Chapter 11: Prevention, Foster Care, and Adoption

Issues: Child Welfare

Federal child welfare policy is largely concerned with preventing the abuse or neglect of children in their own homes and responding to the consequences of any such abuse or neglect. The primary goals of the policy are to ensure children’s safety and permanence, and to promote the well-being of children and their families.

Under the U.S. Constitution, states are understood to have the primary obligation to ensure the welfare of children and their families. At the state level, the child welfare “system” consists of public child protection and child welfare workers, private child welfare and social service workers, state and local judges, prosecutors, and law enforcement personnel. These representatives of various state and local entities assume interrelated roles while carrying out child welfare activities. These include: offering services to strengthen and support biological, adoptive, and kinship families; removing children from their homes when that is necessary for their safety; supervising and administering payments for children placed in foster care; working to permit safe reunification of children with their parents or, when this is not possible, finding them a new permanent family through adoption, legal guardianship or placement with a fit and willing relative; and providing services to help older children in foster care and youth who “age out” of care become successful adults.

Children and Families Served

Most children or families served by a public (state or local) child welfare agency first come into contact with that agency following an allegation of child abuse or neglect. There are some 74 million children in the nation, and in FY2016 state or local child protective service workers investigated or otherwise provided a response to allegations of abuse or neglect involving some 3.5 million children. An estimated 1.3 million of those children and their families received additional services following this child protective services response and states identified 676,000 children as victims of child abuse or neglect under state law and policy. The large majority of children who received services from the child welfare agency after an abuse or neglect investigation or response were served in their own home rather than being removed to foster care.

Foster care is a temporary living arrangement for children who cannot safely remain in their own homes. There were some 274,000 children who entered foster care in FY2014. This represented an increase of 23,000 children compared to five years earlier. and was the highest one-year total of children entering care in five years. For most of the children entering foster care in FY2016 (61%), states reported that neglect was one of the circumstances that led to their removal from their homes and placement in foster care. Other circumstances of removal for children entering care in FY2016 included (alone or in combination with additional factors) drug abuse by the child’s parent (34%), “caretaker inability to cope” due to physical or mental illness or other reason (14%), physical abuse (12%), a child behavior problem (11%), inadequate housing (10%), parental incarceration (8%), alcohol abuse by child’s parent (6%), abandonment (5%), and sexual abuse (4%).

The number of children remaining in foster care declined from a high of 567,000 children on the last day of FY1999 to a low of 397,000 as of the last day of FY2012. Since then the number of children in foster care has steadily climbed, reaching 437,000 as of the last day of FY2016. The general decline in the number of children in foster care across much of FY1999-FY2012 may be credited to successful efforts by states to reduce the length of time children spend in care, locate more permanent homes for children and, in more recent years, reduce the number of children entering care. While state efforts to locate and find new permanent homes for children continues to be strong, the more recent increases in entries to foster care, which  appears linked to rising parental substance abuse, may largely explain the increase in the overall foster care caseload.

Requirements and Oversight

Most federal child welfare requirements are included in Title IV-B and Title IV-E of the Social Security Act.  To receive federal support through the federal child welfare programs authorized under those parts of the law, states must provide no less than 20% of total program costs, and may be required to provide up to 50% of total program costs (depending on the program and kind of activity).  As a condition of receiving these federal funds, states must also provide certain protections to each child in foster care (and without regard to whether or not the child meets federal eligibility criteria for Title IV-E support).  Further, states must meet additional federal requirements related to planning for and administering services to children and families. State compliance with these requirements is subject to various federal audits and conformity reviews, of which the most comprehensive is the Child and Family Services Review (CFSR). 

State Spending on Child Welfare Purposes

States spend substantial funds on child welfare purposes. In FY2018 federal dedicated child welfare funding was about $9.5 billion, and to fully draw down those federal funds states are expected to provide non-federal resources of roughly $7.4 billion. This suggests total federal, state, and local spending for child welfare purposes of close to $17 billion. However, according to a survey of state child welfare agency spending for state fiscal year 2014 (the most recent available), those public agencies spent $29.1 billion on child welfare activities in that year with more than half of this spending ($16.3 billion or 57%) coming from state or local funds.  The remainder ($12.8 billion or 43%) drew on federal funds, including the funding streams discussed previously that are dedicated to child welfare purposes (primarily those authorized in Title IV-E and Title IV-B), as well as additional federal funding that states may choose to direct to child welfare purposes. Principally this “non-dedicated” funding is expended by states’ child welfare agencies out of federal funds provided under the Temporary Assistance for Needy Families (TANF) block grant, the Social Services Block Grant (SSBG), and Medicaid. [1] 

[1] Kristina Rosinsky and Dana Connelly. Child Welfare Financing SFY2014: A survey of federal, state, and local expenditures, Child Trends. Casey Family Programs, and Annie E. Casey Foundation (October 2016).  

Congressional Research Service (CRS) Reports

For more programmatic information, please see reports published by the Congressional Research Service.

CRS works exclusively for the United States Congress, providing policy and legal analysis to Committees and Members of both the House and Senate, regardless of party affiliation.

Additional Tables and Figures

Figure 11-1. Trend in Title IV-E Foster Care and Permanency Assistance Caseload, FY1996-FY2019 and Table 11-1. Title IV-E Caseload by Type of Assistance, Number and Rate, FY1984-FY2017

Figure 11-2. Caseload and Federal Outlay Estimates for the Title IV-E Program, FY2018-FY2028

Figure 11-3. Trends in Foster Care Use, FY1982-FY2016 and Table 11-3.  National Estimates of Foster Care Use, FY1982-FY2016

Figure 11-4. Rate of Entry to Foster Care by State, FY2016; Figure 11-4A. Circumstances Associated with Children’s Removal From the Home, FY2016; Figure 11-4B. Percentage of Children in Foster Care by Type of Placement Setting and by State, FY2016; and Table 11-4. Current Placement Setting of Children in Foster Care by State, FY2016

Figure 11-5. Trend in Title IV-E Foster Care Coverage, FY1996-FY2016 and Table 11-5. Estimated Share of Foster Care Caseload Eligible for and Receiving Title IV-E Foster Care Maintenance Payments by State, FY2016

Figure 11-6. Trend in Federal and State Title IV-E Spending for Foster Care, Adoption Assistance, and Kinship Guardianship Assistance, FY1989-FY2016 and Table 11-6. Federal and State Title IV-E Spending for Foster Care (FC), Adoption Assistance (AA), and Kinship Guardianship Assistance (GA), FY1989-FY2016

Figure 11-7. Trend in Federal Title IV-E Spending by Program Component, FY1989-FY2016; Figure 11-8. Share of Federal Title IV-E Spending by Program Component, FY1989-FY2016; and Table 11-7. Federal Title IV-E Spending by Component, FY1989-FY2016 

Table 11-8. Total Title IV-E Foster Care, Adoption Assistance, and Kinship Guardianship Assistance Spending by State, FY2016

Figure 11-9. Trend in Total Title IV-B Funding, FY1992-FY2018; Table 11-9A. Total Title IV-B Funding, FY1990-FY2018; and Table 11-9B. Title IV-B Funding by State, FY2018 

Legislative History

The following provides a legislative history of amendments to child welfare programs in the Social Security Act from the 2016 Green Book through August 2018. For prior history, please see earlier editions of the Green Book

Bipartisan Budget Act of 2018 (P.L. 115-123)

Title VII, Division E of the Bipartisan Budget Act of 2018, enacted February 9, 2018, includes the Family First Prevention Services Act (Family First). Family First renamed the Title IV-E program in the Social Security Act (SSA) as the Foster Care, Prevention, and Permanency program. It amended that program to authorize new support for services to prevent the need for children to enter foster care; limit federal support for children in foster care who are placed in settings other than foster family homes; require improved standards for group or congregate care facilities providing care to children in Title IV-E financed foster care; and to temporarily reinstate (for certain children adopted before their second birthday) more narrow eligibility for Title IV-E adoption assistance.

Separately, the bill extended, through FY2021, funding authorizations for Adoption and Legal Guardianship Incentive Payments (Section 473A of the SSA) and for the child and family services grant programs included in Title IV-B of the SSA. These are the Stephanie Tubbs Jones Child Welfare Services (CWS) and the Promoting Safe and Stable Families Program (PSSF), which includes funding reservations for the Court Improvement Program, Monthly Caseworker Visit Grants, and Regional Partnership Grants.

Additionally, Family First renamed the program that targets services and supports for older children in foster care and those youth who have aged out of foster care, as the Chafee Foster Care Program for Successful Transition to Adulthood (Section 477 of the SSA). It also extended the age at which those program services and supports may be made available to former foster youth.

These and selected other changes made by Family First are outlined below.

  • Prevention Services. Beginning with FY2020, states, territories, and tribes opting to provide foster care prevention services under their Title IV-E plan are entitled to federal reimbursement for a part of the cost of providing the following services: evidence-based mental health and substance abuse treatment services, and programs for parents whose children are not in foster care (i.e., parenting skills training, parent education, and individual and family counseling). The services and programs may be provided for up to 12 months for children at imminent risk of entering foster care, pregnant or parenting youth in foster care, and the parents or kin caregivers of those children or youth. No income eligibility test applies. From FY2020-FY2026 any state, territory or eligible tribe electing to provide these foster care prevention services and programs under its Title IV-E program is entitled to receive federal reimbursement for one-half (50%) of the cost of providing these evidence-based services, including related administration and training costs. Beginning with FY2027, Title IV-E prevention services and programs are to be reimbursed at a state, territory, or tribe’s federal medical assistance percentage (FMAP), which may range from 50%-83%; reimbursement for related administration and training costs will remain at 50%. In each of these years +however, this federal support is available only to the extent the jurisdiction meets its maintenance of effort (MOE) spending requirement and provided that at least half of its Title IV-E claims for prevention services are for services meeting the highest specified evidence-based practices (“well-supported”).
  •  Limit on Support for Foster Children Placed in Non-Family Settings. As of FY2020 (or no later than FY2022 in states electing to delay implementation of these provisions), federal Title IV-E reimbursement for foster care is more limited for foster children placed in non-family settings. Specifically, no child may be eligible for Title IV-E foster care maintenance payment support for more than two weeks unless the child is placed in a licensed or otherwise approved setting that is a foster family home (caring for six or fewer foster children, unless a specified exception is met) OR is one of the following: (1) a  supervised setting in which youth live independently (provided youth is at least 18 years of age); (2) a setting specializing in prenatal, postpartum, or parenting supports for youth; (3) a setting providing high-quality residential services for youth identified as victims of, or at risk of, sex trafficking; (4) a family-based residential treatment center providing substance abuse treatment services for parents (provided the foster child is placed with a parent who is in treatment and for up to 12 months only); or (5) an accredited and qualified residential treatment program (QRTP), which has a trauma-informed treatment model able to meet identified clinical or other needs of the youth and has licensed or registered nursing and other clinical staff who are on-site consistent with that treatment model (provided additional assessment, documentation, and other requirements are met for the child by the QRTP and the Title IV-E child welfare agency). A state, territory or tribe may choose to delay the implementation date of these provisions by up to two years (i.e., until FY2022). However, no jurisdiction may be permitted to claim Title IV-E support for prevention services before the date that it makes these placement setting provisions effective.
  • Certification Related to Interaction with Juvenile Justice. Requires any state, territory or tribe with an approved Title IV-E plan to certify, under that plan, that they will not advance policies or practices that lead to significant increases in the number of children placed in juvenile justice settings as a response to the limitations placed on Title IV-E foster care support for foster children placed in group settings. Requires the Government Accountability Office (GAO) to evaluate any impact on the juvenile justice system resulting from the Family First changes to Title IV-E support for children in group settings and to report its finding to Congress no later than December 31, 2023.
  • Background Checks. As of October 1, 2018, states, territories and tribes operating a Title IV-E program are required to conduct the same criminal history and child abuse and neglect registry checks for any adult working in a group care facility that is licensed or approved by the state to provide foster care. This includes group homes, residential treatment centers or other congregate care settings. Specifically, the jurisdiction must carry out the same background checks for such adults workers in group care facilities as were previously required under the Title IV-E program only for prospective foster and adoptive parents, and relative guardians.
  • Kinship Navigator. As of October 1, 2018, states, territories and tribes with an approved Title IV-E plan are permitted to seek federal reimbursement under the Title IV-E program for 50% of the cost of an evidence-based kinship navigator program. There is no income test associated with Title IV-E support for kinship navigator programs and kin caregivers may be served without regard to whether the children they care for are in foster care or were previously in foster care.
  • Licensing Standards for Foster Family Homes. Requires states, territories and tribes with an approved Title IV-E plan to review their foster family home licensing standards and to take other steps intended to better enable licensing of both relative and non-relative foster family homes. The U.S. Department of Health and Human Services (HHS) was required to identify model licensing standards by October 1, 2018. Each jurisdiction with a Title IV-E plan must report to HHS on its standards and related licensing practices for relative foster family homes no later than April 1, 2019.
  • Title IV-E Foster Care Support in Family Based Residential Treatment Center. Beginning with FY2019 states, territories and tribes with an approved Title IV-E plan are permitted to seek federal reimbursement for a part of the cost of providing foster care support to children in foster care who are placed with their parent(s) in a licensed family-base residential treatment center that provides substance abuse treatment. For the child’s to be eligible for this Title IV-E support, the treatment provided to the parent must incorporate parent education, parenting skills training, and counseling and must be offered in a trauma-informed manner. To be eligible for this Title IV-E support the child must be formally in foster care (i.e., via court order or voluntary placement agreement) and placement in the family-based facility must be recommended in the child’s case plan. No income eligibility test applies. This Title IV-E support (available at the same federal reimbursement rates as any other IV-E eligible child in foster care) may be claimed for a maximum of 12 months. 
  • Interstate Electronic Case Processing. Requires states (including the 50 states and the District of Columbia) to include the use of an electronic interstate case processing system as part of their Title IV-E procedures for timely placement of children in foster care across state lines. Reserved $5 million in otherwise appropriated PSSF (Title IV-B, Subpart 2) funds to support state efforts to connect with an interstate electronic case-processing and to enable them to achieve safe and appropriate interstate placements for children in less time and at less cost.
  • Extended, at prior law levels, the annual funding authorization for the Stephanie Tubbs Jones Child Welfare Services (CWS) program (Title IV-B, Subpart 1 of the SSA) through FY2021. Generally requires states and other jurisdictions receiving CWS funding to (1) describe their development and implementation of a statewide, multidisciplinary plan to prevent child fatalities caused by abuse and neglect (as of October 1, 2018); and (2) adopt protocols to ensure children in foster care are not placed in non-family settings based on inappropriate diagnoses of mental, medical, or developmental disabilities, conditions, or disorders (effective as if enacted January 1, 2018). Requires HHS to evaluate state protocols to prevent such inappropriate diagnoses, determine whether the protocols are effective, identify best practices, and to submit a report to Congress on this work by January 1, 2020.    
  • Extended, at prior law levels, the annual funding authorizations for the Promoting Safe and Stable Families (PSSF) program (Title IV-B, Subpart 2 of the SSA) through FY2021, including PSSF funding reservations for the Court Improvement Program, Monthly Caseworker Visit Grants, and Regional Partnership Grants. Revised two categories of child and family services supported under the PSSF program to (1) explicitly include services provided to retain and support foster families as a “family support” service and (2) allow “family reunification services” to be offered without regard to the amount of time the child has been in foster care, and for up to 15 months after the child is reunited with family.
  • Revised the competitively awarded Regional Partnership Grants (RPGs), which were designed to improve outcomes for children affected by parental substance abuse, to call for improved outcomes and recovery for children and their families, including those dealing with opioid use disorders. Also (1) requires that most, or all, grantee partnerships include the state agency administering federal substance abuse prevention and treatment block grant funds and the court handling child welfare proceedings (along with the state child welfare agency as required in prior law); (2) requires a planning and implementation phase for each RPG; and (3) requires core indicators to be part of performance measurement, among other changes. All of these changes were effective October 1, 2018 (FY2019).
  • Amends the Court Improvement Program to require state highest courts (as a condition of receiving these funds) to provide training to judges and legal personnel on federal policies and payment limitations related to children placed in non-foster family home settings.
  • Foster Family Home Recruitment and Retention. Appropriates $8 million for competitive grants to states, Indian tribes, or tribal consortia for the recruitment and retention of high-quality foster family homes. This funding, appropriated in FY2018, is to remain available for use through FY2022.
  • Renames the John H. Chafee Foster Care Independence Program as the John H. Chafee Foster Care Program for Successful Transition to Adulthood. Revises multiple Chafee program purposes to focus services on any youth who experiences foster care at age 14 or older. Permits states that provide foster care for youth until their 21st birthday to use this program funding to serve former foster youth up to age 23 (instead of prior law age 21) and permits any state to use Chafee Educational and Training Vouchers (ETVs) for otherwise eligible foster or former foster youth up to age 26 (instead of prior law age 23), provided that no youth may receive an ETV for more than five years, consecutive or non-consecutive. Separately amends the Title IV-E program to require states to provide official documentation of time spent in foster care for youth aging out care. Made each of these changes effective with enactment (February 9, 2018).
  • Extends the Adoption and Legal Guardianship Incentive Payments, as previously authorized, with funding authorized annually through FY2021.
  • Revision to Adoption Assistance Eligibility. For six and a half years (January 1, 2018 through June 30, 2024), reinstates certain federal Title IV-E adoption assistance eligibility criteria (including an income test) for otherwise eligible children who are adopted before their second birthday. Any child determined eligible for Title IV-E adoption assistance prior to January 1, 2018 and any child adopted on or after his/her second birthday is not affected by this change. Further, as of July 1, 2024 (as opposed to prior law October 1, 2018) any child determined by the state to have “special needs” may be eligible for Title IV-E adoption assistance. Requires the GAO to conduct a study to determine if states are re-investing savings from the expansion of federal support for Title IV-E adoption assistance (which began in FY2010) into child welfare services.


This page was prepared October 2018 for the 2018 version of the House Ways and Means Committee Green Book.