Federal Funding for Tribal Child Welfare Programs

Tribes have direct access to some of the federal resources used by states  to finance child welfare programs under programs administered by HHS. Some of these program requirements  with respect to children in foster care require that states and tribes: make reasonable efforts, consistent with the health and safety of the  child, to preserve and reunify families (1) prior to a child’s placement  in foster care, to prevent the need for removing the child; and (2) to  make it possible for the child to safely return home; prepare a written case plan for each child receiving foster care  maintenance payments and ensure periodic court or administrative  review of each such case; ensure that each child is placed in a safe setting that is the least  restrictive (most family like) and most appropriate setting available,  consistent with the child’s best interest and special needs; make reasonable efforts to place siblings together and ensure  frequent visits between siblings not jointly placed, unless contrary to  their safety or well-being; within a specified time period, hold a permanency hearing and make  reasonable efforts to finalize the permanency plan for each child  (reunification, adoption, legal guardianship, placement with a fit and  willing relative, or another planned permanent living arrangement);  and maintain a child’s education and health records in the case plan and  include a plan to ensure the educational stability of the child while in  foster care. We interviewed officials  with 11 tribes that were in various stages of developing a title IV-E plan  and representatives from 7 of these tribes said they have a small number  of staff working on the title IV-E program, and that the staff are often  managing child welfare cases and implementing other tribal programs  such as child support or TANF. Child welfare experts and officials from tribes that initially expressed an  interest in title IV-E also said resource constraints hindered tribes’ ability  to implement title IV-E. All five experts we interviewed also said it is  difficult for tribes to establish title IV-E programs because they often have  fewer resources than states, their staffs are balancing multiple  responsibilities, or there is limited funding to address these needs. Selected Tribes Reported Challenges Adopting Some Title IV-E Requirements

Tribal officials reported challenges adopting some title IV-E program  requirements, including requirements related to termination of parental  rights, collecting case-level data for children in foster care, and  developing a CAM. While the Fostering Connections Act allowed tribes to  directly operate a title IV-E program, it generally did not modify the  program’s requirements or provide flexibilities for tribes. In addition, one study found that more tribes might  qualify for title IV-E if the program’s policies were modified to make them  more applicable to the realities of tribal nation characteristics and  differences in tribal nation structure and culture.Connections Act provided tribes with equitable access to title IV-E funds,  but also required title IV-E program requirements to be applied to tribes in  the same manner as states. HHS has acknowledged that termination of  parental rights may not align with Indian tribes’ traditional beliefs, but  stated that the agency lacks statutory authority to provide a general   However, HHS  exemption for tribal children from the requirement.officials also noted that title IV-E provides exceptions to the requirement,  which tribes may use as appropriate on a case by case basis. 3). However, officials from 5 of the 11 tribes we interviewed that were  developing a title IV-E plan said creating a CAM was challenging. HHS Provided Technical Assistance and Guidance to Tribes Interested in Title IV-E but Did Not Always Meet Tribes’ Needs

		HHS Assisted Tribes, but Selected Tribes Reported Difficulty in Accessing Assistance or with HHS’s Cultural Understanding

HHS provided title IV-E technical assistance to tribes through a variety of  methods (see fig. Although several tribes  used the National Resource Centers’ technical assistance services,  officials from 6 of 11 tribes we spoke with reported difficulties accessing  these services. HHS Does Not Have Procedures in Place to Ensure Consistent Guidance or Timely Reviews of Draft Title IV-E Plans

Although HHS regional staff are the primary technical assistance  providers for tribes, we found that some guidance and relevant HHS  regulations were not in place at the time they began assisting tribes with  their title IV-E plans. Regional  staff may use their discretion to determine what is allowable in a tribe’s  plan. Despite these efforts by ACF, officials from 6 of the 11 tribes developing  title IV-E plans we spoke with told us that they received inconsistent  guidance from HHS regional officials while developing their plans. These  officials also said that participating in title IV-E peer-to-peer consultations  with other tribes—an activity encouraged and sponsored by HHS—can be  frustrating because regional offices have provided tribes with different  information. According to ACF officials, they have not provided tribes or  regional office staff with examples because the language in the examples  for one tribe may not be appropriate for all tribes. Given  HHS’s goal of approving more tribal title IV-E plans, a lack of draft IV-E  plan review timeframes for its staff could continue to result in long tribal  IV-E plan development and review periods. While some tribes received  timely title IV-E draft plan reviews, others did not, in part because HHS  has not provided its regional office staff with expected timeframes for  reviewing draft title IV-E plans. Establishing procedures to ensure timely  reviews could improve relationships with tribes and promote a smoother  process for tribes developing their plans. To improve the consistency of assistance provided to tribes, the  Secretary of Health and Human Services should take steps to provide  consistent title IV-E guidance to tribes across its regional offices. HHS concurred with our recommendation that the agency, in consultation  with tribes, consider whether additional flexibilities in title IV-E program  requirements would enable more tribes to participate in the program. Appendix I: Objectives, Scope, and Methodology

This report examines: (1) the obstacles facing tribes interested in directly  operating a title IV-E program and (2) how HHS assisted interested tribes. We also interviewed Social Services  program staff at the Department of the Interior Bureau of Indian Affairs  (BIA). In addition, according to an  HHS official, tribes were instructed to report on all progress made in  developing title IV-E programs.
Why GAO Did This Study

Title IV-E of the Social Security Act provides federal support for foster care and adoption assistance programs. Since 2008, 5 tribes have been approved to operate their own title IV-E foster care programs, although more than 80 tribes initially expressed an interest in doing so. HHS provides development grants and technical assistance to tribes interested in establishing a title IV-E program. GAO was asked to review tribes' experiences with title IV-E.
This report examines (1) obstacles facing tribes interested in directly operating a title IV-E program and (2) the assistance HHS has provided. GAO interviewed officials from 17 tribes, 11 of which were currently developing title IV-E programs. These tribes were selected to achieve variation in progress toward developing a title IV-E program, size of the tribe, and HHS region. While this information is non-generalizable, it provides examples of tribes' experiences with the program. GAO also interviewed HHS and Bureau of Indian Affairs officials, and child welfare experts.

What GAO Found

Indian tribes developing title IV-E foster care programs faced resource constraints and reported challenges adopting some program requirements. According to GAO's interviews with tribal and Department of Health and Human Services (HHS) officials, the resource constraints faced by tribes include limited numbers of staff and staff turnover. While the Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections Act) allows tribes to administer a title IV-E foster care program, it generally did not modify title IV-E's requirements for tribes. By contrast, some other programs administered by HHS offer tribes additional flexibilities, provided they are consistent with the objectives of the program. Given tribes' resource constraints and cultural values, adopting some title IV-E requirements has been difficult. For example, officials from 6 of 11 tribes developing title IV-E programs that GAO interviewed said that the requirement to electronically submit case-level data on all children in foster care was challenging. In addition, 7 of these 11 tribal officials reported that incorporating termination of parental rights—which severs the legal parent-child relationship in certain circumstances—into their tribal codes was challenging because it conflicts with their cultural values. HHS recognizes that termination of parental rights may not be part of an Indian tribe's traditional beliefs; however according to the agency it lacks the statutory authority to provide a general exemption for tribal children from the requirement.
HHS provided assistance to tribes interested in directly operating a title IV-E program through its regional offices, headquarters office, and technical assistance providers. Eight of the 11 tribes GAO spoke with reported using HHS-funded technical assistance providers, including a tribally-focused center that was established after the enactment of the Fostering Connections Act. However, GAO found that there are no procedures in place to ensure that the guidance provided by HHS regional staff is consistent across offices or that the review of tribes' draft IV-E plans is timely. To operate a title IV-E program, HHS must approve a tribe's title IV-E plan, ensuring that it complies with program requirements. HHS does not provide its staff or tribes with examples of tribal codes or regulations that would satisfy title IV-E requirements. Regional staff may use their discretion to determine what is allowable in a tribe's plan. HHS officials said they do not provide examples because each tribe is unique and examples for one tribe may not be appropriate for all tribes. However, officials from 6 of 11 tribes GAO interviewed said that they received conflicting guidance from HHS officials, some of them from the same HHS office. Officials from one tribe said that participating in title IV-E peer-to-peer consultations with other tribes—an activity encouraged and sponsored by HHS—can be frustrating because regional offices have provided tribes with different information. HHS officials said that inconsistencies often resulted from differing tribal circumstances rather than interpretations of federal policy. In addition, officials from six tribes GAO spoke with said HHS's suggested revisions on their draft title IV-E plans were not provided in a timely manner. HHS headquarters officials have not provided regional staff with expected timeframes for draft title IV-E plan reviews and there is no limit on the amount of time staff may spend on the reviews. As a result, tribes may continue to have long title IV-E plan development and review periods and limited direct access to federal child welfare program funding.

What GAO Recommends

GAO recommends that HHS (1) consider submitting a legislative proposal if it determines that flexibilities in program requirements would enable more tribes to participate in title IV-E, (2) take steps to provide consistent guidance to tribes on their IV-E plans, and (3) establish procedures to ensure timely reviews of draft plans. HHS agreed with our first two, but did not agree with the third recommendation. GAO maintains the need for procedures, such as clear timeframes, to ensure timely IV-E plan reviews.