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Highlights

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.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services 1. 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.
Closed - Implemented
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.
Department of Health and Human Services 2. 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.
Closed - Not Implemented
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.
Department of Health and Human Services 3. 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.
Closed - Not Implemented
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.

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