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

Health Care Costs and Drug PricingHouse Appropriations Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies · 2026-03-26 · 119th Congress
The House Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies held this hearing to examine how federal discretionary and mandatory funding — including the Adoption Opportunities Program, Title IV-E adoption assistance, and the Adoption and Legal Guardianship Incentive Payments — supports permanency for the more than 325,000 children in foster care, over 70,000 of whom were waiting to be adopted at the end of 2023. Begins at 0:06:52
Transcript
Highlights

Title

Federal Funding for Adoption and Foster Care Permanency Programs

Purpose

The House Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies held this hearing to examine how federal discretionary and mandatory funding — including the Adoption Opportunities Program, Title IV-E adoption assistance, and the Adoption and Legal Guardianship Incentive Payments — supports permanency for the more than 325,000 children in foster care, over 70,000 of whom were waiting to be adopted at the end of 2023. Five witnesses testified on mental health services, tribal child welfare, data collection, and privatized foster care models, and members questioned them on workforce shortages, Medicaid reimbursement, and recent cuts to HHS staff. Begins at0:06:52

Who spoke

Chairman Robert Aderholt (R-AL)0:06:52: Opened by citing foster care and adoption statistics — 325,000 children in care, 70,000 waiting to be adopted, 45,000 adopted from foster care in FY20240:07:11; introduced the witness panel0:10:48 and later questioned witnesses on barriers to sustained adoptions0:45:31, workforce building1:32:11, and the adoption tax credit1:46:14.

Ranking Member Rosa DeLauro (D-CT)0:12:55: Described her two adopted grandsons and two cousins in foster care with divergent outcomes0:13:48; noted Congress provided over $10 billion in mandatory funding for foster care and adoption in FY20260:15:32 and pressed for post-adoption mental health support and workforce investment0:16:50.

Kate McLean, Executive Director, Congressional Coalition on Adoption Institute0:19:02: Outlined CCI's three priorities — accessible/ethical adoption, preparedness for adoptive families, and strengthening the permanency workforce0:22:23; later said children wait "years and years, at least three years" for permanency and urged investment in adoption specialists/recruiters0:47:14.

Debbie Riley, CEO, Center for Adoption Support and Education0:24:16: Said CASE has served over 9,000 children and families0:25:36 and trained over 30,000 professionals via its Training for Adoption Competency (TAC) and National Training Institute (NTI) programs0:29:18; cited findings that child welfare workers scored only 50% on loss/grief and clinicians 30% on attachment/bonding0:27:18, and that foster youth receive only about 20% of needed mental health treatment0:28:27.

Sarah Font, Professor, Brown School at Washington University in St. Louis0:29:41: Said federal adoption subsidies don't ensure safety or stability and cash subsidies "may also attract bad actors"0:30:47; noted children spend a median of 31 months in foster care before adoption, exceeding 45 months in some states0:34:21, and proposed five reforms including fixing AFCARS data ID breaks0:33:200:48:35.

Lee Marshall, Founder & CEO, Kids to Love Foundation0:35:11: Called on Congress to establish a national task force to audit foster care and adoption systems0:36:35, described children "sleeping on office floors" and warehoused in detention centers0:37:00, and detailed her privatized Alabama model achieving adoption in 18 months versus "years, plural" under the state system1:29:221:30:16.

Aurene Martin, Board Secretary, National Indian Child Welfare Association0:40:06: Explained tribal customary adoption, which does not require termination of parental rights0:41:52; said only about 25% of tribes participate in the Title IV-E program, limiting adoptive-family recruitment support1:36:56, and recommended a dedicated tribal funding category within Adoption Opportunities0:44:10.

Rep. Robert Aderholt [see above].

Rep. Mike Simpson (R-ID)0:58:57: Asked about unique needs in Indian Country and challenges maintaining tribal connections for children adopted by non-tribal members0:58:57; raised the broader question of what specific legislation Congress should pursue1:00:44.

Rep. Lois Frankel (D-FL)1:06:06: Asked which states have adoption processes working well and pressed on delay causes and Congress's role in funding services and workforce1:08:07.

Rep. Madeleine Dean (D-PA)1:18:46: Asked about the Pennsylvania kinship/sibling-separation example and criticized DOGE cuts of over 500 ACF civil servants (including more than half the Children's Bureau) and closure of five of ten HHS regional offices1:22:56.

Rep. Andrew Clyde (R-GA)1:25:49: Framed adoption as a life-affirming alternative to abortion, cited roughly 120,000 children still waiting to be adopted and a 31-month median foster care stay1:26:19; asked about protections for faith-based adoption providers1:27:06.

Rep. Suzanne Bice (R-OK)1:38:07: Asked all witnesses about the impact of a roughly $1 trillion Medicaid cut in the "big, beautiful bill" on the children and families they serve1:38:07.

Rep. Julia Letlow (R-LA)1:45:28: Defended the One Big Beautiful Bill's Medicaid work requirements and refundable $5,000 adoption tax credit, and asked witnesses about the tax credit's impact and how prospective parents find adoption resources1:45:28.

Rep. Eleanor Holmes Norton (D-DC)1:50:06: Discussed her family's international adoption experience, said the foster care system "is broken," pressed witnesses to speak up about Medicaid cuts' state-level effects, and highlighted HRSA's Infant Toddler Court Team program1:53:16.

Key moments

Riley said only about 21% of families access adoption-competent clinicians despite a quarter of foster youth being prescribed psychotropic medications, and that some adoptive parents relinquish children back to care to secure services0:28:27.

Font argued current federal subsidy and incentive programs "could be better spent," noting the Adoption Opportunities Program has spent over $300 million since 2013 with unclear effect on state practices0:31:140:31:43.

Font testified most states can't confirm whether adopted children remain with their adoptive families or are later maltreated, because states assign new case IDs upon adoption0:48:35.

Marshall called for a congressional "task force" to audit foster care/adoption systems; Aderholt and other witnesses expressed support for the concept1:02:231:03:20.

Multiple witnesses said Medicaid reimbursement (roughly $65/hour versus a $150/hour private rate, per Marshall) drives clinicians out of community-based care, creating "treatment deserts" for foster and adopted children1:14:071:12:47.

Font and Riley agreed evidence-based programs like NTI and TAC struggle to get onto the federal clearinghouse needed for funding recognition, despite over a decade of evidence-building1:04:391:05:36.

Dean stated DOGE cuts eliminated more than 500 ACF civil servants (over half the Children's Bureau staff) and closed five of ten HHS regional offices, forcing Philadelphia's office to absorb New York's and Boston's caseloads without added expertise1:22:561:23:47.

Marshall described her privatized Alabama model completing an adoption in 18 months from placement to permanency, contrasted with "years, plural" in the traditional state-run system1:30:16.

On the "One Big Beautiful Bill," Letlow said its Medicaid changes targeted able-bodied non-working adults and made the adoption tax credit refundable1:45:54; Font countered that the adoption tax credit has limited impact on foster-care adoptions since many states already charge zero adoption cost, identifying workforce and judicial delay as the real barriers1:47:05.

Martin said only about 25% of tribes participate in the Title IV-E program, leaving most tribes unable to access federal adoptive-family recruitment funding1:36:56.

Metadata

CommitteeHouse Appropriations Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies
Chamber / CongressHouse · 119th Congress
Date2026-03-26
TypeHearing
Witnesses
Debbie Riley — CEO, Center for Adoption Support and Education
Aurene Martin — Board Secretary, National Indian Child Welfare Association
Kate McLean — Executive Director, Congressional Coalition on Adoption Institute
Sarah Font — Professor, Brown School at Washington University in St. Louis
Lee Marshall — Founder & CEO, Kids to Love
Videoyoutube
Transcript259 caption blocks · 17,461 words · 1:56:41 runtime
EventCongress.gov 119093