Child Welfare Outcomes 2000:
Annual Report
Chapter I. Interpreting State Performance on National Child Welfare
Outcomes
Section 203 of the Adoption and Safe Families Act (ASFA) requires the U.S. Department of Health and Human Services (the Department) to develop a set of child welfare outcome measures and to “. . . prepare and submit to the Congress a report on the performance of each State on each outcome measure, which shall examine the reasons for high performance and low performance and, where possible, make recommendations as to how State performance could be improved.” In earlier Outcomes Reports, the Department has reported the performance of States on each outcome measure, but has not been able to address the reasons for high and low performance or to provide recommendations for performance improvements. To accomplish these latter objectives, it is necessary to have in-depth qualitative information regarding a State?s child welfare policies, procedures, and practices. Through the Child and Family Service Reviews (CFSR), the Department now collects the kind of in-depth information that is necessary for understanding possible reasons for a State?s high or low performance on the national child welfare outcomes.
Description of the CFSR
During a CFSR, information is obtained from the following sources:
• A report prepared by the State that provides the findings
of the State?s self-assessment conducted prior to the on-site
review;
• A State Data Profile prepared by the Department using data
from the Adoption and Foster Care Analysis and Reporting System
(AFCARS) and the National Child Abuse and Neglect Data System
(NCANDS);1
and
• An on-site review process that includes comprehensive
reviews of 50 cases over 3 sites, and interviews or focus groups
with parents, children (when appropriate), foster and adoptive
parents, private service providers, child welfare agency
caseworkers and supervisors, State and local child welfare agency
administrators, and a range of other stakeholders at local and
State levels.
The Department analyzes the information from these sources to determine whether the State is in substantial conformity with seven outcomes and seven systemic factors assessed through the CFSR. Substantial conformity means that the State has met Federal criteria established for each outcome and systemic factor. The outcomes assessed in the CFSR are somewhat different from those presented in the Outcomes Reports, although all outcomes pertain to children?s safety, permanency, and well-being. The systemic factors address issues such as the capabilities of the State?s information system; the effectiveness of case review practices and procedures; training for child welfare staff, foster parents, and adoptive parents; the quality assurance system; the availability of services; the responsiveness of the agency to the community; and the licensing, recruitment, and retention of foster and adoptive parents.
The results of the analyses are compiled in a final report identifying strengths and areas needing improvement. The State uses this report as a basis for developing a program improvement plan that targets areas of performance where a need for improvement was identified through the CFSR. During FY 2001, the Department conducted 17 reviews; during FY 2002, 15 additional reviews were completed. The Department plans to review all States by the end of FY 2004 (the review schedule is provided in Appendix F). In subsequent years, Department reviews will be used to assess a State?s progress in accordance with its program improvement plan.
The following sections of this chapter discuss how CFSR findings are used in the Outcomes Report to address the statutory mandate requiring the Department to examine reasons for high and low performance and to make recommendations regarding improvements in performance.
Using CFSR findings to enhance interpretation of the performance of States on the national child welfare outcomes
Although the Outcomes Reports and the CFSR represent distinct and separate activities within the Department, they share the same goal—that of assessing the performance of States in achieving safety, permanency, and well-being for all children who come into contact with the public child welfare system. In 2001, as part of the CFSR, the Department established national standards for six outcome measures included in the Outcomes Reports (Appendix G provides information on the development of the standards). The Department uses performance relative to these national standards, along with information from other sources, to determine a State?s substantial conformity with relevant outcomes. The following are the selected outcome measures for which national standards exist (no standards were established for outcomes 3 and 7):
• Outcome 1 - Reduce recurrence of child abuse
and/or neglect.
Standard: Of all children who were victims of substantiated
or indicated child abuse and/or neglect during the first 6 months
of the period under review, 6.1 percent or fewer children had
another substantiated or indicated report within 6 months.
• Outcome 2 - Reduce the incidence of child abuse
and/or neglect in foster care.
Standard: Of all children in foster care in the State
during the period under review, 0.57 percent or fewer were the
subject of substantiated or indicated maltreatment by a foster
parent or facility staff member.
• Outcome 4 - Reduce time in foster care to
reunification without increasing re-entry.
Standard: Of all children who were reunified with their
parents or caretakers at the time of discharge from foster care,
76.2 percent or more were reunified in less than 12 months from the
time of the latest removal from the home.
Standard: Of all children who entered foster care during the
period under review, 8.6 percent or fewer re-entered foster care
within 12 months of discharge from a prior foster care
episode.
• Outcome 5 - Reduce time in foster care to
adoption.
Standard: Of all children who exited foster care to a
finalized adoption during the year under review, 32 percent or more
exited foster care in less than 24 months from the time of the
latest removal from the home.
• Outcome 6 - Increase placement
stability.
Standard: Of all children who have been in foster care for
less than 12 months from the time of the latest removal from the
home, 86.7 percent or more have had no more than two placement
settings.
A key difference between the CFSRs and the Outcomes Reports is that the latter are based solely on quantitative data from the national data reporting systems, while the former incorporate extensive qualitative information pertaining to State child welfare agency functioning and casework practices. In integrating information from both sources, the Department will use relevant qualitative information from the CFSR regarding State child welfare practices and policies to provide depth and clarity to the interpretation of States? performance on the national child welfare outcome measures.
Examples of the types of information that can be incorporated, if available and relevant, to enhance understanding of States? performance are provided below for each outcome.
Outcome 1: Reduce recurrence of child abuse and neglect.
• The extent to which children are maintained safely in
their homes (including children who have been reunified with their
families after a foster-care episode) and to which the risk of harm
is reduced.
• The extent to which service participation and
children?s safety are monitored (for example, through
frequent contact between caseworkers and the child and family or
through followup with families in in-home services cases).
• The extent to which needs and risk assessments are
sufficiently comprehensive to identify a family?s underlying
problems, such as domestic violence, mental illness, and/or
substance abuse.
• The extent to which services are available throughout the
State to support reunification and/or maintain children safely in
their own homes.
• The extent to which basic and ongoing training for
caseworkers and supervisors supports the development of social work
skills pertaining to ensuring children?s safety.
Outcome 2: Reduce the incidence of child abuse and neglect in foster care.
• The extent to which foster families receive the supports
and services they need to assist them in parenting children.
• The existence of clear standards for licensing and
maintaining out-of-home placements that pertain to children?s
safety and the application of these standards to all foster homes
(including kinship foster homes) and to all residential
facilities.
• The extent to which the numbers of existing foster homes,
therapeutic foster homes, and other types of placements are
sufficient to permit careful matching of children and placement
options.
• The extent to which the State adheres to the established
standards, particularly with respect to the numbers of children
permitted in the home.
• The extent to which training for foster parents is provided
prior to placement of a child.
Outcome 3: Increase permanency for children in foster care.
• The extent to which appropriate permanency goals are
established in a timely manner (including implementing concurrent
goals, when relevant).
• The extent to which long-term foster care is used as a
permanency goal.
• The extent to which permanency goals are attained in a
timely manner and the effectiveness of various activities
undertaken to attain those goals.
• The extent to which parents and children (when age
appropriate) are involved in the case-planning process, both
initially and on an ongoing basis.
• The extent to which contact with parents and children is of
sufficient frequency and quality to promote attainment of
permanency.
Outcome 4: Reduce time to reunification without increasing re-entry.
• The extent to which children are being reunified with
their families in a timely manner.
• The extent to which services and supports are provided to
children and parents to support eventual reunification, including
parent-child visitation, preserving children?s connections to
family and community, and providing services to parents to address
the risk issues that brought the child into foster care.
• The extent to which services are provided to children and
families after reunification to prevent re-entry.
• The extent to which the services necessary at both pre- and
post-reunification are available to children and families in all
areas of the State.
• The extent to which training is provided to caseworkers and
supervisors that focuses on permanency and practices intended to
expedite permanency, such as concurrent planning and/or family
group conferencing.
Outcome 5: Reduce time in foster care to adoption.
• The extent to which special activities or programs have
been created specifically to expedite adoptions.
• The extent to which a permanency goal of adoption is
established in a timely manner and petitions for termination of
parental rights (TPR) are filed in accordance with ASFA
timelines.
• The extent to which barriers to timely adoptions are
addressed, including both internal (to the State child welfare
agency) and external barriers, such as court delays or State
policies regarding TPR hearings.
• The extent to which basic and ongoing training of
caseworkers and supervisors addresses issues pertaining to
adoption.
• The extent to which the child welfare agency and the courts
collaborate effectively.
• The extent to which case reviews and permanency hearings are
held in a timely manner and TPR is pursued when appropriate.
Outcome 6: Increase placement stability.
• The extent to which children?s placements are
stable.
• The extent to which shelter placements are used as initial
placements and/or as temporary placements when other placements
disrupt.
• The availability of regular and therapeutic foster family
homes, particularly for children requiring higher levels of care,
so that foster parents and children can be appropriately
matched.
• The availability of placements for children requiring higher
levels of care.
• The extent to which services are provided to foster parents
to support a placement when there is a threat of disruption.
• The extent to which foster parents receive training on
parenting children with behavioral and emotional problems.
Outcome 7: Reduce placements of young children in group homes or institutions.
• The availability of regular and therapeutic foster family
homes.
• The extent to which shelter care placements are used for
young children.
Using CFSR findings to make recommendations to States for improving performance
In addition to understanding reasons for high and low performance on the national child welfare outcomes, section 203 of ASFA also requires the Department to make recommendations, where possible, to assist States in improving performance on the outcomes. During the CFSR, information is collected from stakeholders about their experiences with various State child welfare services, program approaches, and policies. This CFSR information can be used, when relevant, to make suggestions in the Outcomes Reports, particularly in the Federal Comment pages, regarding practices that may improve outcome performance. In subsequent Outcomes Reports, CFSR information about the effectiveness of States? strategies for achieving the goals of their program improvement plans may be useful for making recommendations to other States regarding improvements in performance.
Information from the CFSRs also may be used to identify general practices that appear to be linked to success in attaining positive outcomes for children. For example, CFSR Federal Team leaders, in analyzing the findings for the first 17 States reviewed, identified the following practices as particularly noteworthy:
• Ongoing training pertaining to strengthening practice
skills: Training programs for child welfare workers that focus
on improving case practice by strengthening practice skills and
promoting professional development.
• Concurrent planning: Activities that involve
establishing two potential goals for a child shortly after entry
into foster care and engaging in simultaneous efforts to attain
both goals to expedite permanency.
• Individualized services: Tailoring services to meet
the unique needs of children and families as opposed to
“one-size-fits-all” services that may not target the
issues that need to be resolved to achieve safety, permanency, and
well-being.
• Post-reunification services: Ensuring that families
have the services they need to support and maintain reunification
and prevent re-entry into foster care.
• Specialized adoption-related services: Focusing on
recruiting families that are willing to adopt special-needs
children, helping children make the transition to an adoptive
family, and providing post-adoption support to prevent adoption
disruption.
Considerations in interpreting State performance on the national child welfare outcomes
The Department anticipates that the use of CFSR information will add depth and clarity to interpretations of States? performance on the national child welfare outcomes. This, in turn, will increase States? ability to target areas where improvement is needed and consequently work to achieve better outcomes for children and families.
In understanding States? performance, however, it is important to be aware of the various data issues and individual State child welfare policies and practices that affect performance on outcome measures. The following chapter discusses the key data issues and identifies the variations among States with respect to policies, practices, and data-reporting procedures that significantly affect interpreting performance.
1 In some instances, when appropriate, the Department approves the use of alternative sources of data from the State for some of the data provided in the State Data Profile. This is permitted by regulation. Back
