Findings

This section provides the major findings resulting from the review of the State's AFCARS data collection. Tab B provides detailed information on the findings for each of the foster care and adoption data elements, the general AFCARS requirements, and the case file review. The AFCARS data used for the review was from the report period October 1, 2002 - March 31, 2003 (2003A).

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, some of the original rating factors were modified from those given at the end of the on-site review. The findings matrix in Tab B reports the previous rating with a "strike-through" mark on it, and the new rating. The AFCARS Improvement Plan in Tab C contains the final rating factor.

General Requirement Errors

Population Standards

The State is not including the complete foster care population required under AFCARS. The standards for the AFCARS foster care population require that the State include all children in foster care for whom the agency has responsibility for placement, care, or supervision (45 CFR 1355.40(a)(2)). This includes children who have been in foster care and are returned to their home while still under the placement, care, or supervision of the State agency. If the child is returned home for a specified period of time, the requirement is that the State report the child in AFCARS for the entire specified period of time. If the child is returned home for a non-specified period of time, and the timeframe exceeds six months, the State may consider the child discharged from care, placement or supervision for AFCARS purposes after six months (Child Welfare Policy Manual, Section 1.3, AFCARS Reporting Population). In North Dakota, some children who are returned home, but are still under the agency's responsibility for care, placement or supervision, are being reported as "discharged" in AFCARS. The State will have to address this as a training issue with workers and ensure that the correct foster care population is included in each AFCARS reporting period.

Data Elements

Of the 103 data elements, the State is in full compliance with 38 (37%), needs to improve the quality in at least 3 (3%), and make system corrections to 62 (60%). Changes made to the system with regard to data entry will inevitably result in improved data accuracy and quality. In order to ensure that the data are complete, the agency must require workers to enter the data, and assess its validity prior to submitting it to ACF. To do so, the State may utilize the management reports created by the agency, as well as the Data Quality Utility and the Frequency Utility issued by ACF. Listed below are the areas that the Federal review team found to have the most significant issues.

System defaults for missing data

There are several elements that are mapped to a valid AFCARS value if there is missing data for the element. The State's AFCARS data files would then never fail the missing data standard (which was used previously to assess penalties). In some instances, such as with the race and Hispanic/Latino Origin elements, the information is a required field but the program code contains default language. If the worker is required to enter the information, then there is no need to have language in the program code to map missing data to a valid AFCARS value.

Program code does not always assess the "foster care" and the "birth counseling" records

There is an inconsistency in how the program code checks for information in the "foster care" and the "birth counseling" (BC) records. The program code for some elements does not check both programs and results in the under-reporting or misrepresentation of the data. One example of this issue is the elements associated with the reasons why a child entered foster care. If there is a "BC" record, it sets all circumstances except for "relinquishment" to "does not apply." If there were a foster care record on the child, the circumstances associated with the most recent removal episode would not be reported.

Information on race and Hispanic/Latino Origin

The State has a common database that is shared with other State programs. When an individual is entered into the child welfare information system, the Comprehensive Child Welfare Information and Payment System (CCWIPS), a search is conducted to see if this person is known to the State and if his/her demographic information is in the common database. If the person's information is in the database then it does not need to be re-entered. The race and Hispanic/Latino Origin fields are mandatory fields that workers must complete when entering a new person into the information system. There is a hierarchy for the entry of data into the database and who "owns" the data. The offices for Medicaid and the Temporary Assistance to Needy Families programs (TANF) have precedence over child welfare for "ownership" of the data. Once information is entered by either of these programs, the child welfare agency cannot make changes to it. The problem in regard to child welfare and the AFCARS data is that the database does not include "unable to determine" as an option and the agency does not include this field on its input screens. Since race and Hispanic/Latino Origin are to be self-reported, AFCARS contains the value "unable to determine." This means that if a child was abandoned, there is no one who can identify the child's race. We have also issued clarification that if a person refuses to identify his/her race, or that of their child, then the worker can enter "unable to determine." The State needs to add the option "unable to determine" to the screens.

Another issue with the collection of the race information relates to information on foster parents and adoptive parents. Individuals may identify with more than one race and the information system must be able to collect multiple races. The screens that collect information on foster parents and adoptive parents do not allow the entry of more than one race.

Information on Children Diagnosed with Disabilities (foster care elements #10 - 15)

The State staff indicated that this information is under-reported. For the report period under review, there were 920 (54%) "yes" responses, 599 (35%) for "no," and "not yet determined" was 175 (10%). One issue is the limited number of medical conditions that workers can select. Workers may not select a disability condition because it is not listed on the option list. Another issue is that the screen does not contain the question "Has this child been diagnosed with a disability?" and the options of "yes," "no," and "not yet determined." The State's current approach is to interpret the lack of information as "no." Instead, the worker may have skipped this field or hasn't received the information from a doctor. Another issue that could be contributing to a lack of data is that workers' information entered into narrative notes is never collected in the database. The State should make this a question for workers to answer and increase the number of options the worker can select.

Placement Information (foster care elements #23 and #41).

There were several issues relating to the collection and reporting of placement information. The State's system did not extract to AFCARS all possible locations that a child may be "placed" while under the agency's responsibility for care, placement, or supervision. The State was not reporting children that were on "runaway" status as a placement setting. The State still needs to update the program code to ensure that the "date of current placement" reflects the date the child ran away. Also, the State was not using "trial home visit" as a placement setting for those children who were placed back in their own home while still under the agency's care, placement or supervision. The State must ensure the program code also extracts the start date for these "settings."

The State will need to monitor these data elements to ensure that the placement information accurately reflects the situation of the child 24 hours/seven days a week. The State also needs to review and apply the policy clarification issued July 5, 2002 in the Children's Bureau's Child Welfare Policy Manual on placement settings.

Primary basis for special needs (adoption element #10)

On August 1, 2003 the State added a category of "at-risk" to its conditions that identify a child as "special needs" for adoption purposes. The State did not modify its information system in order to begin collecting this information as of August 1st. The State needs to add this to the input screen and map these conditions to "other" state-defined special needs. This should be in place in order to be reported in AFCARS for the report period that ends March 31, 2004.

Relationship of child to adoptive parents (adoption elements #29 - 32)

The State collects this data but it may be underreported in regards 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, the worker has to select only one condition and the data are underreported for the number of relatives that were foster parents and adopted a child. The State must provide ACF with the proposed screen print reflecting the change it is making to the system.

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