The Children's Bureau, Administration for Children, Youth and Families, Administration for Children and Families of the Department of Health and Human Services funds a number of programs that focus on preventing abuse of children in troubled families, protecting children from abuse, and finding permanent placements for those who cannot safely return to their homes.

One million children were victims of substantiated child abuse and neglect in 1995, the most recent year as reported to HHS by State Child Protection Services agencies. In 1995, 996 child fatalities from maltreatment were reported by the states. Maltreated children are found in all income, racial, and ethnic groups, and incidence rates are similar in urban, suburban, and rural communities. About half are cases of neglect, a quarter physical abuse, and about one in seven sexual abuse.

The Third National Incidence Study on Child Abuse and Neglect, which surveys both state reports and child professionals, found that as many as 2.8 million children were at risk for abuse and neglect in 1993, double the number of children in the previous study in 1988. The study also reported that a half a million children were seriously injured, quadruple the incidences from 1988.

Children in foster care numbered more than 483,000 in 1995, up from 340,000 in 1988. Most of these children will return to their homes, but more than 100,000 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. Currently, over 100,000 children receive title IV-E adoption assistance, which is a subsidy to families who adopt special needs children.

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 with agency administrative costs. Administrative costs include 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 youths 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 FY 96, funding for foster care was $3.7 billion, $510 million for adoption assistance and $70 million for Independent Living. In FY 97, funding for foster care was $3.8 billion, $568 million for adoption assistance, and $70 million for Independent Living. For FY 98, the Clinton administration requests $4.3 billion which is comprised of $3.54 billion for foster care, $700 million for adoption assistance, and $70 million for the Independent Living Program.

Family Preservation and Family Support Services grants focus on strengthening families, preventing abuse, and protecting children. These grants help state child welfare agencies and Indian tribes operate preventive family preservation services and community-based family support services for families at risk or in crisis.

Family Support Services, often provided at the local level by community-based organizations, are voluntary, preventive activities to help families nurture their children. These services are designed to alleviate stress and help parents care for their children's well-being before a crisis occurs. They connect families with available community resources and supportive networks which assist parents with child rearing. Family support activities include respite care for parents and caregivers, early developmental screening of children to identify their needs, tutoring, health education for youth, and a range of center-based activities.

Family Preservation Services typically are activities that help families alleviate crises that might lead to out-of-home placements of children because of abuse, neglect, or parental inability to care for their children. They help to maintain the safety of children in their own homes, support families preparing to reunify or adopt, and assist families in obtaining other services to meet multiple needs.

Funding for Family Preservation and Family Support Services was $225 million in FY 96 and $240 million in FY 97. For FY 98, the Clinton Administration requests $255 million.

The Child Abuse and Neglect program funds states and grantees in several different programs authorized by the Child Abuse and Neglect Prevention and Treatment Act (CAPTA). The programs seek to assist states to meet their responsibilities for the prevention and intervention in cases of child abuse and neglect by providing funds and technical assistance; generate knowledge by funding research, service improvement programs, and demonstration projects; generate knowledge through the ongoing collection of data about the scope and nature of the problem, its consequences, and the effectiveness of prevention and treatment services; facilitate information dissemination and exchange; and support policy development and the education of professionals in the field.

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 was $23 million in FY 96 and $32.835 million in FY 97. For FY 98, the Clinton Administration requests $32.835 million.

Basic State Grants provide assistance in developing, strengthening, and implementing child abuse and neglect prevention and treatment programs. Funding was $18.026 million in FY 96, and $21.026 million in FY 97. For FY 98, the Clinton Administration requests $21.026 million.

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 was $14.154 million in FY 96 and $14.154 million in FY 97. For FY 98, the Clinton Administration requests $14.154 million.

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 was $277 million in FY 1996 and $292 million in FY 1997. For FY 98, the Clinton administration requests $292 million.

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 who would benefit by adoption, particularly those with special needs. Grants and contracts are awarded to public and private non-profit agencies. Funding was $11 million in FY 1996 and $13 million in FY 1997. For FY 98, the Clinton administration requests $13 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. Funding was $12 million in FY 1996 and $12 million in FY 1997. For FY 98, the Clinton administration requests $12 million.

Adoption

To reduce the number of children presently in foster care, the Clinton administration launched an "Adoption 2002" initiative to reduce barriers to adoption and double the number of children adopted or permanently placed each year, from 27,000 in 1996 to 54,000 in 2002.

Adoption 2002 is based on a set of principles that declare that every child deserves a safe, permanent family; that the child's health and safety should be the paramount considerations in all placement and permanency planning decisions; and that foster care is a temporary solution and not an appropriate place for children to grow up. Adoption 2002 establishes unequivocally that the Federal goals for children in the child welfare system are safety, permanency, and well-being.

By offering financial incentives and technical assistance to states, courts, and communities, the federal government will help states meet ambitious new adoption targets. Toward that end, the President's FY 1998 budget proposes $21 million for technical assistance and grants to state agencies, courts and communities, innovative demonstrations to reform the child protective system to reduce barriers to permanency, and a national public awareness campaign.

Efforts are also being made to break down racial and ethnic barriers to adoption: the Clinton Administration is continuing to vigorously enforce the Multiethnic Placement Act of 1994 and the Interethnic Adoption provisions of 1996, which prohibit adoption agencies from denying or delaying placement of a waiting child based on race, color, or national origin.

In August, 1996, President Clinton signed legislation providing a $5000 tax credit to families adopting children and a $6000 tax credit for families adopting children with special needs. This tax credit is designed to help alleviate some of the financial barriers to adoption. Previously, the President signed legislation enabling parents to take time off to adopt a child without losing their jobs or health insurance.

State Child Welfare Reform

Under authority from Congress, HHS can approve child welfare reform demonstrations for up to 10 states to test innovative new ways to strengthen the child welfare system. To date, six states have been approved (Delaware, Illinois, Maryland, North Carolina, Ohio, and Oregon). The states will be expanding the array and improving the quality of child welfare services currently available. Assisted guardianship, managed care, and the flexible use of Federal funds at the community level are among the innovations being examined.

Better Outcomes for Children

Finally, the Department of Health and Human Services is developing new program monitoring procedures that focus on the quality of child welfare services and the outcomes to children and families. Outcomes will be measured by safety, permanency, and well-being, and any additional measures a state may choose. The reviews will cover family preservation, child protection, foster care, and adoption. Following the reviews, states will receive immediate feedback on the extent to which their programs are achieving the stated objectives in accordance with a set of standards for each outcome area.

Information provided by the NIH.