On September 30, 2002, the most recent date for which Department of Health and Human Services (HHS) data were available, about 126,000 foster children were waiting to be adopted. Estimates suggest that a significant portion of these children had one or more special needs, such as a medical condition or membership in a minority group, that may discourage or delay their adoption. Federal support in the form of adoption subsidies and incentive payments to states is available to promote special needs adoption. This report (1) identifies the major challenges to placing and keeping special needs children in adoptive homes, (2) examines what states and HHS have done to facilitate special needs adoptions, and (3) assesses how well the Adoption Assistance Program and the Adoption Incentives Program have worked to facilitate special needs adoptions, and determines if changes might be needed.
Recommendations for Executive Action
|Department of Health and Human Services||1. To better understand delays associated with interstate placements, the Secretary of HHS should assist states in collecting and reporting data related to the interstate placement processes, especially the time needed to complete home studies and the sending and receiving state for each child placed across state lines. Such assistance could include modifying HHS's central data system, the Adoption and Foster Care Analysis and Reporting System, in conjunction with the agency's ongoing efforts to update and revise this system. HHS should analyze the data to assess the extent to which home studies cause delays or impede interstate adoptions and to identify which states are facilitating timely interstate placements. If supported by its findings, HHS should consider proposing legislation to amend existing law so that both sending and receiving states could claim an interstate adoption for purposes of determining award eligibility.|
|Department of Health and Human Services||2. To improve HHS's ability to assess the effectiveness of its funded projects, the Secretary of HHS should develop guidance to ensure that rigorous design elements are incorporated into projects and related evaluations. Such guidance could consider the nature and structure of the projects and include measures to control costs.|
|Department of Health and Human Services||3. To assess the extent to which the Social Security Act's Title IV-E adoption assistance eligibility criteria exclude some economically disadvantaged children with special needs, the Secretary of HHS should (1) gather data on the economic circumstances of special needs children who do not currently qualify for IV-E and (2) develop a model to estimate the federal cost of expanding eligibility.|