    Foster Care: HHS Could Better Facilitate the Interjurisdictional Adoption
    Process (Letter Report, 11/19/1999, GAO/HEHS-00-12).

    Pursuant to a legislative requirement, GAO provided information on
    interjurisdictional adoption issues, focusing on the: (1) number of
    foster children who are available and waiting for an adoptive home to be
    identified; (2) actions taken by state and county child welfare agencies
    and nonprofit organizations to improve the adoption process when
    prospective adoptive families and foster children live in different
    jurisdictions; and (3) actions taken by the federal government to
    improve the adoption process when prospective adoptive families and
    foster children live in different jurisdictions.

    GAO noted that: (1) at any given time about 1.5 percent of foster
    children--about 8,000--are legally available for adoption and waiting
    for an adoptive home but have no prospects for adoption; (2) this number
    is small because, of those foster children who are adopted, about 78
    percent are adopted by their foster parents or relatives; (3) virtually
    all of the remaining foster children who are waiting for adoptive homes
    are among the most difficult to place due to their older age, need to be
    placed with siblings, or other special considerations; (4) because these
    children are hard to place, they are likely to be candidates for
    adoptive placement across jurisdictions; (5) public child welfare
    agencies have directed their efforts toward the initial step in the
    interjurisdictional adoption process--recruitment of prospective
    adoptive families--and have done less to improve the other steps in the
    adoption process because they are largely beyond their legal authority
    to change; (6) for example, these agencies are using traditional
    recruiting methods in new ways, as was the case in two of the three
    states GAO visited; (7) these states enter into contracts with other
    states to conduct recruitment activities in geographic areas outside the
    public child welfare agency's jurisdiction; (8) the agencies also use
    Internet web sites, which can be accessed from anywhere in the nation,
    to reach beyond their borders to recruit prospective adoptive families
    and publicize waiting children; (9) nonprofit organizations that are
    working to improve interjurisdictional adoption processes have targeted
    their efforts at those steps in the adoption process that correspond to
    their professional interests; (10) such interests include nationwide
    recruitment of adoptive homes for hard-to-place waiting foster children
    as well as issues related to improvements in the use of homestudies and
    the Interstate Compact on the Placement of Children (ICPC) process; (11)
    the Department of Health and Human Services (HHS) leadership could
    facilitate improvements in the interjurisdictional adoption process,
    much of which is outside the legal authority of individual public child
    welfare agencies; and (12) HHS has developed plans to address problems
    in the interjurisdictional adoption process and implemented some
    actions.

    --------------------------- Indexing Terms -----------------------------

     REPORTNUM:  HEHS-00-12
         TITLE:  Foster Care: HHS Could Better Facilitate the
    	     Interjurisdictional Adoption Process
          DATE:  11/19/1999
       SUBJECT:  Foster children
    	     State programs
    	     Federal/state relations
    	     State/local relations
    	     Child adoption
    	     Interagency relations
    IDENTIFIER:  Interstate Compact for the Placement of Children

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    Cover
    ================================================================ COVER

    Report to Congressional Requesters

    November 1999

    FOSTER CARE - HHS COULD BETTER
    FACILITATE THE INTERJURISDICTIONAL
    ADOPTION PROCESS

    GAO/HEHS-00-12

    Interjurisdictional Adoption

    (116026)

    Abbreviations
    =============================================================== ABBREV

      AAICPC - Association of Administrators of the Interstate Compact on
         the Placement of Children
      APHSA - American Public Human Services Association
      ASFA - Adoption and Safe Families Act of 1997
      HHS - Department of Health and Human Services
      ICPC - Interstate Compact on the Placement of Children

    Letter
    =============================================================== LETTER

    B-281621

    November 19, 1999

    The Honorable William V.  Roth, Jr.
    Chairman
    The Honorable Daniel Patrick Moynihan
    Ranking Minority Member
    Committee on Finance
    United States Senate

    The Honorable Bill Archer
    Chairman
    The Honorable Charles B.  Rangel
    Ranking Minority Member
    Committee on Ways and Means
    House of Representatives

    The Adoption and Safe Families Act of 1997 (ASFA) is the most recent
    federal legislation to emphasize the importance of permanence in the
    lives of the 520,000 children in foster care and, in particular, the
    importance of adoption when foster children cannot safely and quickly
    return to the care of their birth parents.  This act includes a
    provision prohibiting states from delaying or denying the adoption of
    a foster child when an approved family is available in a jurisdiction
    different from the one in which the child resides.  The Department of
    Health and Human Services (HHS) is responsible for monitoring states'
    adherence to this prohibition and to other provisions in ASFA.  The
    act also requires us to study and consider how to improve procedures
    and policies to facilitate the timely and permanent adoptions of
    children across state and county jurisdictions--referred to as
    interjurisdictional adoptions.

    As agreed with committee staff, in response to the requirement in
    ASFA that we report to the Congress on interjurisdictional adoption
    issues, we are providing information on (1) the number of foster
    children who are available and waiting for an adoptive home to be
    identified, (2) the actions taken by state and county child welfare
    agencies\1 and nonprofit organizations to improve the adoption
    process when prospective adoptive families and foster children live
    in different jurisdictions, and (3) the actions taken by the federal
    government to improve the adoption process when prospective adoptive
    families and foster children live in different jurisdictions.  In
    particular, in ASFA the Congress identified four steps related to
    timely and permanent interjurisdictional adoptions that our study
    should address.  First, states and counties may need to improve
    procedures to recruit prospective adoptive parents from states or
    counties different from the one in which adoptable children reside.
    Second, states and counties may need to improve procedures for the
    acceptance of homestudies when the studies are done in a different
    state or county.\2 Third, states may need to assure their acceptance
    of termination of parental rights orders and adoption decrees issued
    by a court in a different state.\3 Fourth, states may need to improve
    procedures for administering and implementing the Interstate Compact
    on the Placement of Children (ICPC).\4 To develop this information,
    we contacted federal, state, and county child welfare officials and
    experts affiliated with nonprofit organizations interested in
    interjurisdictional adoption issues.  We also conducted case studies
    in three states--California, Florida, and Missouri.  Appendix I
    describes our scope and methodology.  We conducted our review from
    November 1998 to August 1999 in accordance with generally accepted
    government auditing standards.

    --------------------
    \1 In this report, we use the phrase public child welfare agencies
    to refer to both state and county child welfare agencies.

    \2 A homestudy is a written report used to approve individuals as
    adoptive parents.  See the Background section of this report for a
    further description of homestudies and their use in the adoption
    process.

    \3 A court order to terminate parental rights severs the legal
    relationship between parent and child, thus making the child eligible
    for adoption.  An adoption decree finalizes the adoption process and
    provides full parental rights to the adopting parent.

    \4 The ICPC is a uniformly enacted statute that provides the legal
    framework for placing children in adoptive homes across state lines.
    The Background section of this report further describes this compact
    and its process.

       RESULTS IN BRIEF
    ------------------------------------------------------------ Letter :1

    At any given time, about 1.5 percent of foster children--about
    8,000--are legally available for adoption and waiting for an adoptive
    home but have no current prospects for adoption.  This number is
    small because, of those foster children who are adopted, about 78
    percent are adopted by their foster parents or relatives.  Virtually
    all of the remaining foster children who are waiting for adoptive
    homes are among the most difficult to place due to their older age,
    their need to be placed with siblings, or other special
    considerations.  Because these children are hard to place, they are
    likely to be candidates for adoptive placement across jurisdictions.

    Public child welfare agencies have directed their efforts toward the
    initial step in the interjurisdictional adoption process--recruitment
    of prospective adoptive families--and have done less to improve the
    other steps in the adoption process because they are largely beyond
    their legal authority to change.  For example, these agencies are
    using traditional recruiting methods in new ways, as was the case in
    two of the three states we visited.  These states enter into
    contracts with other states to conduct recruitment activities in
    geographic areas outside the public child welfare agency's
    jurisdiction.  The agencies also use Internet web sites, which can be
    accessed from anywhere in the nation, to reach beyond their borders
    to recruit prospective adoptive families and publicize waiting
    children.  Nonprofit organizations that are working to improve
    interjurisdictional adoption processes have targeted their efforts at
    those steps in the adoption process that correspond to their
    professional interests.  Such interests include nationwide
    recruitment of adoptive homes for hard-to-place waiting foster
    children as well as issues related to improvements in the use of
    homestudies and the ICPC process.

    HHS leadership could facilitate improvements in the
    interjurisdictional adoption process, much of which is outside the
    legal authority of individual public child welfare agencies.  HHS has
    developed plans to address problems in the interjurisdictional
    adoption process and implemented some actions.  For example, as part
    of its technical assistance efforts, HHS provided guidelines for
    state legislation on termination of parental rights and assistance to
    states on ICPC issues.  However, because the plans were made in
    response to two presidential directives regarding adoption, HHS
    Office of Inspector General recommendations, and the passage of ASFA,
    they were implemented independently rather than as part of an
    organized strategy.  We are recommending that HHS better coordinate
    its efforts to facilitate improvements to the interjurisdictional
    adoption process.

       BACKGROUND
    ------------------------------------------------------------ Letter :2

    ASFA established as a federal priority the safe and timely placement
    of foster children in permanent homes, even if those homes are
    located in a jurisdiction different from that of the waiting
    children.  Among the many provisions in ASFA, three are specific to
    interjurisdictional adoption issues.  First, the act requires state
    plans\5 to specify that a state will not deny or delay the placement
    of a child for adoption when an approved family\6 is available
    outside of the jurisdiction with responsibility for handling the case
    of the child.  Second, state plans\7 must contain assurances that the
    state will develop plans for the effective use of
    cross-jurisdictional resources to facilitate timely adoptive or
    permanent placements for waiting children.  Third, the act
    established a penalty against federal foster care funds for states
    that are found to deny or delay the placement of a child for adoption
    when an approved family is available outside of the jurisdiction, or
    that fail to promptly grant a fair hearing to an individual who
    alleges such a violation.  HHS has a limited role in determining the
    policies and procedures used by child welfare programs, including
    foster care programs.  HHS is responsible for issuing federal foster
    care regulations containing minimal procedural requirements,
    monitoring states' compliance with them, and administering federal
    foster care funding.

    The public child welfare system, which oversees the adoption of
    foster children, is composed mainly of state and local child welfare
    agencies and state juvenile dependency courts.  State laws provide
    more detail and specificity regarding the circumstances in which
    adoptions may occur than do federal laws and set the parameters,
    consistent with federal constitutional and statutory requirements,
    under which child welfare systems operate.  For example, state laws
    specify the legal grounds for terminating parental rights to free a
    child to be adopted.  The child welfare agencies promulgate the
    regulations, policies, and procedures for foster care programs and
    administer those programs.  Thus, state child welfare agencies have a
    central role in regulating the activities of foster care programs,
    including the adoption of foster children.  In 12 states, that
    responsibility is delegated to local child welfare agencies.  State
    courts are responsible for reviewing child welfare agency actions for
    individual foster children and their families and taking legal
    actions as necessary to protect children.  Such actions include
    ordering the placement of foster children in temporary homes,
    presiding over periodic hearings to plan for a child's permanent
    placement, terminating the parental rights of birth parents when
    their children cannot be safely returned to their care, and granting
    adoption decrees to adoptive parents.

    The ICPC provides the legal framework for the placement of children
    across state lines by public and private agencies, courts, and--in
    some cases--private individuals.  It is a statute enacted uniformly
    by all 50 states, the District of Columbia, and the U.S.  Virgin
    Islands.  A nonprofit organization, the Association of Administrators
    of the Interstate Compact on the Placement of Children (AAICPC),
    provides guidance to states in interpreting and revising ICPC.  Use
    of ICPC ensures that appropriate state laws are followed before a
    placement is made and that children placed out-of-state receive the
    protections and services that would be provided if they remained in
    their home states.  States provide these services on a reciprocal
    basis.  Of the adoptive placements made under ICPC, few are
    placements of foster children; almost all interstate adoptive
    placements involve adoptions either between individuals or through
    private adoption agencies.  However, all foster care placements
    across state lines must be processed through the compact.  HHS has no
    direct role in ICPC administration.  Figure 1 shows the ICPC process
    for obtaining approval for an out-of-state placement for a foster
    child.  Figure 2 shows the ICPC process once the decision has been
    made to place a child out-of-state.

       Figure 1:  ICPC Process to
       Request Homestudy and Placement
       of Foster Child Out-of-State

       (See figure in printed
       edition.)

    \a In a few states, responsibility for contacting the state where the
    prospective adoptive parent resides has been delegated to the local
    child welfare agency.  In those locations, the ICPC state compact
    administrator receives copies of the paperwork but may not be
    responsible for forwarding it.

    Source:  GAO analysis.

       Figure 2:  ICPC Process After
       Homestudy Is Obtained and
       Placement of Foster Child Is
       Approved

       (See figure in printed
       edition.)

    \a In a few states, responsibility for contacting the state where the
    prospective adoptive parent resides has been delegated to the local
    child welfare agency.  In those locations, the ICPC state compact
    administrator receives copies of the paperwork but may not be
    responsible for forwarding it.

    Source:  GAO analysis.

    Prospective adoptive parents come into the foster child's life in a
    variety of ways and through a long, complex process, particularly
    when a hard-to-place child is involved.  Public child welfare
    agencies engage in outreach and other recruitment efforts to attract
    individuals to be foster and adoptive parents and undertake a variety
    of concurrent activities so that a waiting foster child can be placed
    with an appropriate prospective adoptive parent.  Most adoptive
    parents begin their relationship with the child as the child's foster
    parents.  Others are relatives of the foster child.  A small
    percentage of adoptive parents come into the foster child's life
    after the child's foster parents and relatives have declined to adopt
    the child and another home must be sought for the child.  Regardless
    of the way in which a prospective adoptive parent enters the process,
    it can take a prospective adoptive parent 1 to 3 years from the
    initial contact with a child welfare agency to finalization of an
    adoption.  Appendix II shows how prospective adoptive parents enter
    the child welfare system, general activities child welfare agencies
    undertake to make an appropriate adoptive placement, and--when an
    interjurisdictional placement is involved--when the ICPC is invoked.

    The homestudy is a key component in the process of becoming a foster
    or adoptive parent.  Homestudies are written reports that are
    generally prepared by a child welfare caseworker.  The studies assess
    the financial situation, current and previous relationships, life
    experiences, and parenting abilities of a person wishing to become an
    adoptive parent.  The process also usually includes checks for
    criminal activity by the prospective adoptive parent.  The homestudy
    process is generally combined with mandatory training for prospective
    foster or adoptive parents, a combination that typically takes 3
    months to complete.  An applicant is approved as a foster or adoptive
    parent only after the homestudy process is completed, a written
    report of its findings is approved by a child welfare agency, and the
    home is found to meet safety standards.  Agencies may then consider
    whether a prospective adoptive parent would be an appropriate
    caregiver for a particular foster child.  Homestudies must be
    updated, in some locations as frequently as annually, in order for a
    prospective adoptive parent to retain approved status.  In addition,
    homestudies may need to be updated at the time a prospective adoptive
    parent is considered as a placement for a specific foster child in
    order to determine if the person can meet that child's special needs.
    Although no standardized national homestudy format exists, appendix
    III contains an example of one state's recommended homestudy
    format--an example that reflects the scope and detail typically found
    in homestudies.

    --------------------
    \5 State plans are required under title IV-E of the Social Security
    Act in order for states to receive federal foster care funds for
    maintenance of foster children, specific administration costs
    associated with foster care programs, and adoption assistance.

    \6 Approved family generally refers to an individual with an
    approved homestudy.  However, HHS has not issued regulations to
    define this term as used in ASFA.

    \7 Other state plans are required under title IV-B of the Social
    Security Act in order for states to receive federal funds for child
    welfare services.

          FEW FOSTER CHILDREN ARE
          AVAILABLE AND WAITING FOR
          ADOPTIVE HOMES BUT MOST WHO
          WAIT ARE DIFFICULT TO PLACE
    ---------------------------------------------------------- Letter :2.1

    At any given time, an estimated 1.5 percent of foster children--about
    8,000--are available for adoption and, as yet, no adoptive family has
    been identified for them.  About one-third of foster children will
    never return to their birth parents, leaving those children in need
    of permanent homes.  Yet few of the children in need of new permanent
    homes are, at any given time, legally freed from their birth parents
    and thus available for adoption.  Furthermore, HHS estimates that of
    the foster children who are adopted, 78 percent will be adopted by
    their foster parents or relatives.  Figure 3 shows the likely
    permanency outcomes for foster children in care at any given time.

       Figure 3:  Anticipated Outcomes
       for Foster Children

       (See figure in printed
       edition.)

    \a Other outcomes includes aging out of the foster care system at age
    18 and, in some circumstances, legal guardianship.  While in foster
    care, children who have other outcomes live in a variety of
    arrangements including the homes of relatives, foster homes, group
    homes, and residential care facilities.

    \b For this grouping in the figure, we expanded the information to
    indicate the likely legal status of children in that grouping, at any
    given time, prior to attaining the anticipated outcome.

    Source:  GAO analysis of HHS data.

    While estimates of the number of adoptions across state lines vary,
    the number of interjurisdictional adoptions is likely small.  HHS
    administrative data place the number of finalized adoptions of foster
    children across state lines at less than 250 in 1998.  Furthermore,
    the Office of Inspector General noted that one-half of states' ICPC
    offices do not know how many children they place through ICPC due to
    poor quality data and ineffective tracking techniques.

    The foster children who are not adopted by their foster parents or
    relatives are among the most difficult to place.  Almost all of them
    have special needs.  Typically, they are school age, have physical or
    mental impairments, have siblings who should be placed with them, and
    are children of color.  HHS reported that of the children freed for
    adoption, more than 35 percent are teenagers and an additional 17
    percent are between the ages of 9 and 12 years.  In general, within
    the foster care population, only these hard-to-place and legally
    freed children are likely to be candidates for adoptive placements
    across jurisdictions.

       PUBLIC CHILD WELFARE AGENCIES
       FOCUS ON RECRUITMENT WHILE
       NONPROFIT ORGANIZATIONS ADDRESS
       A RANGE OF ISSUES
    ------------------------------------------------------------ Letter :3

    Public child welfare agencies have directed their efforts toward the
    initial step in the interjurisdictional adoption process--recruitment
    of prospective adoptive families--and have done less to improve the
    other steps in the adoption process because changing those steps is
    largely beyond their legal authority.  Nonprofit organizations
    working to improve interjurisdictional adoption processes have
    targeted their efforts at those steps in the adoption process that
    correspond to the organizations' areas of interest.  Such interests
    include nationwide recruitment of adoptive homes for hard-to-place
    waiting foster children as well as issues related to improvements in
    the use of homestudies and the ICPC process.

          PUBLIC CHILD WELFARE
          AGENCIES FOCUS ON IMPROVING
          THE USE OF TRADITIONAL AND
          INTERNET RECRUITMENT METHODS
    ---------------------------------------------------------- Letter :3.1

    In the initial step of the interjurisdictional adoption
    process--recruitment of prospective adoptive families--public child
    welfare agencies are attempting to reach beyond their borders by
    using traditional recruitment methods.  In addition to using TV
    spots, newspaper stories, and billboards, two of the three states we
    visited also contract with other organizations for recruitment
    services; the contracts include provisions for recruitment across
    jurisdictional lines.  For example, Missouri contracts with other
    organizations to recruit prospective foster and adoptive families
    from several bordering states as well as from within the state.  In
    Florida, Broward County contracts with other organizations for
    recruitment within its borders and in adjoining counties.  Public
    child welfare agencies also participate in voluntary
    networks--referred to as adoption exchanges--to identify adoptive
    families for hard-to-place foster children.  These voluntary networks
    provide child welfare agencies with the opportunity to share
    information about children who need adoptive homes and approved
    families who want to adopt a foster child.

    Public child welfare agencies are also using the Internet to expand
    their ability to recruit prospective adoptive families.  Almost all
    state child welfare agencies have set up their own public Internet
    web sites, which can be accessed from anywhere in the nation, to
    promote adoption of foster children; 30 states include photolistings
    of freed and waiting children.\8 Appendix IV lists public Internet
    web sites set up by state child welfare agencies and a listing of the
    types of information that the public can access.  States have taken a
    variety of approaches in determining which children to publicize on
    their child welfare web sites.  Some state web sites have
    photolistings that picture and describe all foster children in a
    state who have been freed and are waiting for an adoptive home; other
    states show only the hardest-to-place children; still others show a
    representative sample of their available foster children.

    In general, states have not evaluated the effectiveness of their
    sites as a means of recruiting potential adoptive families
    nationwide.  While many state web sites welcome inquiries from all
    prospective adoptive families nationwide, three state web sites
    specify that the state will consider only applicants from within the
    state.  Finally, public child welfare agencies also use the Internet
    to participate in privately operated adoption exchanges on
    password-protected sites that can be accessed only by caseworkers.

    Public child welfare agencies do not have authority to specify the
    contents of a homestudy prepared in another jurisdiction, but the
    three states we visited have taken limited actions to increase the
    acceptability of the ones they receive from other states.  For
    example, if the public child welfare agency requests a homestudy on a
    prospective adoptive parent in another jurisdiction, the requesting
    agency notifies the agency preparing the homestudy of its specific
    requirements so that they can be included in the study.  If the
    public child welfare agency receives an approved homestudy from
    outside the agency's jurisdiction, it contacts the agency that
    prepared and approved the homestudy for additional information that
    will allow the homestudy to meet local requirements and allow the
    agency to assess the appropriateness of prospective adoptive parents.
    Additionally, in two of the states we visited that contract with
    other agencies to conduct recruitment activities, the contracts
    specify the content of the homestudies done by the contractors.
    Thus, homestudies done by the contractor will meet the criteria set
    for local homestudies.

    As is the case with homestudies, public child welfare agencies also
    have only limited authority to improve the acceptance of court orders
    across jurisdictions.  The Constitution sets the framework for states
    to accept the court orders of other states but neither the Congress
    nor case law has specifically addressed acceptance of termination of
    parental rights orders or adoption decrees.\9 In addition, the
    Supreme Court has ruled that states are not obligated to honor
    judicial actions of other states in situations where minimum
    standards of due process have not been provided to those affected.
    HHS officials and experts told us that there is little to suggest
    that interjurisdictional adoptions of foster children were delayed or
    denied because termination of parental rights orders or adoption
    decrees were not accepted across jurisdictions.  One of the states we
    visited (Florida) specifies in its adoption statutes that the state
    will accept such orders from any other state.

    Although public child welfare agencies can control only the steps in
    the ICPC process that occur within their own state, two of the states
    we visited, Florida and Missouri, have taken actions to avoid delays
    within their ICPC offices.\10 Officials in the three states we
    visited told us that they process ICPC requests promptly and Florida
    has implemented performance goals to further improve the timeliness
    of its processes.  In Florida, the ICPC office specified that ICPC
    requests related to adoption are to be processed through its office
    within 3 days.  Missouri has also instituted agreements with two of
    its neighboring states with the goal of alleviating delays in
    beginning homestudies requested through the ICPC office.  However,
    the agreements--referred to as border agreements--have been used
    infrequently, even though one of the agreements has been in place for
    more than a year.  State officials were surprised that the 1-year-old
    agreement was used infrequently.  Officials from the two states
    involved have decided to review the agreement with their respective
    staff to emphasize the agreement's value in speeding the start of the
    homestudy process.

    --------------------
    \8 Public child welfare agency's public Internet sites protect the
    privacy of foster children listed on them.  In general, sites limit
    information about the children to first name and age of a child and a
    brief description of a child's special needs.  As an added safeguard,
    courts must grant permission for public distribution of information
    about the foster children under their jurisdiction.

    \9 The acceptance of court orders of other statesotherwise called
    the granting of full faith and creditis governed by Article IV,
    Section 1 of the U.S.  Constitution.  It states, Full faith and
    credit shall be given in each State to the public acts, records, and
    judicial proceedings of every other State.  And the Congress may by
    general laws prescribe the manner in which such acts, records and
    proceedings shall be proved, and the effect thereof. In at least
    five instances since 1948, the Congress passed laws to clarify the
    application of this clause.  Clarifying legislation usually specifies
    the instances in which full faith and credit is to be granted, such
    as is the case with child support orders.  In one instance, the
    Defense of Marriage Act, the legislation specifies that full faith
    and credit need not be extended to marriages between certain parties.

    \10 For placement of children in out-of-state foster or adoptive
    homes, California delegates responsibility for the in-state ICPC
    process to its counties.  Only children whose out-of-state placements
    are in group homes are handled by the state ICPC office.

          NONPROFIT ORGANIZATIONS ALSO
          ADDRESS ISSUES IN
          INTERJURISDICTIONAL ADOPTION
          PROCESS
    ---------------------------------------------------------- Letter :3.2

    Nonprofit organizations have initiated national efforts that cover
    many of the steps in the interjurisdictional adoption process.  The
    National Adoption Center, the American Public Human Services
    Association (APHSA), and its affiliate, AAICPC, are among the
    nonprofit organizations leading such efforts.  The National Adoption
    Center operates two recruitment-related Internet sites.  APHSA
    initiated efforts to address issues related to homestudies, and its
    affiliate provides recommendations to member states to improve the
    ICPC process.

    The National Adoption Center established and maintains\11 two
    recruitment-related Internet sites--a public national photolisting
    service to publicize foster children who are currently available and
    waiting for adoption, and a secure web site with additional resources
    for use by child welfare agencies.\12 The public Internet web site,
    called FACES OF ADOPTION:  America's Waiting Children,\13 listed
    about 1,800 waiting children from about 38 states as of August 1999.
    The center anticipates that additional states will soon become
    members, resulting in some increase in the number of children listed
    on its site in the coming months.  Prospective adoptive parents can
    request information about a specific child from the center.  The
    center's private Internet web site, called NAE-Online, contains
    additional information about the children and also contains
    information about families with approved homestudies.  The site is
    accessible only to child welfare agencies that pay a membership fee
    to the center.  The center estimated that during a 2-month period in
    summer 1999, about 30 foster children were placed for adoption as a
    result of their listings being seen on FACES OF ADOPTION.

    In February 1999, APHSA convened a task force called the Geographic
    Barriers Task Force of APHSA to Identify Barriers to Placements
    across State Lines to explore issues related to the use of
    homestudies across jurisdictions.  The membership of the task force
    is still evolving, although it is expected to include representatives
    of state child welfare agencies, child welfare advocacy
    organizations, the AAICPC, and the Association of Administrators of
    the Interstate Compact on Adoption and Medical Assistance.\14 As of
    August 1999, the task force had not set a time frame for completion
    of its work or identified the scope of the work.

    AAICPC provides guidance to states in interpreting ICPC and
    recommendations on procedures.  This group consists of
    representatives of ICPC administrators from each state.  AAICPC
    members implement procedures that they believe will increase the
    timeliness of the ICPC process.  For example, ICPC Regulation 7
    allows agencies to request an expedited homestudy when a child is
    likely to be placed with a relative residing in another state.

    --------------------
    \11 The Children Awaiting Parents, Inc., cosponsors the public web
    site.

    \12 Similar to web sites set up by state child welfare agencies, the
    center's web site protects the privacy of foster children in the
    photolisting service by providing only general descriptive
    information about the children listed.

    \13 The site can be found on the Internet at http://www.adopt.org.

    \14 The Interstate Compact on Adoption and Medical Assistance
    provides the legal framework to ensure that foster children who are
    eligible for federal adoption assistance continue to receive medical
    and other services after adoption.  The compact is a statute
    uniformly enacted by 30 states.  The Association of Administrators of
    the Interstate Compact on Adoption and Medical Assistance administers
    this compact under a cooperative agreement with HHS.

       HHS HAS IDENTIFIED PROBLEMS
       THAT AFFECT INTERJURISDICTIONAL
       ADOPTIONS BUT LACKS AN
       ORGANIZED STRATEGY
    ------------------------------------------------------------ Letter :4

    In response to presidential, legislative, and departmental actions,
    HHS identified problems that ranged across the interjurisdictional
    adoption process, but its plans were not part of an organized
    strategy.  HHS identified problems ranging from a shortage of
    adoptive families for special needs foster children to placements by
    the courts that violate ICPC.  HHS' action plans did not address all
    identified problems and other actions are behind schedule.  As the
    federal government's primary agency for foster care and adoption
    issues, HHS has a key role in providing leadership to assist states
    in resolving interjurisdictional issues.

    Since1996, the following presidential, legislative, and departmental
    actions have directed HHS' attention to issues related to
    interjurisdictional adoption:

      -- On December 14, 1996, the President issued a Presidential
         Executive Memorandum directing HHS to increase by 100 percent
         the number of foster children adopted within 5 years.

      -- On November 19, 1997, ASFA was enacted, giving HHS
         responsibility for issuing regulations and enforcing penalties
         for, among other provisions, delaying or denying adoptive
         placements across jurisdictions when an approved family is
         available.

      -- On November 24, 1998, the President issued a Presidential
         Executive Memorandum directing HHS to establish a national
         registry for freed foster children who need adoptive homes.

      -- In November 1998, the HHS Office of Inspector General issued a
         report, The Interstate Compact on the Placement of Children:
         State Structure and Process, describing states' implementation
         of ICPC and the number of children affected by ICPC.

      -- In March 1999, the Office of Inspector General issued a
         companion report, Interstate Compact on the Placement of
         Children:  Implementation, describing how well states have
         implemented ICPC and recommending HHS actions for improvement.

    HHS characterized its role in foster care adoptions in its response
    to the President's memorandum on increasing adoptions:  The federal
    role in this initiative [Adoption 2002] is largely one of supporting
    states and communities by providing financial incentives, technical
    assistance, policy and programmatic leadership, and recognition of
    successful efforts.\15 For interjurisdictional adoption issues, HHS'
    efforts to identify problems and develop action plans largely reflect
    these areas.

    For recruitment, HHS determined that the pool of prospective adoptive
    families who can care for children with special needs remained
    insufficient.\16 To improve recruitment, and in response to the
    presidential directive to establish a national registry, HHS
    developed a plan to implement an Internet site publicizing freed and
    waiting foster children.\17 HHS estimated the first-year cost of the
    site at $1.5 million with annual operating costs of $1.25 million.
    The service is slated to begin operation on September 1, 2001.
    Although preliminary implementation actions were to be completed by
    August 1999, HHS had not completed any of the steps outlined in its
    plan by that date.  For example, it has not conducted focus groups to
    identify concerns or established a standing work group to recommend
    photolisting service policy.  However, HHS acknowledges that this
    effort appears to duplicate much of the existing national
    photolisting service maintained by the National Adoption Center and
    now plans to reassess its approach to this effort.

    For homestudies, HHS found that differing state laws and requirements
    for the content of homestudies hamper acceptance of homestudies
    across jurisdictions.\18 HHS has not published plans to address this
    issue.  However, officials told us that they are supportive of
    APHSA's efforts to provide leadership on interjurisdictional
    homestudy issues.

    Although HHS did not identify a specific need to improve the
    acceptance of termination of parental rights orders and adoption
    decrees, it planned, as part of its technical assistance efforts to
    states, to develop and disseminate guidelines for state legislation
    relating to terminating parental rights.\19 While not prepared in
    response to a concern about parental rights orders, HHS' recently
    released guidelines help states review their laws and develop
    statutes and policies that reflect the best practices in child
    welfare, including guidance on the termination of parental rights.\20

    For ICPC, HHS identified several problems.  According to HHS, some
    child welfare agency staff as well as judges and attorneys do not
    understand ICPC and lack training on its purpose and function.\21
    Delays may occur in the placement process, including adoptive
    placements, thus lengthening the multistep process, when key people
    do not comply with ICPC.\22 Furthermore, when placements in violation
    of ICPC\23 occur, states are sometimes unaware that children are
    placed in their jurisdiction.\24 For example, judges sometimes
    disregard the ICPC process and order out-of-state placements without
    ICPC.  To improve the administration of ICPC, HHS planned to work
    with its National Resource Centers\25 to determine how to promote
    awareness of ICPC, provide training to state agency staff who operate
    ICPC, and support development of model procedures to help ICPC
    operate more effectively.\26 To promote awareness of ICPC and provide
    training, HHS invited other organizations, such as AAICPC, to make
    presentations about ICPC at HHS-sponsored workshops and meetings.  To
    support development of model procedures, HHS included improvement of
    ICPC as an example of an interjurisdictional adoption issue that
    could receive funding under the Adoption Opportunities grant
    program.\27 Although HHS received proposals for fiscal year 1998, HHS
    determined that none of the proposals had sufficient merit to be
    recommended for funding.  HHS revised its request for proposals on
    interjurisdictional adoption issues and listed both collaborative
    planning to increase interjurisdictional adoptions and support for
    improving implementation of ICPC as areas of special interest for
    fiscal year 1999 grants.  HHS awarded five grants in those areas of
    special interest.

    --------------------
    \15 Adoption 2002:  A Response to the Presidential Executive
    Memorandum on Adoption, U.S.  Department of Health and Human Services
    (Washington, D.C.:  Dec.  14, 1996), p.  9.

    \16 Adoption 2002, p.  6.

    \17 Plan to Implement a National Internet Adoption Photolisting
    Service, U.S.  Department of Health and Human Services (Washington,
    D.C.:  n.d.), www.acf.dhhs.gov/programs/cb/special/photolts/toc.htm.

    \18 Plan to Implement a National Internet Photolisting Service, p.
    8.

    \19 Adoption 2002, p.  11.

    \20 Adoption 2002:  The President's Initiative on Adoption and Foster
    Care, Guidelines for Public Policy and State Legislation Governing
    Permanence for Children, U.S.  Department of Health and Human
    Services (Washington, D.C.:  June 1999).

    \21 Photolisting Service, p.  9; and Interstate Compact on the
    Placement of Children:  Implementation, U.S.  Department of Health
    and Human Services Office of Inspector General, OEI-02-95-00044
    (Washington, D.C.:  Mar.  1999), p.  7.

    \22 Interstate Compact Implementation, pp.  2 and 8.

    \23 Interstate Compact Implementation, p.  8.

    \24 The Interstate Compact on the Placement of Children:  State
    Structure and Process, U.S.  Department of Health and Human Services
    Office of Inspector General, OEI-02-95-00041 (Washington, D.C.:  Nov.
    1998), p.  9.

    \25 National Resource Centers are operated by contractors who are
    responsible for providing technical assistance on child welfare
    issues to states.

    \26 Interstate Compact Implementation, pp.  11-12.

    \27 The Adoption Opportunities grant program is designed to provide
    support for demonstration projects that facilitate the elimination of
    barriers to adoption and provide permanent loving homes for children
    who would benefit from adoption, particularly children with special
    needs.

       CONCLUSIONS
    ------------------------------------------------------------ Letter :5

    The 8,000 foster children who, at any given time, are freed and
    waiting for an adoptive home are not readily adoptable because of
    their special needs.  Searching across jurisdictional lines for an
    adoptive family for these hard-to-place children may increase the
    likelihood that a foster child can be matched with an appropriate
    family.  However, the interjurisdictional adoption process is longer
    and more complex than the adoption process within a jurisdiction.
    Thus, opportunities for successful outcomes from interjurisdictional
    searches for adoptive families depend, in large measure, on the
    soundness of the process itself.  While states have the primary
    responsibility to regulate adoptions, nonprofit organizations are
    also actively involved in developing needed improvements.  However,
    states' authority does not extend beyond their own borders and
    nonprofit organizations cannot directly change the process.  As a
    result, the states and organizations cannot effect change in all
    steps of the interjurisdictional adoption process.  While HHS has
    made some efforts to assist states in improving this process in areas
    such as provision of technical assistance, a more organized strategy
    and a widely available plan could facilitate dialogue and
    collaboration among all who have an interest in improvements to the
    interjurisdictional adoption process.  For example, such a plan could
    present strategies to promote the standardization of homestudies and
    assist states in their use of web sites.

       RECOMMENDATION
    ------------------------------------------------------------ Letter :6

    We recommend that the Secretary of HHS develop and make widely
    available an action plan to address areas that would facilitate the
    interjurisdictional adoption of foster children.  The plan should
    critically assess planned and ongoing activities by HHS and others
    and, at a minimum, should include strategies to

      -- Encourage collaborative partnerships among governments and
         others to promote standardization of homestudies and additional
         training on ICPC and its process, and

      -- Provide technical assistance to states on the effective use of
         adoption web sites to recruit adoptive families for
         hard-to-place foster children.

       AGENCY COMMENTS AND OUR
       EVALUATION
    ------------------------------------------------------------ Letter :7

    We provided HHS and state child welfare officials in the three states
    we visited with the opportunity to comment on a draft of this report;
    we received comments from HHS and the state of California.  In its
    comments on a draft of the report, HHS acknowledged that the
    interjurisdictional adoption process is not functioning optimally.
    It expanded on two topics addressed in the report--HHS' discretionary
    grantmaking activities and Internet activities--and discussed why HHS
    does not believe that our recommended action is necessary.  In
    discussing the use of discretionary grants, such as Adoption
    Opportunities grants, to improve the interjurisdictional adoption
    process, HHS reiterated its position on its discretionary grantmaking
    activities and provided additional information about the grants that
    were awarded for fiscal year 1999.  In addition, HHS noted that it
    considers the grantmaking process to be its mechanism for
    coordinating with others to improve the interjurisdictional adoption
    process.  In discussing Internet activities, HHS noted that interest
    in Internet activity regarding adoption is high, the interest comes
    from a variety of sources, and adoption agencies have struggled to
    keep up with the rapidly growing Internet technology.  Furthermore,
    HHS seeks to support Internet-based efforts that do not exceed
    states' capacities to respond and that do not duplicate efforts by
    the private sector.

    In responding to our recommendation that HHS develop and make widely
    available an action plan to facilitate the interjurisdictional
    adoption of foster children, HHS stated that it has not had a need to
    create such a plan given the changing nature of technology and the
    continuous efforts it is making to facilitate the interjurisdictional
    adoption process.  We believe that the value of a more organized
    strategy and a widely available action plan lies in the increased
    dialogue, and resulting collaboration, such a plan can generate
    between HHS and the many public agencies and private organizations
    that have an interest in improving the interjurisdictional adoption
    process.  Particularly in light of HHS' stated desire to avoid
    duplicating the efforts of others and its recent decision to reassess
    the value of its plan for a national photolisting service, a
    mechanism that would keep interested parties abreast of HHS' plans is
    warranted.  HHS also made technical comments, which we incorporated
    where appropriate.  The full text of HHS' comments is contained in
    appendix V.

    The state of California agreed with our report and noted its interest
    in being involved in future efforts to improve the
    interjurisdictional adoption process.

    ---------------------------------------------------------- Letter :7.1

    We will send copies of this report to the Secretary of Health and
    Human Services and program officials in California, Florida, and
    Missouri.  We will also make copies available to others on request.

    If you have any questions regarding this letter, please contact me at
    (202) 512-7215.  Key contributors to this report are listed in
    appendix VI.

    Sincerely yours,

    Cynthia M.  Fagnoni
    Director, Education, Workforce,
     and Income Security Issues

    SCOPE AND METHODOLOGY
    =========================================================== Appendix I

    To obtain a national perspective on interjurisdictional issues, we
    interviewed officials at the Department of Health and Human Services
    (HHS) about the department's role and actions relevant to
    interjurisdictional adoption issues.  We also interviewed experts and
    advocates affiliated with nonprofit organizations interested in
    interjurisdictional adoption issues about their organizations'
    related activities.  These organizations included the American Public
    Human Services Association, the Association of Administrators of the
    Interstate Compact on the Placement of Children, the Association of
    Administrators of the Interstate Compact on Adoption and Medical
    Assistance, the National Adoption Center, and the American Bar
    Association.  In addition, we reviewed the public Internet web sites
    maintained by the National Adoption Center and state child welfare
    agencies to determine the types of information available to
    prospective adoptive parents regardless of their geographic location.

    To obtain a state and county child welfare perspective on
    interjurisdictional issues, we conducted case studies in three
    states--California, Florida, and Missouri.  We chose those states
    because they are among the 10 states with the largest foster care
    populations and they have varying levels of experience with the
    placement of foster children across state lines.  In each state, we
    met with state foster care and adoption officials and their local
    counterparts in one county with a large foster care population.
    Those counties were Contra Costa County, California; Broward County,
    Florida; and Jackson County, Missouri.

    We conducted our review from November 1998 to August 1999 in
    accordance with generally accepted government auditing standards.

    THE ADOPTION PROCESS FOR FOSTER
    CHILDREN
    ========================================================== Appendix II

       (See figure in printed
       edition.)

       (See figure in printed
       edition.)

    SAMPLE HOMESTUDY FORMAT
    ========================================================= Appendix III

    The specific content and format of homestudies vary by agency.  This
    suggested format, developed by Florida, reflects the scope and detail
    typically found in homestudies.

    (See figure in printed edition.)

    (See figure in printed edition.)

    (See figure in printed edition.)

    (See figure in printed edition.)

    (See figure in printed edition.)

    (See figure in printed edition.)

    (See figure in printed edition.)

    CHILD WELFARE-RELATED STATE WEB
    SITES AS OF AUGUST 1999
    ========================================================== Appendix IV

       (See figure in printed
       edition.)

       (See figure in printed
       edition.)

    (See figure in printed edition.)Appendix V
    COMMENTS FROM THE DEPARTMENT OF
    HEALTH AND HUMAN SERVICES
    ========================================================== Appendix IV

    (See figure in printed edition.)

    (See figure in printed edition.)

    GAO CONTACTS AND STAFF
    ACKNOWLEDGMENTS
    ========================================================== Appendix VI

    GAO CONTACTS

    David D.  Bellis, (202) 512-7278
    Kerry Gail Dunn, (415) 904-2234

    ACKNOWLEDGMENTS

    In addition to the individuals named above, Ann T.  Walker, Karen E.
    Lyons, and Elizabeth Jarvis-Shean made key contributions to this
    report.

    *** End of document. ***