Child Welfare Outcomes 2000:
Annual Report
Chapter III. Key Findings: State Performance on the National Child
Welfare Outcomes for 2000 and Changes in Performance From 1999 to
2000
The primary objectives of the Outcomes Reports to Congress are to: (1) describe the performance of States on the national child welfare outcomes for the target year and (2) track changes in performance over time, focusing on the continuous improvement of individual States.1 This chapter provides key findings regarding State performance in 2000 and changes in performance from 1999 to 2000. Data from 1998 are not included in the analysis of change because of data quality issues pertaining to that year.2
Table 1 provides an overview of States? performance on selected outcome measures for 1999 and 2000. It includes descriptive statistics for selected outcome measures, the national standard for the outcome measures (when applicable), and the number of States reporting sufficient data for inclusion in the analysis.3 The table shows extensive variation in performance for all measures in 1999 and 2000. For some measures, the pattern of performance across States is equally distributed along the range, while for other measures, States tend to cluster in the upper or lower regions of the range.
Table 1: Range and Median of State Performance on Selected Child Welfare Outcome Measures for 1999 and 2000
|
1999 |
2000 |
|
||||||
Outcome Measure |
N* |
Median |
Minimum |
Maximum |
N* |
Median |
Minimum |
Maximum |
National |
1.1 Children experiencing a recurrance of maltreatment within 6 months
|
29 |
7.4 |
2.1 |
13.5 |
34 |
7.9 |
3.0 |
13.1 |
6.1 |
2.1 Children experiencing maltreatment while in foster care
|
21 |
0.52 |
0.05 |
2.31 |
30 |
0.47 |
0.00 |
3.11 |
0.57 |
3.1 Exits from foster care that were exits to a permanent home (i.e., adoption, guardianship, or reunification)
|
46 |
84.3 |
59.1 |
94.9 |
46 |
84.7 |
68.6 |
94.5 |
N/A |
3.2 Exits of disabled children from foster care that were exits to a permanent home (i.e., adoption, guardianship, or reunification)
|
39 |
75.4 |
41.2 |
90.9 |
37 |
79.5 |
55.9 |
96.7 |
N/A |
3.3 Exits of children who were older than 12 at the time of entry into foster care that were exits to a permanent home (i.e., adoption, guardianship, or reunification)
|
43 |
70.7 |
36.5 |
86.8 |
40 |
72.6 |
37.0 |
87.5 |
N/A |
3.4 Children exiting foster care through emancipation who were age 12 or younger at the time of entry into foster care
|
45 |
28.0 |
0.0 |
63.0 |
45 |
24.2 |
0.0 |
61.2 |
N/A |
4.1 Exits to reunification that occurred within 12 months of time of entry into foster care
|
50 |
64.8 |
33.8 |
86.4 |
51 |
68.0 |
34.9 |
87.0 |
76.2 |
4.2 Children entering foster care that were re-entering care within 12 months of discharge from a prior foster care episode
|
49 |
10.6 |
1.0 |
26.7 |
50 |
10.3 |
0.9 |
27.7 |
8.6 |
5.1 Exits to adoption that occurred within 24 months of time of entry into foster care
|
48 |
24.1 |
3.0 |
70.7 |
48 |
19.7 |
4.6 |
72.4 |
32.0 |
6.1 Children in foster care for less than 12 months who experienced two or fewer placements
|
50 |
83.1 |
58.9 |
99.8 |
50 |
84.3 |
57.7 |
99.9 |
86.7 |
7.1 Children age 12 or younger at the time of entry into foster care who were placed in a group home or institution
|
51 |
8.8 |
1.4 |
26.3 |
50 |
9.0 |
1.3 |
27.2 |
N/A |
N=Number of States reporting with sufficient data for analysis for both 1999 and 2000.
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 Reports to Congress, the extent of change exhibited by a State will be compared to the percent change exhibited in previous years.4
The rest of this chapter presents key findings of the analyses of the performance of States in 2000 and change in performance from 1999 to 2000 for the national child welfare outcomes pertaining to children?s safety and permanency. Preliminary information obtained from the Department?s Child and Family Services Reviews (CFSR) is included to provide a context for interpreting States? performance. This information comes from the 32 States that participated in a CFSR in fiscal year (FY) 2001 and FY 2002. CFSR information pertaining to individual States is provided in the Federal Comment page included with the State?s data pages.
Outcome 1: Reduce recurrence of child abuse and neglect
The most important goal of welfare services is to ensure children?s safety. Children who have been victims of maltreatment must be protected so that they do not become victims again. Child welfare agencies employ two strategies to prevent the recurrence of maltreatment-providing services to families to reduce risk of harm while children remain in their own homes, or removing children from their homes and placing them in foster care.
Preliminary findings from the CFSRs suggest that greater efforts are needed to reduce risk of harm to children while they remain in their own homes. In some States, many children in the cases reviewed as part of the CFSR experienced multiple maltreatment reports over the life of the case. Although not all multiple maltreatment reports were substantiated, the frequency of reports suggests a pattern of risk of harm to the children that is not being adequately addressed by the child welfare agency.
Information from the CFSR Final Reports identified several reasons why children may remain at risk of harm in “in-home services” cases:
• In most States, a parent?s participation in
services in an “in-home services” case is voluntary,
even when the maltreatment has been substantiated. Caseworkers do
not always have the skills and experience necessary to engage
parents so that they will participate in recommended services and
change the behaviors that contributed to a child?s
maltreatment.
• Child welfare caseworkers often have excessive caseloads
and, consequently, are not always able to monitor parents?
participation in services or progress in making the changes
necessary to reduce the risk of harm to children.
• Families do not always have access to the services they need
to reduce the risk of harm to children, particularly substance
abuse treatment and mental health services. The problems with
access may be due to a scarcity of services in the community or to
the family?s inability to afford the services.
The measure developed for the Outcomes Reports to assess the performance of States with regard to reducing recurrence of child abuse and neglect is:
Outcome Measure 1.1: Of all children who were victims of substantiated or indicated child abuse and/or neglect during the first 6 months of the reporting period, what percentage had another substantiated or indicated report within a 6-month period?
In 2000, 34 States provided sufficient data to the National Child Abuse and Neglect Data System (NCANDS) to calculate this outcome measure (compared to 29 States in 1999). As shown in figure 1, the percentage of children who were victims of two substantiated or indicated maltreatment reports within 6 months ranged from 3.0 to 13.1, with the median being 7.9. In 24 (71 percent) of the 34 States, the percentages exceeded the national standard of 6.1. In 9 States, 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 a 6-month period.
The change in performance from 1999 to 2000 for outcome measure 1.1 is depicted in figure 2 for the 29 States that provided data in both years. The percent change for these States ranged from -25.3 to +58.3, with a mean percent change of +10.5. Three States (Missouri, Utah, and Connecticut) exhibited substantial improvements in performance on this measure (“substantial” means that the percent change was at least one standard deviation [SD = 19.5] from the mean percent change for all States). In contrast, five States (Massachusetts, Pennsylvania, Iowa, Delaware, and Nebraska) exhibited substantial declines in performance on this measure. Delaware and Pennsylvania, however, despite declines in performance, still exhibited low rates of child maltreatment recurrence. Also, changes from 1999 to 2000 may be attributed at least in part to States? efforts to increase the accuracy of data reported to NCANDS.
The overall performance of States in 2000 regarding this measure, as well as the number of States demonstrating substantial increases in this measure, suggest that the protection of children is a challenge for many States and that greater efforts are needed to ensure children?s safety. This concern is particularly critical in light of the possibility that the maltreatment recurrence rate calculated for outcome measure 1.1 may represent an undercount in many States, particularly in States that do not investigate maltreatment reports on families if there is an open case in the agency on that family.
Outcome 2: Reduce the incidence of child abuse and neglect in foster care
A fundamental tenet of child welfare practice is that when children are removed from their homes and placed in the care and/or custody of the State child welfare agency, they will be placed in safe environments. Information from the CFSRs indicates that this was most often the case—substantiated incidences of maltreatment in foster care by foster parents or facility staff members were rare. When maltreatment was found to occur, it appeared to result from poor matching of children and foster placements, overcrowding in foster family homes, or the absence of a clear State policy regarding use of physical restraints in residential care facilities.
For the Outcomes Report, the following measure assesses this outcome:
Outcome Measure 2.1: Of all children who were in foster care during the reporting period, what percentage was the subject of substantiated or indicated maltreatment by a foster parent or facility staff member?
As noted in Chapter 2, there are several problems with the validity of this measure. However, the measure does permit a general picture of the extent of child maltreatment by foster parents or facility staff members.
In 2000, 31 States reported sufficient data to NCANDS and AFCARS to calculate this measure (compared to 21 States in 1999). The key finding of the data analysis was that the percentage of children who experience maltreatment in foster care is small for all States, ranging from 0.0 to 3.11, with a median of .45 percent. Nineteen States (61 percent) met the national standard of .57 percent established for this measure. However, the distribution of percentages across States shown in figure 3 indicates that in 7 States (23 percent), more than 1 percent of the children in foster care experienced a substantiated report of maltreatment by foster care providers or facility staff in 2000. Although this is a small percentage, it is important to remember that the safety of each child represented in the statistic has been entrusted to the State.
Change in performance with regard to this measure is depicted in figure 4 for the 19 States providing data for the measure in 1999 and 2000. Because of the small percentages, the percent change in performance ranges considerably from -83 percent to +260 percent, with a mean percent change of +56.1 (SD = 103.5). Only one State (Florida) exhibited a substantial improvement in performance on this measure from 1999 to 2000. In contrast, four States (Washington, Wyoming, Vermont, and Arizona) exhibited substantial declines in performance, although Wyoming and Arizona continued to meet the national standard.
The findings for this analysis suggest that maltreatment in foster care is not a frequently occurring event. However, in some States the rate of maltreatment of children by their foster parents or facility staff suggests that greater efforts are needed to protect children who are in State custody.
Outcome 3: Increase permanency for children in foster care
An ongoing concern among policy makers and child welfare professionals is that too many children experience foster care as a “permanent” living arrangement. When these children leave the foster care system, it is usually because they have “aged out” of the system or “run away,” rather than because a permanent home was found for them. The Department?s efforts with regard to permanency are based on the belief that foster care is a temporary arrangement and not a place for children to grow up. Consequently, permanency planning efforts for children should begin as soon as a child enters foster care.
Preliminary CFSR findings indicate that many States are making diligent efforts to find permanent homes for children and have implemented policies and practices that make it more difficult for caseworkers to establish long-term foster care as a child?s “permanency” goal. However, in some States, these efforts do not apply equally to all children. Children who are “older,” who have disabilities, or who have behavior/emotional problems often are classified by child welfare agency staff and/or juvenile or family court judges as “unadoptable.” When reunification is not possible for these children labeled “unadoptable,” efforts rarely are made to seek other permanent arrangements. In one State, for example, only children age 6 or younger are eligible for a program implemented specifically to expedite permanency for children.
CFSR information also suggests that permanency for children may be enhanced when States permit guardianship as a permanency option, and, in particular, when they have established subsidized guardianship programs for relatives and/or foster parents. Finally, in some States participating in a CFSR, there were financial deterrents to permanency, particularly for older children. For example, older children who age out of foster care often are eligible for a range of independent living services and college tuition benefits that are not available to children who have been adopted from the system or who are in a legal guardianship arrangement. The Federal Chafee Foster Care Independence Program (CFCIP) does permit States to use CFCIP funds for children who have been adopted or who have been discharged from foster care to legal guardians, if they wish to do so. However, in many States independent living services are supported by State as well as Federal funds, and States may choose not to provide independent living services or college tuition benefits to children who do not age out of foster care. In addition, at present, college tuition benefits are determined by State policies or laws and are not affected by the availability of Federal funds through the CFCIP.
For the Outcomes Reports, the performance of States with regard to increasing permanency for children is assessed by the following five measures:
• Measure 3.1: For all children who exited foster care,
what percentage left either to reunification, adoption, or legal
guardianship?
• Measure 3.2: For children who exited foster care and were
identified as having a diagnosed disability, what percentage left
either to reunification, adoption, or legal guardianship?
• Measure 3.3: For children who exited foster care and were
older than age 12 at the time of their most recent entry into care,
what percentage left either to reunification, adoption, or legal
guardianship?
• Measure 3.4: Of all children exiting foster care to
emancipation, what percentage was age 12 or younger at the time of
entry into care?
• Measure 3.5: For all children who exited foster care, what
percentage by racial/ethnic category left either to reunification,
adoption, or legal guardianship?
In the analyses conducted on these measures (excluding measure 3.4), exits to reunification, adoption and legal guardianship were grouped together as “exits to permanency.” The key findings of the analyses of each measure are presented below.
Outcome measure 3.1. Forty-six States provided sufficient data to calculate measure 3.1 in fiscal year (FY) 2000. As shown in figure 5, States included in this analysis exhibited high levels of performance. The percentages of children exiting to permanency ranged from 68.6 to 94.5, with a median of 84.7 percent. In 11 States (24 percent), more than 90 percent of the children exiting foster care during fiscal year (FY) 2000 exited to permanency.
Forty-five States reported sufficient data for this measure for FY 1999 and 2000. The percent change from 1999 to 2000, depicted in figure 6, ranged from +20.2 percent to -12.9 percent, with a mean percent change of .9 and a standard deviation of 5.2. Five States (Ohio, Georgia, Minnesota, Tennessee, and New Hampshire) exhibited substantial improvements in performance on this outcome. In contrast, five States (DC, Rhode Island, Massachusetts, Louisiana, and Utah) demonstrated substantial declines in performance.
At this time, it is not clear whether changes in performance on outcome measure 3.1 from 1999 to 2000 reflect real changes in the attainment of permanency for children, or whether data quality issues may account for the observed changes. In general, however, in most States, the majority of children exiting foster care are exiting to permanent homes. Even those States exhibiting substantial declines in performance on this measure from 1999 to 2000 continued to demonstrate high percentages of children exiting to permanent homes.
Outcome measure 3.2. Measure 3.2 was designed to assess whether a State?s effectiveness in finding permanent homes for children exiting foster care in FY 2000 applied equally to children with a diagnosed disability. Because not all States are consistent in their reporting of the AFCARS data element pertaining to diagnosed disability, only 37 States were included in the data analyses for this measure.5
The distribution of performance on this measure across the 37 States included in the analysis is shown in figure 7. The percentages of children with diagnosed disabilities exiting foster care to a permanent home ranged from 55.9 to 96.7, with a median of 78.8 percent. In 15 States, more than 80 percent of the children with a diagnosed disability exited to a permanent home.
An independent t-test to assess differences between means was conducted to compare the performance of States on outcome measure 3.2 in FY 2000 with performance on outcome measure 3.1 in FY 2000. The purpose of the statistical test was to determine whether the population included in outcome measure 3.2 (children with a diagnosed disability) represented a distinct subsample of the population included in 3.1 with regard to attainment of permanency for children exiting foster care in FY 2000. This analysis resulted in the finding of a significant difference in the performance of States on measures 3.1 and 3.2 (t=2.9; p=0.005), indicating that States experienced significantly less success in achieving permanency for children with a diagnosed disability who exited care than in achieving permanency for all children who exited foster care.
Changes in performance from 1999 to 2000 for measure 3.2 are depicted in figure 8. The percent change ranged from -15.4 to +22.8, with a mean percent change of 1.7 (SD = 8.2). Four States (Georgia, Montana, Tennessee, and New Hampshire) exhibited substantial improvements in performance on this measure; for two of these States (New Hampshire and Tennessee) the percent change was more than two standard deviations from the mean. Four States (South Carolina, Louisiana, South Dakota and North Carolina) exhibited substantial declines in performance on this measure.
The findings for the analysis of measure 3.2 suggest that, although many States are experiencing some success in achieving permanency for children with a diagnosed disability, greater efforts are needed to find permanent homes for these children. The findings with regard to attaining permanency for these children are consistent with preliminary information from the CFSRs indicating that in some States, child welfare agency staff and/or juvenile or family court judges do not make concerted efforts to establish permanency goals of adoption or guardianship for children with disabilities for whom reunification is an unlikely option.
Outcome measure 3.3. Measure 3.3 was designed to assess whether a State?s effectiveness in attaining permanency for children exiting foster care applied to children who were older than age 12 when they entered foster care. The distribution in performance for the 40 States providing sufficient data for this measure is presented in figure 9. The percentage of children exiting foster care to a permanent home who entered foster care when they were older than age 12 ranged from 37.0 to 87.5, with a median of 72.6. This median is 12 percentage points less than the median for outcome measure 3.1.
An independent t-test was conducted to compare the performance of States on this measure with their performance on measures 3.1 and 3.2. The difference in performance on measures 3.3 and 3.1 was found to be significant (t =7.3; p=0.0001), indicating that children exiting foster care who were older than age 12 at the time of entry into foster care represent a distinct subsample of the total population. These children were significantly less likely to exit foster care to a permanent home than all children who exited foster care in FY 2000. The performance of States on measures 3.3 and 3.2 also was found to be significantly different (t=3.5; p=0.001). This finding indicates that children who were older than age 12 at the time of entry into foster care were significantly less likely than children with a diagnosed disability to exit foster care to a permanent home.
An additional finding with regard to measure 3.3 is that when these children do exit to permanency, they exit to reunification. In fact, the mean percent of exits to reunification in FY 2000 for children who were older than 12 at the time of entry into foster care was 67.3, which accounts for a substantial portion of the mean percent of exits to all permanency options (70.3). Exits to adoption and guardianship were rare occurrences for these children, although exits to guardianships occurred more frequently than exits to adoption. Although there were only 3 States (Illinois, Indiana, and Montana) in which more than 2 percent of these children exited to adoption, there were 18 States in which more than 2 percent of these children exited to guardianship.
Forty States provided sufficient data to assess change in performance on this measure from FY 1999 to FY 2000. As shown in figure 10, the percent change ranged from -14.1 to 17.7, with a mean percent change of 1.0 (SD = 7.4). Seven States (New Mexico, Minnesota, Connecticut, Georgia, Tennessee, New Hampshire, and Florida) exhibited substantial improvements in performance on this measure from 1999 to 2000. Substantial declines in performance on this measure were found for five States (Rhode Island, Michigan, Utah, Louisiana, and Virginia). The findings for the analysis of outcome measure 3.3 are consistent with preliminary CFSR information indicating that in some States participating in the CFSR, child welfare agency staff and/or judges were unlikely to establish adoption or guardianship as a permanency goal for older children if reunification is not possible. For the most part, the findings suggest that greater efforts are needed to find permanent homes for children who enter foster care as teenagers and for whom reunification does not appear to be a likely outcome.
Outcome measure 3.4. The primary purpose of outcome measure 3.4 is to assess the percentage of children “aging out” of foster care who were age 12 or younger when they entered foster care. For these children, foster care may be viewed as the “place” where they grew up. Because it is a basic tenet of the Department that foster care is a temporary arrangement, States? performance on this measure is of considerable interest.
In FY 2000, 45 States provided data sufficient to calculate this measure. As shown in figure 11, the percentages of children who were emancipated from foster care, and who were age 12 or younger when they entered foster care, ranged from 0.0 to 61.2, with a median of 24.2 percent (SD = 13.2). Most States fell below the midpoint (30.6 percent) of the range. However, 15 States were above the midpoint of the range with more than 31 percent of the children emancipated from foster care being age 12 or younger when they entered foster care.
The analysis of change in performance on this measure from 1999 to 2000, depicted in figure 12, indicates a range in percent change from -54.1 to 89.8 (SD=25.0 percent). Six States (DC, Georgia, Delaware, Hawaii, Montana, and Utah) exhibited substantial improvements in performance on this measure (SD=25.0 percent). Although three States (Rhode Island, Wyoming, and Iowa) exhibited substantial declines in performance on this measure, these States still exhibited relatively small percentages of children aging out of foster care who were age 12 or younger when they entered foster care.
The findings for this measure are difficult to interpret because not all States consistently report “emancipation” as a discharge reason for children aging out of foster care. Because children who leave foster care when they become of age often go to live with their parents or relatives, some States will report this as a discharge to reunification. In addition, some States do not have “emancipation” as a discharge reason in their own systems, and the reason provided may be recorded in AFCARS as missing data. Finally, in some States, children are not automatically emancipated from foster care at age 18, but may no longer be reported to AFCARS. Although these data issues remain to be resolved, the available data suggest that greater efforts are needed in some States to ensure that young children entering foster care exit to permanent homes as quickly as possible.
Outcome measure 3.5. Measure 3.5 is designed to assess whether the performance of States with respect to achieving permanency for children exiting foster care varies as a function of children?s race or ethnicity. Figure 13 provides the results of the analysis of States? effectiveness in achieving permanency for White children (excluding children of Hispanic origin) compared to Hispanic children. This comparison includes only the 14 States in which at least 10 percent of the children exiting foster care were reported to be Hispanic.6 As demonstrated in figure 13, for all of the States except Utah and Nevada, the rate of exits to permanent homes did not differ as a function of race/ethnicity. In Utah, 90.7 percent of Hispanics exited to permanency compared to only 77.1 percent of White children; in Nevada, 51.1 percent of Hispanic children exited to permanency compared to 42.1 percent of White children. A t-test comparing percentages of exits to permanent homes for Hispanic and White children resulted in a finding of no significant difference (t=0.591, p=0.560).
Figure 14 provides the results of the analysis of States? effectiveness in achieving permanency for White children compared to Black children for the 33 States in which at least 10 percent of the children exiting foster care were Black and at least 10 percent were White. As shown in the graph, exits to permanency for these States did not vary as a function of race, with the possible exception of Kentucky, in which 65.4 percent of the Black children exited to permanent homes compared to 74.2 percent of White children. The t-test comparing percentages of exits to permanent homes for Black children and White children resulted in a finding of no significant difference (t=0.647; p=0.520).
For Native American children, the analysis focused on 12 States in which at least 5 percent of the children exiting foster care were Native American. Figure 15 provides the comparisons for these States. As shown in the figure, the difference between exits to permanency for Native American children compared to White children was considerable in Nebraska, Washington, North Dakota, and New Mexico, with White children far more likely to exit to permanent homes than Native American children. In addition, although the t-test conducted to compare these variables for the 12 States did not reach the 0.05 level of significance, it did approach significance (t=1.84; p=0.080).
Summary of findings for measures for outcome 3
The analyses of the five measures developed to assess outcome 3 indicate that most States experienced success in achieving permanency for children exiting foster care in FY 2000. In addition, in most States, success in achieving permanency for these children did not vary as a function of the child?s race or ethnicity. It should be noted, however, that this measure does not assess time to permanency, only the attainment of permanency.
Despite the general success in attaining permanency, the analyses also demonstrate that success did not apply equally to all children. Children with diagnosed disabilities and children who were older than age 12 at the time of entry into foster care were at greater risk than other children of not exiting foster care to a permanent home. In fact, children who were older than age 12 at the time of entry into foster care were at greater risk than children with a diagnosed disability of not achieving a permanent home by the time they exited foster care. Another finding of concern pertained to the percentages of children exiting foster care to emancipation who were age 12 or younger when they entered foster care. Although in most States this percentage was quite low, there were a number of States in which a substantial percentage of children who exited foster care in FY 2000 may be said to have grown up in the child welfare system.
Changes in performance from 1999 to 2000 across the measures did not follow any clear pattern. For almost all measures, as many States exhibited improvements in performance as exhibited declines in performance. With additional years of data, it should become clearer whether changes in data from 1999 to 2000 reflect real changes in performance or changes in data quality.
Outcome 4. Reduce time in foster care to reunification without increasing re-entry
Although achieving permanency for children is an important goal in general, it also is important that permanency be achieved as quickly as possible so that children spend a minimal amount of time in temporary living arrangements. The timeliness of permanency was a key issue addressed in the Adoption and Safe Families Act (ASFA) of 1997, and is a major focus of the Department?s CFSR. As a result of the concern regarding timeliness of permanency, the Department developed a measure to assess time to reunification for children exiting foster care. However, to ensure that reunification is not achieved at the expense of children?s safety, a second outcome measure was developed to assess the rate of re-entry into foster care.
Preliminary CFSR information indicates extensive variations among States with regard to the timeliness of reunifications. Some States participating in the CFSR during FY 2001 and FY 2002 were found to make diligent efforts to reunify families in a timely manner. In these States, the child welfare agency consistently provided services to parents to reduce the risk of harm to children, placed children in proximity to parents, ensured that the frequency of visitation between children and parents met their needs, provided services to ensure that the bond between parents and children was maintained or promoted, and/or involved families in the case planning process on an ongoing basis. Also, courts in these States were diligent in adhering to ASFA timelines and conducting permanency hearings. Other States, however, were found to be less consistent with respect to these efforts.
Variation among States also was found for the frequency of re-entries into foster care. A key problem identified by the CFSRs pertaining to re-entry into foster care was that many States are not consistent in the provision of post-reunification services to support families after children are returned home.
The measures assessing outcome 4 for the Outcomes Report are the following:
• Measure 4.1: Of all children who were reunified with
their parents or caretakers at the time of discharge from foster
care, what percentage was reunified in the following time
periods?
(1) Less than 12 months from the time of latest removal from
home
(2) At least 12 months, but less than 24 months
(3) At least 24 months, but less than 36 months
(4) At least 36 months, but less than 48 months
(5) 48 or more months
• Measure 4.2: Of all children who entered foster care
during the reporting period, what percentage re-entered care in the
following time periods?
(1) Within 12 months of a prior foster care episode
(2) More than 12 months after a prior foster care episode
Outcome 4.1. In FY 2000, 51 States provided sufficient data for outcome measure 4.1. The analyses focused on the percentage of exits to reunification that occurred (1) within 12 months of the most recent entry into foster care and, (2) in 36 or more months from the most recent entry into foster care (combining data for 4 and 5, above).
As shown in figure 16, the percentages of children reunified within 12 months of entry into foster care ranged from 34.9 to 87.0, with a median of 68.0 percent. Twenty-one States (41 percent) met the national standard of 76.2 percent for this measure. However, in 5 States, fewer than 50 percent of the children were reunified within 12 months of entry into foster care. Fifty States had sufficient data to assess change in performance on this measure from FY 1999 to FY 2000. The percent change in performance, depicted in figure 17, ranged from -21 to 20.5, with a mean percent change of 2.0 (SD=7.6). Six States (North Dakota, Utah, Louisiana, Maryland, Indiana, and Georgia) exhibited substantial improvements in this measure. Five States (Maine, Nebraska, Michigan, New York, and Connecticut) exhibited substantial declines in performance; none of these five States performed higher than the median in either FY 1999 or FY 2000.
In FY 2000, the percentages of children exiting to reunification who were reunified 36 or more months after entry into foster care ranged from 0.2 to 28.1, with a median of 5.1 percent. As shown in figure 18, the majority of the States performed below the midpoint of the range (14.2 percent), with only three States (Maryland, New York, and Illinois) clustering at the upper end of the range. Overall, in 40 of the 51 States included in this analysis, less than 10 percent of the children who were reunified in FY 2000 were in care for more than 36 months.
Percent changes from FY 1999 to FY 2000 with respect to children reunified 36 or more months after entry into foster care ranged from -76.6 to +92.6, with a mean percent change of -8.7 (SD = 28.1). As shown in figure 19, thirty-three States exhibited improvements in performance on this measure from 1999 to 2000, with 7 States (Hawaii, Wisconsin, Indiana, Montana, Colorado, DC, and Texas) demonstrating substantial improvements in performance. Five States (New York, Rhode Island, Michigan, California, and Delaware) exhibited substantial declines in performance on this measure. However, in three of these States (Rhode Island, Michigan, and Delaware) the percentages of children exiting to reunification 36 or more months after entry into foster were quite small.
Outcome measure 4.2. In FY 2000, 50 States provided sufficient data to calculate re-entries into foster care. As shown in figure 20, the percentage of re-entries into foster care within 12 months of discharge from a prior foster care episode ranged from 0.9 to 27.7, with a median of 10.3 percent. Eighteen States (36 percent) met the national standard of 8.6 percent. In 5 States (10 percent), more than 20 percent of the children entering foster care in FY 2000 were re-entering care within 12 months of discharge from a prior episode.
Change in the performance of States on this measure from FY 1999 to FY 2000 for the 48 States with sufficient data for both years is depicted in figure 21. The percent change in performance ranged from -83.2 to +87.5, with a mean percent change of 4.8 (SD=27.8 percent). Four States (DC, Wisconsin, Maine, and Connecticut) exhibited substantial improvements in performance with regard to re-entries into foster care, while six States (Georgia, Virginia, Florida, Vermont, Kansas, and Idaho), exhibited substantial declines in performance. However, in four of these States (Georgia, Virginia, Florida, and Kansas), the percentage of re-entries in FY 2000 remained quite small and below the national standard.
An analysis also was conducted on the percentages of children entering foster care in FY 2000 who were re-entering foster care in more than 12 months from discharge from a prior foster care episode. These percentages ranged from 0 to 17.8, with a median of 7.0. In 10 States (20 percent), at least 10 percent of the children entering foster care were re-entering more than 12 months from discharge from a prior episode.
The relationship between reunification and re-entry
In order to assess attainment of outcome 4 (reduce time in foster care without increasing re-entry) the relationship between reunification within 12 months and re-entry into foster care within 12 months of discharge from a prior episode was examined. For FY 2000, the correlation (Pearson?s r) between the percent of reunifications occurring within 12 months of entry into care and the percent of re-entries into foster care within 12 months of discharge was .50 (p=0.0001). States that had a high percentage of reunifications within 12 months tended to have a high percentage of re-entries into foster care within 12 months. States with a low percentage of reunifications within 12 months tended to have correspondingly lower percentage of re-entries. Of the 21 States that met the national standard of 76.2 percent for reunifications within 12 months of entry into foster care, only 2 (Wyoming and South Carolina) also met the national standard for re-entries into foster care. These findings raise the question of whether in some States children are being reunified before families have made the changes necessary to ensure that the risk of harm to children is no longer present.
The relationship also was examined between the performance of States (in FY 2000) with regard to reunifications within 12 months and re-entries that occurred more than 12 months after discharge from a prior foster care episode. This correlation did not approach significance (Pearson?s r=0.20; p=0.163), suggesting that expedited reunifications may be related to early re-entries into foster care, but not to re-entries that occur after children have been home for more than a year. This suggests that the first 12 months after reunification may be a particularly vulnerable time for families and that services are needed during this time period to support the children?s reintegration into the family.
Outcome 5 - Reduce time in foster care to adoption
In recent years, extensive Federal efforts have focused on promoting adoption of children from the foster care system and expediting the adoption process for them and their adoptive families. ASFA addressed the issue of adoption through its requirement that States seek termination of parental rights (TPR) for children who have been in foster care for 15 of the most recent 22 months, unless there are compelling reasons for not doing so. ASFA also promoted adoption by expanding adoption-assistance subsidies. The Department promotes the ongoing development of strategies and effective practices for increasing and expediting adoptions through a discretionary grant program called the Adoption Opportunities Program, a number of adoption-related resource centers, and a Clearinghouse on adoption information. The attainment of finalized adoptions in a timely manner is one of the primary indicators assessed in the CFSR.
Over the past few decades, professionals in the child welfare field have developed and implemented several strategies designed to expedite adoptions. These include, but are not limited to, concurrent planning, family group conferencing, mediation, the establishment of specialized adoption units or adoption specialist positions, and expedited permanency programs. Preliminary CFSR findings indicate that in many States, these practices are not implemented with sufficient frequency or adequate quality to consistently promote timely attainment of finalized adoptions.
The measure designed to assess outcome 5 is the following:
• Measure 5.1: Of all children who exited foster care
to a finalized adoption, what percentage exited care in the
following time periods?
(1) Less than 12 months from the time of the latest removal from
home
(2) At least 12 months but less than 24 months
(3) At least 24 months, but less than 36 months
(4) At least 36 months, but less than 48 months
(5) 48 or more months
The findings of the data analyses of the performance of States regarding adoptions occurring within 24 months of entry into foster care and adoptions occurring 48 or more months after entry into foster care are presented and discussed below.
Adoptions within 24 months of entry into foster care. As shown in figure 22, for the 48 States with sufficient data for this measure, the percentages of children exiting to a finalized adoption within 24 months of entry into foster care ranged from 4.6 to 72.4 with a median of 19.7. Ten of the 48 States (21 percent) included in this analysis met or exceeded the national standard of 32.0 percent.7
Forty-six States provided sufficient data for this measure in FY 1999 and FY 2000. The percent change from 1999 to 2000 for these States, depicted in figure 23, ranged from -71.9 to +148.1, with a mean percent change of 4.3 (SD=42.3). Five States (New York, Virginia, Massachusetts, Mississippi, and Delaware) exhibited substantial improvements in performance on this measure. In contrast, eight States (New Mexico, DC, Nebraska, Florida, California, Maryland, Connecticut, and North Dakota) exhibited substantial declines in performance on the measure.
Interpreting change in performance on this measure is difficult because, for some States, the percentages provided for FY 1999 and FY 2000 are dramatically different, suggesting that differences may reflect changes in data quality rather than in performance. In New Mexico, for example, the percentage of children experiencing an adoption within 24 months in FY 1999 was 70.7, while in FY 2000, it was 19.8.
Adoptions occurring 48 or more months after entry into foster care. Forty-eight States provided data sufficient to calculate this measure. Figure 24 provides the distribution across States for this measure, which ranged from 0 percent to 68.2 percent, with a median of 31.5 percent. In 21 States (44 percent), over one-third of the finalized adoptions occurred 48 or more months after the child?s entry into foster care; in 4 of those States, more than 50 percent of the finalized adoptions took place after the child had been in foster care for 48 or more months.
Changes from FY 1999 to FY 2000 for the 46 States providing data in both years are depicted in figure 25. The percent change ranged from -60.5 to +61.5, with a mean percent change of -1.3 (SD=27.3). Six States (Arkansas, Utah, Delaware, Wyoming, Vermont, and Oregon) demonstrated substantial improvements in performance on this measure, while 9 States (Maryland, West Virginia, Michigan, California, Nebraska, Rhode Island, Kentucky, Florida, and Connecticut) exhibited substantial declines in performance.
Summary of findings for Outcome 5
Despite possible data problems, the performance of the States on this outcome in FY 2000 suggests that concerted efforts are needed in many States to improve the timeliness of adoptions. This is consistent with information from the CFSR reviews indicating that there are still many barriers to achieving finalized adoptions within 24 months of a child?s entry into foster care. These barriers range from casework practice problems to court-related problems such as crowded court dockets and court requirements for termination of parental rights.
However, it is possible that a State?s lower percentages of children exiting to adoption within 24 months of entry may be due to the State?s efforts to find adoptive placements for children who have been in care for long periods of time. If this proposition is valid, then States should exhibit declines in the percentages of children achieving a finalized adoption 48 or more months after entry into foster care as the children in foster care for long periods of time achieve their adoption goals. In FY 1999, there were 6 States (Mississippi, New Hampshire, Massachusetts, Illinois, New York, and Tennessee) in which over 50 percent of the children exiting to adoption had been in foster care for 48 or more months. Although all of these States exhibited declines in this percentage in FY 2000, the percent change was fairly small, ranging from -0.4 (in Tennessee) to -27.4 (in Mississippi). It will remain to be seen whether these States continue to experience declines in the percentages of children achieving adoption in 48 or more months, and increases in percentages of exits to adoptions occurring within 24 months of entry into foster care.
Outcome 6: Increase placement stability
When children are removed from their homes and placed in the care and custody of the State, it is not only imperative that they be placed in safe environments, but also that they experience stability and security in their living arrangements. Despite the importance of the stability of living arrangements, the common perception is that children in foster care are “bumped around” from place to place. The findings of the CFSR review suggest that this perception may be accurate for many children in foster care. Although some States participating in the CFSR in FY 2001 and FY 2002 experienced success in placing children in stable living arrangements, others were not consistently effective in ensuring placement stability.
Preliminary information from the CFSRs identified the following practices as associated with frequent placement changes: (1) a reliance on shelter care when children first enter care or when a placement disrupts; (2) a lack of careful matching between children?s needs and placements because of an insufficient number of available foster care placements (including group homes as well as foster homes); (3) too few foster care placements for children with behavioral problems; and (4) insufficient assistance provided to foster families when placements are at risk of disruption. Stakeholders interviewed as part of the CFSR process frequently expressed the opinion that the use of relatives as foster care providers generally resulted in greater stability in foster care placements.
The measure designed to assess this outcome is:
• Measure 6.1: Of all children served who had been in
foster care for the time periods listed below, what percentage had
no more than two placement settings during that time period?
(1) Less than 12 months from the time of latest removal from
home
(2) At least 12 months but less than 24 months
(3) At least 24 months but less than 36 months
(4) At least 36 months but less than 48 months
(5) 48 or more months
In FY 2000, 50 States provided data to calculate this measure. The analysis focused on the percentages of children in foster care for less than 12 months who experienced no more than 2 placements. The distribution across States for this measure, which is presented in figure 26, demonstrates that 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. Seventeen States (34 percent) met the national standard of 86.7 percent.
Forty-nine States were included in the analysis of change in performance from 1999 to 2000. The range with respect to percent change was from -16.2 to +27.3, with a mean percent change of 0.6 (SD=6.8 percent). As shown in figure 27, the vast majority of States exhibited minimal changes in this measure primarily because many of them were already performing in the high end of the range. Four States (Arkansas, Indiana, Utah and Vermont) exhibited substantial improvements in this measure, while three States (Tennessee, Kentucky, and DC) demonstrated substantial declines in performance on this measure.
As noted in Chapter 2, the reporting of placement changes to AFCARS has not been consistent across States, although consistency is expected to improve in the future with the clarification of guidelines issued by the Department in July of 2002. In the near future, the Department will be able to attribute changes over time on this measure to changes in the performance of a State rather than to changes in data reporting. Although the existing data issues make it difficult to interpret performance, there is some indication that 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.
Outcome 7: Reduce placements of young children in group homes or institutions
An ongoing concern in the field of child welfare pertains to the placement of young children in group homes or institutions. Although many States have established policies that restrict the placement of young children in these settings, these policies are not always followed. In addition, in many States, this policy may apply to very young children, such as toddlers and infants, but not to “older children,” who may be only 7 or 8 years old. 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 group homes or institutions, others frequently used group homes, particularly shelters, as placement venues for children of all ages.
This outcome is assessed by the following measure:
• Measure 7.1: For all children who entered foster care during the reporting period and were age 12 or younger at the time of their most recent placement, what percentage was placed in a group home or institution?
Fifty States provided sufficient data in FY 2000 to calculate this measure. As shown in figure 28, the performance of States on this measure ranged from 1.3 percent to 27.2 percent, with a median of 9 percent. In 4 States (Arizona, Minnesota, DC, and Iowa), over 20 percent of the children who entered foster care in FY 2000 who were age 12 and younger were placed in group homes or institutions. In 9 States (Hawaii, Washington, Utah, Arkansas, Ohio, Illinois, Kansas, Alaska, and Vermont), less than 5 percent of these children were placed in group homes or institutions.
The percent change in performance on this measure, depicted in figure 29, ranged from -88.2 to +139.7 percent with a mean of -3.0 (SD = 35.3). Five States (Utah, Hawaii, Georgia, Arkansas, and Vermont) exhibited substantial improvements in performance on this measure, while 6 States (Delaware, DC, West Virginia, Montana, North Dakota, and Connecticut) exhibited substantial declines in performance.
The overall findings for this measure suggest that some States are placing a high percentage of young children in group homes and institutions. However, the fact that most States exhibited declines in this measure from 1999 to 2000 is a positive indication that States are attempting to keep young children in family rather than group settings.
Summary of Key Findings
In general, the key findings reported in this chapter suggest that much work needs to be done by States, with technical assistance from the Department, 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 systems. It is anticipated that with the ongoing efforts of the Outcomes Reports, the CFSRs, and the Department?s child welfare-related resource centers (identified in Appendix I), States will begin to exhibit greater and more consistent improvements on these outcomes.
At present, however, the performance of many States on the outcome measures indicates that there are more challenges than successes. With regard to children?s safety, for example, the rate of recurrence of maltreatment is substantial in many States. 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.
On a more positive note, 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. However, States were less successful in finding permanent homes for children who were older than age 12 when they entered care, or who have a diagnosed disability. One clearly positive finding is that children who are Hispanic or Black (excluding children of Hispanic origin) are as likely to exit to permanency as are children who are White (excluding children of Hispanic origin). In several States, however, Native-American children were found to be less likely than White children to exit to permanent homes.
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.
Another area of concern pertains to the time children are in foster care before exiting to a finalized adoption. Despite the multitude of efforts that have been implemented over the past decade to expedite adoptions (such as mediation, concurrent planning, use of adoption specialists, and family group decision making), the data suggest that many States are continuing to experience difficulties finalizing adoptions in a timely manner. Through the CFSR, many barriers to timely adoptions have been identified, ranging from casework practice issues to crowded court dockets and parents? appeals of termination of parental rights decisions. It is anticipated that States will begin to address these barriers as part of their program improvement plans.
The outcome regarding placement stability appears highly positive when the assessment focuses on the placements experienced by children who have been in foster care for less than 12 months. However, the data demonstrate that the number of placements increases as time in foster care increases, indicating that long-term placement stability is an issue that many States need to address.
For the last outcome pertaining to placements of young children in group homes or institutions, it is clear that, in most States, this is not a common practice. However, because group-like placements are in most cases inappropriate for young children, even a small incidence of this occurrence raises concerns regarding children?s well-being.
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 time lines as the agency, or has differing perceptions of what children need with regard to permanency goals. Preliminary CFSR information indicates that these external barriers and challenges exist in almost all of the States participating in a CFSR thus far. Consequently, a key focus of Department and State efforts must be on supporting greater collaboration among agencies and institutions serving these children and families, and ensuring that key gaps in services are addressed.
While this chapter has focused on the performance of States taken together, the next chapter provides data relevant to the performance of individual States on each of the outcome measures. The number of States reporting for each measure is provided in Appendix J. For those States that have participated in a CFSR, a Federal Comment page is included with the State data that integrates findings from the CFSR with the performance of States on the seven national child welfare outcomes.
1 For purposes of this report,
the designation of “State” includes the District of
Columbia and Puerto Rico. Therefore, technically, 52 entities may
report data for each of the measures. However, because Puerto Rico
did not report sufficient data to calculate any of the measures, it
is not included in any of the analyses. Back
2 Some, but not all, States
submitted revised 1998 data in 2002. Back
3 States were excluded from
analyses of a given measure if 20 percent or more of the data for
the measure were classified as “missing data,” or if
the validity of the data was highly questionable. Back
4 A percent change differs from a
change in percentage points. For example, if the percent of
reunifications within 12 months is 50 percent in 1999, and 75
percent in 2000, the percent change would be a 50 percent increase.
That is, year 2 minus year 1 divided by year 1. Back
5 States were excluded from the
analyses if more than 20 percent of exits did not have
“reason for discharge” information or if the percentage
of children exiting care who were identified as having a diagnosed
disability was less than one standard deviation below the mean for
all States reporting data for this measure. Back
6 The 10-percent level was chosen
to ensure that there were a sufficient number of children
represented in the group for a meaningful comparison. Back
7 States were excluded from this
analysis when their data pertaining to discharges to adoptions in
FY 2000, as reported to the AFCARS Foster Care Database, were
considerably different from their data pertaining to the number of
finalized adoptions in FY 2000 reported to the AFCARS Adoption
Database. Back
