The purpose of the new review process is to assess states' conformance with specific Social Security Act Title IV-B subparts 1 and 2 (safe and stable families programs) and Title IV-E (foster care and adoption assistance programs) state plan requirements such that the state is achieving desired outcomes for children and families, and the state system is functioning at a level that promotes achieving identified outcomes. The outcomes are a further definition of the requirements of the Adoption and Safe Families Act (ASFA) for safety, permanency, and child and family well-being.
The CFSR process can be characterized as a federal-state partnership to achieve better results for children and families who are involved in the public child welfare system. All states must complete the CSFR within four years of publication of the final rules. States found to be in substantial compliance will participate in the review process every five years. States not in substantial compliance will develop a program improvement plan in partnership with the Administration for Children and Families (ACF), which retains its responsibility to monitor states' performance, and then go through the review process again in two years. In addition, ACF can require states to participate in a partial Child and Family Services Review or a partial review outside the scope of CFSR if the state appears to be out of conformity.
The new review process has the potential for creating a more effective and accountable child welfare system. In this issue of Best Practice/Next Practice we provide readers with brief information to help clarify the new CFSR, as well as details about the eight National Child Welfare Resource Centers.
Areas to Be Reviewed
Two areas are evaluated in the CFSR process: outcomes and systemic factors.
The CFSR process defines and evaluates the following outcomes around safety, permanency, and well-being:
* Children are, first and foremost, protected from abuse and neglect. And, whenever possible and appropriate, they are safely maintained in their own home.
* Children have permanency and stability in their living situations, and their continuity of family relationships and connections should be preserved.
* Families have enhanced capacity to provide for their children's needs. Children receive appropriate services to meet their educational needs and adequate services to meet their physical and mental health needs.
Safety and permanency will be measured using both qualitative and quantitative indicators. Aggregate data include:
* The percent of children with repeat maltreatment within a 12-month period
* The percent of children re-entering foster care
* The percent of children reunited in less than 12 months from the latest removal from their homes
* The percent of children adopted in less than 24 months from the latest removal
* The percent of children in care less than 12 months with no more than two placements
* The median length of stay in foster care prior to discharge in months
The national standard for each statewide data indicator identified above will be based on the 75th percentile of all state's performance for that indicator, as reported in the Adoption and Foster Care Analysis and Reporting System (AFCARS) and the National Child Abuse and Neglect Data System (NCANDS). States that achieve the 75th percentile will be considered to be in compliance. This national standard will be determined using multiple reporting periods.
In addition to a review of the state's achievement of the outcomes, the state agency must also satisfy qualitative criteria related to the delivery of services. Seven systemic factors are essential to the delivery of quality services. Each state must demonstrate that it has these procedures, systems, and services, briefly noted below, in place.
The Statewide Information System. The state can readily identify the status, demographic characteristics, location, and goals for the placement of every child who is-or has been within the preceding 12 months-in foster care.
Case Review System. The state provides, for each child, a written case plan to be developed jointly with the child's parent(s); provides a periodic review of the status of each child no less than once every six months; assures that each child in foster care has a permanency hearing no later than 12 months from the date the child entered foster care and not less than every 12 months thereafter; provides a process for termination of parental rights proceedings; and provides foster parents, pre-adoptive parents, and relative care givers of children in foster care with notice of and an opportunity to be heard in any review or hearing.
Quality Assurance System. The state ensures that children in foster care placements receive quality services that protect their safety and health and evaluates and reports on these services.
Staff Training. Development and training programs support the goals and objectives in the state's Child and Family Services Plan; address services provided under both sub-parts of title IV-B and the training plan under title IV-E of the Social Security Act; and provide training for staff who provide family preservation and support services, as well as child protective, foster care, adoption, and independent living services. Ongoing training is also provided for staff that addresses the skills and knowledge necessary to carry out their duties within the state's Child and Family Services Plan. Short-term training is also offered for current or prospective foster parents, adoptive parents, and the staff of state-licensed/approved child care institutions that care for foster and adopted children.
Service Array. The state has an array of services that assesses the strengths and needs of children and families; that addresses the needs of the family, as well as the individual child, to create a safe home environment; and that enables children at risk of foster care placement to remain with their families when their safety and well-being can be reasonably assured. Services are designed to help children achieve permanency; be accessible to families and children in all political subdivisions covered in the state's Child and Family Services Plan; and be individualized to meet children and families' unique needs.
Agency Responsiveness to the Community. The state engages in ongoing consultation, coordination, and annual progress reviews with a variety of individuals and organizations representing the state and county agencies responsible for implementing the Child and Family Services Plan and other major stakeholders in the services delivery system including, at a minimum, tribal representatives, consumers, service providers, foster care providers, the juvenile court, and other public and private child and family servicing agencies.
Foster and Adoptive Parent Licensing, Recruitment, and Retention. The state establishes and maintains standards for foster family homes and child care institutions, applies standards to every licensed/approved foster family home or child care institution that receives IV-E or IV-B funds, and complies with the safety requirements for foster care and adoption placements. In addition, each state has a process that recruits foster and adoptive families who reflect the racial diversity of children in the state, and develop and implement plans for the effective use of cross-jurisdictional resources to facilitate timely adoption or permanent placement.
Finally, a team of reviewers composed of state agency staff (both state and local offices), child welfare community stakeholders, and federal and regional HHS staff conduct an on-site review in the state. The team gathers qualitative data that cannot be gleaned from aggregate statewide data described above, assessing the systemic factors through interviews and evaluating a sample of cases.
The on-site review covers the state's programs under Title IV-B and IV-E, including in-home services and foster care. The team conducts the review in three sites across the state. Sources of information collected during the on-site review includes case records and interviews with children, families, caseworkers, foster parents, service providers, and key stakeholders.
The sample 30-50 cases reviewed on-site are selected from a randomly drawn oversample of no more than 150 cases.
A Five Stage Review Process
There are five steps in the review process:
Prior to the state beginning work on its statewide assessment (the state's self assessment of the child welfare system), ACF prepares profiles of the state's foster care and child protective service populations using AFCARS and NCANDS data submitted by the state. For example, the length of stay in foster care, foster care re-entries, and repeat maltreatment rates of children are included. The data indicate whether the state meets the national standards for those statewide indicators used to determine substantial conformity.
The state then completes the statewide assessment. The state examines the data relative to the state's programs, goals, and objectives, and considers them in light of the outcomes for children and families subject to review. Systemic issues are also addressed under review relative to their influence on the state's capacity to deliver effective services. Based on the findings of the statewide assessment, the state and the ACF Regional Office jointly make decisions about the locations of the on-site review activities and the types of cases that will be reviewed on-site.
The on-site review is conducted by the joint federal-state team that combines both the outcomes and the systemic factors being reviewed. In looking at the outcomes, a sample of cases is reviewed intensively using information from the case record and interviews with family members, the caseworker, and service providers involved with the family. The findings from the sample of cases are combined with the state's performance on selected statewide indicators to make determinations about conformity on the outcomes.
In reviewing the systemic factors, interviews are conducted with courts, other agencies, foster families, foster care review boards, and others. The interview results are combined with the systemic factors in the statewide assessment to determine conformity on the systemic factors.
Based on the combination of quantitative and qualitative information from the statewide assessment and the on-site review of outcomes and systemic factors, the review team recommends a determination regarding substantial conformity.
States that are found not to be in substantial conformity are immediately informed of any penalties. Program improvement plans to address each area of nonconformity are developed, and the state has a limited period of time to successfully complete this plan before penalties are taken.