Child Welfare Outcomes 2000:
Annual Report
Executive Summary
Child Welfare Outcomes 2000: Annual Report to Congress (Outcomes Report) is the third annual report from the U.S. Department of Health and Human Services (the Department). This report depicts the performance of States on the following national child welfare outcomes:
• Reduce recurrence of child abuse and/or neglect,
• Reduce the incidence of child abuse and/or neglect in foster
care,
• Increase permanency for children in foster care,
• Reduce time in foster care to reunification without
increasing re-entry,
• Reduce time in foster care to adoption,
• Increase placement stability, and
• Reduce placements of young children in group homes or
institutions.
This third Outcomes Report—Child Welfare Outcomes 2000—is similar to earlier reports in that it presents the States? data on the outcome measures, the States? comments on their data, a discussion of data issues, and key findings of the data analyses.1 A new feature of this report is the inclusion of qualitative information about State child welfare processes, practices, and policies. This provides depth and clarity to the interpretation of States? performance on the national child welfare outcome measures and helps determine possible reasons for a State?s high or low performance on a given outcome.
Qualitative information was obtained from the Department's Child and Family Services Reviews (CFSRs). The CFSR is the Department?s new results-oriented, comprehensive monitoring system. It was developed in response to the mandate in the Social Security Act Amendments of 1994 to promulgate regulations for review of State child and family services. Through the CFSR, the Department assists States in evaluating and improving their child welfare service systems. The CFSR examines State child welfare system operations through case reviews, interviews with stakeholders, and Statewide data pertaining to six outcome measures for which the Department has established national standards. These outcome measures pertain to the recurrence of child abuse and/or neglect, the incidence of child abuse and/or neglect in foster care, the length of stay in foster care prior to reunification, the length of stay in foster care prior to adoption, the rate of re-entry into foster care, and the stability of placements while in foster care. The Department prepares a final report on the CFSR findings with regard to strengths and areas needing improvement, and, based on this report, the States, working in conjunction with the Department, develop program improvement plans targeting key problem areas.
A Federal Comment page is included with the State data pages for each State that has a completed CFSR and an approved final report. The Federal Comment provides a discussion of: (1) the performance of States on the child welfare outcomes; (2) changes in performance over time; and (3) possible reasons for high or low performance based on qualitative information from the State's CFSR.
Child Welfare Outcomes 2000 is organized as follows:
• Chapter I. Interpreting State Performance on the National Child Welfare Outcomes. This chapter discusses how qualitative information from the CFSR Final Reports will be used to provide clarity and depth to understanding States? performance on the national child welfare outcomes.
• Chapter II. Technical Issues to Consider in Interpreting Outcome Data. This chapter presents and discusses key issues regarding reporting and interpreting data used to measure the performance of States on the national child welfare outcomes. A primary focus of discussion is the relevance of these issues for interpreting performance on the outcomes across States.
• Chapter III. Key Findings: State Performance on the National Child Welfare Outcomes for 2000 and Changes in Performance from 1999 to 2000. This chapter presents the findings of the analyses of States? performance in 2000 and changes in performance from 1999 to 2000. It includes a discussion of State policies and practices that may affect performance based on qualitative information obtained from the CFSR Final Reports on the 32 States that participated in the CFSR during 2001 and 2002.
• Chapter IV. State Data Pages. The State data pages include a section on context data, a section on outcomes data, a State comment page, and a Federal comment page for States that participated in a CFSR during 2001 and 2002.
Key findings and highlights of the report pertaining to the performance of States on each outcome and related measures are summarized below. Several data quality issues are discussed that have implications for interpreting performance on particular outcome measures. As these issues have emerged from the CFSRs and other sources, the Department has incorporated the relevant information into its efforts to assist States in developing program improvement plans after their initial CFSR. The Department also plans to take key data issues into consideration in assessing the effectiveness of strategies implemented as part of a State?s program improvement plan.
Key Findings
Because the period from 1999 to 2000 is too brief for a meaningful analysis of trends in performance, the assessment of change over time for individual outcomes offered in Child Welfare Outcomes 2000 provides only preliminary observations of the kinds of changes that are occurring. In addition, due to the short time frame, the percent change in performance experienced by an individual State from 1999 to 2000 cannot be compared against prior percent changes for that State. Consequently, to establish a standard against which to assess the extent of change occurring from 1999 to 2000, the mean and standard deviation for the percent change for all States was calculated. The analysis then focused on the extent to which the percent change exhibited by an individual State differed from the mean percent change exhibited for all States. For purposes of this report, a percent change that was at least one standard deviation from the mean percent change is considered as representing a “substantial” change in performance on the measure, as compared to changes exhibited by other States. In subsequent Outcomes Reports, the extent of change exhibited by a State will be compared to the percent change exhibited in previous years.
Outcome 1: Reduce recurrence of child
maltreatment
States? performance with respect to reducing recurrence of
child maltreatment is measured by the percentage of all children
who were victims of substantiated or indicated child abuse and/or
neglect during the first 6 months of the reporting period and who
had another substantiated or indicated report within a 6-month
period.2 States
report the data used to calculate this measure to the National
Child Abuse and Neglect Data System (NCANDS).
The maltreatment recurrence rate is considerable in many States. There were 34 States that provided sufficient data in 2000 to calculate this measure. The percentage of children who were victims of substantiated or indicated child maltreatment during the first 6 months of the reporting period who had another substantiated or indicated report within 6 months ranged from 3.0 to 13.1, with a median of 7.9. In 24 (71 percent) of these States, the rate of maltreatment recurrence was higher than the national standard of 6.1 percent. In 9 States (26 percent), more than 10 percent of the children who were victims of a substantiated or indicated maltreatment during the first 6 months of the reporting period experienced another substantiated or indicated maltreatment within 6 months.
An additional concern is that the rate of maltreatment recurrence reported in the Outcomes Reports may be less than the actual rate. In some States, for example, maltreatment reports on children who are already being served as part of an open "in-home services" case are not subjected to a formal investigation. Consequently, if maltreatment recurred, it would not be reported to NCANDS. Also, some States assess certain kinds of maltreatment allegations through an alternative response system that does not require determination of whether maltreatment actually occurred. If "maltreatment" actually recurred in families receiving an alternative response assessment, it would not be reported to NCANDS.
The findings with regard to maltreatment recurrence suggest that greater efforts are needed to ensure the safety of children who come into contact with the child welfare system as a result of abuse or neglect.
Outcome 2: Reduce maltreatment in foster
care
Maltreatment in foster care is assessed through the following
measure: Of all children who were in foster care (including
children in foster family homes, residential treatment centers,
group homes, and other care facilities) during the reporting
period, what percentage were the subject of substantiated or
indicated maltreatment by a foster parent or facility staff?
In 2000, 31 States reported sufficient data to NCANDS and the Adoption and Foster Care Analysis and Reporting System (AFCARS) to calculate this measure (compared to 21 States in 1999). The percentage of children who experience maltreatment in foster care ranged from 0.0 to 3.11, with a median of 0.45 percent. Nineteen States (61 percent) met the national standard of 0.57 percent. Although the incidence of maltreatment of children while they are in foster care is low across States, even a low incidence of maltreatment by foster parents and facility staff is not acceptable when the care of children is entrusted to the State.
Outcome 3: Increase permanency for children in foster
care
The findings pertaining to permanency suggest that the majority of
children in all States who exit foster care are exiting to
permanent homes, either through reunification, guardianship, or
adoption. For the 46 States that provided sufficient data to
calculate this measure, the percentage of children exiting to a
permanent home ranged from 68.6 to 94.5, with a median of 84.7
percent. No national standard was established for this outcome.
The data analyses also found, however, that success in attaining permanency was not equal for all children. Children with a diagnosed disability were significantly less likely than other children to exit foster care to a permanent home. Also, children who were older than age 12 at the time they entered foster care were significantly less likely than children with a diagnosed disability to exit to a permanent home. Children who are Hispanic or Black are as likely as White children to exit to permanency.3 In four States, Native-American children were found to be less likely than White children to exit foster care to permanent homes.
Outcome 3 also incorporates an assessment of the percentages of children who exit foster care to emancipation who were younger than age 12 at the time of entry into foster care. For the 45 States that provided data sufficient to calculate this measure, the percentages ranged from 0 to 61.2, with a median of 24.2. In 15 States (33 percent), more than 31 percent of the children who emancipated from foster care had entered care at or before age 12. This suggests that in these States, a substantial percentage of children are growing up in foster care.
These findings suggest that greater efforts are needed to achieve permanency for children who have diagnosed disabilities, who entered foster care when they were older than age 12, and who are of Native American heritage.
Outcome 4: Reduce time in foster care to reunification
without increasing re-entry
For the 51 States providing sufficient data to calculate this
measure, the percentages of children who exited foster care to
reunification within 12 months of entry into care ranged from 34.9
to 87.0, with a median of 68.0. Twenty-one (41 percent) of these
States met the national standard of 76.2 percent for this measure.
These findings are consistent with preliminary CFSR information
indicating that there is extensive variation among States with
regard to the timeliness of reunifications.
Variation among States also was found for the rate of re-entries into foster care. For the 50 States that provided sufficient data to calculate the percentage of re-entries into foster care within 12 months of discharge from a prior foster care episode, the percentages ranged from 0.9 to 27.7, with a median of 10.3 percent. Eighteen (36 percent) of these States met the national standard of 8.6 percent for this measure.
A primary concern raised by the data analysis pertains to the correlation between reunifications occurring within 12 months of foster care and re-entries occurring within 12 months of discharge from a prior foster care episode. This correlation was first noted in Child Welfare Outcomes 1999, and was even more substantial in the analysis of the FY 2000 data. The fact that only two States in FY 2000 exhibited both a high percentage of reunifications within 12 months and a low rate of re-entries within 12 months is disconcerting and raises serious concerns about the safety of some children who are being reunified with their families. The finding also raises questions regarding the quality of services provided to bring about reunifications, whether effective post-reunification services are being provided, and whether the criteria established for reunification are sufficient to ensure its stability. However, caution is warranted in interpreting these data because the two measures do not pertain to the same children (i.e., they are not longitudinal), making the exact nature of the relationship unclear. While it is legitimate to be concerned about the described results, the fact that the data derive from two different groups of children makes it possible that issues other than premature reunification or lack of reunification services are involved in this finding. The Department of Health and Human Services will need to address this question in the future.
Outcome 5: Reduce time in foster care to
adoption
There was extensive variation among States with respect to the
percentages of children exiting foster care to adoption within 24
months. For the 50 States providing sufficient data for this
outcome measure, the percentages of children achieving finalized
adoption within 24 months of entry into foster care ranged from 4.6
to 72.4, with a median of 19.7. Ten (21 percent) of these States
met or exceeded the national standard of 32.0 percent.
Interpreting performance on this measure is difficult because of the differences in the ways States report exits to adoption to AFCARS, and because of efforts in some States to achieve adoption for children who have been in foster care for long periods of time. Despite the multitude of strategies developed over the past decade to expedite adoptions (such as mediation, concurrent planning, use of adoption specialists, and family group decision making), the findings suggest that many States continue to experience difficulties finalizing adoptions in a timely manner. Through the CFSRs, the Department has identified many barriers to timely adoptions ranging from casework practice issues to crowded court dockets and parental appeals of termination of parental rights petitions. The Department anticipates that States will begin to address relevant barriers as part of their program improvement plans developed in response to CFSR findings.
Outcome 6: Increase placement stability
Most States experience a fairly high level of success with respect
to placement stability for children who have been in foster care
for less than 12 months, although placement stability tends to
decline for children remaining in foster care for longer periods of
time. For the 50 States that provided data to calculate this
measure, the percentages of children in foster care for less than
12 months who experienced no more than two placements ranged from
57.7 to 99.9, with a median of 84.3. Thirty percent of States met
the national standard of 86.7 percent.
Interpreting performance on this measure is somewhat difficult because the reporting of placement changes to AFCARS has not been consistent across States. Recently, the Department issued clarifications regarding what constitutes a "placement" or a "placement change," and it is anticipated that there will be fewer inconsistencies in reporting in the future.
Outcome 7: Reduce placements of young children in group
homes and institutions
Although many States have established policies that restrict the
placement of young children in group homes and institutions, these
policies are not always followed. Preliminary CFSR information
suggests that States vary considerably with respect to this
practice. While some States were found to be diligent about not
placing young children in these settings, other States frequently
used group homes, particularly shelters, as placement venues for
children of all ages. This includes children placed in shelters for
emergency care if that placement was longer than 24 hours.
Fifty States provided sufficient data to calculate this measure. The percentages of young children who were age 12 or younger at the time of entry into foster care and who were placed in group homes or institutions ranged from 1.3 to 27.2, with a median of 9 percent. In four States, over 20 percent of the children entering foster care at age 12 and younger were placed in group homes or institutions.
These findings suggest that only a few States are placing large percentages of young children in group homes and institutions. However, because group-like placements are in most cases inappropriate for young children, the fact that even a few States are using these placements for young children raises concerns regarding children's well-being.
Summary
In general, the key findings reported in Child Welfare Outcomes 2000 suggest that greater efforts are necessary to promote attainment of the seven national child welfare outcomes and ensure the safety and permanency of children who come into contact with the nation's public child welfare system. It is anticipated that with the continuation of the annual Outcomes Reports, the CFSRs, and technical assistance provided by the Department and the Department's child welfare-related resource centers, States will begin to exhibit improvements on performance on these outcomes.
Finally, it is important to note that many of the challenges to attaining positive outcomes for children who come into contact with the child welfare system are external to the system itself. A child welfare agency cannot provide services to prevent removal from home or to support reunification if those services are not available in the community. Similarly, a child welfare agency cannot achieve timely permanency for children if the court system is not operating on the same timelines as the agency or has differing perceptions of what children need with regard to permanency. Preliminary CFSR information indicates that these external barriers and challenges exist in all States participating in a CFSR thus far. Consequently, a key focus of Department and State efforts must be on promoting and supporting greater collaboration among agencies and institutions serving these children and families.
1 For purposes of this report,
the designation of “State” includes the District of
Columbia and Puerto Rico. Therefore, there are potentially 52
entities that can report data for each measure. Back
2 For example, if a child is a
victim of maltreatment in January of a Calendar year, and again in
March, then that would be considered recurrence of maltreatment. Back
3 For these analyses, the
categories of White and Black excluded children of Hispanic origin.
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