Foster Youth: HHS Actions Could Improve Coordination of Services
and Monitoring of States' Independent Living Programs (18-NOV-04,
GAO-05-25).
To improve outcomes for youth leaving foster care, Congress
passed the Foster Care Independence Act of 1999 (FCIA), which
increased the allocation of federal funds for independent living
programs from $70 million to $140 million. This report reviews
(1) how states' funding allocations changed to serve youth after
FCIA, (2) the extent to which states have expanded services and
age groups of foster youth served since the passage of FCIA and
what challenges remain, (3) the extent to which states have used
other federal and state programs to coordinate the delivery of
services to foster youth, and (4) how the states and the
Department of Health and Human Services (HHS) have fulfilled the
program accountability provisions of the law and assessed the
effectiveness of independent living services.
-------------------------Indexing Terms-------------------------
REPORTNUM: GAO-05-25
ACCNO: A13594
TITLE: Foster Youth: HHS Actions Could Improve Coordination of
Services and Monitoring of States' Independent Living Programs
DATE: 11/18/2004
SUBJECT: Federal aid to states
Federal funds
Foster children
Program evaluation
Refunds to government
Reporting requirements
State-administered programs
Surveys
Intergovernmental relations
Funding increases
Program coordination
HHS John H. Chafee Foster Care
Independence Program
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GAO-05-25
United States Government Accountability Office
GAO
Report to Congressional Requesters
November 2004
FOSTER YOUTH
HHS Actions Could Improve Coordination of Services and Monitoring of States'
Independent Living Programs
GAO-05-25
Highlights of GAO-05-25, a report to congressional requesters
To improve outcomes for youth leaving foster care, Congress passed the
Foster Care Independence Act of 1999 (FCIA), which increased the
allocation of federal funds for independent living programs from $70
million to $140 million. This report reviews (1) how states' funding
allocations changed to serve youth after FCIA, (2) the extent to which
states have expanded services and age groups of foster youth served since
the passage of FCIA and what challenges remain, (3) the extent to which
states have used other federal and state programs to coordinate the
delivery of services to foster youth, and (4) how the states and the
Department of Health and Human Services (HHS) have fulfilled the program
accountability provisions of the law and assessed the effectiveness of
independent living services.
We are making recommendations to the Secretary of HHS to improve the
availability of information on the array of federal programs that could be
used to assist youth transitioning out of foster care at the state and
local levels and to improve existing processes for monitoring states'
progress in meeting the needs of current and former foster care youth. HHS
disagreed with our latter recommendation, which included standardizing the
reporting format for plans and reports, stating that it would impose an
unnecessary burden on states.
www.gao.gov/cgi-bin/getrpt?GAO-05-25.
To view the full product, including the scope and methodology, click on
the link above. For more information, contact David D. Bellis, (415)
904-2272, [email protected].
November 2004
FOSTER YOUTH
HHS Actions Could Improve Coordination of Services and Monitoring of States'
Independent Living Programs
The doubling of federal funding for independent living programs has
resulted in most states receiving an increase in funds. Although some
states had difficulty expanding their program infrastructure in the first
2 years of increased funding, the amount of funds states returned to HHS
declined the second year. Differences in funding also appeared in the
amounts available per eligible foster care youth.
Following the passage of FCIA, 40 states reported in our survey expanding
independent living services to younger youth, and 36 states expanded
services to older youth, but gaps remain in providing some key services to
youth. State differences in serving youth may have been caused by gaps in
the availability of critical services, such as mental health services,
mentoring, and housing, as well as challenges engaging youth and foster
parents to participate in the program.
Almost all states that we surveyed reported increased levels of
coordination under FCIA, but linkages with other federal and state
youth-serving programs were not always in place to increase services
available across local areas. Despite some coordination efforts, states
may not make full use of available resources. One of the barriers in
linking program services reported by the 4 states we visited included the
inconsistent availability of information on the array of programs that
were operating in each state and local area.
States and HHS have taken action to fulfill the accountability provisions
of FCIA, but little information is available to assess the effectiveness
of independent living services. All states submitted required plans and
reports, but the absence of a uniform reporting format and lack of
standard monitoring practices among HHS regional offices hindered
assessments of state performance. HHS is developing an information system
that may improve program accountability and reported that it expects to
issue a proposed regulation in 2005.
Number of States Providing Key Independent Living Services to Youth
Younger than 16 and Emancipated Youth after FCIA
Contents
Letter 1
Results in Brief 4
Background 6
FCIA Increased Independent Living Allocations for Most States,
but Some States Had Difficulty Absorbing Large Increases in
Funds 11
States Expanded and Improved Services for Youth after FCIA, but
Gaps in Critical Services Remain 17
States Reported Increased Coordination with Federal and State
Programs to Provide Independent Living Services to Youth, but
Barriers Hinder Linkages across Programs 25
States' and HHS's Actions in Response to FCIA Requirements Have
Not Yet Established Accountability for Independent Living
Programs 31
Conclusions 39
Recommendations 39
Agency Comments 40
Appendix I Scope and Methodology
Appendix II Selected Federal Youth Programs and Services That Target
Current and Former Foster Youth
Appendix III Comments from the Department of Health and Human Services
Appendix IV GAO Contacts and Acknowledgments 53
GAO Contacts 53
Staff Acknowledgments 53
Bibliography 54
Related GAO Products 55
Tables
Table 1: Key Purposes of the John H. Chafee Foster Care Independence
Program by Target Populations Table 2: Changes in Funding Allocations
across States since the Passage of FCIA Table 3: Key Independent Living
Services and the Most Prevalent Service Providers Table 4: Proposed NYTD
Data Elements as of April 2003 and the Number of States Currently
Collecting These Data Table 5: Programs Included in the Multisite
Evaluation of Foster Youth Programs
8 12 27 35 38
Figures
Figure 1: Funding per Eligible Youth in Foster Care for Independent Living
Services across States in 2004 16
Figure 2: Increase in the Number of States Offering Selected Independent
Living Services to Youth Younger than 16 and Emancipated Youth 18
Figure 3: States Offering Medicaid to Emancipated Foster Care Youth as of
May 2004 20 Figure 4: Proportion of Youth in Foster Care Receiving
Independent Living Services from States in 2003 22
Abbreviations
ACF Administration for Children and Families
AFCARS Adoption and Foster Care Analysis and Reporting System
CFSP Child and Family Services Plan
CFSR Child and Family Services Review
DCI data collection instrument
ETV Education and Training Voucher
FCIA Foster Care Independence Act of 1999
GED general equivalency diploma
HHS Department of Health and Human Services
HUD Department of Housing and Urban Development
ILP Independent Living Program
NYTD National Youth in Transition Database
NRCYD National Resource Center for Youth Development
PIP program improvement plan
This is a work of the U.S. government and is not subject to copyright
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separately.
United States Government Accountability Office Washington, DC 20548
November 18, 2004
The Honorable Tom DeLay
Majority Leader
House of Representatives
The Honorable Charles E. Grassley
Chairman
Committee on Finance
United States Senate
The Honorable Wally Herger
Chairman
The Honorable Benjamin L. Cardin
Ranking Minority Member
Subcommittee on Human Resources
Committee on Ways and Means
House of Representatives
Almost 40 percent of the more than 530,000 youth in foster care are
adolescents age 13 or older, and approximately 19,000 youth leave the
foster care system each year without being adopted or having a permanent
living arrangement. Research studies have shown that many of these
young people face serious problems once on their own, including
homelessness, a lack of education and stable employment, and difficulties
obtaining medical and mental health services. In response to concerns that
youth leave foster care poorly prepared to live self-sufficiently, in 1986
Congress created the Independent Living Program, which provided states
with funding to prepare foster care adolescents for adulthood. To
strengthen this program, Congress later passed the Foster Care
Independence Act of 1999 (FCIA) and created the John H. Chafee Foster
Care Independence Program (Chafee Program), which doubled overall
federal funding for independent living programs from $70 million to
$140 million. The Administration for Children and Families (ACF) within
the Department of Health and Human Services (HHS) has responsibility
for overseeing and evaluating the Chafee Program, which comprises about
2 percent of the approximately $6 billion obligated to foster care and
adoption programs under Title IV-E of the Social Security Act.1
In addition to providing increased funding, FCIA resulted in other
significant changes for the independent living program. The law expanded
state flexibility to offer independent living services to youth younger
than 16 and to assist youth 18 to 21 years old who are no longer in the
foster care system with room and board, Medicaid health insurance, and
other support services. Further, FCIA called for states to make every
effort to coordinate their independent living programs with other federal
and state programs that provide services to youth, such as housing and
school-towork programs. All states were required to submit a multiyear
plan describing how they planned to use the Chafee Program funds, and HHS
required states to submit annual reports on the progress made to implement
their programs. In addition, states were required to submit certifications
that they would comply with various aspects of the law. Finally, FCIA
directed HHS to develop outcome measures to be used to assess state
performance in operating independent living programs and to conduct
evaluations of state programs deemed to be innovative or of potential
national significance.
We previously reported on HHS's and states' efforts to implement
independent living programs prior to changes under FCIA.2 Because of your
interest in how HHS and states have implemented FCIA and progress made to
assist foster youth achieve self-sufficiency, you asked us to determine
(1) how states' funding allocation changed to serve youth after FCIA, (2)
the extent to which states have expanded independent living services and
age groups of foster youth served since the passage of FCIA and what
challenges remain, (3) the extent to which states have used other federal
and state programs to coordinate the delivery of independent living
services to foster youth, and (4) how the states and HHS have fulfilled
the program accountability provisions of the law and assessed the
effectiveness of independent living services.
1The Chafee Program receives funding under Title IV-E of the Social
Security Act. Title IV-E authorizes the appropriation of federal funds to
states for the purpose of developing and operating foster care and
transitional independent living programs and providing payments to
adoptive parents of eligible foster children with special needs. In 2003,
adoption programs received approximately $1.6 billion, and foster care
programs received approximately $4.9 billion.
2See GAO, Foster Care: Effectiveness of Independent Living Services
Unknown, HEHS-00-13 (Washington, D.C.: Nov. 5, 1999).
To conduct our work, we surveyed the independent living coordinators in
all 50 states, the District of Columbia, and Puerto Rico regarding their
experiences in developing and implementing their Chafee Programs in
federal fiscal year 2003. We received responses from 50 states and the
District of Columbia.3 We compared results with those of a similar survey
we administered to state independent living coordinators that gathered
information on state independent living programs operating in federal
fiscal year 1998. We checked for obvious errors and conducted some
follow-up with states, but we did not independently verify states'
responses. We analyzed federal funding amounts to the 50 states, the
District of Columbia, and Puerto Rico for independent living programs
before and after the passage of FCIA, using federal financial and foster
care population data, as well as data reported by states in our 2004
survey. We analyzed Chafee Program plans from 49 states, the District of
Columbia, and Puerto Rico for federal fiscal years 2001-2004 to determine
states' program strategies for meeting the goals of FCIA. We also analyzed
a total of 90 annual progress and services reports (annual reports) that
states submitted regarding the progress made in implementing their Chafee
Program plans for federal fiscal years 2001 and 2002.4 In addition, we
visited 4 states-Connecticut, Florida, Texas, and Washington-and 2 local
areas within each state to obtain information on their experiences
developing and implementing their independent living programs. We spoke
with state and local officials, caseworkers, several groups of youth,
foster parents, and contract provider staff. We selected states that
represented a variety of approaches to implementing independent living
services and geographic diversity. Finally, we interviewed HHS officials,
federal contractors, and child welfare experts, and reviewed relevant
documents and literature. We conducted our work between August 2003 and
August 2004 in accordance with generally accepted government auditing
standards. A more detailed discussion of our scope and methodology appears
in appendix I.
3Throughout this report, references to state survey responses include the
District of Columbia.
4We obtained the plans and annual reports from the ACF regional offices
after consulting with ACF's central office and the National Resource
Center for Youth Development-a technical assistance center under contract
with ACF. One regional office could not provide us with the state plan for
Wyoming and the annual reports for Colorado, Montana, North Dakota, South
Dakota, Utah, and Wyoming in the time requested. Therefore, these states
are not included in our analysis. In addition, we received only one report
for Tennessee (federal fiscal year 2001) and Puerto Rico (federal fiscal
year 2002). Throughout this report, references to states plans and annual
reports include the District of Columbia and Puerto Rico, where
appropriate.
Results in Brief
The doubling of the federal funding for independent living programs with
the passage of FCIA resulted in most states receiving an increase in
funds, including 31 states receiving more than double the amount of funds
in 2001-the first year of full funding. Some states had difficulty
spending all of their federal allocations in the first year, but the
amount of funds returned declined the second year. In 2001, 20 states
returned nearly $10 million in federal funding to HHS, and in 2002, 13
states returned more than $4 million. The differences in funding among
states appeared not only in overall amounts allocated to states, but also
in the amounts available per eligible foster care youth. Because of
differences in states' eligibility requirements and the funding formula
used to allocate funds, available data indicate that states received from
approximately $500 to $2,300 for each youth in foster care that is
eligible for independent living services.
Following the passage of FCIA, 40 states reported in our survey expanding
existing services to younger youth, and 36 states reported serving youth
older than they had previously served, but gaps remain in providing some
key services. Many states also began to offer the new services under FCIA
that would allow them to meet the unique needs of youth that have been
emancipated from foster care. For example, 31 states now provide Medicaid
health insurance coverage to at least some former foster care youth.
However, states varied in the percentage of eligible youth served. For
example, 40 states providing these data in our survey reported serving
between 10 and 100 percent of foster care youth eligible for independent
living services in 2003, and officials in the states we visited reported
that most services continued to be directed at youth age 16 and older.
States we visited reported difficulties serving youth, such as gaps in the
availability of critical services and challenges engaging youth and foster
parents to participate in the program, which may have contributed to the
difference among states in the proportion of youth served.
Almost all states that we surveyed reported increased levels of
coordination with other federal, state, and local programs under FCIA, but
linkages with other federal and state youth-serving programs were not
always in place to increase services available across local areas. Many
programs exist at the federal, state, or local level that can be used to
provide or supplement independent living services, and each state reported
in our survey using some of these programs to provide services such as
education, employment, health, and housing. In Connecticut, for example,
the child welfare agency collaborated with business entrepreneurs, other
state agencies, and nonprofit organizations to provide youth with
opportunities to develop employment skills and apply independent living
skills training through participation in community-
based youth employment projects. Despite these coordination efforts, some
states may not make full use of the available resources. Officials from
less than half of states responding to our survey, for example, reported
using housing services provided by the U.S. Department of Housing and
Urban Development (HUD) and state housing authorities. One of the barriers
in linking program services included the inconsistent availability of
information on the array of programs that were operating in each state and
local area, according to state and local officials from the 4 states we
visited
States and HHS have taken action to fulfill the accountability provisions
of FCIA, but little information is available to assess the effectiveness
of independent living services. All states have developed multiyear plans
for their programs in compliance with FCIA and submitted annual reports to
ACF, but using these plans and the reports to assess state performance is
hindered by inconsistencies between the plans and reports, an absence of
goals and baseline information to use in measuring progress, and
incomplete information on outcomes for all youth who received services.
Hawaii's plan, for example, lists employment services the state planned to
provide youth. However, the subsequent annual reports do not mention
offering or providing employment-related services, making it unclear
whether the differences were due to service changes for youth or missing
information. ACF officials recognize the limitations of states' plans and
reports as federal monitoring tools but stated that they rely on states to
self-certify program compliance. ACF is developing an information system
that will allow it to capture data on the characteristics, services, and
outcomes of youth in independent living programs, which may allow it to
more effectively monitor and measure states' program performance. ACF
reported that it expects to issue guidance about this system in the form
of a proposed regulation in 2005. ACF also has begun to evaluate selected
independent living programs, and officials reported that the results of
this evaluation should be available in 2007.
We are making recommendations to the Secretary of HHS to improve the
availability of information on the array of federal programs that could be
used to assist youth transitioning out of foster care at the state and
local levels and to improve existing processes for monitoring states'
progress in meeting the needs of current and former foster care youth. HHS
disagreed with our latter recommendation that included standardizing the
reporting format for state plans and annual reports, stating that taking
such action would be overly prescriptive and impose an unnecessary burden
on states.
Background In 1986, Congress amended Title IV-E of the Social Security
Act to authorize federal funds targeted to assist youth aged 16 and over
in making the transition from foster care to living independent of the
child welfare system and created the Independent Living Program (ILP).5
This program was designed to prepare adolescents in foster care to live
self-sufficiently once they exited the child welfare system. As with many
adolescents, foster care youth face a time of uncertainty and change as
they approach age 18. However, research suggests that they may be at
greater risk of experiencing negative consequences in adulthood, such as
unemployment, incarceration, or poor health outcomes. For example,
research indicates that 30 to 40 percent of youth in foster care are
affected by chronic medical problems, but barriers exist to meeting those
needs, such as prolonged delays in getting referrals to specialists. In
addition, research shows that children and youth in foster care have
poorer academic experiences than do their peers not in care. For example,
twice as many youth in foster care than those not in foster care had
repeated a grade, changed schools during the year, or enrolled in a
special education program.
Foster Care Independence Several amendments were made to the Independent Living
Program over Act and the Chafee the years, but the passage of FCIA and the
creation of the Chafee Program Program represented the most significant changes
in the federal independent living
program since its creation. FCIA doubled the federal funds available for
independent living programs to $140 million each year.6 These funds are
5In 1999, we issued a report that reviewed the Title IV-E Independent
Living Program before FCIA amended the program. In that report, we found
that states were using federal, state, local, and private dollars to
assist youth in attaining their educational goals, finding and maintaining
employment, developing daily living skills, and transitioning to
independence with supervised living arrangements and after-care services.
However, the state and local administrators struggled with providing youth
with all the assistance needed to learn to live on their own. In addition,
we found that while HHS was tasked with overseeing the implementation of
ILP, it had done little to determine program effectiveness and had not
established a method to review the states' progress in helping youth in
the transition from foster care. See GAO-HEHS-00-13.
6The actual amount divided among the states, the District of Columbia, and
Puerto Rico totaled $137.9 million. Under the law, 1.5 percent of the $140
million is reserved for evaluation, technical assistance, performance
measurement, and data collection activities conducted by HHS. States must
provide matching contributions of 20 percent to receive Chafee Program
funds. The matching contribution may be in cash or in-kind contributions
of services, equipment, or property.
allocated to states based on their share of the nation's foster care
population.7
In addition to providing increased funding, FCIA eliminated the minimum
age limit of 16 years and provided states with the flexibility to define
the age at which children in foster care are eligible for services to help
them prepare for independent living, as long as services are provided to
youth who are likely to remain in foster care until 18 years of age. The
law provided states the flexibility to develop programs that met the needs
of the adolescents in their care, as long as states designed and conducted
their programs based on the five key purposes outlined in the law (see
table 1).
7A hold-harmless clause in FCIA ensures that states with smaller
populations received either $500,000 or the amount of independent living
funds they received in federal fiscal year 1998, whichever amount is
greater.
Table 1: Key Purposes of the John H. Chafee Foster Care Independence
Program by Target Populations
Support for youth likely to remain in foster care until age 18
Identify children who are likely to remain in foster care until 18 years
of age and help these children make the transition to self-sufficiency by
providing services such as assistance in obtaining a high school diploma,
career exploration, vocational training, job placement and retention,
training in daily living skills, training in budgeting and financial
management skills, substance abuse prevention, and preventive health
activities.
Help children who are likely to remain in foster care until 18 years of
age receive the education, training, and services necessary to obtain
employment.
Help children who are likely to remain in foster care until 18 years of
age prepare for and enter postsecondary training and education
institutions.
Support for youth transitioning out of foster care
Provide personal and emotional support to children aging out of foster
care, through mentors and the promotion of interactions with dedicated
adults.
Support for youth formerly in foster care
Provide financial, housing, counseling, employment, education, and other
appropriate support and services to former foster care recipients between
18 and 21 years of age to complement their own efforts to achieve
self-sufficiency and to ensure that program participants recognize and
accept their personal responsibility for preparing for and then making the
transition from adolescence to adulthood.
Source: Foster Care Independence Act of 1999 (Public Law 106-169).
The law also provided several new services to help youth make the
transition to adulthood. First, it allowed states to use up to 30 percent
of their state allotment for room and board for former foster care youth
up to age 21. Second, it allowed states the option to expand Medicaid
coverage to former foster care adolescents between 18 and 21. Title IV-E
was amended again in 2002 to provide foster youth vouchers for
postsecondary education and training under the Education and Training
Vouchers (ETV) program and authorized an additional $60 million for states
to provide postsecondary education and training vouchers up to $5,000 per
year per youth. Eligible participants include youth otherwise eligible for
services under the states' Chafee Programs, youth adopted from foster care
after attaining the age of 16, and youth participating in the voucher
program on their 21st birthday (until they turn 23 years old) as long as
they are enrolled in a postsecondary education or training program and are
making satisfactory progress toward completion of that program. In federal
fiscal year 2003, approximately $41 million in federal funds was available
for
states' ETV programs.8 The amount increased slightly in federal fiscal
year 2004 to approximately $44 million.9
In addition, the law required that states make every effort to coordinate
their Chafee Programs with other federal and state programs for youth,
such as the Runaway and Homeless Youth Program, abstinence education
programs, local housing programs, programs for disabled youth, and
school-to-work programs offered by high schools or local workforce
agencies. Further, states were required to coordinate their programs with
each Indian tribe in the state and offer the state's independent living
services to Indian children.
State Responsibilities under FCIA
To receive funds under the Chafee Program, states were required to develop
multiyear plans describing how they would design and deliver programs in
accordance with FCIA and to submit program certifications. The multiyear
Chafee plans must include a description of the state's program design,
including its goals, strategies, and its implementation plan for achieving
the five key purposes detailed in the law.10 States were also required to
certify that they would operate a statewide independent living program
that complied with the specific aspects of the law, such as providing
training to help foster parents, adoptive parents, workers in group homes,
and case managers understand and address the issues confronting
adolescents preparing for independent living. Further, to receive annual
funds, ACF required states to submit annual reports that described the
services provided and activities conducted under their Chafee Programs,
including information on any program modifications
8The actual appropriation for the ETV program was $42 million. However,
available funds in federal fiscal year 2003 totaled $41,101,095, which
accounts for a 0.65 percent funding rescission and a 1.5 percent set-aside
for federal evaluation, technical assistance, performance measurement, and
data collection. States must provide matching contributions of 20 percent
to receive ETV funds. The matching contribution may be in cash or in-kind
contributions of services, equipment, or property.
9The actual appropriation for the ETV program was $45 million. However,
available funds in federal fiscal year 2004 totaled $44,062,503, which
accounts for a 0.59 percent funding rescission and a 1.5 percent set-aside
for federal evaluation, technical assistance, performance measurement, and
data collection.
10Following passage of the act, ACF decided to integrate independent
living services into the Child and Family Services Plan (CFSP)-a 5-year
plan states are required to submit that addresses how states will develop
and implement services for multiple child welfare programs and requires
states to submit annual progress and services reports to report updates
and changes in goals and services under the plan.
and their current status of implementation; provide a record of how funds
were expended; and include a description of the extent to which the funds
assisted youth age 18 to 21 in making the transition to self-sufficiency.
Federal Oversight
FCIA required that HHS develop and implement a plan to collect information
needed to effectively monitor and measure a state's performance, including
the characteristics of youth served by independent living programs, the
services delivered, and the outcomes achieved. Further, FCIA required HHS
to conduct evaluations of independent living programs deemed to be
innovative or of potential national significance using rigorous scientific
standards to the maximum extent practicable, such as random assignment to
treatment and control groups.
Currently, ACF's 10 regional offices conduct much of the federal oversight
for the Chafee Program. They hold the responsibility for reviewing and
approving the state plans, certifications, and annual reports. In
addition, the regional offices provide assistance and guidance to the
states on implementing and operating their programs. Technical assistance
is also available to states from 10 national resource centers. In
particular, the National Resource Center for Youth Development (NRCYD)
provides states and tribes assistance with helping youth in care establish
permanent connections and achieve successful transitions to adulthood.
Upon request from the states and approval from the regional offices, the
NRCYD has facilitated stakeholder meetings to bring together officials
from various state and federal programs within a state to facilitate
communication, awareness, and information sharing, and provide strategies
to promote long-term collaborative efforts around independent living.11
In 2001, ACF implemented an outcome-oriented process, known as the Child
and Family Services Review (CFSR), in part, to determine states'
substantial conformity with Title IV-E provisions and hold states
accountable for improving child welfare outcomes.12 The CFSR measures
state performance on 45 performance items, which correspond to
11Resource centers may provide unlimited assistance to states by phone or
e-mail, but onsite training and technical assistance are restricted to 10
days each year. States must first obtain regional office approval before
on-site training and technical assistance can occur.
12The CFSR also reviews states' conformity with Title IV-B of the Social
Security Act. Under IV-B, states receive federal funds for services to
help families address problems that lead to child abuse and neglect and to
prevent the unnecessary separation of children from their families.
FCIA Increased Independent Living Allocations for Most States, but Some
States Had Difficulty Absorbing Large Increases in Funds
7 outcomes and 7 systemic factors.13 States that were reviewed during the
first year of the CFSR were rated on the provision of independent living
services to youth in their care 16 years or older. This item was removed
from the CFSR in subsequent reviews when ACF redesigned the review
instrument to focus more on setting and achieving appropriate permanency
goals for children and less on service delivery. With the redesigned
instrument, reviewers were instructed to consider the provision of
independent living services in other measures, such as when determining if
the youths' needs were assessed and if appropriate services were provided.
While overall federal funding for state independent living programs
doubled with the passage of FCIA, there were significant variations in the
changes to state allocations, and some states had difficulty expanding
their programs quickly enough to spend all of the new funds. Prior to the
passage of FCIA, states were awarded independent living funds based on the
number of children receiving federal foster care payments in 1984.14 The
new law updated the formula, which generally allocates funds to each state
based on the state's proportion of the nation's population of children in
foster care-regardless if the child is receiving federal or state funded
foster care payments.15 In addition, the new formula includes a
holdharmless provision to ensure that each state will receive at least the
13The outcomes relate to children's safety, permanency, and well-being,
and the systemic factors address state agency management and
responsiveness to the community. In addition, states must meet 6 national
standards, as reported in the Adoption and Foster Care Analysis and
Reporting System and the National Child Abuse and Neglect Data System. The
CFSR process combines statewide assessments, which the states complete
using a profile of their recent child welfare data; on-site reviews of
child welfare case files; and interviews with stakeholders. Further,
states are required to develop and implement program improvement plans
(PIP) to improve their child welfare practice and capacity when they are
found to be deficient. We recently issued a report on the CFSR process.
See GAO, Child and Family Services Reviews: Better Use of Data and
Improved Guidance Could Enhance HHS's Oversight of State Performance.
GAO-04-333 (Washington, D.C.: April 20, 2004).
14Under the Independent Living Program, a portion of the federal funds
available at that time-$45 million-was distributed to states as an
entitlement based on each state's proportion of all children receiving
foster care maintenance payments in federal fiscal year 1984. States were
also eligible to receive a proportional share of the remaining $25 million
in federal funds to match the funds they provided.
15Under the new formula, the count of children in foster care is
recalculated each year based on the most recently available data, which
HHS established as 2 years prior to the funding year.
amount it received in federal fiscal year 1998 or $500,000, whichever is
greater. Once the states subject to the hold-harmless provision are
funded, the remaining funds within the cap of $140 million are allotted to
the other states. Under the previous independent living program, states
received funds ranging from $13,000 in Alaska to more than $12 million in
California. In the first year of funding under FCIA, Alaska and eight
other states received the minimum of $500,000, while California received
more than $27 million (see table 2). In most cases, states received an
increase of funds. However, the District of Columbia, Louisiana, and New
Jersey received no additional funds the first year because their
allocations under the new formula were initially lower than the amounts
they received in 1998. Therefore, because of the hold-harmless clause,
they received the same amount awarded in 1998.
Table 2: Changes in Funding Allocations across States since the Passage of FCIA
Percentage change
State 1998 allocation 2001 allocation over 1998 allocation
District of Columbia 1,091,992 1,091,992
Louisiana 1,358,131 1,358,131
New Jersey 2,297,848 2,297,848
New York 11,585,958 12,313,109
Pennsylvania 4,638,225 5,304,231
Alabama 1,038,490 1,288,304
Virginia 1,361,561 1,698,102
Maine 565,888 737,309
West Virginia 521,302 740,816
Mississippi 514,444 747,127
Wisconsin 1,554,305 2,252,837
Michigan 4,171,796 6,109,567
New Hampshire 320,326 500,000
Ohio 2,860,992 4,693,625
Kentucky 791,557 1,332,019 68
Vermont 295,633 500,000 69
Minnesota 1,142,066 2,102,991 84
Oregon 930,799 1,723,115 85
South Carolina 579,606 1,085,860 87
Rhode Island 314,840 612,710 95
Indiana 1,019,970 2,088,263 105
Montana 244,190 504,007 106
Percentage change
State 1998 allocation 2001 allocation over 1998 allocation
Connecticut 754,518 1,567,892 108
Colorado 825,854 1,785,766
California 12,481,777 27,570,079
Kansas 717,477 1,583,555
Missouri 1,295,026 2,940,120
New Mexico 207,149 500,000
Delaware 203,034 500,000
Washington 825,168 2,030,990
Texas 1,841,708 4,600,585
Arkansas 270,940 682,373
Iowa 449,966 1,134,717
Maryland 1,238,095 3,143,032
North Carolina 1,045,349 2,650,713
Georgia 1,098,852 2,803,131
South Dakota 193,430 500,000
North Dakota 192,058 500,000
Utah 202,348 531,358
Nebraska 435,562 1,293,213
Oklahoma 620,076 1,910,598 208 Tennessee 777,838 2,523,776 224 Illinois
2,817,094 9,413,899 234 Nevada 153,647 517,800 237 Massachusetts 635,852
2,610,972 311 Idaho 107,004 500,000 367 Arizona 347,763 1,677,998 383
Florida 987,045 8,016,425 712 Wyoming 44,585 500,000 1,021 Hawaii 17,834
514,994 2,788 Alaska 13,032 500,000 3,737
Source: GAO analysis of HHS data.
Notes: As required by FCIA, no state received less than its federal fiscal
year 1998 allotment under the Title IV-E Independent Living Program.
Federal fiscal year 2001 was the first year states received full funding
under FCIA.
Allocations do not account for unobligated or unliquidated funds.
Puerto Rico is not included in this analysis because the territory did not
receive independent living funds in 1998. The 2001 allocation to Puerto
Rico totaled $1,814,052.
Some states were unable to spend all of their federal allocations in the
first 2 years of increased funding under the program. In 2001, 20 states
returned nearly $10 million in federal funding to HHS, and in 2002, 13
states returned more than $4 million.16 ACF regional officials reported
that one reason for these unspent funds was that some states did not
initially have the infrastructure in place to quickly absorb the influx of
funds. Texas, for example, planned to use some of its $2.75 million in
additional funds to develop services for youth in rural areas, but state
officials said that the process of identifying and issuing contracts to
service providers was lengthy and initially hampered by the need to
identify service providers who were able to provide matching contributions
required to receive federal funds under FCIA. As a result, over $500,000
of the state's total $4.6 million allocation went unspent in federal
fiscal year 2001.
We could not determine the amount of FCIA funding states had available to
spend on each youth eligible for independent living services because of
the lack of data on eligible youth emancipated from foster care. However,
available data on youth in foster care suggest that states may have
different amounts of funds available for services to youth in foster care.
We compared each state's 2004 FCIA allocation with its 2002 population of
eligible youth in foster care.17 This comparison showed that funding for
independent living services ranged from $476 per foster youth in West
Virginia to almost $2,300 per youth in Montana, as shown in figure 1.18
These differences were due in part to the new provision in FCIA that
allowed states to define the age ranges within which youth were eligible
for independent living services. For example, 4 states reported in our
16Financial information for federal fiscal year 2003 will not be available
until July 2005.
17We calculated this figure using financial data from HHS on the FCIA
funding allocations in federal fiscal year 2004 and Adoption and Foster
Care Analysis and Reporting System (AFCARS) data from federal fiscal year
2002 because funding allocations are calculated using foster care
population data from AFCARS 2 years prior to the funding year. These
calculations also included states' 20 percent match requirement. However,
states may use other funds to pay for services and these calculations do
not reflect any additional funding. To determine the eligible population
for each state, we used the age ranges that states reported in our 2004
survey and AFCARS data on the numbers of youth in each age group. For
example, Alabama reported in our survey serving youth between 14 and 21
with independent living services. According to data the state reported to
AFCARS, 2,081 youth in this age range were in care in Alabama in federal
fiscal year 2002. However, this calculation excludes youth emancipated
from foster care since AFCARS does not capture this information.
18Nationwide, the average funding for independent living services
available per eligible youth in foster care was about $1,090 in federal
fiscal year 2004.
survey offering independent living services to youth at age 12, while 27
states reported offering services at age 14.19 In addition, the funding
formula is based on the total number of all children in foster care.
However, some states have a larger share of youth eligible for independent
living services than other states. For example, of the 15 states reporting
in our survey that youth are eligible for services between the ages of 14
and 21, 3 states had 25 percent or less of their foster care population
within this age range, while in 3 other states, this age range accounted
for over 40 percent of the total foster care population.20
19According to results from our 2004 survey, 4 states began services at
age 12, 7 states began services at age 13, 27 states began services at age
14, 9 states began services at age 15, and 4 states began services at age
16.
20These calculations are based on AFCARS data, which does not include
emancipated youth.
Figure 1: Funding per Eligible Youth in Foster Care for Independent Living
Services across States in 2004
Note: The number of eligible youth were determined by using state-reported
data on the ages of youth served and data from HHS's AFCARS on the number
of youth within the specified age ranges in foster care in each state. The
funding calculations also include state 20 percent match requirements.
States Expanded and Improved Services for Youth after FCIA, but Gaps in
Critical Services Remain
Following the passage of FCIA, many states reported expanding eligibility
for independent living services to younger and older youth and to provide
new services, such as Medicaid health insurance, to youth who had already
left the foster care system. Further, the states we visited reported using
the new funds to improve the quality of existing independent living
services, refocus the attention of their programs, or develop new services
to assist youth of all ages in independent living programs. However,
states varied in the proportion of eligible youth served. For example, 40
states providing these data in our survey reported serving between 10 and
100 percent of foster care youth eligible for independent living services
in 2003. A number of factors may have contributed to these differences,
including gaps in the availability of critical services, such as mental
health services, mentoring, and housing, as well as challenges in engaging
youth and foster parents to participate in the program.
FCIA Allowed States to Serve Younger and Emancipated Youth and to Improve
Services for All Youth in Independent Living Programs
After the passage of FCIA, 40 states reported in our survey expanding
services to youth younger than they had previously served, and 36 states
reported serving older youth, and the states we visited reported improving
service quality. While some states had been using nonfederal funds to
provide services to youth in these broader age groups, the number of
states that reported providing core independent living services, such as
independent living skills assessments, daily living skills training, and
counseling, to youth younger than 16 more than doubled after FCIA.
Similarly, more states reported offering these supports and services to
youth who were emancipated from foster care after the passage of FCIA (see
fig. 2).
Figure 2: Increase in the Number of States Offering Selected Independent
Living Services to Youth Younger than 16 and Emancipated Youth
Services to youth younger than 16
Services to emancipated youth
Number of statesNumber of states 50 50
48 48 47 43
40
30
20
10 0 40
30
20
10 0
yDail
Preparing f
Assistance obtaining high school diploma
yDail
Preparing f
Assistance obtaining high school diplomaor
or vocational training enrollmentAssessments Counseling
Independent or semi
independent living arrangementsiving skillsliving skillsl
or
or vocational training enrollmentAssessments Counseling
locating,,
maintaining employment
locating,,
maintaining employment
oo
eor colleg
eor colleg
1998
2003
Source: 1999 and 2004 GAO surveys to state independent living
coordinators.
Many states also began to offer the new services under FCIA that would
allow them to meet the unique needs of youth that emancipated from foster
care. These services include the Education and Training Vouchers, Medicaid
health insurance, and assistance with room and board.
Education and Training All states, the District of Columbia, and Puerto
Rico were allocated funds
Vouchers under the ETV program to assist youth seeking postsecondary
education. The 4 states we visited had started to implement their ETV
programs at the time of our site visits and had plans to use the funds in
different ways.
o Texas officials said that youth would be able to use ETV funds for
educational expenses, housing, food, clothing, or day care, so that the
funds would provide relief for youth who want to continue their education
but are concerned about paying bills while attending postsecondary school
full-time.
o Connecticut officials said they would use ETV funds to provide
computers to youth in postsecondary education and training programs and to
establish an additional liaison between the independent living program and
the Job Corps program.21
o Florida officials said they would use ETV funds for educational
expenses for youth receiving the state's independent living scholarship.
o Washington plans to use ETV funds to expand and enhance service
Medicaid Health Insurance
delivery for education and training, and service providers will be
evaluated on their success in helping youth reach desired educational
outcomes.
Of the 50 states responding to our 2004 survey, 31 reported offering
Medicaid benefits to at least some emancipated youth to help them maintain
access to health care benefits while they transitioned to independence
(see fig. 3). Some states may limit coverage to specific subpopulations of
emancipated youth. For example, according to officials in Florida, the
state limits Medicaid access to emancipated youth who meet minimum
academic requirements to qualify for the state's independent living
scholarship program.
21Job Corps is an education and vocational training program administered
by the U.S. Department of Labor serving youth ages 16 through 24 years.
Room and Board Services
Improving Existing Services
Figure 3: States Offering Medicaid to Emancipated Foster Care Youth as of
May 2004
In our 2004 survey, 46 states reported that they offered assistance with
room and board to youth that had been emancipated from foster care, and
the states we visited reported offering a range of housing supports to
assist youth. Connecticut provided several housing options to meet the
needs of youth at varying levels of independence, including group homes,
supervised apartment sites, and unsupervised apartment sites with periodic
visits from case managers. While other states we visited offered a more
limited supply of housing options, all provided some type of housing
subsidy or placement. For example, Texas and Washington provided youth
with a monthly stipend for rent as well as a onetime stipend for household
supplies.
Chafee Program funds were also used to improve the quality of existing
independent living services, refocus the attention of their programs, or
develop new services to assist youth of all ages in independent living
programs, according to state officials we visited.
o Local officials in Florida said that prior to FCIA, training in daily
living skills was provided haphazardly, and in many cases unqualified
staff taught classes even though such training was considered a core
component of their independent living program. After FCIA, Florida
officials said that the state redesigned staff training, improved
instructor quality, and was better prepared to provide youth with the
skills necessary to live independently outside of the foster care system.
o In Texas, a service provider reported that FCIA encouraged the state
to incorporate more experiential learning opportunities in the daily
living skills curriculum. For example, the curriculum in one locality
included taking the youth on a shopping trip to the grocery store while
working within a set budget. Similarly, in one local area in Florida,
youth in the independent living program described a scavenger hunt in
which they were required to take public transportation around the city and
conduct certain activities that emphasized their daily living skills
training, such as going to the bank and opening a checking account.
o Washington officials reported that FCIA was instrumental in shifting
the emphasis of the state's independent living program to focus on
educational achievement, and some regions in the state developed summer
enrichment programs to provide youth with year-round opportunities to keep
up with their peers academically or to further their educational
development.
o Officials in Connecticut reported using additional funds to develop
mentoring programs and to establish adolescent specialist positions in
each local child welfare office.
Serving Youth Remains Challenging because of Gaps in Services and
Difficulties Engaging Youth and Foster Parents
States differed in the proportion of eligible youth served under their
respective independent living programs, and officials in the 4 states we
visited reported gaps in providing critical services, as well as
challenges in engaging youth and parents in the services offered. Complete
data that show how many youth states are serving through the independent
living programs are not available, and while these programs serve both
youth in foster care and emancipated youth, data we were able to collect
from some states were limited to youth in care. Data from our 2004 state
survey showed that 40 states responding to our survey reported serving
about 56,000 youth-or approximately 44 percent of youth in foster care who
were eligible for independent living services in these states.22 However,
there were substantial differences among states in the proportion of youth
served, ranging from a low of 10 percent up to 100 percent of the state's
eligible foster care population. As shown in figure 4, about one-third of
reporting states were serving less than half of their eligible foster care
youth population, while an equal percentage of states were serving
threefourths or more. The extent to which these differences were related
to whether the states served higher or lower numbers of youth who
emancipated from foster care is unknown.
Figure 4: Proportion of Youth in Foster Care Receiving Independent Living
Services from States in 2003
Number of states
16
14
14
12
10
8
6
4
2
0 0-25 26-50 51-75 76-100
Percentage of eligible youth in foster care receiving services
Source: 2004 GAO survey to state independent living coordinators.
Note: Data are based on responses from 40 states and exclude services
provided to emancipated youth.
While states expanded eligibility to younger youth, most services
continued to be directed at youth age 16 and older in most of the states
we visited. For example, Texas officials told us that although the state
lowered the age that youth are eligible for independent living services to
14 years, serving youth age 16 years and older is the highest priority,
and
22We were unable to identify comparable data on the proportion of eligible
youth in foster care that received independent living services prior to
the passage of FCIA.
Mental Health Services
Mentoring Services
serving younger youth within the various regions is dependent on available
funding. In addition, while Washington expanded eligibility to serve youth
as young as 13 years, state officials reported that the state has yet to
develop a contract for providers to offer services to youth 13 to 15 years
old and few regions have developed services for youth in this age range.
As we found in 1999, state and local officials in the states we visited
reported gaps in the availability of critical services, which may have
contributed to the challenge of serving higher numbers of eligible
youth.23 States also reported that these challenges were more prominent in
rural areas. Service gaps included the following:
Youth in foster care often require mental health services continuing
beyond emancipation, but 3 states we visited cited challenges in providing
youth with a smooth transition between the youth and adult mental health
systems. Officials in Connecticut reported that it is critical for youth
to receive mental health services because mental well-being affects every
aspect of the youths' lives, including learning life skills, locating and
maintaining employment, succeeding in school, and the ability to
transition to a more independent setting. However, state officials
reported that youth who did not qualify for the adult mental health system
were left without critical services. In Florida, many individuals who had
been served by the youth mental health system did not qualify for adult
services because of more stringent eligibility requirements, possibly
losing access to important treatments and therapies. In Washington,
caseworkers reported that the adult mental health system did not provide
the same level of services as the youth system, and long waiting lists
sometimes prevented youth from accessing critical services.
Research studies indicate that the presence of positive adult role models
is critical for youth in foster care because family separations and
placement disruptions have been found to hinder the development of
enduring bonds, but officials in the states we visited cited challenges in
providing all youth with access to mentoring programs to establish and
maintain such relationships. Although the majority of states reported in
our 2004 survey that they offered mentoring programs to youth, officials
in Texas and Florida reported that formal mentoring programs were not
available
23In our 1999 report, state and local administrators reported that their
independent living programs fell short in key areas, including gaps in
employment, daily living skills, and housing services (see
GAO/HEHS-00-13).
Securing Safe and Suitable Housing
throughout the state.24 Connecticut officials said they used FCIA funding
to develop a statewide mentoring program, but the state is still working
to expand program availability to youth in all regions. In addition, one
program director reported challenges recruiting adults to serve as
mentors, especially men willing to make a 1-year commitment to an
adolescent boy. Some state and local officials and service providers
seemed unclear on what should be included in a quality mentoring program
and how to identify qualified service providers. For example, a nonprofit
service provider delivering independent living services in an urban county
in Washington reported being unfamiliar with how a mentoring program
should be run and said that guidance on how to identify and train mentors
would be helpful.
Youth we spoke with across the 4 states we visited said that locating safe
and stable housing after leaving foster care was one of their primary
concerns in their transition to independence, but state officials reported
challenges meeting youths' housing needs. Youth reported difficulties
renting housing because of a lack of an employment history, a credit
history, or a co-signer. State and local officials in the states we
visited said the availability of housing resources for foster youth during
their initial transition from foster care depended on where they lived,
and in some cases the benefits provided did not completely meet the needs
of youth, or were available only to certain youth. For example, in
Washington, local officials reported that housing subsidies may not
completely offset expenses for youth in expensive urban areas like Seattle
and that rental housing in some rural areas is scarce. In Florida, youth
must be full-time students to receive full housing benefits.25
In addition to reporting these service gaps, youth said during our site
visits that living in rural areas made it difficult to access independent
living services, and state and local officials concurred that services for
youth in rural areas were sometimes limited. Difficulties are often
related to a lack of transportation or providers willing to provide
services in remote areas. In large states such as Texas and Florida, the
long distances separating some youth from available service providers made
it difficult for youth to
24Forty-five states reported having mentoring services for youth in foster
care, and 39 states reported having mentoring services for emancipated
youth.
25Florida officials report that some housing funds are available to youth
not receiving the scholarship but that these funds are limited and
insufficient to meet the demand for housing services.
access services on a regular basis. Additional challenges include the lack
of employment opportunities and transitional housing for youth living in
some regions.
Finally, state and local officials, as well as service providers in the 4
states we visited said that it was difficult to get some youth to
participate in the independent living programs and that foster parents
were sometimes reluctant partners. While youth were generally offered
incentives, such as cash stipends, to participate in daily living skills
training or other activities, officials emphasized that participation is
voluntary and it is critical for foster parents to support and encourage
youth participation in the program. Florida and Washington officials said
that some foster parents were reluctant to transport youth to classes or
meetings because of scheduling conflicts or long distances from training
locations and did not always reinforce classroom training in daily living
skills by allowing youth to practice skills such as cooking or financial
management. FCIA emphasized the need to provide training to help foster
parents understand and address the issues confronting adolescents
preparing for independence, and nearly all states reported in our 2004
survey that they provided some training to foster parents in this regard.
However, the number of parents trained differed across 34 states reporting
data-while some states reported training 1,100 or more, others reported
training as few as 24.
After FCIA, 49 states reported increased coordination with a number of
federal, state, and local programs that can provide or supplement
independent living services, but officials from the 4 states we visited
reported several barriers in developing the linkages necessary to access
services under these programs across local areas. These barriers include a
lack of information on the array of programs available in each state and
in local areas, as well as differences in performance measures between
programs. Many child welfare caseworkers, foster parents, and youth we
spoke with during our site visits were unaware of the full array of youth
and adult support services available to youth while in foster care and
after emancipation.
States Reported Increased Coordination with Federal and State Programs to
Provide Independent Living Services to Youth, but Barriers Hinder Linkages
across Programs
States Reported Accessing Federal and State Programs More after FCIA to
Provide Independent Living Services
Federal, state, and local agencies oversee a wide range of programs
providing services that may assist youth in their transition to adult life
and that include current and former foster youth among their target
populations.26 In our 2004 survey, 49 states reported increased
coordination with federal, state, and local agencies and private
organizations that provide services to youth since the passage of FCIA to
provide a wide variety of services. Table 3 displays selected key
independent living services and the most prevalent service providers.
26Appendix II summarizes selected federal agencies and their programs that
include current and former foster youth as a target population, and
displays the types of services offered by those programs that may assist
youth in their transition from foster care to adult life.
Table 3: Key Independent Living Services and the Most Prevalent Service
Providers
Number of states in which entities provide Services and most prevalent
providers services to youth in care or emancipated youth Education
services
High school completion assistance
Job Corps
Local education agencies or schools
State Department of Education
College or vocational training enrollment
Colleges or universities
Technical or vocational schools
Local education agencies or schools
Employment services
Assistance to prepare for, locate, or maintain employment
Workforce board
State Department of Labor
Foundations
Housing services
Services related to locating and establishing a household
Local housing agencies
U.S. Department of Housing and Urban Development 20 State Department of
Housing 19
Daily living skills
Daily living skills such as first aid, health and nutrition, and money
management 48 State Department of Social/Human Services 28 Local education
agencies 25 Tribes 18 Workforce board 18
Source: GAO 2004 survey of state independent living coordinators.
Note: The list of most prevalent providers does not include providers that
contract with the child welfare agency.
States we visited used different strategies to develop linkages among
state youth programs. Three of the states we visited reported establishing
statelevel work groups that included representatives from the independent
living program and other state agencies to bring agency officials together
to discuss the needs of youth in foster care and possible strategies for
improving service delivery. For example, Florida's legislature mandated a
state-level work group to facilitate information sharing at the state
level
among various agencies, such as the State Departments of Children and
Families and Education, the Agency for Workforce Innovation, and the
Agency for Health Care Administration. Texas was developing a strategy to
redesign the provision of social services in the state, including services
to youth in the independent living program. The goals of this effort
included establishing a local, cross-system network composed of youth in
foster care, emancipated youth, caregivers, and professionals to
facilitate linkages between stakeholders and improve the delivery of
services to youth transitioning out of foster care.
Additional strategies states developed to establish linkages with other
federal, state, or local programs included establishing liaisons between
agencies or programs or through less formal collaborative arrangements.
o In Connecticut, the child welfare agency established a liaison
position with the Job Corps program to meet with foster care youth to
determine whether they were appropriate candidates for the program, and to
monitor their progress, address any obstacles or concerns, and help youth
plan for the future. In addition, a liaison between the independent living
program and Connecticut's mental health agency assists youth in their
transition to the adult mental health system to ensure that youth who need
the continued support maintain access to medication and services after
youth leave the foster care system.
o In local areas in Texas and Florida, child welfare officials worked
with local housing authorities to assist youth in accessing federal
housing vouchers provided by HUD. For example, in Tallahassee, Florida,
the local housing authority secured 30 of 100 available housing vouchers
for youth emancipating from foster care and established a case manager
position especially for the youth in the program.
o In Florida, the independent living program officials worked with the
state's youth mental health department to access the Assertive Community
Treatment for Teens Program. The program consisted of community-based
teams-nurses, job developers, housing and education officials, and other
relevant stakeholders-who worked together to develop integrated service
plans for youth with serious and persistent mental illness.
In addition, officials reported developing linkages with other private
resources in their communities, such as business owners, to provide
services to youth in the independent living program.
o Connecticut independent living officials collaborated with business
owners, nonprofit organizations, and other state agencies to develop an
experiential employment training program that gave youth 16 and older the
opportunity to learn skills through participation in workshops covering
all aspects of a local business. For example, some youth worked in a
boatbuilding business and learned skills ranging from carpentry and
construction to sales and financial management.
o In one Florida county, independent living staff utilized a community
resource know as the speakers' bureau-a service that links members of the
community with youth to talk about a wide range of professions and
activities. Caseworkers said as youth moved through their daily living
skills curriculum they were asked to decide whom they wanted as guest
speakers.
o In Texas, the child welfare agency worked with the Orphan Foundation
of America-a nonprofit organization-so youth could access a Web-based
mentoring program. Youth participating in the program were matched with
online mentors based on mutual interests, and they communicated regularly
via e-mail or by phone.
States Reported Barriers to Establishing Linkages between the Independent
Living Programs and Other Youth-Serving Programs
o
o
While table 3 shows that states are using a wide variety of programs to
provide independent living services, officials in the 4 states we visited
reported several barriers that hinder their ability to establish linkages
with other agencies and programs, including the lack of information on the
array of programs available in each state or local area and differences in
program priorities. Officials from 3 states we visited said that they
relied on local officials to identify potential partners and initiate and
maintain coordination efforts; and while individuals in some local areas
may have developed successful collaborations with service providers in
their area, these relationships have not always been expanded statewide.
To some extent, this has been due to the fact that state and local child
welfare officials differ in their awareness of resources available from
various federal and state agencies.
Local officials in one area of Florida were working with a U.S. Department
of Labor workforce program, while officials in another local area of the
state were not familiar with this program to train and find employment for
youth.
In one local area in Washington, independent living coordinators and
caseworkers expressed concern about access to affordable health care for
youth emancipating from foster care and were not aware of a federal health
center located nearby that was required to provide medical and mental
health services on a sliding fee scale.
These gaps in awareness may be partly due to turnover rates for
caseworkers reported by the states we visited.27 Caseworkers' lack of
knowledge about available programs may have contributed to foster parents
and youth reporting that they were unaware of the array of services
available from other federal, state, or local programs.
Officials in the independent living programs in the states we visited also
cited barriers to establishing linkages with other federal and state
programs because of different program priorities.
o Difference in performance goals among programs can affect the ability
of independent living staff to obtain services for foster youth from other
agencies. For example, child welfare and workforce officials in Florida
reported that performance goals for workforce programs may act as barriers
to serving youth in the child welfare system who may be more difficult to
place in employment and might not maintain the jobs once placed,
potentially bringing down workforce program performance measures.28 As a
result, the officials reported that local workforce programs may target
those individuals with whom they can most easily achieve successful
outcomes and foster youth may be unable to access services they need to
achieve positive employment outcomes.
o According to independent living service providers in one local area in
Washington, privacy concerns were a barrier to developing linkages with
education programs. For example, schools in one area we visited would not
allow anyone besides biological parents-including caseworkers and foster
parents-access to youths' individualized education programs.29 Yet
according to caseworkers, foster parents, and service providers, lack of
27In a recent report, we reviewed how caseworker turnover and staffing
shortages remain challenges for child welfare agencies. See GAO, Child
Welfare: HHS Could Play a Greater Role in Helping Child Welfare Agencies
Recruit and Retain Staff, GAO-03-357 (Washington, D.C.: Mar. 31, 2003).
28See GAO, Workforce Investment Act: Improvements Needed in Performance
Measures to Provide a More Accurate Picture of WIA's Effectiveness,
GAO-02-275 (Washington, D.C.: Feb. 1, 2002), for a review of the Workforce
Investment Act's performance measures and GAO's recommendation to the
Department of Labor to more clearly define its policies and measures.
29An individualized education program is a written statement that is
developed for each student with a disability that specifies, among other
components, the goals and objectives for the student, describes the
services that a student will receive, and specifies the extent to which
the student will participate in the regular education setting with
nondisabled peers and or in the general curriculum adopted for all
students.
access to these plans made it difficult to align the individualized
education programs with the youths' independent living plans.
States' and HHS's Actions in Response to FCIA Requirements Have Not Yet
Established Accountability for Independent Living Programs
All states developed multiyear plans as required under FCIA and submitted
annual progress reports to ACF for their independent living programs, but
the absence of standard comprehensive information within and across state
plans and reports precludes using them at the state and federal level to
monitor how well the programs are working to serve foster youth. HHS has
not yet implemented its plan to collect information to measure states'
program performance, and while some states reported collecting some data,
states have experienced difficulties in contacting youth to determine
their outcomes. HHS has begun to evaluate selected independent living
programs, and officials reported that the results of this evaluation
should be available in 2007.
States Submitted Plans and Annual Reports to Comply with Federal
Requirements, but the Documents Do Not Provide Information Necessary to
Assess Progress
o
All states developed state plans as required by FCIA that described
independent living services they planned to provide to foster youth and
submitted annual reports to ACF, but for several reasons, these plans and
reports cannot be used to assess states' independent living programs. To
assist states in preparing these documents, ACF developed guidance that
set out broad expectations for the plans and reports that would meet the
FCIA requirements. However, while ACF officials stated that the plans and
annual reports served as the primary method the agency used to monitor
states' use of the Chafee Program funds, ACF did not require states to use
a uniform reporting format, set specific baselines for measuring progress,
or report on youths' outcomes. As a result, each state developed plans and
reports that varied in their scope and level of detail, making it
difficult to determine whether states had made progress in preparing
foster youth to live self-sufficiently.30 Our review of plans from 51
states covering federal fiscal years 2001 through 2004, and annual reports
for 45 states from federal fiscal years 2001 and 2002 showed that
Few states both organized the information in their plans to address the
purposes of FCIA and presented specific strategies they would use to meet
these purposes. For example, Nebraska's plan was aligned according
30We previously reported similar problems using state reports for federal
monitoring of independent living programs prior to FCIA and had
recommended that HHS establish a uniform set of data elements and a
standard reporting format for state reporting on independent living
programs. See GAO-HEHS-00-13.
to the five purposes of FCIA, but when describing how the state would help
youth receive the education, training, and services necessary to obtain
employment, the plan provided only a broad statement about the
collaborative efforts between state agencies without mention of specific
strategies to deliver the services. In contrast, New Hampshire submitted a
comprehensive state plan that described the state's holistic approach to
providing services to youth transitioning out of care, such as specialized
trainings for youth, foster parents, and independent living staff;
programs offered through community resources; and resources available for
youth with emotional and physical challenges, but these services were not
attached to any one purpose of FCIA.
o The plans vary in their usefulness in establishing outcomes the states
intended to achieve for youth. For example, the District of Columbia
indicated that it will use Chafee Program funds to establish a computer
lab where current and former foster care youth can search for jobs, but
the plan does not establish any outcomes the District hoped to achieve
with this service, such as the percentage of youth that find employment
over a period of time. In contrast, the Nevada plan identified 2001 and
2002 as the baseline years for the number of foster youth who graduate or
receive a general equivalency diploma (GED) and planned to increase by 3
percent each year the number of youth who receive a high school diploma or
GED until the youth are within the overall state average.
o Annual reports for all 45 states contained information that did not
directly relate to information in their state plan making it unclear
whether the differences were due to service changes or missing
information. For example, in Hawaii's plan, the state listed several
services and supports provided to youth, including employment services,
such as career exploration and job placement and retention. However, in
each of the annual reports, the state does not mention offering or
providing any employment-related services.
o Of the 90 annual progress reports we reviewed, 52 reports did not
include clear data that could be used to determine progress toward meeting
the goals of the states' independent living program. For example,
Arkansas' report for federal fiscal year 2002 listed several workshops
provided to youth, such as money management and college preparation, and a
count of the number of youth who participated in the workshops. In
contrast, Nevada consistently reported data on youths' participation in
different independent living activities, including the changes between
each year, progress towards meeting the goals established in their plan,
and reasons for not yet meeting the goals.
ACF officials said that they recognize the limitations of these documents
as tools to monitor states' use of independent living program funds, but
explained that they rely on states' to self-certify that their independent
living programs adhere to FCIA requirements. Staff in ACF's 10 regional
offices conduct direct oversight of the program by reviewing the multiyear
plans and annual reports, interpreting program guidance, and communicating
with states when clarification about their plans or reports is needed.
However, officials in three offices said that their review of the
documents was cursory and that the plans and annual reports do not serve
as effective monitoring tools. Only three regions reported that they
conducted site visits to observe independent living programs in at least
some states in their regions. The other regions reported that they do not
have the funds to travel or when they do, the review is focused on other
programs or planning efforts. One region commented that even if it had
funds, ACF had not developed a standard mechanism for regional offices to
use in monitoring states' use of FCIA funds.
Alternatively, ACF officials reported that the Child and Family Services
Review used to evaluate the states' overall child welfare systems could
serve as a tool to monitor independent living programs, but the CFSR is
limited in the type and amount of data collected on youth receiving
independent living services. While states evaluated under the first year
of the CFSR were rated on the provision of independent living services to
youth in care, this item was removed in subsequent reviews.31 ACF
redesigned its review instrument with the intent of focusing on setting
and achieving appropriate permanency goals for children rather than
evaluating specific services. Despite the fact that independent living
services are no longer a specific focus of the CFSR, ACF officials believe
that two broader measures used in the review will provide opportunities to
evaluate states' performance in assisting youth: the measurement of the
stability of foster care placements and the review of permanency goals of
other planned permanent living arrangements, such as the goal of
emancipation. However, some regional officials performing these reviews
reported that the on-site portion of the CFSR is limited in scope and does
not present an opportunity to determine if states are delivering
independent living services to youth and if youth receiving such services
are achieving better outcomes than their peers. Further, the CFSR
31Items reviewed included the services youth received to prepare for
independent living and the extent to which service being provided matched
the youth's needs.
includes a review of a small number of foster care case files and does not
include a review of emancipated youth.32
HHS Has Not Yet Complied with Requirements to Collect Program Data to
Assess States' Programs, and Some States Collecting Information on Youth
Are Experiencing Difficulties
ACF has not completed efforts to develop a plan to collect data on youths'
characteristics, services, and outcomes in response to the FCIA
requirement, and some states that are attempting to collect information on
youths' outcomes are experiencing difficulties. In 2000, ACF started to
develop the National Youth in Transition Database (NYTD) to collect
information needed to effectively monitor and measure states' performance
in operating independent living programs. However, HHS officials stated
that as of August 2004, implementation had not yet occurred. The agency
has completed many of the steps laid out in its original plan dated
September 2001, including consulting with child welfare and information
technology professionals, developing a set of preliminary data elements
and outcomes measures, and pilot testing the data collection instruments
with 7 states.33 However, HHS reported that it had not taken the next step
of publishing the notice for proposed rule making because the agency
decided to develop regulations for the data collection system in order to
fulfill a statutory requirement to assess penalties on states for
noncompliance. As a result, the proposal has been under internal review
since the conclusion of the pilot test process in November 2001. HHS
reported that it expects to issue guidance in the form of a proposed
regulation in 2005.
Officials in all the states we visited supported the idea of having data
on former foster youth, and 26 states reported in our 2004 survey that
they have begun to plan for the impending data reporting requirements
despite the federal delays. Many states reported in our 2004 survey that
they already collect many of the data elements HHS had developed as part
of the consultation and pilot testing process (see table 4).
32The total number of foster care cases reviewed across the 52 states
(including the District of Columbia and Puerto Rico) was 1,462. Of that
number, 23 percent of the youth in the sample were between 13 and 18
(13-15: 17 percent, 16-18: 6 percent). According to recent data from ACF,
approximately 37 percent of the youth in foster care are between 13 and 18
years old (13-15: 19.5 percent, 16-18: 17.4 percent).
33Colorado, Indiana, New Hampshire, North Carolina, North Dakota,
Oklahoma, and Texas participated in the pilot tests that were held in
August 2001. The pilot test process concluded in November 2001 when the
contractors that conducted the tests held a briefing with the pilot states
and HHS officials.
Table 4: Proposed NYTD Data Elements as of April 2003 and the Number of
States Currently Collecting These Data
Number of states Proposed NYTD data elementsa collecting data
Youth characteristics
Tribal membership
Point of entry into foster care
Last grade completed
Special education status
Services
Independent living needs assessment
Academic support
Postsecondary educational support
Career preparation
Employment programs or vocational training
Budget and financial management
Housing education and home management
Planned supervised independent living
Health education
Risk prevention
Mentoring
Room and board financial assistance 36
Financial assistance for education/educational support 34
Other financial assistance 21
Outcomes
Current full-time employment 22
Current part-time employment 22
Employment experience 22
Social Security 21
Scholarship 22
Public assistance 21
Food stamps 19
Housing assistance 24
Medicaid 22
Other support 10
Homelessness 23
Highest educational certification received 31
Number of states Proposed NYTD data elementsa collecting data
Current enrollment and attendance 26
Connection to adult
Substance abuse referral
Incarceration
Number of children
Martial status
Health insurance
Reason for nonreporting
Source: HHS and 2004 GAO survey.
aThis list does not include the data elements HHS will use that states
report to the Adoption and Foster Care Analysis and Reporting System.
In addition, some states are attempting to collect outcome information on
former foster care youth but have experienced difficulties. According to
results from our survey, in federal fiscal year 2003, 30 states attempted
to contact youth who had been emancipated from foster care for initial
information to determine their status, including education and employment
outcomes. Of those states, most reported that they were unsuccessful in
contacting more than half of the youth. Further, 21 states reported
attempting to follow up with emancipated youth after a longer period of
time had elapsed but had trouble reaching all the youth.
Officials in the states we visited reported that collecting outcome data
is especially challenging since there is little they can do to find youth
unless the youth themselves initiate the contact. Further, some officials
were concerned about the value of the outcome data since they believe that
youth who are doing well are more likely to participate in the follow-up
interviews, thus skewing the results. Similarly, an ACF regional official
reported that the value of the NYTD would be determined by the resources
available to states to support the follow-up component. Some state
officials, caseworkers, and youth we interviewed suggested strategies
states may need to develop to maintain contact with former foster care
youth, including offering incentives to the youth to stay in touch;
establishing a toll-free telephone line that will make the process of
staying in touch as easy as possible; or using other resources that may
help locate the youth or provide the necessary data, such as other service
providers or other social services information systems.
HHS Has Begun Multiyear Evaluation of Four Approaches to Delivering
Independent Living Services
By December 2007, ACF expects to complete the evaluations of four
approaches to delivering independent living services. As required by FCIA,
these evaluations will use rigorous scientific standards, such as an
experimental research design that randomly assigns youth in independent
living programs to different groups: one that is administered the
experimental treatment and one that is not. HHS initiated this effort in
2001 with a nationwide review of potentially promising approaches to
delivering independent living services. HHS contracted with a research
institute to conduct a nationwide search to identify independent living
programs that meet the criteria of the evaluation34 and to conduct 5-year
evaluations of the selected programs.35 On the basis of the search and the
established criteria, HHS selected four programs for the evaluation (see
table 7).
34In the nationwide search, HHS contractors sought programs that met four
criteria for a rigorous research study: Programs should be directed, at
least in part, at youth leaving foster care or expected to remain in
foster care until adulthood; be innovative, of national significance, and
capable of expanding into new geographic areas; be willing and capable of
participating in experiments involving random assignment of youth to
treatment services or the alternative services; and have an adequate
sample size and should have a need for the services greater than what is
currently available so an experiment would not reduce the total number of
youth serviced by the program. Many programs could not support a
randomized study because their youth population was not large enough to
ensure youth did not go without services.
35HHS contracted with the Urban Institute and its partners-the Chapin Hall
Center for Children and the National Opinion Research Center.
Table 5: Programs Included in the Multisite Evaluation of Foster Youth
Programs Employment skills training, job referral, and employment support
provided through county Temporary Assistance to Needy Families agency
Number of
youth
Age of (control and Length of Key outcome
service of
Site Type of focus interest
Program service experimental) provision
Los Angeles Community Classroom-based 17 450 5 weeks (10 Education,
County,
California College and experiential workshops) employment,
Life Skills housing
(LST) life skills stability,
Training training, avoidance of
risk
teen support behaviors
group, and
exposure to
community college
opportunities
Los Angeles Early Start to Structured 14-15 450 6 months of tutoring
County, tutoring Education,
California Emancipation and mentoring on average,
employment,
Preparation curriculum for mentoring
interpersonal and
(ESTEP) youth 1-3 continues less
years relationship skills
behind grade intensively after
level
in reading and tutoring ends for 3
math skills months on average
Kern County, Employment
California program
16 250 Ongoing through Employment and age 21 economic self
sufficiency
Mean Employment,
Massachusetts Adolescent Intensive, 17 250 of 1 housing
year
Outreach individualized stability,
Program life service
skills mentoring linkages
and casework
Source: HHS.
The study is designed to answer the following questions: (1) How do the
outcomes of youth randomly assigned to the identified interventions
compare with those of youth who are assigned to "services as usual"? (2)
For the identified programs, what are the features of these programs that
are likely to influence their impact on youth clients? (3) How are these
services implemented? (4) To what extent might these programs be adapted
to other locales? (5) What are the barriers to implementation? Each
program will be evaluated using similar techniques: in-person structured
interviews to establish a baseline and to follow up with youth in the
treatment and control groups; a Web-based survey of caseworkers; and
program site visits including semistructured interviews with
administrators, staff, and youth. All youth will be interviewed shortly
Conclusions
Recommendations
following referral and random assignment, and 1 year and 2 years later. As
of August 2004, all evaluation studies were in the early stages. Baseline
interviews with the youth had begun or were completed in three sites and
the process was starting in the fourth site.
Many youth in the foster care system need additional services and support
throughout and beyond their adolescence to make the transition to
selfsufficiency. States have generally expanded their independent living
programs to provide new and enhanced services to a wider age range of
youth, but some states have been slower to implement the program, and
foster youth across the nation may not have access to the full array of
services they may need to lead independent and successful lives. While
many other federal, state, and private resources exist to cover some
shortfalls in service, the absence of information on resources available
in local areas may continue to hinder efforts to establish needed linkages
among programs. Similarly, while ACF provides some assistance to states,
there is still a lack of awareness about available resources among
caseworkers, foster parents, and youth that may further limit youths'
ability to access needed services once emancipated from the foster care
system.
While the Chafee Program funding is small compared with that of other
child welfare programs, effective federal oversight requires reliable
information on states' implementation efforts and results. At a minimum,
information from state plans and annual reports could be useful in federal
oversight and monitoring. However, the ability of ACF to monitor state
performance continues to be hindered by an absence of standard,
comprehensive information within and across state plans on each state's
goals, services, and youth outcomes as measured against baselines of past
achievement. Oversight is similarly hindered by a lack of standard
monitoring practices across ACF regional offices. While ACF is developing
an information system that may address some of these limitations, it may
be unavailable for several years. In the meantime, additional actions to
strengthen federal monitoring of state programs may serve to provide
greater assurance of program accountability at the state and federal
level.
To improve access to the array of services available to youth
transitioning out of foster care and assist states in leveraging available
resources, HHS should make information available to states and local areas
about other federal programs that may assist youth in their transition to
self-
sufficiency and provide guidance on how to access services under these
programs.
To improve HHS's ability to monitor implementation of the Chafee Program,
HHS should develop a standard reporting format for state plans and
progress reports and implement a uniform process regional offices can use
to assess states' progress in meeting the needs of youth in foster care
and those recently emancipated from care.
Agency Comments
We provided a draft copy of this report to the following agencies for
comment: the Departments of Health and Human Services, Education, Labor,
Housing and Urban Development, and Justice, and the Social Security
Administration. We obtained comments from the Department of Health and
Human Services, which are reproduced in appendix III. HHS also provided
technical comments, which we incorporated as appropriate. All other
agencies did not have any comments on this report.
HHS did not comment on our recommendation to make information available to
states and local areas about other federal programs that may assist youth
in their transition to self-sufficiency and to provide guidance on how to
access services under these programs. HHS listed several efforts that they
had undertaken to collaborate with other related federal agencies, such as
Labor, Justice, and Education, to expand services to youth. While these
efforts will help strengthen the relationships among federal agencies and
better inform the states, we believe that implementing our recommendation
to develop ways to better disseminate such information to state and local
child welfare agencies and to provide assistance on ways to leverage these
resources can improve services to youth both in and recently emancipated
from foster care.
HHS disagreed with our recommendation to develop a standard reporting
format for state plans and progress reports but said it was taking action
to implement a uniform process that its regional offices can use to assess
states' progress in meeting the needs of youth in foster care and those
recently emancipated from care. HHS stated that taking action to
standardize the reporting format for state plans and annual reports would
be overly prescriptive and impose an unnecessary burden on states. HHS
added that a significant change under the law was to require states to
selfcertify their compliance with statutory requirements in their state
plan, and that rather than report on performance outcomes, the plan was
intended to be a narrative to ensure state adherence to plan requirements
and assurances. In addition, HHS reported that when standard data are
available through the National Youth in Transition Database, the agency
would be better positioned to determine how best to assess state
performance. HHS further reported that ACF did provide regional office
staff with a checklist to review and approve the first state plan and that
in fiscal year 2005, ACF will develop and provide a review protocol to be
used in regional office desk reviews of states' annual progress reports.
We continue to believe that strengthening the state reporting process is
needed to provide assurance of program accountability at the state and
federal level. HHS officials stated that they consider their review of the
state plans and annual reports as the primary method the agency uses to
monitor states' use of Chafee Program funds. However, comments by ACF
regional officials conducting the oversight reviews-as well as our own
review-have shown that the diverse format and content of these documents
are insufficient for this purpose. Developing a standard reporting format
that states can use for their plans and annual reports would help HHS
improve the efficiency of the reporting process by clarifying the broad
guidance ACF provides to the states, allowing ACF reviewers to quickly
identify states' progress toward meeting program goals, and thereby reduce
the burden of the reporting process currently in place. As we reported,
some states have already taken action to establish baselines and goals as
well as strategies for action in their state plan that can be linked with
information in the annual progress reports to identify areas of strength
and needed improvement. HHS should consider these efforts undertaken by
states and take a cooperative approach in working with them and cognizant
national organizations in developing a standard report format to garner
support and reduce perceptions of burden. HHS could, for example, continue
its partnership with the workgroup that contributed to the NYTD proposal
or convene a session at the annual conference with state independent
living coordinators. HHS action to implement our recommendation may also
serve to strengthen the usefulness of uniform review protocols that ACF
plans to develop for use by regional staff in evaluating state progress
during their annual desk reviews of state performance.
As agreed with your offices, unless you publicly announce its contents or
authorize its release earlier, we plan no further distribution of this
report until 30 days after its issue date. At that time, we will send
copies of this report to the Secretaries of Health and Human Services,
Education, Housing and Urban Development, Labor, and Justice; relevant
congressional committees; and other interested parties. Copies will be
made available to others upon request. In addition, the report will be
available at no charge on GAO's Web site at http://www.gao.gov. Please
contact me at (415) 904-2272 if you or your staff have any questions about
this report. Other major contributors to this report are listed in
appendix
IV.
David D. Bellis Director, Education, Workforce, and Income Security Issues
Appendix I: Scope and Methodology
To determine how states' funding allocations changed to serve youth after
the Foster Care Independence Act of 1999 (FCIA), we analyzed federal
funding to the 50 states, the District of Columbia, and Puerto Rico for
independent living programs before and after the passage of FCIA. We
compared state allocations after the passage of FCIA with the numbers of
eligible youth in foster care in each state to determine available funding
per eligible youth across states. To perform this comparison, we used data
reported by states to the Department of Health and Human Services (HHS) in
the Adoption and Foster Care Analysis and Reporting System (AFCARS) on the
numbers of eligible youth in foster care within each state in federal
fiscal year 2002. Since states' funding allocation are based on AFCARS
data, we determined that these data were the best available information
for the purposes of this analysis. The procedures the agency uses to
assess data quality, which includes identifying out-of-range or missing
data, were sufficient for our purposes. To determine the age ranges of
youth in foster care eligible for independent living services within each
state, we used data reported by states in our 2004 survey of state
independent living coordinators. In addition to reviewing these data, we
interviewed HHS staff in headquarters and each of the 10 regional offices.
To determine the extent to which states expanded independent living
services and age groups of foster youth served since the passage of FCIA,
as well as what challenges remain, we surveyed all 50 states, the District
of Columbia, and Puerto Rico through a Web-based questionnaire. We
pretested the survey instrument with administrators of the independent
living program in Texas, Florida, Washington, Maryland, and Connecticut.
On the basis of the feedback from the pretests, we modified the questions
as appropriate. Information about accessing the questionnaire was provided
via e-mail. To ensure security and data integrity, we provided each
official with a password that allowed him or her to access and complete
the questionnaire for his or her state. We received responses from all 50
states and the District of Columbia for a response rate of about 98
percent. Our survey collected a variety of state data, including
information on services provided to youth, numbers of youth eligible and
served with independent living services, funding for independent living
programs, and changes since the passage of FCIA. We designed the survey to
parallel several questions from a 1999 GAO survey of states regarding
their independent living programs prior to the passage of FCIA in fiscal
year 1998. We compared responses between the surveys to identify changes
with state independent living programs since the passage of FCIA.
The practical difficulties of conducting any survey may introduce errors,
known as nonsampling errors. For example, differences in how a
Appendix I: Scope and Methodology
particular question is interpreted, the sources of information available
to respondents, or the types of people who do not respond can introduce
unwanted variability into the survey results. We included steps in both
the data collection and data analysis stages for the purpose of minimizing
such nonsampling errors.
In addition to conducting the survey, we visited independent living
programs in 4 states (Texas, Florida, Washington, and Connecticut) to
obtain more detailed information regarding the provision of independent
living services and changes to state independent living programs since the
passage of FCIA in 1999. We selected these states to represent a range in
size of foster care populations, approaches to the provision of
independent living services, federal allocations of independent living
funds, and geographic locations. During our state visits, we interviewed
state and local child welfare officials, caseworkers, contracted service
providers, foster parents, and youth. We also spoke with HHS staff in the
central office and each of the 10 regional offices; National Resource
Center for Youth Development officials; and child welfare experts from
various organizations including the National Independent Living
Association, the Chapin Hall Center for Children, and the Casey
organizations.
To determine to what extent states used other federal and state programs
to coordinate the delivery of independent living services to foster youth,
we surveyed states using the above-mentioned survey instrument. In
addition, during our site visits we interviewed state and local child
welfare officials; officials from other state agencies that provide
services that may assist youth in their transition to self-sufficiency; as
well as contracted service providers, caseworkers, foster parents, and
youth. We also spoke with HHS officials in the central and regional
offices and officials at a number of federal agencies that are responsible
for programs that may benefit transitioning youth. These included the U.S.
Departments of Education, Labor, Housing and Urban Development, and
Justice; the Social Security Administration; and the Substance Abuse and
Mental Health Services Administration.
To determine how states and HHS fulfilled the accountability provisions of
FCIA, we analyzed Chafee Foster Care Independence Program state plans for
49 states, the District of Columbia, and Puerto Rico for fiscal years
2001-2004 to determine each state's program goals and strategies. We also
analyzed 90 annual progress and services reports (annual reports) that
states submitted regarding the progress made in implementing their Chafee
plans for fiscal years 2001 and 2002. We obtained the plans and progress
reports from the Administration of Children and Families (ACF)
Appendix I: Scope and Methodology
regional offices after consulting with ACF's central office and the
National Resource Center for Youth Development. One regional office could
not provide us with the state plan for Wyoming and the annual reports for
Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming in the
time requested. Therefore, these states are not included in our analysis.
In addition, we received only one report for Tennessee (federal fiscal
year 2001) and Puerto Rico (federal fiscal year 2002). We developed a data
collection instrument (DCI) based on the federal guidance provided that
described how states were expected to develop their plans and reports. A
DCI was completed for each state plan and annual report, and another staff
person reviewed each record for clarity and accuracy. We supplemented this
analysis with discussions with state officials and ACF central and
regional office officials. In addition, we reviewed ACF's draft proposals
for the National Youth in Transition Database (NYTD) and talked with the
contractor staff responsible for development of this system and the
multisite evaluation of promising independent living programs. We were not
able to obtain the most current information on the NYTD proposals.
Therefore, we only have information as recent as August 2003, and our
description of NYTD may not accurately describe the final proposal when it
becomes available.
Appendix II: Selected Federal Youth Programs and Services That Target
Current and Former Foster Youth
Types of services funded
Agency and programs
Academic services Tutoring
Employment training
Selfsufficiency/ skills
development Mentoring Counseling
Mental health
Pregnancy prevention Substance abuse prevention/ treatment Department of
Education
21st Century X X X X X
Community
Learning
Centers
Migrant X X X X X X
Education Even
Start
Parent X X X X X X X X
Assistance and
Local Family
Information
Centers
Elementary and X X X X X X
Secondary
School
Counseling
Program
Safe X X X X X X X X X
Schools/Healthy
Students
Department of Health and Human Services
Social X X X X X X
Economic
Development
Strategies
(SEDS)
Community- X X X
Based Family
Resource and
Support
Program
Promoting Safe X X X X X
and Stable
Families
Runaway and X X X X X X X X
Homeless
Youth-
Transitional
Living Program
and Maternity
Group Homes
Appendix II: Selected Federal Youth Programs and Services That Target
Current and Former Foster Youth
Types of services funded
Self-Substance
sufficiency/ abuse Agency and Academic Employment skills Mental Pregnancy
prevention/ programs services Tutoring training development Mentoring
Counseling health prevention treatment
Temporary X X X X X X X X
Assistance for
Needy Families
(TANF)
Healthy Schools X X X
Healthy
Communities
Family and X X X X X
Community
Violence
Prevention
Program
Department of Housing and Urban Development Department of Justice
Community X X X X X X X X X
Development
Block Grant
Indian Housing X X X X
Block Grant
Gang X X X X X
Resistance
Education and
Training
(G.R.E.A.T)
Big Brothers/Big X
Sisters of
America
Safe Kids/Safe X X X
Streets
State Challenge X X
Activities
Program
Tribal Youth X X X X X X X X
Program
Department of Labor
Job Corps X X X X X X X
Rewarding X X X X X X
Youth
Achievement
Grants
Appendix II: Selected Federal Youth Programs and Services That Target
Current and Former Foster Youth
Types of services funded
Self-Substance
sufficiency/ abuse Agency and Academic Employment skills Mental Pregnancy
prevention/ programs services Tutoring training development Mentoring
Counseling health prevention treatment
Workforce X X X X X X X
Investment Act
Formula Youth
Youth Offender X X X X X X
Demonstration
Initiative
Source: White House Task Force For Disadvantaged Youth, October 2003.
Note: An "X" indicates that the service is funded by the agency or
program.
Appendix III: Comments from the Department of Health and Human Services
Appendix III: Comments from the Department of Health and Human Services
Appendix III: Comments from the Department of Health and Human Services
Appendix III: Comments from the Department of Health and Human Services
Appendix IV: GAO Contacts and Acknowledgments
GAO Contacts Lacinda Ayers, (206) 654-5591 Sara L. Schibanoff, (202)
512-4176
Staff In addition to those named above, Adam Roye, Catherine Roark, and R.
Jerry Aiken made key contributions to this report. Diana
Pietrowiak,Acknowledgments Luann Moy, Catherine M. Hurley, and Amy Buck
also provided key technical assistance.
Bibliography
Casey Family Programs. Providing Education Related Supports and Services
under the Chafee Independence Act of 1999: Selected State Activities, and
Postsecondary Education and Training Voucher Information. Seattle,
Washington, May 2003.
---. Assessing the Effects of Foster Care: Early Results from the Casey
National Alumni Study. Seattle, Washington, October 2003.
Chapin Hall Center for Children, University of Chicago. Midwest Evaluation
of the Adult Functioning of Former Foster Youth: Conditions of Youth
Preparing to Leave State Care. February 2004.
U.S. Department of Health and Human Services, Administration for Children
and Families; Administration on Children, Youth, and Families; Children's
Bureau. Title IV-E Independent Living Programs: A Decade in Review.
Washington, D.C., November 1999.
Wald, M., and T. Martinez. Connected by 25: Improving the Life Chances of
the Country's Most Vulnerable 14-24 Year Olds. William and Flora Hewlett
Foundation Working Paper. Menlo Park, CA: William and Flora Hewlett
Foundation, November, 2003.
White House Task Force for Disadvantaged Youth Final Report. Washington,
D.C., October 2003.
Related GAO Products
D.C. Child and Family Services Agency: More Focus Needed on Human Capital
Management Issues for Caseworkers and Foster Parent Recruitment and
Retention. GAO-04-1017. Washington, D.C.: September 24, 2004.
Child and Family Services Reviews: Better Use of Data and Improved
Guidance Could Enhance HHS's Oversight of State Performance. GAO-04-333
Washington, D.C.: April 20, 2004.
Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide
States Additional Information to Improve Services. GAO-03-956. Washington,
D.C.: September 12, 2003.
Child Welfare: Most States Are Developing Statewide Information Systems,
but the Reliability of Child Welfare Data Could Be Improved. GAO-03-809.
Washington, D.C.: July 31, 2003.
Child Welfare and Juvenile Justice: Federal Agencies Could Play a Stronger
Role in Helping States Reduce the Number of Children Placed Solely to
Obtain Mental Health Services. GAO-03-397. Washington, D.C.: April 21,
2003.
Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare
Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March 31,
2003.
Foster Care: Recent Legislation Helps States Focus on Finding Permanent
Homes for Children, but Long-Standing Barriers Remain. GAO-02-585.
Washington, D.C.: June 28, 2002.
Workforce Investment Act: Improvements Needed in Performance Measures to
Provide a More Accurate Picture of WIA's Effectiveness.
GAO-02-275. Washington, D.C.: February 1, 2002.
Child Welfare: New Financing and Service Strategies Hold Promise, but
Effects Unknown. GAO/T-HEHS-00-158. Washington, D.C.: July 20, 2000.
Foster Care: States' Early Experiences Implementing the Adoption and Safe
Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999.
Foster Care: HHS Could Better Facilitate the Interjurisdictional Adoption
Process. GAO/HEHS-00-12. Washington, D.C.: November 19, 1999.
Related GAO Products
Foster Care: Effectiveness of Independent Living Services Unknown.
GAO/HEHS-00-13. Washington, D.C.: November 10, 1999.
Foster Care: Kinship Care Quality and Permanency Issues. GAO/HEHS-99-32.
Washington, D.C.: May 6, 1999.
Juvenile Courts: Reforms Aim to Better Serve Maltreated Children.
GAO/HEHS-99-13. Washington, D.C.: January 11, 1999.
Child Welfare: Early Experiences Implementing a Managed Care Approach.
GAO/HEHS-99-8. Washington, D.C.: October 21, 1998.
Foster Care: Agencies Face Challenges Securing Stable Homes for Children
of Substance Abusers. GAO/HEHS-98-182. Washington, D.C.: September 30,
1998.
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