Foster Care: State Efforts to Improve The Permanency Planning Process
Show Some Promise (Letter Report, 05/07/97, GAO/HEHS-97-73).

Pursuant to a congressional request, GAO reviewed states efforts to
improve the permanency planning process and reduce the time a child
spends in foster care, focusing on what: (1) statutory and policy
changes states have made to limit the time allowed to determine
permanent placements for foster children; (2) changes states or
localities have made in their operations in an attempt to achieve more
timely permanent placements and what the impact of those changes has
been; and (3) factors officials believe helped them meet the challenges
of achieving more timely permanent placements.

GAO noted that: (1) signaling the importance of a permanent placement to
the well-being of children, 23 states have enacted laws establishing
requirements regarding the timing of the permanency hearing that are
more stringent than those under federal law; (2) federal law requires a
hearing within 18 months after the child's entry into foster care; (3)
an additional three states, while not enacting such statutes, have
imposed similar requirements as a matter of policy; (4) statutory or
policy changes alone, however, are not sufficient to resolve the final
placement of foster children more quickly; (5) the states GAO reviewed
have made changes in their operations to facilitate reunifying children
with their families, expedite terminating parental rights when
reunification efforts have failed, or modify the role and operations of
the court both to streamline the process and to make well-informed
permanent placement decisions; (6) while these initiatives focus on
certain stages of the permanency planning process, such as when a child
first enters foster care, two states are implementing major changes to
their overall foster care systems; (7) although initiatives are in
place, most of these states have not systematically evaluated the impact
of them, and data concerning these efforts were limited; (8) however,
most states did report that many of these initiatives contributed to
reducing the time spent in foster care or decreasing the total number of
placement changes while a child is in foster care; (9) state officials
identified a number of factors that helped them meet the challenges
involved in making changes; (10) in some cases, child welfare officials
and staff had to undergo significant culture change, modifying long-held
views about the merits of pursuing termination of parental rights versus
family reunification; (11) they found that changing the way they
approached making decisions about the well-being of children and their
families was a lengthy process; (12) to implement these initiatives
successfully, program officials believed that it was necessary to have
the long-term and active involvement of key officials at all levels,
including the governor, legislators, and agency officials as well as
caseworkers, service providers, attorneys, and judges; (13) this
participation was essential to define the problem and reach consensus;
and (14) doing so required considerable coordination efforts and an ext*

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

 REPORTNUM:  HEHS-97-73
     TITLE:  Foster Care: State Efforts to Improve The Permanency 
             Planning Process Show Some Promise
      DATE:  05/07/97
   SUBJECT:  Foster children
             Child adoption
             State programs
             Hearings
             State law
             Child custody
             Privatization
IDENTIFIER:  Kentucky Termination of Parental Rights Project
             Tennessee Wraparound Funding Project
             Arizona State Adoption Project
             Arizona Housing Assistance Program
             Tennessee Concurrent Planning Program
             Georgia Citizen Review Panel Program
             Arizona Project Redesign
             Statewide Automated Child Welfare Information System
             Arizona
             Georgia
             Kansas
             Kentucky
             Ohio
             Tennessee
             
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Cover
================================================================ COVER


Report to the Chairman, Subcommittee on Human Resources, Committee on
Ways and Means, House of Representatives

May 1997

FOSTER CARE - STATE EFFORTS TO
IMPROVE THE PERMANENCY PLANNING
PROCESS SHOW SOME PROMISE

GAO/HEHS-97-73

State Efforts Show Some Promise

(106710)


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

  AFDC - Aid to Families With Dependent Children
  HHS - Department of Health and Human Services

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


B-270234

May 7, 1997

The Honorable E.  Clay Shaw, Jr.
Chairman, Subcommittee on
 Human Resources
Committee on Ways and Means
House of Representatives

Dear Mr.  Chairman: 

The mid-1980s through the mid-1990s witnessed dramatic increases in
the number of children placed in foster care to protect them from
abuse and neglect at home.  From fiscal year 1984 to 1995, the foster
care population rose from an estimated 276,000 children to 494,000.\1
In 1995, states received more than $2.8 billion in federal assistance
for approximately half of these 494,000 children in foster care.\2
The Congressional Budget Office estimates that by 2001, federal costs
will rise to $4.8 billion with caseloads of federally assisted foster
care children increasing by almost 26 percent.  Longer stays in
foster care have contributed to these rising costs.  Many of these
children are among the nation's most at risk for future problems,
having suffered the effects of both physical and emotional abuse, and
poverty. 

The continued growth in the foster care caseload and its associated
costs, as well as the likely adverse effects of long stays in foster
care on children, increase the importance of quickly finding
permanent placements for children.  These placements can range from
reuniting children with their parents, to finding adoptive homes and,
in increasing numbers, to placing foster children with relatives. 
Yet navigating the child welfare system in pursuit of permanent homes
for these children can be a daunting task.  State child welfare
agencies--working with many players that include the courts and
public and private service providers--guide a child through temporary
or shelter placements, multiple court hearings, and, as often
happens, more than one foster family placement.  This circuitous and
burdensome route to a permanent placement can often take years, cost
thousands of dollars for each child, and have serious emotional
consequences for the children. 

The federal government plays an important role in financing foster
care and establishes minimum procedural requirements for the
placement process.  The Adoption Assistance and Child Welfare Act of
1980
(P.L.  96-272) requires that states conduct a permanency hearing
within 18 months after a child enters foster care to determine the
future status of the child.\3 If a final decision is not made, then
additional hearings must be held at least every 12 months.  During
this time, to be eligible for federal foster care funds, states are
required to facilitate the reunification of parent and child or, if
those efforts fail, begin the process of terminating parental rights
or finding a long-term foster care placement. 

Because of your concerns about the length of the permanency planning
process and your interest in improving foster care, you asked us for
information about state efforts to hasten the process and ultimately
reduce the time a child spends in foster care.  More specifically,
you asked us to determine (1) what statutory and policy changes
states have made to limit the time allowed to determine permanent
placements for foster children, (2) what changes states or localities
have made in their operations in an attempt to achieve more timely
permanent placements and what the impact of those changes has been,
and (3) what factors officials believe helped them meet the
challenges of achieving more timely permanent placements. 

In conducting this work, we collected and summarized state statutory
and policy changes that limited the time allowed for permanent
placement hearings.  We also interviewed officials and collected
program information from six states--Arizona, Georgia, Kansas,
Kentucky, Ohio, and Tennessee--on initiatives that had been
implemented between 1987 and 1992 and were expected to achieve more
timely permanent placements for foster children.  A complete
discussion of our scope and methodology appears in appendix I. 


--------------------
\1 The American Public Welfare Association estimated these numbers on
the basis of data voluntarily reported by the states; it designated
the 1995 number as preliminary. 

\2 Under title IV-E of the Social Security Act, federal matching
funds are provided to states for foster care maintenance costs for
children from families eligible for Aid to Families With Dependent
Children (AFDC).  Although legislation passed in 1996 eliminated the
AFDC program, children who meet the 1995 eligibility criteria for
AFDC will continue to be eligible for title IV-E assistance.  The
states incur all foster care costs for children not eligible for
federal support. 

\3 At the permanency hearing, the choices that can be made regarding
the future status of the child can include reunifying the child with
his or her family, continuing the child in foster care for a
specified period, placing the child for adoption, or continuing the
child in foster care on a permanent or long-term basis because of the
child's special needs or circumstances.  This hearing must be held in
a family or juvenile court or another court of competent jurisdiction
or by an administrative body appointed or approved by the court. 
Although the hearing must be held, the law does not require that a
final decision on the status of the child be made. 


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

Signaling the importance of a permanent placement to the well-being
of children, 23 states have enacted laws establishing requirements
regarding the timing of the permanency hearing that are more
stringent than those under federal law.  Federal law requires a
hearing within 18 months after the child's entry into foster care. 
An additional three states, while not enacting such statutes, have
imposed similar requirements as a matter of policy. 

Statutory or policy changes alone, however, are not sufficient to
resolve the final placement of foster children more quickly.  The
states we reviewed have made changes in their operations to
facilitate reunifying children with their families, expedite
terminating parental rights when reunification efforts have failed,
or modify the role and operations of the court both to streamline the
process and to make well-informed permanent placement decisions. 
While these initiatives focus on certain stages of the permanency
planning process, such as when a child first enters foster care, two
states are implementing major changes to their overall foster care
systems. 

Although initiatives are in place, most of these states have not
systematically evaluated the impact of them, and data concerning
these efforts were limited.  However, most states did report that
many of these initiatives contributed to reducing the time spent in
foster care or decreasing the total number of placement changes while
a child is in foster care.  For example, Tennessee's Wraparound
Funding Project focused on removing economic barriers to
reunification.  State officials credited the effort with helping to
reunite children with their families more quickly by allowing
caseworkers to provide services such as payment for respite care,
rent, utility bills, or car repairs, which they were previously
unable to provide because of restrictions on the use of foster care
funds.  In Kentucky, a state report indicated that once the decision
to terminate parental rights was made, the Termination of Parental
Rights Project reduced the time it takes to complete the termination
procedure by about 1 year, making it possible for adoption
proceedings to begin earlier. 

State officials identified a number of factors that helped them meet
the challenges involved in making changes.  In some cases, child
welfare officials and staff had to undergo significant culture
change, modifying long-held views about the merits of pursuing
termination of parental rights versus family reunification.  They
found that changing the way they approached making decisions about
the well-being of children and their families was a lengthy process. 
To implement these initiatives successfully, program officials
believed that it was necessary to have the long-term and active
involvement of key officials at all levels, including the governor,
legislators, and agency officials as well as caseworkers, service
providers, attorneys, and judges.  This participation was essential
to define the problem and reach consensus.  Doing so required
considerable coordination efforts and an extended commitment of
resources. 


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

State child welfare systems consist of a complicated network of
policies and programs designed to protect children.  Today, these
systems must respond to growing numbers of children from families
with serious and multiple problems.  Many of these families also need
intensive and long-term interventions to address these problems. 
With growing caseloads over the past decade, the systems' ability to
keep pace with the needs of troubled children and their families has
been greatly taxed.  In addition, the continued growth in caseloads
expected over the next few years will give child welfare agencies
little relief. 

When parents or guardians are unable to care for their children,
state child welfare agencies face the difficult task of providing
temporary placements for children while simultaneously working with a
wide array of public and private service providers, as well as the
courts, to determine the best long-term placement option.  The
permanency planning process is guided by federal statute and
typically occurs in stages requiring considerable time.  Finding an
appropriate placement solution is extremely difficult because it
often involves numerous steps and many different players. 

In each case, states must make reasonable efforts to prevent the
placement of a child in foster care.  If the child must be removed
from the home, states are required under the Adoption Assistance and
Child Welfare Act to take appropriate steps to make the child's safe
return home possible.  Once removed, if reunification with the
parents cannot be accomplished quickly, a child will be placed in
temporary foster care while state child welfare agencies and
community service providers continue to work with the parents in hope
of reunification.  To be eligible for federal funding, the state must
demonstrate to the appropriate court that it has made reasonable
efforts to prevent out-of-home placement and to reunify the family. 
Federal law further requires that placement be as close as possible
to the parent's home in the most family-like setting possible. 

To guide the permanency planning process by which a state is to find
permanent placements for foster care children, the act also requires
that the state develop a case plan for each child within 60 days of
the time the state agency begins providing services to the child. 
This plan must describe services to be provided to aid the family and
must outline actions that will be expected of various agencies and
family members to make reunification possible.  States are then
required to hold reviews every 6 months before a court or
administrative panel to evaluate progress made toward reaching a
permanency goal.\4 If progress toward reunification cannot be made,
state agencies often face the arduous task of either preparing a case
for the termination of parental rights or finding a long-term foster
care placement.  The federal requirement of conducting a permanency
hearing within 18 months serves to ensure that child welfare agencies
focus on determining a permanent placement, including return to the
family or adoption, in a timely manner rather than continuing a child
in foster care. 

For abused and neglected children, living with their parents may be
unsafe.  Yet foster care is not an optimal situation, especially not
as a permanent solution.  State child welfare agencies and the courts
are confronted with the dilemma of whether to reunite families as
quickly as possible or keep the children in foster care with the
expectation of future reunification.  They must also determine at
what point to abandon hope of reunification, terminate the parents'
rights, and initiate a search for an adoptive home or other permanent
placement for the child.  If children are reunited with their
families too quickly, they may return to foster care because the home
environment may still be unstable.  On the other hand, when children
remain in foster care too long, it is difficult to reestablish
emotional ties with their families.  Furthermore, the chances for
adoption can be reduced because the child is older than the most
desirable adoption age or has developed behavioral problems. 

Determining an appropriate placement option for children quickly is
of twofold importance.  First, finding permanent placements for
children removed from their families is critical to ensure their
overall well-being.  Children without permanent homes and stable
caregivers may be more likely to develop emotional, intellectual, and
behavioral problems.  A second reason for placing children more
quickly is the financial costs of children remaining in foster care. 
The federal share of the average monthly maintenance payment for
title IV-E was $574 in 1996.  While some options for permanent
placements, such as providing long-term support to a relative to care
for a child, may not realize cost savings, other options, such as
adoption, will reduce foster care costs.  Title IV-E payments,
between fiscal years 1984 and 1996, increased from $435.7 million to
an estimated $3.1 billion. 


--------------------
\4 During these periodic reviews, states must determine if continued
temporary placement is necessary and appropriate, whether the
permanency plan is being adequately followed, and what degree of
progress has been made toward reunifying the family.  States must
also project a likely date for achieving a permanency goal.  If not
reviewed by a court, these periodic reviews may be held before panels
including those formed by a child welfare agency or a panel of area
citizens. 


   STATUTORY AND POLICY CHANGES
   REQUIRE STATES TO HOLD FIRST
   PERMANENCY HEARING SOONER
------------------------------------------------------------ Letter :3

The prolonged stays of children in foster care have prompted states
to enact laws or policies to shorten to less than the federally
allowed 18 months the time between entry into foster care and the
first permanency hearing at which permanent placement is considered. 
As shown in figure 1, 23 states have enacted such laws, with a
majority of these requiring the hearing to be held within 12 months. 
In two states, the shorter time frame applies only to younger
children.  Colorado requires the permanency hearing be held within 6
months for children under 6, and Washington requires the hearing to
be held within 12 months for children 10 years old or younger.  An
additional three states, while not enacting such statutes, have
policies requiring permanency hearings earlier than 18 months.  For a
description of the 26 state statutes, policies, and time
requirements, see appendix II.  The remaining 24 states and the
District of Columbia have statutes consistent with the federal
requirement of 18 months. 

   Figure 1:  States That Require
   a Permanency Hearing Earlier
   Than the Federal Government, as
   of December 31, 1996

   (See figure in printed
   edition.)

The state laws, like federal law, do not require that a final
decision be made at the first hearing.  Ohio and Minnesota, however,
do require that a permanency decision be determined after a limited
extension period.  Ohio, for example, requires a permanency hearing
to be held within 12 months, with a maximum of two 6-month
extensions.  At the end of that time, a permanent placement decision
must be made.  According to officials in Ohio's Office of Child Care
and Family Services, this requirement was included in an effort to
expedite the permanency planning process and reduce the time children
spend in foster care.  However, state officials also believed that
this requirement may have had the unintended result of increasing the
number of children placed in long-term foster care because other
placement options could not be developed.  State data, in part,
confirmed this observation.  While long-term foster care placements
for children supported with state-only funds dropped from 1,301 in
1990 to 779 in 1995, long-term placements for children supported with
federal funds rose from 1,657 to 2,057 for the same period.  The
reasons for the difference between these two groups are unknown. 


   STATES MAKE CHANGES IN
   PERMANENCY PLANNING PROCESS
   WITH SOME POSITIVE RESULTS FOR
   FOSTER CARE CHILDREN
------------------------------------------------------------ Letter :4

Although the states we reviewed did not systematically evaluate the
impact of their initiatives, they implemented a variety of
operational and procedural changes to expedite and improve the
permanency process.  Other efforts made changes to the operation of
the courts and the use of resources available to them for making
permanency decisions.  These states reported that these actions have
improved the lives of some children by (1) reuniting them with their
families more quickly, (2) expediting the termination of parental
rights when reunification efforts were determined to be
unfeasible--thus making it possible for child welfare agencies to
begin looking for an adoptive home sooner--or (3) reducing the number
of different foster care placements in which they lived.  States are
also addressing changes in the permanency planning process through
larger reform efforts of their child welfare systems.  However,
because these efforts were only recently implemented or were still in
the initial implementation stage, no evaluation information on their
effect was available. 


      NEW SERVICE STRATEGIES HELP
      REUNIFICATION EFFORTS
---------------------------------------------------------- Letter :4.1

Two states we reviewed implemented low-cost and creative methods for
financing and providing services that address specific barriers to
reunification.  For example, Arizona's Housing Assistance Program
focused on families where children had been removed and placed in
state custody and the major barrier to reunification was inadequate
housing for the family.  In 1989, the state enacted a bill
authorizing the use of state foster care funds to provide special
housing assistance.  According to state reports summarizing the
program and statistics provided by Arizona Department of Economic
Security officials, between 1991 and 1995, 939 children were reunited
with their families as a result of this program, representing almost
12 percent of those children reunified during this period.  This
program saved the state over $1 million in foster care-related costs
between 1991 and 1995. 

Also, Tennessee's Wraparound Funding Program allowed caseworkers to
use state funds to provide services that removed economic barriers to
reunification.  These services were not typically associated with
traditional reunification services and prior to this program were not
allowable foster care expenditures.  Examples include home or car
repairs, utilities or rent payments, and respite care.  According to
a report summarizing the program, during one 6-month period in 1995,
the program provided services to 1,279 children.  A state Department
of Children's Services official estimated that had these children
remained in care as long as the average child in foster care, the
state would have incurred an additional $700,000 in state and federal
foster care maintenance payments. 


      STATES STREAMLINE
      TERMINATION PROCEDURES
---------------------------------------------------------- Letter :4.2

Regarding other changes, Arizona and Kentucky placed special emphasis
on expediting the process by which parental rights could be
terminated.  Arizona's Severance Project focused on cases where
termination of parental rights was likely or reunification services
were not warranted and for which a backlog of cases had developed. 
In April 1986, the state enacted a bill providing funds for hiring
severance specialists and legal staff to work on termination cases. 
The following year, in 1987, the state implemented the Arizona State
Adoption Project.  This project focused on identifying additional
adoptive homes, including recruiting adoptive parents for specific
children and contracting for adoptive home recruitment activities. 
State officials reported that the Adoption Project resulted in a
54-percent increase in the number of new homes added to the state
registry in late 1987 and 1988.  In addition, they noted that the
Severance Project contributed to a more than 32-percent reduction in
the average length of stay between entry into care and the filing of
the termination petition for fiscal years 1991 through 1995. 

To reduce a backlog of pending cases, Kentucky's Termination of
Parental Rights Project focused on reducing the time required to
terminate parental rights once this permanency goal was established. 
This effort included retraining caseworkers, lawyers, and judges on
the consequences of long stays in foster care and streamlining and
improving the steps caseworkers must follow when collecting and
documenting the information required for the termination procedures. 
A report on this effort indicated that between 1989 and 1991, the
state decreased the average time to terminate parental rights by
slightly over 1 year.  In addition, between 1988 and 1990, the
average length of stay for children in foster care decreased from 2.8
years to 2 years, and the number of different foster care placements
for each child decreased from four to three.\5 However, as the number
of children available for adoption rose, the state was forced to
focus its efforts on identifying potential adoptive homes and shifted
its emphasis to strategies to better inform the public about the
availability of adoptive children. 


--------------------
\5 Report on Improving Practice:  Termination of Parental Rights,
Kentucky Department for Social Services (Sept.  1991). 


      CONCURRENT PLANNING CAN LEAD
      TO GREATER EFFICIENCY
---------------------------------------------------------- Letter :4.3

Tennessee's Concurrent Planning Program allowed caseworkers to work
toward achieving family reunification while at the same time
developing an alternate permanency plan if reunification efforts did
not succeed.\6 The goal was to obtain permanency for the child by
either (1) strengthening the family and reducing the risks in the
home so that the child can be reunified with his or her family; or
(2) verifying that the family cannot protect the child, meet the
child's needs, or reduce the risks to the child in a timely manner
and that termination of parental rights should be pursued.  By
working on the two plans simultaneously, caseworkers reduced the time
required to prepare the necessary paperwork to terminate parental
rights if reunification efforts failed. 

Under a concurrent planning approach, caseworkers emphasize to the
parents that if they do not adhere to the requirements set forth in
their case plan, parental rights can be terminated.  Since this
program was initiated in 1991, state officials report that 70 percent
of the children in the program obtained permanency, primarily through
reunification, within 12 months of placement in foster care.  Without
this program the children would have stayed in foster care longer
than 12 months.  The officials attributed obtaining quicker
permanency in part to parents making more concerted efforts to make
the changes needed to have their children return home. 


--------------------
\6 The program was used in cases involving children aged 8 and under. 


      USE OF COMMUNITY RESOURCES
      AND STREAMLINED PROCEDURES
      IMPROVE COURT FUNCTIONING
---------------------------------------------------------- Letter :4.4

All decisions regarding both the temporary and final placement of
foster care children come through states' court systems.  As a
result, some states and counties focused attention on the courts'
involvement in achieving permanency more quickly.  Georgia's Citizen
Review Panel Program created local advisory panels of private
citizens within the child's community to assist judges in their
review and decisions regarding foster care placements for each child
in care.  The objective of these panels is (1) to gather additional
information regarding the placement options for each foster
child--often information that cannot be collected by state agencies
because of large caseloads and limited staff resources--and (2) to
review compliance with court-ordered case plans to ensure that the
state agencies are working toward permanent placements.  The program
operates in 56 counties and, in 1996, covered over 42 percent of
Georgia's foster care population.  The state reported that between
1994 and 1996, the review panels recommended that 5,855 children be
placed for adoption, 10,845 children be reunified with their
families, and 3,048 children remain in foster care. 

In Hamilton County, Ohio, juvenile court officials focused attention
on the court's involvement in achieving permanency more quickly by
developing new procedures to expedite case processing.  In 1985, they
revised court procedures by (1) designating lawyers specially trained
in foster care issues as magistrates to hear cases, (2) assigning one
magistrate to each case for the life of that case to achieve
continuity and consistent rulings, and (3) agreeing at the end of
every hearing--while all participants are present--to the date for
the next hearing.  According to court officials, the county saved
thousands of dollars because it could operate three magistrates'
courtrooms for the cost of one judge's courtroom.  Also, a report on
court activities indicated that because of these changes, between
1986 and 1990, the number of children placed in four or more
different foster care placements decreased by 11 percent and the
percentage of children leaving temporary and long-term foster care in
2 years or less increased from 37 percent to 75 percent. 

Even where improvements have been made, there can still be problems
that are beyond the control of officials.  According to reports
prepared by court officials, between 1986 and 1989 the number of
children in care in Hamilton County decreased 15 percent.  However,
in 1992, the number returned to the 1986 level of about 1,100
children and continued to increase through the first half of 1996 to
about 1,500.  According to court officials, a dramatic rise in crack
cocaine use in the county contributed to this sharp increase.  Child
welfare agencies were unable to readily arrange for the increased
services that these families needed. 


      SOME INITIATIVES ATTEMPT
      SYSTEMWIDE CHANGES TO
      IMPROVE THE PERMANENCY
      PROCESS
---------------------------------------------------------- Letter :4.5

Some states are also addressing the need for quicker permanency as
part of larger initiatives designed to make major changes in their
foster care programs.  One state plans to privatize foster care
services.  Another state has redesigned its foster care operating
policies and procedures to improve outcomes for children.  Because
these efforts are recent, no information on results was available. 


         PRIVATIZATION PROPOSES
         INCENTIVES FOR SPEEDIER
         PLACEMENTS
-------------------------------------------------------- Letter :4.5.1

In 1996, Kansas began privatizing most child welfare services,
including foster care.  Two events contributed to this decision. 
First, because of rising state costs, the Governor directed all state
agencies to consider privatizing services to reduce the size of the
state workforce.  Second, the state had settled a suit brought by the
Kansas chapter of the American Civil Liberties Union citing
unacceptable increases in the number of children in foster care and
lengthy stays in care.  The goal of privatization is to allow
children in out-of-home placements to experience a minimal number of
placements or to achieve permanency in their lives in the shortest
time possible. 

Kansas contracted with private social services agencies for family
preservation services, foster and residential care, and adoption
services.  State officials continue to be responsible for determining
if the original charges of dependency, neglect, or abuse are
substantiated and to monitor contractor performance.  The contracted
service providers are responsible for providing all services to the
families. 

Under the contracts, providers will be paid a per-child rate, with a
payment structure that pays contractors for results.  For example, in
the foster care contract, 25 percent of costs will be paid at the
time of referral, 25 percent upon receipt of the first 60-day
progress report, and 25 percent upon receipt of the 180-day formal
case plan.  The final 25 percent will not be paid until reunification
or a permanent placement is achieved.  If a child reenters care
before 12 months have passed, the contractor is responsible for all
the foster care maintenance costs for out-of-home placement. 


         AGENCY REDESIGN INTENDED
         TO EXPEDITE PLACEMENT
         DECISIONS
-------------------------------------------------------- Letter :4.5.2

Arizona also is pursuing major changes to its child welfare system. 
Arizona's Project Redesign was prompted by a number of fatalities of
young children in foster homes in a very short time.  Begun in 1994,
this project focused on writing and implementing new child welfare
policies and procedures with a goal of increasing caseworker contact
with foster families and reducing caseworkers' caseloads and the
length of time children spend in foster care. 

The major activities of Project Redesign included rewriting policies
and licensing rules, preparing a new supervisors' handbook, creating
a mentoring program for new supervisors, developing and implementing
a method to more equitably distribute workload among staff, and
creating the Uniform Case Practice Record.  This record methodically
guides caseworkers through all the steps necessary to make a
permanent placement decision.  This helps ensure that all the needed
information is available to the courts, thus preventing delays in the
process. 


      STATES HAVE NOT ASSESSED THE
      IMPACT OF INITIATIVES
---------------------------------------------------------- Letter :4.6

Our efforts to assess the overall impact of these initiatives were
hampered by the absence of evaluation data.  In general, we found
that the states did not conduct evaluations of their programs, and
outcome information was often limited to state reports and the
observations of state officials.  While many of these efforts
reported improvements, for example, in speeding the termination of
parental rights once this permanency goal was established, the lack
of comparison groups or quality pre-initiative data made it difficult
to reach definitive conclusions about the effectiveness of these
initiatives. 

Several national efforts are under way that may improve the
information available on foster children and facilitate states'
design and implementation of systematic evaluations in the future. 
Nationwide, most states are currently designing or implementing
Statewide Automated Child Welfare Information Systems as required
under the title IV-E foster care program.  These systems are to
include case-specific data on all children in foster care and all
adopted children placed or provided adoption assistance by the state
or its contractors.  From 1994 to 1996, federal funds have provided
up to 75 percent of the costs of planning, design, development, and
installation of these state systems.  The Personal Responsibility and
Work Opportunity Reconciliation Act (P.L.  104-193), enacted in
August 1996, continues this enhanced federal match through 1997, at
which time the federal match rate will be reduced to 50 percent.  In
addition, P.L.  104-193 appropriated funds for a national
longitudinal study based on random samples of children at risk of
abuse or neglect or determined by a state to have been abused or
neglected.  This study is to include state-level data for selected
states.\7


--------------------
\7 The law states that the study yield data reliable at the state
level for as many states as the Secretary of the Department of Health
and Human Services (HHS) determines is feasible. 


   KEY FACTORS ESSENTIAL FOR
   MEETING GOALS OF NEW
   INITIATIVES
------------------------------------------------------------ Letter :5

States increased their chances for successfully developing and
implementing new initiatives when certain key factors were a part of
the process.  When contemplating changes, state officials had to take
into consideration the intricacies of the foster care process; the
inherent difficulty that caseworkers and court officials face when
deciding if a child should be returned home; and the need in some
cases to change the culture of caseworkers and judges to recognize
that, in certain cases, termination of parental rights should be
pursued.  Some experts believe that current child welfare practices
often discourage caseworkers from finding permanent placements other
than with the biological parents.  Officials in the states we
reviewed recognized that addressing these challenges required
concerted time and effort, coordination, and resources.  These
officials identified several critical, often interrelated, factors
required to meet these challenges.  These included (1) long-term
involvement of officials in leadership positions; (2) involvement of
key stakeholders in developing consensus and obtaining buy-in
concerning the nature of the problem and the solution; and (3) the
availability of resources to plan, implement, and sustain the
project.  The following two examples illustrate these concepts. 


      STATEWIDE INVOLVEMENT
      CULMINATES IN NEW CHILD
      WELFARE LEGISLATION
---------------------------------------------------------- Letter :5.1

In the mid-1980s, Ohio officials began a multiyear effort that
culminated with the state enacting a new child welfare law that
became effective in January 1989.  Before enacting this law, the
legislature created a task force whose members were involved in
planning throughout the drafting and passage of legislation.  The
task force was cochaired by a state senator and a representative. 
Other members included state and county child welfare agency
officials, juvenile court judges, attorneys, and county
commissioners.  In addition, public hearings were held throughout the
state that provided a forum for input from all parties interested in
child welfare, including private citizens, service providers,
caseworkers, judges, attorneys, and foster care parents. 

By involving all interested parties and by providing numerous
opportunities for input, state officials were able to develop
consensus on the problems and solutions and obtain buy-in to the
proposed solutions from program staff.  For example, there were
numerous discussions about whether a specific time frame for
remaining in temporary foster care should be stipulated.  They
ultimately compromised on 12 months plus two 6-month extensions. 


      STATEWIDE EFFORTS SHORTEN
      TERMINATION OF PARENTAL
      RIGHTS PROCESS
---------------------------------------------------------- Letter :5.2

In 1988, to shorten the termination of parental rights process, the
Kentucky Department of Social Services collaborated with seven other
agencies to obtain a federal grant to develop new approaches to
address this issue.  As part of this effort and to ensure buy-in, the
Secretary of Human Resources appointed a multidisciplinary advisory
committee chaired by a chief Circuit Court judge.  Other members of
the committee included representatives from social service agencies,
court officials, attorneys, the legislature, and child welfare
advocacy groups.  The committee met quarterly throughout the 2-year
project. 

Committee members recognized they needed to change the way
caseworkers and members of the legal system viewed termination of
parental rights.  Many caseworkers had viewed terminating parental
rights as a failure on their part because they were not able to
reunify the family.  As a result, they were reluctant to pursue
termination and instead kept the children in foster care.  Also,
often judges and lawyers were not sufficiently informed of the
negative consequences for children who do not have permanent homes. 
Thus, as part of this project, newsletters and training were provided
about the effects on the child of delaying termination of parental
rights. 

After 2 years, many meetings, and retraining caseworkers, state
officials reported that they had reduced the time to complete the
termination of parental rights process by 1 year.  Among the changes
they believed contributed to this reduction were (1) simplifying the
process caseworkers follow when providing termination of parental
rights information to the attorneys that handle these cases and (2)
using an absent parent search handbook, which was developed to assist
caseworkers in conducting more timely and complete searches. 


   CONCLUSIONS
------------------------------------------------------------ Letter :6

Many of the children in foster care are among the nation's most
vulnerable citizens.  The consequences of long spells in foster care
and multiple placements, coupled with the effects of poverty,
highlight the need for quick resolution of placement questions for
these children.  With the expected rise in foster care caseloads
through the start of the next century further straining state and
federal child welfare budgets, increasing pressure will be placed on
states to develop strategies to move children into permanent
placements more quickly.  Many of these initiatives will need to
address the difficult issues of deciding under what circumstances to
pursue reunification and what time is appropriate before seeking the
termination of parental rights. 

We found promising initiatives for changing parts of the permanency
process so that children can be moved out of foster care into
permanent placements more quickly.  Developing and successfully
implementing these innovative approaches takes time and often
challenges long-standing beliefs.  To succeed, these initiatives must
look to local leadership involvement, consensus building, and
sustained resources. 

As new initiatives become a part of the complex child welfare system,
however, they can also create unintended consequences.  For example,
if states are identifying appropriate cases for the quicker
termination of parental rights and processing them more
expeditiously--thereby freeing more children for possible
adoption--additional problems can occur if efforts to develop more
adoptive homes have not been given equal emphasis.  Also, if states
require more stringent time frames for holding permanency hearings,
they must adjust to this shorter time to avoid placements based on
expedience rather than careful deliberation about what is best for
the child. 

We also found that a critical feature of these initiatives was often
absent:  Many of them lacked evaluations designed to assess the
impact of the effort.  The availability of evaluation information
from these initiatives would not only point to the relative success
or failure of an effort but also such information could assist in
identifying unintended outcomes.  The absence of program and
evaluation data will continue to hinder the ability of program
officials and policymakers to fully understand the overall impact of
these initiatives.  Efforts are under way, however, to improve the
availability of information on foster children. 


   AGENCY COMMENTS
------------------------------------------------------------ Letter :7

In its written comments on a draft of this report, HHS generally
concurred with the conclusions in this report.  It agreed that
efforts to improve the timeliness of permanent placements are
important and indicated that they are a priority of the department. 
HHS also commented that it would be useful to include a definition of
permanency planning in the report, and we revised the report in
response to this comment.  Although federal requirements establish
some guidelines, variation in state policies and priorities make the
development of a single definition difficult.  Finally, the
department recognized the benefits of presenting different approaches
to speeding the permanency planning processes while stressing the
need for systemic changes.  Because of the complex nature of the
child welfare system, we agree that states and localities must
consider the entire system when attempting to make reforms. 

We have incorporated the department's technical comments into our
report where appropriate.  See appendix III for HHS' comments. 


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

We are sending copies of this report to the Secretary of HHS, state
child welfare agencies, and other interested parties.  Copies also
will be made available to others on request.  If you or your staff
have any questions about this report, please call me at (202)
512-7215.  Other major contributors to this report are listed in
appendix IV. 

Sincerely yours,

Mark V.  Nadel
Associate Director,
Income Security Issues


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

To identify states that have enacted laws or implemented policies
establishing requirements regarding the timing of the first
permanency hearing that are more stringent than those under federal
law, we reviewed pertinent state legislation and policies of 50
states and the District of Columbia.  We also discussed those laws
and state policies with state legal and child welfare officials. 
Federal law allows the hearing to be held as late as 18 months after
the child's entry into foster care, but state laws vary widely in the
terms they use for various hearings.  In cases where state law did
not specifically identify a hearing as a permanency hearing, we asked
for further clarification from state officials.  If we determined
that the state law was consistent with the federal requirement, we
treated the required hearing as a permanency hearing. 

To determine what changes states and localities have made to achieve
more timely permanent placements and factors that contributed to
their success, we first reviewed literature on foster care and
permanency planning.  In addition, we discussed permanency planning
and permanent placement decisions with experts in the field,
including child welfare officials in all 50 states and the District
of Columbia.  In the course of our discussions with state officials
and experts, we identified specific state and local initiatives that
were attempting to permanently place foster care children in a more
timely manner. 

We selected six states that had implemented initiatives that
addressed making more timely permanent placements for children in
foster care.  The states were Arizona, Georgia, Kansas, Kentucky,
Ohio, and Tennessee.  Each state selected had at least one initiative
that was implemented between 1989 and 1992, ensuring that we would be
able to obtain historical information about the planning and
implementation of those initiatives and that the initiatives had been
in place long enough to have some impact.  We included states that
had initiatives that addressed different aspects of the permanency
process.  We also included states with statutory requirements for
holding the first permanency hearing that were stricter than the
federal requirement as well as states with requirements that were
consistent with the federal requirement. 

We conducted site visits in four of the six states--Georgia, Kansas,
Kentucky, and Tennessee--and obtained information from Arizona and
Ohio through telephone interviews.  We interviewed state and county
foster care and adoption officials and juvenile court officials and
collected information on the initiatives, including descriptions of
program goals and objectives and factors that facilitated change,
reports on program results, and other statistical information on the
foster care population.  We did not verify program data from these
states. 

We did our work between January 1996 and January 1997 in accordance
with generally accepted government auditing standards. 


STATES THAT REQUIRE A PERMANENCY
HEARING EARLIER THAN THE FEDERAL
REQUIREMENT OF 18 MONTHS, AS OF
DECEMBER 31, 1996
========================================================== Appendix II

                Requirement
                for holding                                             State policy/
                the permanency  Year law was                            regulation
State           hearing\a            enacted  State law citation        citation
--------------  --------------  ------------  ------------------------  ----------------
Arizona         12 months               1995  Ariz. Rev. Stat. Ann.,
                                              Section 8-515.C.(West
                                              Supp. 1996)

Colorado        6 and 18                1994  Colo. Rev. Stat.,
                months\b                      Section 19-3-
                                              702(1)(Supp. 1996)

Connecticut     12 months               1995  Conn. Gen. Stat. Ann.,
                                              Section 46b-129(d),(e)
                                              (West 1995)

Delaware        17 months               1987                            Child Protective
                                                                        Service
                                                                        Directive Policy
                                                                        #3026

Georgia         12 months               1996  Ga. Code Ann., Section
                                              15-11-419 (j),(k)(1996)

Illinois        16 months               1993  705 Ill. Comp. Stat.
                                              Ann., 405/2-22(5)(West
                                              Supp. 1996)

Indiana         12 months               1996  Ind. Code Ann., Section
                                              31-6-4-19(c)(Michie
                                              Supp. 1996)

Iowa            12 months               1987  Iowa Code Ann., Section
                                              232.104 (West 1994)

Kansas          12 months               1994  Kan. Stat. Ann., Section
                                              38-1565(b),(c)(1995)

Louisiana       12 months               1991  La. Ch. Code Ann., Arts.
                                              702,710(West 1995)

Michigan        15 1/2                  1988  Mich. Stat. Ann.,
                months\c                      Section
                                              27.3178(598.19a)(Law Co-
                                              op Supp. 1996)

Minnesota       12 months               1993  Minn. Stat. Ann.,
                                              Section 260.191 Subd.
                                              3b(West Supp. 1997)

Mississippi     12 months               1985  Miss. Code Ann., Section
                                              43-21-613 (3)(1993)

New Hampshire   12 months               1987                            New Hampshire
                                                                        Court Rules
                                                                        Annotated, Abuse
                                                                        and Neglect,
                                                                        Guideline 39
                                                                        (Permanency
                                                                        Planning
                                                                        Review)\d

New Mexico      6 months                1993                            State official's
                                                                        statement\e

New York        12 months               1989  N.Y. Jud. Law, Section
                                              1055(b)(McKinney Supp.
                                              1997)

Ohio            12 months               1989  Ohio Rev. Code Ann.,
                                              Sections 2151.353(F),
                                              2151.415 (A) (Anderson
                                              1994)

Pennsylvania    6 months                1986  42 Pa. Cons. Stat. Ann.,
                                              Section 6351(e-g)(West
                                              Supp. 1996)

Rhode Island    12 months               1985  R.I. Gen. Laws, Section
                                              40-11-12.1(1990)

South Carolina  12 months               1983  S.C. Code Ann., Section
                                              20-7-766(Law. Co-op.
                                              Supp. 1996)

Utah            16 months               1995  Utah Code Ann., Sections
                                              78-3a-312,(1996)

Virginia        12 months\f             1994  Va. Code Ann., Section
                                              16.1-282(Michie 1996)

Washington      12 and 18               1994  Wash. Rev. Code Ann.,
                months\g                      Section 13.34.145(3)(4)
                                              (West Supp. 1997)

West Virginia   12 months               1984  W. Va. Code, Sections
                                              49-6-5, 49-6-8(1996)

Wisconsin       12 months               1981  Wis. Stat. Ann.,
                                              Sections 48.355(4);
                                              48.38; 48.365(5)(West
                                              1987)

Wyoming         12 months               1995  Wyo. Stat. Ann., Section
                                              14-6-229 (k)(Michie
                                              Supp. 1996)
----------------------------------------------------------------------------------------
\a Generally, a permanency hearing must be held within the indicated
number of months after the child enters foster care. 

\b Colorado law requires that for children under age 6, the
permanency hearing must be held within 6 months from the time a child
enters care.  The time frame to hold the permanency hearing was
calculated by adding the days needed to conduct the adjudicatory,
dispositional, and permanency planning hearings.  This expedited
procedures program will be implemented on a county-by-county basis
and will be fully implemented in the state by June 30, 2004.  For
children aged 6 and older, the permanency hearing is held within 18
months of placement. 

\c Michigan's time frame to hold the permanency hearing was
calculated by adding the days needed to conduct the preliminary
hearing, trial, dispositional hearing, and the permanency hearing. 

\d New Hampshire law is unclear regarding the time frame for holding
the permanency hearing; therefore, we relied on the New Hampshire
Court Rules Annotated--Statutory Requirements Guidelines for Abuse
and Neglect, Guideline 39, which requires that a permanency hearing
be held within 1 year of the child's placement in foster care. 

\e New Mexico law does not refer to permanency hearings.  It does
require that a dispositional hearing be conducted every 6 months to
review the permanency plan of the child.  During this review, a
permanency decision for the child can be made but is not required. 

\f Virginia's time frame to hold the permanency hearing was
calculated by adding the number of months required to file the
petition to hold the permanency hearing plus the number of days
within which the court is required to schedule the hearing. 

\g Washington's law requires the permanency hearing to be held no
later than 12 months after a child is placed in foster care for
children 10 years old and under.  For children over age 10, the
permanency hearing must be held no later than 18 months after a child
is placed in foster care. 




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



(See figure in printed edition.)


GAO CONTACTS AND STAFF
ACKNOWLEDGMENTS
========================================================== Appendix IV

GAO CONTACTS

Gale C.  Harris, Assistant Director, (202) 512-7235
Shellee S.  Soliday, Evaluator-in-Charge, (404) 679-1950

STAFF ACKNOWLEDGMENTS

In addition to those named above, Diana Eisenstat served as an
adviser; David D.  Bellis, Octavia V.  Parks, and Rathi Bose
coauthored the report and contributed significantly to all
data-gathering and analysis efforts.  Also, Julian P.  Klazkin
provided legal analysis of state statutes. 

RELATED GAO PRODUCTS

Child Welfare:  States' Progress in Implementing Family Preservation
and Support Activities (GAO/HEHS-97-34, Feb.  18, 1997). 

Child Welfare:  Complex Needs Strain Capacity to Provide Services
(GAO/HEHS-95-208, Sept.  26, 1995). 

Child Welfare:  Opportunities to Further Enhance Family Preservation
and Support (GAO/HEHS-95-112, June 15, 1995). 

Foster Care:  Health Needs of Many Young Children Unknown and Unmet
(GAO/HEHS-95-114, May 26, 1995). 

Foster Care:  Parental Drug Abuse Has Alarming Impact on Young
Children (GAO/HEHS-94-89, Apr.  4, 1994). 

Residential Care:  Some High-Risk Youth Benefit, But More Study
Needed (GAO/HEHS-94-56, Jan.  28, 1994). 

Foster Care:  Services to Prevent Out-of-Home Placements Are Limited
by Funding Barriers (GAO/HRD-93-76, June 29, 1993). 

Foster Care:  State Agencies Other Than Child Welfare Can Access
Title IV-E Funds (GAO/HRD-93-6, Feb.  9, 1993). 

Foster Care:  Children's Experiences Linked to Various Factors;
Better Data Need (GAO/HRD-91-64, Sept.  11, 1991). 

Child Welfare:  Monitoring Out-of-State Placements (GAO/HRD-91-107BR,
Sept.  3, 1991). 


*** End of document. ***