State child welfare programs; outcomes and performance; comment request,

[Federal Register: February 2, 1999 (Volume 64, Number 21)]

[Notices]

[Page 5063-5066]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr02fe99-76]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

Invitation To Comment on Child Welfare Outcomes and Measures

AGENCY: Administration on Children, Youth and Families, ACF, HHS.

ACTION: Notice of plan to report on outcomes and performance of State child welfare programs, and invitation to comment.

SUMMARY: Section 203 of the Adoption and Safe Families Act (ASFA), signed into law in November 1997, requires the Secretary of the Department of Health and Human Services (DHHS) ``* * * in consultation with Governors, State legislatures, State and local public officials responsible for administering child welfare programs, and child welfare advocates * * * to develop a set of outcome measures (including length of stay in foster care, number of foster care placements, and number of adoptions) that can be used to assess the performance of States in operating child protection and child welfare programs * * *.'' In addition, the law requires that ``* * * to the maximum extent possible, the outcome measures should be developed from data available from the Adoption and Foster Care Analysis and Reporting System.'' Section 203 of ASFA also directs the Secretary to prepare and submit to Congress a report on the performance of each State on each outcome measure on May 1, 1999, and annually thereafter.

To meet these requirements, the Children's Bureau, the Federal agency charged with the task of implementing ASFA, engaged in a consultation process with various stakeholders. The outcomes presented in this notice are the result of the Children's Bureau's consultation process and reflect widely-held performance objectives for child welfare program practice. This notice is to advise the public of DHHS's plan to report on these outcomes for State child welfare programs and to invite public comment on them. This notice can be found at http:// www.acf.dhhs.gov/programs/cb/special/index.htm.

DATES: Written comments must be submitted to the office listed in the ADDRESS section below on or before March 4, 1999.

ADDRESS: Mail written comments (in duplicate) to Marianne Rufty at the address below.

FOR FURTHER INFORMATION CONTACT: Marianne Rufty, Children's Bureau, 330 C Street, SW, Washington, DC 20447.

SUPPLEMENTARY INFORMATION: The Nation's child welfare systems are designed to protect children who have suffered maltreatment, who are at risk for maltreatment, or who are under the care and placement responsibility of the State because their families are unable to care for them. These systems also focus on securing permanent living arrangements for children who are unable to return home. The Children's Bureau is the agency within the Federal Government that is responsible for assisting State child welfare systems by promoting continuous improvement in the delivery of child welfare services.

The Adoption and Safe Families Act (ASFA) represents a significant effort on the part of the Federal Government to improve child welfare service systems. The ASFA establishes clear goals for children served by the Nation's child welfare systems--safety, permanency, and well- being. It calls on the Department of Health and Human Services (DHHS), State officials, advocates, and other experts in the field to work together to identify useful outcome measures to gauge State and

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national progress in reaching those goals.

The ASFA also requires that DHHS prepare and submit to Congress a Report on the performance of each State on each outcome measure on May 1, 1999, and annually thereafter. This Report is intended to encourage continued improvements in State child welfare systems. It will provide an overview of system effectiveness by focusing on performance related to particular outcome measures. Additional data will be presented that pertain to system characteristics, some of which were requested in Section 203 of ASFA, to provide a context for the outcome measures. These data will address characteristics of a State's child welfare system such as the number of children reported for abuse or neglect, the number of children found to be victims of maltreatment, the number of children in out-of-home care, the number of adoptions, etc.

The first Report to Congress will include outcome measures that are based on data already available through the Adoption and Foster Care Analysis and Reporting System (AFCARS) and the National Child Abuse and Neglect Data Systems (NCANDS) to avoid additional reporting by the States. The AFCARS, which was implemented in December 1993, is the first federally-mandated data collection program for the collection of foster care and adoption data. The data are case-level data representing children in foster care under the responsibility of the State child welfare agencies and those children adopted with the involvement of those agencies. A list of the AFCARS data elements for foster care and adoption can be found at http://www.acf.dhhs.gov/ programs/cb/special/elements.htm.

The NCANDS, which is a voluntary data collection system established in 1990, is the primary source of national information on abused and neglected children known to State child protective services agencies. The NCANDS is comprised of two parts: (1) A Summary Data Component, which is a compilation of key aggregate indicators of State child abuse and neglect statistics, and (2) a Detailed Case Data Component, which is a compilation of case-level data about individual children who are are the subjects of child maltreatment reports. A list of the data elements for the Summary Data Component can be found at http:// www.acf.dhhs.gov.programs/cb/special/ncands.htm. The data elements for the Detailed Case Data Component can be found at http:// www.acf.dhhs.gov.programs/cb/special/casedata.htm.

One consequence of focusing on outcomes that can be measured through AFCARS and NCANDS is that the outcomes to be included in the first Annual Report do not address the goal of child well-being. In the first Annual Report to the Congress, the Children's Bureau intends to discuss issues pertaining to the development of future child well-being outcomes and possible procedures for collecting data pertaining to those outcomes. It is anticipated that these outcomes will relate to the educational and health status of children served by the foster care system.

Because of the extensive variation among State child welfare systems with respect to policies, definitions, resources, capacities, and demographic characteristics, future Annual Reports to the Congress will assess State performance by recording changes in each State's performance on each outcome measure. The ultimate objective will be to document either a pattern of continuous improvement or performance problems relevant to particular outcomes.

In order to ensure that the outcomes presented in the Annual Report would be meaningful with respect to the performance of a child welfare system, the Children's Bureau engaged in a consultation process to assist in developing the outcome measures. This consultation process included:

‹bullet› Establishing a Consultation Group comprised of representatives from State, Tribal, county, and municipal child welfare agencies; private non-profit child and family services agencies; State legislatures; State Governors' offices; juvenile and family courts; local child advocacy organizations; and a public employee organization;

‹bullet› Inviting national organizations to serve as resources to the Consultation Group, including the American Bar Association Center on Children and the Law, the American Public Human Services Association, the Child Welfare League of America, the Children's Defense Fund, the National Association of Child Advocates, the National Center for Juvenile Justice, the National Child Welfare Resource Center for Organizational Improvement, the National Conference of State Legislatures, the National Council of Juvenile and Family Court Judges, and the National Governors's Association;

‹bullet› Convening a meeting of the Consultation Group in September 1998 during which multiple outcomes were proposed and discussed;

‹bullet› Conducting a review of the outcomes proposed during the Consultation Group meeting by a Children's Bureau staff to identify those outcomes that reflect desired goals and objectives and could be measured using data from the AFCARS and the NCANDS;

‹bullet› Preparing and disseminating a report on the outcome measures to the Consultation Group and resource organization representatives for their review and comment;

‹bullet› Convening telephone conference calls and meetings to obtain feedback on the outcome measures from Consultation Group members and resource organization representatives;

‹bullet› Presenting the outcome measures to participants of three focus groups at the 12th National Conference on Child Abuse and Neglect in Cincinnati, Ohio, to obtain feedback from the larger child welfare community;

‹bullet› Conducting a review of comments from reviewers and focus group participants to determine areas for revision; and

‹bullet› Disseminating the revised outcome measures to Consultation Group members and resource organization representatives for review and comment during the second meeting of the Consultation Group in December 1998.

The following outcome measures are the result of this consultation process. The Children's Bureau of DHHS invites your comment on these outcome measures. Revisions resulting from the comment process will be reflected in the final list of outcome measures, which will be used as the basis for the first and subsequent Annual Reports to the Congress on the performance of each State in meeting the goals and objectives of the child welfare system.

Safety-Related Outcome 1: Reduce Recurrence of Child Abuse and/or Neglect

During a specified reporting period:

--Of all children who were victims of substantiated child abuse and/or neglect, what percentage had another substantiated report within 12- month period? --Of all children who were victims of substantiated child abuse and/or neglect, who were not placed in foster care, and whose families received services from the agency, what percentage had another substantiated report within a 12-month period? --Of all children who were victims of substantiated child abuse and/or neglect, who were not placed in foster care, and whose families did not receive services from the agency, what

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percentage had another substantiated report within a 12-month period?

Note: This outcome addresses a primary objective of all child welfare systems-to prevent the recurrence of child abuse or neglect once it has come to the attention of the system. It is acknowledged that recurrence is the result of multiple factors and that child welfare interventions cannot prevent all recurrence. This outcome may be modified or expanded in the future to include a measure that addresses all reports referred for investigation, not solely those that are substantiated. In the current measure, ``substantiated'' reports include those that are classified by some States as ``indicated.''

Safety-Related Outcome 2: Reduce Child Fatalities Due to Child Maltreatment

During a specified reporting period:

--Of all child fatalities resulting from abuse or neglect, what percentage of child victims had been the subject of a substantiated report of child abuse or neglect within 12 (24) months prior to the reported fatality?

Note: This outcome reflects a fundamental goal of child welfare systems--to prevent child fatalities as a result of abuse or neglect. The measure focuses on fatalities among children who were known to the child welfare system.

Safety-Related Outcome 3: Improve the Child Welfare System's Response Time To Investigate Abuse or Neglect Reports

During a specified reporting period:

--Of all child protection investigations initiated, what was the mean length of time between the report and the initiation of the investigation?

Note: The selection of this outcome was based on the assumption that a rapid response to an abuse or neglect report can be used as at least one measure of a system's performance in protecting children. The outcome may be modified in the future to incorporate State response standards for various types of maltreatment reports. The Summary Data Component of NCANDS recently incorporated data elements pertaining to response time information for different categories of reports.

Permanency-Related Outcome 1: Reduce Time in Foster Care To Reunification Without Increasing the Rate of Foster Care Re-Entry

During a specified reporting period:

--Of all children who were reunified with their parents or caretakers from foster care placements, what percentage was reunified in less than 12 months from the time of latest removal from home? --Of all children who were reunified with their parents or caretakers from foster care placements, what percentage was reunified in 12 to 24 months from the time of latest removal from home? --Of all children who were reunified with their parents or caretakers from foster care placements in less than 12 months from the time of removal, what percentage re-entered foster care in less than 12 months from the time of reunification?

Note: The term ``foster care'' as used in this outcome refers to all out-of-home care arrangements for children for whom the State child welfare agency has responsibility for placement, care, or supervision. The term ``reunification'' refers to children who are returned to their parents as well as those who are discharged to other relatives (i.e., the child's case is closed, but the relatives are not the child's legal guardians).

This outcome reflects the objective of returning children in foster care to their families as soon as possible. The third measure is designed to address the concern that by expediting reunifications a child welfare system may risk increasing re-entries into foster care. Distribution of time-in-care information for all children in foster care may be provided as context information.

Permanency-Related Outcome 2: Reduce Time in Foster Care to Adoption Finalization Without Increasing the Number of Adopted Children Who Re-Enter Foster Care

During a specified reporting period:

--Of all children who were younger than age 3 at the time of foster care entry and who exited foster care to finalized adoptions, what percentage exited to finalized adoptions in less than 24 months from entry? --Of all children who were age 3 or older at the time of foster care entry and who exited foster care to finalized adoptions, what percentage exited to finalized adoptions in less than 36 months from entry? --Of all children entering foster care, what percentage had been previously adopted when they were older than 2 years of age?

Note: This outcome addresses the objective that children who cannot be reunified with their families should be adopted as quickly as possible. The first two measures reflect a decision to track adoptions of children younger than 3 years of age separately from adoptions of older children. Research findings indicate that adoptions can be achieved more frequently and quickly for children who are under age 3 at the time of entry into care than for children who enter foster care at age 3 or older. The third measure is designed to reflect concerns that expedited adoptions may result in re-entries into the foster care system. By only including children older that age 2 at the time of adoption, we expect to reduce the number of private agency or international adoptions that may be included in the data.

Permanency-Related Outcome 3: Reduce Time in Foster Care to Legal Guardianship

During a specified reporting period:

--Of all children who were discharged with a legal guardianship, what percentage was discharged in less than 24 months from time of removal?

Note: This outcome reflects the objective of establishing a timely permanency option for children when reunification and adoption have been ruled out as permanency options.

Permanency-Related Outcome 4: Reduce the Disparity of Length of Time in Foster Care Between Children of Color and Caucasian Children

During a specified reporting period:

--For children in non-relative foster care who exited care, what was the median length of time in care for African American children, American Indian/Alaska Native children, Asian and Pacific Islander children, Caucasian children, and Hispanic children? --For children in relative foster care who exited care, what was the median length of time in care for African American children, American Indian/Alaska Native children, Asian and Pacific Islander children, Caucasian children, and Hispanic children?

Note: This outcome reflects concerns that children of color may receive differential treatment in many of National's foster care systems. The measures are designed to track both the disparity of length of time in foster care and the impact of relative foster care on length of time in care.

Permanency-Related Outcome 5: Increase Permanency for Disabled and Older Children

During a specified reporting period:

--For all children who were identified as disabled and who exited care, what percentage exited to reunification, adoption, or legal guardianship? --For all children who were 12 years of age or older at the time of their most recent entry into care and who exited care, what percentage exited to reunification, adoption, or legal guardianship? --For all children exiting care through emancipation, what percentage was younger than 12 years of age at the time of their most recent entry into care?

Note: These measures address general concerns in the field about permanency for disabled children, children who enter care when they are adolescents, and older children for who efforts to achieve permanent homes are lacking or ineffective.

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Permanency-Related Outcome 6: Increase Placement Stability

During a specified reporting period:

--For all children who had been in foster care for longer than 3 months, what percentage had not more than two placement settings during their most recent episode?

Note: This outcome addresses the objective of reducing the number of placement settings in a single-foster care episode. The measure acknowledges that in many States a large percentage of children will experience at least two placements because of the use of emergency foster care services at the time of removing a child from the home.

Permanency-Related Outcome 7: Reduce Placements of Children in Group Homes, Institutions, and Out-of-State Care

During a specified reporting period:

--For all children who were younger than age 12 when they were placed in their current foster care settings, what percentage had a current placement in a group home? What percentage had a current placement in an institution? --For all children who were 12 years of older when they were placed in their current foster care settings, what percentage had a current placement in a group home? What percentage had a current placement in an institution? --For all children whose current placement settings are group homes or institutions, what percentage is placed out of State?

Note: This outcome reflects the objective of placing most children in family foster homes and in placements that are in close proximity to their families. It is acknowledged that for some children, particularly adolescents, group homes, institutions, or out-of-State placements may be appropriate.

Dated: January 26, 1999. Patricia Montoya, Commissioner, Administration on Children, Youth and Families.

[FR Doc. 99-2361Filed1-29-99; 8:45 am]

BILLING CODE 4184-01-M