April 17,2002

Grassley Initiates Review of Foster Care


WASHINGTON – Sen. Chuck Grassley, ranking member of the Committee on Finance, todaysaid he is initiating a review of key accountability measures in the nation’s foster care system.“The foster care system has some problems,” Grassley said. “Experts have known for sometime that data sharing doesn’t happen the way it should, and states are having trouble trackingparticipating children, money and services. Congress has responded by requiring states todemonstrate the effectiveness of their foster care programs. It’s important to get an accounting ofhow states are performing and recommendations for fixing performance problems. Foster care is thelifeline for thousands of kids. It has to work.”

Grassley said a patchwork of laws and regulations have developed over time to governvarious aspects of foster care, involving several different entities such as the federal Centers forMedicare and Medicaid Services, state social services departments and state and federal courts.Federal funding for foster care is $4.3 billion a year. Grassley said the timing is appropriate for anindependent review of key program areas. Grassley is asking the federal General Accounting Office(GAO) to review:

? The coordination of state data systems. States have data systems associated with their childwelfare/foster care programs that cannot communicate with each other and with the courts,which also have inadequate data systems. Based on initial discussions with GAO, Grassleysaid, this project is important to understanding the accountability problems with the states’inability to track children in the foster care system, money, and services.

? Independent living programs. The second GAO project concerns federal funds to states foryouths who “age out” of foster care at 18 and lack the skills to sustain employment and selfsufficiency.

The Foster Care Independence Act of 1999 (P.L. 106-169) expanded services toformer foster care youths with programs including the Chafee Foster Care IndependenceProgram (CFCIP). Under the CFCIP, the entitlement ceiling doubled to $140 million, andstates have been given more flexibility to design programs to improve the transition for olderfoster care children to life on their own. CFCIP also contains accountability provisions fromGrassley. These provisions require the federal Department of Health and Human Services todevelop outcome measures to evaluate the state CFCIPs. Congress appropriated $140 millionfor the CFCIP for Fiscal Year 2002 (P.L. 107-116), and the Bush administration’s Fiscal Year2003 budget request includes an additional $60 million to fully fund the education and trainingvoucher program. Grassley said this project should provide a national snapshot of trends andareas of concern and improvement, and shine sunlight on how effectively and efficiently thestates are using these federal dollars.

In addition to these GAO reports, Grassley said he is working with the Health and HumanServices Inspector General on four reports: (1) Challenges in Retaining Foster Care Providers,projected for release this month; (2) Recruitment of Foster Care Providers, projected for release thismonth; (3) Foster Care Children’s Access to Health Care Services: New Jersey, projected for releasein July/August 2002; and (4) Enrollment in Medicaid and SCHIP, The Adolescent Population,projected for release in January/February 2003.

Grassley’s request letters to the GAO follow.

April 16, 2002
Via Regular Mail and Facsimile: (202) 512-9096
The Honorable David M. Walker
Comptroller General
U.S. General Accounting Office
441 G Street, N.W.
Washington, D.C. 20548
Re: GAO Request, Child Welfare Data Audit

Dear Mr. Walker:

As Ranking Member on the Senate Committee on Finance (Committee), I write to requestthat the General Accounting Office (GAO) review the adequacy of existing child welfare data tomeasure outcomes for children in the child welfare system pursuant to this Committee’s jurisdictionover health programs under the Social Security Act and health programs financed by a specific taxor trust fund.

With an increased focus on appropriate outcomes for these children, the need for accuratedata is of paramount importance. The ability of states to collect and report accurate and timely datais one of the first steps toward meaningful improvements in the state child welfare programs thatserve these children. The states and the Department of Health and Human Services (HHS) haveundertaken new initiatives to ensure that accurate data is available for child welfare caseworkers,supervisors, managers, and policymakers to enhance their ability to do their jobs. The StateAutomated Child Welfare Information Systems (SACWIS) have been in development for a numberof years, data improvements have occurred within the Adoption and Foster Care Reporting System(AFCARS), and HHS recently began conducting Child and Family Service Reviews that are heavilydependent on accurately reported child welfare data.

Concerns arise regarding the consistency with which states report data, the commonality ofdefinitions used, and whether appropriate data systems are in place to monitor the lives of childrenin foster care. As such, I am interested in the progress states have made in implementing theirSACWIS systems, the reliability and suitability of the AFCARS data, and the appropriateness of thecurrent child welfare outcome measures. Accordingly, I ask that GAO answer the followingquestions:

1. To what extent have states implemented their SACWIS systems, and how are thesesystems designed to respond to the needs of child welfare workers and policymakers?

2. What problems, if any, exist in the states in responding to federal data requests? Doesthe federal government have an appropriate system for capturing the information it needs in thisregard?

3. How has the new focus on outcome measures influenced states’ efforts to improvedata collection and quality and what challenges, if any, remain?

4. What promising practices exist in the states to ensure the accuracy, timeliness, andusefulness of child welfare-related data?

As you proceed with this request, I appreciate your keeping Faith Cristol and RebeccaReisinger of my Committee staff informed of your progress. Also, please contact Ms. Cristol withany questions concerning this request.

Sincerely,

Charles E. Grassley
Ranking Member

April 16, 2002
Via Regular Mail and Facsimile: (202) 512-9096
The Honorable David M. Walker
Comptroller General
U.S. General Accounting Office
441 G Street, N.W.
Washington, D.C. 20548
Re: GAO Request, Youths Who Age Out of Foster Care

Dear Mr. Walker:

As Ranking Member on the Senate Committee on Finance (Committee), I write to requestthat the General Accounting Office (GAO) review the implementation of the Chafee Foster CareIndependence Act of 1999 (Act [P.L. 106-169]) pursuant to the Committee’s jurisdiction over healthprograms under the Social Security Act and health programs financed by a specific tax or trust fund.The Act expanded services to foster care youths by authorizing programs such as the ChafeeFoster Care Independence Program (CFCIP). The purpose of CFCIP is to provide the states withflexible funding to design and conduct programs to help children remaining in foster care until the ageof 18 become self-sufficient, obtain education and training for employment, receive personal andemotional support, and receive other support services necessary to aid their transition fromadolescence to adulthood. Funding for such programs doubled from previous Independent LivingProgram allocations as Congress appropriated $140 million for the CFCIP for Fiscal Year 2002 (P.L.107-116) and the Administration’s Fiscal Year 2003 budget request includes the additional $60million to fully fund the education and training voucher program. My interest in and contribution toCFCIP focuses on the Act’s accountability provisions that require HHS to develop outcomesmeasures and conduct data collection activities to monitor the state programs.

At the present time, I am aware that GAO may be limited in its data collection for this requestprimarily due to HHS’ progress in developing appropriate outcome measures and developing andimplementing a plan to collect the needed data from the states. It is my understanding that HHS iscollecting its first year of data from the states during the current fiscal year. However, in reviewingHHS’ plan, nationwide implementation of the proposed National Youth in Transition InformationSystem is not scheduled until October 2003. I realize that states may need to enhance current systemsor develop a new system for collecting the required data.

Accordingly, I would like GAO to commence this audit at an appropriate time in the futureto be determined in coordination with my Committee staff. At that time, I request that GAO answerthe following questions:

1. How have states used the increased federal dollars to better serve the needs of olderfoster care youth who will age out of the foster care system?

2. How did states determine which new services to implement or which existing servicesto enhance?

3. What is known about the effectiveness of these new or enhanced services?

4. To date, what actions has HHS taken to fulfill the accountability provisions of the Act?

As you proceed with this request, I appreciate your keeping Faith Cristol and RebeccaReisinger of my Committee staff informed of your progress. Also, please contact Ms. Cristol withany questions concerning this request.

Sincerely,

Charles E. Grassley
Ranking Member