African American Children in Foster Care: HHS and Congressional  
Actions Could Help Reduce Proportion in Care (31-JUL-08,	 
GAO-08-1064T).							 
                                                                 
A significantly greater proportion of African American children  
are in foster care than children of other races and ethnicities  
relative to their share of the general population. Given this	 
situation, GAO was asked to analyze the (1) major factors	 
influencing their proportion in foster care, (2) strategies	 
states and localities have implemented that appear promising, and
(3) ways in which federal policies may have influenced the	 
proportion of African American children in foster care. This	 
testimony is based on a GAO report issued in July 2007		 
(GAO-07-816), which included a nationwide survey; a review of	 
research and policies; state site visits; analyses of child	 
welfare data; and interviews with researchers, HHS officials, and
other experts. It includes updates where possible.		 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-08-1064T					        
    ACCNO:   A83223						        
  TITLE:     African American Children in Foster Care: HHS and	      
Congressional Actions Could Help Reduce Proportion in Care	 
     DATE:   07/31/2008 
  SUBJECT:   Blacks						 
	     Child adoption					 
	     Child welfare					 
	     Children						 
	     Disadvantaged persons				 
	     Families						 
	     Federal aid to states				 
	     Federal funds					 
	     Federal/state relations				 
	     Foster children					 
	     Minorities 					 
	     Parents						 
	     Policy evaluation					 
	     Program evaluation 				 
	     Racial discrimination				 
	     State-administered programs			 
	     Surveys						 
	     Foster care					 

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GAO-08-1064T

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Testimony: 

Before the Subcommittee on Income Security and Family Support, 
Committee on Ways and Means, House of Representatives: 

United States Government Accountability Office: 

GAO: 

For Release on Delivery Expected at 10:00 a.m. EDT: 

Thursday, July 31, 2008: 

African American Children In Foster Care: 

HHS and Congressional Actions Could Help Reduce Proportion in Care: 

Statement of Kay Brown, Director: 

Education, Workforce, and Income Security: 

GAO-08-1064T: 

GAO Highlights: 

Highlights of GAO-08-1064T, a testimony before the Subcommittee on 
Income Security and Family Support, Committee on Ways and Means, House 
of Representatives. 

Why GAO Did This Study: 

A significantly greater proportion of African American children are in 
foster care than children of other races and ethnicities relative to 
their share of the general population. Given this situation, GAO was 
asked to analyze the (1) major factors influencing their proportion in 
foster care, (2) strategies states and localities have implemented that 
appear promising, and (3) ways in which federal policies may have 
influenced the proportion of African American children in foster care. 
This testimony is based on a GAO report issued in July 2007 (GAO-07-
816), which included a nationwide survey; a review of research and 
policies; state site visits; analyses of child welfare data; and 
interviews with researchers, HHS officials, and other experts. It 
includes updates where possible. 

What GAO Found: 

According to our survey results, key factors contributing to the 
proportion of African American children in foster care included a 
higher rate of poverty, challenges in accessing support services, 
racial bias and distrust, and difficulties in finding appropriate 
adoptive homes. Families living in poverty have greater difficulty 
accessing housing, mental health, and other support services needed to 
keep families stable and children safely at home. Bias or cultural 
misunderstandings and distrust between child welfare decision makers 
and the families they serve also contribute to childrenï¿½s removal from 
their homes into foster care. African American children also stay in 
foster care longer because of difficulties in recruiting adoptive 
parents, the lack of services for parents trying to reunify with their 
children, and a greater reliance on relatives to provide foster care 
who may be unwilling to terminate the parental rights of the childï¿½s 
parentï¿½as required in adoptionï¿½or who need the financial subsidy they 
receive while the child is in foster care. 

Most states we surveyed reported using various strategies intended to 
address these issues, such as building community supports, providing 
cultural competency training for caseworkers, and broadening the search 
for relatives to care for children. Researchers and officials also 
stressed the importance of analyzing data to address the proportion of 
African American children in care in order to better understand the 
issue and devise strategies to address it. HHS provides information and 
technical assistance, but states reported that they had limited 
capacity to analyze their own data and formulate strategies to address 
disproportionality. 

According to our survey, states viewed some federal policies, such as 
those that promote adoption, as helpful for reducing the proportion of 
African American children in foster care. However, they also expressed 
concerns regarding policies that limit the use of federal funds to 
provide preventive services and support legal guardianship 
arrangements. As an alternative to adoption, subsidized guardianship is 
considered particularly promising for helping African American children 
exit from foster care. 

Figure: Proportion of Children in Foster Care Settings, End of Fiscal 
Year 2006: 

This figure is a combination bar graph showing proportion of children 
in foster care settings at the end of fiscal year 2006. The X axis 
represents race, and the Y axis represents the percent of population. 

Race: White; 
Child population: 59; 
Foster care population: 40. 

Race: African American; 
Child population: 15; 
Foster care population: 32. 

Race: Hispanic; 
Child population: 21; 
Foster care population: 19. 

Race: Asian; 
Child population: 4; 
Foster care population: 1. 

Race: Native American; 
Child population: 1; 
Foster care population: 2. 

[See PDF for image] 

Source: GAO analysis of preliminary 2006 data from the Adoption and 
Foster Care Analysis and Reporting System and 2006 Census data. 

[End of figure] 

What GAO Recommends: 

In our July 2007 report, GAO recommended that HHS further assist states 
in addressing disproportionality. HHS noted that GAOï¿½s recommendation 
was consistent with its efforts to provide technical assistance to 
states, but it has not addressed the specific actions. GAO continues to 
believe that further assistance is important for helping states address 
disproportionality. GAO also suggested that Congress consider amending 
current law to allow subsidies for legal guardianships. HHS believes 
its proposal for restructuring child welfare funding, first offered in 
2004, would give states the option to do this, but the viability of 
this proposal is uncertain. 

[End of section] 

Mr. Chairman and Members of the Subcommittee: 

I am pleased to be here today to discuss our work on African American 
children and the extent to which they are disproportionately 
represented in foster care relative to their share of the general 
population.[Footnote 1] Nationwide, about 510,000 children were in 
foster care at the end of fiscal year 2006, a significant proportion of 
them African American children. African American children were about 
three times as likely to be placed in foster care compared with White 
children in 2006, and African American children remained in foster care 
about 9 months longer as well.[Footnote 2] This disproportionality 
occurs despite the fact that national studies have shown that children 
suffer from abuse and neglect at the same rates regardless of their 
race or ethnicity.[Footnote 3] Although states vary considerably, data 
from nearly all states show some overrepresentation of African American 
children in foster care. 

As you know, about 60 percent of children who enter foster care do so 
in response to reports of child abuse or neglect that are provided to a 
state's child welfare system by doctors, teachers, police officers, and 
others.[Footnote 4] Child welfare staff make decisions about whether a 
child can or cannot remain safely at home with their families, which 
are then presented before a judge who corroborates or overturns the 
decision. If a child enters foster care, child welfare staff develop 
case plans, approved by the courts, outlining the actions that parents 
must take before a child can be returned home. If the courts decide 
that children cannot be safely returned home, caseworkers establish 
other goals for them, such as adoption or legal guardianship. Although 
states have the primary responsibility for establishing the structures 
and programs of their child welfare services, federal policies 
establish a framework within which states make their programmatic and 
fiscal decisions. The Department of Health and Human Services (HHS) is 
the principal federal agency that provides federal oversight of states' 
child welfare systems. 

My remarks today will focus on the following issues with regard to the 
proportion of African American children in foster care: 

(1)The major factors that have been identified as influencing the 
proportion of African American children entering and remaining in 
foster care; 

(2)the strategies that states and localities have implemented that 
appear promising in addressing African American children's 
overrepresentation in foster care; and: 

(3)the ways in which key federal child welfare policies[Footnote 5] may 
have influenced African American children's representation in foster 
care. 

This testimony is based on findings from our July 2007 report[Footnote 
6] on this subject, which we developed using multiple methodologies, 
including a nationwide Web-based survey of state child welfare 
administrators,[Footnote 7] site visits to multiple states and 
counties, and interviews with child welfare researchers and HHS 
officials.[Footnote 8] For our 2007 report, we also analyzed HHS data 
on foster care and adoption, conducted a review of research on racial 
disproportionality in foster care, and analyzed federal legislation and 
policies. For this testimony, we updated some information based on 
foster care and adoption data sources, but HHS did not provide us with 
any updates on its activities in time for this testimony. We conducted 
our work between June 2006 and July 2007 and updated as possible in 
July 2008 in accordance with generally accepted government auditing 
standards. Those standards require that we plan and perform the audit 
to obtain sufficient, appropriate evidence to provide a reasonable 
basis for our findings and conclusions based on our audit objectives. 
We believe that the evidence obtained provides a reasonable basis for 
our findings and conclusions based on our audit objectives. 

Summary: 

A higher rate of poverty and challenges in accessing support services, 
as well as racial bias coupled with distrust of the child welfare 
system, and difficulties in finding appropriate permanent homes were 
identified in our survey of child welfare directors as key factors 
influencing the proportion of African American children in foster care. 
Thirty-three states in our survey cited high rates of poverty among 
African Americans as a factor influencing children's entry into foster 
care. Also, families living in impoverished neighborhoods often do not 
have access to support services that can help them weather problems 
when they arise. However, research suggests that poverty does not fully 
account for differing rates of entry into foster care. State child 
welfare directors we surveyed also responded that bias or cultural 
misunderstanding and distrust between child welfare decision makers and 
the families they serve also contribute to the removal of children from 
their homes. For children who cannot be reunified with their families, 
state officials reported difficulties in finding them appropriate 
permanent homes, in part, because of the challenges in recruiting 
adoptive parents, especially for youth who are older or have special 
needs. African American children also stay in foster care longer, in 
part, because of a greater reliance on relatives to provide foster 
care. Although this type of foster care placement, known as kinship 
care, can be less traumatic for children, it is also associated with 
longer lengths of stay. 

Researchers and officials stressed that no single strategy would fully 
address the issue of disproportionality, and most states in our survey 
reported implementing some strategies that experts have identified as 
promising for African American children. For example, some states are 
working to reduce bias by providing cultural competency training for 
caseworkers and to increase access to support services by collaborating 
with neighborhood-based support organizations. States also reported 
that they were working to increase the availability of permanent homes 
by diligently searching for fathers and other paternal kin who could 
provide care. However, public and private officials in the forefront of 
research and implementation said that the ability to analyze data was 
fundamental to any attempt to address racial disproportionality. State 
child welfare directors generally reported in our survey that they 
needed additional support in analyzing data on disproportionality and 
disseminating strategies. Our July 2007 report therefore recommended 
that the Secretary of HHS provide states with additional technical 
assistance and tools to develop strategies to address 
disproportionality. In its comments, HHS noted that our recommendation 
was consistent with its efforts to provide technical assistance to 
states for addressing disproportionality, but the department did not 
address the specific actions we recommended. We continue to believe 
that it is important for HHS to take these actions to help states 
address this complex issue. 

Finally, while states viewed some federal policies as helpful for 
reducing the proportion of African American children in foster care, 
they also expressed concerns regarding policies that limit the use of 
federal funds for services to prevent the removal of children in the 
first place and to place children with legal guardians. First, states 
expressed concerns that federal funding emphasized finding permanent 
homes for children after they had been removed, rather than on 
preventing the removal of children from their homes in the first place. 
With regard to finding homes for children who had already been removed, 
states generally viewed federal adoption policies as helpful in 
reducing disproportionality, including federal subsidies for adoptive 
families and the requirement to recruit minority adoptive parents. 
However, states faced challenges in recruiting enough adoptive parents. 
States also considered legal guardianship as particularly helpful in 
enabling African American children to exit foster care, but noted that 
while they can use federal funds to pay subsidies to adoptive parents, 
they cannot do so for legal guardians. Our draft report recommended 
that HHS pursue specific measures to allow adoption assistance payments 
to be used for subsidizing legal guardianship. In its comments, HHS 
disagreed with our recommendation, stating that its proposal for 
restructuring child welfare funding would give states the option to do 
this. However, HHS has presented this option in its budget proposal 
each year since 2004, but no legislation has been offered to date to 
authorize it. Because the viability of HHS's proposal is uncertain, in 
our July 2007 report we suggested that Congress consider amending 
current law to allow subsidies for legal guardianships. To date, the 
House of Representatives has passed a bill with a provision to allow 
states to use federal funds to subsidize legal guardianship for 
relatives, and the Senate has introduced a bill with a similar 
provision. 

Background: 

African American children were more likely to be placed in foster care 
than White or Hispanic children in 2006, and at each decision point in 
the child welfare process the disproportionality of African American 
children grows. Nationally, although African American children made up 
less than 15 percent of the overall child population in the 2000 
Census, they represented 26 percent of the children who entered foster 
care during fiscal year 2006 and 32 percent of the children remaining 
in foster care at the end of that year (see fig. 1).[Footnote 9] 

Figure 1: Proportion of Children by Race in Foster Care Settings, End 
of Fiscal 2006: 

This figure is a combination bar graph showing proportion of children 
in foster care settings at the end of fiscal year 2006. The X axis 
represents race, and the Y axis represents the percent of population. 

Race: White; 
Child population: 59; 
Foster care population: 40. 

Race: African American; 
Child population: 15; 
Foster care population: 32. 

Race: Hispanic; 
Child population: 21; 
Foster care population: 19. 

Race: Asian; 
Child population: 4; 
Foster care population: 1. 

Race: Native American; 
Child population: 1; 
Foster care population: 2. 

[See PDF for image] 

Source: GAO analysis of preliminary 2006 data from the Adoption and 
Foster Care Analysis and Reporting System and 2006 Census data. 

[End of figure] 

There are various options for placing children in temporary and 
permanent homes through the child welfare system. Temporary options 
include foster care with relatives or nonrelatives--whether licensed or 
unlicensed--and group residential settings. According to HHS, 
approximately one-fourth of the children in out-of-home care are living 
with relatives, and this proportion is higher for Hispanic and African 
American families. For permanent placements, children can be reunified 
with their parents, or if reunification is not considered possible, 
children can be adopted or live with a legal guardian. Although both 
adoption and guardianship are considered permanent placement options 
under federal law,[Footnote 10] an important difference is that 
adoption entails terminating parental rights, while guardianship does 
not. Another difference is that some adoptions may be subsidized with 
federal funds. 

Federal funds account for approximately half of states' total reported 
spending for child welfare services, with the rest of funding coming 
from states and localities. In fiscal year 2004, total federal spending 
on child welfare was estimated to be $11.7 billion based on analysis of 
data from more than 40 states.[Footnote 11] Titles IV-E and IV-B of the 
Social Security Act are the principal sources of federal funds 
dedicated for child welfare activities. Title IV-E supports payments to 
foster families, subsidies for families who provide adoptive homes to 
children who states identify as having special needs that make 
placement difficult,[Footnote 12] and related administrative costs on 
behalf of children who meet federal eligibility criteria. Title IV-E 
payments for foster care maintenance are open-ended entitlements. Title 
IV-B authorizes funds to states for broad child welfare purposes, 
including child protection, family preservation, and adoption services; 
these funds are appropriated annually.[Footnote 13] Federal block 
grants, such as the Temporary Assistance for Needy Families (TANF) and 
the Social Services Block Grant (SSBG), provide additional sources of 
funds that states can use for child welfare purposes. States have 
discretion to provide direct social services for various populations, 
including child welfare families, the elderly, and people with 
disabilities. 

In 1994, the Congress authorized the use of demonstration waivers to 
encourage innovative and effective child welfare practices. These 
waivers, typically authorized for 5 years, allowed states to use Title 
IV-E funds to provide services and supports other than foster care 
maintenance payments. For example, four states had completed 
demonstrations that involved subsidized guardianships, and, as of May 
2007, seven states had active guardianship demonstrations and one state 
had not yet implemented its guardianship demonstration. Demonstration 
waivers must remain cost-neutral to the federal government, and they 
must undergo rigorous program evaluation to determine their 
effectiveness. 

States Report Poverty and Difficulty in Finding Permanent Homes Are 
among Major Factors Influencing African Americans Entry and Length of 
Stay: 

A complex set of interrelated factors influence the disproportionate 
number of African American children who enter foster care, as well as 
their longer lengths of stay. Major factors affecting children's entry 
into foster care included African American families' higher rates of 
poverty, difficulties in accessing support services, and racial bias or 
cultural misunderstanding among child welfare decision makers, as well 
as families' distrust of the child welfare system. Factors often cited 
as affecting African American children's length of stay in foster care 
included the lack of appropriate adoptive homes for children, parents' 
lack of access to support services needed for reunification with their 
children, and a greater use of kinship care among African American 
families. (See fig. 2.) 

Figure 2: State Views of Factors Affecting Higher Entry of African 
American Children to Foster Care: 

This figure is a combination bar graph showing state views of factors 
affecting higher entry of African American children to foster care. The 
X axis represents the number of states, and the Y axis represents the 
factors affecting higher entry of African American children to foster 
care. 

Poverty-related factors: 

Factor: High rates of poverty in African American communities; 
Very great extent: 11; 
Great extent: 17; 
Moderate extent: 5. 

Factor: Large number of single-parent African American households; 
Very great extent: 4; 
Great extent: 10; 
Moderate extent: 11. 

Factor: High rates of substance abuse in African American households; 
Very great extent: 2; 
Great extent: 10; 
Moderate extent: 12.

Factor: Greater degree of interaction of African American children with 
mandated reporters; 
Very great extent: 2; 
Great extent: 4; 
Moderate extent: 8. 

Factors related to support services: 

Factor: Lack of affordable housing options for African American 
parents; 
Very great extent: 4; 
Great extent: 11; 
Moderate extent: 10. 

Factor: Lack of access to substance abuse treatment for African 
American parents; 
Very great extent: 2; 
Great extent: 10; 
Moderate extent: 11. 

Factor: Limited access to family support services to prevent placement 
into foster care and re-entry; 
Very great extent: 3; 
Great extent: 10; 
Moderate extent: 11. 

Factor: Limited or inadequate legal representation of birth parents; 
Very great extent: 3; 
Great extent: 7; 
Moderate extent: 10. 

Factors related to bias: 

Factor: Distrust of the child welfare system within the African 
American community; 
Very great extent: 4; 
Great extent: 14; 
Moderate extent: 10. 

Factor: Racial bias or cultural misunderstanding among those reporting 
abuse or neglect to the child welfare agency; 
Very great extent: 4; 
Great extent: 7; 
Moderate extent: 12. 

Factor: Caseworker bias, cultural misunderstanding, or inadequate 
training in making placement decisions; 
Very great extent: 1; 
Great extent: 10; 
Moderate extent: 10. 

Factor: Racial bias or cultural misunderstanding in judicial rulings; 
Very great extent: 1; 
Great extent: 8; 
Moderate extent: 8. 

[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

In our survey, 33 of the 48 states from which we received responses 
reported that high rates of poverty in African American communities and 
issues related to living in poverty may increase the proportion of 
African American children entering foster care compared to that of 
children of other races and ethnicities. Across the nation, African 
American families were nearly four times more likely to live in poverty 
than White families, according to U.S. Census data.[Footnote 14] Since 
foster care programs primarily serve children from low-income families, 
this could account for some of the disproportionate number of African 
American children in the foster care system. In addition, child welfare 
directors in 25 states reported that the greater number of African 
American single-parent households contributed to African American 
children's entry into foster care. According to the most recent 
National Incidence Study, children of single parents, who are also more 
likely than married couples to be poor, had a 77 to 87 percent greater 
risk of harm than children from two-parent families.[Footnote 15] 
Across the nation, 34 percent of African American family households 
with children under 18 years of age were headed by single females 
compared to 9 percent for Whites and 19 percent for Hispanics, 
according to U.S. Census data.[Footnote 16] 

Moreover, families living in impoverished neighborhoods often do not 
have access to the kinds of supports and services that can prevent 
problems in the home from leading to abuse or neglect, according to 
states we surveyed and other research. Such supports and services 
include affordable and adequate housing; substance abuse treatment; 
access to family services such as parenting skills workshops and 
counseling; and adequate legal representation.[Footnote 17] Also, there 
is some evidence that African American families, in particular, are not 
offered the same amount of support services when they are brought to 
the attention of the child welfare system.[Footnote 18] 

Coupled with African American parents' greater distrust of the child 
welfare system, racial bias or cultural misunderstanding among decision 
makers also emerged in our survey as major factors contributing to the 
disproportionate number of African American children entering foster 
care. According to state child welfare officials and some researchers 
we interviewed, African American families' distrust of the child 
welfare system stems from their perception that the system is 
unresponsive to their needs and racially biased against them. This 
perception can shape the families' dynamics in their initial contacts 
with mandated reporters, caseworkers, and judges, which can increase 
the risk the child will be removed from the home. In our survey, state 
child welfare directors also reported that they considered racial bias 
or cultural misunderstanding on the part of those reporting abuse or 
neglect---such as teachers, medical professionals, or police officers, 
as well as among caseworkers---as factors in the disproportionate 
representation of African American children entering foster care. In 
support of this view, some studies have found that medical 
professionals are more likely to report low-income or minority children 
to child protective services.[Footnote 19] Although research on racial 
bias or race as a predictor for entry into foster care is not always 
consistent, a recent review of the current research concluded that race 
is an important factor that affects the decision to place children into 
foster care.[Footnote 20] 

Among factors cited as affecting African American children's longer 
lengths of stay in foster care, officials from 29 states cited an 
insufficient number of appropriate adoptive homes as a key factor. 
African American children constituted nearly half of the children 
legally available for adoption in 2004, and they waited significantly 
longer than other children for an adoptive placement. Factors that make 
finding adoptive families for African American children challenging 
include the difficulty many states have in recruiting adoptive families 
of the same race and ethnicity as the children waiting for adoption and 
the unwillingness of some families to adopt a child of another race. In 
addition, states we surveyed reported that African American children 
waiting to be adopted were older, and prospective adoptive parents are 
more inclined to adopt younger children.[Footnote 21] (See fig. 3.) 

Fig. 3: State Views of Factors Affecting Longer Time in Foster Care for 
African American Children: 

This figure is a combination bar graph showing state views of factors 
affecting longer time in foster care for African American children. The 
X axis represents the number of states, and the Y axis represents the 
state views of factors affecting longer time in foster care for African 
American children. 

Factors related to finding permanent homes: 

Factor: Insufficient number of appropriate adoptive homes; 
Very great extent: 6; 
Great extent: 12; 
Moderate extent: 11.

Factor: Older (and harder to adopt) foster children are more likely to 
be African American; 
Very great extent: 7; 
Great extent: 10; 
Moderate extent: 4. 

Factor: African American children are more likely to be diagnosed with 
special needs, making them more difficult to adopt; 
Very great extent: 5; 
Great extent: 5; 
Moderate extent: 6. 

Factors related to achieving reunification:  

Factor: Lack of affordable housing options for African American 
parents; 
Very great extent: 4; 
Great extent: 14; 
Moderate extent: 7. 

Factor: Distrust of the child welfare system within the African 
American community; 
Very great extent: 6; 
Great extent: 3; 
Moderate extent: 16. 

Factor: Lack of substance abuse treatment for African American parents; 
Very great extent: 3; 
Great extent: 11; 
Moderate extent: 9. 
[See PDF for image] 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

Additionally, the belief that African American children are more likely 
to be diagnosed as having medical and other special needs, which may 
contribute to their longer lengths of stay in foster care, was reported 
by state officials. In fact, African American children in foster care 
in 2004 were only slightly more likely to have been diagnosed as having 
medical conditions or other disabilities (28 percent) than White 
children in foster care (26 percent), according to HHS data. However, 
23 percent of African American children who were adopted out of foster 
care had a medical condition or disability, compared to 31 percent of 
White children in the same category. 

Some of the same factors that states view as contributing to African 
American children's entry also contribute to their difficulties in 
exiting foster care and being reunified with their families. In our 
survey, nearly half of the states considered the lack of affordable 
housing, distrust of the child welfare system, and lack of substance 
abuse treatment as factors contributing to African American children's 
longer lengths of stay. The lack of such supports and other services in 
many poor African American neighborhoods contributes to children's 
longer stays in foster care because services can influence a parent's 
ability to reunify with their child in a timely manner, according to 
our survey, interviews, and research. 

States also reported that the use of kinship care was a factor 
contributing to longer lengths of stay in foster care for African 
American children. African American children are more likely than White 
and Asian children to enter into the care of relatives, which is 
associated with longer lengths of stay. Relatives may be unwilling to 
adopt the child because it would require termination of their 
relative's parental rights or because they might lose needed financial 
support they receive as foster parents. However, despite the longer 
lengths of stay, child welfare researchers and officials we interviewed 
consider these placements to be positive options for African American 
children because they are less stressful to the child and maintain 
familial ties. 

States Reported Implementing Strategies Considered Promising for 
Addressing Disproportionality but Also Reported Needing More Technical 
Assistance: 

Researchers and child welfare administrators we interviewed stressed 
that no single strategy could fully address disproportionality in 
foster care, partly because so many interrelated factors contribute to 
it. According to our survey, the strategies that states implemented 
tended to focus on addressing racial and cultural bias in decision 
making, families' problems in accessing support services, and agencies' 
challenges in finding permanent homes so that children can exit foster 
care more quickly. In addition, data collection and analysis were 
considered essential for identifying problems and devising strategies 
to address them, but states reported needing additional assistance in 
this area. 

To help mitigate bias and cultural misunderstanding among decision 
makers, states reported implementing a range of strategies, such as 
including family members in case planning; providing training to 
strengthen caseworkers' competency in working with families from 
various cultures; reaching out to ensure that public officials are not 
inappropriately referring families for abuse and neglect through 
mandated reporting; and implementing the use of certain tools to help 
caseworkers make more systematic decisions regarding the level of a 
child's risk. (See fig. 4.) According to an evaluation in Texas, for 
example, for African American families who participated in case 
planning that included family group decision making, 32 percent of the 
children returned home--more than twice as many as in families who 
received traditional services. 

Figure 4: Number of States Using Strategies to Address 
Disproportionality, Grouped by Type of Factor: 

This figure is a bar graph showing the number of states using 
strategies to address disproportionality, grouped by type of factor. 
The bars represent the strategies intended to: improve decisions by 
reducing bias, improve access to support services, and to reduce the 
length of stay in foster care. The X axis represents the number of 
states using strategy, and the Y axis represents strategies to address 
disproportionality. 

Strategies intended to improve decisions by reducing bias; 
Strategies to address disproportionality: Involving family in case 
planning process; 
Number of states using strategy: 48. 

Strategies intended to improve decisions by reducing bias; 
Strategies to address disproportionality: Cultural competency training; 
Number of states using strategy: 45. 

Strategies intended to improve decisions by reducing bias; 
Strategies to address disproportionality: Outreach to mandated 
reporters; 
Number of states using strategy: 37.  

Strategies intended to improve decisions by reducing bias; 
Strategies to address disproportionality: Recruiting, retaining, and 
promoting culturally competent staff; 	
Number of states using strategy: 36. 

Strategies intended to improve decisions by reducing bias; 
Strategies to address disproportionality: Use of culturally competent 
or validated risk assessment tools; 
Number of states using strategy: 29. 

Strategies intended to improve access to support services; 
Strategies to address disproportionality: Collaboration with 
neighborhood-based services; 
Number of states using strategy: 38. 

Strategies intended to improve access to support services; 
Strategies to address disproportionality: Interagency agreements to 
improve access to services; 
Number of states using strategy: 34. 

Strategies intended to improve access to support services; 
Strategies to address disproportionality: Alternative, dual or 
differential response; 
Number of states using strategy: 25. 

Strategies intended to improve to reduce the length of stay in foster 
care; 
Strategies to address disproportionality: Diligent search for fathers 
or paternal kin; 
Number of states using strategy: 46. 

Strategies intended to improve to reduce the length of stay in foster 
care; 
Strategies to address disproportionality: Recruitment of African 
American adoptive families; 
Number of states using strategy: 38. 

Strategies intended to improve to reduce the length of stay in foster 
care; 
Strategies to address disproportionality: Subsidies for guardianship at 
exit; 
Number of states using strategy: 30. 

Source: GAO analysis of state child welfare survey responses. 

[End of figure] 

To improve families' access to services, states reported collaborating 
with neighborhood-based support organizations, establishing interagency 
agreements to improve access to these services, and implementing an 
alternative approach to the assessment process that emphasizes helping 
families obtain needed supports and services, instead of removing 
children from their families. For example, in Los Angeles County, child 
welfare officials went door to door in minority neighborhoods to find 
service providers beyond those with whom they historically contracted. 
This collaboration helped build trust between the community and the 
child welfare agency and increased families' use of the services 
provided. 

For African American children who cannot ultimately be reunified with 
their parents, states also reported devising strategies to increase the 
number of permanent homes available to them. To increase the options 
for African American children, 46 states reported making diligent 
searches for fathers and other paternal kin who can care for these 
children--not a routine practice until recently. Additionally, a 
federal law passed in 1994 and amended in 1996 require states to 
diligently recruit potential foster and adoptive families that reflect 
the ethnic and racial diversity of children in the state who need 
foster and adoptive homes.[Footnote 22] Likely in response to these 
laws, states have adopted various strategies to recruit greater numbers 
of African American adoptive parents, such as contracting with faith- 
based organizations and convening adoption support teams. However, 
despite these efforts, the number of African American children adopted 
by African American parents has not increased in recent years. In 
addition, HHS's 2001 to 2004 review found that only 21 of 52 states 
were sufficiently recruiting minority families, and one report found 
that the recruitment of minority families was one of the greatest 
challenges for nearly all states.[Footnote 23] 

Using subsidized guardianship as an alternative to adoption may hold 
particular promise for reducing disproportionality, and more than half 
of the states surveyed reported using this strategy.[Footnote 24] 
African American children are more likely than White children to be 
placed with relatives for foster care, which is generally a longer-term 
placement, and these relative caregivers are also more likely than 
nonrelative foster parents to be low-income. They may be unwilling to 
adopt because they may find it difficult financially to forego foster 
care payments or because adoption entails terminating the parental 
rights of their kin. However, subsidized guardianship programs provide 
financial support for foster parents (often relatives) who agree to 
become legally responsible for children but are unable or willing to 
adopt. When Illinois and California implemented two of the largest of 
such programs, they subsequently saw an increase in permanent 
placements for all children. After instituting their subsidized 
guardianship programs, more than 40 percent of children who were in 
long-term relative foster care in both states found permanency. In 
Illinois, this decrease also coincided with a reduction in 
disproportionate numbers of African American children in foster care. 

In addition to these types of strategies, child welfare administrators 
and researchers told us that data collection, analysis, and 
dissemination are needed to inform attempts to address 
disproportionality. These data can include not only disproportionality 
rates but also information that identifies the extent to which 
disproportionality occurs among different age groups, at different 
stages in the child welfare process, and in different locations. For 
example, a California researcher used state data to show that African 
American infants enter foster care at a much higher rate than infants 
of other races or ethnicities and that this disproportionality grows as 
children get older because African American children are also less 
likely to exit foster care. Such data analyses help states and 
localities devise strategies to address the issue and can also be 
useful for building consensus among community leaders and policymakers 
for action. However, some state and local agencies have limited 
capacity to do this. In responding to our survey, 25 states reported 
that receiving technical assistance from HHS in calculating 
disproportionality rates and tracking it over time would be 
useful.[Footnote 25] California state child welfare officials told us 
that without the aid of a university researcher, they would not have 
the ability to help counties that lack the capacity to collect and 
analyze their data. Despite the importance of data analysis, 18 states 
reported that they were not regularly analyzing or using data in their 
efforts to address disproportionality. 

HHS has made technical assistance and information on disproportionality 
available to states at conferences and through various HHS Web sites. 
In addition, the agency is compiling an inventory of tools and best 
practices for addressing disproportionality. Despite these efforts, 
states report that they need further information and technical 
assistance to strengthen their current efforts in addressing 
disproportionality. Accordingly, in our July 2007 report, we 
recommended that HHS take certain actions to further assist states in 
understanding and addressing the nature and extent of racial 
disproportionality in their child welfare systems. In its comments, HHS 
noted that our recommendation was consistent with its efforts to 
provide technical assistance to states for addressing 
disproportionality, but the department did not address the specific 
actions we recommended. We continue to believe that it is important for 
HHS to take these actions to help states address this complex issue. 

States Reported That More Flexibility to Use Federal Funds for 
Prevention Services and Subsidized Guardianship Could Help Reduce 
Disproportionality: 

While states viewed some federal policies as helpful for reducing the 
proportion of African American children in foster care, they also 
expressed concerns regarding policies that limit the use of federal 
funds to provide preventive services and support legal guardianship 
arrangements. As an alternative to adoption, states considered 
subsidized guardianship as particularly helpful in enabling African 
American children to exit foster care but noted that while they can use 
federal child welfare funds to pay subsidies to adoptive parents, they 
cannot do so for guardians.[Footnote 26] 

At least half the states we surveyed noted that the structure of 
federal child welfare funding may contribute to disproportionality by 
favoring foster care placements over services to prevent the removal of 
children from their homes in the first place. Of particular concern to 
28 states in our survey were the caps on funding for preventive and 
family support services under Title IV-B, and 25 states expressed 
concern about their inability to use foster care funds under Title IV- 
E for purposes other than making payments to foster care families. A 
recent GAO report similarly found that preventive and family support 
services were the services most in need of greater federal, state, or 
local resources.[Footnote 27] According to California and Minnesota 
officials, because the majority of federal child welfare funds are used 
for foster care payments instead of preventive services, federal 
funding policies did not align with states' efforts to reduce the 
number of children entering foster care by serving at-risk children 
safely in their homes. However, states do have the freedom to use other 
federal funds, particularly TANF block grants, to provide preventive 
and supportive services to families, and 23 states reported that the 
ability to use these funds contributes to a reduction in the proportion 
of African American children in foster care.[Footnote 28] States face 
competing priorities for the use of their TANF block grant funds, and 
not all states use them for child welfare activities. 

Once children are removed, states reported that federal policies 
promoting adoption were generally helpful; however, states' views were 
mixed on certain requirements specifically intended to eliminate race- 
related barriers to adoption. Policies that promote adoption of African 
American children were generally viewed as helpful, such as allowing 
states to classify African American children as having "special needs," 
which allows them to provide subsidies to adoptive parents, according 
to our survey results. However, views of other requirements were mixed. 
Although 22 states reported that the federal policies requiring states 
to diligently recruit ethnically and racially diverse adoptive families 
would help reduce disproportionality, 9 states reported the federal 
requirements had no effect, and 15 states reported that they were 
unable to tell.[Footnote 29] 

States continue to face challenges in recruiting adoptive families--- 
such as a shortage of willing and qualified parents, especially for 
older African American children, or a lack of resources for recruiting 
initiatives---and more than half of states are not meeting HHS 
performance goals in this area[Footnote 30]. Over the last 5 years, 
African American children and Native American children have 
consistently experienced lower rates of adoption than children of other 
races and ethnicities, and since 2000, adoption rates have reached a 
plateau, according to HHS data and other research. 

As an alternative to adoption, many child welfare officials and 
researchers we interviewed considered subsidizing legal guardianship a 
particularly important way to help African American children exit 
foster care. However, there are no federal subsidies for guardianship 
similar to those available for adoption, which constrains states' 
ability to place children in these arrangements. Seven states have a 
federal demonstration waiver, which allows them to use Title IV-E funds 
for subsidized guardianship. All states did so in a cost-neutral 
manner, as required by the waivers[Footnote 31]. In California and 
Illinois, subsidizing these legal guardianships has been found to 
reduce the number of children in foster care, including African 
American children. In addition, guardianship and adoption both have 
been found to provide comparable levels of stability for children and 
show similar outcomes in terms of emotional and physical health, 
according to an evaluation of Illinois's guardianship program. Because 
of the challenges states face finding adoptive homes for many African 
American children and because legal guardianship may offer a more 
suitable alternative for families who want to permanently care for 
related children without necessarily adopting them, we recommended, in 
our 2007 draft report, that HHS pursue specific measures to allow 
adoption assistance payments to be used for subsidizing legal 
guardianship. In its comments, HHS disagreed with our recommendation, 
stating that its proposal for restructuring child welfare funding, 
known as the Child Welfare Program Option, would give states the option 
to do this. However, HHS has presented this option in its budget 
proposal each year since 2004, but no legislation has been offered to 
date to authorize it. Moreover, even if enacted, it is unknown how many 
states would choose to implement this funding structure. Because the 
viability of HHS's proposal is uncertain, in our final July 2007 
report, we suggested that Congress consider amending current law to 
allow adoption assistance payments to be used for legal guardianship. 
To date, the House of Representatives has passed a bill with a 
provision to allow states to use federal funds to subsidize legal 
guardianship for relatives, and the Senate has introduced a bill with a 
similar provision. 

Mr. Chairman, this concludes my statement. I would be pleased to 
respond to any questions you or other Members of the Subcommittee may 
have. 

GAO Contacts and Acknowledgments: 

For further information about this testimony, please contact me at 
(202) 512-7215 or [email protected]. Individuals making key contributions 
to this testimony include Kim Siegal, Theresa Lo, Deborah A. Signer, 
Gale Harris, and Charlie Willson. 

[End of section] 

Related GAO Products: 

Disconnected Youth: Federal Action Could Address Some of the Challenges 
Faced by Local Programs That Reconnect Youth to Education and 
Employment. GAO-08-313. Washington, D.C.: February 28, 2008. 

African American Children in Foster Care: Additional HHS Assistance 
Needed to Help States Reduce the Proportion in Care. GAO-07-816. 
Washington, D.C.: July 11, 2007. 

Child Welfare: Improving Social Service program, Training, and 
Technical Assistance Information Would Help Address Long-standing 
Service-level and Workforce Challenges. GAO-07-75. Washington, D.C.: 
October 6, 2006. 

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. 

HHS Actions Could Improve Coordination of Services and Monitoring of 
States' Independent Living Programs. GAO-05-25. Washington, D.C.: 
November 18, 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 and Juvenile Justice: Federal Agencies Could Play a 
Stronger Role in Helping States Reduce the Number of Children Placed 
Solely to Obtain Mental Health Service. GAO-03-397. Washington, D.C.: 
April 23, 2003 (reissued on August 11, 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. 

Foster Care: Kinship Care Quality and Permanency Issues. GAO-99-32. 
Washington, D.C.: May 6, 1999. 

Foster Care Implementation of the Multiethnic Placement Act Poses 
Difficult Challenges. GAO-98-204. Washington, D.C.: September 14, 1998. 

[End of section] 

Footnotes: 

[1] Racial disproportionality refers to the extent that children of a 
certain race or ethnic group are over-or underrepresented in foster 
care relative to their proportion in the population. 

[2] The difference in length of time in foster care is based on 2004 
Adoption and Foster Care Analysis and Reporting System data because we 
were not able to obtain more recent data in time for this testimony. 

[3] See the National Incidence Study (NIS), a congressionally mandated, 
periodic effort of the National Center on Child Abuse and Neglect to 
obtain information about the current incidence of child abuse and 
neglect in the United States. NIS-1 was published in 1981, NIS-2 in 
1988, and NIS-3 in 1996. The NIS-3 findings are based on a nationally 
representative sample of over 5,600 professionals in 842 agencies 
serving 42 counties in the United States. Reports from the NIS-4 are 
anticipated in December 2008. 

[4] Children also enter foster care for other reasons, such as their 
parentsï¿½ illness, death, or disability or because of the childrenï¿½s 
delinquent behavior and truancy. 

[5] We are using the term "policy" in this testimony to include federal 
laws, regulations, and informal agency guidance. 

[6] GAO, African American Children in Foster Care: Additional HHS 
Assistance Needed to Help States Reduce the Proportion in Care, GAO-07-
816 (Washington, D.C.: July 11, 2007). 

[7] We surveyed the 50 states and the District of Columbia and received 
responses from 47 states and the District of Columbia. 

[8] Although we focused on African American children in this testimony 
and our report, our report also noted points of similarity or 
difference with children of other races and ethnicities as appropriate. 
Native Americans are also overrepresented nationally, but some are 
affected by different child welfare laws and oversight authority than 
African Americans, making comparisons challenging. See GAO-07-816 for 
more information. 

[9] Although racial disproportionality is most severe and pervasive for 
African American children, Native American children also experience 
higher rates of representation in foster care than children of other 
races or ethnicities. It is also important to understand local 
variations for Hispanic and Asian children, since they are 
underrepresented in foster care nationally and in most states but are 
overrepresented in some counties and states. For disproportionality 
rates for African American, White, Hispanic, Asian, and Native American 
children by state in fiscal year 2004, see appendix II of GAO-07-816. 

[10] The Adoption and Safe Families Act of 1997 (Pub. L. No. 105-89) 
recognized legal guardianship under federal law as another option for 
placing children in permanent homes. Prior to this, children's options 
for exiting foster care included being reunified with their parents, 
adopted by a relative or nonrelative, or emancipated from foster care 
when they had reached a certain age, usually 18. 

[11] These data were reported in the Urban Institute 2005 Child Welfare 
Survey in May 2006. This funding analysis is the most recent available 
that shows federal funding used specifically for child welfare. 

[12] The term "special needs" is used in a distinct way in Title IV-E 
programs. In order to be considered a child with special needs for the 
purpose of providing adoption assistance payments, states must 
determine that the child should not return home and have a factor or 
condition that would make the child difficult to place for adoption 
without such payments. States are provided discretion under federal law 
to determine what these factors or conditions are and may include age, 
membership in a sibling or minority group, or having a medical or 
developmental disability that would make placement difficult. There are 
additional eligibility requirements to obtain adoption assistance 
subsidies as well. 

[13] For further information on Title IV-B funds, see GAO, Child 
Welfare: Enhanced Federal Oversight of Title IV-B Could Provide States 
Additional Information to Improve Services, GAO-03-956 (Washington, 
D.C.: Sept. 12, 2003). 

[14] U.S. Census American Community Survey, 2006. 

[15] A. Sedlak and D. Broadhurst, Executive Summary of the Third 
National Incidence Study of Child Abuse and Neglect. A report prepared 
for the U.S. Department of Health and Human Services, (Washington, 
D.C., 1996). 

[16] U.S. Census American Community Survey data from 2006. 

[17] Some child welfare officials also pointed out that lower income 
families may be referred to the child welfare system in order to gain 
access to such services. 

[18] Ann F. Garland et al., "Racial and Ethnic Variations in Mental 
Health Care Utilization Among Children in Foster Care," Children's 
Services: Social Policy, Research and Practice, 3(3): 133-146 (2000). 

[19] For example: R. L. Hampton and E. Newberger, "Child Abuse 
Incidence and Reporting by Hospitals: Significance of Severity, Class 
and Race," American Journal of Public Health (75) 1: 56-60 (1985). For 
information on other studies, see Robert Hill, Synthesis of Research on 
Disproportionality in Child Welfare: An Update (Casey-Center for the 
Study of Social Policy Alliance for Racial Equity in the Child Welfare 
System, 2006). 

[20] Robert B. Hill, Synthesis of Research on Disproportionality in 
Child Welfare: An Update (Casey-Center for the Study of Social Policy 
Alliance for Racial Equity in the Child Welfare System, 2006). 

[21] According to our analysis of Adoption and Foster Care Analysis and 
Reporting System (AFCARS) fiscal year 2004 data, African American 
children are even more disproportionally represented in foster care at 
older ages than other children. 

[22] See the Multi-Ethnic Placement Act of 1994 (Pub. L. No. 103-382, 
ï¿½ï¿½ 551-553), as amended in 1996 by the Interethnic Adoption Provisions 
included in the Small Business Job Protection Act (Pub. L. No. 104-88, 
ï¿½ 1808), referred to as MEPA/IEP. 

[23] Urban Institute Child Welfare Research Program, Foster Care 
Adoption in the United States: A State by State Analysis of Barriers 
and Promising Approaches (November 2004). 

[24] A 2006 report by Generations United found that a total of 35 
states and the District of Columbia were subsidizing legal 
guardianships, generally through federal IV-E waivers; federal block 
grants, such as TANF; or state and local funds. (See [hyperlink, 
http://ipath.gu.org/documents/A0/GU-GeneralFactSheetJune.pdf].) Three 
of these states, Maryland, New Jersey, and Rhode Island, did not 
respond to our survey on disproportionality. Other states may subsidize 
guardianships but not limit these subsidies to families involved in the 
state child welfare system. 

[25] Although 18 states in our survey believed that having reporting 
requirements on disproportionality rates in HHS's Child and Family 
Services Review process would be useful, nearly as many responded that 
it would not be useful. HHS officials told us that this process was 
governed by statute and that they could not add such a requirement. 

[26] As of May 2007, seven states that were granted waivers to use 
Title IV-E funds to provide services and supports other than foster 
care maintenance payments were actively using Title IV-E funds to 
provide subsidies for guardianships. 

[27] See GAO, Child Welfare: Improving Social Service program, 
Training, and Technical Assistance Information Would Help Address Long-
standing Service-level and Workforce Challenges, GAO-07-75 (Washington, 
D.C.: Oct. 6, 2006). 

[28] As with all block grants, state officials determine the use of 
these funds and their program priorities. 

[29] MEPA/IEP also prohibits foster care and adoption agencies 
receiving federal funds from delaying or denying placement decisions on 
the basis of race, color, or national origin. Fifteen states reported 
that encouraging race-neutral adoptions would help reduce 
disproportionality, 18 states responded that this policy had no effect, 
and 12 states reported that they were unable to tell. 

[30] This is based on HHS data from between 2001 and 2004. Challenges 
in recruiting are consistent with survey responses in an earlier GAO 
study as well. See GAO-07-75. 

[31] According to HHS officials, these programs can be cost-neutral 
because the administrative costs associated with maintaining a child in 
foster care are no longer incurred with permanent legal guardianships. 

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