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Home > Advocacy > National Fact Sheet 2007

 
 

National Fact Sheet 2007

The Nation's Children 2007

America's Children: A Snapshot

   Child population under age 18, 2005 1 73,469,984
   White children under 18, 2005 2 58.3%
   Nonwhite children (non-Hispanic) under 18, 2005 3 41.7%
   Children and youth (under 14), 2005 4 76.8%
   Children and youth (ages 14-17), 2005 5 23.2%

America's Most Vulnerable Children: A Snapshot

   Estimated referrals of possible child abuse and neglect, 2004 6 3,000,000
   Children substantiated/indicated as abused or neglected, 2004 7 872,088
   Children who died as a result of abuse or neglect, 2004 8 1,387
   Children in foster care on September 30, 2004 9 509,662
   Children adopted from the public foster care system, 2004 10 51,993
   Children waiting to be adopted on September 30, 2004 11 117,436
   Children living in poverty, 2005 12 12,814,806
   Children living in low-income families, 2005 13 28,365,801
   National Poverty Rate, 2005 14 13.3%
   National Poverty Rate for children under age 18, 2005 15 18.2%
   National Poverty Rate for children ages 5-17, 2005 16 17.0%
   National Poverty Rate for children birth to age 5, 2005 17 21.3%

Child Abuse and Neglect

  • In 2004, child protection agencies received an estimated 3,000,000 reports of child abuse and neglect. Of those, 2,043,523 reports were referred for investigation, as reported by 38 states. 18

  • In 2004, an estimated 872,088 children were substantiated or indicated as abused or neglected as reported by 50 states. Of these children, 62.4% were neglected, 17.5% were physically abused, and 9.7% were sexually abused. The victimization rate was 11.9 per 1,000 children, representing a 4% increase/decrease from 2003. 19

  • Of the children substantiated as abused and neglected, only 59.4% received follow up services. Nearly 30% of the children reported as abused and neglected but not substantiated received follow up services. 20

  • In 2004, 1,387 children died as a result of abuse or neglect. 21

  • On September 30, 2004, 509,662 children lived apart from their families in out-of-home care, compared with 515,500 children on September 30, 2003. In 2004, 30.6% of the children living apart from their families were age 5 or younger, and 20.3% were 16 or older. 22

  • Of the children living in out-of-home care on September 30, 2004, 40.3% were white, 34.3% were black, 16.9% were Hispanic, 2.0% were American Indian/Alaskan Native, and 6.4% were children of other races and ethnicities. 23

Permanent Families for Children

  • Of the 280,660 children exiting out-of-home care in the United States in 2004, 64.2% were reunited with their parents or other family members. 24

  • In 2004, approximately 51,993 children were legally adopted through public child welfare agencies, a 4% increase from 49,919 in 2003. 25

  • Of the 509,662 children in out-of-home care in 2004, 117,436, or 23.0%, were waiting to be adopted. 26

Kinship Support

  • In 2005, approximately 2,458,806 grandparents nationwide had primary responsibility caring for their grandchildren. 27

  • Of the 509,662 children in out-of-home care on September 30, 2004, 23.5% were living with relatives while in care. 28

  • Of all of children in kinship care on September 30, 2004, 34.8% were white, 38.2% were black, 18.8% were Hispanic, 2.2% were Native American, and 6.1% were all other races. 29

Child Poverty and Income Support

  • The percent of children younger than 18 living in poverty increased from 16.1% in 2000 to 17.6% in 2005-a 9.3% increase over six years. 30

  • The total number of individuals receiving Temporary Assistance for Needy Families (TANF) in the United States declined from 4,547,143 in March 2005 to 4,230,951 in March 2006, a decrease of 7%. The number of families receiving TANF in March 2006 was 1,814,040, a 6% decrease from 2005. 31

  • In 2005, $23 billion in child support funds were collected and distributed in the United States, an increase of 5% from 2004. 32

Child Care and Head Start

  • In 2005, an estimated monthly average of 1,782,000 of the nation's children received subsidized child care; 1,732,500 children were served in 2004, and 1,751,300 children were served in 2003. 33

  • Funding for child care has declined in recent years. Federal child care funding dropped from $4.817 billion in 2002 to $4.800 billion in 2005. At the same time, TANF funding for child care decreased from $3.96 billion in 2000 to $3.28 billion in 2004. 34

  • States can provide child care for families whose incomes are up to 85% of the state's median income (SMI). In 2005, 48 states had eligibility levels below 85% of SMI. In fact, in three-quarters of the states, families earning 200% of the federal poverty level of $32,180 did not qualify for assistance. 35

  • As of early 2005, an estimated 436,808 children nationwide were on the waiting list for subsidized child care. 36

  • In 2006, a family at 150% of poverty in 28 states had to pay a copayment of $150 per month (7% of income) or more to receive child care assistance. In eight states, a family at this income level wasn't even eligible for child care assistance. 37

  • In 2001, nearly half the states paid child care providers at 75% of an up-to-date market rate. By 2006, however, fewer than one-fifth of states did. 38

  • In 2005, Head Start served 906,993 children, a 0.1% increase from 2004, and a 0.4% decrease from 2002, when 912,345 children were enrolled in Head Start. 39

Health and Mental Health

Medicaid and Children in Foster Care
  • In 2001, 869,087 children in foster care were enrolled in Medicaid, representing 4% of all children enrolled in Medicaid. 40

  • Nearly 40% of Medicaid spending on children in foster care was for rehabilitative, inpatient psychiatric, targeted case management (TCM), and inpatient hospital services. 41

  • In 2001, $265,877,628 of total Medicaid spending for foster children was for TCM services, and $492,764,301 was for Rehabilitative Services. 42

  • Children in foster care receiving TCM services were much more likely treceive other important services supported by Medicaid than were children in foster care not receiving TCM services. 43

Child and Youth Mental Health

  • Recent estimates show approximately 1 in 5 children with a diagnosable mental disorder, and 1 in 10 with a severe emotional or behavioral disorder causing significant impaired functioning at home, at school, or in the community. 44

  • Co-occurring mental health and substance abuse disorders are increasingly prevalent for youth treated for substance abuse disorders, with 80% to 85% also having a mental health disorder. 45

  • Suicide is the third leading cause of death in youth ages 15-24. In 2003, 3,988 youth in this age range committed suicide in the United States, a rate of 9.67 per 100,000 adolescents in the population. 46

  • Mental disorders are really the chronic diseases of the young-half of all lifetime cases of mental illness begin by age 14, and 75% have begun by age 24. 47

  • In any given year, only 20% of children with mental disorders are identified and receive mental health services. 48
Foster Care, Mental Health, and Medicaid
  • An estimated 80% of youth in foster care or more have emotional disorders or substance abuse problems, and 30% have severe behavioral, emotional, or developmental problems. 49

  • Although children in foster care represent only 3.7% of the nondisabled children enrolled in Medicaid, they account for 12.3% of expenditures for the same group. 50

  • Although children in foster care represent a very small percentage of Medicaid enrollees, they account for 25%-41% of Medicaid mental health expenditures. 51

  • According to a recent study, approximately half of adult participants who were placed in foster care as children have one or more mental health problems well into adulthood, and 25% suffer from post-traumatic stress disorder. 52
Newborn Health and Infant Mortality
  • Nationally, 324,064 babies were born weighing less than 2,500 grams in 2003. Low-birthweight babies accounted for 7.9% of all births in 2003, compared with 7.6% in 2000-a 4% increase. 53

  • After several decades of constantly falling infant mortality rates, improvement has stalled. In 2003, 28,025 infants under age 1 died in the United States. That's almost 77 infant deaths each day, and an infant mortality rate or 6.9 deaths per 1,000 live births- the same as in 2000. 54
Pregnancy and Parenting
  • In 2004, 6,789 babies were born to girls younger than 15; 415,408 were born to girls ages 15-19-a rate of 41.2 births per 1,000 girls ages 15-19. 55
HIV/AIDS
  • From the beginning of the AIDS epidemic through 2004, 934,863 adults and adolescents in the United States, and 9,443 children younger than 13, were diagnosed with HIV/AIDS. 56

Substance Abuse

  • Parental addiction is a significant factor in child abuse and neglect-studies suggest 40%-80% of families in the child welfare system are affected by addiction. 57

  • In a 2005 National Association of Counties survey, 40% of child welfare officials reported increases in the number of children placed in foster care due to parental methamphetamine use in the past year. 58

  • Between 2002 and 2005, 12,077 children were residing at or visiting the site in question when a methamphetamine lab was seized by local or federal law enforcement. 59

  • An estimated 23.2 million people age 12 or older need treatment for substance abuse problems in 2005. 60

  • Only 2.3 million people age 12 or older received specialty substance abuse treatment in 2005. 61

  • In a survey by the National Center on Child Abuse Prevention Research, 85% of states reported substance abuse as one of the two major problems exhibited by families in which maltreatment was suspected. 62

  • Data indicate that abused and neglected children from substance abusing families are more likely to be placed in foster care and are more likely to remain there longer than are maltreated children from non-substanceabusing families. 63

Vulnerable Youth

  • In 2004, 22,718 children aged out of out-of-home care. 64

  • In 2004, 8% of teens ages 16-19 (or 1,138,000) were high school dropouts, a 36.5% decrease from 2000. 65

  • In 2005, 8% of teens age 16-19 were not enrolled in school and were not working. 66

  • In 2004, 1,262,000 children ages 12-17 needed but did not receive treatment for illicit drug use in the past year. 67

  • In 2004, 1,444,000 children ages 12-17 needed but did not receive treatment for alcohol use in the past year. 68

  • In 2003, 2,226 children under age 20 committed suicide, a rate of 2.6 per 100,000 children in the population. 69

  • In one state's multiyear study of gay, lesbian, and bisexual students in grades 9-12,

    • 34% were threatened or injured at school, compared with 7% of heterosexual students; 70
    • 25% skipped school because they felt unsafe, compared with 5% of heterosexual students; and 71
    • 45% attempted suicide, compared with 8% of heterosexual students. 72

  • In a study of young adults who had spent a year or more in foster care between the ages of 14 and 18, 25% had experience post-traumatic stress compared with 4% of the general adult population. 73

Juvenile Justice and Delinquency Prevention

  • In 2003, 2,849 children age 19 and younger were killed in firearm deaths nationwide, a 2% decrease from 2,893 in 2002. 74

  • In 2005, 1,403,555 children under age 18 were arrested, a 3.1% decrease from 1,360,641 arrests in 2004. Of the arrests in 2005, 55,853 were for violent crimes, and 26,859 were for possession of a weapon. 75

  • A 2003 census of juvenile offenders showed 96,655 children in juvenile correction facilities in the United States, an 8% decrease from 104,413 children in 2001. 76

Funding Child Welfare Services



  • In 2004, the United States spent $23.3 billion for child welfare services. Child welfare services refer to all direct and administrative services a state agency provides to children and families. Of amount, 50% was from federal funds, 39% was from state funds, and 11% was from local funds. 77

  • Of the $11.7 billion federal dollars spent for child welfare in 2004, 50% came from Title IV-E Foster Care and Adoption Assistance, 4% from Title IV-B Child Welfare Services and Promoting Safe and Stable Families, 10% from Medicaid, 11% from Social Services Block Grant, 20% from TANF, and 3% from other federal sources, including Supplement Security Income and Survivors Benefits. 78

  • Out of 509,662 children in out-of-home care in 50 states and the District of Columbia on September 30, 2004, only 231,553, or 45%, received Title IV-E federal foster care assistance. 79

    Child Welfare Workforce

    • A 2003 General Accounting Office (GAO) report documented that staff shortages, high caseloads, high worker turnover and low salaries impinge on the delivery of services to achieve safety, permanence, and well-being for children. 80

    • That report cited the average caseload for a child welfare/ foster care caseworker to be 24-31 and that these high caseloads contribute to high worker turnover rates and insufficient services being provided to children and families. 81

    • According to a 2004 child welfare workforce survey, the average caseload size, where child is defined as the case, was 24 for child protective service (CPS) workers and 23 for foster care caseworkers. CWLA recommends that a CPS caseworker responsible for the initial assessment/investigation have no more than 12 active cases per month. CWLA recommends that a foster care caseworker have a caseload of 12-15 children. 81

    • The average minimum salary for a caseworker responsible for investigating reports of abuse and neglect was $29,797 in 2004; the median income for a family of two in the was $47,397. 82

    • The average vacancy rate for CPS workers at public agencies was 8.5% in 2004, down from 9.3% in 2000. On average, filling a vacant CPS position took 10 weeks. 83

    • The turnover rate for CPS workers increased from 19.9% in 2000 to 22.1% in 2004. 84

    • The findings of the federal Child and Family Service Reviews have clearly demonstrated that the more time a caseworker spends with a child and family, the better the outcomes for those children and families. 85
    Also available:
    • This document in PDF format. (Requires Adobe Acrobat Reader)
    • The National Fact Sheet from 2006.
    • The National Fact Sheet from 2005.
    • The National Fact Sheet from 2004.
    • The National Fact Sheet from 2003.
    • The National Fact Sheet from 2002.
    • The National Fact Sheet from 2001.
    • The National Fact Sheet from 2000.

    Sources

    1. U.S. Census Bureau. (2005). National population estimates - characteristics. National sex and age (NC-EST2005-02). Retrieved online January 17, 2007. Washington, DC: Author. back

    2. U.S. Census Bureau. (2005). National population estimates-characteristics. National sex, age, race, and Hispanic origin (NC-EST2005-04). Retrieved online January 17, 2007. Washington, DC: Author. back

    3. Ibid. back

    4. U.S. Census Bureau. National population estimates-characteristics. National sex and age (NC-EST2005-02). Retrieved online January 17, 2007. Washington, DC: Author. back

    5. Ibid. back

    6. Administration on Children, Youth, and Families (ACYF). (2006). Child maltreatment 2004, Table 2-1. Retrieved online January 17, 2007. Washington, DC: U.S. Department of Health and Human Services (HHS). back

    7. Administration on Children, Youth, and Families. (2006). Child maltreatment 2004, Table 3-2. Retrieved online January 17, 2007. Washington, DC: HHS. back

    8. Administration on Children, Youth, and Families. (2006). Child maltreatment 2004, Table 4-1. Retrieved online January 17, 2007. Washington, DC: HHS. back

    9. Child Welfare League of America (CWLA). (2006). Special tabulation of the Adoption and Foster Care Analysis Reporting System (AFCARS). Washington, DC: Author. back

    10. Ibid. back

    11. Ibid. back

    12. National Center for Children in Poverty, Columbia University. (2006). Low-income children in the United States. Retrieved online January 17, 2007. New York: Author. back

    13. Ibid. back

    14. U.S. Census Bureau. (2005). Data profiles: Selected economic characteristics. Retrieved online January 17, 2007. Washington, DC: Author. back

    15. Ibid. back

    16. Ibid back

    17. Ibid. back

    18. ACYF, Child maltreatment 2004, Table 2-1. back

    19. Administration on Children, Youth, and Families (ACYF). (2006). Child maltreatment 2004. Retrieved online January 17, 2007. Washington, DC: HHS; Administration on Children, Youth, and Families. (2005). Child maltreatment 2003. Retrieved online January 17, 2007. Washington, DC: HHS. back

    20. ACYF, Child maltreatment 2004back

    21. Ibid. back

    22. CWLA, Special tabulation from AFCARS. back

    23. Ibid. back

    24. Ibid back

    25. Ibid. back

    26. Ibid. back

    27. U.S. Census Bureau. (2005). Data profiles: Selected social characteristics. Retrieved online January 17, 2007. Washington, DC: Author. back

    28. CWLA, Special tabulation from AFCARS. back

    29. Ibid. back

    30. U.S. Census Bureau, Current Population Survey. (2006, March). 2006 annual social and economic supplement. Retrieved online January 17, 2007. Washington, DC: Author; U.S. Census Bureau, Current Population Survey. (2001, March). 2002 annual social and economic supplement. Retrieved online January 17, 2007. Washington, DC: Author. back

    31. Administration for Children and Families. (2006). Caseload data. Retrieved online January 17, 2007. Washington, DC: HHS. back

    32. Administration for Children and Families. (2005). Financial overview, FY2004 and FY2005. Retrieved online January 17, 2007. Washington, DC: HHS. back

    33. Administration on Children and Families, Child Care Bureau. (2006). CCDF data tables and charts: Children served. Retrieved online January 17, 2007. Washington, DC: HHS. back

    34. Schulman, K., & Blank, H. (2006). State child care assistance policies 2006: Gaps remain, with new challenges ahead. Retrieved online January 17, 2007. Washington, DC: National Women's Law Center. back

    35. Schulman, K., & Blank, H. (2005). Child care assistance policies 2005: States fail to make up lost ground, families continue to lack critical supports. Retrieved online January 17, 2007. Washington, DC: National Women's Law Center. back

    36. Ibid. back

    37. Schulman & Blank, State child care assistance policies 2006back

    38. Ibid. back

    39. Administration for Children and Families. (2005). Head Start statistical fact sheets. Retrieved online January 17, 2007. Washington, DC: HHS. back

    40. Geen, R.; Sommers, A.S.; & Cohen, M. (2005). Medicaid spending on foster children. Retrieved online January 17, 2007. Washington, DC: Urban Institute. back

    41. Ibid. back

    42. Urban Institute estimates based on data from the Medicaid Statistical Information System (MSIS) Summary File, 2001. back

    43. Geen, Sommers, & Cohen. Medicaid spending on foster childrenback

    44. Huang, L.N. (2004). Transforming Mental Health Care for Children and Families. Networks: Special Edition, 8(3-4). Retrieved online January 17, 2007. Alexandria, VA: National Technical Assistance Center for State Mental Health Planning. back

    45. Ibid. back

    46. Hoyert, D.L.; Heron, M.P.; Murphy, B.S.; & Kung, H. (2006, April). Deaths: Final Data for 2003. National vital statistics reports, 54(13). Retrieved online January 17, 2007; National Center for Injury Prevention and Control. (2005). Injury mortality reports, 1999-2004. Retrieved online January 17, 2007. Atlanta: National Centers for Disease Control and Prevention (CDC). back

    47. National Institute of Mental Health. (2005, June). NIMH national comorbidity survey replication (NCS-R). Retrieved online January 17, 2007. Bethesda, MD: Author. back

    48. U.S. Public Health Service. (2000). Report of the Surgeon General's conference on children's mental health: A national action agenda. Retrieved online January 17, 2007. Washington, DC: HHS. back

    49. American Academy of Child and Adolescent Psychiatry. (2002). Policy statements: AACAP/CWLA foster care mental health values subcommittee. Retrieved online online, January 17, 2007; Halfon, N.; Mendonca, A.; & Berkowitz, G. (1995). Health Status of Children in Foster Care. The Experience of the Center for the Vulnerable Child. Pediatrics and adolescent medicine, 149(4), 386-392. Retrieved online January 17, 2007; American Academy of Child and Adolescent Psychiatry. (2005, May). Facts for families: Foster care, No. 64. Retrieved online January 17, 2007. back

    50. Geen, Sommers, & Cohen. Medicaid spending on foster childrenback

    51. Rubin, D.M.; Alessandrini, E.A.; Feudtner, C.; Mandell, D.S.; Localio, A.R.; & Hadley, T. (2004). Placement Stability and Mental Health Costs for Children in Foster Care. Pediatrics, 113(5), 1336-1341. Retrieved online January 17, 2007. back

    52. Pecora, P.; Kessler, R.; Williams, J.; O'Brien, K.; Downs, A.C.; English, D.; et. al. (2005). Improving family foster care: Findings from the Northwest Foster Care Alumni Study. Retrieved online January 17, 2007. Seattle: Casey Family Programs. back

    53. Annie E. Casey Foundation. (2006). State level data online: Low-birthweight babies: Number: 2003. Retrieved online January 17, 2007. Baltimore: Author. back

    54. Annie E. Casey Foundation. (2006). State level data online: Infant mortality: Number: 2003. Retrieved online January 17, 2007. Baltimore: Author. back

    55. Hamilton, B.E.; Martin, J.A.; Ventura, S.J.; Sutton, P.D.; and Menacker, F. (2005, December). Births: Preliminary Data for 2004. National vital statistics reports, 54(8). Retrieved online January 18, 2007. back

    56. Centers for Disease Control and Prevention. (2005). HIV/AIDS surveillance report, 2004, 16. Retrieved online January 17, 2007. Atlanta: Author. back

    57. Rubenstein, G. (2003). Safe and sound: Models for collaboration between the child welfare & addiction treatment systems. Retrieved online January 17, 2007. New York: Legal Action Center of the Arthur Liman Policy Institute. back

    58. National Association of Counties. (2005, July). The meth epidemic in America. Retrieved online January 17, 2007. Washington, DC: Author. back

    59. Office of National Drug Control Policy. (2005). Drug endangered children. Retrieved online January 17, 2007. back

    60. Substance Abuse and Mental Health Services Administration. (2006). Results from the 2005 national survey on drug use and health: National findings (Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Retrieved online January 17, 2007. Rockville, MD: Author. back

    61. Ibid. back

    62. National Center on Child Abuse Prevention Research. (2001). Current trends in child abuse prevention, reporting, and fatalities: The 1999 fifty state survey. Chicago: Prevent Child Abuse America.  back

    63. U.S. Department of Health and Human Services. (1999). Blending perspectives and building common ground: A report to Congress on substance abuse and child protection. Retrieved online, November 7, 2006. Washington, DC: Author. back

    64. Children who aged out of foster care are captured by the AFCARS emancipation data element. Children who exit care to emancipation are those who reached the age of majority; CWLA, Special tabulation from AFCARS. back

    65. Annie E. Casey Foundation. (2006). State level data online: Teens who are high school dropouts: Number: 2000-2004. Retrieved online January 17, 2007. Baltimore: Author. back

    66. Forum on Child and Family Statistics. (2006). America's children in brief: Key national indicators of well-being, 2006, Table ED6.A. Retrieved online January 17, 2007. Washington, DC: Author. back

    67. Substance Abuse and Mental Health Services Administration. (2006). Results from the 2005 National Survey on Drug Use and Health: National findings, Table 5.73A. (Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Retrieved online January 17, 2007. Rockville, MD: Author. back

    68. Substance Abuse and Mental Health Services Administration. (2006). Results from the 2005 National Survey on Drug Use and Health: National findings, Table 5.86A. (Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Retrieved online January 17, 2007. Rockville, MD: Author. back

    69. National Center for Injury Prevention and Control. Injury mortality reports, 1999 - 2004. Retrieved online. Atlanta: CDC. back

    70. Goodenow, C. (2003). Violence-related experiences of sexual minority youth: Looking at data from the Massachusetts Youth Risk Behavior Survey, 1995-2001. Springfield: Massachusetts Department of Education. back

    71. Pecora et. al. Improving family foster careback

    72. National Center for Injury Prevention and Control. Injury Mortality Reports. Retrieved online. Atlanta: CDC. back

    73. Federal Bureau of Investigation. (2005). Crime in the United States 2005, Table 36. Retrieved online January 17, 2007. Washington, DC: Author. back

    74. Office of Juvenile Justice and Delinquency Prevention. (2003). Census of juveniles in residential placement databook. Retrieved online January 17, 2007. Washington, DC: Author. back

    75. Examples of direct services are child abuse and neglect investigations, foster care, community-based programs, case management, and all such services required for the safety, permanency, and well-being of children. Examples of administrative services include management information systems, training programs, eligibility determination processes, and all services that provide the infrastructure supports for the public agency; Scarcella, C.A.; Bess, R.; Zielewski,E.H.; & Geen, R. (2004). The cost of protecting vulnerable children V: Understanding state variation in child welfare financing. Retrieved online January 17, 2007. Washington, DC: Urban Institute. back

    76. Ibid. back

    77. CWLA, Special tabulation from AFCARS. back

    78. U.S. General Accounting Office (GAO). (March 2003). Child welfare: HHS could play a greater role in helping child welfare agencies recruit and retain staff. Retrieved online January 17, 2007. Washington, DC: Author. back

    79. Ibid. back

    80. American Public Human Services Association (APHSA). (2005). Report from the 2004 Child Welfare Workforce Survey: State agency findings. Retrieved online January 17, 2007. Washington, DC: Author. back

    81. Child Welfare League of America. (1999). CWLA standards of excellence of child welfare services. Retrieved online January 17, 2007. Washington, DC: Author. back

    82. APHSA, Report from the 2004 Child Welfare Workforce Survey; U.S. Census Bureau, American Community Survey. (2004) Detailed tables: Median family income in the past 12 months. Retrieved online January 17, 2007. Washington, DC: Author. back

    83. APHSA, Report from the 2004 Child Welfare Workforce Surveyback

    84. Ibid. back

    85. GAO, Child welfare: HHS could play a greater role in helping child welfare agencies recruit and retain staffback




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