Adoption & Foster Care

This brief summarizes discussions among experts participating in a roundtable. The discussions focused on promising strategies to identify substance use disorder (SUD) among human services participants and refer them to treatment and recovery supports. The roundtable concentrated on four programs: Temporary Assistance for Needy Families, child welfare, domestic violence, and Head Start.

Program Integrity and Effectiveness through Data and Analysis (PIEDA) aims to enhance the capacity to share and link data between state child welfare and Medicaid agencies on issues at the nexus of the two systems. PIEDA intends to sustainably improve the data infrastructure of states to increase their ability to analyze challenges experienced by families involved in child welfare systems.

The Child and Caregiver Outcomes Using Linked Data project provides technical assistance to states to develop state-specific datasets linking the Medicaid administrative claims of parents with the records of their children from the child welfare system. The data will be combined into a multi-state, de-identified data sets for secondary data analysis.

Many child welfare systems have begun to provide prevention services to mitigate economic-related factors that place children at risk of entering foster care. Transforming child welfare systems to prevent child maltreatment and child welfare system involvement requires adequate information and analytic approaches.

The Family First Prevention Services Act (FFPSA) permits states to use title IV-E foster care funding for children placed in foster care with their parent in a licensed residential family-based treatment facility for substance abuse. However, few states currently use this funding, due to barriers such as competing priorities and lack of facilities.

Between 2011 and 2018, increasing numbers of infants were removed from their parents or caregivers. From 2011 to 2018 the number of infants entering foster care increased 24 percent reaching around 50,000 in 2018. This increase was nearly 13 times as much as the 1.8 percent increase in placements for other age groups .

Permanency, that is ensuring children have long-term, enduring connections to family or other caring adults, is one of the three primary goals of the child welfare system, along with safety and child well-being.

The Multiethnic Placement Act, as amended, enacted in 1994 and known as MEPA (or MEPA/IEP to acknowledge amendments passed in 1996), prohibits child welfare agencies that receive federal funding from delaying or denying foster or adoptive placements because of a child or prospective foster or adoptive parent’s race, color or national origin and from using those factors as a basis for denying ap

Parental opioid use disorder (OUD) is a risk factor for the maltreatment of children and placement into foster care. Opioid agonist therapy (OAT) is an evidence-based treatment for OUD using medications such as methadone and buprenorphine. OAT can help parents enter recovery and reduce the risk of maltreatment, and potentially improve child welfare outcomes.

This toolkit aims to help states develop a plan for Title IV-E prevention services, and to assist states in planning a comprehensive array of services to help prevent the need for foster care placement (“prevention services”) by braiding Title IV-E prevention services reimbursement with Medicaid and other funding mechanisms.