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 reporting period under review was April 1, 2002 through September 30, 2002 (2002B).

As part of the post-site visit analysis the State's documents, the data, the case file review findings, team member notes, and the State's revised program code 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 Requirements Errors

Population Standards

The State is not including the complete foster care and adoption 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. The State is required to continue reporting these children to AFCARS (Child Welfare Policy Manual, Section 1.3, AFCARS Reporting Population). Based on our analysis and discussions with the State, there appears to be children that are returned home, but are still in the agency's responsibility for care, placement or supervision and the State is reporting them 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 AFCARS each reporting period.

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 those in which there is an adoption agreement. The State has adoption agreements and subsidies with families that adopted a child through a private agency and the child is a special needs child. The State is not including these adoptions in AFCARS. The State must include these children.

Technical Standards

In regard to the technical standards, the major problem is that the State does not extract the AFCARS files based on the transaction date associated with either the date of the current removal from home or a discharge from care, placement, or supervision (ACYF-PI-CB-95-09, Re-issued May 23, 1995). This results in fluctuations in the number of children being reported in AFCARS each report period and missing data regarding discharges. Instead the State based its extraction on service codes and, therefore, was extracting information on children that were not in the State agency's responsibility for care, placement, or supervision. The State has made corrections to the program code and the data will be extracted based on the transaction date.

Data Elements

Of the 103 data elements, the State is in full compliance with 31 (30%), needs to improve the quality in at least 42 (41%), and make system corrections to 30 (29%). Listed below are the areas that the Federal review team found to have the most significant issues.

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

According the frequency report for the report period under review, there were 1,601 (49%) children that had not been to a medical professional for an assessment of their health and mental health needs. Also, there were only 748 (23%) children within the State's foster care population that were diagnosed with a medical/psychological condition. This is an area that needs significant attention with regard to both system design and caseworkers entering the information. One of the problems is that there are a limited number of medical conditions that the workers can select. This may result in workers not selecting a medical condition because of uncertainty of how to categorize the condition. The results of the case file review indicate that there were several psychological conditions that were either not reported, or were reported as "other medical condition." Additionally, the screen and the program code defaults to "not yet determined," which is why the frequencies indicate children have not been evaluated by medical professionals.

Has the child been previously adopted and the age at time of the adoption (foster care elements #16 and #17)

The State has a good approach to collecting this information. The State included this as a question for caseworkers to answer on the screen and the caseworker can enter the date the adoption was legalized. From the legalization date the program code calculates the age of the child at the time of his/her adoption. The problem with these elements is that the screen pre-fills with the response "no." Therefore, the worker can save the screen without addressing the question. This is resulting in data that cannot be truly relied on to be accurate. The State needs to leave the question blank, thus, forcing the worker to address the question. This should increase the reliability of the data. The State will need to monitor this information once the program code is changed to ensure it accurately reflects the circumstances of the foster care population. During the case file review, reviewers identified five children that had been adopted prior to the child's current removal episode. While this was a small number of cases it represents 11% of the cases reviewed. The State should also consider adding an age field to the screen. This would allow the worker to estimate an age at the time of adoption if the legalization date is unknown.

Information on Removal Episodes (foster care elements #18 - 22, 26 - 40, and 56 - 58)

The State needs to ensure the accuracy and completeness of these elements. The State designed the system with the removal information and placement information on the same screen. To differentiate between dates of removal and dates for placement, the worker selects a field to indicate whether the "placement" was due to a removal from home. Once this box is checked the question is not asked each time the child is moved from placement to placement. When the worker selects that the placement is due to a removal, the worker also gets a "pop-up" window with the circumstances associated with removal. However, the worker can answer "no" even if the "placement" is due to a removal from home. This is creating missing or underreported data for several elements. The State needs to either implement an on-line edit check or have supervisors monitor the accuracy of this data.

Once the State starts to extract data based on the requirements in ACYF-PI-CB-CB-95-09, reissued May 23, 1995, there could possibly be records that will not be extracted because the removal flag was not checked. This would result in an underreporting of the foster care population.

Placement Information (foster care elements #23, 24, and #41)

The State has corrected most of the system errors, however, there are some that still need to be completed. The State's system did not extract to AFCARS all possible locations that a child may be "placed" in 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 that 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.

Case Plan Goal (foster care element #43)

The State has a practice that the case plan goal must be established within 60 days of the assignment of the case to the Family Services Unit worker. This is not always within 60 days of a child's removal from his/her home. The State must ensure that all case plans are established within 60 days of child's removal from home.

Primary basis for special needs (adoption element #10)

The State has a field for "primary" basis for special needs. However, based on the case file review, it appears that there was a higher incidence of workers selecting the first item (age) on the list, instead of the actual primary basis. Also, the State will be including deferred payments as a part of the adoption agreements with families. This may be based on conditions that the child may be "at-risk" for developing in the future. The State needs to add a category to reflect this situation and map these conditions to "other" state-defined special needs.

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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