Who’s Who in Trump’s Child Welfare Agenda
Policy follows people.
In child welfare, the structure of federal decision-making means a few leaders wield outsized influence.
The Trump Administration’s key players have taken — or soon will take — their seats. With them comes the future direction of child welfare.
This piece is a who’s who of those players; a power map to inform your policy agenda.
By Doug Steiger, MPP, Child Welfare Wonk Senior Contributor
KEY POWER CENTERS TO KNOW
Robert F. Kennedy, Jr., Secretary of the HHS
HHS leadership always has the authority to steer child welfare policies, but rarely the bandwidth or inclination. Secretary Kennedy’s “Make America Health Again” agenda will dominate his focus, yet it could ripple into child welfare.
Two areas to watch: Kennedy may place a renewed focus on reducing the use of psychotropic medications, including in child welfare.
His proposed consolidation of some public health agencies could also have an impact on departmental efforts to address substance abuse and mental health.
While the stated goal is increased efficiency and coordination, it could result in fewer resources and less expertise focused tailored to those issues in the new combined agency.
Administration for Children and Families (ACF)
ACF is the U.S. Department of Health and Human Services’ hub for human services programs — everything from child care to refugee resettlement.
ACF is the epicenter of federal child welfare policy. It can shape the field through regulations, guidance, legislative proposals, and convenings. The question is whether ACF leaders drive policy, or react to policies from other higher ups, including HHS, the White House, or Congress. This dynamic is still developing in the Trump Administration.
Alex Adams, Assistant Secretary for ACF (Nominee)
Adams is Trump’s nominee to be the Administration for Children and Families’ (ACF) Assistant Secretary, and is widely expected to be confirmed by the Senate soon. Previously, he was the head of Idaho’s Department of Health and Welfare, in charge of the state’s Medicaid, SNAP, and social service programs.
Given the wide variety of programs ACF oversees, leaders of the agency may be child welfare experts or have little knowledge of it. Adams appears to be somewhere between those poles; a pharmacist and budget wonk with some recent child welfare experience but not a long history on these issues
In Idaho, he significantly increased the staff devoted to prevention services, extended foster care to older youth, and emphasized regulatory and spending efficiency. Some speculate that given this history, he may push for some sort of child welfare financing reform.
In addition, during his confirmation hearing, Adams cited child welfare priorities that include:
Accelerating evidence-based prevention services;
Recruiting and retaining qualified foster families;
Speeding adoption permanency; and,
Improving outcomes for youth aging out of care.
Andrew Gradison, Acting Assistant Secretary for ACF
Gradison has served as ACF’s Acting Assistant Secretary since the start of the Administration, and is expected to remain as Adams’ Deputy. A former staffer on House Ways and Means and Senate HELP committees, he brings deep Hill experience. He was involved in drafting the pandemic-era child welfare provisions that provided extra Chafee program funding and flexibility.
Gradison has been unusually active for an “acting,” which may signal a willingness to continue championing the Administration’s priorities. For example, he recently appeared on Fox News to discuss the suspension of federal funding for California’s sex ed program. He could just as easily slip into an internal management role once Adams is confirmed. Either way, with his Hill connections, he may have ongoing influence on any legislative work in child welfare, and will continue to be worth your time to engage.
Commissioner for Administration for Children, Youth, and Families (ACYF) in ACF, Unfilled
The Administration has yet to nominate a Commissioner for ACYF, the Senate-confirmed position within ACF that oversees the Children’s Bureau and all of ACF’s child welfare funding. The individual in this position is often an Administration’s lead on child welfare.
Dr. Mehmet Oz, Administrator of Centers for Medicare and Medicaid Services (CMS)
As the head of CMS, Dr. Oz now oversees Medicaid. How CMS implements the Medicaid provisions of the recent reconciliation bill will have an impact on state budgets and child welfare agencies.
For example, guidance on how to implement the work requirements for some Medicaid recipients could make them more or less difficult for recipients to fulfill or more expensive for states to implement. (link back to prior analyses we've done) In addition, Medicaid waiver policies and flexibilities in guidance documents could also affect access to mental health care for young people in foster care.
Melania Trump
A First Lady can always influence Administration policy. First Lady Melania Trump has already been involved in child welfare by helping secure a $25 million proposal for the Department of Housing and Urban Development’s Foster Youth to Independence (FYI) program in the Administration’s proposed FY26 budget.
Her hire of veteran child welfare expert Sarah Gesiriech as Director of Policy signals that her interest in child welfare is likely to be sustained, strategic, and well-informed.
Will the First Lady stick to using the White House platform to spotlight programs and celebrate success stories? Or will she– via Gesiriech– push forward concrete policy proposals, even if other Administration actors – like OMB Director Vought – are less enthusiastic?
Should the First Lady take an interest in legislation, Congressional Republicans are likely to support her views, given how wary they are of getting crosswise with the President.
Whatever form her interest takes, it will be an important element of the Administration’s child welfare approach, and a key signal to watch
Russell Vought, Director of the Office of Management and Budget (OMB)
OMB Director Vought is one of the most important figures in the Administration, and was one of the main architects of the Project 2025 report. He previously served as OMB Director at the end of President Trump’s first term and is a strong advocate for reducing federal spending. OMB is the organization that oversees government spending and regulations on behalf of the President, giving it potentially sweeping power within an Administration.
At OMB in this Administration, he has aggressively stretched OMB’s fiscal authority, delaying and withholding funds Congress has already approved. If this practice continues, it could reach funds for child welfare programs – once you have been willing to touch very popular Head Start grants, it’s hard to see what other ACF funds are off limits.
More broadly, the OMB Director appears to be urging a hardline in appropriations negotiations for the coming fiscal year. His stance heightens the risk of a government shutdown — with child and family programs caught in the crossfire.
Vince Haley, Director of the White House Domestic Policy Council (DPC)
DPC Director Haley is a long-time aide to President Trump, including serving as a speechwriter during the recent campaign. Earlier in his career, he was an aide to Newt Gingrich. The DPC has the potential to generate Administration child welfare policy initiatives and, at a minimum, likely will review proposals from others, such as HHS and OMB. The workings of the current DPC are opaque and the interest level in child welfare is unclear so far.
POWER IN PLAY
The Trump 2.0 lineup combines high-level turbulence (Kennedy’s HHS restructuring, Vought’s budget brinkmanship) with mid-level uncertainty (an unfilled ACYF commissioner, Adams’ unknown appetite for reform). Add in wildcards like Melania Trump’s policy role, and the Administration’s child welfare agenda will be shaped as much by personalities as by plans.
For state leaders, funders, and advocates: the signal is not just who holds the titles, but which of them choose to use their leverage, on what, and how.
The field should prepare for policymaking that is uneven and at times unpredictable. Given the internal competition dynamics, a single internal champion, even at the White House, does not guarantee progress.
Those engaging the Administration would do well to develop multiple and reinforcing relationships, and track the posture of all of these power players toward the issues you care about.