Reports

This brief describes progress in the Child Welfare and Health Infrastructure for Linking and Data Analysis of Resources, Effectiveness, and Needs (CHILDREN) Initiative, which is in its fourth year. At this time, four jurisdictions participate in the CHILDREN Initiative: District of Columbia, Iowa, Oklahoma, and Wyoming.

KEY POINTSThe average state provider tax law, which typically taxed a hospital up to 3.5 percent of net patient revenue, resulted in an increase in ESI premiums of 1.5-1.7 percent, plus any spillover effect on interstate markets for provider resources.

KEY POINTSAnnual growth in the number of kidney transplants began to accelerate in 2019.

The Kidney Care National Plan highlights the continued commitment of HHS to advance kidney care and identifies opportunities for policy reform and improvement across the Department’s efforts. The relative lack of innovation in kidney care is the structural outcome of anti-competitive and burdensome actions that have maintained the national crisis of kidney disease and kidney failure.

The Administration for Children and Families’ initiative, A Home for Every Child, is designed to help achieve at least a one-to-one ratio of foster homes available for children and youth in foster care, where the numerator is the number of foster homes available and the denominator is the number of children in care.

The goal of the Administration for Children and Families’ (ACF’s) A Home for Every Child initiative is to have a safe and supportive home available for every child or youth in foster care. ACF measures the initiative’s success by a one-to-one home-to-child ratio, meaning there are as many foster homes available as there are children in foster care.

Efforts by CMS to reform the 340B Drug Pricing Program aim to decrease financial incentives that place revenue over patients' health outcomes and access to care.

The use of psychotropic medications in children is a complex issue for parents, caregivers, health care professionals, researchers, and policymakers. Psychotropic medications are used to treat behavioral health conditions. When these medications are prescribed appropriately, they can be effective in managing behavioral health symptoms.

This brief examines the utilization of Low-Income Home Energy Assistance Program (LIHEAP) funds for weatherization from Fiscal Year 2016 (FY16) through FY24, as well as the waiver process states can use to increase their weatherization spending limits.Key findings include:

The 2016 Head Start Program Performance Standards final regulation anticipated that improved quality would justify potential reductions in access.

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This brief describes available data on the licensing status of Head Start service locations and child care programs, and outlines existing infrastructure that can support alignment and coordination between Head Start and state licensing systems.

This brief examines how states allocated Low Income Home Energy Assistance Program (LIHEAP) funds from FY16 through FY25, including spending on direct energy assistance, weatherization, administrative and other activities, and funds carried over to subsequent fiscal years. Key findings include:

EXECUTIVE SUMMARYMedicare reimbursement is administered, but it is not insulated from markets for provider labor, capital, facilities, and technology. Traditional Medicare payment formulas incorporate market-basket input prices, geographic wage indexes, case mix, and quality adjustments; total spending also depends on utilization.

This brief reviews the literature on the relationship between teacher-child ratios and child outcomes, then describes how Head Start ratio standards compare with existing state licensing standards. Key findings include:

Executive SummaryRegulations often restrict the range of market choices available to consumers, yet they are promulgated without a quantitative analysis of that cost—a fundamental flaw in regulatory impact analysis. This paper fills the gap by supplying a portable choice-value factor.

KEY POINTSCoverage of non-recurring adoption expenses can help reduce upfront adoption costs for families – covering expenses like legal fees, court costs, home studies, and necessary transportation, food, and lodging – supporting permanency for children with special needs.

KEY POINTSThe Ryan White HIV/AIDS Program (RWHAP) provides critical services to low-income peo

This brief synthesizes national caseload and expenditure data related to Title IV-E foster care eligibility and summarizes the Children’s Bureau’s published Title IV-E foster care eligibility review findings. Key findings include:

h1, h2, h3, h4, h5, h6, p, li {max-width: 100% !important;} KEY POINTSThe Head Start Act sets a ceiling of 15 percent for development and administrative costs.The Head Start Act gives the HHS Secretary the flexibility to determine that administrative

KEY POINTSExisting research shows that children’s exposure to domestic violence (DV)/ intimate partner violence (IPV) increases the likelihood of involvement with the child welfare system (including child protective services (CPS) involvement and foster care entry).

This brief examines how Head Start’s comprehensive service delivery changed between the 2015-2016 (FY16) and 2024-2025 (FY25) program years, focused on volume (total number) and rate (percent) of children and families who received comprehensive services. Key findings include:

h3 { max-width: 100% !important; } p{max-width: 100% !important;}KEY POINTSFederal spending per child support case increased from $374.31 to $435.82 (in inflation adjusted dollars) between Fiscal Year 2015 (FY15) and FY24.

This brief describes HHS' historical approach to Head Start regulation following the 2007 statutory reauthorization. Key findings include:

To facilitate cross-state learning, the Office of Child Care (OCC), in partnership with the Assistant Secretary for Planning and Evaluation (ASPE), is launching a snapshot series to highlight promising state practices.

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Health care provider taxes and state-directed payment policies in the Working Families and Tax Cut legislation are expected to reduce non-Medicaid prices by up to 3.5 percent in markets with provider taxes and reduce spending on Medicaid, commercial and Medicare coverage.

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Artificial intelligence (AI) tools, particularly those that use natural language processing (NLP), are becoming increasingly prominent in healthcare delivery. For these systems to operate safely and reliably in clinical settings, they require high-quality training datasets drawn from multiple sources, including electronic health record (EHR) data, that closely reflect real-world conditions.

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In 2022, 11.8 million children were eligible for childcare subsidies under federal rules; under state rules – which can be more restrictive – 9.1 million were eligible.1.8 million children received subsidies, representing 16 percent of those eligible under federal rules and

The United States (U.S.) faces urgent health challenges, including poor maternal and childhood health outcomes, childhood obesity, opioid use disorder, cancer, and chronic conditions, which require personalized care tailored to each patient’s unique circumstances.

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The overall goal of the project is to expand the utility of National Center for Health Statistics (NCHS) linked data resources to support patient-centered outcomes research (PCOR) through the development of publicly available synthetic linked data files.

The Welfare Indicators Act of 1994 (Public Law 103-432) requires the Secretary of the Department of Health and Human Services to prepare an annual report to Congress on indicators and predictors of “welfare dependence.” That Act requires the report to include three programs: Temporary Assistance for Needy Families (TANF) program (which replaced the Aid to Families with Dependent Children (AFDC)

Patients, clinicians, decision makers, and other stakeholders depend on robust, evidence-based information to make informed health care decisions. Linking Medicaid data to other sources enables a deeper understanding of how Medicaid services and interventions influence health outcomes.

This summary highlights key findings from this study. Readers are encouraged to download the full report for complete details and analysis.

The Title IV-E Guardianship Assistance Program (GAP): Use of Guardianship is Growing, but Lags Adoption Assistance and is Unevenly Used Across States May 2026 Administration for Children and Families & Office of the Assistant Secretary for Planning and Evaluation 

This brief provides an overview of child welfare ombudsman offices, describes the landscape of state child welfare ombudsman programs and their common functions, reviews the effectiveness of their oversight, and identifies successes in improving child welfare processes and procedures. Key findings include:

ASPE’s Office of Health Policy has developed an Issue Brief modeling the key determinants of rural hospital closure or conversion as well as an interactive Rural Hospital Dashboard to highlight key characteristics and trends among rural hospitals.

Background. Accurately estimating the prevalence of intellectual and developmental disabilities (ID/DD) in the United States remains a challenge, with reported rates varying widely (3%-17%) based on the definitions and data sources used.

This brief describes Consolidated Block Grant (CBG) authority, which allows federal agencies to consolidate grants to insular areas into a single block grant, and how it is used with the Social Services Block Grant (SSBG) within the Administration for Children and Families (ACF). Key findings include: