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United States Government Accountability Office: 
GAO: 

Report to Congressional Requesters: 

October 2011: 

TANF and Child Welfare Programs: 

Increased Data Sharing Could Improve Access to Benefits and Services: 

GAO-12-2: 

GAO Highlights: 

Highlights of GAO-12-2, a report to congressional requesters. 

Why GAO Did This Study: 

In 2010, over 40 percent of families receiving cash assistance through 
the Temporary Assistance for Needy Families (TANF) program were “child-
only,” meaning the adults in the household were not included in the 
benefit calculation, and aid was provided only for the children. TANF 
and child welfare programs provide cash assistance and other services 
that support children living with nonparent caregivers. The U.S. 
Department of Health and Human Services (HHS) Administration for 
Children and Families (ACF) oversees TANF and child welfare programs, 
which are administered by states. GAO was asked to examine the (1) 
trends and composition of the child-only caseload, (2) characteristics 
of caregivers and children in nonparent child-only cases, (3) factors 
influencing the level of benefits and services for children with non-
parent caregivers, and (4) coordination efforts between state TANF and 
child welfare programs. GAO analyzed federal TANF and child welfare 
data; surveyed states; interviewed HHS officials and researchers; and 
conducted site visits in Tennessee, Texas, and Washington, selected 
for variation in TANF caseload characteristics and implementation of 
programs to support relative caregivers. 

What GAO Found: 

Between fiscal years 2000 and 2008, TANF child-only cases increased 
slightly but represented a greater share of the overall TANF caseload 
because cases with adults in the assistance unit experienced a 
significant decline. The national composition of the TANF child-only 
caseload has remained relatively unchanged since 2000. At the end of 
2010, the majority of children receiving TANF lived with parents who 
were ineligible for cash assistance, and one-third lived with 
nonparent caregivers who were relatives or unrelated adults. However, 
this composition varies by state. For example, in Tennessee, almost 60 
percent of the TANF child-only caseload included children living with 
nonparent caregivers, compared with about 30 percent in Texas. 

Most nonparent caregivers in TANF child-only cases are unmarried women 
who are over 50 years old, and research suggests that they often have 
low incomes and health problems. The children tend to be related to 
their caregiver, who is often a grandparent, and they remain on 
assistance for at least 2 years. Some of these children live with 
nonparent caregivers as a result of parental abuse or neglect, 
substance abuse, incarceration, or mental illness, but these 
circumstances may or may not be known by the child welfare agency. 

The level of benefits and services available to children living with 
nonparents depends on the extent to which a child welfare agency 
becomes involved in the family’s situation and the licensing status of 
the caregiver. Children in foster care with licensed foster parents 
are generally eligible for greater benefits and services than children 
in other living arrangements, who may receive TANF child-only 
assistance. For one child, the national average minimum monthly foster 
care payment is $511 while the average TANF child-only payment is 
$249. Most children live with relatives who do not receive foster care 
payments because they are not licensed foster parents or they are in 
informal arrangements without child welfare involvement. Other factors 
influencing the assistance made available to children in a relative’s 
care include available federal funding, state budget constraints, and 
increased state efforts to identify relative caregivers to prevent 
children from being placed in the foster care system. 

Several state and local efforts are under way to coordinate TANF and 
child welfare services to better serve children living with relative 
caregivers, but information sharing is a challenge. Coordination 
efforts include colocating TANF and child welfare services and having 
staff from each agency work together to help relative caregivers 
access services. ACF currently provides grants to states and tribes to 
support collaboration between TANF and child welfare programs and 
plans to disseminate the findings. However, information and data 
sharing between the two programs does not occur consistently, which 
can hinder relatives’ access to available benefits. For example, 
although HHS provides funding, guidance, and technical assistance to 
promote data sharing between TANF and child welfare programs, more 
than half of states reported obstacles to sharing data, such as 
privacy concerns. 

What GAO Recommends: 

GAO recommends the Secretary of HHS direct ACF to provide more 
guidance on data sharing opportunities. HHS agreed with GAO’s 
recommendation. 

View [hyperlink, http://www.gao.gov/products/GAO-12-2] or key 
components. For more information, contact Kay E.Brown at (202) 512-
7215 or brownke@gao.gov. [End of section] 

Contents: 

Letter: 

Background: 

TANF Child-Only Cases Have Increased Slightly, and the Composition of 
the Caseload Varies by State: 

Most Nonparent Caregivers Are Women, and Some Children Have 
Experienced Abuse or Neglect: 

Child Welfare Involvement and Funding Availability Influence Benefit 
Levels and Services for Children Living with Nonparents: 

Coordination Efforts Between TANF and Child Welfare Programs Can 
Affect Access to Services: 

Conclusions: 

Recommendations for Executive Action: 

Agency Comments and Our Evaluation: 

Appendix I: Scope and Methodology: 

Appendix II: States' Reported Child-Only Caseloads and Reasons That 
Cases Are Child-Only: 

Appendix III: States' Monthly TANF Child-Only and Foster Care Payment 
Rates: 

Appendix IV: Subsidized Guardianship and the TANF Child-Only Caseload: 

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

Appendix VI: GAO Contact and Staff Acknowledgments: 

Tables: 

Table 1: Characteristics of Head of Household Nonparent Caregivers in 
TANF Child-Only Cases with Nonparents: 

Table 2: Characteristics of Children in TANF Child-Only Cases with 
Head of Household Nonparent Caregivers: 

Table 3: State Monthly Foster Care Payments and TANF Child-Only 
Payments in Site Visit States and Nationally: 

Table 4: Estimates and 95 Percent Confidence Intervals for Number of 
TANF and Child-Only Cases (FY 2000-2008): 

Table 5: Estimates and 95 Percent Confidence Intervals for Composition 
of TANF Child-Only Caseload in 2000 and 2008 (percentage of each type 
of case): 

Table 6: Estimates and 95 Percent Confidence Intervals for Assistance 
Received by TANF Child-Only Families with Head of Household Nonparent 
Caregivers (FY 2008): 

Table 7: Estimates and 95 Percent Confidence Intervals for 
Characteristics of Nonparent Caregivers in TANF Child-Only Cases with 
Head of Household Nonparent Caregivers (FY 2008): 

Table 8: Estimates and 95 Percent Confidence Intervals for 
Characteristics of Children in TANF Child-Only Cases with Head of 
Household Nonparent Caregivers (FY 2008): 

Figures: 

Figure 1: Number of TANF Cases and Number of TANF Child-Only Cases (FY 
2000-2008): 

Figure 2: Change in the Number of Child-Only Cases by Type of Case (FY 
2000-2008): 

Figure 3: Composition of TANF Child-Only Caseload in Site Visit States 
(reported by 40 states, as of Dec. 31, 2010): 

Figure 4: Assistance Received by TANF Child-Only Families with Head of 
Household Nonparent Caregivers: 

Figure 5: Circumstances Influencing a Child's Receipt of TANF Child- 
Only or Foster Care Payments: 

Figure 6: Percentage of Relative Homes That Are Licensed as Foster 
Parents by State: 

Figure 7: Services Child Welfare Agencies Refer or Provide to Foster 
Children and Services TANF Agencies Refer or Provide to Children in 
TANF Child-Only Cases (number of states): 

Figure 8: Number of States Reporting Benefits of Coordination Between 
State and Local TANF and Child Welfare Agencies: 

Figure 9: State TANF and Child Welfare Agencies Reporting on Access to 
Information: 

Figure 10: State Implementation of the Federal Guardianship Assistance 
Program (GAP) option and Other State Subsidized Guardianship Programs: 

Abbreviations: 

ACF: Administration for Children and Families: 

AFCARS: Adoption and Foster Care Analysis and Reporting System: 

AFDC: Aid to Families with Dependent Children: 

CPS: Child Protective Services: 

GAP: Guardianship Assistance Program: 

HHS: Department of Health and Human Services: 

MOE: maintenance of effort: 

PRWORA: Personal Responsibility and Work Opportunity Reconciliation 
Act of 1996: 

SACWIS: Statewide Automated Child Welfare Information Systems: 

SNAP: Supplemental Nutrition Assistance Program: 

SSI: Supplemental Security Income: 

TANF: Temporary Assistance for Needy Families: 

[End of section] 

United States Government Accountability Office: 
Washington, ?DC 20548: 

October 7, 2011: 

Congressional Requesters: 

The Temporary Assistance for Needy Families (TANF) program provides 
cash assistance and other services to low-income families. Over 40 
percent of families receiving TANF cash assistance in 2010 were "child-
only" cases, meaning the adults in the family receive the cash benefit 
on behalf of the child, but the needs of the adults are not included 
in the calculation of the cash benefit. These cases occur when either 
the children's parents are ineligible for benefits, for example if 
they are ineligible due to their immigration status, or the child is 
living with a nonparent caregiver, who is either a relative or 
unrelated adult acting in place of a parent. Children come into the 
care of nonparent caregivers for a variety of reasons, including when 
the parents are absent due to military deployment or incarceration, 
are incapacitated due to substance abuse or mental illness, or have 
been determined to be abusive. One of the purposes of TANF is to 
provide assistance to needy families so that children may be cared for 
in their own homes or the homes of relatives. Child welfare agencies 
also aim to keep families together, but when children must be removed 
from the home due to abuse or neglect by their parents, these programs 
provide financial assistance and services to support children who live 
with nonparent caregivers. 

The U.S. Department of Health and Human Services (HHS) oversees TANF 
and child welfare programs and states are responsible for 
administering these programs. States have broad discretion in how they 
design TANF and child welfare programs, which includes setting 
available benefits and services. Although some of the same families 
may be served by these programs, they are often administered by 
different state agencies and involve different staff and information 
systems. The extent to which these programs are coordinated or state 
agencies share information is unclear. To address these issues and 
inform the expected reauthorization of the TANF program, we examined 
the: (1) trends in the TANF child-only caseload and composition of 
these cases, (2) general characteristics of the caregivers and 
children in TANF child-only cases where a child is living with a 
nonparent caregiver, (3) factors influencing the level of benefits and 
services children living with nonparent caregivers receive, and (4) 
coordination efforts between state TANF and child welfare programs. 

In addition, this report provides information in appendix IV on how 
states have implemented the federal guardianship assistance option and 
what is known about how it has affected TANF child-only caseloads. 

To answer our research questions, we collected data through several 
methods. To gather national level information about how the TANF child-
only caseload has changed over time, and the characteristics of 
nonparent caregiver cases, we analyzed HHS's TANF data for fiscal 
years 2000 through 2008. To collect information about TANF child-only 
policies, the current TANF child-only caseload, financial assistance 
and services available to children in these cases, and coordination 
between TANF and child welfare programs, we conducted a Web-based 
survey of state TANF administrators in all 50 states and the District 
of Columbia. We also conducted a survey of state child welfare 
administrators in all 50 states and the District of Columbia to gather 
information on the financial assistance and services available to 
children in foster care, the extent to which relatives are licensed as 
foster parents, and coordination efforts between TANF and child 
welfare programs. We administered the surveys between March and June 
2011. While we did not validate specific information that 
administrators reported through our surveys, we reviewed their 
responses and followed up, as necessary, to determine that their 
responses were complete, reasonable, and sufficiently reliable for the 
purposes of this report. All state TANF and child welfare 
administrators responded to the surveys. To collect more detailed 
information from state and local offices, we conducted site visits in 
three states (Tennessee, Texas, and Washington). Our site visit states 
were selected because of their variation in TANF caseload 
characteristics and programs to assist relative caregivers. Within 
each state, we interviewed state TANF and child welfare 
administrators, as well as TANF and child welfare staff from two to 
three local offices serving urban and rural areas. We cannot 
generalize our findings from the site visits beyond the states and 
local offices we visited. We also interviewed HHS officials and 
researchers knowledgeable about TANF and child welfare programs and 
reviewed relevant federal laws and regulations. We conducted this 
performance audit from October 2010 to October 2011 in accordance with 
generally accepted government auditing standards. Those standards 
require that we plan and perform the audit to obtain sufficient, 
appropriate evidence to provide a reasonable basis for our findings 
and conclusions based on our audit objectives. We believe that the 
evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. See appendix I for 
additional information on our scope and methodology. 

Background: 

TANF Program Funding and Goals: 

The Personal Responsibility and Work Opportunity Reconciliation Act of 
1996 (PRWORA)[Footnote 1] significantly changed federal welfare policy 
for low-income families with children, from a program that entitled 
eligible families to monthly cash payments to a capped block grant 
that emphasizes employment and work supports for most adult 
recipients. As part of PRWORA, Congress created the TANF program, 
[Footnote 2] through which HHS provides states about $16.5 billion 
each year in block grant funds to implement the program. To receive 
its TANF block grant, each state must also spend at least a specified 
level of its own funds, which is referred to as state maintenance of 
effort (MOE).[Footnote 3] 

TANF is a flexible funding stream that states can use to provide cash 
assistance and a wide range of services that further the program's 
four goals, including assisting needy families so that children can be 
cared for in their own homes or in the homes of relatives. In 2009, 
states spent about 30 percent of their TANF funds on cash assistance 
for needy families, and the remaining funds were spent on other 
purposes, such as child care, employment programs, and child welfare 
services.[Footnote 4] 

Determining Eligibility for TANF Cash Assistance and Benefit Levels: 

Although the specific eligibility requirements vary by state, to 
qualify for TANF cash assistance, families must pass both nonfinancial 
tests based on the demographic characteristics of the family, and 
financial tests based on the income and asset holdings available to 
the family. The TANF program gives states the flexibility to develop 
their own definition of an eligible family. While some states allow 
unrelated caregivers acting in place of a parent to apply for TANF 
benefits, other states limit benefits to relative caregivers and 
parents, according to information contained in the Urban Institute's 
Welfare Rules Database.[Footnote 5] 

Each state sets its own TANF benefit levels, and the amount a family 
receives depends in part on who is in the assistance unit. An 
assistance unit is a group of people living together, often related by 
blood or some other legal relationship. States can exclude adults from 
the assistance unit but still allow the children to receive some 
assistance. In these child-only cases, the adults in the family are 
excluded from the assistance unit and are not considered when 
calculating the benefit amount. There are four main types of family 
circumstances that result in child-only cases: 

* SSI parents. A parent is receiving Supplemental Security Income 
(SSI) and is receiving TANF child-only payments on behalf of their 
children.[Footnote 6] 

* Immigrant parents. A family is headed by an immigrant parent who is 
not eligible for TANF. These parents could include illegal immigrants, 
as well as certain recent legal immigrants who are ineligible for 
TANF.[Footnote 7] Ineligible immigrants can receive TANF for their 
children, provided the children are U.S. citizens. 

* Sanctioned or disqualified parents. The parent has not complied with 
TANF program requirements, such as work requirements, and has been 
denied benefits, but the state allows the children to continue 
receiving benefits. States must also disqualify adults from receiving 
TANF benefits for other reasons, such as if they are fleeing to avoid 
a felony conviction, violating a condition of probation or parole, or 
in certain circumstances, fraudulently receiving TANF assistance. 

* Nonparent caregivers. A child is living with a family headed by a 
nonparent caregiver, often a relative who receives cash assistance on 
a child's behalf. According to HHS, nonparent caregivers may not be 
legally obligated to support these children, and states can provide 
child-only grants to any relative caring for a child, regardless of 
the relative's income, provided that the relative meets the state's 
TANF definition of a relative caretaker.[Footnote 8] If the nonparent 
caregiver chooses to have their income and resources considered in 
order to receive a higher level of assistance, the caregiver may be 
subject to work requirements and time limits. 

Families receiving cash assistance with adults in the assistance unit 
are subject to federal time limits[Footnote 9] and work 
requirements.[Footnote 10] PRWORA established a 60-month time limit 
for families with an adult receiving aid; however, states have the 
option to use federal funds to extend assistance beyond the federal 
time limit for hardship reasons the state has defined.[Footnote 11] 
PRWORA also requires adults to engage in work activities after 2 years 
of assistance, or sooner, if the state determines the recipient is 
ready. TANF child-only cases are typically not subject to these 
requirements. 

Child Welfare Program Administration and Federal Funding: 

Child welfare programs provide services to protect children from abuse 
and neglect, to help parents care for their children successfully, and 
to provide support to children who cannot safely live with their 
parents. HHS' Children's Bureau oversees federal funding to states for 
child welfare programs, and states administer these programs. The 
principal federal funding sources for child welfare are through Titles 
IV-E and IV-B of the Social Security Act,[Footnote 12] although child 
welfare services are also supported by nondedicated federal funding 
sources, including TANF. In fiscal year 2011, about $6.5 billion was 
available under IV-E, and about $757 million was made available to 
states under IV-B, according to HHS budget documents. 

Child welfare agencies typically become involved in family situations 
after receiving reports of child abuse and neglect. Child welfare 
staff screen and investigate reports of child maltreatment and make 
recommendations about whether a child can remain safely at home. When 
abuse or neglect is identified, the agency may provide services 
designed to improve the situation and avoid removing children from 
their homes. If such services cannot ensure a child's safety in their 
home, the agency may work with the family to determine another living 
arrangement for the child or petition a court to place the child in 
foster care. 

When children are taken into foster care, the state child welfare 
agency becomes responsible for determining where the child should live 
and providing the child with support. The agency may place the foster 
child in the home of a relative or with unrelated foster 
parents.[Footnote 13] States receiving Title IV-E foster care funding 
must make foster care payments on behalf of eligible children whose 
foster care placements have been licensed or approved. Under the act, 
states are responsible for establishing standards for foster family 
homes and child care institutions that protect the safety of children. 
Foster parent licensing requirements vary by state and may include 
training, background checks, and home inspections, according to a HHS 
report.[Footnote 14] States must provide foster care payments on 
behalf of each child who meets certain requirements to cover the cost 
of providing food, clothing, shelter, daily supervision, and other 
expenses, but are given flexibility in determining the payment amount. 
[Footnote 15] The agency must also assess the needs of the children 
and arrange for needed services. States must ensure that caseworkers 
develop a case plan for each child receiving foster care payments to 
assure that services are provided, and caseworkers must visit with the 
children periodically. Foster care is intended to be a temporary 
living arrangement until children can be returned safely to their 
parents or placed in some other permanent living arrangement, such as 
guardianship or adoption by a nonparent caregiver.[Footnote 16] 

HHS' Administration on Aging: 

HHS' Administration on Aging oversees a separate program that provides 
support to nonparent caregivers. The National Family Caregiver Support 
Program, established in 2000, provides grants to states to fund a 
range of supports that assist caregivers. In fiscal year 2010, the 
National Family Caregiver Support Program was allocated about $153 
million. State agencies can use up to 10 percent of their funding to 
provide support services to grandparent caregivers or caregivers age 
55 and older who are raising children of relatives. The Administration 
on Aging funds these activities primarily through grants to each 
state's agency on aging. States must fund five types of services under 
this program: information to caregivers about available services; 
assistance to caregivers in gaining access to the services; individual 
counseling, organization of support groups, and caregiver training in 
the areas of health, nutrition, and financial literacy; respite care; 
and supplemental services on a limited basis. 

TANF Child-Only Cases Have Increased Slightly, and the Composition of 
the Caseload Varies by State: 

The TANF child-only caseload increased slightly between fiscal years 
2000 and 2008, but comprised a greater share of the overall TANF 
caseload because TANF cases with adults in the assistance unit 
decreased substantially. During this time period, the number of TANF 
child-only cases increased from about 772,000 cases to approximately 
815,000 cases, but the number of families with adults receiving 
assistance decreased by about 700,000 cases from about 1.5 million to 
about 800,000 cases.[Footnote 17] As a result, the share of child-only 
cases in the overall TANF caseload increased from about 35 percent to 
about half (see figure 1). We previously reported that changes states 
made to their welfare programs as they implemented TANF, including 
work requirements, time limits,[Footnote 18] sanctions, and diversion 
policies, contributed to a significant decline in program 
participation.[Footnote 19] TANF cases also declined in part because 
during the 1990s when the economy was stronger, incomes increased, and 
fewer families were eligible for TANF. Our past work and survey 
results indicated that one of the reasons child-only cases may not 
have declined as much as cases with adults in the assistance unit is 
because these cases are not subject to time limits in most states and 
recipients may receive assistance for a longer time period.[Footnote 
20] 

Figure 1: Number of TANF Cases and Number of TANF Child-Only Cases (FY 
2000-2008): 

[Refer to PDF for image: stacked vertical bar graph] 

TANF cases: 

Year: 2000; 
Child-only (families without adults in the assistance unit): 0.77 
million; 
Families with adults in the assistance unit: 1.5 million; 
Total: 2.2 million. 

Year: 2001; 
Child-only (families without adults in the assistance unit): 0.78 
million; 
Families with adults in the assistance unit: 1.31 million; 
Total: 2.1 million. 

Year: 2002; 
Child-only (families without adults in the assistance unit): 0.77 
million; 
Families with adults in the assistance unit: 1.21 million; 
Total: 2.0 million. 

Year: 2003; 
Child-only (families without adults in the assistance unit): 0.8 
million; 
Families with adults in the assistance unit: 1.15 million; 
Total: 1.9 million. 

Year: 2004; 
Child-only (families without adults in the assistance unit): 0.86 
million; 
Families with adults in the assistance unit: 1.11 million; 
Total: 2.0 million. 

Year: 2005; 
Child-only (families without adults in the assistance unit): 0.87 
million; 
Families with adults in the assistance unit: 1.03 million; 
Total: 1.9 million. 

Year: 2006; 
Child-only (families without adults in the assistance unit): 0.85 
million; 
Families with adults in the assistance unit: 0.94 million; 
Total: 1.8 million. 

Year: 2007; 
Child-only (families without adults in the assistance unit): 0.82 
million; 
Families with adults in the assistance unit: 0.86 million; 
Total: 1.7 million. 

Year: 2008; 
Child-only (families without adults in the assistance unit): 0.81 
million; 
Families with adults in the assistance unit: 0.80 million; 
Total: 1.6 million. 

Source: GAO analysis of HHS TANF administrative data. 

Note: These data are national estimates produced from our analysis of 
HHS' TANF data and are subject to sampling error. See appendix I for 
the 95 percent confidence intervals associated with these estimates. 

[End of figure] 

Between fiscal years 2000 and 2008, increases in two of the categories 
were statistically significant: children living with parents who were 
ineligible because they receive SSI benefits and children living with 
parents who were ineligible because of their immigration status. Cases 
in which the parents were ineligible due to immigration status almost 
doubled and increased from 11 percent of the TANF child-only caseload 
in fiscal year 2000 to 19 percent in fiscal year 2008 (see figure 2). 
This increase of 8 percentage points is statistically significant and 
represents an increase from about 83,000 cases in fiscal year 2000 to 
over 155,000 cases in fiscal year 2008, with the greatest increase 
occurring in California.[Footnote 21] Specifically, TANF child-only 
cases headed by ineligible immigrants in California more than doubled, 
from about 46,000 to almost 93,000.[Footnote 22] This increase 
accounts for 64 percent of the estimated total increase in these cases 
nationwide. 

Over this same time period, the number of cases in the "unknown 
caregiver" category-where the relationship between the child and 
caregiver is unclear-decreased significantly and it is possible that 
some of the increase in child-only cases with ineligible parents due 
to SSI receipt or immigration status resulted from better 
identification of previously unknown caregivers. Given available data, 
we were unable to determine how much of the increase was due to better 
reporting versus an actual increase in the number of cases. 

Figure 2: Change in the Number of Child-Only Cases by Type of Case (FY 
2000-2008): 

[Refer to PDF for image: 2 pie-charts] 

2000: 
Nonparent caregiver: 31%; 
Unknown caregiver: 24%; 
Parent, SSI: 18%; 
Parent, other: 11%; 
Parent, immigration status: 11%; 
Parent, sanction: 5%; 

2008: 
Nonparent caregiver: 33%; 
Parent, SSI: 22%; 
Parent, immigration status: 19%; 
Unknown caregiver: 12%; 
Parent, other: 9%; 
Parent, sanction: 5%; 
Total cases = 814,977. 

Source: GAO analysis of HHS TANF administrative data. 

Notes: The unknown caregiver category refers to cases where it is not 
clear what type of relationship the child has with the adult(s) living 
in the family. For example, in some cases, no family affiliation 
information is reported. 

These data are national estimates produced from our analysis of HHS' 
TANF data and are subject to sampling error. See appendix I for the 95 
percent confidence intervals associated with these estimates. 

[End of figure] 

Through our TANF survey, officials from 40 states indicated that the 
composition of their TANF child-only caseload, as of December 2010, 
was similar to the composition in 2008. The majority of families who 
received TANF child-only assistance included children living with 
parents who were ineligible for cash assistance, and about one-third 
included children living with nonparent caregivers. However, the 
composition of the TANF child-only caseload varies by state. For 
example, as reported through our survey, almost 60 percent of TANF 
child-only cases in Tennessee included children living with nonparent 
caregivers, compared with 31 percent in Texas. In addition, cases that 
are child-only because the parent receives SSI comprise 40 percent of 
the TANF child-only caseload in Tennessee compared with 10 percent in 
Texas (see figure 3). 

Figure 3: Composition of TANF Child-Only Caseload in Site Visit States 
(reported by 40 states, as of Dec. 31, 2010): 

[Refer to PDF for image: horizontal bar graph] 

National average: 
Other: 2
Nonparent caregiver: 35%; 
Parent, SSI: 23%; 
Parent, sanction or disqualification: 9%; 
Parent, immigration status: 31%. 

Tennessee: 
Other: 0%; 
Nonparent caregiver: 59%; 
Parent, SSI: 40%; 
Parent, sanction or disqualification: 0%; 
Parent, immigration status: 1%. 

Texas: 
Other: 3%; 
Nonparent caregiver: 31%; 
Parent, SSI: 10%; 
Parent, sanction or disqualification: 3%; 
Parent, immigration status: 53%. 

Washington: 
Other: 0%; 
Nonparent caregiver: 44%; 
Parent, SSI: 19%; 
Parent, sanction or disqualification: 1%; 
Parent, immigration status: 36%. 

Source: GAO analysis of GAO survey data. 

Note: Out of the 50 states and D.C. that submitted responses to the 
GAO survey, 49 reported the total number of TANF cases and TANF child-
only cases, and 40 states reported numbers for the different types of 
TANF child-only cases. For more information on each state's total 
child-only caseloads, see appendix II. 

[End of figure] 

Some of the variation in the composition of TANF child-only cases can 
be attributed to differences in state demographics and state TANF 
policies. For example, parents who were ineligible for TANF due to 
their immigration status account for a greater portion of the TANF 
child-only caseload in states with relatively large immigrant 
populations, such as California and Texas. Our survey found that for 
the 40 states that reported data, about one-third of the TANF child- 
only caseload is comprised of families in which the parents are 
ineligible due to their immigration status compared to more than half 
of the caseloads in California and Texas. Another variation among 
states is how they determine TANF eligibility for children living with 
nonparent caregivers. States with less restrictive eligibility rules 
may have larger numbers of nonparent caregiver cases. For example, 
Washington, which has a relatively high percentage of nonparent cases, 
allows unrelated caregivers, such as a friend or neighbor, to apply 
for TANF child-only assistance after undergoing a home study and 
background check, according to information provided by state 
officials. Other states, such as Texas, reported that they limit 
eligibility for TANF child-only assistance to nonparent caregivers 
related to the child by blood, marriage, or adoption. 

Most Nonparent Caregivers Are Women, and Some Children Have 
Experienced Abuse or Neglect: 

Nonparent caregivers in TANF child-only cases tend to be unmarried 
women over 50 years old (see table 1). African-Americans are 
overrepresented in these cases, making up 39 percent of the nonparent 
caregivers but representing approximately 13 percent of the general 
U.S. population.[Footnote 23] 

Table 1: Characteristics of Head of Household Nonparent Caregivers in 
TANF Child-Only Cases with Nonparents: 

Characteristic: Gender; 

Female: 91%; 
Male: 9%. 

Characteristic: Age of caregiver; 

Under 30 years old: 8%; 
31-40 years old: 12%; 
41-50 years old: 27%; 
51-60 years old: 32%; 
Over 60 years old: 22%. 

Characteristic: Race/ethnicity: 

White/non-Hispanic: 40%; 
African American/non-Hispanic: 39%; 
Hispanic: 14%; 
Other/multiracial: 4%; 
Unknown: 3%. 

Characteristic: Marital status; 

Single, never married, divorced, or separated: 65%; 
Married: 29%; 
Widowed: 6%. 

Characteristic: Education; 

Less than high school degree: 24%; 
High school degree: 38%; 
Associates degree, bachelors degree, or other credentials: 4%; 
No formal education: 8%; 
Unknown: 27%. 

Source: GAO analysis of HHS TANF administrative data (FY 2008). 

Note: These data are national estimates produced from our analysis of 
HHS' TANF data and are subject to sampling error. See appendix I for 
the 95 percent confidence intervals associated with these estimates. 

[End of table] 

Research suggests that many relative caregivers receiving cash 
assistance have low incomes and health problems. A study analyzing 
national survey data found that an estimated 55 percent of families in 
which a child was living in an informal arrangement with a nonparent 
caregiver receiving cash assistance had income levels below the 
federal poverty level.[Footnote 24] The same study found that an 
estimated 63 percent of these caregivers were unemployed, and an 
estimated 43 percent of them were in fair or poor health.[Footnote 25] 
According to our analysis of HHS' TANF administrative data, TANF child-
only families with nonparent caregivers often receive other types of 
public assistance. For example, over 90 percent receive Medicaid, and 
over 40 percent receive Supplemental Nutrition Assistance Program 
(SNAP) benefits (see figure 4). 

Figure 4: Assistance Received by TANF Child-Only Families with Head of 
Household Nonparent Caregivers: 

[Refer to PDF for image: horizontal bar graph] 

Percentage of eligible recipients: 

Medical: 
Do not receive assistance: 4.7%; 
Receive assistance: 95.3%. 

SNAP: 
Do not receive assistance: 57.4%; 
Receive assistance: 42.6%. 

Housing: 
Do not receive assistance: 91.4%; 
Receive assistance: 8.6%. 

Child care: 
Do not receive assistance: 94.3%; 
Receive assistance: 5.7%. 

Source: GAO analysis of HHS TANF administrative data (FY 2008). 

Note: These data are national estimates produced from our analysis of 
HHS' TANF data and are subject to sampling error. See appendix I for 
the 95 percent confidence intervals associated with these estimates. 
The Food Stamp Program was renamed the Supplemental Nutrition 
Assistance Program in 2008. 

[End of figure] 

Children who live with nonparents and receive TANF child-only 
assistance tend to be over 10 years old, related to their nonparent 
caregiver, and on assistance for at least 2 years (see table 2). More 
than three-quarters of children are over age 5, and about half of the 
children are at least 11 years old. A small percentage of children in 
child-only cases are 18 years old or older.[Footnote 26] Almost all 
children are related to their nonparent caregiver, and most often the 
child is the caregiver's grandchild. Like the nonparent caregivers, 
African-American children are overrepresented, making up 40 percent of 
the children in these cases but approximately 16 percent of the child 
population in the United States.[Footnote 27] 

Table 2: Characteristics of Children in TANF Child-Only Cases with 
Head of Household Nonparent Caregivers: 

Characteristic: Gender; 

Female: 51%; 
Male: 49%. 

Characteristic: Age of children; 

Less than 1 year old: 2%; 
1-5 years old: 23%; 
6-10 years old: 29%; 
11-17 years old: 44%; 
18 years or older: 2%. 

Characteristic: Race/ethnicity; 

White/non-Hispanic: 36%; 
African American/non-Hispanic: 41%; 
Hispanic: 17%; 
Other/multiracial: 5%; 
Unknown: 1%. 

Characteristic: Length of time on assistance; 

Less than 1 year: 25%; 
1-2 years: 16%; 
2-5 years: 30%; 
5+ years: 29%%; 

Characteristic: Relationship to caregiver[A]; 

Grandchild or great grandchild: 63%; 
Other related person: 24%; 
Unrelated child: 3%; 
Unknown: 10%. 

Source: GAO analysis of HHS TANF administrative data (FY 2008). 

Note: These data are national estimates produced from our analysis of 
HHS' TANF data and are subject to sampling error. See appendix I for 
the 95 percent confidence intervals associated with these estimates. 

[A] HHS's TANF administrative data include a variable that allows 
states to indicate whether the caregiver is taking care of a foster 
child. However, we determined this information was unreliable after 
reviewing HHS documentation and comparing the TANF data to HHS' data 
on children in foster care and information we collected during our 
site visits. For more detail on our analysis of HHS data, see appendix 
I. 

[End of table] 

Some children living with nonparents who receive TANF child-only 
assistance live with nonparent caregivers as a result of parental 
abuse or neglect, but the extent to which these children have had 
involvement with the state's child welfare agency is unclear because 
few states collect this information. In our survey, 6 states reported 
that between 10 percent and 73 percent of children in TANF child-only 
cases had been the subject of a Child Protective Services (CPS) 
investigation, and 6 states reported that between 0 percent and 10 
percent had been in state custody. During our site visits, officials 
from Washington provided us with data showing that about 12 percent of 
their TANF child-only cases with nonparent caregivers included 
children who had CPS involvement. Officials from Texas provided us 
with data showing that one-third of their TANF child-only cases with 
nonparent caregivers included children who were in state custody. 

Child Welfare Involvement and Funding Availability Influence Benefit 
Levels and Services for Children Living with Nonparents: 

Benefits and Services Available to Children Living with Nonparents 
Depend on Child Welfare Involvement and Licensing Status of Caregiver: 

A child's circumstances, level of child welfare agency involvement, 
and licensing status of the caregiver influence whether a child is 
eligible for a foster care payment or a TANF child-only payment (see 
figure 5). In some cases, a child may be living with a nonparent 
caregiver in an informal arrangement made by the parents, and other 
family members, and a child welfare agency may not be involved because 
either the child has not experienced abuse or neglect or the 
maltreatment was not reported to the agency. In other cases, the child 
welfare agency may be involved after receiving a report of child abuse 
or neglect; however, instead of taking legal custody of the child the 
agency helps the parent voluntarily place the child with a relative 
caregiver.[Footnote 28] When determining whether to seek custody of a 
child, child welfare agencies generally consider factors such as the 
circumstances of the maltreatment, choices made by the parent, and the 
availability of a relative willing to intervene. Children living with 
relatives in informal arrangements or voluntary placements are 
typically eligible for TANF child-only payments provided the relatives 
meet their state's definition of a relative caregiver, according to a 
2007 survey of state child welfare agencies.[Footnote 29] This survey 
also found that relative caregivers of children taken into state 
custody may be compensated as foster parents if they meet the training 
and home requirements to be licensed.[Footnote 30] Relative caregivers 
may still apply for TANF child-only payments if they cannot or choose 
not to meet licensing requirements. 

Figure 5: Circumstances Influencing a Child's Receipt of TANF Child- 
Only or Foster Care Payments: 

[Refer to PDF for image: process illustration] 

Parent unable to care for child: 
Child is not maltreated, go to #1; 
Child is maltreated, go to #2. 

1. Parent makes an informal arrangement for the child to live with a 
relative or an unrelated nonparent caregiver; go to #8. 

2. Is maltreatment reported to child welfare agency? 
If yes, go to #3; 
If no, go to #1. 

3. Is child taken into child welfare agency custody/foster care? 
If yes, go to #4; 
If no, go to #6. 

4. Can child welfare agency locate a relative willing to assume 
caregiving for the child? 
If yes, go to #7; 
If no, go to #5. 

5. Child welfare agency places child with an unrelated foster parent; 
Go to #10. 

6. Parent voluntarily places child with relative; go to #8. 

7. Child welfare agency places child with relative; go to #9. 

8. Eligible for TANF child-only payment ($81 to $577 per month) 
(depending on the state). 

9. Is the relative willing and able to become a licensed foster parent? 
If no, go to #8. 
If yest, go to #10. 

10. Eligible for foster care payment ($220 to $919 per month). 

Source: GAO analysis of related studies and GAO survey results. 

Note: Specific TANF eligibility requirements vary by state, and 
applicants may be required to comply with several requirements that 
are not listed in this figure in order to receive assistance. States 
must provide foster care payments to licensed caregivers of children 
in state custody who are IV-E eligible. When foster children are not 
eligible for Title IV-E funding, they may be eligible for TANF child- 
only benefits. In addition, some states may provide a foster care 
payment even if the relative caregivers are not fully licensed foster 
parents. Specifically, 11 states reported in our survey that having an 
unlicensed relative caregiver would not be a reason to deny a foster 
care payment for a child in state custody. 

[End of figure] 

States are not federally prohibited from providing caregivers a foster 
care payment and a TANF payment for the same child, but the three 
states we visited did not allow caregivers to receive both payments to 
support the same child, according to state officials. Specifically, 
according to HHS officials, there is no programmatic prohibition in 
either the IV-E program or the TANF program against a caregiver 
receiving a foster care payment and a TANF payment for the same child, 
provided eligibility for both programs exists. A state must, however, 
ensure that it does not use federal TANF or state MOE funds to fulfill 
the IV-E matching requirement. Officials in the three states we 
visited reported that children may receive ongoing financial 
assistance from TANF and services from a state's child welfare 
program, but relative caregivers were not allowed to receive ongoing 
financial assistance to support the same child from both programs at 
the same time. For example, a child may receive services from a 
state's child welfare program but receive ongoing financial assistance 
through the TANF program because the child is living with a relative 
who is not a licensed foster parent. 

[Side bar: 
Tennessee Family First Kinship Program: 

This pilot program provides eligible relatives caring for children who 
were determined at risk of entering state custody an additional 
payment to supplement the TANF child-only payment. To be eligible for 
the additional payment, the relative caregiver must pass background 
checks and a home study and have an income below 200 percent of the
federal poverty level. 

Texas Relative Caregiver and Other Designated Caregiver Assistance 
Program: 

This program assists unlicensed relative and fictive kin caregivers 
who are caring for children in state custody and who meet income and 
other standards. Fictive kin caregivers are not related to the child but
have a long-standing and significant relationship with the child or 
the child’s family. The program provides a one-time $1,000 payment per 
sibling group to integrate the child into the home and help the 
caregiver purchase items such as a bed, bedding, and clothing. 
Caregivers may also be reimbursed for child-related expenses up to 
$500 per child per year while the child is in state custody. This 
program also provides reimbursement for child-related expenses up to 
$500 per year for up to 3 years (or until the child is 18, whichever 
comes first) to caregivers who become legally responsible for the child
through Permanent Managing Conservatorship. 

Sources: Tennessee and Texas state officials. End of side bar] 

Foster care and TANF payment amounts vary by state; however, the 
minimum monthly foster care payment exceeded the TANF child-only 
payment in almost all states, according to our survey results. For one 
child, the national average minimum monthly foster care payment is 
$511 while the average TANF child-only payment is $249 (see table 3). 
The amount of the foster care payment also depends on the child's age 
and any special needs in most states, according to our survey results, 
and licensed foster parents may receive payments higher than the 
minimum foster care payment. Gaps between the TANF child-only and 
foster care payments increase as caregivers take care of additional 
children because the TANF child-only payment may decrease with each 
individual child while the foster care payment does not, according to 
information collected in the states we visited. States may provide 
relative caregivers additional financial assistance to supplement the 
TANF child-only payment. For example, Texas and Tennessee provide 
supplements to the TANF child-only payment under certain circumstances. 

Table 3: State Monthly Foster Care Payments and TANF Child-Only 
Payments in Site Visit States and Nationally: 

State: Tennessee; 
Minimum foster care payment per child: $697; 
Total TANF child-only payment: 
1 child: $$140; 
2 children: $$192; 
3 children: $$232. 

State: Texas; 
Minimum foster care payment per child: $674; 
Total TANF child-only payment: 
1 child: $$89; 
2 children: $$128; 
3 children: $$179. 

State: Washington; 
Minimum foster care payment per child: $423; 
Total TANF child-only payment: 
1 child: $$305; 
2 children: $$385; 
3 children: $$478. 

State: Nationwide; 
Minimum foster care payment per child: $220-919 (average $511); 
Total TANF child-only payment: 
1 child: $$81-$577 (average $249); 
2 children: $$128-$719 (average $344); 
3 children: $$170-$900 (average $423). 

Source: GAO child welfare and TANF surveys. 

Note: For state-by-state information on TANF child-only and foster 
care payment rates, see appendix III. 

[End of table] 

Many children in state custody live with relatives who do not receive 
foster care payments because they are not licensed foster parents. 
Unlicensed relative caregivers of children in state custody are not 
eligible to receive foster care payments in 32 of the 43 states 
responding to this question in our child welfare survey.[Footnote 31] 
States reported licensing between 0 and 100 percent of relatives 
caring for children in state custody. Specifically, 12 states reported 
that all relatives caring for children in state custody were licensed 
while in 10 states, less than 15 percent of relatives were licensed. 
Figure 6 shows licensure rates reported by 34 states and the District 
of Columbia. 

Figure 6: Percentage of Relative Homes That Are Licensed as Foster 
Parents by State: 

[Refer to PDF for image: plotted point graph] 

Greater number of homes: More relatives caring for foster children. 

Higher percentage of relatives licensed as foster parents: More 
relatives licensed. 

State: Kentucky; 
Number of homes: 202; 
Percentage of relatives licensed as foster parents: 0%. 

State: Nebraska; 
Number of homes: 986; 
Percentage of relatives licensed as foster parents: 2%. 

State: Georgia; 
Number of homes: 1,291; 
Percentage of relatives licensed as foster parents: 3%. 

State: Kansas; 
Number of homes: 1,584; 
Percentage of relatives licensed as foster parents: 3%. 

State: Texas; 
Number of homes: 9,653; 
Percentage of relatives licensed as foster parents: 4%. 

State: Arkansas; 
Number of homes: 300; 
Percentage of relatives licensed as foster parents: 7%. 

State: Arizona; 
Number of homes: 2,096; 
Percentage of relatives licensed as foster parents: 9%. 

State: Iowa; 
Number of homes: 1,394; 
Percentage of relatives licensed as foster parents: 10%. 

State: South Carolina; 
Number of homes: 301; 
Percentage of relatives licensed as foster parents: 11%. 

State: Washington; 
Number of homes: 2,122; 
Percentage of relatives licensed as foster parents: 11%. 

State: Colorado; 
Number of homes: 1,091; 
Percentage of relatives licensed as foster parents: 17%. 

State: South Dakota; 
Number of homes: 239; 
Percentage of relatives licensed as foster parents: 21%. 

State: Louisiana; 
Number of homes: 1,395; 
Percentage of relatives licensed as foster parents: 26%. 

State: Michigan; 
Number of homes: 5,259; 
Percentage of relatives licensed as foster parents: 31%. 

State: Tennessee; 
Number of homes: 492; 
Percentage of relatives licensed as foster parents: 43%. 

State: Utah; 
Number of homes: 617; 
Percentage of relatives licensed as foster parents: 46%. 

State: Illinois; 
Number of homes: 4,038; 
Percentage of relatives licensed as foster parents: 54%. 

State: Missouri; 
Number of homes: 1,774; 
Percentage of relatives licensed as foster parents: 57%. 

State: Nevada; 
Number of homes: 1,609; 
Percentage of relatives licensed as foster parents: 57%. 

State: Maine; 
Number of homes: 465; 
Percentage of relatives licensed as foster parents: 58%. 

State: Alaska; 
Number of homes: 548; 
Percentage of relatives licensed as foster parents: 60%. 

State: Rhode Island; 
Number of homes: 481; 
Percentage of relatives licensed as foster parents: 71%. 

State: Washington, DC; 
Number of homes: 249; 
Percentage of relatives licensed as foster parents: 95%. 

State: Connecticut; 
Number of homes: 456; 
Percentage of relatives licensed as foster parents: 100%. 

State: Hawaii; 
Number of homes: 534; 
Percentage of relatives licensed as foster parents: 100%. 

State: Idaho; 
Number of homes: 320; 
Percentage of relatives licensed as foster parents: 100%. 

State: Massachusetts; 
Number of homes: 1,177; 
Percentage of relatives licensed as foster parents: 100%. 

State: Minnesota; 
Number of homes: 1,094; 
Percentage of relatives licensed as foster parents: 100%. 

State: New Jersey; 
Number of homes: 1,752; 
Percentage of relatives licensed as foster parents: 100%. 

State: New York; 
Number of homes: 3,476; 
Percentage of relatives licensed as foster parents: 100%. 

State: Ohio; 
Number of homes: 1,049; 
Percentage of relatives licensed as foster parents: 100%. 

State: Oregon; 
Number of homes: 2,040; 
Percentage of relatives licensed as foster parents: 100%. 

State: Pennsylvania; 
Number of homes: 4,702; 
Percentage of relatives licensed as foster parents: 100%. 

State: Vermont; 
Number of homes: 144; 
Percentage of relatives licensed as foster parents: 100%. 

State: Virginia; 
Number of homes: 321; 
Percentage of relatives licensed as foster parents: 100%. 

Source: GAO survey of state child welfare administrators. 

[End of figure] 

States' efforts to inform relative caregivers of their options can 
affect whether the caregivers become licensed. State and local offices 
we visited reported using a number of different practices to inform 
relative caregivers of their options and encourage them to become 
licensed. For example, in Washington, child welfare officials said 
relatives are informed of the licensing process in letters sent 
directly by the caseworker and during family meetings facilitated by 
the child welfare agency. In Tennessee, a kinship coordinator is 
located in every local child welfare office to inform relative 
caregivers of their options, according to child welfare staff we 
interviewed. Child welfare workers we interviewed in Texas said that 
in the past they did not emphasize the option to become licensed, but 
they have recently begun a concerted effort to help relatives become 
licensed so that they can take advantage of the state's new subsidized 
guardianship program.[Footnote 32] These three states also reported 
making some non-safety-related changes to their licensing processes to 
help relatives become licensed, such as waiving physical space 
requirements in the home and reducing the amount of required training 
hours. 

The ability and willingness of relatives to go through the licensing 
process also affects the extent to which states license relative 
caregivers. Some relative caregivers may not be able to meet the 
standards applied to prospective foster parents in their state. For 
example, relative caregivers or other adults living in the home may 
have been convicted of a drug-related offense that would preclude the 
caregiver from becoming licensed but would not prevent them from 
caring for the child as an unlicensed caregiver, according to some 
child welfare staff we interviewed during our site visits. In other 
cases, relatives may perceive the licensing process as too intrusive 
or burdensome, according to some child welfare staff we interviewed. 
During our site visits, TANF officials indicated that when relative 
caregivers apply for TANF child-only assistance, they are required to 
provide documentation verifying their relationship to the child and 
that the child resides with them without a parent present. Relative 
caregivers applying for TANF child-only assistance are not required to 
undergo a background check, home assessment, or have any ongoing 
interaction with caseworkers, according to TANF officials in the 
states we visited. 

Although relative caregivers may be eligible for some level of ongoing 
financial assistance to help them raise the children in their care, 
research suggests that many relative caregivers in informal 
arrangements do not receive any cash assistance. A study analyzing 
national survey data found that about 20 percent of relatives caring 
for children in informal arrangements reported receiving cash 
assistance.[Footnote 33] State and local TANF staff we interviewed 
suggested various reasons for relatives not accessing TANF child-only 
benefits. For example, relative caregivers may not be aware that they 
are eligible for assistance or may not want to receive public 
assistance. In other cases, the relative caregiver may have a 
difficult time providing the necessary documentation to verify their 
relationship with the child or may not want to provide required 
information about the child's parents (often the caregiver's son or 
daughter) to help the state collect child support.[Footnote 34] 

[Side bar: 
Foster Parent Licensing Requirements in Texas: 

Persons who apply to be foster parents in Texas must participate in an 
information meeting, a home screening, and 12 hours of pre-service 
training. The following information is documented in the home 
screening: 
* age of applicant(s) (must be at least 21 years of age) and all 
household members; 
* educational level of each applicant; 
* emotional stability of each applicant;
* history of marriages, divorces, deaths of former spouses, residences; 
* financial status; 
* background checks; 
* health status of all persons living in the home; 
* quality of applicant(s) relationships; 
* applicant(s) feelings about their childhood, the foster child's 
history, child care, discipline, child abuse and separation/loss; and; 
* other general information. 

The family file must include copies of: 
* pictures/floor plan of the home; 
* approved fire/health inspections; 
* CPR/first aid cards; 
* pet vaccinations; 
* verification certificate; 
* TB screening results for all household members over age 1; 
* training certificates; and; 
* foster home agreement/rights and responsibilities. 

Training: 
* Each applicant must participate in 12 hours of pre-service training. 
* 20 hours of annual training per couple.
* 20 hours of annual training per single foster parent. 

TANF Child-Only Requirements for Relative Caregivers in Texas: 

Examples of some of the documentation required: 
* proof that the nonparent caregiver is related to the child. 
Caregivers must be related to the child by blood, marriage, or 
adoption; and; 
* proof that the nonparent caregiver lives with and is the primary 
caretaker of the child. 

Applicants must be interviewed by a caseworker. If approved, TANF 
recipients agree to: 
* cooperate with child support requirements; 
* get medical screenings and all required immunizations for all 
children in the family; and; 
* make sure that children are attending school. 
Source: Texas state officials. End of side bar] 

More services are generally available to children in foster care than 
children who are not in state custody. Foster children are eligible 
for a broad array of services from child welfare agencies, such as 
case management, education, and mental health services.[Footnote 35] 
Caseworkers are expected to visit foster children on a monthly basis 
and help children access needed services. In addition, child welfare 
agencies in most states provide assistance to nonparent caregivers of 
children in state custody with child care expenses and respite care. 
In contrast, direct provision of child welfare services to children 
and relative caregivers in voluntary placements is infrequent, 
according to the 2007 survey of state child welfare agencies, and only 
14 of the 39 states that allow voluntary placements routinely maintain 
ongoing supervision of the children removed from their parents' 
homes.[Footnote 36] Families with informal arrangements made by the 
parents and other family members to care for children are typically 
not involved with the child welfare system, but some states have 
developed programs to help these families.[Footnote 37] 

Children living with relatives receiving TANF child-only payments may 
be eligible for other services through the TANF agency, but fewer 
services are available compared to the services child welfare agencies 
provide for foster children (see figure 7). According to our survey of 
state TANF administrators, TANF agencies in 23 states offer child care 
assistance to nonparent caregivers, and 3 states offer respite care. 
Less than half of TANF agencies provide case management for TANF child-
only cases, so in a majority of states, TANF agencies are unlikely to 
have ongoing contact with the caregiver after eligibility is 
determined. 

[Side bar: 
Tennessee’s Relative Caregiver Program: 

Tennessee developed the Relative Caregiver Program, which provides 
support to children who are not in state custody and whose relative 
caregivers have incomes below 200 percent of the federal poverty 
level, according to information provided by Tennessee state officials. 
To be eligible, the relative caregiver must be related by blood, 
marriage, or adoption, be the child’s primary caregiver, and agree to 
an in-home assessment. Tennessee’s child welfare agency contracts with 
community based organizations throughout the state to operate the 
program. The types of assistance available through this program, which 
became available statewide in 2006, include information about available
benefits, support groups, respite care, short-term case management, 
and start-up or emergency financial assistance. 
Source: Tennessee state officials. End of side bar] 

Figure 7: Services Child Welfare Agencies Refer or Provide to Foster 
Children and Services TANF Agencies Refer or Provide to Children in 
TANF Child-Only Cases (number of states): 

[Refer to PDF for image: 2 horizontal bar graphs] 

Foster care: 

Service: Case management; 
State provides the service: 50 states; 
State provides referrals for the service: 0 state. 
State provides neither the service nor referrals: 0 states. 

Service: Clothing allowance; 
State provides the service: 45 states; 
State provides referrals for the service: 2 state. 
State provides neither the service nor referrals: 2 states. 

Service: Education and training; 
State provides the service: 42 states; 
State provides referrals for the service: 8 state. 
State provides neither the service nor referrals: 0 states. 

Service: Food assistance; 
State provides the service: 25 states; 
State provides referrals for the service: 20 state. 
State provides neither the service nor referrals: 3 states. 

Service: Independent living; 
State provides the service: 46 states; 
State provides referrals for the service: 4 state. 
State provides neither the service nor referrals: 0 states. 

Service: Legal services; 
State provides the service: 26 states; 
State provides referrals for the service: 16 state. 
State provides neither the service nor referrals: 3 states. 

Service: Medicaid; 
State provides the service: 44 states; 
State provides referrals for the service: 5 state. 
State provides neither the service nor referrals: 0 states. 

Service: Mental health services; 
State provides the service: 33 states; 
State provides referrals for the service: 16 state. 
State provides neither the service nor referrals: 0 states. 

Service: Short-term cash benefit; 
State provides the service: 22 states; 
State provides referrals for the service: 5 state. 
State provides neither the service nor referrals: 13 states. 

Service: Support groups; 
State provides the service: 33 states; 
State provides referrals for the service: 17 state. 
State provides neither the service nor referrals: 0 states. 

Service: Transitional housing; 
State provides the service: 30 states; 
State provides referrals for the service: 17 state. 
State provides neither the service nor referrals: 1 state. 

Service: Transportation; 
State provides the service: 45 states; 
State provides referrals for the service: 4 state. 
State provides neither the service nor referrals: 1 state. 

TANF: 

Service: Case management; 
State provides the service: 20 states; 
State provides referrals for the service: 7 states; 
State provides neither the service nor referrals: 21 states. 

Service: Clothing allowance; 
State provides the service: 10 states; 
State provides referrals for the service: 16 states; 
State provides neither the service nor referrals: 21 states. 

Service: Education and training; 
State provides the service: 6 states; 
State provides referrals for the service: 21 states; 
State provides neither the service nor referrals: 21 states. 

Service: Food assistance; 
State provides the service: 42 states; 
State provides referrals for the service: 7 states; 
State provides neither the service nor referrals: 1 state. 

Service: Independent living; 
State provides the service: 6 states; 
State provides referrals for the service: 21 states; 
State provides neither the service nor referrals: 19 states. 

Service: Legal services; 
State provides the service: 2 states; 
State provides referrals for the service: 36 states; 
State provides neither the service nor referrals: 12 states. 

Service: Medicaid; 
State provides the service: 45 states; 
State provides referrals for the service: 5 states; 
State provides neither the service nor referrals: 0 states. 

Service: Mental health services; 
State provides the service: 7 states; 
State provides referrals for the service: 30 states; 
State provides neither the service nor referrals: 10 states. 

Service: Short-term cash benefit; 
State provides the service: 17 states; 
State provides referrals for the service: 6 states; 
State provides neither the service nor referrals: 25 states. 

Service: Support groups; 
State provides the service: 6 states; 
State provides referrals for the service: 22 states; 
State provides neither the service nor referrals: 16 states. 

Service: Transitional housing; 
State provides the service: 3 states; 
State provides referrals for the service: 27 states; 
State provides neither the service nor referrals: 16 states. 

Service: Transportation; 
State provides the service: 11 states; 
State provides referrals for the service: 17 states; 
State provides neither the service nor referrals: 18 states. 

Source: GAO survey of state child welfare administrators and state 
TANF administrators. 

Note: Child welfare agencies were asked whether child welfare staff 
provide (either directly or through other organizations) or refer 
children in state custody living with kinship caregivers to any of the 
following types of assistance. TANF agencies were asked whether 
workers in their state's local assistance offices provide (either 
directly or through other organizations) or refer children in TANF 
child-only cases to any of the following types of assistance. 

[End of figure] 

Available Federal Funding and State Budget Constraints Influence 
Support Levels: 

Available federal funding influences the level of assistance states 
offer relative caregivers. Thirty-seven states reported in our survey 
that federal financing of child welfare services had some influence on 
the assistance made available to children in a relative's care. Title 
IV-E funding, which accounts for most of the federal funding dedicated 
for child welfare services, is restricted to supporting foster 
children who live with licensed or approved foster parents. 
Specifically, states can only be reimbursed by the federal government 
for payments made to support children if, among other requirements, 
the children are in foster care, meet income and resource 
requirements, and are living with licensed or approved foster parents. 
In addition, changes made by the Deficit Reduction Act of 2005 
clarified the amount that states can seek in federal reimbursement for 
IV-E administrative costs associated with foster children living with 
unlicensed relatives.[Footnote 38] Many states have used TANF to fund 
child welfare services because although TANF funding is a capped block 
grant, it is a more flexible funding source. For example, in Texas, 30 
percent of the child welfare agency's budget was funded with TANF 
dollars in state fiscal year 2010, according to state officials. 
However, some states may not be able to continue relying on TANF to 
fund child welfare services because they need to use TANF funds to 
address other program goals, such as promoting work. For example, 
Tennessee officials told us that they previously used some of their 
TANF grant to fund enhanced payments for relative caregivers and their 
Relative Caregiver Program, but that the state recently discontinued 
this practice due to budget constraints. 

In addition to federal funding constraints, 28 states reported that 
the cost to the state of serving children in TANF or child welfare 
programs influences the supports that are made available. Officials in 
the three states we visited described recent budget problems that made 
it more difficult to fund supports for children living with relative 
caregivers. Tennessee's Relative Caregiver Program was cut by 15 
percent, and the state limited participation in their Families First 
Kinship Program to about 90 children, according to state officials. 
Officials in Texas told us that their state legislature recently 
proposed eliminating Texas' Relative Caregiver Assistance Program, but 
that the program was ultimately spared after state agency officials 
successfully argued that, without this support, many relatives would 
be unable to care for the children, and the state would incur much 
higher costs if these children were placed with licensed foster care 
providers. In Washington, the state legislature authorized the TANF 
agency to begin means-testing child-only applicants to help address 
the state's budget shortfall, according to state officials. 

In addition to federal and state funding constraints, states' child 
welfare reform efforts have affected the types of assistance states 
offer children living with relative caregivers. Specifically, 31 
states reported in our child welfare survey that their state's efforts 
to place maltreated children with relatives and prevent entry into 
foster care had some influence on the type of assistance made 
available. For example, Texas implemented a child welfare reform 
effort that involved hiring additional CPS staff and implemented 
family group decision-making meetings. The state also began providing 
more in-home services to parents and increased efforts to identify 
relatives when out-of-home care is necessary. These efforts resulted 
in significant reductions in the number of children taken into state 
custody, an increase in relative placements, and lower costs for the 
state. State officials in Tennessee reported implementing a similar 
child welfare reform effort, which involved hiring more CPS staff, 
using family group decision-making meetings, and improving efforts to 
identify relatives and prevent children from entering foster care. 

Coordination Efforts Between TANF and Child Welfare Programs Can 
Affect Access to Services: 

Several State and Local Efforts Are Under Way to Coordinate TANF and 
Child Welfare Programs: 

Several states have initiated efforts to coordinate TANF and child 
welfare programs to better serve children living with relative 
caregivers. About two-thirds of states reported in our surveys that 
state TANF and child welfare staff meet periodically to work on common 
areas of concern, such as state budget or policy issues, and about 
half of state child welfare administrators reported working with their 
state TANF agency to make additional services available. For example, 
Washington's TANF agency convened various state agencies including 
child welfare, in part to improve coordination and help relative 
caregivers access resources and services. Tennessee's TANF and child 
welfare agency collaborated on a pilot project to provide an 
additional payment to supplement the TANF child-only payment for 
relative caregivers caring for children who were determined to be at 
risk of entering foster care. New York reported in our survey that the 
state's TANF and child welfare agencies worked together to launch an 
informational campaign to help relative caregivers access TANF child- 
only and child welfare benefits and services. 

States surveyed and local offices we visited reported that various 
efforts are also under way at the local level to coordinate services 
for children living with relative caregivers. These efforts include 
colocating TANF and child welfare services in the same building and 
working together on case planning. Thirty-two states reported about 
half of their child welfare offices are located in the same building 
as TANF offices. Some TANF and child welfare staff from our site 
visits said colocation facilitated coordination by allowing staff to 
more easily contact each other about cases. In addition, officials 
from five states--California, Colorado, Kansas, Louisiana, and North 
Carolina--reported having a combined team of TANF and child welfare 
staff who work with relative caregivers within their states. In North 
Carolina, combined TANF and child welfare units, which provide "one-
stop" services, improved communication about families, programs, and 
resources with the goal of preventing children from entering foster 
care. 

Most states cited benefits to coordination between state and local 
TANF and child welfare agencies (see figure 8). States reported that 
coordination was most helpful in providing customer service to parents 
and relative caregivers, followed by improved decision-making 
regarding appropriate services for families and better use of TANF and 
child welfare staff resources. For example, Colorado commented in our 
survey that one benefit of coordination is maximizing available TANF 
resources to prevent children from entering the child welfare system 
if the family lacks its own resources. 

[Side bar: 
Washington State’s TANF redesign: 

In an effort to improve Washington’s TANF program while decreasing 
spending, the state’s TANF agency reported making the following 
recommendations related to children living with relative caregivers: 
1. develop appropriate standards and requirements to ensure the 
health, well-being, and success of children, including caregiver 
training and well-child exams; 
2. complete a means test of relative caregivers for the TANF child-
only grant; 
3. improve coordination between TANF staff, child welfare staff, and 
kinship navigators, which are nonprofit organizations funded by the 
state’s Department on Aging that help relative caregivers access 
benefits; and; 
4. implement a more integrated case management model that would 
include relative caregivers receiving child-only grants. 
Source: Washington state officials. End of side bar] 

Figure 8: Number of States Reporting Benefits of Coordination Between 
State and Local TANF and Child Welfare Agencies: 

[Refer to PDF for image: horizontal bar graph] 

Customer service to parent and nonparent caregivers: 
TANF responses: 42 states; 
Child welfare responses: 39 states. 

Decision-making on appropriate services for families: 
TANF responses: 40 states; 
Child welfare responses: 39 states. 

Use of TANF and child welfare staff resources: 
TANF responses: 36 states; 
Child welfare responses: 39 states. 

Eligibility determination: 
TANF responses: 22 states; 
Child welfare responses: 30 states. 

Source: GAO survey. 

[End of figure] 

To promote coordination between TANF and child welfare programs, HHS' 
Administration for Children and Families (ACF) provided approximately 
$3.5 million per year for five years in grants to states and tribes. 
ACF's Office of Financial Assistance awarded 10 grants to tribes to 
test the effectiveness of efforts to coordinate tribal TANF and child 
welfare services for tribal families at risk of child abuse or 
neglect. In addition, ACF's Children's Bureau provided grants to 2 
states, a tribal organization, and 2 counties to support collaboration 
between TANF and child welfare programs. The purposes of the 
Children's Bureau grants are to: (1) demonstrate models of effective 
collaboration between TANF and child welfare agencies that will 
improve outcomes for children and youth who are in, or are at risk of 
entering, the child welfare system; (2) evaluate and document the 
processes and outcomes of these collaborations; and (3) develop 
identifiable sites that state and local TANF and child welfare 
agencies can look to for guidance and possible replication of 
collaboration efforts. ACF officials told us they convene meetings so 
that grantees can share information about their projects, but 
information about the outcomes of these efforts has not been made 
available to other states, in part because the demonstration projects 
and evaluations are still under way. ACF officials told us that, 
although dissemination activities to date have focused on information 
sharing among grantees, as grantees complete their work, the agency 
plans to disseminate best practices and lessons learned to all states. 
They noted that as site visits to the grantees are completed, the 
agency plans to post on relevant web sites information gleaned from 
the grantees on promising practices. 

[Side bar: 
California’s effort to improve local coordination between TANF and 
child welfare agencies: 

In 2000, California’s TANF and child welfare agencies launched a 
project called Linkages to develop a coordinated services approach to 
better serve families and improve outcomes. The first phase of the 
project involved a statewide county survey to compile information 
about coordination practices that were already under way and develop 
recommendations about how to coordinate child welfare and public 
assistance programs in California. The state provides funding to 
counties to support local coordination efforts, and the counties are 
encouraged to develop their own work plans and provide leadership to 
promote coordination. Currently, 27 of California’s 58 counties are 
participating in the project. Activities and information include: 
* training of TANF and child welfare staff and management; 
* four regional meetings and one statewide meeting per year; 
* peer support clusters;
* Web site [hyperlink, http://www.cfpic.org] with information on the 
project, a toolkit including best practices, videos, and presentations; 
* monthly newsletter; and; 
* technical assistance. 
Sources: California state officials and Linkages Web site. End of side 
bar] 

Limited Information Sharing Can Hinder Relative Caregiver Access to 
Available Benefits and Services: 

Information sharing between TANF and child welfare programs can 
benefit children living with relative caregivers, but our review in 
states where we performed site visits suggests this does not occur 
consistently. When case workers are knowledgeable about other 
government programs and community resources, they may be better able 
to refer families to appropriate services. A few offices we visited 
reported holding regular meetings during which information is shared 
about the policies of each program, however, some offices did not 
report meeting regularly. In our site visits, some TANF and child 
welfare staff reported being unaware of the services offered in each 
others' programs and the correct TANF eligibility rules for relative 
caregivers. For example, some TANF workers in Tennessee described 
instances in which child welfare workers had told relative caregivers 
that they were eligible for child care from the TANF agency, without 
clarifying that the caregivers must be working and meet certain income 
limits to qualify. In Texas and Tennessee, TANF and child welfare 
staff at the state and local levels were unaware of services available 
to relative caregivers provided by their respective state agencies on 
aging. 

In addition to information sharing between state TANF and child 
welfare staff, data sharing is another way to help caregivers access 
benefits and services. Under Title IV-E, states that receive federal 
funding to develop their child welfare information systems--known as 
statewide automated child welfare information systems (SACWIS)--are 
required to the extent practicable to develop an interface with the 
information system used by the state's TANF program. This interface is 
intended to allow the exchange of client data.[Footnote 39] According 
to ACF officials, 23 of the 34 state child welfare systems they 
formally reviewed have met this requirement, and 11 state child 
welfare systems have not met this requirement.[Footnote 40] ACF has 
not reviewed the remaining 17 state child welfare systems because 
either the states do not operate SACWIS systems or the systems are 
still being developed. Child welfare administrators from 10 of these 
17 states reported in our survey that case information cannot be 
shared between the child welfare and TANF information systems. 
Similarly, less than half of state TANF administrators responding to 
our survey reported that their information systems share data with 
their state's child welfare systems, which would allow them to 
identify duplicate payments or information on whether a client is 
receiving child welfare services (see figure 9). Some local TANF 
workers we spoke to in all three states we visited said they would 
like to access information in their state's child welfare information 
system in order to more easily confirm if a child has been removed 
from their parents and placed with a relative. Similarly, some local 
child welfare workers we interviewed said that their state's TANF 
agency often has more accurate contact information than their office 
and that this information could help them locate relative caregivers 
or parents. 

Figure 9: State TANF and Child Welfare Agencies Reporting on Access to 
Information: 

[Refer to PDF for image: horizontal bar graph] 

Number of state TANF and child welfare agencies responding: 

TANF workers can access child welfare data to identify potential 
duplicate payments: 
Yes: 12 states; 
No: 39 states. 

TANF information system can be used to identify clients served by 
child welfare: 
Yes: 20 states; 
No: 30 states. 

Child welfare workers can access TANF data to identify potential 
duplicate payments: 
Yes: 25 states; 
No: 17 states. 

Child welfare information system can be used to identify clients 
served by TANF: 
Yes: 23 states; 
No: 24 states. 

Source: GAO survey. 

[End of figure] 

In addition to providing federal funding for the development of 
SACWIS, HHS provides guidance and technical assistance to help states 
develop child welfare information systems that can interact with TANF 
information systems, but more than half the states report obstacles to 
sharing information, such as privacy concerns and technical 
challenges. According to HHS officials, federal law should not present 
a barrier to the sharing of information between the TANF and child 
welfare agencies, although state law may, as states are permitted to 
determine their own confidentiality rules. Thirty state TANF 
administrators and 20 state child welfare administrators said that 
concerns about client confidentiality have prevented them from sharing 
information in their state. The National Association of State TANF 
Administrators, an affiliate of the American Public Human Services 
Association, suggested in a recent paper that more clarification was 
needed about whether federal laws prohibit states from sharing 
information between state TANF and child welfare agencies.[Footnote 
41] HHS officials indicated they have provided states with technical 
assistance on the interface requirement through conferences and 
ongoing training.[Footnote 42] HHS also funds the National Resource 
Center for Child Welfare Data and Technology, which provides technical 
assistance to states focused on, among other things, improving case 
management and data collection systems to improve outcomes for 
children and families in the child welfare system.[Footnote 43] 

Conclusions: 

Children often come into the care of relatives unexpectedly and under 
very difficult circumstances, and many of these caregivers have 
limited resources. TANF and child welfare programs provide financial 
assistance and other types of services to these families, but many 
relative caregivers may not know how to access benefits and services 
or that such assistance is available. Coordination among programs that 
provide financial assistance and support to these families is one way 
to ensure that caregivers are aware of available resources. It will be 
important for ACF to follow through with its plans to disseminate 
information gathered from its grants about effective collaboration 
practices so states can have models to look to for possible 
replication. Data sharing is another way for states to help caregivers 
access assistance. If caseworkers have automatic access to information 
about shared clients, they may be able to make better decisions about 
what services are needed and accelerate eligibility determination. 
Although some states are currently sharing data, others indicated they 
are not due to confidentiality and privacy concerns. HHS has issued 
guidance to clarify that federal rules do not prohibit data sharing, 
but less than half of states are moving forward with data sharing 
efforts. 

Recommendations for Executive Action: 

To help states share data between TANF and child welfare information 
systems operating within states, we recommend that the Secretary of 
Health and Human Services direct ACF to clarify its guidance and 
provide additional technical assistance to states on data sharing 
opportunities. For example, the HHS-funded National Resource Center 
for Child Welfare Data and Technology could collect information from 
states that are successfully sharing data, including how they 
addressed concerns about client confidentiality, and disseminate that 
information to all states. 

Agency Comments and Our Evaluation: 

We provided a draft of this report to the HHS for review and comment. 
HHS agreed with our recommendation and indicated it will provide 
additional guidance to states and tribes concerning the ability to 
share information between TANF and child welfare agencies. HHS also 
provided technical comments, which we incorporated as appropriate. A 
letter conveying HHS's comments is reproduced in appendix V. 

As agreed with your offices, unless you publicly announce the contents 
of this report earlier, we plan no further distribution until 30 days 
from the report date. At that time, we will send copies to the 
appropriate congressional committees, the Secretary of Health and 
Human Services, and other interested parties. In addition, this report 
will be available at no charge on the GAO Web site at [hyperlink, 
http://www.gao.gov]. 

If you or your staff members have any questions regarding this report, 
please contact me at (202) 512-7215 or brownke@gao.gov. 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 
contributors to this report are listed in appendix VI. 

Signed by: 

Kay E. Brown: 
Director, Education, Workforce, and Income Security Issues: 

List of Requesters: 

The Honorable Charles Grassley:
Ranking Member:
Committee on the Judiciary:
United States Senate: 

The Honorable Orrin G. Hatch:
Ranking Member:
Committee on Finance:
United States Senate: 

The Honorable Geoff Davis:
Chairman:
Subcommittee on Human Resources:
Committee on Ways and Means:
House of Representatives: 

[End of section] 

Appendix I: Scope and Methodology: 

To address the objectives of this study, we used a variety of methods. 
Specifically, we: 

* analyzed publicly available Temporary Assistance for Needy Families 
(TANF) active caseload data from the U.S. Department of Health and 
Human Services (HHS), including the number and types of families 
receiving TANF cash assistance and the characteristics of children and 
nonparent caregivers in TANF child-only cases; 

* analyzed HHS' Adoption and Foster Care Analysis and Reporting System 
(AFCARS) data reported by states including the number of foster 
children, number of foster children living with relatives, and the 
number receiving federally supported foster care payments; 

* conducted a nationwide survey of state TANF administrators and a 
separate nationwide survey of state child welfare administrators; 

* visited three states and selected localities within each state and 
interviewed officials administering TANF and child welfare programs; 

* reviewed related studies;[Footnote 44] 

* interviewed officials from HHS and reviewed pertinent federal laws, 
regulations, and agency guidance;[Footnote 45] and: 

* interviewed researchers and others knowledgeable about TANF and 
child welfare programs from a range of organizations.[Footnote 46] 

We conducted our work from October 2010 to October 2011 in accordance 
with generally accepted government auditing standards. Those standards 
require that we plan and perform the audit to obtain sufficient, 
appropriate evidence to provide a reasonable basis for our findings 
and conclusions based on our audit objectives. We believe that the 
evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. 

Review of TANF and Child Welfare Data from HHS: 

TANF Data: 

Because HHS is responsible for collecting state TANF data and 
reporting on state TANF programs nationally, we reviewed relevant TANF 
data compiled by that agency. HHS collects aggregated and 
disaggregated case record information from states on the families 
receiving TANF cash assistance. States are required to collect monthly 
TANF data and report the data to HHS quarterly. States have the option 
to submit either sample data or data on their entire TANF caseload 
(universe) data to HHS. Using the disaggregated data, we developed 
national estimates of the TANF caseload, TANF child-only caseload, the 
types of TANF child-only cases, and characteristics of the children 
and head-of-household adults in TANF child-only cases with nonparent 
caregivers. To analyze how the TANF child-only caseload has changed 
over time, we analyzed HHS's TANF data for fiscal years 2000 through 
2008, the most recent data available. To identify the characteristics 
of TANF child-only cases with nonparent caregivers, we analyzed 2008 
data, including several variables that provided information about the 
demographics and economic circumstances of these cases. Because the 
scope of our work extended to the 50 states and Washington, D.C., we 
excluded data for the U.S. territories from our analyses. Because many 
of the states report samples of cases to HHS, we weighted the 
estimates to reflect the sample design employed by each of these 
states. All national estimates produced from our analysis of the TANF 
data are subject to sampling errors. We express our confidence in the 
precision of our results as a 95 percent confidence interval. This is 
the interval that would contain the actual population value for 95 
percent of the samples the states could have drawn. 

To assess the reliability of HHS' TANF data, we reviewed relevant HHS 
documentation, including guidance for states on data collection and 
sampling, interviewed HHS officials, conducted electronic data 
testing, and compared our results with related information reported by 
HHS and other researchers. While we interviewed HHS officials to 
gather information on the processes they use to ensure the 
completeness and accuracy of the TANF caseload data, we did not 
independently verify these data with states. In addition, although HHS 
does not perform on-site reviews of states' TANF data, auditors in 
each state periodically review state TANF programs, including 
administrative data, to comply with the Single Audit Act of 
1984.[Footnote 47] Because of these reviews, as well as the steps 
taken by HHS officials to ensure the completeness and accuracy of 
these data, we determined that they were sufficiently reliable for the 
purposes of this report. 

Tables 4, 5, 6, 7, and 8 provide the estimates and 95 percent 
confidence intervals for the data we present in the body of this 
report. 

Table 4: Estimates and 95 Percent Confidence Intervals for Number of 
TANF and Child-Only Cases (FY 2000-2008): 

Number of TANF cases; 
2000: 2,232,570 (2,229,148-2,235,992); 
2001: 2,090,024 (2,087,255-2,092,793); 
2002: 1,983,862 (1,970,328-1,997,396); 
2003: 1,948,820 (1,939,976-1,957,664); 
2004: 1,965,713 (1,963,769-1,967,657); 
2005: 1,898,118 (1,895,362-1,900,874); 
2006: 1,786,245 (1,784,557-1,787,933); 
2007: 1,682,143 (1,680,459-1,683,827); 
2008: 1,613,032 (1,611,315-1,614,749). 

Number of child-only cases; 
2000: 772,227 (731,702-812,751); 
2001: 781,677 (743,671-819,684); 
2002: 771,031 (736,694-805,367); 
2003: 799,506 (765,729-833,282); 
2004: 860,317 (825,456-895,178); 
2005: 866,378 (831,273-901,483); 
2006: 846,523 (813,218-879,827); 
2007: 818,289 (782,715-853,864); 
2008: 814,977 (779,313-850,642). 

Percentage of TANF cases that were child-only; 
2000: 34.6 (32.8-36.4); 
2001: 37.4 (35.6-39.2); 
2002: 38.9 (37.1-40.6); 
2003: 41.0 (39.3-42.8); 
2004: 43.8 (42.0-45.5); 
2005: 45.6 (43.8-47.5); 
2006: 47.4 (45.5-49.3); 
2007: 48.6 (46.5-50.8); 
2008: 50.5 (48.3-52.7). 

Source: GAO analysis of HHS administrative data. 

[End of table] 

Table 5: Estimates and 95 Percent Confidence Intervals for Composition 
of TANF Child-Only Caseload in 2000 and 2008 (percentage of each type 
of case): 

Type of child-only case: Nonparent caregiver; 
2000 estimate: 31.1%; 
95 percent confidence interval: 28.3-33.9; 
2008 estimate: 32.5%; 
95 percent confidence interval: 29.8-35.2. 

Type of child-only case: Parent ineligible due to immigration status; 
2000 estimate: 10.8%; 
95 percent confidence interval: 8.1-13.5; 
2008 estimate: 19.1%; 
95 percent confidence interval: 15.9-22.3. 

Type of child-only case: Parent ineligible due to receipt of SSI; 
2000 estimate: 18.2%; 
95 percent confidence interval: 15.8-20.5; 
2008 estimate: 22.4%; 
95 percent confidence interval: 19.9-25.0. 

Type of child-only case: Parent ineligible due to sanction; 
2000 estimate: 4.6%; 
95 percent confidence interval: 2.7-6.5; 
2008 estimate: 4.9%; 
95 percent confidence interval: 2.8-7.0. 

Type of child-only case: Parent, other; 
2000 estimate: 11.0%; 
95 percent confidence interval: 9.2-12.8; 
2008 estimate: 9.3%; 
95 percent confidence interval: 6.8-11.9. 

Type of child-only case: Unknown caregiver; 
2000 estimate: 24.3%; 
95 percent confidence interval: 21.6-26.9; 
2008 estimate: 11.7%; 
95 percent confidence interval: 10.8-12.6. 

Source: GAO analysis of HHS administrative data. 

[End of table] 

Table 6: Estimates and 95 Percent Confidence Intervals for Assistance 
Received by TANF Child-Only Families with Head of Household Nonparent 
Caregivers (FY 2008): 

Type of assistance: Medical-enrolled in Medicaid or CHIP; 
Percentage receiving assistance: 95.3; 
95 percent confidence interval: 94.5-96.1; 
Percentage not receiving assistance: 4.7; 
95 percent confidence interval: 3.9-5.5. 

Type of assistance: SNAP; 
Percentage receiving assistance: 42.6; 
95 percent confidence interval: 38.2-46.9; 
Percentage not receiving assistance: 57.4; 
95 percent confidence interval: 53.1-61.8. 

Type of assistance: Housing-public housing-rent subsidy; 
Percentage receiving assistance: 8.6; 
95 percent confidence interval: 6.3-10.9; 
Percentage not receiving assistance: 91.4; 
95 percent confidence interval: 89.1-93.7. 

Type of assistance: Child care; 
Percentage receiving assistance: 5.7; 
95 percent confidence interval: 4.4-7.1; 
Percentage not receiving assistance: 94.3; 
95 percent confidence interval: 92.9-95.6. 

Source: GAO analysis of HHS administrative data. 

[End of table] 

Table 7: Estimates and 95 Percent Confidence Intervals for 
Characteristics of Nonparent Caregivers in TANF Child-Only Cases with 
Head of Household Nonparent Caregivers (FY 2008): 

Characteristic: Gender; 

Female: 91%; 
95 percent confidence interval: 88.5-93.9. 

Male: 9%; 
95 percent confidence interval: 6.1-11.5. 

Characteristic: Age of caregiver; 

Under 30 years old: 8%; 
95 percent confidence interval: 5.2-10.3. 

31-40 years old: 12%; 
95 percent confidence interval: 9.2-14.5. 

41-50 years old: 27%; 
95 percent confidence interval: 23.1-31.0. 

51-60 years old: 32%; 
95 percent confidence interval: 27.4-36.1. 

Over 60 years old: 22%; 
95 percent confidence interval: 17.5-25.7. 

Characteristic: Race/ethnicity; 

White/non-Hispanic;: 40%; 
95 percent confidence interval: 35.5-44.4. 

African American/non-Hispanic: 39%; 
95 percent confidence interval: 34.9-43.1. 

Hispanic: 14%; 
95 percent confidence interval: 9.5-18.9. 

Other/multiracial: 4%; 
95 percent confidence interval: 1.8-6.2. 

Unknown: 3%; 
95 percent confidence interval: 2.2-3.4. 

Characteristic: Marital status; 

Single, never married, divorced, or separated: 65%; 
95 percent confidence interval: 60.7-69.7. 

Married: 29%; 
95 percent confidence interval: 24.7-33.2. 

Widowed: 6%; 
95 percent confidence interval: 3.4-8.2. 

Characteristic: Education; 

Less than high school degree: 24%; 
95 percent confidence interval: 19.6-27.5. 

High school degree: 38%; 
95 percent confidence interval: 33.5-41.9. 

Associates degree, bachelors degree, or other credentials: 4; 
95 percent confidence interval: 2.5-5.1. 

No formal education: 8%; 
95 percent confidence interval: 6.4-10.5. 

Unknown: 27%; 
95 percent confidence interval: 22.2-31.0. 

[End of table] 

Source: GAO analysis of HHS TANF administrative data. 

Table 8: Estimates and 95 Percent Confidence Intervals for 
Characteristics of Children in TANF Child-Only Cases with Head of 
Household Nonparent Caregivers (FY 2008): 

Characteristic: Gender; 

Female: 51%; 
95 percent confidence interval: 47.6-55.0. 

Male: 49%; 
95 percent confidence interval: 45.0-52.5. 

Characteristic: Age of children; 

Less than 1 year old: 2%; 
95 percent confidence interval: 0.7-2.7. 

1-5 years old: 23%; 
95 percent confidence interval: 19.2-26.2. 

6-10 years old: 29%; 
95 percent confidence interval: 25.8-33.1. 

11-17 years old: 44%; 
95 percent confidence interval: 39.6-48.1. 

18 years or older: 2%; 
95 percent confidence interval: 1.0-3.7. 

Characteristic: Race/ethnicity; 

White/non-Hispanic: 36%; 
95 percent confidence interval: 31.8-41.1. 

African American/non-Hispanic: 41%; 
95 percent confidence interval: 36.6-46.1. 

Hispanic: 17%; 
95 percent confidence interval: 11.0-22.5. 

Other/multiracial: 5%; 
95 percent confidence interval: 2.9-6.5. 

Unknown: 1%; 
95 percent confidence interval: 0.2-1.3. 

Characteristic: Length of time on assistance; 

Less than 1 year: 25%; 
95 percent confidence interval: 21.4-29.2. 

1-2 years: 16%; 
95 percent confidence interval: 12.2-19.0. 

2-5 years: 30%; 
95 percent confidence interval: 26.1-34.6. 

5+ years: 29%; 
95 percent confidence interval: : 24.5-33.0. 

Characteristic: Relationship to caregiver; 

Grandchild or great grandchild: 63%; 
95 percent confidence interval: 58.3-68.1. 

Other related person: 24%; 
95 percent confidence interval: 19.8-27.8. 

Unrelated child: 3%; 
95 percent confidence interval: 1.7-3.3. 

Unknown: 10%; 
95 percent confidence interval: 6.8-14.1. 

Source: GAO analysis of HHS TANF administrative data. 

[End of table] 

Child Welfare Data: 

To examine the extent to which foster children live with relatives and 
what payments foster children receive, we reviewed relevant national 
data on children in foster care from HHS's Adoption and Foster Care 
Analysis and Reporting System (AFCARS). HHS uses AFCARS to capture, 
report, and analyze information collected by the states concerning all 
foster care children for whom state child welfare agencies have 
responsibility for placement, care, or supervision. We reviewed AFCARS 
data for fiscal years 2005 through 2009 and identified the number of 
foster children living with relatives and the number of children 
receiving a federally supported IV-E foster care payment. To assess 
the reliability of these data, we reviewed documentation about the 
collection and reporting of AFCARS data and conducted electronic 
testing of AFCARS data. We also interviewed relevant HHS officials to 
clarify data elements, procedures, and reasons for missing 
information. The AFCARS data on the placement setting of children in 
foster care and whether they receive a IV-E foster care payment were 
found to be sufficiently reliable for the purposes of this engagement. 

Surveys of State TANF and Child Welfare Administrators: 

To help address all of our research objectives, we conducted a Web- 
based survey of state TANF administrators and a separate survey of 
state child welfare administrators in all 50 states and the District 
of Columbia. The survey was conducted between March 2011 and June 
2011, and administrators from every state and the District of Columbia 
responded. The TANF survey included questions about: TANF child-only 
policies, the current TANF child-only caseload, financial assistance 
and services available to children in these cases, kinship care 
programs, coordination between TANF and child welfare programs, and 
the factors influencing the assistance available to children living 
with relative caregivers. The child welfare survey included questions 
about: the financial assistance and services available to children in 
foster care, the extent to which relative homes are licensed as foster 
parents, kinship care programs, implementation of subsidized 
guardianship, coordination between TANF and child welfare programs, 
and the factors influencing the assistance available to children 
living with relative caregivers. 

Because this was a survey of all states and not a sample survey, there 
are no sampling errors. However, the practical difficulties of 
conducting any survey may introduce errors, commonly referred to as 
nonsampling errors, such as variations in how respondents interpret 
questions and their willingness to offer accurate responses. We took 
steps to minimize nonsampling errors, including reviews by experts in 
the content field, pretesting draft instruments, and having an 
independent analyst check all computer programs. Specifically, during 
survey development, we pretested draft instruments with TANF and child 
welfare administrators from four states (Maryland, Ohio, Virginia, and 
Washington) in February 2011. We selected the pretest states to 
provide variation in program administration (e.g., state-administered 
vs. county-administered programs) and geographic location. In the 
pretests, we were generally interested in the clarity, precision, and 
objectivity of the questions, as well as the flow and layout of the 
survey. For example, we wanted to ensure definitions used in the 
surveys were clear and known to the respondents, categories provided 
in closed-ended questions were complete and exclusive, and the 
ordering of survey sections and the questions within each section was 
appropriate. We revised the final survey based on pretest results. To 
further minimize errors, programs used to analyze the survey data and 
make estimations were independently verified to ensure the accuracy of 
this work. 

While we did not fully validate specific information that states 
reported through our survey, we took steps to ensure that the 
information was of sufficient quality for the purposes of this report. 
For example, we reviewed the responses and identified those that 
required further clarification and, subsequently, conducted follow-up 
interviews with those respondents to ensure the information they 
provided was reasonable and reliable. On the basis of these checks, we 
believe our survey data are of sufficient quality for use in our work. 

Site Visits: 

To gather information about how TANF and child welfare programs are 
implemented at the local level, we conducted site visits, between 
December 2010 and March 2011, to Tennessee, Texas, and Washington, and 
selected localities in those states. Specifically, we met with state 
officials in each state and visited Upper Cumberland, Rutherford, and 
Davidson counties in Tennessee; Travis, Williamson, and Hays counties 
in Texas; and King, Grays Harbor, and Thurston counties in Washington. 
These states were selected because they varied in TANF caseload 
characteristics and implementation of programs to assist relative 
caregivers. We worked with the states to select localities that were 
located in both urban and rural areas to help ensure that we captured 
any differences in TANF and child welfare program implementation. 
Within each state, we interviewed state TANF and child welfare 
administrators, as well as TANF and child welfare staff from two to 
three local offices. Through these interviews, we collected 
information on TANF child-only policies and caseload characteristics, 
the types of assistance available to children living with relative 
caregivers, coordination between TANF and child welfare programs, and 
the factors influencing the types of assistance available to support 
children living with relative caregivers. 

[End of section] 

Appendix II: States' Reported Child-Only Caseloads and Reasons That 
Cases Are Child-Only: 

State: Alabama; 
Total cash assistance caseload: 24,792; 
Child-only cases: 7,933; 
Percentage of caseload that is child-only: 32%; 
Nonparent caregiver: data not provided; 
Number of child-only cases by reason: 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Alaska; 
Total cash assistance caseload: 3,573; 
Child-only cases: 932; 
Percentage of caseload that is child-only: 26%; 
Number of child-only cases by reason: 
Nonparent caregiver: 408; 
Parent receives SSI: 373; 
Parent ineligible because of immigration status: 39; 
Parent sanction or disqualification: 0; 
Other reason: data not provided. 

State: Arizona; 
Total cash assistance caseload: 19,790; 
Child-only cases: 8,119; 
Percentage of caseload that is child-only: 41%; 
Number of child-only cases by reason: 
Nonparent caregiver: 3,685; 
Parent receives SSI: 1,523; 
Parent ineligible because of immigration status: 2,185; 
Parent sanction or disqualification: 726; 
Other reason: data not provided. 

State: Arkansas; 
Total cash assistance caseload: data not provided; 
Child-only cases: data not provided; 
Percentage of caseload that is child-only: data not provided; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: California; 
Total cash assistance caseload: 587,964; 
Child-only cases: 244,952; 
Percentage of caseload that is child-only: 42%; 
Number of child-only cases by reason: 
Nonparent caregiver: 36,693; 
Parent receives SSI: 34,536; 
Parent ineligible because of immigration status: 122,646; 
Parent sanction or disqualification: 46,031; 
Other reason: 5,046. 

State: Colorado; 
Total cash assistance caseload: 14,849; 
Child-only cases: 4,874; 
Percentage of caseload that is child-only: 33%; 
Number of child-only cases by reason: 
Nonparent caregiver: 2,735; 
Parent receives SSI: 943; 
Parent ineligible because of immigration status: 980; 
Parent sanction or disqualification: 216; 
Other reason: data not provided. 

State: Connecticut; 
Total cash assistance caseload: 18,637; 
Child-only cases: 7,079; 
Percentage of caseload that is child-only: 38%; 
Number of child-only cases by reason: 
Nonparent caregiver: 3,701; 
Parent receives SSI: 2,682; 
Parent ineligible because of immigration status: 666; 
Parent sanction or disqualification: 30; 
Other reason: data not provided. 

State: Delaware; 
Total cash assistance caseload: 7,818; 
Child-only cases: 2,261; 
Percentage of caseload that is child-only: 29%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided ; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: 696; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: District of Columbia; 
Total cash assistance caseload: 6,551; 
Child-only cases: 3,074; 
Percentage of caseload that is child-only: 47%; 
Number of child-only cases by reason: 
Nonparent caregiver: 2,188; 
Parent receives SSI: 517; 
Parent ineligible because of immigration status: 318; 
Parent sanction or disqualification: 2; 
Other reason: data not provided. 

State: Florida; 
Total cash assistance caseload: 58,020; 
Child-only cases: 38,454; 
Percentage of caseload that is child-only: 66%; 
Number of child-only cases by reason: 
Nonparent caregiver: 28,236; 
Parent receives SSI: 5,482; 
Parent ineligible because of immigration status: 3,396; 
Parent sanction or disqualification: 436; 
Other reason: 904. 

State: Georgia; 
Total cash assistance caseload: 20,499; 
Child-only cases: 16,458; 
Percentage of caseload that is child-only: 80%; 
Number of child-only cases by reason: 
Nonparent caregiver: 10,638; 
Parent receives SSI: 5,222; 
Parent ineligible because of immigration status: 650; 
Parent sanction or disqualification: 2; 
Other reason: 36. 

State: Hawaii; 
Total cash assistance caseload: data not provided; 
Child-only cases: data not provided; 
Percentage of caseload that is child-only: data not provided; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Idaho; 
Total cash assistance caseload: 2,404; 
Child-only cases: 2,163; 
Percentage of caseload that is child-only: 90%; 
Number of child-only cases by reason: 
Nonparent caregiver: 2,127; 
Parent receives SSI: 0; 
Parent ineligible because of immigration status: 36; 
Parent sanction or disqualification: 0; 
Other reason: 0. 

State: Illinois; 
Total cash assistance caseload: 37,621; 
Child-only cases: 15,312; 
Percentage of caseload that is child-only: 41%; 
Number of child-only cases by reason: 
Nonparent caregiver: 5,819; 
Parent receives SSI: 7,045; 
Parent ineligible because of immigration status: 2,144; 
Parent sanction or disqualification: 304; 
Other reason: [Empty]. 

State: Indiana; 
Total cash assistance caseload: 31,325; 
Child-only cases: 9,547; 
Percentage of caseload that is child-only: 30%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,197; 
Parent receives SSI: 3,243; 
Parent ineligible because of immigration status: 1,915; 
Parent sanction or disqualification: 0; 
Other reason: 192. 

State: Iowa; 
Total cash assistance caseload: 18,390; 
Child-only cases: 5,454; 
Percentage of caseload that is child-only: 30%; 
Number of child-only cases by reason: 
Nonparent caregiver: 2,817; 
Parent receives SSI: 1,496; 
Parent ineligible because of immigration status: 716; 
Parent sanction or disqualification: 7; 
Other reason: 364. 

State: Kansas; 
Total cash assistance caseload: 15,362; 
Child-only cases: 4,183; 
Percentage of caseload that is child-only: 27%; 
Number of child-only cases by reason: 
Nonparent caregiver: 2,278; 
Parent receives SSI: 1,005; 
Parent ineligible because of immigration status: 764; 
Parent sanction or disqualification: 49; 
Other reason: 0. 

State: Kentucky; 
Total cash assistance caseload: 24,629; 
Child-only cases: 12,329; 
Percentage of caseload that is child-only: 50%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided ; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Louisiana; 
Total cash assistance caseload: 10,696; 
Child-only cases: 7,609; 
Percentage of caseload that is child-only: 71%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Maine; 
Total cash assistance caseload: 14,861; 
Child-only cases: 2,879; 
Percentage of caseload that is child-only: 19%; 
Number of child-only cases by reason: 
Nonparent caregiver: 707; 
Parent receives SSI: 1,167; 
Parent ineligible because of immigration status: 0; 
Parent sanction or disqualification: 1,005; 
Other reason: data not provided. 

State: Maryland; 
Total cash assistance caseload: 27,558; 
Child-only cases: 8,743; 
Percentage of caseload that is child-only: 32%; 
Number of child-only cases by reason: 
Nonparent caregiver: 6,547; 
Parent receives SSI: 1,698; 
Parent ineligible because of immigration status: 0; 
Parent sanction or disqualification: 0; 
Other reason: 498. 

State: Massachusetts; 
Total cash assistance caseload: 52,463; 
Child-only cases: 18,642; 
Percentage of caseload that is child-only: 36%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,493; 
Parent receives SSI: 8,068; 
Parent ineligible because of immigration status: 3,729; 
Parent sanction or disqualification: 2,352; 
Other reason: data not provided. 

State: Michigan; 
Total cash assistance caseload: 84,570; 
Child-only cases: 18,341; 
Percentage of caseload that is child-only: 22%; 
Number of child-only cases by reason: 
Nonparent caregiver: 12,613; 
Parent receives SSI: 11,439; 
Parent ineligible because of immigration status: 2,314; 
Parent sanction or disqualification: 1,662; 
Other reason: data not provided. 

State: Minnesota; 
Total cash assistance caseload: 37,290; 
Child-only cases: 11,409; 
Percentage of caseload that is child-only: 31%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,448; 
Parent receives SSI: 5,426; 
Parent ineligible because of immigration status: 2,844; 
Parent sanction or disqualification: 127; 
Other reason: 33. 

State: Mississippi; 
Total cash assistance caseload: 12,047; 
Child-only cases: 5,265; 
Percentage of caseload that is child-only: 44%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided ; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Missouri; 
Total cash assistance caseload: 42,828; 
Child-only cases: 9,781; 
Percentage of caseload that is child-only: 23%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,505; 
Parent receives SSI: 3,739; 
Parent ineligible because of immigration status: 795; 
Parent sanction or disqualification: 751; 
Other reason: 0. 

State: Montana; 
Total cash assistance caseload: 3,694; 
Child-only cases: 1,329; 
Percentage of caseload that is child-only: 36%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Nebraska; 
Total cash assistance caseload: 8,880; 
Child-only cases: 8,239; 
Percentage of caseload that is child-only: 93%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Nevada; 
Total cash assistance caseload: 12,073; 
Child-only cases: 4,833; 
Percentage of caseload that is child-only: 40%; 
Number of child-only cases by reason: 
Nonparent caregiver: 1,491; 
Parent receives SSI: 900; 
Parent ineligible because of immigration status: 2,129; 
Parent sanction or disqualification: 0; 
Other reason: 314. 

State: New Hampshire; 
Total cash assistance caseload: 6,252; 
Child-only cases: 2,421; 
Percentage of caseload that is child-only: 39%; 
Number of child-only cases by reason: 
Nonparent caregiver: 1,181; 
Parent receives SSI: 1,051; 
Parent ineligible because of immigration status: 82; 
Parent sanction or disqualification: 0; 
Other reason: 230. 

State: New Jersey; 
Total cash assistance caseload: 37,847; 
Child-only cases: 9,474; 
Percentage of caseload that is child-only: 25%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,311; 
Parent receives SSI: 2,764; 
Parent ineligible because of immigration status: 1,949; 
Parent sanction or disqualification: 0; 
Other reason: 450. 

State: New Mexico; 
Total cash assistance caseload: 21,664; 
Child-only cases: 7,265; 
Percentage of caseload that is child-only: 34%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: New York; 
Total cash assistance caseload: 123,450; 
Child-only cases: 59,088; 
Percentage of caseload that is child-only: 48%; 
Number of child-only cases by reason: 
Nonparent caregiver: 18,647; 
Parent receives SSI: 17,632; 
Parent ineligible because of immigration status: 18,722; 
Parent sanction or disqualification: 0; 
Other reason: 4,087. 

State: North Carolina; 
Total cash assistance caseload: 25,999; 
Child-only cases: 16,757; 
Percentage of caseload that is child-only: 64%; 
Number of child-only cases by reason: 
Nonparent caregiver: 11,344; 
Parent receives SSI: 2,587; 
Parent ineligible because of immigration status: 2,494; 
Parent sanction or disqualification: 172; 
Other reason: 0. 

State: North Dakota; 
Total cash assistance caseload: 1,988; 
Child-only cases: 497; 
Percentage of caseload that is child-only: 25%; 
Number of child-only cases by reason: 
Nonparent caregiver: 497 ; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: 0; 
Other reason: data not provided. 

State: Ohio; 
Total cash assistance caseload: 103,513; 
Child-only cases: 43,891; 
Percentage of caseload that is child-only: 42%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Oklahoma; 
Total cash assistance caseload: 9,273; 
Child-only cases: 4,759; 
Percentage of caseload that is child-only: 51%; 
Number of child-only cases by reason: 
Nonparent caregiver: 3,105; 
Parent receives SSI: 1,057; 
Parent ineligible because of immigration status: 586; 
Parent sanction or disqualification: 10; 
Other reason: 0. 

State: Oregon; 
Total cash assistance caseload: 32,140; 
Child-only cases: 7,575; 
Percentage of caseload that is child-only: 24%; 
Number of child-only cases by reason: 
Nonparent caregiver: 1,570; 
Parent receives SSI: 1,572; 
Parent ineligible because of immigration status: 3,307; 
Parent sanction or disqualification: 284; 
Other reason: 842. 

State: Pennsylvania; 
Total cash assistance caseload: 86,991; 
Child-only cases: 23,209; 
Percentage of caseload that is child-only: 27%; 
Number of child-only cases by reason: 
Nonparent caregiver: data not provided ; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: data not provided; 
Other reason: data not provided. 

State: Rhode Island; 
Total cash assistance caseload: 7,105; 
Child-only cases: 2,258; 
Percentage of caseload that is child-only: 32%; 
Number of child-only cases by reason: 
Nonparent caregiver: 344; 
Parent receives SSI: 1,572; 
Parent ineligible because of immigration status: 324; 
Parent sanction or disqualification: 8; 
Other reason: 10. 

State: South Carolina; 
Total cash assistance caseload: 19,523; 
Child-only cases: 7,273; 
Percentage of caseload that is child-only: 37%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,548; 
Parent receives SSI: 1,857; 
Parent ineligible because of immigration status: 494; 
Parent sanction or disqualification: 331; 
Other reason: data not provided. 

State: South Dakota; 
Total cash assistance caseload: 3,307; 
Child-only cases: 2,179; 
Percentage of caseload that is child-only: 66%; 
Number of child-only cases by reason: 
Nonparent caregiver: 1,844; 
Parent receives SSI: 295; 
Parent ineligible because of immigration status: data not provided; 
Parent sanction or disqualification: 40; 
Other reason: 0. 

State: Tennessee; 
Total cash assistance caseload: 63,153; 
Child-only cases: 18,851; 
Percentage of caseload that is child-only: 30%; 
Number of child-only cases by reason: 
Nonparent caregiver: 11,151; 
Parent receives SSI: 7,604; 
Parent ineligible because of immigration status: 96; 
Parent sanction or disqualification: 0; 
Other reason: 0. 

State: Texas; 
Total cash assistance caseload: 49,753; 
Child-only cases: 31,996; 
Percentage of caseload that is child-only: 64%; 
Number of child-only cases by reason: 
Nonparent caregiver: 10,074; 
Parent receives SSI: 3,042; 
Parent ineligible because of immigration status: 16,846; 
Parent sanction or disqualification: 974; 
Other reason: 1,060. 

State: Utah; 
Total cash assistance caseload: 6,932; 
Child-only cases: 2,846; 
Percentage of caseload that is child-only: 41%; 
Number of child-only cases by reason: 
Nonparent caregiver: 1,640; 
Parent receives SSI: 645; 
Parent ineligible because of immigration status: 561; 
Parent sanction or disqualification: 0; 
Other reason: 0. 

State: Vermont; 
Total cash assistance caseload: 3,371; 
Child-only cases: 1,329; 
Percentage of caseload that is child-only: 39%; 
Number of child-only cases by reason: 
Nonparent caregiver: 638; 
Parent receives SSI: 704; 
Parent ineligible because of immigration status: 21; 
Parent sanction or disqualification: 0; 
Other reason: data not provided. 

State: Virginia; 
Total cash assistance caseload: 36,604; 
Child-only cases: 5,477; 
Percentage of caseload that is child-only: 15%; 
Number of child-only cases by reason: 
Nonparent caregiver: 154; 
Parent receives SSI: 3,289; 
Parent ineligible because of immigration status: 1,458; 
Parent sanction or disqualification: 576; 
Other reason: data not provided. 

State: Washington; 
Total cash assistance caseload: 70,759; 
Child-only cases: 25,251; 
Percentage of caseload that is child-only: 36%; 
Number of child-only cases by reason: 
Nonparent caregiver: 11,550; 
Parent receives SSI: 4,978; 
Parent ineligible because of immigration status: 9,447; 
Parent sanction or disqualification: 169; 
Other reason: data not provided. 

State: West Virginia; 
Total cash assistance caseload: 11,716; 
Child-only cases: 4,907; 
Percentage of caseload that is child-only: 42%; 
Number of child-only cases by reason: 
Nonparent caregiver: 4,907; 
Parent receives SSI: data not provided; 
Parent ineligible because of immigration status: 0; 
Parent sanction or disqualification: 226; 
Other reason: data not provided. 

State: Wisconsin; 
Total cash assistance caseload: 25,717; 
Child-only cases: 11,404; 
Percentage of caseload that is child-only: 44%; 
Number of child-only cases by reason: 
Nonparent caregiver: 5,174; 
Parent receives SSI: 6,417; 
Parent ineligible because of immigration status: 0; 
Parent sanction or disqualification: 0; 
Other reason: 0. 

State: Wyoming; 
Total cash assistance caseload: 477; 
Child-only cases: 298; 
Percentage of caseload that is child-only: 62%; 
Number of child-only cases by reason: 
Nonparent caregiver: 235; 
Parent receives SSI: 56; 
Parent ineligible because of immigration status: 4; 
Parent sanction or disqualification: 0; 
Other reason: 0. 

State: U.S. total; 
Total cash assistance caseload: 1,946,718; 
Child-only cases: 769,199; 
Percentage of caseload that is child-only: 40%; 
Number of child-only cases by reason: 
Nonparent caregiver: 233,190; 
Parent receives SSI: 153,626; 
Parent ineligible because of immigration status: 205,353; 
Parent sanction or disqualification: 56,490; 
Other reason: 14,066. 

Source: GAO TANF survey. 

Note: States were asked to report on their caseloads as of December 
31, 2010. Some of the totals may not add up because cases may be 
counted in multiple categories. 

[End of table] 

[End of section] 

Appendix III States' Monthly TANF: 

Child-Only and Foster Care Payment Rates: 

State: Alabama; 
TANF child-only payment: 
1 child: $165; 
2 children: $190; 
3 children: $215; 
Minimum foster care payment for TANF child-only payment: 
1 child: $432. 

State: Alaska; 
TANF child-only payment: 
1 child: $452; 
2 children: $554; 
3 children: $656; 
Minimum foster care payment for TANF child-only payment: 
1 child: $738. 

State: Arizona; 
TANF child-only payment: 
1 child: $164; 
2 children: $220; 
3 children: $278; 
Minimum foster care payment for TANF child-only payment: 
1 child: $608. 

State: Arkansas; 
TANF child-only payment: 
1 child: $81; 
2 children: $162; 
3 children: $204; 
Minimum foster care payment for TANF child-only payment: 
1 child: $432. 

State: California; 
TANF child-only payment: 
1 child: $345; 
2 children: $561; 
3 children: $694; 
Minimum foster care payment for TANF child-only payment: 
1 child: $446. 

State: Colorado; 
TANF child-only payment: 
1 child: $128; 
2 children: $269; 
3 children: $404; 
Minimum foster care payment for TANF child-only payment: 
1 child: $374. 

State: Connecticut; 
TANF child-only payment: 
1 child: $354; 
2 children: $470; 
3 children: $576; 
Minimum foster care payment for TANF child-only payment: 
1 child: $764. 

State: Delaware; 
TANF child-only payment: 
1 child: $270; 
2 children: $336; 
3 children: $428; 
Minimum foster care payment for TANF child-only payment: 
1 child: $391. 

State: District of Columbia; 
TANF child-only payment: 
1 child: $201; 
2 children: $270; 
3 children: $338; 
Minimum foster care payment for TANF child-only payment: 
1 child: $919. 

State: Florida; 
TANF child-only payment: 
1 child: $180; 
2 children: $241; 
3 children: $303; 
Minimum foster care payment for TANF child-only payment: 
1 child: $417. 

State: Georgia; 
TANF child-only payment: 
1 child: $155; 
2 children: $235; 
3 children: $280; 
Minimum foster care payment for TANF child-only payment: 
1 child: $452. 

State: Hawaii; 
TANF child-only payment: 
1 child: $450; 
2 children: $607; 
3 children: $763; 
Minimum foster care payment for TANF child-only payment: 
1 child: $529. 

State: Idaho; 
TANF child-only payment: 
1 child: $309; 
2 children: $309; 
3 children: $309; 
Minimum foster care payment for TANF child-only payment: 
1 child: $274. 

State: Illinois; 
TANF child-only payment: 
1 child: $117; 
2 children: $230; 
3 children: $284; 
Minimum foster care payment for TANF child-only payment: 
1 child: $286. 

State: Indiana; 
TANF child-only payment: 
1 child: $139; 
2 children: $198; 
3 children: $256; 
Minimum foster care payment for TANF child-only payment: 
1 child: $760. 

State: Iowa; 
TANF child-only payment: 
1 child: $183; 
2 children: $361; 
3 children: $426; 
Minimum foster care payment for TANF child-only payment: 
1 child: $456. 

State: Kansas; 
TANF child-only payment: 
1 child: $186; 
2 children: $284; 
3 children: $375; 
Minimum foster care payment for TANF child-only payment: 
1 child: $570. 

State: Kentucky; 
TANF child-only payment: 
1 child: $186; 
2 children: $225; 
3 children: $262; 
Minimum foster care payment for TANF child-only payment: 
1 child: $690. 

State: Louisiana; 
TANF child-only payment: 
1 child: $122; 
2 children: $188; 
3 children: $240; 
Minimum foster care payment for TANF child-only payment: 
1 child: $426. 

State: Maine; 
TANF child-only payment: 
1 child: $138; 
2 children: $263; 
3 children: $386; 
Minimum foster care payment for TANF child-only payment: 
1 child: $487. 

State: Maryland; 
TANF child-only payment: 
1 child: $433; 
2 children: $583; 
3 children: $733; 
Minimum foster care payment for TANF child-only payment: 
1 child: $835. 

State: Massachusetts; 
TANF child-only payment: 
1 child: $428; 
2 children: $531; 
3 children: $633; 
Minimum foster care payment for TANF child-only payment: 
1 child: $578. 

State: Michigan; 
TANF child-only payment: 
1 child: $158; 
2 children: $274; 
3 children: $420; 
Minimum foster care payment for TANF child-only payment: 
1 child: $426. 

State: Minnesota; 
TANF child-only payment: 
1 child: $250; 
2 children: $437; 
3 children: $532; 
Minimum foster care payment for TANF child-only payment: 
1 child: $620. 

State: Mississippi; 
TANF child-only payment: 
1 child: $110; 
2 children: $146; 
3 children: $170; 
Minimum foster care payment for TANF child-only payment: 
1 child: $665. 

State: Missouri; 
TANF child-only payment: 
1 child: $136; 
2 children: $234; 
3 children: $292; 
Minimum foster care payment for TANF child-only payment: 
1 child: $282. 

State: Montana; 
TANF child-only payment: 
1 child: $298; 
2 children: $401; 
3 children: $504; 
Minimum foster care payment for TANF child-only payment: 
1 child: $487. 

State: Nebraska; 
TANF child-only payment: 
1 child: $222; 
2 children: $293; 
3 children: $364; 
Minimum foster care payment for TANF child-only payment: 
1 child: $246. 

State: Nevada[A]; 
TANF child-only payment: 
1 child: [Empty]; 
2 children: [Empty]; 
3 children: [Empty]; 
Minimum foster care payment for TANF child-only payment: 
1 child: $683. 

State: New Hampshire; 
TANF child-only payment: 
1 child: $539; 
2 children: $606; 
3 children: $675; 
Minimum foster care payment for TANF child-only payment: 
1 child: $474. 

State: New Jersey; 
TANF child-only payment: 
1 child: $162; 
2 children: $322; 
3 children: $424; 
Minimum foster care payment for TANF child-only payment: 
1 child: $713. 

State: New Mexico; 
TANF child-only payment: 
1 child: $266; 
2 children: $357; 
3 children: $447; 
Minimum foster care payment for TANF child-only payment: 
1 child: $408. 

State: New York; 
TANF child-only payment: 
1 child: $577; 
2 children: $719; 
3 children: $900; 
Minimum foster care payment for TANF child-only payment: 
1 child: $474. 

State: North Carolina; 
TANF child-only payment: 
1 child: $181; 
2 children: $236; 
3 children: $272; 
Minimum foster care payment for TANF child-only payment: 
1 child: $475. 

State: North Dakota; 
TANF child-only payment: 
1 child: $163; 
2 children: $238; 
3 children: $310; 
Minimum foster care payment for TANF child-only payment: 
1 child: $656. 

State: Ohio; 
TANF child-only payment: 
1 child: $259; 
2 children: $355; 
3 children: $434; 
Minimum foster care payment for TANF child-only payment: 
1 child: $300. 

State: Oklahoma; 
TANF child-only payment: 
1 child: $87; 
2 children: $171; 
3 children: $241; 
Minimum foster care payment for TANF child-only payment: 
1 child: $365. 

State: Oregon; 
TANF child-only payment: 
1 child: $228; 
2 children: $348; 
3 children: $477; 
Minimum foster care payment for TANF child-only payment: 
1 child: $639. 

State: Pennsylvania; 
TANF child-only payment: 
1 child: $205; 
2 children: $316; 
3 children: $403; 
Minimum foster care payment for TANF child-only payment: 
1 child: $456. 

State: Rhode Island; 
TANF child-only payment: 
1 child: $327; 
2 children: $449; 
3 children: $554; 
Minimum foster care payment for TANF child-only payment: 
1 child: $409. 

State: South Carolina; 
TANF child-only payment: 
1 child: $128; 
2 children: $172; 
3 children: $216; 
Minimum foster care payment for TANF child-only payment: 
1 child: $332. 

State: South Dakota; 
TANF child-only payment: 
1 child: $575; 
2 children: $628; 
3 children: $681; 
Minimum foster care payment for TANF child-only payment: 
1 child: $478. 

State: Tennessee; 
TANF child-only payment: 
1 child: $140; 
2 children: $192; 
3 children: $232; 
Minimum foster care payment for TANF child-only payment: 
1 child: $697. 

State: Texas; 
TANF child-only payment: 
1 child: $89; 
2 children: $128; 
3 children: $179; 
Minimum foster care payment for TANF child-only payment: 
1 child: $674. 

State: Utah; 
TANF child-only payment: 
1 child: $288; 
2 children: $399; 
3 children: $498; 
Minimum foster care payment for TANF child-only payment: 
1 child: $426. 

State: Vermont; 
TANF child-only payment: 
1 child: $503; 
2 children: $605; 
3 children: $710; 
Minimum foster care payment for TANF child-only payment: 
1 child: $495. 

State: Virginia; 
TANF child-only payment: 
1 child: $242; 
2 children: $323; 
3 children: $389; 
Minimum foster care payment for TANF child-only payment: 
1 child: $448. 

State: Washington; 
TANF child-only payment: 
1 child: $305; 
2 children: $385; 
3 children: $478; 
Minimum foster care payment for TANF child-only payment: 
1 child: $423. 

State: West Virginia; 
TANF child-only payment: 
1 child: $262; 
2 children: $301; 
3 children: $340; 
Minimum foster care payment for TANF child-only payment: 
1 child: $600. 

State: Wisconsin[B]; 
TANF child-only payment: 
1 child: [Empty]; 
2 children: [Empty]; 
3 children: [Empty]; 
Minimum foster care payment for TANF child-only payment: 
1 child: $220. 

State: Wyoming; 
TANF child-only payment: 
1 child: $321; 
2 children: $528; 
3 children: $561; 
Minimum foster care payment for TANF child-only payment: 
1 child: $650. 

State: U.S. average; 
TANF child-only payment: 
1 child: $249; 
2 children: $344; 
3 children: $423; 
Minimum foster care payment for TANF child-only payment: 
1 child: $511. 

Source: GAO TANF survey. 

[A] In Nevada, officials reported that the maximum TANF child-only 
payment per child under 12 is $534 per month; per child 13 and older 
is $616 per month. 

[B] Wisconsin officials reported that it has two types of TANF child- 
only caretaker payments. If a parent is on Supplemental Security 
Income (SSI), the rate is $250 for the 1st child and $150 for each 
additional child. Nonparent caregivers can receive $220 per child. 

[End of table] 

[End of section] 

Appendix IV: Subsidized Guardianship and the TANF Child-Only Caseload: 

As part of this study, we were asked to examine how states have 
implemented the option, known as the Guardianship Assistance Program 
(GAP), and how it has affected TANF child-only caseloads. To address 
this question, we collected information from HHS, our survey of state 
child welfare administrators, and interviews with researchers who have 
expertise in child welfare. We also reviewed the evaluations of the 
guardianship waiver demonstration projects that 11 states submitted to 
HHS.[Footnote 48] 

Status of Subsidized Guardianship: 

The Fostering Connections to Success and Increasing Adoptions Act of 
2008 gave states the option to use federal Title IV-E funding--that 
was previously reserved for foster care and adoption services--to 
support relatives who become guardians under certain 
circumstances.[Footnote 49] To receive funding, the child must be 
Title IV-E eligible, the caregiver must be a licensed or approved 
foster parent, and the child must live with the caregiver for at least 
6 months. In addition, reunification with the child's birth parents 
and adoption by the relatives must be ruled out as permanency options. 
States that adopt the federal GAP option can be federally reimbursed 
for a portion of the cost of providing kinship guardianship assistance 
payments on behalf of eligible children.[Footnote 50] Many states 
developed subsidized guardianship programs prior to the availability 
of federal funding, according to previous studies. States that had 
subsidized guardianship programs funded with state funds could benefit 
from the new federal option, provided the children meet federal 
eligibility requirements. States that did not previously have 
subsidized guardianship programs have to consider whether state 
funding is available to cover the costs that will not be federally 
reimbursed. 

To adopt the option, states must submit an amendment of their IV-E 
plan to ACF for review and approval. As of August 2011, 29 states have 
submitted Title IV-E plan amendments to adopt the option to operate a 
guardianship assistance program. ACF has approved 22 amendments, and 
amendments from the remaining 7 states are under ACF review or are 
being revised (see figure 10). As of the second quarter of fiscal year 
2011, 10 states submitted claims for federal reimbursement for IV-E 
guardianship assistance payments on behalf of 1,004 children. In 
addition, Illinois, which implemented one of the IV-E waiver projects, 
submitted claims on behalf of 2,893 children who were eligible based 
on their participation in the waiver demonstration. 

In addition to the federal GAP option, 30 states reported in our 
survey that they had another subsidized guardianship program in place 
(see italicized states in figure). Some of these other state 
subsidized guardianship programs have broader eligibility rules 
compared with the federal program. Specifically, 7 states reported 
that children who were not in state custody could benefit from their 
state subsidized guardianship program, and 14 allowed unlicensed 
relative caregivers to participate. 

Figure 10: State Implementation of the Federal Guardianship Assistance 
Program (GAP) option and Other State Subsidized Guardianship Programs: 

[Refer to PDF for image: illustrated U.S. map] 

Approved to implement GAP: 
Alabama: 
Alaska: 
Colorado: 
District of Columbia: 
Hawaii: 
Idaho: 
Illinois: 
Maine: 
Maryland: 
Michigan: 
Missouri: 
Montana: 
Nebraska: 
New Jersey: 
New York: 
Oregon: 
Pennsylvania: 
Rhode Island: 
South Dakota: 
Tennessee: 
Texas: 
Washington: 

Planning to implement GAP (proposals to ACF under review): 
California: 
Connecticut: 
Louisiana: 
Massachusetts: 
Oklahoma: 
Vermont: 
Wisconsin: 

No submitted plan to implement GAP: 
Arizona: 
Arkansas: 
Delaware: 
Florida: 
Georgia: 
Indiana: 
Iowa: 
Kansas: 
Kentucky: 
Minnesota: 
Mississippi: 
Nevada: 
New Hampshire: 
New Mexico: 
North Carolina[A]: 
North Dakota: 
Ohio: 
South Carolina: 
Utah: 
Virginia: 
West Virginia: 
Wyoming: 

Sources: GAO analysis of ACF data and GAO survey results. 

[A] Officials from North Carolina responded that they did not know 
whether the state had a subsidized guardianship program in place other 
than the federal GAP option. 

[End of figure] 

Subsidized Guardianship and TANF Child-Only Cases: 

Based on our review, we were unable to determine whether or not there 
is connection between the availability of guardianship and TANF child- 
only cases. States are just beginning to implement the GAP option, and 
it is too early to determine whether the availability of subsidized 
guardianship will have an effect on the TANF child-only caseload at 
this point in time. The state evaluations of the 11 IV-E subsidized 
guardianship waiver projects did not include any information that 
indicates that subsidized guardianship programs have affected TANF 
child-only caseloads. The state evaluations indicated that the IV-E 
subsidized guardianship waiver projects offered a guardianship option 
to children in state or tribal custody, and 6 of the 11 states 
required the caregivers be licensed foster parents. Most state child 
welfare agencies responding to a question in our survey about the 
relationship between subsidized guardianship and the TANF child-only 
caseload reported that they did not believe the number of TANF child-
only cases with nonparent caregivers would be affected by the 
availability of subsidized guardianship in their state. Researchers we 
interviewed were not aware of a connection between subsidized 
guardianship and TANF child-only caseloads. Subsidized guardianship 
may not be a viable option for most children in TANF child-only cases 
because most of the children are not in state custody, and the 
relative caregivers are not licensed, according to some of the 
researchers we interviewed. 

[End of section] 

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

Department Of Health & Human Services: 
Office Of The Secretary: 
Assistant Secretary for Legislation: 
Washington, DC 20201: 

Septemb12 19, 2011: 

Kay Brown, Director: 
Education, Workforce and Income Security Issues: 
U.S. Government Accountability Office: 
441 G Street NW: 
Washington, DC 20548: 

Dear Ms. King: 

Attached are comments on the U.S. Government Accountability Office's 
(GAO) draft report entitled, "TANF and Child Welfare Programs: 
Increased Data Sharing Could Improve Access to Benefits and Services" 
(GA0-12-2). 

The Department appreciates the opportunity to review this report prior 
to publication. 

Sincerely, 

Signed by: 

Jim R. Esquea: 
Assistant Secretary for Legislation: 

Attachment: 

[End of letter] 

General Comments Of The Department Of Health And Human Services (HHS) 
On The Government Accountability Office's (GAO) Draft Report Entitled, 
"TANF And Child Welfare Programs: Increased Data Sharing Could Improve 
Access To Benefits And Services" (GAO-12-2) 

The Department appreciates the opportunity to review and comment on 
this draft report. 

GAO Recommendation: 

To help states share data between Temporary Assistance for Needy 
Families (TANF) and child welfare information systems operating within 
states, we recommend that the Secretary of Health and Human Services 
direct the Administration for Children and Families (ACF) to clarify 
its guidance and provide additional technical assistance to states on 
data sharing opportunities. For example, the HHS-funded National 
Resource Center for Child Welfare Data and Technology could collect 
information from states that are successfully sharing data, including 
how they addressed concerns about client confidentiality, and 
disseminate that information to all states. 

ACE Comments: 

In light of the indications that some jurisdictions may wish 
additional clarification on this topic, HHS will provide guidance to 
States and Tribes concerning the ability to share information between 
TANF and child welfare agencies. In addition, ACF would like to share 
the activities we have under way that address some of the issues 
identified in the report. 

The National Resource Center for Child Welfare Data and Technology 
(NRC-CWDT) gathers and disseminates information from States on the 
subject of data exchange as part of its ongoing technical assistance 
activities. NRC-CWDT disseminates information via webinars and on 
NRC's website there is a page specifically devoted to data sharing. 
NRC has issued "Tips, Tools, and Trends" papers (located on the 
website) that highlight promising practices in States. In Fiscal Year 
2011, NRC-CWDT held meetings/webinars specifically on the 
issue/misconceptions of confidentiality as it relates to data sharing. 
(See website [hyperlink, https://www.nrccwdt.org/index.html] for more 
information.) NRC-CWDT will continue to make data exchange a priority 
topic. 

As the report addresses, ACF has also provided discretionary grants to 
a limited number of States and Tribes to support collaboration between 
TANF and child welfare programs. We will share best practices and 
lessons learned from the grants when they are completed and assess 
needed next steps, including the possible need for additional guidance 
on data sharing. 

As part of its report, GAO may also want to reference that ACF has 
provided 13 kinship navigator grants as part of the Family Connections 
grant projects authorized by the Fostering Connection to Success and 
Increasing Adoptions Act of 2008. Under the law, at least $5 million 
of the $15 million is dedicated to kinship navigation programs to help 
localities to assist kinship caregivers in learning about, finding, 
and using programs and services to meet the needs of the children they 
are raising and their own needs, and to promote effective partnerships 
among public and private agencies to ensure kinship caregiver families 
are served. Many of the people served under these grants are relatives 
receiving TANF child only benefits. Information on these 13 funded 
projects are available on the National Resource Center for Permanency 
and Family Connections website at [hyperlink, 
http://www.nrcpfc.org/grantees.html]. Dissemination of the findings of 
this program will be made available in an ACF cross-site evaluation 
report to be released in 2013 after the termination of these three-
year grant projects. 

Regarding data sharing, States (and for 1V-E, Tribes) are permitted to 
determine their own confidentiality rules and there are no specific 
Federal barriers to Title IV-E and IV-A programs exchanging 
information. Further points for clarity on Federal confidentiality 
rules: 

* On page 30 of the report, GAO references an HHS Action Transmittal 
from 1995 (ACF-OISM-001). The Action Transmittal, which provided 
guidance to States on implementing State Automated Child Welfare 
Information Systems, stated that confidentiality requirements are not 
an obstacle to the development of effective electronic interfaces to 
the systems used to administer the Title IV-A, IV-D and XIX programs, 
and that confidentiality requirements are not an appropriate rationale 
for a State's inability to pursue effective interfaces. This Action 
Transmittal pre-dates the passage of the Personal Responsibility and 
Work Opportunity Reconciliation Act in 1996 which revised the statutory
language related to confidentiality for the Title IV-A program. The 
new language simply requires that a State shall "Wake such reasonable 
steps as the State deems necessary to restrict the use and disclosure 
of information about individuals and families receiving assistance 
under the [TANF] program attributable to funds provided by the Federal 
Government." As such, the regulations that were applicable to the 1V-A 
program are no longer applicable, and the States are now permitted to 
determine their own confidentiality rules, which may or may not 
include sharing TANF information with child welfare. 

The Title IV-E program confidentiality requirements have been in law 
and regulation since the 1980s and, as required under the Title IV-E 
program, States must have safeguards that restrict the use of or 
disclosure of information in place in order to receive IV-E funding. 
Federal law expressly provides that the safeguards must restrict the 
use of or disclosure of information concerning individuals assisted 
under the State plan to certain purposes; among those purposes is the 
administration of the state plan under part A of Title IV, i.e., the 
TANF program. For TANF, Federal law only requires that a State's plan 
provide that the State will "Make such reasonable steps as the State 
deems necessary to restrict the use and disclosure of information 
about individuals and families receiving assistance under the program 
attributable to funds provided by the Federal Government." 

[End of section] 

Appendix VI: GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Kay E. Brown, (202) 512-7215, brownke@gao.gov: 

Staff Acknowledgments: 

In addition to the individual named above, others making key 
contributions to this report include: Elizabeth Morrison, Cathy Roark, 
John Townes, Marissa Dondoe, Allyson Goldstein, Kate van Gelder, James 
Bennett, Hiwotte Amare, Carl Barden, Luann Moy, Lorraine Ettaro, 
Beverly Ross, Alex Galuten, Leia Dickerson, Amy Frazier, Kristy 
Kennedy, Claudine Pauselli, and Almeta Spencer. 

[End of section] 

Footnotes: 

[1] Pub. L. No. 104-193, 110 Stat. 2105. TANF replaced the Aid to 
Families with Dependent Children (AFDC) program. Id. § 103(a)(1), 110 
Stat. 2105, 2112. 

[2] Id. 

[3] 42 U.S.C. § 609(a)(7). To meet the MOE requirement, each state 
must generally spend 75 or 80 percent of what it spent in fiscal year 
1994 on welfare-related programs, including: AFDC, Job Opportunities 
and Basic Skills Training, Emergency Assistance, and AFDC-related 
child care programs. 

[4] States may use TANF funds to support a variety of child welfare 
services, such as screening for child abuse and neglect, case 
management activities, and cash assistance and services for relative 
caregivers. 

[5] This database provides information from1996-2009 about states' 
TANF cash assistance programs, including the policies and rules 
governing their programs. We did not conduct any legal analysis of 
state laws, requirements, rules, or policies. 

[6] The SSI program allows a person to get both SSI and TANF payments, 
but TANF is considered income for SSI purposes. 

[7] Under PRWORA, legal immigrants who entered the country after 
August 1996 must be in the United States for five years to be eligible 
for TANF. 8 U.S.C. § 1612(b). 

[8] Of the 49 states responding to this question in our TANF survey, 
45 states reported that the income of nonparent caregivers is not 
considered when determining eligibility for child-only benefits. The 
income of nonparent caregivers is considered in Arizona, Nevada, and 
Oregon, and 1 state did not know. 

[9] 42 U.S.C. § 608(a)(7). 

[10] 42 U.S.C. § 607. 

[11] A state may only use federal funds to extend assistance beyond 
the 60-month time limit for up to 20 percent of its caseload. 

[12] 42 U.S.C. § 670 et seq. and 42 U.S.C. § 620 et seq., 
respectively. Under Title IV-E of the Social Security Act, funds are 
available to states for the maintenance (food, shelter, incidentals, 
etc.) of all foster children meeting certain income and other 
criteria. Title IV-E also provides payments to relatives who become 
legal guardians of foster children and payments to adoptive parents of 
eligible foster children with special needs, such as health problems, 
that may make adoptive homes more difficult to find. Title IV-E foster 
care, guardianship, and adoption assistance payments are authorized as 
open-ended entitlements, meaning states may claim federal 
reimbursement for a specified amount of the costs for every eligible 
child. Title IV-B provides limited or "capped" funding for child 
welfare services to foster children, as well as children remaining in 
their homes. States are required to coordinate services provided under 
IV-B with aid provided under IV-E and TANF. 

[13] Children in foster care may also by placed in other settings, 
such as group homes or residential facilities, but the least 
restrictive setting is preferred under federal law. Title IV-E directs 
states to consider giving priority to relatives when deciding with 
whom to place children while they are in foster care. In addition, in 
order to receive funding under Title IV-E, states must agree to 
identify and provide notice to adult relatives of the child's removal 
from parent custody. States are also required to notify relatives 
about their options to participate in the care of the child, become a 
foster parent, and receive services. 

[14] U.S. Department of Health and Human Services, Administration for 
Children and Families, Kinship Caregivers and the Child Welfare System 
(Washington, D.C.: March 2005). 

[15] States can be reimbursed for a portion of the costs of providing 
foster care payments to support children meeting specific eligibility 
criteria. To be IV-E-eligible, many criteria must be met including the 
following: (1) the child must meet eligibility criteria for the AFDC 
program (including income and resources requirements) that were in 
effect in 1996, (2) the caregiver must be licensed or approved by the 
state, (3) the child must be in the placement and care responsibility 
of the agency, (4) the state must generally make reasonable efforts to 
keep the child at home, and (5) the state must generally make 
reasonable efforts to reunify the child with his or her parents. In 
2009, about 40 percent of foster children received federally supported 
foster care payments. The federal reimbursement for foster care 
payments is equal to each states' Federal Medical Assistance 
Percentage match rate (match rate used for Medicaid), of the state's 
foster care maintenance payments expended. 42 U.S.C. § 674(a)(1); 42 
U.S.C. § 1396d(b). 

[16] Adoption and guardianship are considered permanent placements for 
children in temporary foster care. Both options involve the nonparent 
caregiver assuming legal custody of the child. 

[17] The 95 percent confidence interval for the estimate of 772,000 
cases is 731,702 to 812,751; for 815,000 cases, 779,313 to 850,642; 
for 1.5 million cases, 1,419,993 to 1,500,752; and for 800,000 cases, 
762,391 to 833,719. 

[18] HHS has indicated that under the TANF statute, once a TANF case 
that includes an adult in the assistance unit has received 60 months 
of federally funded assistance, the state may not use federal TANF 
funds to continue providing assistance to members of the assistance 
unit (subject to allowable exceptions for up to 20 percent of a 
state's caseload). However, the federal time limit does not apply to 
state-funded assistance. Our survey results indicate that, in 35 
states, benefits for all family members are terminated when cases with 
adults in the assistance unit reach a time limit. However, states may 
choose to use their MOE funds to continue benefits when a family 
reaches its time limit. Officials from 2 states (California and 
Louisiana) reported that only the adult benefits are terminated, and 
the children can continue receiving benefits as a child-only case. 
Four states (Maine, Maryland, Michigan, New York) said no benefits 
would be terminated, and 9 states had other responses. For example, 
some states said the adults may be given an extension if they met the 
state's hardship criteria. 

[19] See GAO, Temporary Assistance for Needy Families: Fewer Eligible 
Families Have Received Cash Assistance Since the 1990s, and the 
Recession's Impact on Caseloads Varies by State, [hyperlink, 
http://www.gao.gov/products/GAO-10-164] (Washington, D.C.: Feb. 23, 
2010). 

[20] Based on state responses to our TANF survey, child-only cases are 
subject to time limits in Arizona, Connecticut, North Dakota, and 
Tennessee. 

[21] The 95 percent confidence interval for the estimate of 83,000 
cases is 61,064 to 105,358 and for 155,000 cases, 127,595 to 183,880. 

[22] The 95 percent confidence interval for the estimate of 46,000 
cases is 26,176 to 65,157 and for 93,000 cases, 65,601 to 119,870. 

[23] The 95 percent confidence interval for the estimate of 13 percent 
is 13.208 percent to 13.242 percent. The source for this estimate is 
the 2008 American Community Survey. 

[24] Michelle Sheran and Christopher A. Swann, "The Take Up of Cash 
Assistance Among Private Kinship Families," Children and Youth 
Services Review: 29 (May 3, 2007) 973-987. This study is based on the 
National Survey of America's Families conducted in 1997, 1999 and 2002 
by the Urban Institute. It measured the use of all types of cash 
assistance, not specifically TANF. This study uses the term private 
kinship care to describe an informal living arrangement, one in which 
the child has no involvement with the child welfare agency. The 95 
percent confidence interval for the estimate of 55 percent is 40 to 70. 

[25] The 95 percent confidence interval for the estimate of 63 percent 
is 49 to 78 and for 43 percent, 28 to 57. 

[26] Federal law allows any minor child--which it defines as any 
individual who is not yet 18, or is not yet 19 and is attending an 
elementary, middle, or high school--to be eligible for TANF benefits 
if they meet eligibility criteria. 

[27] The 95 percent confidence interval for the estimate of 16 percent 
is 16.35 percent to 16.43 percent. 

[28] Caregivers may be granted two types of custody over a child: 
legal custody and physical custody. Legal custody is the authority to 
make significant decisions on the child's behalf, while physical 
custody is the right to have the child live with the person awarded 
custody. Thus, a child could be under state legal custody, while being 
in a caregiver's physical custody. 

[29] Tiffany Allen, Kerry DeVooght, and Rob Geen, State Kinship Care 
Policies for Children that Come to the Attention of Child Welfare 
Agencies: Findings from the 2007 Casey Kinship Foster Care Policy 
Survey. (December 2008). This study was conducted by Child Trends and 
funded by Casey Family Programs and the Annie E. Casey Foundation. 

[30] Data reported in HHS' Adoption and Foster Care Analysis and 
Reporting System indicate there were 423,773 children in foster care 
on September 30, 2009. Twenty-four percent (101,688 children) were 
living with relatives (this includes licensed and unlicensed relative 
caregivers). The number of foster children living with relatives 
represents about 4 percent of the 2.46 million children the U.S. 
Census estimates were living with relatives in 2009. 

[31] Eleven states reported that having an unlicensed relative 
caregiver would not be a reason to deny a foster care payment for a 
child in state custody, and 8 states did not respond to this question 
on our child welfare survey. 

[32] Texas adopted the federal Guardianship Assistance Program option, 
which provides federal support for states that provide assistance to 
relatives taking legal guardianship of eligible children who have been 
in foster care. See appendix IV for the status of state implementation 
of the Guardianship Assistance Program option. 

[33] Michelle Sheran and Christopher A. Swann, "The take up of cash 
assistance among private kinship families." The researchers counted 
families as receiving cash assistance if they said they received AFDC, 
public assistance or welfare payments, or a regular payment to help 
care for the child. This study found that 21.2 percent of relative 
caregivers in informal arrangements received cash assistance for which 
they were eligible. The 95 percent confidence interval for this 
estimate is 15.8 to 26.6. 

[34] TANF requires that individuals with children for whom paternity 
has not been established or for whom a child support order needs to be 
established, cooperate with child-support enforcement agencies. 
According to a HHS handbook on child support enforcement, people who 
have received assistance under the TANF, Medicaid, and federally 
assisted foster care programs are automatically referred by state 
agencies for child support enforcement services. 

[35] According to child welfare staff in the three states we visited, 
foster children are eligible for the same services from the child 
welfare agency regardless of whether they live with a licensed foster 
parent or an unlicensed relative. 

[36] Tiffany Allen, Kerry DeVooght, and Rob Geen, "State Kinship Care 
Policies for Children that Come to the Attention of Child Welfare 
Agencies: Findings from the 2007 Casey Kinship Foster Care Policy 
Survey." 

[37] The majority of states reported in our survey that there are 
kinship care programs separate from the traditional TANF and child 
welfare programs operating within their state. Examples of the kinship 
care programs states reported include subsidized guardianship 
programs, programs that offer short-term financial assistance, respite 
care, and support groups, and kinship navigator programs to help 
relative caregivers access available benefits. ACF has also provided 
13 kinship navigator grants to help localities assist kinship 
caregivers find programs and services to meet their needs and the 
needs of the children in their care. According to HHS officials, many 
of the people served under these grants are relative caregivers 
receiving TANF child-only benefits. 

[38] Pub. L. No. 109-171, § 7403(a), 120 Stat. 4, 151 (2006). 

[39] Since fiscal year 1994, designated federal matching funds have 
been available to states to develop and implement SACWIS. States have 
the option to implement a SACWIS or develop different information 
systems without using SACWIS funds to support their child welfare 
agencies and collect information on their child welfare cases. 

[40] Twenty-three of the 34 states formally reviewed have met the 
interface requirement. Ten states do not have a SACWIS system, and 7 
states have systems in development. 

[41] The National Association of State TANF Administrators, "Temporary 
Assistance for Needy Families: Recommendations for Reauthorization" 
(Washington, D.C.: 2010). 

[42] Under federal regulations, in order for a state to receive 
federal reimbursement for developing and installing a SACWIS, that 
system must to the extent practicable be capable of interfacing with 
and retrieving information from, as appropriate, other automated 
information systems used to administer certain federally funded 
programs administered under Titles IV-A (TANF), IV-D (Child Support 
Enforcement), XIX (Medicaid) and the National Child Abuse and Neglect 
Data System. 45 C.F.R. § 1355.53(b)(2). 

[43] According to HHS officials, the National Resource Center for 
Child Welfare Data and Technology provides information about data 
sharing on its Web site [hyperlink, 
https://www.nrccwdt.org/index.html] and held webinars in fiscal year 
2011 on confidentiality issues as it relates to data sharing. 

[44] We searched for studies published since 2000 in several databases 
and collected studies from HHS and researchers we interviewed. We 
reviewed selected studies' research methodology and assessed the 
extent to which the studies' data and methods supported its findings 
and conclusions. 

[45] GAO did not conduct any legal analysis of state laws, 
requirements, rules, or policies. Information about state policies 
were collected through our surveys, site visits, and a 2007 survey of 
state child welfare agencies conducted by Child Trends. 

[46] We interviewed selected researchers and other officials from the 
American Public Human Services Association, Annie E. Casey Foundation, 
Center for Budget and Policy Priorities, Center on Law and Social 
Policy, Chapin Hall, Child Trends, Congressional Research Service, 
Fostering Connections Resource Center, Generations United, University 
of North Carolina School of Social Work, and the Urban Institute. 

[47] Pub. L. No. 98-502, 98 Stat. 2327. 

[48] From 1997-2010, 11 states received IV-E waivers from HHS, 
allowing them to use federal IV-E funding for subsidized 
guardianships. These states were Delaware, Iowa, Illinois, Maryland, 
Minnesota, Montana, New Mexico, North Carolina, Oregon, Wisconsin, and 
Tennessee. 

[49] Pub. L. No. 110-351, § 101(a), 122 Stat. 3949, 3950. 

[50] The reimbursement rate for the guardianship payments is the rate 
states are reimbursed for Medicaid. States opting to provide such 
payments may also claim federal reimbursement for a portion of the 
administrative and training costs associated with operating the 
program. 

[End of section] 

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