Child Welfare:

Enhanced Federal Oversight of Title IV-B Could Provide States Additional Information to Improve Services

GAO-03-956: Published: Sep 10, 2003. Publicly Released: Sep 12, 2003.

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In 2001, states determined that over 900,000 children were the victims of abuse or neglect. In fiscal year 2003, subparts 1 and 2 of Title IV-B of the Social Security Act provided $697 million in federal funding for services to help families address problems that lead to child abuse and neglect. This report describes (1) the services provided and populations served under subparts 1 and 2; (2) federal oversight of subpart 1; and (3) existing research on the effectiveness of services unique to subpart 1--that is, when states used subpart 1, but not subpart 2, to fund programs in a particular service category. The report focuses primarily on subpart 1 because little research exists on this subpart, while studies have been conducted on subpart 2.

On a national level, GAO's survey showed that the primary emphases of subparts 1 and 2 vary somewhat, but the range of services offered and the types of families served overlap significantly. No single category of service was funded solely by either subpart. In fiscal year 2002, states used subpart 1 funds most frequently for the salaries of child welfare agency staff, administrative and managerial expenses, child protective services, and foster care maintenance payments. Subpart 2 primarily funded family support, family preservation, family reunification, and adoption support services. Programs funded by the two subparts served similar types of populations--predominantly children at risk of being abused or neglected and their parents, as well as children in foster care and their parents. HHS's oversight focuses primarily on states' overall child welfare systems and outcomes, but the agency provides relatively little oversight specific to subpart 1. For example, HHS works with states to establish goals to improve the safety and well-being of children and measure progress toward those goals. However, HHS has limited knowledge about how states spend subpart 1 funds. States submit an annual estimate about how they plan to use their subpart 1 funds in the upcoming year, but provide no data on actual expenditures. HHS reports that it reviews these estimates for relatively limited purposes. We also found that HHS regional offices pay little attention to statutory limits on the use of subpart 1 funds for foster care maintenance and adoption assistance payments. For example, 9 of the 10 HHS regional offices do not monitor states' compliance with these limits. As a result, HHS approved projected 2002 spending plans for 15 states that reported estimated spending amounts that exceeded the limits by over $30 million in total. While GAO's survey data revealed no unique service categories funded by subpart 1 on a national level, 37 states reported unique subpart 1 service categories within their state. Little research is available on the effectiveness of the services in these categories, such as hotlines to report child abuse and emergency shelter services. No states conducted rigorous evaluations of these services, although several states provided some information on outcomes.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: ACF agreed with GAO's recommendation that HHS provide the necessary guidance to ensure that HHS regional offices monitor and enforce statutory restrictions on the use of Title IV-B, subpart 1 funds. On November 20, 2003, HHS issued a program instruction to remind states that expenditure of these funds is limited for foster care maintenance payments, adoption assistance, and day care related to employment or training or employment. HHS referred to this program instruction in its annual instruction to the regional offices about monitoring states' annual request for Title IV-B funds (published on February 2, 2004) and reminded the regional offices that subpart 1 spending for these three purposes could be no greater than a states' total 1979 Title IV-B funding.

    Recommendation: The Secretary of HHS should provide the necessary guidance to ensure that HHS regional offices monitor states' use of Title IV-B subpart 1 funds for compliance with statutory restrictions on the use of these funds.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Not Implemented

    Comments: HHS disagreed with GAO's recommendation to consider the feasibility of collecting basic data on states' use of Title IV-B subpart 1 funds. HHS believes that its level of oversight is commensurate with the scope and intent of the program and minimizes states' reporting requirements. Analyzing the correlation between states' subpart 1 spending and their outcomes on HHS Child and Family Services Reviews is not useful, given the lack of a direct relationship between the relatively small Title IV-B funding levels and the broad outcomes of safety, permanency, and well-being. The agency has not taken any action on this recommendation.

    Recommendation: In addition, the Secretary should consider the feasibility of collecting basic data on state' use of these funds to facilitate its oversight of the program and to provide guidance to help states determine appropriate services to fund. For example, an analysis of how states' spending patterns correlate to outcomes--both positive and negative--from the CFSRs could yield useful information for this purpose.

    Agency Affected: Department of Health and Human Services

  3. Status: Closed - Not Implemented

    Comments: The agency disagrees with the need for enhanced oversight of Title IV-B and will not have any additional information available to inform the development of the new child welfare option. The agency has not taken any action on this recommendation.

    Recommendation: Given that HHS is currently developing the new child welfare option that would allow states to use Title IV-E dollars for services similar to those provided under Title IV-B subpart 1, the Secretary should use the information gained through enhanced oversight of subpart 1--as well as information it may have on states' use of subpart 2 funds--to inform its design of this option. For example, HHS could use this information to help states determine the most appropriate services to provide under this option.

    Agency Affected: Department of Health and Human Services


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