I. Introduction
This report, Child Welfare Outcomes 1998: Annual Report, is the first in a series of annual reports from the Department of Health and Human Services required by the Adoption and Safe Families Act of 1997 (ASFA). Its purpose is to present data on State performance in meeting the needs of children and families who come into contact with the child welfare system, focusing specifically on the "outcomes," or results, for these children. The outcomes presented in this report were developed by the Department of Health and Human Services (the Department) in consultation with State officials, advocates, and other experts in the field and reflect widely held performance objectives for child welfare program practice. The outcomes follow:
- 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 report establishes the baseline performance of each State for which data are available on each outcome measure and will be the basis for assessing State progress on the measures in the future. |
This introductory chapter depicts the child welfare system as seen through the perspective of children in the system. It also describes the current challenges in child welfare, the Congress' and Department's response to these challenges, and the material that is presented in the remaining sections of this report.
The Faces of Children in Need
Many children enter the child welfare system because they have been abused or neglected by their families. Other children come to the attention of the system because their families have not been able to meet their emotional and developmental needs. Still others, mainly older children, enter the child welfare system because their own behavior makes them unable to live with their families.
Each year, almost 3 million children are alleged to have been abused or neglected, and nearly 1 million are found to have been victims of maltreatment. As of September 30, 1998, an estimated 560,000 children were living in foster care in the United States. The median length of stay for these children was almost 2 years, and more than one-third of these children had been in foster care for 3 or more years. Approximately 122,000 children were unable to return to their parents' homes and were waiting for new permanent families. (See appendix A for additional national statistics.)
| Based on 1997 data from 43 States, more than half of all victims of maltreatment suffered neglect, while almost a quarter suffered physical abuse. |
As troubling as these statistics are, the real challenges of child welfare are most clearly illustrated by looking at the experience through the eyes of a child.
One day my mother did not come home. I was all alone with my little brother, David. He began to cry and so I carried him around a while. Then we ate something in the kitchen. The next day she still didn't come home. When we had no more food, I went to the neighbors. They called child welfare. We went to foster care, but David went to one family and me to another. I am still waiting for my mother to come get me. Amy, age 11
I have been in foster care for 5 years and been in four foster homes. The last place I lived, I really hated. No one liked me and I didn't like anyone either. I really liked my first family and wish I could go back there. My social worker comes now and then, but she doesn't know what to do with me. I'm going to run away soon. William, age 13
My mom and dad fight a lot. Some days my mother looks real bad. One day a neighbor called the social worker. The social worker came to our apartment and told my parents that all the shouting and yelling wasn't good for us kids. I think that they are going to counseling now. Sometimes the social worker comes to see us to be sure that we are okay. My mom seems happier now. Jimmy, age 8
I was living with my grandmother and my two little brothers. My dad is an addict and I don't know where my mother is. One day a social worker came and took us all away. I am living with a foster family. They treat me real good, even better than my mom did. I miss my brothers and my dad. I am afraid that my brothers will forget me. Patrice, age 9
As the experiences of these children demonstrate, the complexities of meeting the needs of children present major challenges. Service providers must work to assure the continuity and stability of foster care placements, reduce the time children spend in foster care, assist parents in resolving problems so children can be reunified, and increase the opportunities for adoption for children in foster care who cannot be safely returned to their own families.
The Challenges Faced by the Child Welfare System
No single agency or group in a community can resolve all of the problems children face. Meeting the needs of these children requires the collective work of many professions, community organizations, and Government agencies. However, public child welfare systems are charged with (1) protecting children who have suffered maltreatment or are at risk for maltreatment and (2) securing permanent living arrangements for children who are unable to live at home. These agencies must ensure that children are safe in their homes, removed if they are not safe, returned to their families if their safety can be assured, or adopted by a new family if returning home is not feasible.
As they work to accomplish these objectives, child welfare professionals face many difficult challenges. They must balance respect for family privacy with the need to protect children from abuse and/or neglect; they must balance children's need for a safe environment with children's need to return to their birth families. They must also balance children's need for connection to their birth families with the possible need to find them safer, alternative families.
Over the past 10 years, there have been a number of high-profile child deaths due to maltreatment and an increase in the number of children in foster care. This has led policymakers, legislators, child welfare administrators, and child advocates to become increasingly concerned that the child welfare system has not been able to strike the right balance between safety and permanency and, hence, has fallen short in meeting children's needs. Fortunately, public debate and concern over the fate of children in child welfare has generated a productive climate of reform as people around the country have begun to address new and innovative ways to focus attention on improved results for children.
| A trigger for concern-by the public, the Congress, and the media-is the number of high-profile child deaths across the country. |
Responding to the Challenges
In reaction to these and similar challenges, on November 19, 1997, the President signed into law the Adoption and Safe Families Act of 1997 (ASFA). This legislation, passed by the Congress with overwhelming bipartisan support, represents an important landmark in Federal child welfare law. First and foremost, it establishes unequivocally that our national goals for children in the child welfare system are safety, permanency, and well-being. It puts into place key provisions to ensure that child safety is the paramount concern in all child welfare decision-making, to shorten the timeframes for making permanency planning decisions, and to promote the adoption of children who cannot safely return to their own homes. Section 203 of ASFA requires, for the first time, the development of a set of outcome measures that can be used to assess the performance of States in achieving the national child welfare system goals. Through ASFA, policymakers and the public have asked for a new level of accountability from public child welfare agencies serving children and families. As a result, States are being asked to demonstrate that their programs have actually made a positive difference in the lives of children.
| Following the passage of ASFA, the Department held 37 focus group meetings nationwide and convened 10 regional conferences to get early feedback on ASFA implementation issues, including the performance measurement requirements in section 203. |
Section 203 of ASFA also requires the Department to submit two reports to the Congress. Child Welfare Outcomes 1998: Annual Report is one of the required reports. The other report, which will be issued later this year, will address performance-based incentive systems for child welfare. (Section 203 can be found in appendix B.)
ASFA's emphasis on outcomes reflects a broader concern with ensuring positive results in the field of child welfare in general. The Government Performance and Results Act of 1993 (GPRA), P.L.103-62, requires all programs in the Federal Government to develop specific goals and outcome measures on which to assess the performance of Federal agencies. In response to the GPRA requirements, the Department has developed annual performance plans and annual performance reports. Within the Department, the Children's Bureau (the Federal agency with oversight responsibility for State child protection and child welfare programs) identified several key outcomes for monitoring the Children's Bureau's performance, which are included in the Department's annual performance plans and reports. In the future, Federal agency budgets may be linked to their performance on the measures.
A focus on results is also at the heart of the new Child and Family Services (CFS) reviews the Department is implementing to assess the performance of State child welfare systems. The new CFS review process was published in a final rule in the Federal Register (65 FR 4020-4093) on January 25, 2000. The reviews use statewide data indicators and qualitative information, obtained from intensive on-site reviews, to determine State achievement in two areas: (1) outcomes for children and families in the areas of safety, permanency, and well-being; and (2) systemic factors that directly impact the State's capacity to deliver services that support improved outcomes. Unlike previous review systems, which focused exclusively on procedural compliance, States now will be required to demonstrate that children and families served by the child welfare system are experiencing positive results.
| All 50 States and the District of Columbia will participate in a Child and Family Services review over the next 4 years. |
To the extent possible, the statewide data indicators used in the CFS reviews have been coordinated with the child welfare outcome measures found in chapter II of this report, such as the incidence of child abuse and/or neglect in foster care, length of time to achieve adoption and reunification, and stability of foster care placements. Because a State's performance in the CFS review is linked to its performance on these outcome measures, future annual reports will identify State CFS review results.
In a number of programs, Federal funding is being tied to successful State performance. For instance, the Adoption Incentive Program, also authorized by ASFA and first recommended by President Clinton as part of the Adoption 2002 initiative to double the annual number of children adopted from foster care, provides per-child financial incentives to States that succeed in increasing the number of children adopted from foster care.
| Thirty-five States qualified for $42,510,000 in adoption bonuses for their FY 1998 performance. |
Another important part of current Federal-State efforts to reform child welfare is the Child Welfare Waiver Demonstration Program, authorized under section 1130 of the Social Security Act (the Act) and expanded and extended to FY 2002 under ASFA. These demonstrations involve the waiver of certain requirements of titles IV-B and IV-E of the Act that govern foster care, adoption assistance, independent living, child welfare services, promoting safe and stable families, and related expenses for title IV-E program administration, training, and automated systems. The program allows States the flexibility to use existing funds to develop creative approaches to achieve permanency for children. The States can design and demonstrate a wide range of approaches to improve and reform child welfare. The demonstrations have specific program goals and outcome measures, which collectively are aimed at improving permanency outcomes for children. Here too, Federal-State efforts are working to ensure that innovations in financing and service delivery actually result in improved outcomes for children and families.
| As of September 1999, 21 States and the District of Columbia had received approval for 24 child welfare waiver demonstration projects. |
Through the new CFS reviews and these other efforts, the Department is supporting a shift to an outcomes focus. This report is part of that effort. It is framed by the overriding mission of child welfare to ensure the safety, permanency, and well-being of America's most vulnerable children.
Child Welfare Outcomes 1998: Annual Report
Child Welfare Outcomes 1998: Annual Report is the first of its kind. Although many States have begun to use data to report outcomes, this is the first attempt to report outcomes in child welfare on a national scale. While the Department is excited about the opportunity to improve the lives of children through outcome measurement, it recognizes that outcome measurement in child welfare is still in its infancy. Future reports will incorporate refinements and enhancements-in addition to analysis of trends-to reflect advances in outcome measurement in child welfare.
This report is organized into five chapters. Following this introductory chapter, chapter II presents the seven outcomes, the measures for each outcome, and the rationale for the selection of each of the measures. Chapter III describes the data sources used for measuring State performance on the outcomes. Chapter IV presents key findings resulting from this first year's effort and includes a summary of the best available State data on the outcome measures. Chapter V presents the individual State data pages. The State data pages consist of two pages of context data and three pages of outcome measures. Some States have included an optional page of commentary on their data as well.
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