Funding under Title IV-E has historically not been available to American Indian communities, therefore, tribes have had to develop agreements with states to access these funds for child care services. This study analyzes Title IV-E intergovernmental provisions to help tribes and states strengthen Title IV-E agreements. A nationwide content analysis of existing Title IV-E documents, phone interviews, and focus groups revealed that Title IV-E tribal/state agreements vary widely, with most tribes not receiving full access to state services. These agreements focus on foster care maintenance payments and services. This article includes recommendations to help facilitate tribal access to Title IV-E funding for foster care and adoption services.