Advancing Permanency in Child Welfare: Leveraging Federal Funding for Adoption Programs

Oh, well, good morning, everyone. It's good to have everyone here this morning, and I just want to say a special thank you to our witnesses who have come to testify on this very important topic today, advancing permanency in child welfare in the United States. Adoption has long played an important role in building families and providing children with safe and stable homes. Today, adoption remains a critical part of our child welfare system. But the data shows that there are still significant ways that we can improve and that we can make it better. Currently, there are more than 325,000 children that are living in the United States under the foster care system. And many of those entered because of abuse, neglect, and family instability. Among these children, tens of thousands are waiting for a permanent adoptive family. In fact, recent data shows that over 70,000 children are waiting to be adopted at the end of 2023, and many already had spent years in foster care. Each year, adoption helps thousands of children find permanent homes. More than 45,000 children were adopted from foster care in FY 2024 alone. Despite the progress that's been made, challenges still remain. Some children age out of the system without ever finding a permanent home, and in 2023, over 15,000 young people left foster care without adoption or reunification, entering adulthood without a long-term stability with family support that, of course, a family always provides. Encouraging adoption can change these outcomes in so many powerful ways. There are many benefits from adoption, as I think everyone in this room knows. But let me just say first, adoption provides stability and permanence. Children who are adopted often gain the emotional security of a long-life family connection, something that I don't think anyone would disagree that every child needs. Also, stable homes improve outcomes in education, health, and overall well-being. Second, adoption strengthens communities and society as a whole. When children grow up in supportive environments, they are much, much more likely to succeed in school, to contribute to their communities, and avoid many of the challenges associated with instability or with homelessness. Third, encouraging adoption supports the child welfare system. By helping more children transition from temporary foster care to permanent homes, adoption reduces the strain on foster care resources and allows agencies to focus on children who most urgently need care. And I think it also should be noted that adoption today takes many forms. Families adopt through foster care, through kinship adoptions, through private domestic adoptions, and through international adoptions. Many adoptive families are single parents, they're relatives, or they're blended families. As policymakers, advocates, and citizens, we have an opportunity to encourage adoption by supporting adoptive families, improving adoption awareness, and ensuring that the process is accessible and it's also ethical. Policies such as post-adoption services and recruitment of adoption parents can make a meaningful difference. And ultimately, adoption is more than just policy. It is about people. It's about ensuring that every child has the chance to grow up in a safe, a supportive, and loving home. And when we encourage adoption, we invest not only in individual children, but also the future of our communities of this country. Before I turn to the ranking member for her remarks, I do want to introduce our panel of witnesses. First, we have Ms. Kate McLean. She is the executive director of the Congressional Coalition on Adoption Institute. I look forward to hearing from her and about how the institution works to identify and remove barriers for vulnerable children and families. And let me just add a side note here. I've had the chance to get to know Kate over the last several years as I've served as co-chair of the Congressional Adoption Caucus on Adoption and worked hand-in-hand with her team at CCAI. Next, we'll hear from Ms. Debbie Riley. She is the CEO of the Center for Adoption Support and Education, whose expertise includes adoption therapy and developing adoptive competent training programs. We'll also hear from Dr. Sarah Font, who is a professor at the Brown School at Washington University in St. Louis. Her research focuses on the impacts of the child welfare system on families and using data to improve agencies' outcomes. And next, we have Ms. Lee Marshall, founder and CEO of Kids to Love. She will also speak with us. She is a long-time friend in Huntsville, in Alabama, and runs an amazing program down there working to help in the foster care space. So, glad that she was able to join us. And last, and certainly not least, we have Ms. Aurene Martin, and she is board secretary of the National Indian Child Welfare Association, and she has extensive experience in federal Indian law and policy, having served in several tribal and federal key government positions. We appreciate all of you taking time today to be here to share your insights from folks that are on the ground and can tell us first-hand. And at this point, I'd like to recognize the committee's ranking member, Ms. DeLauro, for her remarks that she would like to make at this time.

Thank you very much, Mr. Chairman. And a very big thanks to our witnesses this morning, Ms. Riley, Ms. McLean, Ms. Font, Ms. Martin, and Ms. Marshall, for joining us, making time to share your thoughts and to share your valuable insight and expertise with this committee. Foster care and adoption provide children in need with loving, safe places to land, offer stability, healing, and a chance to thrive. Foster parents provide essential, stable, nurturing environments, caring for children during uncertain times. Adoption gives families and children a chance to live happy lives, form family bonds, and experience the comfort, the security, and fulfillment of a loving home. This is an issue that's very, very personal to me. I have two adopted grandsons, Teo and Gus. And I cannot fully express to you all the joy that they have brought into our lives, to me, to my husband, and to our entire family. They are a blessing in every sense of the word. But the foster care system is not without its challenges. And I have two young cousins who were for many years in the foster care system. One of them made it through the system. She found her footing. She has a son, a job, and she is doing well. The other, unfortunately, has continued to struggle, and she struggles every single day to this day. It puts a strain on both the children and the families involved, and the mental health repercussions are real, they're lasting, and must be taken into account when making decisions about the foster care and adoption system. The system is not perfect by any stretch of the imagination. But it is our responsibility to improve it, to make it better for the families and the children who need it. We do not want to do anything that would keep responsible, qualified, and loving parents from adopting children who need a home. We must take precautions, of course, to ensure that children are being adopted into safe, responsible, and stable environments. But it is wrong to keep children from loving families. While individual states have the primary responsibility for implementing child welfare services, including foster care and adoption, Congress sets the national standards and provides crucial federal funding for the U.S. foster care and adoption system. For fiscal year 2026, Congress provided over $10 billion in mandatory funding to states to support foster care, adoption assistance, and family guardianship for children removed from unsafe homes. This subcommittee also directly oversees funding for several discretionary spending programs at the Administration for Children and Families to collect data, conduct research, and to provide services that help eliminate barriers to adoption, to successfully match more children with loving families. The Adoption Opportunities program funded through the Labor, HHS, Education bill supports efforts to increase the number of children adopted from foster care, eliminate the barriers to adoption, provide post-legal adoption services to families, and train caseworkers to improve permanency and outcomes. Every child deserves a loving home. To help achieve that, we need to recognize the barriers to adoption. We need to offer post-adoption support to ensure a successful transition, help improve the process for families and children. We need to support the workforce and the care economy. How can we train and support these caseworkers? How can we retain them, provide them with the tools they need to support children, families, help them to avoid burnout from a job that is emotionally taxing? These are only a few of the many questions we need to be thinking about as we work to improve the adoption and foster care system throughout the country. I'm grateful to Ms. Debbie Riley for being here as one of our witnesses today. As you note in your testimony, children in foster care experience a disproportionately high rate of mental health conditions. We need first to acknowledge the trauma that can come from disrupted childhoods. If we acknowledge it, we can invest in mental health support and training. We can support the child welfare system, these children, and the families who we know, based on evidence, are concerned about the mental health of the children they want to welcome into their families. We need to acknowledge the mental health needs of these families as well, to support potential adoptive parents through their adoptive journeys so that they can enjoy the precious rewards of love that come from welcoming a child into their home. On this committee, we have the power to help these families. We have invested in some solutions. We need to continue to do so. I am glad that we will be highlighting some of those solutions today and talking about how we can direct discretionary resources to do better. As appropriators, we have an obligation to ensure the resources are available for these programs to be successful. A thank you to our witnesses for being here. Thank you sincerely for the work that you are doing outside of this hearing room for children and families, and indeed it can be taxing, and we appreciate that. I look forward to hearing your testimony today, and I yield back. Thank you, Mr. Chairman.

Thank you, Ms. DeLauro. Well said, and I want to now turn to our witnesses, and you'll each be given five minutes to make your opening remarks. I know each of you submitted some testimony, and of course that will be submitted to the record in full. So, Ms. McLean, let me begin with you, and you may begin.

Chairman Aderholt, Ranking Member DeLauro, and members of the subcommittee, thank you for inviting me to participate today in the hearing. My name is Kate McLean. I'm proud to serve as executive director of the Congressional Coalition on Adoption Institute, a nonprofit, nonpartisan organization founded in 2001 to remove barriers that prevent children from experiencing the safety, stability, and permanency of family. Family permanency means a child has the safety and belonging that comes from knowing they are part of a permanent family who will love and support them for a lifetime. Legally, this may include adoption, kinship guardianship, or reunification, but true permanency also requires the relational and emotional stability every child needs to thrive. For 25 years, CCAI has served as a trusted source of information, expertise, and resources for the Adoption Caucus, the Congressional Coalition on Adoption. As the historically largest bipartisan, bicameral caucus in Congress, the Adoption Caucus reflects a strong and enduring commitment to children and families. CCAI extends its sincere appreciation to Chairman Aderholt, co-chair of the caucus, for his leadership, and to Ranking Member DeLauro and Representatives Bice, Letlow, Moolenaar, and Pocan for their membership. CCAI raises awareness among policymakers by connecting them directly with adoptees, foster youth, foster kinship and adoptive families, and birth parents to ensure legislative decisions reflect real-world experiences. Programs like Angels in Adoption and the Foster Youth Internship Program create opportunities for Congress to meet and learn from important lived experiences firsthand. I come before you today carrying the collective voices of the thousands of individuals and families CCAI has had the privilege to work with. Adoption is at the heart of CCAI's mission. It offers children the chance to belong, to be cared for and supported throughout life, and to know they will always have family to share holidays, milestones, and everyday moments. Adoption has the power to create lifelong family connections, but it should strengthen, not replace, a child's support network. Effective adoption practice preserves relationships and belonging while also providing the stability of a permanent family. Federal adoption incentive programs like Adoption Opportunities and the Adoption and Legal Guardianship Incentive Payments help youth in foster care, especially those with complex needs, find permanent families. These programs reward state practices that advance timely, child-centered adoptions and legal guardianships. Children with complex needs, older youth, sibling groups, or those with medical, developmental, or behavioral challenges often face greater barriers to adoption, and these programs foster policies and opportunities that make lasting permanency possible. I included stories in my written testimony to illustrate progress as well as some ongoing challenges. These systems are multifaceted, there is no single solution, and meaningful progress requires coordinated effort. Three key priorities can help strengthen outcomes and support successful adoptions and family permanency. First, making adoption more accessible and ethical. Increase accessibility by encouraging the adoption of children with complex needs and removing barriers to family permanency. For example, as shared in my written testimony, our California youth story shows the importance of helping older youth find permanent families while still supporting their goals like pursuing higher education without forcing a choice between the two. It also includes sibling placements like the family I shared from Tennessee keeping all five siblings together. And removing financial or systemic barriers that may prevent adoption, as illustrated by the Pennsylvania youth story. Second, ensuring preparedness and readiness for adoption and guardianship. Adoptees, birth parents, and adoptive families must be fully prepared, supported, and have a meaningful voice to ensure lasting placements. Gaps in training and pre- and post-adoption support can increase the risk of disruption, while system pressures and limited youth input can undermine stability. Strengthening trauma-informed, adoption-competent care along with pre- and post-adoption services is essential so children and families can thrive together. Third, reducing barriers and strengthening the permanency workforce. Bolstering the permanency workforce will help children reach stable placements more efficiently. In particular, shortages of trained professionals can slow progress and create challenges for families. By investing in skilled permanency specialists and focusing on their recruitment, retention, and training, we can provide timely, child-centered outcomes and ensure children are connected with safe, permanent families without unnecessary delays. CCAI urges continued investment in policies, programs, and a skilled workforce to expand family permanency, support youth and families before and after placement, and uphold the rights and well-being of every child. Thank you for the opportunity to testify on the life-changing impact of adoption and family permanency.

Good morning, Chairman Aderholt and Ranking Member DeLauro and subcommittee members. Thank you very much for the work that you do every day to ensure a child has a permanent, loving family. It's truly an honor to speak on this topic as it's personally and professionally of deep importance to me. I'm Debbie Riley, co-founder and CEO of the Center for Adoption Support and Education, a licensed marriage and family therapist of 40 years, and an adoptive parent. When my husband and I considered adoption 38 years ago, I hesitated because of what I'd seen in my clinical work. Foster and adopted children were overrepresented in higher levels of mental health settings with unacceptable outcomes. My career has dedicated to changing that reality. Early in this journey, I met Kathleen Dugan, who with her husband adopted eight children from foster care, expanding their family from four to 12. We did not understand the impact of brain development and trauma, how children grieve, and their alarming behaviors. Professionals told the Dugans their children were too damaged and they should return them. They refused. Together, we founded CASE so that no parent would ever be told to return their child into care. In Maryland, Virginia, and Washington, D.C., I'm proud that we have served over 9,000 children and families in pre- and post-adopt services. The adoption serves as a critical protective factor, as we've all discussed, by providing permanency, stability, and nurturing. Yet unavailable adoption-competent mental health services compromises foster care recruitment, retention, child well-being, and preparedness of confidence of adoptive families. Children with traumatic backgrounds face higher risk of development, health, and behavioral issues. Adoptive parents identify mental health services as one of their greatest unmet needs. Evidence revealed clinicians had a minimal in post-doctoral trainings of seven minutes per semester. So CASE created Training for Adoption Competency, known as TAC, in 2009, the only evidence-based accredited program in the United States today. We've trained over 3,000 clinicians in 21 states. In December, the strongest published research showed superior outcomes for families who were treated by adoption-competent therapists. 300 families were studied. They had stronger therapeutic alliance, invested in treatment, and actually the families were encouraged to be a part of the treatment and not left in the waiting room. The Children's Bureau funded the National Competency Training Institute, NTI, in 2014 to fill a gap in child welfare. Two free, state-of-the-art online adoption competency curriculums were developed for all states, tribes, and territories. Over 9,000 professionals have completed this training. Concerning results showed child welfare workers scored 50 percent on loss and grief, with mental health clinicians averaged only 30 percent in understanding attachment and bonding, despite having 13 years of clinical experience. This explains delayed permanency, unstable adoptions, and persistent mental health challenges for children. The promising news is that this pilot, those that participated, achieved proficiency post-training at high rates. 34 state child welfare systems now use NTI, reporting 95 percent satisfaction. The pilot highlighted a significant workforce shortage contributing to gaps in care for children. To address this, the Children's Bureau established the National Center for Adoption Competent Mental Health Services in 2023 to enhance coordination between two important systems: child welfare and behavioral health, to address how they share responsibilities, manage cases, improve access, especially in provider deserts where there are no therapists available. Children's mental health is in crisis. Foster youth experience mental health disorders three to four times more than their peers, yet they only receive about 20 percent of treatment. A quarter are prescribed psychotropic medications. Yet only 21 percent of families access adoption-competent clinicians. This leads to unnecessary and expensive residential placement, and most concerning to me, that adoptive parents will relinquish their child back to care to secure services. Unacceptable. Meanwhile, the mental health and child welfare workforces are shrinking. A third of child welfare turnover yearly. This is only there is only one psychiatrist per 9,000 youth in our country. Adoptive families report shortages, insurance issues, Medicaid reimbursement issues, and long wait times. To conclude, adoption-competent care is crucial. With your support, CASE has trained more than 30,000 professionals across the country. And we want to expand this training, establish national standards, improve system integration, and secure post-adoption funding, and elevate adoption competency as the standard of care. NTI and the center prepared for broad implementation. Accessible and affordable services will eliminate barriers to adoption if we invest in and prioritize prevention over crisis response. Thank you, and I appreciate this time.

Thank you for the invitation to speak to the committee. Federal policy has long recognized adoption as an essential option for children. Yet, children wait far too long to be adopted, many children are denied the opportunity of an adoptive family, and an unknown number of children are subject to unsafe and unstable adoptions. I provide a detailed explanation of these concerns in my written remarks, but I'll focus my brief comments today on how federal funding is used and recommendations for improving adoption outcomes. Current federal funding for adoption largely goes to Title IV-E subsidies. Although studies have found that these subsidies increase the likelihood of adoption or reduce time to adoption, the factors that increase the probability of adoption do not necessarily assure safety, stability, and well-being in adoptions, nor do they address the shortage of approved families. Monetary support may help some adoptive families purchase specific support services, but unconditional cash subsidies, which can be tens of thousands annually, may also attract bad actors. Beyond subsidies, the federal government funds the Adoption and Legal Guardianship Incentives Program, which provides monetary rewards to states that improve on their rate of adoptions or guardianships. There is little reason to believe that this money has favorably impacted state practices. The formula is complicated and the incentive payments are too small and unreliable to address the systemic barriers that states face. More importantly, IV-E funding already incentivizes states to reduce delays to adoption because the federal match for adoption subsidies is untethered from the income criteria that is attached to IV-E foster care eligibility. These funds could be better spent addressing specific problems in adoption practice. The Adoption Opportunities Program has also been funded for decades and has spent over $300 million since 2013. The program seeks to improve adoption options and post-adoption outcomes for older children and children with special needs. A sizable portion of this funding is spent on the AdoptUSKids photo listing services and website, where people can see information about children available for adoption. Thousands of children are listed, and the information provided is far too generic to assess fit, leading to missed match opportunities as well as unsuccessful matches. A licensed family may need to send out hundreds of requests for information, many of which will receive no response, before a possible match is identified. With all the technology available today, children deserve better. Millions more have been spent on training and technical assistance to states and tribes, which often involves working around, rather than actually addressing, barriers related to antiquated data systems, overly complex federal regulations, or understaffing. Increasing the rate, timeliness, and quality of adoptions from foster care starts with recruitment of foster families and relatives open to adoption and families specifically pursuing adoption. But it is not just a numbers game. Many of the children who ultimately age out of care have experienced unsuccessful pre-adoptive placements or dissolved adoptions. Signing up more families will not change that. And if states are recruiting families who are ill-prepared or ill-suited, real harm will be done to our most vulnerable children. With this in mind, I leave five considerations for the committee. First, modernize the process through which children are matched with prospective adoptive families. Current processes are inefficient and leave far too much to chance. Second, consider new strategies to verify adoption continuity and prevent breakdown. Nearly all families adopting from foster care receive ongoing federal subsidies, but current verification processes fail to even confirm that children are still living with their adoptive parents. This should be fixed. In addition, proactive rather than reactive efforts to connect adoptive families with evidence-based training and therapeutic services, particularly for adoptions of older children and children with special needs, may help to prevent the crises that lead to dissolution. Third, improve federal data collection and linkage capacity. The federal government spends billions to support adoption and yet lacks basic information on how those adoptions have panned out for children due to inconsistent tracking and unaddressed barriers to cross-system data linkages. Fourth, disincentivize inappropriate reunification efforts. Federal data show that children spend a median of 31 months in foster care before exiting to adoption. In several states, the median time exceeds 45 months. Given that most children who exit to adoption entered foster care as infants and toddlers, many of these children spend more time in foster care than they ever spent in the care of their biological parents. These delays are in large part due to inappropriate reunification plans. Some children are left so traumatized by the time reunification efforts are finally ended that few adoptive families could safely care for them. Lastly, prevent the misuse of kin guardianship. Increasingly, federal policy treats adoption and guardianship as equal, though they are not legally nor in their outcomes. This is a perverse incentive because adoption is harder for agencies than guardianship, so it's increasingly treated as a first resort rather than a last one. Thank you.

Chairman Aderholt, Ranking Member DeLauro, and distinguished members of Congress, good morning. My name is Lee Marshall. I'm the founder and CEO of the Kids to Love Foundation, headquartered in Huntsville, Alabama. I hold a Master of Social Work and I'm a certified trauma therapist, and I've worked on the front lines serving child welfare for the last 20 years. This work isn't just a profession, it is truly a life calling. I understand personally what it means to have a forever family through adoption. I'm here today to speak to the crisis in our country, one where our youngest and most vulnerable citizens are often unseen, unheard, and unprotected: children in our child welfare system. The system is broken. And while we all agree that it must be fixed, we must also be honest about why it's failing. Historically, the government has carried this responsibility because no one else has stepped forward. But the federal government was never meant to raise children. Caring for vulnerable children should be a shared responsibility, one embraced by families, communities, and our faith-based organizations. It is both a moral obligation and for many, a spiritual calling. Until that broader support system fully rises to meet the need, we must act decisively and with urgency. Today I'm calling on Congress to establish a national task force, a coalition charged with evaluating and auditing our current foster care and adoption systems. Federal dollars must come with federal accountability. Right now, federal funding is flowing into state systems that are failing our kids. We are seeing systems where our children are dying. Systems where children are sleeping on office floors at county offices days and months at a time. Systems where children are warehoused in juvenile detention centers, not because they've committed crimes, but because there is nowhere else for them to go. And behind it all is a level of bureaucracy that is suffocating the very people trying to help: the case managers and social workers that are on our front lines, that are facing burnout, high turnover rate, leading to constant disruption in the lives of children who have already experienced profound loss. But there is hope, and there's a solution that works, and our Kids to Love organization is leading the way. In Alabama, Kids to Love has spent more than two decades serving children in foster care and adoption. We have implemented a privatized foster care and adoption model operating outside of the traditional state-run system, and our results are clear. Children spend less time in foster care and permanency is achieved faster. Because of us, permanency is not just a goal, it's the plan. Our model is built on four key pillars with the child always at the center. The first pillar starts in our court system, with judges who will stand in the gap for our kids. We must have a judiciary that is both informed and bold. We have judges who place children with us directly because their expectations are high and they trust that we have our kids' best interest as a priority. Whether it's a sibling group that we're able to keep together in our foster homes, a teen mom placed in a foster home with her baby, or a child who has been victimized by the very system sworn to protect them. Secondly, our model supports not just the child, but the foster families we train and license who step up to care for our kids. By deeply investing in our foster families, we don't just place children, we build relationships. Our families have 24/7 access to case managers and trauma therapists, ensuring that they are never alone in this journey. Our third pillar is a critical piece in our model of care for our families. We take a trauma-focused approach to foster care and adoption. We don't just treat trauma, we work to heal it. That means supporting not only the child, but the birth family when possible, the foster family, and the entire care team. And critically, we ensure that trauma support continues through the transition into adoption, reducing the risk of disrupted foster and adoptive placements. Fourth, we address the crisis of aging out. Too many times foster care becomes a pipeline to prison. We've developed a workforce training initiative, K-TECH, where we're teaching young people skill sets to go to work. We're also solving the housing crisis with our cottage community, tiny homes that provide safe housing and independent living. We're helping young people transition successfully into adulthood. Every child in foster care deserves a forever family. Every child in foster care deserves an advocate. Every child deserves stability, dignity, and hope. My passion is personal. It's a calling and a mission to me. As a child who was born into foster care and adopted at the age of two, by the grace of God, I could be like any of the kids that walk in our doors every day. Adoption and stability matters. No child should spend a lifetime navigating, surviving a system that was meant to protect them. We have the knowledge, we have the models that work, and now we need the will to act. Thank you for your time.

Good morning, Chairman Aderholt, Ranking Member DeLauro, members of the committee. Thanks for the opportunity to testify today. I'm Aurene Martin and I serve as the secretary of the Board of Directors for the National Indian Child Welfare Association, or NICWA for short. More importantly, I am the lucky mother of two wonderful teenage boys whom my husband and I were fortunate to adopt. I'm honored to speak on behalf of NICWA and to share insights drawn from their more than 40 years of experience serving Native children and families. NICWA serves tribal nations and urban communities across the country, working to strengthen policies and services for Native children and families. A core principle guiding our work is tribal sovereignty. Tribal nations are governments that provide for their citizens, and when they are able to design programs that reflect their values, they are best positioned to support the well-being of their children. When Native children cannot safely return home, it is essential that they remain connected to their tribal communities, cultures, and identities, helping to break the cycle of trauma many Native families have experienced. Today I'll briefly focus on how tribal systems support permanency and where federal funding can better support their efforts. In many tribal communities, child-rearing is considered a shared responsibility. Extended family and community members play a central role in raising children, which means permanency decisions often involve a broader network of support. When reunification is not possible, children are most often placed with relatives or other tribal members. One important tool tribes use is tribal customary adoption. This is a permanency option in which a child is placed in a permanent home, often with relatives, while maintaining important relationships with their birth family and tribe. Unlike conventional adoption, it does not require termination of parental rights, allowing children to remain connected to their identity, culture, and community. As an adoptive parent myself, these issues are deeply personal for me. I've experienced adoption through both the private adoption system and through tribal court. Those experiences showed me how important it is to center a child's identity and relationships in permanency decisions. For tribes, adoption is not just about creating a legal relationship, it is about ensuring a child remains connected to who they are and where they come from. Federal funding plays a critical role in making these permanency options possible, but there are significant gaps. Programs like Title IV-E adoption assistance and Title IV-B adoption support provide important help, but many tribes face barriers to accessing or fully utilizing these funds. These include very small grant allocations, high eligibility thresholds that exclude some tribes, and administrative requirements such as matching funds that can be difficult to meet for tribal governments with limited resources. As a result, tribes are often forced to prioritize basic child protection services over building robust adoption programs. Discretionary funding is especially important in this context, but it is not reaching tribal communities as effectively as it could. For example, the ACF Adoption Opportunities program is designed to remove barriers to adoption, yet it has not resulted in meaningful tribal participation. This is largely due to limited outreach and a lack of funding opportunities that reflect tribal priorities. At the same time, there have recently been important steps forward. The OBBB extended and enhanced federal adoption tax credit to tribal court adoptions for special needs children, which they didn't previously qualify. And HHS recently clarified that tribal customary adoptions are eligible for Title IV-E assistance. These are meaningful actions that support parity between tribal and state systems. However, more targeted investment is needed. To strengthen adoption services for Native children, we offer two recommendations. First, create a dedicated funding category within the Adoption Opportunities program specifically focused on tribal priorities. This would ensure that discretionary funding is accessible and relevant to tribal nations. Second, support ongoing consultation by HHS with tribal nations to ensure that other federal funding programs are designed in ways that reflect tribal needs and reduce barriers to access. In closing, supporting adoption for Native children means supporting their connection to family, to culture, and to community. Federal funding plays a critical role in making that possible, and with targeted improvement, it can better support tribal nations in ensuring strong, stable futures for Native children. Thank you for your time and your commitment to Native children and families and creating successful adoption programs and policy. I'd be happy to answer any questions.

Thank you, thanks all of you for your testimony this morning, and we'll begin our rounds of questions by the members of the committee. And I will begin with a question for Ms. McLean. Congress funds several programs that aim to incentivize adoptions. From your experience in working with adoptive families and the policymakers that are involved, what is the primary barrier that you see preventing families from achieving and sustaining adoptions on a permanent basis?

For CCAI, our mission is to help remove those barriers that help more children find safe, nurturing, and permanent families. We do support making adoption more accessible and ethical. We support in removing those financial barriers and any time that we can remove unnecessary costs and help more families say yes to adoption is a good one. We also support helping encourage states and agencies to help support the adoptions of those with complex needs. So helping states promote sibling adoption, helping promote the adoption of older youth, and also those with various needs that are not supported when they're in foster care and deserve the love and stability that comes with a permanent family. Our goal is to ensure that every child knows that safety and stability and belonging that comes with family, and we're defining family permanency in whatever situations in the best interest of the child, whether reunification, kinship guardianship, or adoption.

And on average, can you tell us about how long children usually have to wait for final adoption and what contributes to the delay if there is any?

Sure. So each child's situation varies on a case-by-case basis, but we do know that children are waiting way too long for permanency. It's years on time, years and years, at least three years is what the data is telling us. And when we're looking at what causes delays, there can be many delays. One that I wanted to uplift was the importance of investing in the permanency workforce. When we know we have a skilled workforce, we know that kids and families are able to navigate the child welfare and adoption system more efficiently without delay. And so encouraging agencies and states to hire adoption specialists like recruiters who are dedicated to helping promote families and dedicated to finding adoptive families for these youth is critical.

Thank you. Let me turn to Dr. Font. Let me ask you, you of course know data is fundamental to helping us to identify evidence-based strategies, improve child placements, and uphold accountability and transparency when it comes to the taxpayer programs, taxpayer-funded programs. What changes to the existing federal data collection do you think is needed to better access the safety, stability, and the quality of adoptions from foster care?

Thank you for that question. So currently the federal government requires that states report foster care and adoption information through the Adoption and Foster Care Reporting and Analysis System, also known as AFCARS. The challenge with those data is that when a child is adopted, states often assign them a new identifier in their system. And so if a child is adopted and then later re-enters foster care or is reported to child protection for maltreatment, they come in with a completely new system identifier and they're not identified as an adopted child. And so currently most states are unable to tell you how many of the children they place in adoptive homes are later maltreated in those homes or re-enter foster care. So fixing the ID break will be an important step forward towards being able to monitor outcomes. Another thing I'll note is that most children who are adopted from foster care maintain their Medicaid eligibility, and there are a lot of untapped opportunities to understand health and well-being outcomes by linking federal foster care data and adoption data to Medicaid claims records, which the federal government already collects. Thank you.

Thank you. And Ms. Riley, Congress provided more than $11 billion for foster care and adoption services in FY 2026. From your perspective, which programs or strategies are delivering the most meaningful improvements in outcomes for children and for families?

I think ensuring that there's a continuum of pre- and post-adopt supports are really critical and weaving in that those supports are being provided, as I said earlier in my testimony, by adoption-competent therapists. We know that families who feel empowered and confident will not hesitate to move towards permanency, and we also know when children feel that those that they're seeking support, as you heard today, from understand the issues of loss and grief and trauma, that they're going to heal and they're going to be able to move into permanency in a way that we haven't seen before. So I think the key is dedicated funding streams for pre- and post-adopt supports, really critical.

Thank you. Ms. DeLauro.

Thank you, Mr. Chairman, and thank you all for your testimony. According to the National Council for Adoption, children are spending increasing amounts of time in foster care. 2020, 43 percent of children who exited foster care spent more than two years in foster care, more than 64,000 children and youth. Of those, about 35,000 children spent three or more years in care. As I mentioned in my opening, I've seen how the system failed one of my cousins many years ago, and the fallout continues to this day. In many instances, these kids learn how to game the system in so many ways, and they go from one counselor to another to another to another and are always telling the same story over and over and over again. Ms. Riley, your testimony helps to clarify why a family may hesitate to pursue adoption without appropriate post-adoption support, mainly to meet the mental health needs of the child. I could not help wonder what could have been had if the training and services provided by CASE had been available years ago. How do you think the mental health support for adoptive families and certainty of knowing that those services will be there for them can reduce the hesitancy in potential adoptive parents and potentially reduce time in foster care?

Again reiterating that I think if we know that those supports are in place and they're in place by qualified individuals that have the specialized training, I've spent a quarter of a century now understanding the unique needs and aligning those core competencies with the professionals that we're all engaging for all of our children. And when that disconnect creates, I think, instability, it creates hesitancy as you describe, and it creates really poor outcomes where we're seeing our children moving into levels of care or out-of-home care or stability, instability that we're hearing from others testify today. So I think it's really investing in a workforce, as Kate talked about earlier, that has the competencies and the skills and the confidence that aligns with the needs of this special population.

Should these, should there be some certification for the trained personnel? Should they be certified in some way that provides that confidence for a family to know that there's somebody there who is, to be honest, is competent, who's not just listening to you and trying to help you out, but that really has clinical knowledge and background?

We are advocating for levels of standards of care and a certification to align with that and then having national directories so that families know who to seek services from and the type of training that they should have. It's critical.

How a family in need, you were getting to that, would identify an adoption-competent mental health provider, whether it would be a covered service? And look, you've have the experience and you all do in this as when families do not have that kind of access, what's, there's so many kids that are just languishing. And the more they languish, the deeper the mental health issues are personified, that sense that you're on your own, you're there, there's nobody out there, etc. So how do we look at connecting the family with the service and the trained personnel that they need? Again, is it a covered something? Is this something that should be covered by insurance or something that you know? How do we make it work for a family? Because if they can't access it or they can't, they have the service and they can't pay for it. How?

Well, I think that it needs to be covered in private insurance as a subspecialty. It needs to be addressed in managed care entities. We're partnering with Centene right now across the country to enhance their providership to have this level of competence so that families know how to access the right supports at the right time and be protected. I think that's what we're all talking about here is that we want to protect our children and our families. And right now they're feeling unprotected.

Right now, is this subspecialty covered under insurance?

I would say minimally, minimally if at all. It's not recognized at this point in time as a subspecialty.

Mr. Chairman, Ms. Marshall would like to respond. Is that all right?

I would also like to build on what Ms. Riley said. I also think a gap is the uneducatedness of those on the front line and also the judicial system of not understanding the true correlation between trauma and the children we serve. The work and the research that we have done, we understand that trauma and foster care and adoption go hand in hand or in tandem. I don't believe that that has been appropriately communicated to become part of the narrative of the national child welfare system where social workers and case managers understand the correlation. And I certainly believe that there is a gap in the judicial system where our judges don't understand. Judges that we educate, they welcome that education. We now have judges court-ordering therapy for children in foster care. So I do think it is a lack of accessibility to services, but I also think it's a lack of understanding the importance of a trauma-focused foster and adoption system.

Right. No, it's really, and again, I say this with watching this up close, you know, this is a number of years ago, but just, you know, we're just the foster family didn't know what to do, didn't know what to do, and just, you know, just as and would ask me, I'm not trained, you know, I clearly want to help and so forth, but I'm not trained.

But I think that's why we have the, as I shared before, the National Adoption Competency Training Institute where we are training child welfare professionals, their supervisors, in regards to understanding these core competencies and then aligning the services as we've been describing. And beyond the judges, I think we have to also move into the school systems, and that's something that we've begun to create derivative training because that's where our children spend most of their time and their impact of trauma often gets misunderstood in the classroom setting.

Thank you. Thank you very much, Mr. Chairman.

Dr. Simpson.

Thank you, Mr. Chairman. Thanks for holding the hearing today. Thanks for coming and bringing your testimony to us. Aurene, you testified last week before my committee on Tribal Witnesses Day. Good to see you again. Tell me, could you highlight what some of the unique needs are in Indian Country when it comes to adoption? I know that what percentage of Indian children that are adopted are adopted by tribal members and which by non-tribal members, and is that a challenge? And how do you maintain those tribal connections with those children that might not be adopted by tribal members? I know that's always been a challenge in the past.

That was a lot. I think we don't really have accurate numbers on that. One of the problems that we have is that AFCARS system, which collects data on these types of situations, doesn't have specific questions related to native children and the rates that they're adopted. And there were recently changes proposed to that, but they're on hold. So we really don't know the full set of data. But I think the main challenge facing native children who are adopted, and several witnesses have talked about this, is trauma. Trauma with not just the child in that situation, but family trauma, intergenerational trauma that native families and communities have suffered over time. And there's a lack of understanding about that and how to treat that. There's a lot of awareness about it now, but that I think is the main challenge for particularly non-tribal people who adopt native children. They might not understand that. Whereas when we place them within the community, we all have a better understanding of that and we're able to deal with that directly.

Thank you. This is a question any of you can answer it if you want to. It probably requires a much longer answer than anybody could. You've all laid out the problem. We generally in Congress don't vote on concepts. We vote on specific pieces of legislation. And while if you ran a resolution that said we support foster care and we support adoption and stuff like that, every member on the floor would vote for it. What I'm wondering, is there an organization combined where you make recommendations on specific legislation and that type of stuff? I don't know a lot about adoption and stuff. I suspect that Mr. Aderholt is going to get me in the Adoption Caucus before too long.

As of today.

As of today, yeah. But I will tell you that, I mean, and sometimes it's money. But we have an awful lot of organizations that come before us that are important and need money. And I will tell you that Chairman Aderholt and Ms. DeLauro have a very difficult task with limited resources of trying to do the best we can. So how do we know, how do I know what the specific proposals are that would address the concerns that you've all raised? And I appreciate, I know that Sarah had some of that in her testimony and stuff. And thanks for coming from Washington University since I was a graduate of Washington University. It's a great school. But how do I know what I'm voting on and if that's going to move us in the right direction or the wrong direction?

With all due respect, I think that I would love for you to adhere my request to start a coalition and let's do a task force.

I was interested in that, yeah.

Because I do believe there are some amazing programs already in place and several of my colleagues on the panel today that have testified to that. I do believe that it is overall broken. And in due fairness, you have limited knowledge. This is not your expertise because you have your expertise. And so what I would love is to offer up, I'm doing this collectively, I would love for us to help get you to a solution of understanding what works, what is evidence-based, and what we need more. I think now that we understand the component of trauma like we've never understood it, it completely reframes everything we do in the child welfare system. And that historically, that new focus is not a priority in, I would say, the current structure. And so I would, my proposal would be we come back to you with a trauma-focused approach that is evidence-based that can truly heal these children so they don't become part of that system so we can break the cycle.

Would everybody else agree with that?

Yes.

Do you like the idea of having a, what'd you call it?

Task force.

Task force to do this?

I think that's a good idea. I also think there are opportunities within the legislation that's already been passed. So for example, the Family First Prevention Services Act should be able to be leveraged to provide evidence-based post-permanency services for adoptive families, but it's very underutilized in that respect. And partly that has to do with how the process of getting high-quality programs onto the clearinghouse in the first place, helping states build the capacity in terms of workforce and other issues to actually scale those programs and implement them effectively. But that's one funding stream that already exists in legislation that could be better used for this population. And likewise, I think the Adoption and Safe Families Act has a lot of provisions that would, I think, reduce the trauma of children who ultimately are adopted by encouraging states to use the aggravated circumstances provision so that children are not subject to three years of reunification efforts with a parent who's sexually abused them. And that is happening. And so I think we should really focus on enforcing some of the policies on the books. Yeah.

I would also concur with Sarah about the clearinghouse. You know, I'm holding a program that has the evidence and through the National Training Institute Adoption Competency, and we're not able to get our program onto the clearinghouse, yet it has the evidence. And it's something that, you know, Adoption Opportunities has invested in over a period of time. It's critical to get it to the point that Sarah's describing. So I support that very much.

How do you get it on the clearinghouse?

It's been a challenge in getting certain programs evaluated. And I think back to what Lee is saying and Sarah, everyone on this panel is workforce is a key here, that we have to have a competent workforce. And we have built now over 12 years this training through Adoption Opportunities funding. And it needs to get onto the clearinghouse. We need to move it to evidence. We need to have the evaluation to show that not only does it change the practice of our workforce, but it also impacts the children and families that we're also speaking here today about. It's critical.

Thank you. My time's up.

Ms. Frankel.

Thank you. Thank you all for being here. I just want to make sure we're all talking about the same thing. Are we talking about children being adopted by their foster parents or children who are in foster care being adopted? Or both?

Both.

Both. Okay. So Florida has, I know, what they call a decentralized system. I'd like you to comment on that, but in terms of where can you point to a state where the process is working well? Where is there success right now?

I would say that our organization developing a privatized system outside of the state-run system with less bureaucracy and child-focused, we have had amazing success rates. We have had children move through the court system for adoption timelines to be much less than the state guidelines that have been outlined here.

And which state is that?

We're in Alabama.

Alabama. Okay, great. Let me, Ms. McLean, I see you look like you want to answer. Yeah.

Yeah, I'm happy to add on. I think, you know, each state has their way to run child welfare and all states are doing some really neat projects and also uplift important community-based organizations that are leading this work on the ground. I'll say in Florida, there are also a lot of youth-centered programs and something that resonates with us and that policies are most effective when they're designed in partnership with the individuals they intend to serve. And there's great groups in Florida who are promoting youth voice and including them in the policymaking process, which is showing great outcomes.

So you would, I think you all talked about delay. It sounds to me there's all kinds of factors. People, the court system, reunification, right, that, people having the resources, I guess mental health issues, I guess investigations have to be done. Is that correct?

Correct.

So what, how do we make that efficient? I mean, what's the shortcut? Is there a shortcut? How long should it actually take? Once a child hits foster care, they should be, it would be after they would be, I guess, separated from their parents. Is that correct legally? Is that when you wait or do you start before that? Whoever wants to give that a crack.

So states are supposed to use concurrent planning, meaning that they might be hoping for reunification and working towards that, but they should have a backup plan because that's not always realistic or feasible. Unfortunately, I think because of staffing constraints and other barriers, they often wait until all reunification efforts have been exhausted. And then if that child isn't going to be adopted by their current foster family, they basically start from scratch trying to find a family. And that process is extraordinarily inefficient. A lot of the family information is siloed at a bunch of different agencies. Caseworkers can't respond to all the inquiries, most of them are unproductive. And so I think there's some real opportunities to improve the quality and timeliness of matching children to appropriate families that relies on some of our more advanced technologies in terms of algorithms that uses child-specific recruitment and other processes that say, I know this kid, I know what they need, and I'm going to find the best family for them versus waiting for families to say, tell me about every kid you have available.

So what, now relate that to our role because I have a couple questions in that regard. Are we providing enough financial assistance to the adoptive or potential adoptive families? I'm assuming that that's a barrier for people to know if they can actually even afford to take on a child. And also, having the proper workforce, whether do we have enough trained people and are we providing enough money to actually train the people? So and so give us what you think our role should be here in Congress.

Yeah, so I think the direct financial resources to adoptive families are actually quite generous. The problem is that you can't buy the services that you need because they're not available. And so it's really, I think, more a service gap.

Which are?

Things like adoption competent therapists, you know, crisis mental health supports. It's very hard to find psychiatry or psychology services that accept Medicaid, which is the, you know, form of insurance for a lot of children who are adopted. The training provided to parents pre-adoption is not skills-based and it could be. There are a lot of evidence-based options out there. So it's more of a service gap and a workforce gap, I think, than a direct resources problem.

Thank you. Thank you, Mr. Chair. Yield back.

Ms. Bice.

Thank you, Mr. Chairman and Ranking Member. I want to sort of follow up on that discussion. You mentioned that there is a lack of services for these young people that have probably some high ACE scores that need that type of specific intervention. What can we do here to be able to help increase the number of providers that can actually help these children? Because I've witnessed it in my own state with these young people who end up in RAD, have RAD and they're ending up in programs, but they don't have the specific individual therapies that they need, frankly.

I think we need to incentivize the level of competency that we're all advocating for. So that would be one thing that I think that we need to do.

And if I can add, you mentioned Medicaid, which you're right, a lot of these children are on Medicaid. Are we harming ourselves because we're not giving the providers a payment that's commensurate with their education and their ability to treat these children, which is why they're not accepting these children?

That's right. I mean, clinicians are moving into private practice, they're leaving community-based care because of the reimbursement rates. And I think that we really have to look at that seriously because we have these treatment deserts all over the country. And back to the point, we have children in child welfare offices and moving into emergency rooms and moving into detention centers where they don't belong because we can't, we can't build this provider network. And we know that training is the number one predictor in stability in our workforce. Our workforce wants to feel, I wanted to feel as a therapist, confident and have the skill sets. I mean, I graduated from a wonderful master's program in marriage and family therapy 40 years ago. I did not have the skills that I have today to work with the families that we're talking about today. I didn't have them.

Are there programs across the country that are specifically tailored towards helping children that have experienced this type of trauma?

I think we're trying to build those programs. I think we need more and we need more dedicated funding streams for post-permanency supports.

Lee, do you want to? Yes, ma'am. Just to give you an idea. So my goal is to hire the best therapists because I have the children that are hurt the most. Private rate for insurance, we can bill 150 an hour. Medicaid pays less than 65 an hour for reimbursement. So from a business standpoint, the math doesn't add up. I'm always in the red. If it wasn't for the generosity of our community and our donors to pay the difference so our kids in foster care can get the level of care that we are able to administer, because from a business model, it will not be successful. So you have so many providers that have trained staff, skilled therapists, but they cannot afford to treat the children that need it the most, the children that are on Medicaid in our communities. There has to be a reevaluation. Our children are worth top billing. They need it. And if we can heal them and get them off the system, I think if we looked at a 10-year, 20-year trajectory, we could see such a difference in so many ripple effects of homelessness, trafficking, teen pregnancy, the pipeline to prison. I think we could really curb that if we took a proactive approach to getting the kids the mental health services they need with that super trauma focus that we're able to provide.

So let me throw this out there to anyone on the panel. Tell me a state that's doing things well and why.

There isn't one.

I would agree with that. I do just want to uplift that the Title IV-E training partnerships that are supposed to support the child welfare workforce are pretty underutilized and not really having much of an impact on addressing workforce problems and that revisiting the structure of those could help provide both higher quality of training in the existing workforce for the kids that these agencies actually serve and also potentially just be a more effective use of federal dollars.

Why do you believe that that's not being utilized effectively?

So they primarily go to schools of social work. There are a relatively small number of slots and so it's just a very small share of the workforce because it provides tuition and stipend versus more specialized training. It also doesn't, a lot of places have unfilled slots because there are not a lot of people who want to go into this work long-term, so that's another problem. And then lastly, agencies broadly feel that the students they get are not graduating with the skills they need to actually serve the population.

Right. Deb, would you like to?

Yeah, I mean, that's where we would really like to see the NTI training be integrated in the Title IV-E training programs across the country and in university settings. We are partnering, we did in Alabama with Tuskegee University that integrated the NTI training into the university and we're trying to partner with more universities to do that. So I think that is a solution that we have at our fingertips. I mean, we have something that's evidence that we can move into these systems. We just need the funding and support to do it.

If I may just finally say two things. One, I'm a little disheartened to hear that no one's doing it well.

I want to say one thing about that. Sure. I mean, there are three states, one, Oklahoma has been doing, and I'm not just saying that because you represent Oklahoma, but Oklahoma has taken these federal initiatives and integrated it in an amazing way where they are building statewide adoption competency in all avenues of care. They start in child welfare and now they're moving into the university and they are one of our leading centers for the national center that's being funded along with Georgia, Wisconsin has been one of our top sites. So I think there are a lot of states that are taking these resources and these new approaches and making tremendous progress, but it takes time. It also takes a willingness of the leadership in the states to, I guess, let go of some old ways and to embrace new opportunities. Reimagine how this is supposed to be.

Yeah. I would like to just dovetail, that's exactly what it has to be. It has to be an embracement of public and private that are doing different and new ways to break the cycle.

My time is long expired, but I just want to say thank you to each and every one of you for being here, but also for your hard work in this very important area of families across the country. Thank you. Mr. Chairman, I yield.

Ms. Dean.

Thank you, Chairman Aderholt and Ranking Member DeLauro, for this important hearing. I'm Madeleine Dean from suburban Philadelphia, a mom and a grandmom who thinks an awful lot about children's welfare, children's mental health, children's safety. So I thank you, each one of our witnesses, for your testimony, but much more importantly for your work around all of those issues. As I travel my district, whether I'm visiting schools or I'm talking to families, children's mental health, whether they're not in adoption or foster care settings, you all know, we're at a crisis point. And for the population that you are so ably talking about and caring for, I guess what I'd like to know from you, and I was thinking of I think both Ms. Riley and Ms. McLean referenced the Pennsylvania example. As somebody from Pennsylvania, can you talk to speak to that example and speak to, if you can, what's going on on the ground in Pennsylvania? What are we doing well and what are we not doing well in terms of our youth, our foster youth, our adoptive youth, as well as in the school setting?

I'm happy to start and then turn to my colleague Debbie to continue. But a lot of CCAI's work is rooted in engaging those with lived experience, those who are living this in their real lives firsthand. And so we work with all folks involved in the adoption and child welfare system, including foster youth, adoptees, foster, kinship and adoptive parents and birth parents. And the example that I shared in my testimony was about a youth in our foster youth internship program from the state of Pennsylvania who, the program's purpose is to bring foster youth to D.C. to intern for a member of Congress, but also read and research recommendations rooted in their own lived experience. And so that example was to uplift that he had a kinship placement with his grandmother with his siblings, a loving, supportive home, but the housing wasn't deemed appropriate as far as the number of bedrooms from the state. And so they were then placed into foster care and separated and lost the sibling connections. And so if there's ways that we can help states be able to keep siblings together and promote kinship if that is in what's in the best interest of the child, we want to support that. And so that was the example, but.

When was that example?

When was that example? That was in 2021 he was here advocating for that. But sorry, but he was a child when that experience and so, you know.

Has Pennsylvania changed its rules since then?

Not that I'm aware of. I will note CCAI does work mostly federally and so others on the panel that may be more familiar with Pennsylvania's state.

I'm a former state legislator, so I might have to talk to some of my friends and see what's going on.

Yeah, I was in Pennsylvania for about 10 years and I've worked closely with state and county agencies. So the challenge with Pennsylvania is that it's decentralized, it's a county-administered system, so you can't really say something statewide, even their data infrastructure doesn't really allow for that. But I think one of the challenges that Pennsylvania has in terms of adoption specifically is that decentralization where each county has different contracting agencies, it's actually pretty challenging to match children with families across the different data silos.

Interesting.

I would agree with Sarah about the sort of challenge of it being county-administered. We're having a very hard time moving our two federal initiatives at a statewide level because of that. I'm excited though that in Harrisburg, it is one area where they are committed to moving the adoption competency training TAC into workforce there, but we'd really like to see it move across the state. Any help you can give us would be great.

Thank you. I will do whatever I can to help. And before I yield, I just wanted to make a statement or an observation about the Trump administration administration to the administration on children and families, ACF. In many ways, this is a familiar story. We've seen it across different agencies where we saw last year the so-called Department of Government Efficiency come into HHS last April and fire more than 500 civil servants in the administration on children and families, including more than half of the staff in the Children's Bureau, which administers federal funds we the appropriators are coming up with for foster care and adoption and provides technical assistance to states. Not only that, DOGE closed five HHS of HHS's 10 regional offices that provide on-the-ground technical support to geographic regions and its grantees. This is affecting my area. The Philadelphia office remains open, yet it has absorbed the caseloads of New York and Boston regional offices without any of the local expertise. That seems absurd to me. That seems that we are going in reverse, that we are not improving our care, our connections, making sure that people are getting the kinds of grants and services that they should get. I'm super grateful for the civil servants who are trying their best. Do any of you have any anecdotal information about what happens when you dump all this casework into the Philadelphia region without any additional support or local expertise?

I think we're seeing it across the nation. It's the burnout, it's the, you have amazing people that feel called to serve this population that leave in less than six months because the workload, honestly, the residual trauma that these case managers are then picking up with no support. And then when they leave and you talk about permanency in a case, then that child, all the relationship that had been established is gone. So a child that's on the trajectory for adoption and you have a case manager that knows that child personally, knows the case, when that case manager leaves, it starts all over and it's reassigned. And every time that happens, the length of time a child stays in the system increases significantly. So it becomes the victim of its own system.

Heartbreaking. Thank you all again for your work.

Mr. Clyde.

Thank you, Mr. Chairman, and thank you to our witnesses for appearing before the subcommittee today. One of my greatest missions here in Congress is to advance policies that protect our God-given right to life. As a strong advocate for the lives of the unborn, I also recognize the importance of supporting life-affirming alternatives such as adoption for those who may be considering abortion. Every child deserves a chance to live and we must champion policies that give children the stability of a permanent, loving family. Even decades after the passage of the Adoption and Safe Families Act, which invests billions of federal dollars in adoption support, it's estimated approximately 120,000 eligible children are still waiting to be adopted. The median time a child spends in foster care before being adopted is about 31 months as I understand it, an outcome that remains still unacceptable. As we consider the state of adoption in our country, I appreciate your commitment to serving our nation's children by helping them find safe and permanent homes. I look forward to discussing how we can strengthen and support adoption efforts nationwide. Mrs. Marshall, faith-based adoption providers play an essential role in identifying and supporting families for adoptive and foster children. However, many state and local governments have restricted these organizations from offering adoption and foster care services due to their sincerely held religious convictions, often through discrimination laws or administrative rules. What should be done to protect faith-based providers so that they can continue their important work?

I believe so many people are called from a faith standpoint to serve the demographic that we're talking about today. But I can tell you there's also a breakdown in that. We have several teen moms and babies that are placed in our custody, judges that place those young ladies and their babies with us directly because we would guarantee that we could keep mom and baby together. I think we have a disconnect. I think we have a faith-based community that will rally on Sunday to do the right thing and convict these young ladies on Monday for doing it. I don't think we have a continued support system, a continuum of that. To me, I believe a person's faith drives them to do more. I don't think any organization should face backlash because of that. But I do believe sometimes that those personal values might overstep a little bit. For us, what I mean by that is we are very intentional of meeting our children where they are, and we understand the backgrounds where they come. We don't force any views or any positions on the children that we serve, and we respect them. I think we, I would say as a believer, I have to get out of my comfort zone every day and understand the trauma and the hell that the kids that we serve come from. Do they need Jesus? Yes. But sometimes they just need a roof over their head and a warm meal before we can even start to talk about their salvation.

Absolutely. I 100 percent agree with you on that. State and federal governments spend billions of dollars annually towards supporting the adoption process, but prolonged adoption placement continues to be a problem. In your experience, how has shifting towards a privatized model of adoption in the state of Alabama been successful in helping children secure a permanent home in a timely manner?

So we had a situation where a birth mom was in a homeless shelter and voluntarily placed her child with us because she was facing drug addiction. Our team tried to work with that mom so she would have the resources to overcome the addiction. She chose not to participate. She was very proactive in the placement, and so I have nothing but respect for that birth mom. She did ask our foster parents at that initial meeting, if I can't or don't get my life together, will you adopt my child? And the foster parents said yes. So we gave the mom six months. When she showed us continually that she did not want to participate, that she did not want to work on her addiction, we then moved to a position of permanency. Within a year and a half, we had gone through the traditional court system, worked with the judges through the juvenile court to get termination of parental rights handled, and then on to the probate court in our state for the adoption to be handled. And again, that from day one to permanency was a year and a half. And that's with our team actively working to support the birth mom when she wanted to and the foster parents when she didn't. I can tell you that every other situation that we've been in with adoption with the state-run system, it has been years, plural. The fact that we were able to get this accomplished in a year and a half working through the appropriate system should be the model of what our children deserve with the permanency in adoption.

Thank you. One last question, and this is for Dr. Font. Adoption stigma for pregnant women and the lack of accurate adoption information seems to persist across our country. What efforts are currently underway or should be taken to better support awareness of adoption?

Your microphone. Yes. So I'm not sure how to think about the idea of awareness efforts. I do think it's the case that we've seen situations where there are moms who don't feel like they can safely parent their child and they want to make a different choice and are essentially discouraged from making that choice. Judges will continue to order reunification efforts even when a mom says, I'm not going to continue doing this or I don't think this is a good idea for our family. And so I do think that that stigma has really made it difficult for moms to feel good about the choice that they want to make. And so I think that's a workforce training issue, a judge training issue, more so than a general public problem. Thanks.

Thank you, and I yield.

Okay. Make sure we got everybody on the first round, and we'll do a quick second round. I think there's a few other little questions for cleanup would like to really go over. And I'll begin. Ms. Riley, a few minutes ago you were mentioned, you said, first of all, the statement was that no state really has a great program when it comes to foster care and adoption programs. But Ms. Riley, you said there are two or three that stand out a little bit, and Oklahoma being one of them. What were the other states that you would hold up?

Well, and I was also referencing more about building the workforce in my comments about states that are doing better and also the integration of working with building the bridge between child welfare and behavioral health. I mean, we have siloed systems and we're really trying to integrate those two systems. So I think we've seen a lot of strides in Oklahoma, in Georgia, in Wisconsin, in Illinois right now as some of our national center sites that are really trying to pull systems together to look at the best way that we can improve permanency and stability with families. And I think one of the key areas is building our workforce. As we've all been talking about today, it's just critical so that our children and families have the supports that they need.

Sure. Okay. Thank you for that. Ms. McLean, I want to, let me turn to you as I noted in my opening statement, honored to serve as co-chair for the Congressional Coalition on Adoption, not only as a bipartisan but bicameral caucus. But in this role, I've long worked with colleagues on both sides of the aisle to promote safe, stable, permanent families for adoption and of course worked with you and your staff. From your viewpoint, if there's just one or two things that you would say that we need to change at the federal level to improve adoption, what would it be?

So adoption and child welfare have long been a bipartisan priority, and this subcommittee's ongoing support sends a clear message that Congress does believe in the fundamental principle that every child deserves a safe, nurturing, and permanent family and every child deserves the opportunity to do so. And so when we're looking at ways to make that happen, I want to encourage both investing in the permanency workforce and what my colleagues have shared, the critical importance of supporting everyone involved in the adoption process, birth parents, adoptees, and adoptive parents, make sure they're fully supported and prepared and have a meaningful voice in that planning before and after the placement is critical.

Okay. Thank you. And Mrs. Marshall, I want to ask you, I was very intrigued with your national adoption task force that you talked about. How would you see that being set up and from what sectors would be represented on this task force?

I think to start, I would love to get in a room with my colleagues today. I think Dr. Font has made some amazing points that there are good laws on the books and good regulations that aren't being utilized. My suggestion is not to blow the system up. Let's evaluate it. And if we have things that are working that aren't a priority, I do believe that it could be at the encouragement of Congress to make those priority. And then once we understand what is working, we can then identify gaps. And for me, it would be once we identify the gaps, which I think we've spoken to today, that would be I think we could come back and make recommendations to say here are ways that we feel Congress could best cover these gaps. That would be trauma-informed focus care, more training, more accessibility to the clinical side. I just don't think it is historically a priority. I think we would all agree that mental health has come on the scene as a priority that is now a community conversation really since 2020 and COVID. We've got to have the conversations, and we're not having those. And so to me, I think having a trauma-informed, in-focus child welfare system is the biggest and quickest way that we're going to see the best results for the children that are lingering in the system.

Thank you. And Ms. Martin, let me turn to you for my last question. Federal law, including the Indian Child Welfare Act, as you're well aware, establishes important protections to preserve tribal identity and placement preferences for native children. Can you share with us how federal funding supports the recruitment of adoptive families for native children?

So Title IV-E programs allow for that recruitment of adoptive families. The problem for tribes is that only about 25 percent of tribes participate in the IV-E program. So the support isn't there for the majority of tribes to be able to do that through federal funding. When tribes are able to put those programs together, they're able to design them so that they fit the needs of that particular community, which can take a lot of different forms. I was actually recruited as an adoptive parent, and it came through an adoption home study that I had placed with a tribe. And the person who actually saw my home study knew my family and was familiar with me, and they had to make a placement that was very specific outside of the community, and that's how they came to me. So when you have specific situations like that, you just have to be able to provide for those different things, and I don't know that federal funding matches that for tribes right now because most tribes can't even take advantage of it.

Okay. Thank you. Ms. DeLauro.

Thank you very much, Mr. Chairman. I just want to ask a quick question to everyone here. There has passed last year a bill that's been referred to as the big beautiful bill, which would cut Medicaid by about a trillion dollars. I've heard everybody here talk about Medicaid. What's your view of that in terms of the work that you do and the families that you work with, a cut of $1 trillion to Medicaid? What does that mean?

To answer your question, I guess I would like to specifically know how that would directly impact children in care that we're talking about, if they would be impacted, if it's a cut or realignment.

It's a cut. It's a cut.

To cut. I... our kids need, our children in foster care must have Medicaid, and it needs to be increased for the children we serve.

Anybody else?

Well, Medicaid is the primary source of behavioral health support.

Medicaid is the primary source of behavioral healthcare support. We need to write that writ large. Kate?

I'll just add that estimates show that about 99 percent of foster youth rely on Medicaid, and so I'd be happy to follow up in writing for the record about what the field is saying.

No, I'd be very happy to. You know, that just came up in the conversation with all of you and with regard to Indian Health Service, what that will do. I mean, people sometimes lose the sense that Medicaid serves children, the disabled, low-income workers, and the elderly. That's those are the foundations. So your help in gathering that information I think can help us to make a case because without that, it's going to hamstring already tough situations. I'd also like to... well, I can say that in a closing thing, but I wanted to aging out because I, as I again, I watched someone age out and there was two things. Ms. Riley, what mental health do we have to offer to kids aging out? Ms. Marshall, tell us more about your K-Tech workforce training program.

Our K-Tech workforce training is a 16-week short-term credential program where we teach young people skill sets like mechatronics, robotics, soldering, and virtual reality, all skill sets that are needed in our manufacturing economy across America. We certainly have seen an increase of that in Alabama. I'd like to tell you a story about a young man named Willie who... Willie grew up in foster care in 25 homes. When Willie came back on our radar, he was living in a homeless shelter in Montgomery. We spent... we took $100, bought him a bus ticket, brought him to Huntsville so he could interview for the program. Willie was homeless, had no job, had no hope, and was really one bad decision away from going to prison. We brought Willie to K-Tech, we solved the issue of homelessness, we solved the issue of needing a part-time job, we solved the issue of transportation by putting him close enough where he could walk to school. Willie now has successfully completed K-Tech, our 16-week credential, went straight into the workforce, it's a pathway to work. He then went on because he had so much potential but had not had encouragement or opportunity to receive a bachelor's degree, now a master's degree, and now he's picking his PhD program. Willie sent a text to me about a year and a half ago of pictures of keys where he now is a homeowner. He has been able to keep gainful employment since completing our K-Tech program. We believe we have a national model to solve the crisis of aging out. You add on to that our cottage community, which is housing for these young people in this aging out demographic. You cannot expect someone to do better if they don't have the skills or the opportunity or the ability or a mentor to navigate what they do not know.

Thank you.

I also had a thought just to share if I may on older youth. I think for those older youth that are aging out of the system, helping set them up to be successful and thrive in adulthood is critical, but also the importance of doing concurrent permanency planning and exploring permanency for youth, whether it is legal permanency or relational and emotional permanency as well, but more than anything with older youth, ensuring that their voice is included in the process is critical.

Thank you. Ms. Riley?

Yeah, I mean, to me, no child, no youth should age out of care. It just shouldn't happen. And I think that we're all talking about ways that we can prevent that from happening, that every child deserves permanency as Kate said, and putting the resources behind that, whether it's vocational, educational, the mental health supports, so that they have the greatest chance for success. That's what we want.

Thank you. And continue, okay.

Thank you. Mr. Simpson.

Thank you, and thank you all for being here. This really is an important subject and it's, as you got from my first round of questioning, I need specifics on what we do to improve the program and stuff. I'm interested and whether that comes from a task force or whatever, I need to get better educated on all of this, and you're the experts, not me. So I plan on listening to what you have to say about it. It's interesting that when you talk about not being able to pay therapists what they would get their going rate or whatever and stuff, I was a dentist in the real world. And I can tell you it's across the board that if you're going to save money in Medicaid, what the program does is say, well, we'll just cut reimbursement rates to the providers. And I used to tell my state that would always do this, I was in practice with my dad and my uncle, so there was three of us, but most dentists in the community stopped seeing Medicaid patients because it cost them money to see them. I would lose money every time I would see a Medicaid patient. And I would tell the state, hey, I'll do it for free, my time for free, but I still have overheads that I have to pay. And I can understand why dentists, particularly in solo practices, stopped seeing Medicaid patients. And that's unfortunate. We were lucky in that we had three dentists so that we could all donate some time to actually do it. But that's across the board in almost all of the all of the professions and stuff. So that's something that needs to be addressed when we're when we're addressing this. So I enjoyed your testimony and I look forward to working with you as we try to solve this problem and as the newest member of the adoption caucus. [Laughter.] Thank you all for being here.

A fully fledged member. Well, thank you.

First I want to address the one big beautiful bill. You know, the Medicaid, the focus on Medicaid was to protect the most vulnerable in the one big beautiful bill by making those who are able-bodied adults non-working to work. All right. That's what saved the money in Medicaid. All right. It wasn't to take any sort of support away from the most vulnerable, it was to shift it back to the most vulnerable from those from those who were taking it away from the most vulnerable. That's what the one big beautiful bill did. And then also you have the $5,000 adoptive tax credit was made refundable in the one big beautiful bill. So House Republicans, we successfully passed a provision in the one big beautiful bill that allows the $5,000 of the adoptive tax credit to be refundable, supporting more families who step up to adopt. So my question is, and this is for all of you, what impact has making this tax credit refundable had on supporting adoption? I mean, if you want to address it, please do.

Yeah, I will. I think that research generally suggests that the adoption tax credit is not super effective in getting children adopted, in part because states and the federal government actually done quite a bit to make adoption from foster care very affordable. I think it has a probably a larger impact on private domestic or international adoptions, but in many states, the cost of adopting a child from foster care is already zero. So cost is just not the primary barrier that I think kids face in finding families.

So what is?

Workforce and judges, frankly. Children are just sit in foster care for years before adoption even is considered an option for them.

Okay. Anyone else want to address the tax credit?

Yes. CCAI serves as the secretariat to the Adoption Tax Credit Working Group and has done that for years, and we've been working with nearly 100 non-partisan organizations and working towards making adoption more accessible and removing financial barriers. And so I want to say that, yes, the adoption tax credit supports all forms of adoption, and if financial barriers is a barrier, helping remove that for families to make it possible is critical.

Okay. All right. I have one last question for you. Let's say there's a set of parents or folks that don't have children and they want to adopt, but they have no idea where to start. Where do you start for, you know, a husband and wife?

Kidstolove.org.

Pardon?

Kidstolove.org.

Okay. All right. Ms. Martin, where do you start?

I think I'm an unusual case because I already worked in the system, so I knew how to access it. I mean, the internet.

Dr. Font?

Yeah, so I will say you can easily Google options in your area and find which agencies will license families and conduct home studies. The real challenge is figuring out which agencies are really high quality and supportive and I think provide the quality of training that they'll need to be successful. Unfortunately, a lot of families who are interested in adoption and even initiate the process never complete it because of barriers in terms of agency responsiveness, lack of training, and lack of support.

Okay. Ms. McLean?

Yes. I will say the internet is a great tool, but also there's a lot that doesn't go on well there. And so we are seeing one of our issues is making adoption more ethical, including reducing fraudulent advertising of services and making sure that families are connected to licensed agencies that have the regulations and procedures in place to make it a safe and responsible adoption.

So you don't have to start with a lawyer.

No. And I think there's strong parental support systems across the country of adoptive parents that are able to give the kind of information not on the internet that are ethical and are safe.

Well, thank you. Appreciate it. Now yield back.

Thank you. Thank you so much, Mr. Chairman, and thank you for the hearing this morning. I want to say a thank you to all of our witnesses. It really is so very helpful to hear the stories from across the country about specific children, about their families. Your personal experiences and your journey are really critical. As I think it was said in the course of this hearing, you're on the ground, you understand it, you know it, etc. We make decisions and decisions about resources and public policy, and sometimes without the benefit of the broad spectrum of knowledge that you have. So it's important for us to have that knowledge to make correct decisions and not go down roads that are going nowhere in terms of your effort. I said to you at the outset, tremendous joy with adoption in my family, and part of that included international adoption, which is a whole another world to deal with, which we didn't talk about today. But I have witnessed the challenges in the foster care system particularly. And I made a note, I don't, I don't, in many respects, I think the foster care system is broken. How to fix it is what you are all about and you're being successful at how to, how to address it. This is about services and not, less about resources, but services often times cost, you know, and that's where there's the opportunity with what those services are and how we can play a role in providing the resources for those services because it's our responsibility to improve the system to make it better. The one thing that comes through is you're right, kids can thrive in the right environment. They can, we've all witnessed that. But sometimes the trauma in their lives, unaddressed, then they are off the tracks for a lifetime. And we've all witnessed that as well. So, and there are so many families that are out there that are desperate to have a child in their home. And that is I think what we're talking about. Mental health care, we talked about services, we talked about mental health, we talked about workforce. You've got, I'm, we could pursue this after, why we can't get these programs into a clearinghouse, I don't get it, but so I would welcome the opportunity to hear more about that and what direction that we can go in. I am, and I heard my colleague, I am really worried overall about what Medicaid means and what we can do there. So I'd just say this to you, if you believe that it's going to be impactful to all of you, then you ought to be really speaking up about that. States are not going to be able to increase reimbursement rates when they are going to be cutting billions of dollars from their budgets. That is what the effect of that is. So you ought to check with your respective states and find out what the situation is. You don't have to listen to me about it, you can find that out for yourself. I want to make a pitch for one more program at HRSA. It's something called the Infant-Toddler Court Team program. It is focused on helping these kids and their families in partnership with the child welfare system, the court system. They provide comprehensive services to reduce child removals, improve permanency outcomes, and enhance timely reunifications, if that's the road. I see you shaking your head in some regard, so you may have dealt with this in some way, but trying to see if we can provide some resources in this area. I can only just say to you that you do the Lord's work. I say that with a lot of emotion, having witnessed how hard this is and what a toll it takes on our children, what a toll it takes on the workers who are there, the families who are foster care families when they are at their wits' end and they don't know what to do. So I thank you for that. I'm hoping, Chairman, that we can, you picked up on it, if there's a way to deal with getting your advice and help through this task force or any other opportunity, we would welcome that to help to try to make a difference. Thank you for the difference you are making every day. Thank you.

Thank you, Ms. DeLauro. Well, let me, let me thank each of you and this is, this is really is an important issue and obviously by my involvement with the coalition or caucus for adoption, I, you know, my, I consider this a big issue that we can really make a difference for kids around the world, in the United States, but literally around the world because I'm also a big supporter of international adoptions as well. So, but there's so many opportunities and, you know, I think what we as a whole Congress, what those of us that are involved in this issue want to do is try to find out what the barriers are that we can do to make it adoption affordable, but also any other barriers such as red tape that really causes families to shun away from adoption. And then to do what we can to encourage adoption as much as possible from a federal level. I mean, each obviously it has to be an individual situation and you don't want to ever force adoption on anyone because that's it would just it would not work. But there's a lot of things we can do to encourage it. And I look forward to working with each of you in any way we can be at this subcommittee can be of help and for a reference or anything, we'd be glad to be of help. So thank you for your attendance today and your sharing your testimony and we look forward to working with you. The hearing is adjourned.