Approximately 879,000 children were found to be victims of child maltreatment in 2000. Maltreatment categories typically include neglect, medical neglect, physical abuse, sexual abuse, and psychological maltreatment. Almost two-thirds of child victims (63%) suffered neglect (including medical neglect); 19 percent were physically abused; 10 percent were sexually abused; and 8 percent were psychologically maltreated. Child fatalities are the most tragic consequence of maltreatment. Approximately 1,200 children died of abuse or neglect in the year 2000-a rate of 1.71 children per 100,000 children in the population. The increase in the rate of fatalities compared to earlier years is hypothesized to be largely attributable to improved reporting. Youngest children were the most vulnerable. Children younger than one year old accounted for 44 percent of child fatalities and 85 percent of child fatalities were younger than 6 years of age.
Children in foster care numbered 556,000 in September 2000. Most of these children will return to their homes, but more than 70,000 cannot return safely. Many of these children are considered to have "special needs" because they are older, members of minority or sibling groups, or physically, mentally or emotionally disabled. They often need special assistance in finding adoptive homes. During FY 2001, over 250,000 children received Title IV-E adoption assistance, which is a subsidy to families who adopt special needs children.
Foster Care/Adoption Assistance/Independent Living
For those children who cannot remain safely in their homes, foster care provides a stable environment that assures a child's safety and well-being while their parents attempt to resolve the problems that led to the out of home placement. When the family cannot be reunified, foster care provides a stable environment until the child can be placed permanently with an adoptive family. Authorized under title IV-E of the Social Security Act, Foster Care and Adoption Assistance programs provide Federal matching funds of 50 to 80 percent, depending on the state's per capita income, to states which directly administer the programs. Under Foster Care, funds are available for monthly payments to foster care providers on behalf of foster children. These payments vary from state to state.
Under Adoption Assistance, funds are available for a one-time payment for the costs of adopting a child as well as for monthly subsidies to adoptive families for care of the child (who is eligible for welfare under the former AFDC program or for Supplemental Security Income). Similar to Foster Care, the amounts vary from state to state.
Additionally, funds received under Foster Care and Adoption Assistance are used by states to assist costs related to child placement and case management activities; training for staff, foster parents, and adoptive parents; foster and adoptive parent recruitment; and other relevant expenses.
Assistance is also available to current or former foster care youth age 16 and older to help in the transition to independent living. The Independent Living program provides grants to states for education and employment assistance, training in daily living skills, and individual and group counseling.
In December 1999, "The Foster Care Independence Act of 1999" was signed into law. This legislation helps ensure that young people who leave foster care get the tools they need to make the most of their lives. It empowers them by providing better educational opportunities, access to health care, training, housing assistance, counseling and other services.
The Act increased the annual funding for the Independent Living program and expanded the services and supports available to help prepare foster care youth for the transition to adulthood. These programs are funded jointly by the federal and state governments. Monthly payments to families and institutions vary from state to state. Under the new legislation, states are now required to serve youth up to 21years old, enabling more young people to obtain a college education. It also enables states to provide time-limited financial assistance to help these youth with living expenses as they develop the skills and education needed to move successfully into the workforce. In addition, the new law gives states the option to let these young people remain eligible for Medicaid up to age 21.
In FY 2002, funding for Foster Care is $5.05 billion, $1.4 billion for Adoption Assistance and $140 million for Independent Living.
Promoting Safe and Stable Families
The primary goals of Promoting Safe and Stable Families (PSSF) are to prevent the unnecessary separation of children from their families, improve the quality of care and services to children and their families, and ensure permanency for children by reuniting them with their parents, by adoption or by another permanent living arrangement. The programs include: family support, family preservation, time-limited family reunification and adoption promotion and support services.
The services are designed to help State child welfare agencies and eligible Indian tribes establish and operate integrated, preventive family preservation services and community-based family support services for families at risk or in crisis. Funds go directly to child welfare agencies and eligible Indian tribes to be used in accordance with their 5-year plans. Other grant funds are set aside for nationally funded evaluation, research, and training and technical assistance projects. In addition, funds are set-aside for court improvement programs.
PSSF services are based on several key principles. The welfare and safety of children and of all family members should be maintained while strengthening and preserving the family. It is advantageous for the family as a whole to receive services which identify and enhance its strengths while meeting individual and family needs. Services should be easily accessible, often delivered in the home or in community-based settings, and they should respect cultural and community differences. In addition, they should be flexible, responsive to real family needs, and linked to other supports and services outside the child welfare system. Services should involve community organizations and residents, including parents, in their design and delivery. They should be intensive enough to keep children safe and meet family needs, varying between preventive and crisis services. Funding for Promoting Safe and Stable Families is $305 million in 2002.
Child Abuse and Neglect Prevention and Treatment
The Child Abuse Prevention and Treatment Act (CAPTA) funds States and grantees in several different ways: by providing funds and technical assistance for prevention and intervention; supporting research, service improvement programs, and demonstration projects; collecting data about the problem, its consequences, and the effectiveness of prevention and treatment services; facilitating information dissemination and exchange; and supporting policy development and professional education.
Community-based Family Resource and Support Grants fund statewide networks of local child abuse and neglect prevention and family resource programs. To receive these funds, states must have in place a trust fund or other funding mechanism that pools Federal, state, and private funds and makes them available for child abuse and neglect prevention and family resource programs. Funding is $33.4 million in FY 2002.
Basic State Grants provide assistance in developing, strengthening, and implementing child abuse and neglect prevention and treatment programs. Funding is $22 million in FY 2002.
Federal funds also support research on the causes, prevention, and treatment of child abuse and neglect. These demonstration programs identify the best means of preventing maltreatment and treating troubled families. Funding is $26 million in FY 2002.
Child Welfare Services
The Child Welfare Services program provides grants to states and Indian tribes under title IV-B of the Social Security Act. Services are available to children and their families without regard to income. Publicly funded Child Welfare Services are directed toward the goal of keeping families together. They include preventive intervention so that, if possible, children will not have to be removed from their homes. If this is not possible, placements and permanent homes through foster care or adoption can be made. In addition, reunification services are available to encourage the return home, when appropriate, of children who have been removed from their families.
Each state receives a base amount of $70,000. Additional funds are distributed in proportion to the state's population of children under age 21 multiplied by the complement of the state's average per capita income. The state match requirement is 25 percent. Funding is approximately $292 million in FY 2002.
HHS/ACF has other programs that address the welfare of children at risk. The Adoption Opportunities program eliminates barriers to adoption and helps to find permanent homes for children, particularly those with special needs, who would benefit by adoption. In FY 2002, funding for Adoption Opportunities is $27.3 million.
The Abandoned Infants Assistance program provides grants to help identify ways to prevent the abandonment of children in hospitals and to identify and address the needs of infants and young children, particularly those with acquired immune deficiency syndrome (AIDS) and prenatal drug or alcohol exposure. In FY 2002, $12.2 million is available for Abandoned Infants Assistance.
The Infant Adoption Awareness Training program has funded grantees to develop curricula and implement training programs to train designated staff of eligible health centers in providing adoption information and referrals to pregnant women on an equal basis with all other courses of action included in non-directive counseling to pregnant women. In FY 2001, $8.6 million was awarded to four grantees to implement this new program, which was enacted in October 2000. In FY 2002, $9.9 million is available.
Better Outcomes for Children
The 1994 Amendments to the Social Security Act (SSA) authorize the U.S. Department of Health and Human Services (DHHS) to review State child and family service programs to ensure conformance with the requirements in titles IV-B and IV-E of the SSA. Traditionally, reviews have focused primarily on assessing State agencies' compliance with procedural requirements, as evidenced by case file documentation, rather than on the results of services and States' capacity to create positive outcomes for children and families. In addition, reviews have not provided States with opportunities for making improvements before penalties have been imposed.
On January 25, 2000, the DHHS published a final rule in the Federal Register to establish a new approach to monitoring State child welfare programs. Under the rule, which became effective March 25, 2000, States will be assessed for substantial conformity with certain Federal requirements for child protective, foster care, adoption, family preservation and family support, and independent living services. The Children's is administering the new review system. The system comprises two review components: (1) child and family services and (2) title IV-E foster care eligibility reviews.
The new child and family services reviews are an important tool that will enable the Children's Bureau to accomplish the following: (1) ensure conformity with Federal child welfare requirements; (2) determine what is actually happening to children and families as they are engaged in child welfare services; and (3) assist States to enhance their capacity to help children and families achieve positive outcomes.
Ultimately, the goal of the reviews is to help States to improve child welfare services and achieve the following outcomes for families and children who receive services:
*Children are, first and foremost, protected from abuse and neglect.
*Children are safely maintained in their homes whenever possible and appropriate.
*Children have permanency and stability in their living situations.
*The continuity of family relationships and connections is preserved for families.
Family and Child Well-Being
*Families have enhanced capacity to provide for their children's needs.
*Children receive appropriate services to meet their educational needs.
*Children receive adequate services to meet their physical and mental
The Federal government conducts the reviews in partnership with State child welfare agency staff; peer consultants round out the review teams. The reviews are structured to help States identify strengths and areas for improvement within their agencies and programs. Technical assistance is provided to the States to help them make improvements in identified areas.
State Child Welfare Waiver Demonstrations
Under authority from Congress, HHS may approve Child Welfare Demonstration Projects for up to 10 states a year in each of the five Fiscal Years 1998-2002. Under this initiative, HHS may waive certain provisions of the titles IV-B and IV-E of the Social Security Act (while maintaining all protections for children in foster care) and states may carry out demonstration projects to test innovations in service delivery and financing in order to strengthen outcomes for children and families involved with the child welfare system. All demonstrations are required to have a rigorous, independent evaluation and must be cost-neutral. Currently, there are 21 demonstration projects being implemented in 18 States (several States have more than one project). States with currently approved projects are: California, Colorado, Connecticut, Delaware, Illinois, Indiana, Maine, Maryland, Michigan, Mississippi, Montana, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Texas, Washington). The states will be expanding the array and improving the quality of child welfare services currently available. Among the innovations being tested are assisted guardianship/kinship permanence, managed care/capitated payment systems, the flexible use of Federal funds at the community level, intensive service options, substance abuse services, and tribal administration of title IV-E foster care funds.
National Adoption Internet Photolisting Service - AdoptUSKids
The Children's Bureau is implementing a project to operate and maintain the National Adoption Internet Photolisting Web site, AdoptUSKids, and a National Adoption Information Exchange System. The purpose of this initiative is to eliminate barriers to adoption and to provide permanent homes for children who would benefit from adoption, particularly children with special needs, including infants with life-threatening conditions. The website and information exchange are designed to link eligible children with qualified prospective adoptive parents and to promote national recruitment efforts to reach prospective parents for children awaiting adoption. The initiative will implement a national public education campaign about the adoption of children with special needs. It will also provide training and technical assistance to State and Tribal child welfare and adoption agencies on recruitment planning to develop an adequate pool of adoptive families that represent the ethnic and racial diversity of children in the State for whom adoptive families are needed. Recruitment efforts will also target foster families since 64% of the children adopted from the foster care system in FY 1999 were adopted by foster parents. The project will provide assistance to support groups for adoptive parents, adopted children and siblings of adopted children. Studies will be conducted to identify the barriers to completing adoptions and pinpoint the factors that lead to favorable long-term outcomes for families that adopt children with special needs.
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