Pandemic Posed Challenges, but also Created Opportunities for Agencies to Enhance Future Operations (GAO-21-483)
Summary
A GAO report to congressional committees, GAO-21-483, dated July 2021, on child welfare during the COVID-19 pandemic. Child welfare officials GAO interviewed in five selected states reported challenges affecting both child protective and foster care services during the pandemic in 2020-2021. Officials in all five state and 10 local child welfare agencies noted concerns about unreported child abuse and neglect, as children had less contact with mandated reporters such as teachers and doctors because of school and office closures. Its title states that the pandemic also created opportunities for agencies to enhance future operations.
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United States Government Accountability Office
Report to Congressional Committees
CHILD WELFARE
July 2021
Pandemic Posed
Challenges, but also
Created Opportunities
for Agencies to
Enhance Future
Operations
GAO-21-483
July 2021
CHILD WELFARE
Pandemic Posed Challenges, but also Created
Opportunities for Agencies to Enhance Future
Highlights of GAO-21-483, a report to Operations
congressional committees
Why GAO Did This Study What GAO Found
The Coronavirus Disease 2019 Child welfare officials GAO interviewed in five selected states reported
(COVID-19) pandemic has raised challenges affecting both child protective and foster care services during the
concerns about the welfare of children pandemic in 2020-2021. Officials interviewed in all five state and 10 local child
and disruptions to child welfare welfare agencies noted concerns about unreported child abuse and neglect, as
services. children had less contact with mandated reporters such as teachers and doctors
This work was conducted as part of due to school and office closures. Officials also discussed challenges initially
GAO’s COVID-19 monitoring and accessing technology and personal protective equipment needed to reduce
oversight responsibilities under the health risks to staff and families. In addition, officials in four state and all 10 local
CARES Act. It examines (1) challenges agencies discussed delays in child welfare hearings because of court closures,
child welfare agencies reported as a which can affect when children can reunify with their parents or be adopted.
result of the pandemic; (2) actions
these agencies reported taking to
Aided by federal funding and other supports provided by the Department of
respond to challenges, including using Health and Human Services (HHS), child welfare agencies reported navigating
the additional funds and other supports pandemic challenges by increasing assistance to families and providing virtual
provided by HHS; and (3) practices services. HHS distributed CARES Act funds in amounts ranging from $15,686 to
agencies reported they may continue $4,690,717 to states for certain child welfare services, and provided various
based on what they learned during the flexibilities to allow child welfare agencies to adapt their work. Child welfare
pandemic. officials in 35 of the 53 states GAO surveyed reported that they had reached out
to support families who had previously been in contact with the agency to offer
GAO interviewed and gathered assistance, such as with food, diapers, and formula. Officials in GAO’s survey
information from officials at HHS; five
also reported that most agencies in their state had implemented various forms of
state and 10 local child welfare
virtual services. This included facilitating visits for children in foster care to spend
agencies in California, Florida, Illinois,
New York, and Texas, selected for time with their biological families (52 states), participating in court hearings (47
factors such as high numbers of states), and providing virtual health services (35 states).
children in foster care and confirmed Child welfare officials in the 53 states GAO surveyed reported that they may
COVID-19 cases; and eight national continue providing virtual services (see figure), strengthening stakeholder
organizations with child welfare partnerships, and updating disaster plans after the pandemic ends. Officials
expertise. GAO also reviewed relevant interviewed in all five state and 10 local agencies discussed benefits they
federal laws, regulations, and HHS
observed when providing virtual services, such as increased options for children
guidance; analyzed reports states
in foster care to spend time with their biological families (e.g., virtual dinners and
submitted to HHS in July 2020 about
their plans for using CARES Act funds;
bedtime stories). In addition, these officials discussed considerations for
and conducted a survey between determining when virtual services are appropriate. Officials in all of the state and
December 2020 and February 2021 of local agencies also discussed the importance of stakeholder communication and
child welfare administrators in all 50 partnerships, such as with community organizations and health and education
states, the District of Columbia, Puerto departments, which allowed them to quickly share information and serve families.
Rico, and the U.S. Virgin Islands Lastly, officials in all of these agencies discussed being unprepared for the
(referred to as states). pandemic. Officials in several agencies said they needed to update their disaster
plans, for example, to include health safety guidance.
Virtual Services Child Welfare Agencies May Continue after the COVID-19 Pandemic
View GAO-21-483. For more information,
contact Kathryn Larin at (202) 512-7215 or
larink@gao.gov.
United States Government Accountability Office
Contents
Letter 1
Background 3
Pandemic Challenges Reported by Selected Child Welfare
Agencies Included Concerns about Unreported Child Abuse,
Health Risks to Staff, and Delays in Court Hearings 7
Aided by Supports from HHS, Child Welfare Agencies Reported
Navigating Pandemic Challenges by Increasing Assistance to
Families and Using Virtual Services 15
Child Welfare Agencies Reported that they May Continue
Practices to Enhance Virtual Services, Partnerships, and
Disaster Plans, and HHS Provided Needed Guidance 20
Agency Comments 26
Appendix I Federal Funding for Child Welfare Services during the Pandemic 29
Appendix II Federal Funding Amounts Distributed to States for Child Welfare
Services during the Pandemic 32
Appendix III Examples of HHS Flexibilities, Guidance, and Other Supports to Help
Child Welfare Agencies during the Pandemic 35
Appendix IV GAO Contact and Staff Acknowledgments 38
Tables
Table 1: Examples of Federal Funding Distributed by HHS for
Child Welfare Services during the COVID-19 Pandemic 29
Table 2: Federal Funding Amounts Distributed to States for Child
Welfare Services during the COVID-19 Pandemic from
Appropriations under Selected Statutes 32
Table 3: Examples of ACF Supports to Help Child Welfare
Agencies during the COVID-19 Pandemic 35
Page i GAO-21-483 Child Welfare during COVID-19
Figures
Figure 1: Examples of Child Welfare Court Hearings and Their
Timeframes 12
Figure 2: Remote Work and Virtual Services Reported to Have
Been Implemented by Most Child Welfare Agencies in
Response to the COVID-19 Pandemic in States GAO
Surveyed, February 2021 18
Figure 3: Virtual Services Child Welfare Agencies Reported they
May Continue after the COVID-19 Pandemic in States
GAO Surveyed, February 2021 21
Figure 4: Examples of Guidance on Health Safety Developed by
Child Welfare Agencies in Five Selected States in
Response to the COVID-19 Pandemic 25
Abbreviations
ACF Administration for Children and Families
COVID-19 Coronavirus Disease 2019
HHS Department of Health and Human Services
PPE personal protective equipment
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Page ii GAO-21-483 Child Welfare during COVID-19
Letter
441 G St. N.W.
Washington, DC 20548
July 29, 2021
Congressional Committees
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic and its
widespread effects on communities around the nation have raised
concerns about the well-being of children and families and the continuity
of child welfare services during this time, as well as potential long-term
effects on this population. We reported in November 2020 on concerns
raised by representatives from national organizations with child welfare
expertise about potential unreported child abuse during the pandemic,
particularly as families may have experienced increased stress and
children had less frequent contact with those mandated to report child
abuse and neglect, such as teachers and doctors. We also reported on
challenges child welfare agencies faced early in the pandemic accessing
personal protective equipment and technology needed to protect the
health of caseworkers, families, and children in foster care while
continuing visits to ensure children’s safety and well-being. 1
We conducted this work on child welfare services during the pandemic as
part of GAO’s COVID-19 monitoring and oversight responsibilities under
the CARES Act. 2 The CARES Act appropriated $45 million for child
welfare services to prevent, prepare for, and respond to COVID-19. 3 The
Department of Health and Human Services (HHS) distributed these funds
in April 2020. This report examines: (1) challenges child welfare agencies
reported as a result of the COVID-19 pandemic; (2) actions these
agencies reported taking to respond to challenges, including using the
additional funds and other supports provided by HHS; and (3) practices
agencies reported they may continue based on what they learned during
the pandemic.
1GAO, COVID-19: Urgent Actions Needed to Better Ensure an Effective Federal
Response, GAO-21-191 (Washington, D.C.: Nov. 30, 2020).
2Pub. L. No. 116-136, § 19010, 134 Stat. 281, 579-81 (2020). We regularly issue
government-wide reports on the federal response to COVID-19. For the latest report, see
GAO, COVID-19: Continued Attention Needed to Enhance Federal Preparedness,
Response, Service Delivery, and Program Integrity, GAO-21-551 (Washington, D.C.: July
19, 2021). Our next government-wide report will be issued in October 2021 and will be
available on GAO’s website at https://www.gao.gov/coronavirus.
3Id. at 134 Stat. 559.
Page 1 GAO-21-483 Child Welfare during COVID-19
To examine all three of our objectives, we interviewed and gathered
information from officials from HHS’s Administration for Children and
Families (ACF), state and local child welfare agencies in five states, and
eight national organizations with child welfare expertise. For our
interviews with child welfare agencies, we spoke with state officials in
California, Florida, Illinois, New York, and Texas. We selected these
states based on factors such as high numbers of children in foster care,
high numbers of confirmed COVID-19 cases, variety in child welfare
administration systems (e.g., state- versus county-administered), and
geographic diversity. In each state, we also spoke with local officials in
two counties, which we selected based on the factors described above as
well as variety in population density (i.e., rural versus urban). Our
interviews with child welfare officials included administrators, managers,
and child protective service workers (e.g., investigators). The information
obtained in selected states and localities is not generalizable to all states
and localities, and is meant to provide illustrative examples. For our
interviews with national organizations, we selected organizations to
provide a variety of perspectives. For example, these organizations
include those that conduct child welfare related advocacy, training, and
research, and specialize in certain aspects of child welfare, such as
workforce, foster youth, and family courts. Because we had previously
reported on challenges for child welfare agencies described by
representatives from these national organizations in November 2020, we
focus this report on responses provided by child welfare officials. 4 We
gathered and reviewed relevant documents and literature to corroborate
information obtained in our interviews.
To provide additional information on actions child welfare agencies
reported taking and practices they reported they may continue, we
reviewed relevant federal laws, regulations, and HHS guidance; analyzed
reports states submitted to HHS in July 2020 about their plans for using
funds provided under the CARES Act; and conducted a web-based
survey of child welfare administrators in all 50 states, the District of
Columbia, Puerto Rico, and the U.S. Virgin Islands. The survey was
conducted between December 2020 and February 2021. We received 52
responses to our survey for a response rate of 98 percent. The survey
included four open- and closed-ended questions about (1) practices child
welfare agencies implemented to respond to the pandemic, (2) practices
agencies are considering continuing after the pandemic ends, (3)
4See GAO-21-191.
Page 2 GAO-21-483 Child Welfare during COVID-19
additional HHS supports that may be helpful to agencies, and (4) any
additional comments about child welfare practices, HHS information, and
the COVID-19 pandemic. 5
To ensure the quality and reliability of the survey, we pretested the
questionnaire with four states that vary in percentage of children in foster
care out of the nationwide total, child welfare administration systems
(e.g., state- versus county-administered), and geographic location. We
conducted the pretests to check (1) the clarity and flow of the questions,
(2) the appropriateness of the terminology used, (3) if the information
could be easily obtained and whether there were concerns about the
reliability of data that would be collected, and (4) if the survey was
comprehensive and unbiased. We revised the questionnaire based on the
pretests. We reviewed survey responses to assess if they were consistent
and contained all relevant information, and followed up as necessary to
determine that states’ responses were complete, reasonable, and
sufficiently reliable for the purposes of this report.
We conducted this performance audit from May 2020 to July 2021 in
accordance with generally accepted government auditing standards.
Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe that
the evidence obtained provides a reasonable basis for our findings and
conclusions based on our audit objectives.
Background
Overview of Child Welfare State and local child welfare agencies provide a continuum of services
Services intended to prevent the abuse or neglect of children; ensure they have
5In an effort to reduce burden on state child welfare administrators, the survey was
conducted in coordination with three other GAO studies on (1) reinvestment of adoption
assistance savings; (2) data exchange agreements with the Social Security Administration
related to represented minor beneficiaries; and (3) protections and supports for LGBTQ+
and religious foster youth and parents. In addition to the 50 states and the District of
Columbia, the survey was administered to Puerto Rico and the U.S. Virgin Islands to meet
needs across the GAO studies. In this report, we include all 53 entities surveyed and refer
to them as “states” in our survey results. However, we do not include territories in other
data presented. We also did not include tribes or tribal organizations in our report, though
they may provide child welfare services and receive federal support for their programs.
Oklahoma did not respond to the survey.
Page 3 GAO-21-483 Child Welfare during COVID-19
safe, permanent homes; and promote the well-being of families. 6
Generally, after receiving a report of suspected child abuse or neglect,
child protective investigators follow up on the report and assess family
needs. For example, an investigator may speak with the child and their
family, and visit the home to assess the physical environment. If needed,
the agency may arrange services to help support the family, such as
counseling, parenting classes, and substance abuse treatment programs.
Such services can help stabilize families to prevent situations in which a
child may need to enter foster care. If the agency, in coordination with a
juvenile or family court, determines that the child cannot safely remain at
home, it will remove the child and place them in foster care. For example,
the child welfare agency may work with private foster care providers to
place children with unrelated foster parents, with relatives, or in
congregate care settings, such as a group home or residential treatment
facility. 7
For children in foster care, the child welfare agency is responsible for
ensuring each child’s well-being and meeting their health, educational,
and other needs. For example, foster care caseworkers are required to
visit each child in their foster care placement setting at least monthly.
They may also facilitate regular visits so that the child can spend time
with their biological parents and siblings. 8 In addition, caseworkers may
coordinate physical and mental health, education, child care, and
transportation services, and arrange meetings that may include the child,
their parents, relatives, foster family, and other service providers to
develop a plan for the child to receive needed services and exit foster
6Though not all functions of child welfare agencies may be considered services, we refer
to all of their functions generally as “child welfare services” in this report for readability.
7State and local child welfare agencies investigated or assessed nearly 2.4 million reports
of child abuse or neglect in fiscal year 2019, the most recent year of data available.
Sixteen percent of reports were substantiated, where the child is determined to have been
abused or neglected or at risk thereof under state law or policy, though the majority of
reports were not. See U.S. Department of Health and Human Services, Child
Maltreatment 2019 (Washington, D.C.: Jan. 14, 2021). Of over 251,000 children who
entered foster care in fiscal year 2019, common reasons for their removal involved neglect
(63 percent) and parents’ drug abuse (34 percent). Of nearly 424,000 children in foster
care in fiscal year 2019, most were commonly placed with unrelated foster families (46
percent), with relatives (32 percent), and in congregate care settings, such as group
homes and institutions (10 percent). See U.S. Department of Health and Human Services,
The AFCARS Report, No. 27 (Washington, D.C.: June 23, 2020).
8Though we refer to biological parents and siblings in this report, children in foster care
may also visit with others, such as guardians, relatives, and family friends.
Page 4 GAO-21-483 Child Welfare during COVID-19
care with a permanent home (e.g., reunifying with their parents or being
adopted). The agency may continue to provide supports after a child exits
foster care, such as to adoptive families and guardians. For children who
age out of foster care without a permanent placement with a family,
caseworkers may arrange for transitional supports, such as housing and
job search services. 9
Federal Funds to Support ACF administers several federal funding sources that states can use for
Child Welfare Agencies child welfare services, in addition to state, local, and other funds. For
example, funding appropriated under Title IV-E of the Social Security Act
is available to states to help cover the costs of operating their foster care,
adoption assistance, and guardianship assistance programs. 10 For foster
care, this can include payments to foster families and providers to help
cover the costs of care for eligible children (e.g., food, clothing, and
shelter) and for certain administrative expenses. The Family First
Prevention Services Act amended Title IV-E, among other changes, to
also make optional federal funding available to states to help cover the
costs of providing certain time-limited prevention and kinship navigator
services. 11 These services are intended to enhance supports to families
to prevent them from entering the foster care system and help kin
caregivers (e.g., relatives) learn about, find, and use needed services in
raising children in their care. In addition, states may use funding under
Title IV-E for services to support older youth who will or have recently
transitioned out of foster care to live on their own. 12 Title IV-B of the
Social Security Act provides funding to states to use for a range of child
9In fiscal year 2019, about 249,000 children exited foster care, most commonly through
reunifications with their parents or primary caretakers (47 percent), adoptions (26
percent), guardianships (11 percent), and aging out (8 percent). See U.S. Department of
Health and Human Services, The AFCARS Report, No. 27.
1042 U.S.C. §§ 670-679c.
11Pub. L. No. 115-123, div. E, tit. VII, subt. A, pt. 1, § 50713, 132 Stat. 64, 245 (2018)
(amending 42 U.S.C. § 674(a)(7)).
12The Family First Prevention Services Act amended Title IV- E to allow states to provide
services to youth up to age 23 under certain circumstances, and to make transition
services available to youth who have experienced foster care at age 14 or older. Id. §
50753(a)(1), (d)(1)(2)(A), 132 Stat. at 64, 263, 265 (amending 42 U.S.C. § 677(a)).
Page 5 GAO-21-483 Child Welfare during COVID-19
welfare services, from preventing the abuse and neglect of children to
supporting families who have reunified or who have adopted children. 13
Additional funds were appropriated for child welfare services through
several laws enacted in 2020 in response to the COVID-19 pandemic. For
example:
• The Families First Coronavirus Response Act, enacted in March
2020, increased federal funding to states for their foster care,
adoption assistance, and guardianship assistance programs under
Title IV-E. 14
• The CARES Act, also enacted in March 2020, provided funds for child
welfare services as authorized by Title IV-B Subpart 1 to prevent,
prepare for, and respond to COVID-19. 15
• The Supporting Foster Youth and Families through the Pandemic Act,
enacted in December 2020, provided additional funds and flexibilities
for certain programs under Titles IV-B and IV-E, including services to
promote safe and stable families and to support older youth in foster
care. 16
In addition to administering funds, ACF is responsible for monitoring
states’ implementation of programs under Titles IV-E and IV-B. ACF
conducts periodic Title IV-E reviews of child welfare agencies’ case
1342 U.S.C. §§ 620-629m. The two primary programs under Title IV-B are the Stephanie
Tubbs Jones Child Welfare Services Program (Subpart 1) and the MaryLee Allen
Promoting Safe and Stable Families Program (Subpart 2).
14Pub. L. No. 116-127, § 6008, 134 Stat. 178, 208 (2020).
15Pub. L. No. 116-136, div. B, tit. VIII, 34 Stat. 281, 559 (2020). The statutory purposes of
Title IV-B Subpart 1 are to (1) protect and promote the welfare of all children; (2) prevent
the abuse, neglect, and exploitation of children; (3) support at-risk families through
services which allow children, where appropriate, to remain safely with their families or
return to their families in a timely manner; (4) promote the safety, permanence, and well-
being of children in foster care and adoptive families; and (5) provide training, professional
development and support to ensure a well-qualified child welfare workforce. 42 U.S.C. §
621.
16Pub. L. No. 116-260, tit. XIV, div. X, §§ 3, 6, 134 Stat. 1182, 2409, 2413 (2020). The
statutory purposes of Title IV-B Subpart 2 are to (1) prevent maltreatment among families
at risk through the provision of supportive family services, (2) assure children’s safety at
home and preserve intact families in which children have been maltreated, when the
family’s problems can be addressed effectively, (3) address problems of families whose
children have been placed in foster care so that reunification may occur in a safe and
stable manner, and (4) provide support services as necessary to adoptive families so that
they can make a lifetime commitment to their children.
Page 6 GAO-21-483 Child Welfare during COVID-19
records and payment documentation to ensure that funds covering the
federal share of costs to help care for children in foster care are provided
on behalf of eligible children. 17 ACF also reviews states’ 5-year Child and
Family Services Plans and Annual Progress and Services Reports
required under Title IV-B. Child and Family Services Plans set forth a
state’s vision, goals, and objectives to strengthen its child welfare system,
and documents the state’s compliance with federal program
requirements. 18 For example, states are required to include in their plans
procedures that address how programs under Titles IV-E and IV-B would
respond to a disaster. In addition, Annual Progress and Services Reports
provide annual updates on the progress made by states toward their
goals and objectives. 19
Pandemic Challenges
Reported by Selected
Child Welfare
Agencies Included
Concerns about
Unreported Child
Abuse, Health Risks
to Staff, and Delays in
Court Hearings
Concerns about Officials in all of the five state and 10 local child welfare agencies with
Unreported Child Abuse whom we conducted interviews said they observed declines in the
number of child abuse and neglect reports made to their agencies,
and Neglect
particularly during the early months of the pandemic, raising concerns
1745 C.F.R. § 1356.71.
1845 C.F.R. § 1357.15.
1945 C.F.R. § 1357.16.
Page 7 GAO-21-483 Child Welfare during COVID-19
about unreported cases. 20 Our analysis of data from one state agency, for
example, showed that its child abuse and neglect reports dropped by
about 20 percent, on average, for each month between January and
September 2020, compared to those same time periods in 2019. The
largest decline occurred in April 2020, in which reports were 49 percent
lower than in April 2019. Declines in the number of reports did not
necessarily mean that fewer instances of child abuse and neglect
occurred. Rather, officials we interviewed in several state and local
agencies said these declines likely happened because people who are
mandated to report in those jurisdictions, such as teachers and doctors,
had less contact with children and thus, were less able to identify possible
child abuse and neglect. For example, officials in one local agency said
they believed their decrease in reports occurred because children were
not going to school, doctor appointments, and church. 21
Officials we interviewed in two of the five state and six of the 10 local child
welfare agencies shared varied observations about the impact of the
pandemic on the incidence of child abuse and neglect, as families may
have experienced financial distress and social isolation that can
negatively affect their well-being. For example, officials in one local
agency said family conditions worsened during the pandemic as some
family members were laid off from jobs and the mental health of some
parents deteriorated. Officials in most state and local child welfare
agencies said they observed more severe cases of abuse during this
time, such as increases in the number of cases involving burns and bone
fractures and in the number of investigations requiring removal of the
child from the home. Officials in one local agency said they saw more
20We conducted our interviews with state and local child welfare officials using a semi-
structured interview protocol, which included open-ended questions on challenges, actions
taken, and lessons learned during the pandemic, among other topics. Officials volunteered
their responses to these open-ended questions, and thus the counts of officials in state
and local agencies citing such responses vary. We also use indefinite quantifiers in this
report, such as “several” and “many,” in some cases to quantify responses from officials
across the five state and 10 local agencies (15 total). These quantifiers are defined as
follows: “few” represents 2 to 4 agencies; “several” represents 5 to 7 agencies; “most”
represents 8 to 9 agencies; “many” represents 10-12 agencies; and “nearly all” represents
13-14 agencies.
21In 2019, the largest sources of child abuse and neglect reports were education (21
percent of reports); legal and law enforcement (19.1 percent); and medical personnel (11
percent). We reported in November 2020 that almost all school districts had rapidly shifted
to distance learning in spring of the 2019-2020 school year due to the pandemic. See
GAO, Distance Learning: Challenges Providing Services to K-12 English Learners and
Students with Disabilities during COVID-19, GAO-21-43 (Washington, D.C.: Nov. 19,
2020).
Page 8 GAO-21-483 Child Welfare during COVID-19
cases reported by hospitals, law enforcement, and family members. This
could be, in part, because potential child abuse or neglect was not visible
until it became more severe. Officials in two state and three local
agencies said they have not observed more severe cases. For example,
officials in one local agency said they thought they would have seen more
severe cases during the pandemic, but had not. Further, they said their
data show the number of investigations requiring removal of the child was
similar to pre-pandemic trends.
Despite concerns about unreported child abuse and neglect stemming
from reporting declines during the early months of the pandemic, officials
we interviewed in many state and local child welfare agencies noted that
their reporting trends had begun to return to pre-pandemic levels in
summer and fall 2020. For example, officials in three state and six local
agencies told us that their decrease in reports did not appear as dramatic
during the summer months when children went on summer break and
child welfare agencies typically see fewer cases. As children returned to
school in fall 2020, either in-person or virtually, officials in three of the five
state and seven of the 10 local agencies said they saw their reporting
trends return to levels observed in prior years.
Though the most recent nationwide data on child abuse and neglect are
from 2019, ACF has a project underway to help assess the impact of the
pandemic on child abuse and neglect and examine current trends in the
child welfare system. The project involves collecting available state-level
data on key child welfare metrics to produce monthly reports using “real-
time” data. Such data may include the number of child abuse and neglect
reports made to child welfare agencies, the number of investigations and
cases substantiated, the percentage of cases involving physical abuse
versus neglect, and the number of foster care entries and exits. ACF
officials said they are collecting such data from states in 2021, and will
soon make this information publicly available.
Health Risks to Staff and Officials we interviewed in all of the five state and 10 local child welfare
Families agencies discussed how the pandemic increased health risks to staff and
families, who typically meet in-person for investigations and caseworker
visits. For example, officials in one local agency told us that they had to
shift work responsibilities to fill in for multiple staff who had tested positive
for COVID-19. Officials we spoke with in most state and local child
welfare agencies underscored the anxiety and nervousness felt by
frontline staff about their health, given the risks involved with their work
and the number of staff who tested positive for COVID-19.
Page 9 GAO-21-483 Child Welfare during COVID-19
Officials in nearly all of the state and local child welfare agencies also
spoke about challenges they experienced accessing technology and
personal protective equipment (PPE) needed to protect the health of staff
and families, particularly during the early months of the pandemic, though
officials in many agencies said access improved over time. For example,
officials in one local agency said the move to remote work was
challenging for child welfare managers, supervisors, and administrative
assistants, who needed to acquire laptops and other equipment. Officials
in another local agency said their laptops did not have videoconferencing
capabilities needed to meet with staff and families virtually. Even if staff
had technology needed to do their job, officials in five state and seven
local agencies said some families, including foster families, did not have
technology or reliable internet needed to participate in virtual meetings,
particularly those in low-income and rural communities. In cases where
in-person meetings may still be needed (e.g., child abuse investigations),
officials we spoke with in four of the five state and seven of the 10 local
agencies said acquiring PPE for staff and families was challenging amid
nationwide shortages. 22 Officials in one local agency also said concerns
about health risks made some foster families reluctant to participate in in-
person caseworker visits. As the pandemic continued, officials in nearly
all state and local agencies said PPE and technology has become more
readily accessible.
Officials in three of the five state and nine of the 10 local child welfare
agencies also expressed concerns about placements in foster care, given
health risks resulting from the pandemic. For example:
• Officials in many agencies reported concerns about placements with
families. Specifically, officials in six local agencies discussed
22One study that surveyed child welfare administrators, managers, and frontline staff in
four states on challenges they experienced during the pandemic found similar challenges
with accessing technology and PPE. For example, staff reported on challenges they had
connecting with families who were not “tech savvy” or did not have reliable phone or
internet access, particularly in rural areas. In addition, staff reported that it took 2 months
before they were provided with face masks that they had to use repeatedly, despite their
status as essential workers. See A.S. He, K. Golieb, M. Keniston, A. Grenier, and R.
Leake, COVID-19 Workforce Needs Assessment Cross-site Report for Workforce
Excellence Public Child Welfare Sites (Albany, NY: November 2020). In addition to this
study, ACF is currently conducting the National Survey of Child and Adolescent Well-
Being III, which intends to provide nationally representative information from child welfare
administrators, managers, and frontline staff about their experiences during the pandemic.
ACF officials said they plan to publish results from the survey in September or October
2021.
Page 10 GAO-21-483 Child Welfare during COVID-19
difficulties finding placements for children because of concerns from
foster families about caring for newly placed children, particularly
when these children may have been exposed to the virus. In addition,
officials in three state and two local agencies shared concerns about
placing children in foster care with older caregivers because these
caregivers may be more vulnerable to COVID-19 complications than
the general population. 23
Similarly, officials in several agencies discussed concerns about
placements with foster care providers, including those providing
congregate care. Officials in one local agency said some congregate
care facilities in their area had outbreaks because staff may have
contracted the virus outside of work and inadvertently exposed
children when they returned. Officials in another local agency we
interviewed in December 2020 said they were seeing a resurgence of
COVID-19 cases primarily in these residential facilities.
Delays in Court Hearings Officials we interviewed in four of the five state and all 10 local child
welfare agencies expressed concerns about delays in child welfare
hearings during the pandemic because many courts closed or operated in
a limited capacity. These officials described how courts in their area
temporarily ceased hearings, or prioritized the types of hearings they
would hold, such as scheduling hearings about whether to detain youth
who may have committed infractions over hearings to determine a plan
for children in foster care to reunify with their families or be adopted.
Officials in most state and local agencies said delays in these types of
hearings can negatively impact children and families in the foster care
system. For example, officials in one local agency said court delays have
prevented them from engaging with biological parents to develop and
implement a plan to reunify with their children. Similarly, officials in
another local agency said court delays can affect when family visits take
place, and when children can return home. Officials in three local
agencies also said court delays have caused children who are waiting to
be adopted to linger in foster care. Officials in several state and local
agencies told us that, because of the pandemic, courts in their jurisdiction
have not been able to meet timeframes typically required for child welfare
23We previously reported that about 2.7 million children lived with kin caregivers—
grandparents, other relatives, or close family friends—because their parents were unable
to care for them, in addition to 139,000 children placed with such caregivers through the
foster care system in 2018. We reported further that the average age of grandparent
caregivers rose from 55 in 2005 to nearly 59 in 2018. See GAO, Child Welfare and Aging
Programs: HHS Could Enhance Support for Grandparents and Other Relative Caregivers,
GAO-20-434 (Washington, D.C.: July 10, 2020).
Page 11 GAO-21-483 Child Welfare during COVID-19
cases. Examples of the types of child welfare hearings held by courts and
their timeframes are outlined in figure 1.
Figure 1: Examples of Child Welfare Court Hearings and Their Timeframes
Note: Child welfare agencies are generally required to meet these timeframes as a condition for
receiving federal funds under Title IV-E of the Social Security Act. States may have additional
requirements for child welfare court hearings.
Though officials we interviewed in nearly all of the agencies said their
courts have taken measures to resume operations virtually, officials in two
of the five state and eight of the 10 local child welfare agencies discussed
continuing challenges with court delays. For example, officials in most
state and local agencies said despite moving to remote hearings, some
courts continued to operate in a limited capacity and experience
backlogs, and have faced challenges transitioning to a virtual
environment. Officials in two state and four local agencies explained that
most courts have struggled to quickly adapt to the use of technology, in
addition to challenges some families may have in accessing technology
needed to participate in virtual court hearings.
Service Disruptions for Officials we interviewed in four of the five state and seven of the 10 local
Children and Families child welfare agencies expressed concerns about ongoing disruptions to
health and other services for children and families, as many providers
Page 12 GAO-21-483 Child Welfare during COVID-19
limited their operations or closed their doors because of the pandemic.
For example, officials in one local agency said special education and
mental health service providers in their area stopped delivering services
because they did not want to risk their health. Similarly, officials in
another local agency said they faced challenges obtaining services for
children and families, including mental health and substance use
treatment as well as required drug tests for parents.
Officials we interviewed in four local child welfare agencies said the lack
of access to services can negatively affect the well-being of children and
families, and officials in a few agencies said this can disrupt efforts to
reunify them. For example, officials in one local agency explained that
some families may receive in-home parenting services that are ordered
by the court as a condition for the child to stay in the home. However,
these officials said if such services cannot be delivered, the child may be
placed in foster care. Officials in another local agency said service
disruptions can affect whether parents are able to follow through with
court-ordered services required for reunification. Officials in a few
agencies said they were concerned that parents who are unable to
complete court-ordered services may be at risk of having their parental
rights terminated. 24 Officials in a few agencies said social isolation due to
stay-at-home advisories and remote learning has increased mental health
needs for children in foster care. Officials in one local agency said this
has resulted in some children running away from their foster homes.
Impacts of the Economic Officials we interviewed in several child welfare agencies described
Crisis concerns about the impact of the economic crisis stemming from the
pandemic on their agencies’ budget and operations. Officials in a few
agencies in one state told us about budget cuts to their agencies due, for
example, to decreases in state revenue from taxes and tourism. Similarly,
officials in one local agency said expenditures their agency made to
respond to the pandemic (e.g., for technology and PPE) depleted the
funding they had set aside for developing and implementing evidence-
based prevention programs, in keeping with federal priorities to support
24Child welfare agencies receiving federal funds under Title IV-E are required to initiate a
petition to terminate a parent’s rights if the child has been in foster care for 15 out of the
most recent 22 months, unless the child is being cared for by a relative, the agency has
not provided the family with services needed for a safe return of the child, or the agency
has documented a compelling reason that filing a petition is not in the child’s best
interests. 42 U.S.C. § 675(5)(E), 45 C.F.R. § 1356.21(i)(1)(i), (2). ACF issued a letter to
child welfare leaders in June 2020 that urged agencies to carefully consider whether it is
appropriate to terminate a parent’s rights given service disruptions during the pandemic,
and highlighted some service delivery strategies.
Page 13 GAO-21-483 Child Welfare during COVID-19
families and prevent children from entering foster care. Though officials in
all of the state and local child welfare agencies described how they were
able to respond to the pandemic, officials in a few of these agencies said
budget cuts may affect their ability to support foster families as well as
providers. In addition, officials in one state agency said some local
agencies have had to furlough staff.
Officials we interviewed in four of the five state and seven of the 10 local
child welfare agencies also expressed concerns about the impact of the
economic crisis on the financial status and well-being of families and
providers. Officials in several agencies said foster families, which can
include kin caregivers, may have lost jobs, as well as child care due to
school closures. Officials in a few agencies said foster care providers,
including those providing congregate care, also may have lost funding
and staff. Officials in one state agency said private providers
administering services to families in the child welfare system have limited
budgets, and delays in paying for their services due to child welfare
agency budget cuts can be a significant setback for these providers.
Lastly, officials we interviewed in three state and three local child welfare
agencies reported concerns about older youth who will or have
transitioned out of foster care, for example, because these youth may
have lost jobs and housing and have few support networks on which they
can rely. Officials in one local agency said many older youth lost jobs
waiting tables in restaurants, and needed financial and housing
assistance due to these lost wages. Officials in another local agency
shared that some older youth in foster care encountered issues with
housing as their colleges and dorms closed. 25
25We previously reported that older youth in foster care may face hardships, including
physical or psychological trauma which may affect their mental health. Additionally, they
faced housing instability and higher rates of other economic hardships compared with the
general population. See GAO, Foster Care: States with Approval to Extend Care Provide
Independent Living Options for Youth up to Age 21, GAO-19-411 (Washington, D.C.: May
21, 2019).
Page 14 GAO-21-483 Child Welfare during COVID-19
With the help of federal funding and other supports from HHS, child
Aided by Supports welfare agencies reported they primarily navigated challenges during the
from HHS, Child pandemic by increasing assistance to families and others in the child
welfare system, and using remote work, virtual services, and PPE. For
Welfare Agencies example, all states received federal funds under the CARES Act for child
Reported Navigating welfare services, and reports that the states submitted to ACF in July
2020 on ways they planned to use these funds were consistent with the
Pandemic Challenges actions reported by child welfare officials in our survey of 53 states and in
by Increasing our interviews with five state and 10 local agencies. 26 States are required
by ACF to report on the actual use of these funds in their Annual
Assistance to Progress and Services Reports in June 2021 and 2022.
Families and Using
Virtual Services
Supports from HHS All states received federal funds from ACF to help them respond to the
pandemic, in addition to state and other funds they may have used. 27
ACF distributed $45 million provided under the CARES Act for child
welfare services in April 2020. The amounts states received ranged from
$15,686 to $4,690,717 with a median of $631,809. More recently, ACF
distributed funds under the Supporting Foster Youth and Families through
the Pandemic Act. This included $400 million to help support older youth
in foster care as well as $85 million to promote safe and stable families
and address court improvements, distributed in February and March
2021, respectively. 28 For additional information on federal funding
26The most common ways states reported that they may use some or all of their funds
were to provide financial and other assistance to families, foster care providers, and older
youth in foster care (29 states); purchase technology to help facilitate remote work and
virtual services (27 states), and purchase PPE for staff and families (22 states).
27Our analysis of federal funds provided to states in this report included the 50 states and
the District of Columbia. We did not examine funds provided to territories, tribes, and tribal
organizations. We also did not examine non-federal funding sources, though officials in
many of our interviews with state and local child welfare agencies told us that they had
responded to the pandemic with additional or reprioritized state and local funding as well
as private funding and donations.
28Of the $400 million, $344 million was provided for the John H. Chafee Foster Care
Program for Successful Transition to Adulthood, $50 million was provided for the
Education and Training Vouchers program, and the remaining $6 million was reserved for
ACF’s technical assistance and evaluation activities under Title IV-E. Of the $85 million,
$75 million was provided for the MaryLee Allen Promoting Safe and Stable Families
program, $9.5 million for the State Court Improvement Program, and the remaining
$500,000 for tribal court improvement activities.
Page 15 GAO-21-483 Child Welfare during COVID-19
provided to states for child welfare services during the pandemic and
specific amounts provided to each state, see appendices I and II.
In addition to these funds, ACF provided various flexibilities, guidance,
and other supports that helped child welfare agencies adapt their work
and navigate pandemic challenges. 29 For example, beginning in March
2020, ACF provided flexibilities for child welfare agencies to virtually
conduct required caseworker visits with children in foster care. Officials
we interviewed in all of the five state and 10 local agencies described how
they used these flexibilities to reduce in-person contact and thus health
risks to staff and families. In another example, ACF provided flexibilities
for agencies, beginning in May 2020, to extend federal support to youth in
foster care up to age 21, such as waiving education and employment
requirements for youth if they are unable to meet them due to the
pandemic. 30 Officials in two state agencies and one local agency
discussed their appreciation of these flexibilities, which allowed them to
continue supporting older youth in foster care who may have lost jobs or
housing because of the pandemic. For additional information on ACF
supports to help child welfare agencies address challenges during the
pandemic, see appendix III.
Increasing Assistance to Child welfare officials in the states we surveyed and officials we
Families and Others in the interviewed in three state and seven local child welfare agencies reported
that they had increased outreach and provided supports to families. Such
Child Welfare System
actions could help address concerns about unreported child abuse and
neglect. For example, officials in 35 of the 53 states we surveyed reported
that, in response to the pandemic, most of the agencies in their state had
specifically reached out to support families who had previously been in
contact with the agency (e.g., for an investigation), but did not have a
29ACF officials told us they were able to provide flexibilities to states under the Robert T.
Stafford Disaster Relief and Emergency Assistance Act, which allows federal agencies to
modify or waive administrative conditions of federal assistance programs under certain
limited circumstances. See 42 U.S.C. § 5141. Officials said they have yet to determine
when and whether to end the flexibilities provided, given that the pandemic is ongoing.
30The Supporting Foster Youth and Families through the Pandemic Act subsequently
provided additional supports for older youth in foster care. For example, it (1) prohibited
child welfare agencies receiving federal funds under Title IV-E from requiring a youth to
leave foster care solely due to age from December 27, 2020 through September 30, 2021,
(2) required these agencies to allow any youth who had previously left foster care due to
their age to voluntarily re-enter, and (3) prohibited agencies from determining a youth
ineligible for Title IV-E foster care maintenance payments due to age or failure to meet
education and employment requirements from December 27, 2020 through September 30,
2021, among other provisions.
Page 16 GAO-21-483 Child Welfare during COVID-19
Officials in one local child welfare agency child currently in foster care. Officials we interviewed in one state and
described how the pandemic underscored the eight local child welfare agencies explained that families, including those
importance of helping families in order to
prevent children in these families from who have previously been investigated for child abuse or neglect, may be
entering the foster care system. They said the particularly vulnerable during times of financial need and social isolation.
immediate needs of families included They said these families need concrete assistance and support, which
assistance with rent, food, diapers, and
formula. officials in a few agencies said can help prevent situations that may
Source: GAO interviews. | GAO-21-483 ultimately result in a child entering foster care. Officials in one local
agency said they had reached out to over 5,000 families to offer help with
any needs. Officials in another state agency said their state had provided
funds directly to families, and to resource centers to connect families with
parenting supports and help them apply for financial and food assistance
programs. Officials in one state and six local agencies also said they had
engaged others, such as teachers, doctors, and law enforcement to help
look for signs of family distress so the agency could reach out and offer
help.
Officials we interviewed in many of the state and local child welfare
agencies also reported that they provided direct supports to foster
families and providers as well as to older youth in foster care. Such
supports could help address the economic impacts of the pandemic. For
example:
• Officials in two state and three local agencies said they increased
payment rates for certain foster families. Officials in one local agency
said they paid foster families a higher rate for 30 days if the family
took children who had been exposed to or tested positive for COVID-
19 to compensate for the increased health risks and higher level of
care for the child.
• Officials in three state agencies and one local agency said they
increased payment rates for providers caring for children in
congregate settings. Officials in one state agency explained that
congregate care providers have incurred extra costs during the
pandemic, such as for more staff and PPE, as children are spending
more time in their placements and in need of care due to school
closures.
• Officials in 49 of 53 states reported in our survey that most agencies
in their state enhanced outreach and supports to older youth in foster
care who are aging out of the system. Officials in one local agency
said they contacted older youth on a daily basis and provided up to
$6,500 per youth to help with rent and transportation costs. Officials in
another state agency said their state had worked on an agreement
Page 17 GAO-21-483 Child Welfare during COVID-19
with local colleges to allow youth in foster care to stay on campus,
even with the closure of dorms and other college housing facilities.
Using Remote Work, Child welfare officials in our survey and officials we interviewed in all of
Virtual Services, and PPE the state and local child welfare agencies reported that their agencies
implemented remote work and virtual services, which could help reduce
health risks to staff and families as well as address disruptions to court,
health, and other services. Officials in our survey reported that most of
the agencies in their state had implemented various forms of remote work
and virtual services in response to the pandemic, from facilitating time for
children in foster care to visit virtually with their biological families to
conducting virtual health services (see fig. 2).
Figure 2: Remote Work and Virtual Services Reported to Have Been Implemented by Most Child Welfare Agencies in
Response to the COVID-19 Pandemic in States GAO Surveyed, February 2021
Officials we interviewed in all of the state and local child welfare agencies
described actions they took as well as modifications they made in moving
to a virtual environment. For example:
• Officials in four of the five state and six of the 10 local agencies said
their agencies acquired technology, such as laptops, cellphones,
licenses for videoconferencing platforms, and internet access.
Officials in one local agency said these investments helped them
move staff responsible for receiving phone calls on their child abuse
hotline to receiving calls while working at home. These officials also
Page 18 GAO-21-483 Child Welfare during COVID-19
described a statewide effort to provide technology to children in foster
care so they could participate in caseworker visits, court hearings,
telehealth appointments, and remote learning.
• Officials in three state and five local agencies said they made
modifications to their work because of the virtual environment.
Officials in several state and local agencies said they increased the
frequency of virtual caseworker visits, for example, to weekly from
monthly, to ensure the well-being and safety of children in foster care.
Officials in a few agencies also described facilitating more frequent
virtual family visits, such as 15 minute video calls for parents to spend
time with their children.
• Officials in four state and seven local agencies described steps they
and their courts took to move to a virtual environment. For example,
officials in one local agency said they had to determine how to get
participants to sign documents virtually, and officials in another local
agency said they had to find a way to record court proceedings
virtually.
• Officials in most state and local agencies also described efforts to
provide technology to children and families or set up access points so
they could participate in court and other virtual services, such as at
courthouses or in caseworkers’ offices.
Officials we interviewed in all of the state and local child welfare agencies
also discussed considerations they made in determining whether in-
person work was needed, and how they prioritized PPE for child welfare
staff, children, and families. For example, officials in three of the five state
and all 10 local agencies said they continued in-person investigations of
possible child abuse and neglect, since they said investigators in their
jurisdictions must visit families and physically observe the home
environment to assess child safety. Officials in several state and local
agencies described protocols they developed to screen families for
COVID-19 exposure when determining whether to conduct an in-person
versus a virtual caseworker visit. During in-person visits, officials in most
of the agencies described measures investigators and caseworkers took
to meet with children and families outdoors and to provide PPE to all
those involved, when possible. In our survey, officials in 39 of 53 states
reported that most agencies in their state had obtained or used the
designation of essential workers for child welfare staff to increase access
to PPE. Officials in a few agencies said this designation was helpful at the
beginning of the pandemic when PPE was scarce.
Page 19 GAO-21-483 Child Welfare during COVID-19
As the pandemic continued, officials in three state and seven local
agencies told us that their staff had begun to work in the office and
resume in-person visits. For example, officials in one local agency said
they were back in the office beginning July 2020 at a 50 percent capacity.
Officials in another local agency said all caseworker visits were
conducted in person with the appropriate PPE as of December 2020,
except in cases where a child or their foster family had a known exposure
to COVID-19.
Child Welfare
Agencies Reported
that they May
Continue Practices to
Enhance Virtual
Services,
Partnerships, and
Disaster Plans, and
HHS Provided
Needed Guidance
Continuing Virtual Child welfare officials in the 53 states we surveyed reported that they may
Services continue providing various forms of virtual services after the pandemic
ends (see fig. 3).
Page 20 GAO-21-483 Child Welfare during COVID-19
Figure 3: Virtual Services Child Welfare Agencies Reported they May Continue after the COVID-19 Pandemic in States GAO
Surveyed, February 2021
Officials in four of the five state and eight of the 10 local child welfare
Officials in one local agency said their use of
virtual services resulted in a better agencies also indicated that they were planning to continue providing
relationship between a biological and foster virtual services, which were seldom used in the past. In addition, they
family. They described working with the foster
family to create a virtual “safe space’” in their
described the benefits they observed in using these services during the
home to facilitate family time between a child pandemic. For example:
in their care and the child’s biological family.
They said this allowed the foster family to get
to know the biological family, which resulted in • Officials in four state and six local agencies said holding virtual
the biological family becoming more meetings improved participation and saved time for staff and families.
comfortable with the foster family adopting the For example, officials in several agencies observed more participation
child. The biological family agreed to serve as
a respite care resource to stay involved in the from family members in meetings to develop plans for children in
child’s life. foster care to receive needed services and exit the system. Officials in
Source: GAO interviews. | GAO-21-483
a few agencies said the increased participation was likely because
family members did not have to overcome obstacles such as
transportation, finding child care, or missing work to attend meetings
when the meetings were virtual.
• Officials in two state and six local agencies said virtual services
enabled them to provide more options for children in foster care to
spend time with their biological parents and siblings. For example,
officials in a few agencies described using virtual platforms to allow
parents to read bedtime stories to their children and have family
dinners on a regular basis.
Page 21 GAO-21-483 Child Welfare during COVID-19
• Officials in one state agency said virtual court hearings were easier
and less intimidating for families to attend, and allowed court officials
to observe children playing in their home environments.
• Officials in one local agency described how telehealth options
improved access to health care for children and families, particularly
in rural communities where providers may be scarce and medical
facilities may not be located nearby.
While officials we interviewed in the five state and 10 local child welfare
agencies said virtual services can help families stay connected, officials in
all of these agencies discussed considerations for determining when
these services are appropriate. Officials in nearly all state and local
agencies said virtual services may not be appropriate in instances where
staff must assess child safety and living conditions, such as during child
abuse and neglect investigations. In addition, officials in several agencies
said certain children, including those who are younger or have higher
needs, may not be best served by virtual services. Officials in one local
agency said teleconferences are not a desirable option for facilitating
attachment and bonding between children and their biological parents
and siblings, particularly for infants and toddlers. Lastly, officials in nearly
all the state and local agencies discussed how the shift to virtual services
during the pandemic highlighted disparities in access to technology.
Officials in three state and four local agencies said these disparities would
need to be further addressed as child welfare agencies consider using
virtual services in the future.
Child welfare officials in 44 of the 53 states we surveyed reported that
additional guidance on providing virtual services would be very or
extremely helpful, and ACF has provided various guidance and supports
in this area. For example, beginning in March 2020, ACF held various
peer-to-peer roundtable events and webinars on responses to the
pandemic that included information about virtual visits and services.
ACF’s Capacity Building Center for Courts also published guidance in
April 2020 on best practices for virtual hearings in child welfare cases.
Lastly, beginning in April 2020, ACF published numerous tip sheets and
guides for child welfare agencies on topics such as supporting virtual
family time; promoting effective virtual and phone engagement with
children, caregivers, and families in times of crisis; and technological tools
and tips for facilitating virtual meetings. ACF officials said they will
continue to develop tools, information, and resources and facilitate
information sharing among states related to ongoing challenges and
lessons learned from the pandemic, including on the use of virtual
Page 22 GAO-21-483 Child Welfare during COVID-19
services. For additional information on ACF supports to help child welfare
agencies implement practices based on what they learned from the
pandemic, see appendix III.
Strengthening Stakeholder Child welfare officials in 50 of the 53 states we surveyed reported that
Partnerships they may continue efforts to strengthen stakeholder partnerships. For
example, officials reported that most child welfare agencies in their state
forged partnerships with community organizations during the pandemic to
provide services to families at risk of entering the foster care system (42
states), as well as partnerships with other government entities, such as
health and education departments (47 states). Officials we interviewed in
all five state and 10 local child welfare agencies also highlighted the
importance of communication and partnerships in responding to the
pandemic, including efforts to continue strengthening the partnerships
they developed. For example:
• Officials in all of the state and local agencies described how increased
communication was needed to address the concerns and needs of
multiple stakeholders in a continually changing environment. These
stakeholders included child welfare managers, staff, private foster
care providers, congregate care providers, families, and children and
youth in foster care. Officials in one local agency described how they
provided staff with daily or weekly updates on how to operate during
the pandemic, met regularly with community partners about ways to
help families, and had continuous conversations with foster families to
help address their concerns about health risks.
• Officials in one local agency discussed how they increased
communication among staff to share information and provide moral
support. They explained that the pandemic significantly affected their
community because many people worked in meatpacking plants that
experienced COVID-19 outbreaks, and staff also feared they would
expose their own families to the virus.
• Officials in four of the five state and eight of the 10 local agencies
described partnerships they strengthened to assist families
experiencing financial distress or social isolation during the pandemic.
Officials in one local agency told us about their work with non-profit
organizations in their area to deliver food and other needed items to
families. Officials in another local agency discussed partnerships they
formed with other local officials in social services and education to
ensure families had access to any available financial resources or
technology in order to stay connected.
Page 23 GAO-21-483 Child Welfare during COVID-19
ACF officials also underscored the importance of strengthening
stakeholder communication and partnerships moving forward from the
pandemic, and provided a number of supports in this area. For example,
ACF officials said they have maintained regular communication with child
welfare agencies and other stakeholders to share information on
pandemic response, continuing challenges, and lessons learned. Officials
we interviewed in two of the five state child welfare agencies said they
appreciated the frequent phone calls with ACF officials. For example,
officials in one state agency said the phone calls facilitated by their ACF
regional office allowed child welfare administrators in their region to
coordinate and share “real-time” information about strategies they took to
respond to the pandemic. In addition, ACF published guidance in January
2021 that shared lessons learned from the pandemic. This guidance
discussed gaps within human services delivery systems and highlighted
the need for flexibilities with federal requirements to aid pandemic
response. It also acknowledged a severe and disproportionate impact of
the pandemic on families and communities of color in illness, fatalities,
and increased economic hardship, which it said reflected pre-existing
systemic disparities. Among other actions, HHS encouraged agencies,
organizations, and entities to work together across disciplines to ensure
that equity, access, inclusion, participation, and support are central
aspects of all family-serving agencies. 31
Updating Disaster Plans Child welfare officials in 49 of the 53 states we surveyed reported that
they may continue to develop guidance or update disaster plans to be
better prepared in the future. For example, officials in 48 states reported
that most child welfare agencies in their state had developed guidance or
updated disaster plans to address COVID-19 related procedures, such as
how to prioritize PPE and isolate those who are ill. Officials we
interviewed in all of the five state and 10 local child welfare agencies
discussed being unprepared for a widespread pandemic, and officials in
several agencies said they needed to update their disaster plans. For
example:
31See Department of Health and Human Services, Emerging Transformed: Taking
Lessons from the COVID-19 Pandemic to Create More Just, Equitable, Proactive, and
Integrated Approaches to Supporting Families and Ensuring Child and Family Health and
Well-being, ACYF-CB-IM-21-03 (Washington, D.C.: Jan. 12, 2021).
Page 24 GAO-21-483 Child Welfare during COVID-19
Officials in one state child welfare agency • Officials in four state and eight local agencies said their existing plans
described their disaster plans at the beginning focused on region-specific disasters, such as hurricanes, wildfires,
of the pandemic as “glorified phone trees” that and terrorist attacks. In these types of disasters, places not affected
were used to call the appropriate people to
make decisions. Officials said it would have by the event can help provide staff, supplies, and other supports, said
been helpful if their plans had addressed how officials in one state agency. However, officials in five state and nine
to designate essential personnel and prioritize
equipment, and what information should be
local agencies described how the pandemic affected all aspects of
communicated to staff, families, children, and work in all locations for a long duration, and revealed gaps in needed
providers in advance. supplies, particularly technology and PPE.
Source: GAO interviews. | GAO-21-483
• Officials in all five state and 10 local agencies described their efforts
to rapidly secure needed supplies and continue services to children
and families, and officials in many of these agencies also said they
developed guidance on health safety as they learned more about
COVID-19. Officials in five state and five local agencies said the
guidance they developed could be useful in the future. This included
guidance on how to support families at risk of entering the foster care
system and how to respond when someone becomes ill (see fig. 4).
Figure 4: Examples of Guidance on Health Safety Developed by Child Welfare Agencies in Five Selected States in Response
to the COVID-19 Pandemic
Child welfare officials in 39 of the 53 states we surveyed reported that
additional guidance on disaster planning would be very or extremely
helpful, and ACF has provided guidance and supports in this area. For
example, beginning in April 2020, ACF published resources and guidance
Page 25 GAO-21-483 Child Welfare during COVID-19
on topics such as prioritizing resources in a disaster and moving from in-
person to remote work. In addition, beginning in December 2020, ACF
held various webinars on lessons learned in responding to disasters, as
well as on disaster planning, response, and recovery. ACF plans to
publish updated guidance by fall 2021 on coping with disasters and
strengthening child welfare systems, including tools child welfare
agencies can use to facilitate planning.
We provided a draft of this report to the Secretary of HHS for review and
Agency Comments comment. HHS provided technical comments, which we incorporated as
appropriate.
We are sending copies to the appropriate congressional committees, the
Secretary of Health and Human Services, and other interested parties.
The report will also be available at no charge on the GAO website at
www.gao.gov.
If you or your staff have any questions about this report, please contact
me at (202) 512-7215 or larink@gao.gov. Contact points for our Offices of
Congressional Relations and Public Affairs may be found on the last page
of this report. GAO staff who made key contributions to this report are
listed in appendix IV.
Kathryn Larin, Director
Education, Workforce, and Income Security Issues
Page 26 GAO-21-483 Child Welfare during COVID-19
List of Committees
The Honorable Patrick Leahy
Chairman
The Honorable Richard Shelby
Vice Chairman
Committee on Appropriations
United States Senate
The Honorable Ron Wyden
Chairman
The Honorable Mike Crapo
Ranking Member
Committee on Finance
United States Senate
The Honorable Patty Murray
Chairwoman
The Honorable Richard Burr
Ranking Member
Committee on Health, Education, Labor, and Pensions
United States Senate
The Honorable Gary C. Peters
Chairman
The Honorable Rob Portman
Ranking Member
Committee on Homeland Security and Governmental Affairs
United States Senate
The Honorable Rosa DeLauro
Chairwoman
The Honorable Kay Granger
Ranking Member
Committee on Appropriations
House of Representatives
The Honorable Robert C. “Bobby” Scott
Chairman
The Honorable Virginia Foxx
Republican Leader
Committee on Education and Labor
House of Representatives
Page 27 GAO-21-483 Child Welfare during COVID-19
The Honorable Frank Pallone, Jr.
Chairman
The Honorable Cathy McMorris Rodgers
Republican Leader
Committee on Energy and Commerce
House of Representatives
The Honorable Bennie G. Thompson
Chairman
The Honorable John Katko
Ranking Member
Committee on Homeland Security
House of Representatives
The Honorable Carolyn B. Maloney
Chairwoman
The Honorable James Comer
Ranking Member
Committee on Oversight and Reform
House of Representatives
The Honorable Richard E. Neal
Chairman
The Honorable Kevin Brady
Republican Leader
Committee on Ways and Means
House of Representatives
Page 28 GAO-21-483 Child Welfare during COVID-19
Appendix I: Federal Funding for Child Appendix I: Federal Funding for Child Welfare
Services during the Pandemic
Welfare Services during the Pandemic
Federal funding was appropriated for child welfare services during the
COVID-19 pandemic under various statutes, which was distributed by the
Department of Health and Human Services’ (HHS) Administration for
Children and Families (ACF). This funding was in addition to the annual
appropriations received by HHS. These funds were directed to be used
for a number of programs under Titles IV-E and IV-B of the Social
Security Act (see table 1).
Table 1: Examples of Federal Funding Distributed by HHS for Child Welfare Services during the COVID-19 Pandemic
Authorizing Additional COVID-19
legislation related funding Program purposes HHS distributiona
Families First Federal share of costs for Provides funds to states to cover a portion of Full amount to be determinedc
Coronavirus the Title IV-E Foster Care, costs for operating foster care, adoption
Response Act Adoption Assistance, and assistance, and guardianship assistance
Guardianship Assistance programs
program increased by 6.2
percentb
CARES Act $45 million for Title IV-B Provides funds to states for the following Distributed April 2020
Subpart 1, the Stephanie purposes: (1) protect and promote the Amounts states received ranged from
Tubbs Jones Child Welfare welfare of all children; (2) prevent the abuse, $15,686 to $4,690,717 with a median of
Services program neglect, and exploitation of children; (3) $631,809
support at-risk families through services
which allow children, where appropriate, to
remain safely with their families or return to
their families in a timely manner; (4) promote
the safety, permanence, and well-being of
children in foster care and adoptive families;
and (5) provide training, professional
development and support to ensure a well-
qualified child welfare workforce
Supporting Federal share of costs for Provides funds to states to cover a portion of Full amount to be determinede
Foster Youth certain Title IV-E costs for services intended to enhance
and Families Prevention and Kinship support to children and families and prevent
through the Navigator programs foster care placements, if such services
Pandemic Act increased to 100 percentd meet evidence-based requirements
determined by HHS; services can include
mental health, substance abuse treatment,
in-home parent skill-based, and kinship
navigator programs
$400 million to help support Provides funds to states for independent Distributed in February 2021f
older youth in foster care living services, such as mentoring, Amounts states received under the
under the Title IV-E John educational assistance, and vocational Chafee Foster Care Program for
H. Chafee Foster Care training, to support older youth in foster care Successful Transition to Adulthood
Program for Successful and youth who have recently left foster care, ranged from $464,109 to $41,280,026
Transition to Adulthood and as well as for education and training with a median of $4,302,679
Education and Training vouchers to help eligible youth pay for
Vouchers programs college, career school, or training Amounts states received under the
Education and Training Vouchers
program ranged from $67,458 to
$6,000,004 with a median of $625,389
Page 29 GAO-21-483 Child Welfare during COVID-19
Appendix I: Federal Funding for Child Welfare
Services during the Pandemic
Authorizing Additional COVID-19
legislation related funding Program purposes HHS distributiona
$85 million to promote safe Provides funds to states to (1) provide Distributed in March 2021g
and stable families and supportive services to prevent child Amounts states received under the
address state court maltreatment among at-risk families, (2) MaryLee Allen Promoting Safe and
improvements under Title assure children’s safety at home and Stable Families program ranged from
IV-B Subpart 2, the preserve intact families in which children $57,345 to $8,319,214 with a median of
MaryLee Allen Promoting have been maltreated, when the family’s $1,007,723
Safe and Stable Families problems can be addressed effectively, (3)
program address problems of families whose children Amounts states received for state court
have been placed in foster care so that improvements ranged from $93,375 to
reunification may occur in a safe and stable $686,351 with a median of $152,921
manner, and (4) provide support services as
necessary to adoptive families so that they
can make a lifetime commitment to their
children; also provides funds to states to
improve state court processes related to
foster care and adoptions
Source: GAO summary of information from federal laws and the Department of Health and Human Services (HHS). | GAO-21-483
a
Our analysis of federal funds provided to states in this report included the 50 states and the District
of Columbia. We did not examine funds provided to territories, tribes, and tribal organizations, though
they may provide child welfare services and receive federal support for their programs.
b
These funds were made available to states by temporarily increasing the federal medical assistance
percentage, which is used in determining the federal share of expenditures for Title IV-E Foster Care,
Adoption Assistance, and Guardianship Assistance programs. The expanded support is available to
eligible states retroactively to January 27, 2020, and will remain in place until the last day of the
calendar year quarter in which the public health emergency period ends. Pub. L. No. 116-127, §
6008(a), 134 Stat. 178, 208 (2020). The Supporting Foster Youth and Families through the Pandemic
Act also extended supports based on the federal medical assistance percentage to the District of
Columbia and states with Title IV-E demonstration waivers. Pub. L. No. 116-620, 134 Stat. at 2417.
c
ACF officials estimated that states received an additional $459 million as of February 2021. States
submit claims to ACF to be reimbursed for a portion of costs for child welfare programs funded under
Title IV-E. ACF officials said the actual amounts provided to states may change as states make
adjustments to their claims over time. ACF also conducts periodic Title IV-E reviews to ensure that
federal funds are provided to states on behalf of eligible children, though it announced in April 2020
that these reviews have been postponed indefinitely due to the pandemic. ACF officials told us they
would continue assessing states’ circumstances when determining when to resume the reviews, and
that the agency has historically accounted for flexibilities provided to states during disasters when
conducting reviews.
d
The expanded support is available to eligible states retroactively to April 1, 2020 through September
30, 2021.
e
ACF officials projected that states may receive nearly $21 million for their prevention programs
through June 30, 2021. ACF officials said the actual amounts provided to states may change, for
example, because more states may submit claims to be reimbursed for their programs. ACF officials
said prior to the pandemic, no states had submitted claims for their kinship navigator programs
because no programs had met evidence-based requirements for federal funding. ACF provided
flexibilities to help states continue their efforts to meet evidence-based requirements during the
pandemic, though officials in three of the five state child welfare agencies with whom we conducted
interviews expressed uncertainty about their ability to do so, given shifting priorities. The Supporting
Foster Youth and Families through the Pandemic Act temporarily waived evidence-based
requirements for kinship navigator programs.
Of this amount, $344 million was provided for the John H. Chafee Foster Care Program for
f
Successful Transition to Adulthood, $50 million was provided for the Education and Training
Vouchers program, and the remaining $6 million was reserved for ACF’s technical assistance and
evaluation activities.
Page 30 GAO-21-483 Child Welfare during COVID-19
Appendix I: Federal Funding for Child Welfare
Services during the Pandemic
g
Of this amount, $75 million was provided for the MaryLee Allen Promoting Safe and Stable Families
program, $9.5 million for the State Court Improvement program, and the remaining $500,000 for tribal
court improvement activities.
Page 31 GAO-21-483 Child Welfare during COVID-19
Appendix II: Federal Funding Amounts Appendix II: Federal Funding Amounts
Distributed to States for Child Welfare Services
Distributed to States for Child Welfare
during the Pandemic
Services during the Pandemic
Congress provided additional funds to support child welfare agencies
during the pandemic. Among these supports, the CARES Act included
$45 million for child welfare services as authorized by Title IV-B Subpart 1
to prevent, prepare for, and respond to COVID-19. In addition, the
Supporting Foster Youth and Families through the Pandemic Act included
$400 million to help support older youth in foster care, with $50 million
designated for education and training vouchers for these youth. The Act
also provided $85 million to promote safe and stable families, including
$10 million designated for court improvement programs. Table 2 details
the amounts provided to the 50 states and the District of Columbia for
these provisions. 1
Table 2: Federal Funding Amounts Distributed to States for Child Welfare Services during the COVID-19 Pandemic from
Appropriations under Selected Statutes
Amount provided under the Supporting Amount provided under the
Foster Youth and Families through the Supporting Foster Youth and
Pandemic Act to help support older Families through the Pandemic Act
youth in foster care to promote safe and stable families
Amount provided under John H. Chafee
the CARES Act for the Foster Care Program MaryLee Allen
Stephanie Tubbs Jones for Successful Education and Promoting Safe and State Court
Child Welfare Services Transition to Training Vouchers Stable Families Improvement
State program Adulthood program program program
Alabama $794,578 $4,659,625 $677,271 $1,434,197 $158,827
Alaska $15,686 $2,319,740 $337,172 $146,420 $96,891
Arizona $1,005,282 $10,452,735 $1,540,836 $1,597,355 $196,601
Arkansas $506,915 $3,325,310 $483,330 $724,416 $132,239
California $4,580,101 $41,280,026 $6,000,004 $7,844,858 $686,351
Colorado $714,583 $4,302,679 $625,389 $847,869 $170,327
Connecticut $276,116 $3,491,294 $507,455 $552,458 $135,849
Delaware $127,441 $464,109 $67,458 $244,094 $98,879
District of $48,985 $541,461 $78,701 $164,951 $94,219
Columbia
Florida $2,727,901 $19,791,518 $2,876,674 $5,028,565 $370,811
Georgia $1,729,109 $10,367,523 $1,506,907 $2,954,126 $254,844
Hawaii $176,363 $1,374,601 $199,797 $265,125 $104,988
Idaho $304,731 $1,411,666 $205,184 $315,933 $114,900
1For additional information on the purposes for which these funds can be used, see
appendix I. We did not examine funds provided to territories, tribes, or tribal organizations
in our report, though ACF documents show that territories, tribes, and tribal organizations
also received federal funds.
Page 32 GAO-21-483 Child Welfare during COVID-19
Appendix II: Federal Funding Amounts
Distributed to States for Child Welfare Services
during the Pandemic
Amount provided under the Supporting Amount provided under the
Foster Youth and Families through the Supporting Foster Youth and
Pandemic Act to help support older Families through the Pandemic Act
youth in foster care to promote safe and stable families
Amount provided under John H. Chafee
the CARES Act for the Foster Care Program MaryLee Allen
Stephanie Tubbs Jones for Successful Education and Promoting Safe and State Court
Child Welfare Services Transition to Training Vouchers Stable Families Improvement
State program Adulthood program program program
Illinois $1,625,609 $14,758,834 $2,145,179 $3,234,488 $275,751
Indiana $1,068,762 $13,139,286 $1,909,780 $1,223,351 $191,856
Iowa $476,722 $4,798,212 $697,415 $610,050 $134,767
Kansas $443,475 $6,475,743 $941,241 $411,268 $132,635
Kentucky $732,995 $7,370,957 $1,071,360 $1,015,242 $152,921
Louisiana $739,882 $3,157,715 $458,970 $1,694,360 $157,747
Maine $164,476 $1,688,842 $245,471 $225,795 $102,101
Maryland $664,640 $3,094,061 $449,718 $1,104,067 $175,175
Massachusetts $596,272 $7,946,259 $1,154,979 $1,084,133 $180,764
Michigan $1,424,370 $9,403,852 $1,366,839 $1,981,268 $231,521
Minnesota $720,287 $6,768,259 $983,759 $772,035 $172,407
Mississippi $540,246 $3,352,706 $487,312 $1,007,723 $132,313
Missouri $931,147 $10,220,877 $1,485,593 $1,345,900 $177,696
Montana $108,741 $2,978,840 $432,971 $186,465 $100,469
Nebraska $277,744 $2,796,128 $406,414 $335,617 $117,165
Nevada $445,939 $3,658,889 $531,815 $746,384 $130,732
New Hampshire $137,578 $987,038 $143,465 $138,505 $102,856
New Jersey $881,540 $3,569,451 $518,816 $1,430,012 $215,068
New Mexico $244,677 $1,874,163 $272,407 $797,668 $117,291
New York $1,902,197 $12,961,217 $1,883,898 $4,045,821 $359,977
North Carolina $1,593,398 $9,042,878 $1,314,372 $2,175,582 $242,796
North Dakota $76,858 $1,210,229 $175,905 $92,513 $97,261
Ohio $1,710,674 $13,203,746 $1,919,149 $2,442,286 $260,139
Oklahoma $163,077 $6,692,519 $972,750 $1,074,638 $149,202
Oregon $548,639 $5,542,398 $805,581 $853,069 $143,558
Pennsylvania $1,570,611 $12,509,999 $1,818,314 $2,738,300 $266,250
Rhode Island $127,345 $1,772,639 $257,651 $208,042 $99,731
South Carolina $797,811 $3,642,774 $529,473 $1,314,830 $160,823
South Dakota $82,341 $1,374,601 $199,797 $174,379 $99,570
Tennessee $1,009,708 $7,485,372 $1,087,990 $1,769,942 $186,636
Texas $4,690,717 $25,322,153 $3,680,546 $8,319,214 $581,168
Page 33 GAO-21-483 Child Welfare during COVID-19
Appendix II: Federal Funding Amounts
Distributed to States for Child Welfare Services
during the Pandemic
Amount provided under the Supporting Amount provided under the
Foster Youth and Families through the Supporting Foster Youth and
Pandemic Act to help support older Families through the Pandemic Act
youth in foster care to promote safe and stable families
Amount provided under John H. Chafee
the CARES Act for the Foster Care Program MaryLee Allen
Stephanie Tubbs Jones for Successful Education and Promoting Safe and State Court
Child Welfare Services Transition to Training Vouchers Stable Families Improvement
State program Adulthood program program program
Utah $631,809 $2,004,694 $291,380 $403,974 $147,058
Vermont $74,778 $1,003,153 $145,807 $98,477 $93,375
Virginia $1,051,457 $3,968,295 $576,787 $1,337,210 $211,948
Washington $859,381 $8,752,957 $1,272,232 $1,311,300 $196,291
West Virginia $276,154 $5,856,961 $851,303 $472,497 $109,471
Wisconsin $782,295 $6,157,504 $894,986 $1,123,698 $171,575
Wyoming $61,093 $800,911 $116,411 $57,345 $93,979
Source: GAO summary of information from the Department of Health and Human Services (HHS). | GAO-21-483
Page 34 GAO-21-483 Child Welfare during COVID-19
Appendix III: Examples of HHS Flexibilities,
Appendix III: Examples of HHS Flexibilities,
Guidance, and Other Supports to Help Child
Guidance, and Other Supports to Help Child
Welfare Agencies during the Pandemic
Welfare Agencies during the Pandemic
Officials we interviewed in five state and 10 local child welfare agencies
identified challenges they faced as well as practices they may continue
based on what they learned during the COVID-19 pandemic. The
Department of Health and Human Services’ (HHS) Administration for
Children and Families (ACF) provided various flexibilities, guidance, and
other supports to child welfare agencies throughout this time. Table 3
provides examples of these supports as they relate to the challenges and
practices identified by child welfare agencies in our interviews.
Table 3: Examples of ACF Supports to Help Child Welfare Agencies during the COVID-19 Pandemic
ACF flexibilities, guidance, and other supports
Challenges for child welfare agencies
Concerns about unreported child abuse • A joint letter to stakeholders with HHS’s Health Resources and Services
and neglect Administration on May 28, 2020 outlines concerns about the well-being of families
during the pandemic and encourages continued partnerships with families and
providers as well as virtual service delivery.
Health risks to staff and families • A letter to child welfare agencies on March 18, 2020 provides flexibilities for
caseworkers to conduct required visits with children in foster care virtually. A letter
issued on April 15, 2020 expands on these flexibilities and outlines flexibilities in
how fingerprints can be collected during background checks for new foster parents.
• A letter to governors on April 17, 2020 encourages them to classify foster care
caseworkers and providers as essential personnel to allow these workers greater
access to personal protective equipment.
• A letter to child welfare agencies on April 17, 2020 outlines opportunities to use
existing child welfare funds for personal protective equipment and cellphones to
conduct work virtually.
• A webinar held jointly with the Centers for Disease Control and Prevention in June
11, 2020 provides information on child welfare staff safety during in-person
interactions with families.
• A series of webinars held in July through November 2020 provides information on
supporting a virtual child welfare workforce.
Delays in court hearings • A letter to child welfare legal and judicial leaders on March 27, 2020 encourages
them to continue hearings for child welfare cases as required under law, and
underscores the need for children in foster care to have ongoing contact with their
parents.
• A letter to chief justices and state court administrators on April 14, 2020 outlines
opportunities to use existing federal funds for court improvement programs to
support telework and videoconferencing capabilities for virtual hearings.
• A letter to child welfare agencies and court leaders on December 4, 2020 continues
to urge them to ensure that critical court hearings occur with consideration for how
pandemic disruptions may affect family efforts for reunification. It also shares
resources on managing child welfare cases and addressing backlogs.
Page 35 GAO-21-483 Child Welfare during COVID-19
Appendix III: Examples of HHS Flexibilities,
Guidance, and Other Supports to Help Child
Welfare Agencies during the Pandemic
ACF flexibilities, guidance, and other supports
Service disruptions for children and families • A letter to child welfare agencies on June 23, 2020 urges them to carefully consider
whether it is appropriate to terminate a parent’s rights given service disruptions
during the pandemic. It also highlights some service delivery strategies.
• A letter to child welfare agencies on November 20, 2020 provides flexibilities for
them to provide certain services intended to enhance support to children and
families and prevent foster care placements virtually. Such services can include
mental health, substance abuse treatment, in-home parent skill-based, and kinship
navigator programs approved in state plans.
Impacts of the economic crisis • A letter to child welfare agencies on March 12, 2020 encourages them to contact
older and former youth in foster care in colleges or other settings who may need
assistance while their campus is closed.
• A letter to child welfare agencies on April 27, 2020 encourages them to use existing
flexibilities for federal funds, such as to enhance payment rates to those caring for
children in foster care, provide hazard pay for caseworkers, and support older and
former youth in foster care.
• Program instructions to child welfare agencies on May 8, 2020 provide flexibilities
for agencies to extend federal support to youth in foster care up to age 21, such as
by waiving education and employment requirements for youth if they are unable to
meet them due to the pandemic.
• Program instructions to child welfare agencies on June 8, 2020 provide information
on the allowable uses of and reporting requirements for funds provided under the
CARES Act.
• A letter to child welfare agencies on November 18, 2020 shares information on
major challenges and needed supports for older and former youth in foster care,
based on 12 roundtables held with youth.
• Guidance to child welfare agencies on January 13, 2021 and March 9, 2021 provide
information on additional federal funding provided under the Supporting Foster
Youth and Families through the Pandemic Act.
Practices child welfare agencies may continue
Continuing virtual services • Various peer-to-peer roundtable events and webinars since March 2020 share
information with child welfare stakeholders on responses to the pandemic and
lessons learned with virtual visits and services.
• Guidance on April 16, 2020 through ACF’s Capacity Building Center for Courts
outlines best practices for virtual hearings in child welfare cases.
• Guidance in April 2020 provides information for child welfare agencies on
technological tools and tips for facilitating virtual meetings.
• Guidance in July 2020 provides tips for supporting virtual family time so children in
foster care can visit with their biological parents and siblings.
• Guidance in September 2020 outlines strategies to promote effective virtual and
phone engagement to support child, caregiver, and family well-being in times of
crisis.
Page 36 GAO-21-483 Child Welfare during COVID-19
Appendix III: Examples of HHS Flexibilities,
Guidance, and Other Supports to Help Child
Welfare Agencies during the Pandemic
ACF flexibilities, guidance, and other supports
Strengthening stakeholder partnerships • Regular communication among child welfare agencies and other stakeholders
provides opportunities to share information on pandemic response, continuing
challenges, and lessons learned.
• Websites and newsletters, including via ACF’s Child Welfare Information Gateway,
share information with child welfare stakeholders on lessons learned, state
practices, and other resources.
• Guidance on January 12, 2021 shares lessons learned from the pandemic and
highlights strategies and opportunities for family-serving agencies and stakeholders
to create equitable, proactive, and integrated approaches to support children and
families.
Updating disaster plans • Various guidance documents issued since April 2020 address topics including
prioritizing resources in a disaster, pivoting practices (e.g., moving from in-person to
remote work), and planning for future disasters.
• Various webinars since December 2020 provide information such as on lessons
learned in responding to disasters and disaster planning, response, and recovery.
• Guidance planned to be issued by fall 2021 updates prior guidance for child welfare
agencies on coping with disasters and strengthening child welfare systems,
including tools agencies can use to facilitate planning.
Source: GAO analysis of information from the Department of Health and Human Services’ (HHS) Administration for Children and Families (ACF) and obtained in interviews with officials in state and local
child welfare agencies in five selected states. | GAO-21-483
Note: We included examples of flexibilities, guidance, and other supports developed during the
pandemic, though supports ACF provided prior to the pandemic may also address the challenges and
lessons learned that were identified by child welfare agencies. Further, we included each support
once, though some may relate to multiple challenges and lessons learned.
Page 37 GAO-21-483 Child Welfare during COVID-19
Appendix IV: GAO Contact and Staff
Appendix IV: GAO Contact and Staff
Acknowledgments
Acknowledgments
Kathryn A. Larin, (202) 512-7215, larink@gao.gov
GAO Contact
In addition to the contact named above, the following staff members
Staff made key contributions to this report: Elizabeth Morrison (Assistant
Acknowledgments Director), Nhi Nguyen (Analyst-in-Charge), Lauren Gomez, and Ada
Nwadugbo. Also contributing to this report were Susan Aschoff, James
Bennett, Joyce Harvey, Morgan Jones, David Lin, Jean McSween,
Jessica Orr, Steven Putansu, James Rebbe, Monica Savoy, and Almeta
Spencer.
(104343)
Page 38 GAO-21-483 Child Welfare during COVID-19
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