Findings

This section provides the major findings resulting from the review of the State's AFCARS data collection. Tab A provides detailed information on the findings for the general AFCARS requirements, each of the foster care and adoption data elements, and the case file review. The AFCARS data used for the review was from the report period April 1, 2003 through September 30, 2003 (2003B).

As part of the post-site visit analysis, the State's documents, the data, the case file review findings, and team member notes are assessed to make the final determination of findings. As a result, the draft rating factors were modified from those given at the end of the on-site review. The findings matrix in Tab A reports the previous rating with a “strike-through” mark on it, and the new rating. The AFCARS Improvement Plan in Tab B contains the final rating factor.

General Requirements

Population Standards

The most significant problem with the State's reporting population is that the State is not including children placed for adoption through a private agency. The standards for the adoption population require that the State submit all adoptions that it has involvement with either due to the child being in its foster care system and/or one in which there is an adoption agreement. The State has adoption agreements with, and provides subsidies to families that adopted a special needs child through a private agency. The State is not including these adoptions in AFCARS, and must begin doing so immediately.

In regard to the foster care population, the State's program code will extract “trial home visits.” The State/counties must ensure that case workers enter situations in which a child is placed back into his/her own home while the county agency still has responsibility for care, placement, or supervision. During the site visit concern was raised that these children are not being included in the State's reporting population. Case workers must not enter these situations as a discharge from foster care; they should enter it as a placement change. If there is a specified period of time that the court has ordered the child home, the State is to continue reporting this child in AFCARS and the placement setting should be “trial home visit.” When a child is returned home for a non-specified period of time, if the timeframe extends beyond six months, for AFCARS purposes the child would then be discharged from care.

Technical Requirements

The State was not using the transaction dates associated with the date of removal and the date of discharge to extract the data file. This results in fluctuations in the number of children being reported in AFCARS each report period.

Data Element

Lack of system capacity to report certain data elements
At the time of the site visit, the State's information system, CWS/CMS, did not capture the following data elements:
- Title IV-D (Child Support) (foster care element #62) as a source of income;
- Child was placed by [agency or person] (adoption element #34)
CWS/CMS does not have the capability to collect child support information. This is a required data element for AFCARS data reporting. Completing an interface is an action item identified in the State's Statewide Child Welfare Information System (SACWIS) Assessment. Whether or not the interface is complete, the State must develop a method to collect and report if child support payments are paid on behalf of the child during each AFCARS report period. The collection and reporting of AFCARS data is required regardless of whether a State has a SACWIS. The development of SACWIS is optional for States. If a State does develop a SACWIS it must, at the time of becoming operational, be able to collect and report all of the AFCARS data. Otherwise, the State is out of compliance with the SACWIS Federal regulations.

AFCARS asks for who or what agency placed the child for adoption - the public agency, a private agency, a tribal agency, an independent person, or the birth parent. The State is incorrectly reporting this information. The program code only extracts the response “public agency.” This is incorrect because the State is also involved in non-State agency adoptions. The State enters into adoption agreements with families adopting children from private agencies where the child was determined to have special needs. These records should indicate “placed by private agency” in the AFCARS report.

Information on record numbers (foster care element #4 and adoption element #3)
For AFCARS reporting, each record has a number that must be either a sequential number or a unique, encrypted number. California submits an encrypted record number. These record numbers are to be used for a child for as long as he/she is in foster care, and regardless of where the child is placed within the state. Should a child exit foster care and re-enter in either the same or a different county the same record number should be given to the child. The State indicated to the AFCARS team that a number is assigned to the child the first time he/she receives any service and this number is used Statewide and remains the child's number.

ACF noted that the same record number appears in different submissions and may have different demographic information. The State staff indicted this may be due to the client merge functionality (i.e., merging the records when a client has been entered twice). Based on the State and ACF's analyses this element needs to be further investigated and corrections made.

Information on Children Diagnosed with Disabilities (foster care elements #10 - 15; adoption elements #11 - 15, if the primary basis for special needs is a medical/emotional condition)
The State staff indicated that this information is underreported for the foster care file. For the report period under review, the number of responses for “yes” were 45,610 (36%), 78,734 (62%) for “no,” and 2,859 (2%) for “not yet determined.”

In the foster care file, AFCARS contains the question “Has the child been clinically diagnosed as having a disability(ies)?” The State's CMS/CWS system does not have this question. Instead, the case worker selects the child's diagnosed conditions. The response to the question on diagnosed disabilities is derived from these fields. So, if a disability is checked, the response to the question is “yes.” Otherwise, the response is coded as “no,” possibly creating a false “no” in the reported data. A blank in any of the fields could mean the child has not been seen by a physician, that the worker has not received the doctor's report, or the child had been seen by a doctor and has no medical needs. The responses in AFCARS have specific definitions:

“Yes” indicates that a qualified professional has clinically diagnosed the child as having at least one of the disabilities listed below.

“No” indicates that a qualified professional has conducted a clinical assessment of the child and has determined that the child has no disabilities.

“Not Yet Determined” indicates that a clinical assessment of the child by a qualified professional has not been conducted.

Included in Tab A is a list of the State's mapping of diagnosed conditions and ACF's notes as to whether the condition should be mapped, or if mapped incorrectly, what it should be mapped to instead.

Information on race and Hispanic/Latino origin (foster care elements #8 - 9, #52 - 55, adoption elements #7 -8, and #25 - 28)
One of the significant issues with the collection of this information is that the case worker can select “Hispanic” as a primary “ethnicity” (race) and not select a secondary “ethnicity” (race). (The State refers to the race field as “ethnicity.”) Also, missing data is mapped to “unable to determine.” Therefore, if a case worker enters the information only on Hispanic/Latino there will be no race information reported on the individual. Case workers must ask individuals to self-identify with one or more of the races and whether they are of Hispanic/Latino origin.

Information related to foster parents (foster care elements #49 and #50 - 55)
An error was found in the program code. Foster parent information is being mapped to the “caretaker” (the people from whom the child was removed) elements.

The case file review findings indicate a significant amount of data missing for foster parents. This included race, Hispanic/Latino origin, and dates of birth. These were all cases in which the child was living in a foster home and this information is required. In general, the reviewers often did find the information in the paper case file. The State needs to ensure that this data is entered in a timely manner. In the situation of children placed with private child placing agencies under contract to the State/county, these agencies must provide the information on the foster parents.

Relationship of child to adoptive parents (adoption elements #29 - 32)
In the adoption file, the State is to report the relationship of the child to the adoptive parent(s). AFCARS allows for the reporting of more than one relationship. The State collects this data but it may be underreported in regard to multiple relationships. The system allows the worker to select only one relationship (step-parent, foster parent, other relative or other non-relative) of the adoptive parent to the child. For instance, if the adoptive parent was a relative and had been a foster parent, only one of the relationships is reported in AFCARS. This is resulting in an under-representation of the number of relatives and foster parents that are adopting children in California.

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