster children. To help address 

court delays, for example, Massachusetts has developed a mediation 

program to help birth families and potential adoptive parents agree on 

the permanent plan for a child, thereby avoiding the time associated 

with a court trial and an appeal of the court’s decision. States are 

testing different approaches to address these barriers; however, 

limited data are available on the effectiveness of these practices.



Background:



The foster care system has grown dramatically in the past two decades, 

with the number of children in foster care nearly doubling since the 

mid-1980s. Concerns about children’s long stays in foster care 

culminated in the passage of ASFA in 1997, which emphasized the child 

welfare system’s goals of safety, permanency, and child and family 

well-being. HHS’s Administration for Children and Families (ACF) is 

responsible for the administration and oversight of federal funding to 

states for child welfare services under Titles IV-B and IV-E of the 

Social Security Act.



These two titles of the Social Security Act provide federal funding 

targeted specifically to foster care and related child welfare 

services.[Footnote 4] Title IV-E provides an open-ended individual 

entitlement for foster care maintenance payments to cover a portion of 

the food, housing, and incidental expenses for all foster children 

whose parents meet certain federal eligibility criteria.[Footnote 5] 

Title IV-E also provides payments to adoptive parents of eligible 

foster children with special needs.[Footnote 6] Special needs are 

characteristics that can make it more difficult for a child to be 

adopted and may include emotional, physical, or mental disabilities; 

age; or being a member of a sibling group or a member of a minority 

race. Title IV-B provides limited funding for child welfare services to 

foster children, as well as children remaining in their homes. In 

fiscal year 2002, total Title IV-E spending was approximately $6.1 

billion and total Title IV-B spending was approximately $674 million.



HHS compiles data on children in foster care and children who have been 

adopted from state child welfare agencies in the Adoption and Foster 

Care Analysis and Reporting System (AFCARS). HHS is responsible for 

collecting and reporting data and verifying their quality. States began 

submitting AFCARS data to HHS in 1995. Twice a year, states are 

required to submit data on the characteristics of children in foster 

care, foster parents, adopted children, and adoptive parents. Prior to 

AFCARS, child welfare data were collected in the Voluntary Cooperative 

Information System (VCIS), operated by what was then called the 

American Public Welfare Association.[Footnote 7] Since reporting to 

VCIS was not mandatory, the data in the system were incomplete. In 

addition, the data submitted were inconsistent because states used 

different reporting periods and different definitions for various data 

elements.



ASFA included two key provisions intended to help states move into 

safe, permanent placements those foster children who are unable to 

safely return home in a reasonable amount of time. Under the fast track 

provision, states are not required to pursue efforts to prevent removal 

from home or to return a child home if a parent has (1) lost parental 

rights to that child’s sibling; (2) committed specific types of 

felonies, including murder or voluntary manslaughter of the child’s 

sibling; or (3) subjected the child to aggravated circumstances, such 

as abandonment, torture, chronic abuse, or sexual abuse. In these 

egregious situations, the courts may determine that services to 

preserve or reunite the family are not required. Once the court makes 

such a determination, the state must begin within 30 days to find the 

child an alternative permanent family or other permanent 

arrangement.[Footnote 8]



The second provision requires states to file a TPR with the courts if 

(1) an infant has been abandoned; (2) the parent committed any of the 

felonies listed in the fast track provision; or (3) the child has been 

in foster care for 15 of the most recent 22 months. ASFA allows for 

some exemptions from the 15 of 22 provision. Under ASFA, states are not 

required to file a TPR if the child is placed with a relative; the 

state has not provided services needed to make the home safe for the 

child’s return; or the state documents a compelling reason that filing 

a TPR is not in the child’s best interest.



ASFA also created two new adoption-related funding sources. First, ASFA 

reauthorized the family preservation and family support program under 

subpart 2 of Title IV-B of the Social Security Act, renaming it 

Promoting Safe and Stable Families (PSSF) and adding two new funding 

categories: adoption promotion and support services and time-limited 

family reunification services. The original family preservation program 

included only family preservation and community-based family support 

services. In January 2002, the PSSF program was reauthorized, 

authorizing $305 million for each of fiscal years 2002 through 2006, 

along with an additional $200 million in discretionary grant funds for 

each of those years.



Second, ASFA created the adoption incentive payment program, which 

awards states $4,000 for each foster child who is adopted over a 

previously established baseline and an extra $2,000 for each adopted 

child characterized by the state as having a special need. States have 

earned a total of approximately $145 million in incentive payments for 

adoptions finalized in fiscal years 1998 through 2001.



ASFA also expanded the use of federal child welfare demonstration 

waivers that allow states to test innovative foster care and adoption 

practices. In 1994, the Congress gave HHS the authority to establish up 

to 10 child welfare demonstrations that waive certain restrictions in 

Titles IV-B and IV-E of the Social Security Act and allow broader use 

of federal foster care funds. ASFA authorized 10 additional waivers in 

each year between fiscal years 1998 and 2002 to ensure more states had 

the opportunity to test innovations. States with an approved waiver 

must conduct a formal evaluation of the project’s effectiveness and 

must demonstrate the waiver’s cost neutrality--that is, a state cannot 

spend more in Titles IV-B and IV-E funds than it would have without the 

waiver. Projects generally are to last no more than 5 years.



Limited Data are Available to Measure Changes in the Outcomes and 

Characteristics of Children Since ASFA:



The number of annual adoptions has increased since the implementation 

of ASFA; however, data limitations restrict comparative analysis of 

other outcomes and characteristics of children in foster care.[Footnote 

9] Foster care adoptions grew from 31,004 in fiscal year 1997 to 48,680 

in fiscal year 2000, representing a 57 percent increase.[Footnote 10] 

However, current data constraints make it difficult to determine what 

role ASFA played in this increase. The lack of reliable and comparable 

pre-and post-ASFA data limits our ability to analyze how other foster 

care outcomes or children’s characteristics have changed. Current data 

do, however, provide some information about the characteristics and 

experiences of foster children after ASFA. For example, children 

leaving foster care between 1998 and 2000 spent a median of 

approximately 1 year in care. Of these children, those who were adopted 

spent more time in care--a median of approximately 3-½ years.



Adoptions Have Increased Since ASFA, but Changes in Other Outcomes 

Unclear:



Adoptions from state foster care programs have increased nationwide by 

57 percent from the time ASFA was enacted through fiscal year 2000, but 

changes in other outcomes are less clearly discernable. According to 

data available from HHS, the increase in adoptions began prior to the 

enactment of federal child welfare reforms (see fig. 1). For example, 

adoptions generally increased between 8 percent and 12 percent each 

year between 1995 and 2000, except in 1999 when they increased by 29 

percent over 1998 adoptions. The increase in overall adoptions of 

children in foster care is accompanied by a parallel increase in the 

adoptions of children with special needs.



Figure 1: Number of Children Adopted from Foster Care between Fiscal 

Years 1995 and 2000:



[See PDF for image]



Note: The percentages in parentheses represent the increase in 

finalized adoptions over the previous year.



[End of figure]



The role ASFA played in the increase in adoptions after 1997, however, 

is unclear. Similarly, whether the number of foster children being 

adopted will continue to rise in the future is unknown. For example, 

since our report was issued last June, HHS reported that 48,741 

adoptions were finalized in 2001, which represents only a slight 

increase over adoptions finalized in 2000. While ASFA may have 

contributed to the adoptions of these children, other factors may have 

also played a role. For example, HHS officials told us that state child 

welfare reform efforts that occurred before ASFA might be linked to the 

observed increase in adoptions. Since it can take several years for 

foster children to be adopted, and ASFA has only been in existence for 

a few years, evidence of ASFA’s effect may not be available for some 

time.



ASFA’s effect on other foster care outcomes, such as birth family 

reunifications, is also difficult to determine. Lack of comparable and 

reliable data on foster care children, before and after ASFA, make it 

difficult to know how ASFA has affected the child welfare system. While 

HHS officials report that some data are reliable to provide a picture 

of children in foster care after ASFA, they state that the child 

welfare data covering pre-ASFA periods are not reliable due to problems 

such as low response rates and data inconsistencies. Since 1998, 

however, HHS data specialists have observed improvements in the data 

submitted to HHS by states and attribute the changes to several 

factors, including the provisions of federal technical assistance to 

the states on data processing issues, the use of federal financial 

penalties and rewards, and the use of outcome measures to evaluate 

states’ performance. According to HHS, these data improvements make it 

impossible to determine whether observed changes in outcomes from one 

year to the next are the result of changes in data quality or changes 

in state performance. HHS expects that the data will stabilize over 

time and can eventually be used as a reliable measure of state 

performance.



Current Data Describe Characteristics and Experiences of Children Who 

Exited Care between 1998 and 2000:



Although pre-ASFA data are limited, current data do shed some light on 

the characteristics and experiences of the more than 741,000 children 

who exited foster care between 1998 and 2000.[Footnote 11] According to 

HHS data for this time period and results from our survey, the 

following outcomes and characteristics describe the experiences 

children had while in foster care:



* Children left foster care after a median length of stay of 

approximately 1 year, although the amount of time spent in care 

differed depending on where the children were permanently placed. For 

example, in 2000, the median length of stay for children exiting care 

was 12 months. In contrast, the median length of stay for adopted 

children was 39 months in 2000.



* Many children have only one placement during their foster care stay, 

but a few experience five or more placements. Adopted children tend to 

have more foster care placements than other children, in part, because 

of their longer foster care stays.



* Upon leaving foster care, most children returned home to the families 

they had been living with prior to entering foster care. However, 

approximately 33 percent of the children who went home to their birth 

families in 1998 subsequently returned to foster care by 2000, for 

reasons such as additional abuse and neglect at home.



* Our survey results indicated that the median percentage of children 

abused or neglected while in foster care during 1999 and 2000 was 0.60 

percent and 0.49 percent, respectively.[Footnote 12] Maltreatment rates 

in foster care ranged from a high of 2.74 percent in the District of 

Columbia to a low of 0.02 percent in Nebraska.[Footnote 13]



Children exit foster care in a number of ways, including reunifying 

with their families,[Footnote 14] being adopted, 

emancipation,[Footnote 15] or entering a guardianship 

arrangement.[Footnote 16] Although most children reunify with their 

families, the second most common way of exiting foster care is through 

adoption. The children adopted from foster care have a wide variety of 

characteristics, yet the data indicate some general themes.



* On average, 85 percent of the children adopted in 1998, 1999, and 

2000 were classified as having at least one special need that would 

qualify them for adoption subsidies under Title IV-E.[Footnote 17] 

According to results from our survey, 18 states reported that, on 

average, 32 percent of the children adopted from foster care in 2000 

had three or more special needs.[Footnote 18]



* Children adopted from foster care are equally likely to be male or 

female, slightly more likely to be black, and much more likely to be 

under age 12. The gender and race/ethnicity distributions of children 

adopted from foster care are similar to those of the general population 

of children in foster care. However, children adopted from foster care 

tend to be younger than the general population of children in foster 

care.



* Our survey results indicate that in fiscal year 2000 adopted children 

spent an average of 18 months living with the family that eventually 

adopted them prior to their adoption being finalized.[Footnote 19]



As noted for other outcomes, the lack of reliable and national pre-ASFA 

data make it difficult to determine whether the rate at which adoptions 

encountered problems has changed since ASFA was enacted.[Footnote 20] 

However, limited data suggest that problems occur in a small percentage 

of foster care adoptions. According to our survey,[Footnote 21] about 5 

percent of adoptions planned in fiscal years 1999 and 2000 disrupted 

prior to being finalized.[Footnote 22] States also reported that 

approximately 1 percent of adoptions finalized in these years legally 

dissolved at a later date and that about 1 percent of the children who 

were adopted in these years subsequently re-entered foster 

care.[Footnote 23] However, little time has elapsed since these 

adoptions were finalized, and some of these adoptions may fail at a 

later date.



While Little Data are Available on Key ASFA Permanency Provisions, Some 

States Describe Circumstances That Limit Their Broader Use:



While few states were able to provide data on the numbers of children 

affected by ASFA’s fast track and 15 of 22 provisions, some reported on 

circumstances that make it difficult to use these provisions for more 

children. In addition, HHS collects very little data on the use of 

these provisions. Data from four states that provided fast track data 

in response to our survey indicate that they do not use this provision 

frequently. However, they described several court-related issues that 

make it difficult to fast track more children, including court delays 

and a reluctance on the part of some judges to relieve the state from 

reunification efforts. Survey responses from the few states that 

provided data on the 15 of 22 provision indicate that these states do 

not file TPRs for many children who are in care for 15 months. 

Officials in the six states we visited reported that they determine 

that filing a TPR under this provision for many children is not in the 

children’s best interests. The determination is based on a variety of 

factors, such as difficulties in finding adoptive parents.



While Data on Fast Track Are Limited, Some States Report Court-Related 

Issues That Hinder the Use of the Fast Track Provision for More 

Children:



Few states were able to provide data on their use of the fast track 

provision in response to our survey and HHS does not collect these data 

from the states. As a result, we do not have sufficient information to 

discuss the extent to which states are using this provision. Survey 

data reported by four states suggest the infrequent use of fast track. 

In fiscal year 2000, for example, about 4,000 children entered the 

child welfare system in Maryland, but only 36 were fast-tracked. Child 

welfare officials in the six states we visited told us that they used 

ASFA’s fast track provision for a relatively small number of cases. 

Three states indicated that they fast-tracked abandoned infants, while 

four states reported using fast track for cases involving serious 

abuse, such as when a parent has murdered a sibling; however, some 

state officials also noted that few child welfare cases involve these 

circumstances. In addition, five states reported that they would fast 

track certain children whose parents had involuntarily lost parental 

rights to previous children if no indication exists that the parents 

have addressed the problem that led to the removal of the children.



Officials in five of the states we visited described several court-

related issues that they believe hindered the greater use of the fast 

track provision. However, because of the lack of data on states’ use of 

fast track, we were unable to determine the extent of these problems. 

Officials in these states told us that some judges or other legal 

officials are at times reluctant to approve a state’s fast track 

request. For example, child welfare staff for a county in North 

Carolina described a case in which a judge approved a fast track 

request involving a child who had suffered from shaken baby syndrome, 

but refused a similar request on a sibling who was born a few months 

after the shaking episode. County staff said that the judge’s decision 

was based on the fact that the parents had not hurt the newborn and 

should be given an opportunity to demonstrate their ability to care for 

this child. State officials in North Carolina also told us that delays 

in scheduling TPR trials in the state undermine the intent of fast 

tracking. They noted that the agency may save time by not providing 

services to a family, but the child may not be adopted more quickly if 

it takes 12 months to schedule the TPR trial. Officials in 

Massachusetts expressed similar concerns about court delays experienced 

in the state when parents appeal a court decision to terminate their 

parental rights.



Other difficulties in using fast track to move children out of foster 

care more quickly are related to the specific categories of cases that 

are eligible to be fast-tracked. Officials in five states told us that 

they look at several factors when considering the use of fast track for 

a parent who has lost parental rights for other children. If a 

different birth father is involved, child welfare officials told us 

that they are obligated to work with him to determine if he is willing 

and able to care for the child. According to Maryland officials, if the 

agency is providing services to the father to facilitate reunification, 

pursuing a fast track case for the mother will not help the child leave 

foster care more quickly. In addition, child welfare officials in 

Massachusetts and Illinois emphasized that a parent who has addressed 

the problems that led to a previous TPR should have an opportunity to 

demonstrate the ability to care for a subsequent child.



Regarding the fast track category involving parents who have been 

convicted of certain felonies, child welfare officials in Massachusetts 

and Texas described this provision as impractical due to the time it 

takes to obtain a conviction. Massachusetts officials told us that, in 

most cases, the children are removed at the time the crime is 

committed, and judges will not approve the fast track in these cases 

until the parent is actually convicted, which is usually at least a 

year after the actual crime. Finally, in Massachusetts, Texas, and 

Maryland, officials reported that it can be difficult to prove that a 

parent subjected a child to aggravated circumstances, such as torture 

or sexual abuse. According to these officials, the time and effort to 

go through additional court hearings to demonstrate the aggravated 

circumstances is not worthwhile; instead, the child welfare agency 

chooses to provide services to the family.



Although Little Data Exist on 15 of 22, Some States Report That They Do 

Not File TPRs on Many Children:



Most states do not collect data on their use of ASFA’s 15 of 22 

provision. In response to our survey, only nine states were able to 

provide information on the number of children for whom the state filed 

a TPR due to the 15 of 22 provision or the number of children who were 

in care for 15 of the most recent 22 months and for whom a TPR was not 

filed. In addition, HHS does not systematically track these data, 

although it does collect some limited information on the 15 of 22 

provision as part of its review of state child welfare agencies. The 

survey responses from 9 states indicated that they did not file a TPR 

on a number of children--between 31 and 2,919 in 2000--who met the 

requirements of the 15 of 22 provision. For most of these nine states, 

the number of children for whom a TPR was not filed greatly exceeded 

the number of children for whom a TPR was filed. For example, while 

Oklahoma filed over 1,000 TPRs primarily because the child had been in 

foster care for 15 of the most recent 22 months, it did not file a TPR 

for an additional 2,900 children.



Officials in all six states we visited told us that establishing 

specific timeframes for making permanency decisions about children in 

foster care has helped their child welfare agencies focus their 

priorities on finding permanent homes for children more quickly. Two of 

the states we visited--Texas and Massachusetts--created procedures 

prior to ASFA to review children who had been in care for a certain 

length of time and decide whether continued efforts to reunify a family 

were warranted. Other states had not established such timeframes for 

making permanency decisions before the 15 of 22 provision was enacted. 

The director of one state child welfare agency told us that, prior to 

ASFA, the agency would work with families for years before it would 

pursue adoption for a child in foster care. Officials in Maryland, 

North Carolina, and Oregon said that the pressure of these new 

timeframes has helped child welfare staff work more effectively with 

parents, informing them up front about what actions they have to take 

in the next 12 to 15 months in order to reunify with their children. 

Private agency staff in three states, however, expressed concern that 

pressure from these timeframes could push the child welfare agency and 

the courts to make decisions too quickly for some children.



Child welfare officials in the six states we visited described several 

circumstances under which they would not file a TPR on a child who was 

in care for 15 of the most recent 22 months. In five of the six states, 

these officials told us that the provision is difficult to apply to 

children with special needs for whom adoption may not be a realistic 

option, such as adolescents and children with serious emotional or 

behavioral problems. Officials from Maryland and North Carolina 

reported that, in many cases, the child welfare agency does not file a 

TPR for children who have been in care for 15 of the most recent 22 

months because neither the agency nor the courts consider it to be in 

the children’s best interest to be legal orphans--that is, to have 

their relationship to their parents legally terminated, but have no 

identified family ready to adopt them.[Footnote 24] State officials in 

Oregon told us that state law requires that parental rights be 

terminated solely for the purposes of adoption, so as to avoid creating 

legal orphans.



Officials in four states noted that many adolescents remain in long-

term foster care. In some cases, they have strong ties to their 

families, even if they cannot live with them, and will not consent to 

an adoption.[Footnote 25] In other cases, the teenager is functioning 

well in a stable situation with a relative or foster family that is 

committed to the child but unwilling to adopt.[Footnote 26] For 

example, officials in a child welfare agency for a county in North 

Carolina told us about a potentially violent 16-year old foster child 

who had been in a therapeutic foster home for 10 years. The family was 

committed to fostering the child, but did not want to adopt him because 

they did not have the financial resources to provide for his medical 

needs and because they did not want to be responsible for the results 

of his actions.



Child welfare staff from two states told us that some parents need a 

little more than 15 months to address the problems that led to the 

removal of their children. If the child welfare agency is reasonably 

confident that the parents will be able to reunify with their children 

in a few months, the agency will not file a TPR for a child who has 

been in foster care for 15 months. In addition, child welfare officials 

in four states observed that parents must have access to needed 

services, particularly substance abuse treatment, soon after a child 

enters care in order for the child welfare system to determine if 

reunification is a realistic goal by the time a child has been in care 

for 15 months. Officials in Maryland, Oregon, and Texas reported that 

the lack of appropriate substance abuse treatment programs that address 

the needs of parents makes it difficult to get parents in treatment and 

stable by the 15th month.



New ASFA Adoption-Related Funds Most Commonly Used to Recruit Adoptive 

Families and Provide Post Adoption Services:



States reported in our survey that they most commonly used their 

adoption incentive payments and PSSF adoption promotion and support 

services funds to recruit adoptive families and to provide post 

adoption services (see table 1). Child welfare officials in all of the 

states we visited reported that they are struggling to recruit adoptive 

families for older children and those with severe behavioral or medical 

problems. To meet this challenge, states are investing in activities 

designed to match specific foster care children with adoptive families, 

as well as general campaigns to recruit adoptive families. Child-

specific recruitment efforts include: featuring children available for 

adoption on television, hosting matching parties for prospective 

adoptive parents to meet children available for adoption, and taking 

pictures and videos of foster children to show to prospective families. 

For example, Massachusetts used its incentive payments to fund 

recruitment videos to feature the 20 children who had been waiting the 

longest for adoptive families. General recruitment efforts being funded 

by states include promoting adoption through National Adoption Month 

events, hiring additional recruiters, and partnering with religious 

groups.



Table 1: Main Uses of Adoption Incentive Payments and PSSF Adoption 

Promotion and Support Funds:



Activity: Recruitment of adoptive families; Number of states using 

adoption incentive payments: (FY 1999 and FY 2000): 19[A]; Number of 

states

using PSSF adoption promotion and support funds (FY 2000): 16[B].



Activity: Post adoption services[C]; Number of states using adoption 

incentive payments: (FY 1999 and FY 2000): 17[A]; Number of states

using PSSF adoption promotion and support funds (FY 2000): 21[B].



Activity: Preadoptive counseling; Number of states using adoption 

incentive payments: (FY 1999 and FY 2000): [D]; Number of states

using PSSF adoption promotion and support funds (FY 2000): 15.



Activity: Hiring/Contracting additional social work staff; Number of 

states using adoption incentive payments: (FY 1999 and FY 2000): 13[E]; 

Number of states

using PSSF adoption promotion and support funds (FY 2000): d.



Activity: Training; Number of states using adoption incentive payments: 

(FY 1999 and FY 2000): 11; Number of states

using PSSF adoption promotion and support funds (FY 2000): 4.



Source: GAO survey.



Note: Of the 46 states that responded to our survey, 34 provided data 

on the use of FY 1999 and FY 2000 incentive payments and 26 provided 

information on the use of FY 2000 PSSF funds.



[A] One state provided data for calendar year 1999.



[B] One state provided data for calendar year 2000.



[C] Post adoption services include: counseling, respite care (short-

term specialized child care to provide families with temporary relief 

from the challenges of caring for adoptive children), support groups, 

adoption subsidies, and adoption preservation services.



[D] This activity was not included as a response for this funding 

source.



[E] One state provided data for state fiscal years 1999 and 2000.



[End of table]



States are also investing adoption incentive payments and PSSF funds in 

services to help adoptive parents meet the challenges of caring for 

children who have experienced abuse and neglect. During our site 

visits, officials in Massachusetts and Illinois pointed out that the 

population of adopted children had increased significantly in recent 

years and that the availability of post adoption services was essential 

to ensure that these placements remain stable. Approximately 60 percent 

of the states responding to our survey used their adoption incentive 

payments or their PSSF funds or both for post adoption services, such 

as post adoption counseling, respite services, support groups, and 

recreational activities. For example, California has used some of its 

adoption incentive funds to pay for therapeutic camps and tutoring 

sessions for adopted children. In addition, Minnesota has used PSSF 

funds to teach adoptive parents how to care for children with fetal 

alcohol syndrome and children who find it difficult to become 

emotionally attached to caregivers.



Although the 46 states responding to our survey reported that they are 

most frequently using the money for the activities described above, 

about two-thirds of them also reported that they are investing some of 

these funds in a variety of other services. Many states are using PSSF 

funds to provide pre-adoptive counseling to help children and parents 

prepare for the emotional challenges of forming a new family. 

Similarly, some states are using incentive payments and PSSF funds to 

train foster families, adoptive families, and service providers. For 

example, Arkansas used its incentive payments to help families attend 

an adoptive parent conference, while Kentucky used its incentive funds 

to train judges and attorneys on adoption matters. Finally, some states 

are using their adoption incentive payments to hire or contract 

additional child welfare and legal staff.



States Develop Practices in Response to Long-Standing Barriers That 

Continue to Hamper Efforts to Promote Permanency for Foster Children:



States have been developing a range of practices to address long-

standing barriers to achieving permanency for children in a timely 

manner--many of which have been the subject of our previous reports. 

Both independently and through demonstration waivers approved by HHS, 

states are using a variety of practices to address barriers relating to 

the courts, recruiting adoptive families for children with special 

needs, placing children in permanent homes in other jurisdictions, and 

the availability of needed services. Because few of these practices 

have been rigorously evaluated, however, limited information is 

available on their effectiveness.



Systemic Court Problems Continue to Delay Child Welfare Cases:



Our previous work, officials in all the states we visited, and over 

half of our survey respondents identified problems with the court 

system as a barrier to moving children from foster care into safe and 

permanent homes.[Footnote 27] In 1999, we reported on systemic problems 

that hinder the ability of courts to produce decisions on child welfare 

cases in a timely manner that meet the needs of children.[Footnote 28] 

The barriers included inadequate numbers of judges and attorneys to 

handle large caseloads, the lack of cooperation between the courts and 

child welfare agencies, and insufficient training of judges and 

attorneys involved in child welfare cases.



During our visit to Massachusetts, state officials told us that the 

courts experienced significant delays in court hearings and appeals due 

to a lack of court resources. As an alternative to court proceedings, 

Massachusetts implemented a permanency mediation program--a formal 

dispute resolution process in which an independent third party 

facilitates permanency planning between family members and potential 

adoptive parents in a nonadversarial setting. By avoiding trials to 

terminate parental rights, Massachusetts officials reported that 

permanency mediation helps reduce court workloads, eliminate appeals, 

and more effectively uses limited court resources. A preliminary 

evaluation of the Massachusetts program suggested that cases involved 

in the mediation program needed less time and fewer court resources to 

reach an agreement than cases that go to trial. However, the evaluation 

did not directly compare outcomes, such as the length of time a child 

spent in foster care, for mediation and nonmediation cases.



Texas officials identified court barriers in rural areas that 

negatively affect both the timeliness and quality of child welfare 

proceedings--specifically, the lack of court time for child welfare 

cases and the lack of judges with training and experience in child 

welfare issues. In response to these barriers, Texas developed the 

visiting judge cluster court system, an approach in which a judge 

trained in child welfare issues is assigned to a cluster of rural 

counties. The judge travels from county to county presiding over all 

child welfare cases. This approach may create more court time in rural 

areas and allows knowledgeable and experienced judges to make the best 

possible decisions for children in foster care. While Texas officials 

believe this approach has been helpful in moving children to 

permanency, no formal evaluation of the approach has been conducted.



Permanency for Children with Special Needs Hindered by Lack of Adoptive 

Families:



Officials in five states we visited, along with the majority of the 

respondents to our state survey, reported that difficulties in 

recruiting families to adopt children with special needs is a major 

barrier to achieving permanent placements for these children.[Footnote 

29] Our survey revealed that states relied on three main activities to 

recruit adoptive families for children who are waiting to be adopted: 

listing a child’s profile on state and local Web sites, exploring 

adoption by adults significantly involved in the child’s life, and 

featuring the child on local television news shows.[Footnote 30]



Several states we visited are using recruitment campaigns targeted to 

particular individuals who may be more likely to adopt children with 

special needs. For example, the child welfare agencies in Illinois, 

Maryland, North Carolina, and Texas are collaborating with local 

churches to recruit adoptive families specifically for minority 

children. However, an Illinois recruitment report noted that little 

information exists on what kinds of families are likely to adopt 

children with specific characteristics. While the states we visited 

used a variety of recruitment efforts to find families for special 

needs children, they generally did not collect data on the 

effectiveness of their recruiting efforts.



In addition to the activities described above, some demonstration 

waivers are testing a different approach to finding permanent homes for 

children in foster care.[Footnote 31] Seven states are using 

demonstration waivers to pay subsidies to relatives and foster parents 

who become legal guardians to foster children in their care. These 

states hope to reduce the number of children in long-term foster care 

by formalizing existing relationships in which relatives or foster 

parents are committed to caring for a child but adoption is not a 

viable option. Evaluation results from Illinois’s waiver suggest that 

offering subsidized guardianship can increase the percentage of 

children placed in a permanent and safe home. Results from most of the 

other guardianship waiver projects are not yet available.



Placing Children Across Jurisdictions Remains Problematic for States:



Many states encounter long-standing barriers in placing children with 

adoptive families in other states. As we reported previously, these 

interjurisdictional adoptions take longer and are more complex than 

adoptions within the same child welfare jurisdiction.[Footnote 32] 

Interjurisdictional adoptions involve recruiting adoptive families 

from other states or other counties within a state, conducting 

comprehensive home studies of adoptive families in one jurisdiction, 

sending the resulting home study reports to another jurisdiction, and 

ensuring that all required legal, financial, and administrative 

processes for interjurisdictional adoptions are completed. Five states 

we visited reported frequent delays in obtaining from other states the 

home study reports necessary to place a child with a potential adoptive 

family in another state. According to recent HHS data, children adopted 

by out-of-state families typically spend about 1 year longer in foster 

care than children adopted by in-state families.



Child welfare agencies have implemented a range of practices to 

facilitate adoptions across state and county lines. In our survey, the 

most common practices for recruiting adoptive families in other 

jurisdictions included publicizing profiles of foster care children on 

websites, presenting profiles of children in out-of-state media, and 

contracting with private agencies to recruit adoptive parents in other 

states.[Footnote 33] States have also developed practices to expedite 

the completion of home studies and shorten the approval processes for 

interstate adoptions. The two primary practices cited by states on our 

survey were working with neighboring states to facilitate interstate 

placements and contracting with private agencies to conduct home 

studies in other states.[Footnote 34]



States we visited have implemented several of these practices to 

overcome barriers to interjurisdictional adoptions. In Oregon, the 

state child welfare agency works with neighboring states in the 

Northwest Adoption Exchange to recruit adoptive parents for children 

with special needs. In Texas, the state contracts with private agencies 

to place foster care children with out-of-state adoptive families. In 

Illinois, the state works with a private agency in Mississippi to 

conduct home studies because families in Mississippi adopt many 

Illinois children.



Poor Access to Services Can Impede Permanency Decisions:



Officials in four states told us that making decisions about a child’s 

permanent home within a year is difficult if the parent has not had 

access to the services necessary to address their problems, 

particularly substance abuse treatment. We have previously reported on 

barriers to working with parents who have a substance abuse problem, 

including inadequate treatment resources and a lack of collaboration 

among substance abuse treatment providers and child welfare 

agencies.[Footnote 35] Similarly, 33 states reported in our survey that 

the lack of substance abuse treatment programs is a barrier to 

achieving permanency for children.[Footnote 36]



To address this issue, four states have developed waiver projects to 

address the needs of parents with substance abuse problems. By testing 

ways to engage parents in treatment and to provide more supportive 

services, these states hope to increase the number of substance abusing 

parents who engage in treatment, increase the percentage of children 

who reunify with parents who are recovering from a substance abuse 

problem, and reduce the time these children spend in foster care. For 

example, Delaware’s waiver funds substance abuse counselors to help 

social workers assess potential substance abuse problems and engage 

parents in treatment. Final evaluation results were published in March 

2002 and concluded that the project successfully engaged many parents 

in substance abuse treatment and resulted in foster care cost savings, 

although it did not achieve many of its intended outcomes. For example, 

children participating in the waiver project spent 31 percent less time 

in foster care than similar children who were not part of the waiver 

project, although the project’s goal was a 50 percent reduction. 

Evaluation results for the other states are not yet available.



Concluding Observations:



Most of the states we visited reported that ASFA has played an 

important role in helping them focus on achieving permanency for 

children within the first year that they enter foster care. However, 

numerous problems with existing data make it difficult to assess at 

this time how outcomes for children in foster care have changed since 

ASFA was enacted. While an increasing number of children have been 

placed in permanent homes through adoption during the last several 

years, we know little about the role ASFA played in the adoption 

increases or other important outcomes, such as whether children who 

reunify with their families are more or less likely to return to foster 

care or whether these adoptions are more or less stable than adoptions 

from previous years.



The availability of reliable data, both on foster care outcomes and the 

effectiveness of child welfare practices, is essential to efforts to 

improve the child welfare system. In the past few years, HHS and the 

states have taken important steps to improve the data available to 

assess child welfare operations. In addition, evaluation data from the 

demonstration waivers should be available in the next few years, 

providing key information on child welfare practices that are effective 

and replicable. However, important information about ASFA’s impact on 

children in foster care is still unavailable. For example, the lack of 

comprehensive and consistent data regarding the fast track and 15 of 22 

provisions make it difficult to understand the role of these new 

provisions in reforming the child welfare system and moving children 

into permanent placements. To obtain a clearer understanding of how 

ASFA’s two key permanency provisions are working, we recommended in our 

June 2002 report that the Secretary of HHS review the feasibility of 

collecting data on states’ use of ASFA’s fast track and 15 of 22 

provisions. In commenting on that report, ACF generally agreed with our 

findings and recommendation. ACF officials report that they are 

currently in the process of reviewing child welfare data issues, which 

includes an internal review of AFCARS and obtaining input from the 

states through focus groups. In addition, GAO is currently conducting 

an engagement for the Senate Finance Committee and the House Majority 

Leader on states’ implementation of automated information systems and 

reporting of child welfare data to HHS. I expect this report to be 

released in July.



Mr. Chairman, this concludes my prepared statement. I would be pleased 

to respond to any questions that you or other members of the 

Subcommittee may have.



GAO Contact and Acknowledgments:



For further contacts regarding this testimony, please call Cornelia M. 

Ashby at (202) 512-8403. Individuals making key contributions to this 

testimony include Diana Pietrowiak, Sara L. Schibanoff, and Michelle 

St. Pierre.



[End of section]



Related GAO Products:



Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare 

Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March 

31, 2003.



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.



Child Welfare: New Financing and Service Strategies Hold Promise, but 

Effects Unknown. GAO/T-HEHS-00-158. Washington, D.C.: July 20, 2000.



Foster Care: HHS Should Ensure That Juvenile Justice Placements Are 

Reviewed. GAO/HEHS-00-42. Washington, D.C.: June 9, 2000.



Foster Care: States’ Early Experiences Implementing the Adoption and 

Safe Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999.



Foster Care: HHS Could Better Facilitate the Interjurisdictional 

Adoption Process. GAO/HEHS-00-12. Washington, D.C.: November 19, 1999.



Foster Care: Effectiveness of Independent Living Services Unknown. GAO/

HEHS-00-13. Washington, D.C.: November 5, 1999.



Foster Care: Kinship Care Quality and Permanency Issues. GAO/HEHS-99-

32. Washington, D.C.: May 6, 1999.



Foster Care: Increases in Adoption Rates. GAO/HEHS-99-114R. Washington, 

D.C.: April 20, 1999.



Juvenile Courts: Reforms Aim to Better Serve Maltreated Children. GAO/

HEHS-99-13. Washington, D.C.: January 11, 2000.



Foster Care: Agencies Face Challenges Securing Stable Homes for 

Children of Substance Abusers. GAO/HEHS-98-182. Washington, D.C.: 

September 30, 1998.



Foster Care: State Efforts to Improve the Permanency Planning Process 

Show Some Promise. GAO/HEHS-97-73. Washington, D.C.: May 7, 1997.



Child Welfare: States’ Progress in Implementing Family Preservation and 

Support Activities. GAO/HEHS-97-34. Washington, D.C.: February 18, 

1997.



Permanency Hearings for Foster Children. GAO/HEHS-97-55R. Washington, 

D.C.: January 30, 1997.



Child Welfare: Complex Needs Strain Capacity to Provide Services. GAO/

HEHS-95-208. Washington, D.C.: September 26, 1995.



Child Welfare: HHS Begins to Assume Leadership to Implement National 

and State Systems. GAO/AIMD-94-37. Washington, D.C.: June 8, 1994.





FOOTNOTES



[1] Throughout this testimony, fiscal year refers to federal fiscal 

year, unless noted otherwise. In addition, we selectively updated 

information contained in this testimony.



[2] Throughout this testimony, references to state survey responses 

include the District of Columbia.



[3] In addition, we requested survey data by federal fiscal year for 

1999 and 2000. However, of the 46 states responding to our survey, 22 

provided data for time periods other than federal fiscal years 1999 and 

2000, such as calendar year or state fiscal year.



[4] In addition, Title XX provides funds under the social services 

block grant that may be used for many purposes, including child 

welfare.



[5] Certain judicial findings must be present for the child in order 

for the child to be eligible for Title IV-E foster care maintenance 

payments.



[6] Special needs are defined as a specific factor or condition that 

make it difficult to place a child with adoptive parents without 

providing adoption assistance. States have the discretion to define the 

specifics of the special needs category. The existence of special needs 

is used to determine a child’s eligibility for adoption assistance 

under Title IV-E. To qualify for an adoption subsidy under Title IV-E, 

the state must determine that the child cannot or should not return 

home; the state must make a reasonable, but unsuccessful effort to 

place the child without the subsidy; and a specific factor or condition 

must exist that makes it difficult to place the child without a 

subsidy. 



[7] In 1998, the American Public Welfare Association became the 

American Public Human Services Association.



[8] In addition, the Abandoned Infants Assistance Act of 1988, as 

amended in 1996, requires states to expedite the termination of 

parental rights for abandoned infants in order to receive priority to 

obtain certain federal funds.



[9] HHS officials believe that the adoption data available as early as 

1995 are more reliable than early data on other outcomes because of the 

incentive payments that states can earn for increasing adoptions. They 

noted that states made great efforts to improve the accuracy of their 

adoption data when the incentive payment baselines were established. 

For example, HHS initially estimated about 20,000 adoptions for fiscal 

year 1997, but after states reviewed and submitted their adoption data, 

as required for participation in the adoption incentive program, they 

reported about 31,000 adoptions.



[10] All HHS data are presented in terms of federal fiscal year.



[11] According to HHS’s AFCARS data, 223,255 children exited foster 

care in fiscal year 1998 from 44 states (including the District of 

Columbia and Puerto Rico); 250,950 exited foster care in fiscal year 

1999 from 51 states (including the District of Columbia and Puerto 

Rico); and 267,344 exited foster care in fiscal year 2000 from 51 

states (including the District of Columbia).



[12] Of the 46 states that responded to our survey, 16 provided data on 

the percentage of foster children who had a substantiated report of 

abuse or neglect in fiscal year 1999, 2 provided data for calendar year 

1999, 1 provided data for state fiscal year 1999, 18 provided data for 

fiscal year 2000, 1 provided data for calendar year 2000, and 2 

provided data for state fiscal year 2000.



[13] According to HHS’s Child Welfare Outcomes 1999: Annual Report, the 

median percentage of foster children abused and neglected while in care 

was 0.5 percent for the 20 states reporting. Maltreatment rates in 

foster care range from a high of 2.3 percent in Rhode Island to a low 

of 0.1 percent in Arizona, Delaware, and Wyoming.



[14] In AFCARS, reunification is defined as the child returning to the 

family with whom the child had been living prior to entering foster 

care. 



[15] A child is emancipated from foster care when the child reaches 

majority age according to state law.



[16] Guardianship arrangements occur when permanent legal custody is 

awarded to an individual, such as a relative.



[17] While current AFCARS data indicate that 85 percent of children 

adopted in fiscal years 1998 through 2000 have at least one special 

need, the adoption incentive data presented earlier in figure 1 

indicate a lower proportion of children with special needs adopted from 

foster care. An HHS official explained that this discrepancy is due to 

the timing of the measurement of the data. The data in figure 1 were 

measured at an earlier point in time and the numbers are not updated 

since adoption incentive payments are awarded to states based on the 

number of finalized adoptions reported at the end of each fiscal year. 

The data presented here reflect changes to AFCARS based on states 

resubmitting previous data after the initial reporting periods and are 

as recent as April 2002. 



[18] One of the 18 states reporting on the number of children adopted 

with three or more special needs provided data based on calendar year 

2000.



[19] Of the 46 states responding to our survey, 22 provided fiscal year 

data on the length of time children lived with the family that 

eventually adopted them and 1 provided data for calendar year 2000.



[20] Studies on adoption problems prior to ASFA’s enactment have 

several limitations, such as small samples sizes, coverage of a few 

locations, and a focus on narrowly defined groups of children. 



[21] Of the 46 states that responded to our survey, 17 provided data on 

adoption disruptions for fiscal year 1999, 2 provided data for calendar 

year 1999, 18 provided data on adoption disruptions for fiscal year 

2000, and 2 provided data for calendar year 2000. 



[22] For example, Illinois reported a 12.4 percent disruption rate for 

fiscal year 1999 on our survey. In comparison, one study (Robert Goerge 

and others, Adoption, Disruption, and Displacement in the Child Welfare 

System, 1976-1995 (Chicago: Chapin Hall Center for Children at the 

University of Chicago, 1995)) reviewed all planned and finalized 

adoptions in Illinois between 1981 and 1987. During that time, an 

average of 9.9 percent of adoption plans for Illinois foster children 

disrupted.



[23] Of the 46 states that responded to our survey, 18 provided data on 

dissolutions for fiscal year 1999, 19 provided data on dissolutions for 

fiscal year 2000 and 1 provided data for calendar year 2000. In 

addition, 21 states provided survey data on foster care re-entries by 

children adopted in fiscal year 1999, 22 provided data for children 

adopted in fiscal year 2000, and 1 provided data for children adopted 

in calendar year 2000. Our survey results indicate that of all the 

children with finalized adoptions in fiscal year 1999, 0.55 percent 

returned to foster care in fiscal year 1999 or 2000. Of all the 

children with finalized adoptions in fiscal year 2000, 1.43 percent 

returned to foster care in fiscal year 2000.



[24] In North Carolina, child welfare agency staff may recommend to the 

court that a TPR not be filed on a child who has been in care for 15 of 

the most recent 22 months; however, according to state officials, North 

Carolina requires that a judge determine that one of the ASFA 

exceptions exists.



[25] All the states we visited require that children over a certain age 

consent to their adoption. For example, Maryland requires that children 

10 years or older consent to their adoption.



[26] ASFA specifically allows states to exempt children placed with 

relatives from the 15 of 22 provision.



[27] Of the 29 states that reported an insufficient number of judges or 

court staff, 18 reported that the problem represented either a 

moderate, great, or very great hindrance to finding permanent homes for 

children. Of the 28 states that reported insufficient training for 

court staff, 20 reported that the problem represented a moderate or 

great hindrance. Of the 23 states that reported that judges were not 

supportive of ASFA’s goals, 10 reported that the problem represented 

either a moderate, great, or very great hindrance. Of the 46 states 

that responded to our survey, 40 reported on the insufficient number of 

judges and court staff, 41 reported on the lack of training for judges 

and court staff, and 39 reported on judges not being supportive of 

ASFA’s goals.



[28] U.S. General Accounting Office, Juvenile Courts: Reforms Aim to 

Better Serve Maltreated Children, GAO/HEHS-99-13 (Washington, D.C.: 

Jan. 11, 1999).



[29] Of the 46 states responding to our survey, 43 states reported on 

the sufficiency of adoptive homes for children with special needs. All 

43 states reported that they did not have enough adoptive homes for 

children with special needs, with 39 reporting that the problem 

represented a moderate, great, or very great hindrance to finding 

permanent homes for children.



[30] Of the 46 states responding to our survey, 44 answered the 

question about recruitment activities used in their states. 



[31] HHS is authorized to approve child welfare demonstration projects 

in up to 10 states for each of the 5 fiscal years 1998 through 2002. 

Under these projects, HHS waives certain restrictions in title IV-E and 

allows broader use of federal foster care funds.



[32] U.S. General Accounting Office, Foster Care: HHS Could Better 

Facilitate the Interjurisdictional Adoption Process, GAO/HEHS-00-12 

(Washington, D.C.: Nov. 19, 1999).



[33] Of the 46 states that responded to our survey, 22 reported that 

they publicized profiles of foster children in media in other states, 

41 reported that they publicized profiles of foster children on web 

sites, and 15 reported that they contracted with private agencies to 

recruit adoptive parents in other states. 



[34] Of the 46 states responding to our survey, 35 reported that they 

worked with neighboring states to facilitate interstate placements and 

19 reported that they contracted with private agencies in other states 

to conduct home studies.



[35] U.S. General Accounting Office, Foster Care: Agencies Face 

Challenges Securing Stable Homes for Children of Substance Abusers, 

GAO/HEHS-98-182 (Washington, D.C.: Sept. 30, 1998). 



[36] Of the 46 states that responded to our survey, 39 reported on the 

lack of substance abuse treatment programs. Of the 33 states that 

reported that not enough drug treatment programs were available, 26 

reported that the problem represented either a moderate, great, or very 

great hindrance to finding permanent homes for children.