The Department of Health and Human Services is amending its Child and Family Services Review (CSFR) process, including the addition of a few key measurements.
The CFSR process, which began during the Bush administration, includes a litany of metrics and case studies created to gauge the performance and progress of state child welfare agencies. In a nutshell: every state is reviewed over a four-year period, and notified of indicators on which they failed.
States are given a chance to submit program improvement plans aimed at addressing those shortcomings; they face financial penalties for continued failure. The second round of reviews was completed in 2010.
HHS is still taking input from the public on changes. Here’s a look at some of the new data the agency hopes to draw from states:
Re-Report of Maltreatment
Denominator: Number of children with at least one screened-in report of alleged maltreatment in a 12-month period.
Numerator: Number of children in the denominator that had another screened-in report with a disposition within 12 months of their initial report.
Notes: This would be the first time that states will be held accountable for unsubstantiated allegations of abuse or neglect. If the system screens in a report of maltreatment, and then screens in another one within a year, it will be measured and counted against the state in the CFSR.
More Data on Permanency Outcomes
HHS is proposing several new ways to measure a state when it comes to moving foster youths into permanent situations.
“Children’s Bureau is committed to maintaining focus on the key outcome of achieving permanency for all children in foster care and shortening the time to permanency,” the notice said.
The new measures:
Permanency Within 12 Months
Denominator: Number of children who enter foster care in a 12-month period.
Numerator: Number of children in the denominator who discharged to permanency within 12 months of entering foster care.
12-Month Resolution After 2 Years in Care
Denominator: Number of children in foster care on the first day of a 12-month period who had been in foster care (in that episode) for 2 or more years.
Numerator: Number of children in the denominator who discharged to permanency within 12 months of the first day.
Re-Entry to Foster Care
Denominator: Number of children who entered foster care in a 12-month period who discharged within 12 months to reunification, living with a relative, or guardianship.
Numerator: Number of children in the denominator who re-entered foster care within 12 months of their discharge from foster care.
Notes: It is hardly a surprise that HHS wants to know more about the permanency process, because the area of the CFSR where states struggle most is in permanency. The goal set in the CFSR is for a permanency goal to be established in 90 percent of cases, and for a stable placement to be maintained in 90 percent of cases. One state achieved the former, zero states achieved the latter.
The re-entry measurement is actually a redux of an existing measurement. The proposed change would focus re-entry measurement on an “entry cohort” followed for outcomes, as opposed to an “exit cohort.”
Limiting Permanency/Stability Metrics to Under 18
This is not a new measurement, but HHS made clear in the proposals that it wants to keep the CFSR process focused on minors. From the notice:
“The Children’s Bureau believes that it is appropriate to limit the permanency statewide data indicators to children under age 18 in this way to maintain consistency as we have in prior rounds.”
Notes: The impetus for this notification is the Fostering Connections to Success and Increasing Adoptions Act, which was signed into law in 2008. The law gave states the option to receive federal funding to provider foster care for young adults between 18 and 21.
This is reasonable; the anticipated experience for over-18 foster youths is notably different than minors. But one hopes that some amount of federal research will be done on services and outcomes for older foster youth. For one, it would be nice to know how many youths changed placements during those older years.
Foster Care Experience
HHS is proposing two different measures for gauging the foster care experience:
Maltreatment During Foster Care
Denominator: All child days in foster care over a 12-month period.
Numerator: Number of instances of substantiated or indicated maltreatment among children in foster care over that same period.
Foster Care Placement Stability
Denominator: Among children who enter foster care in a 12-month period, the total number of days these children were in foster care as of the end of the 12-month period.
Numerator: Among children in the denominator, the total number of placement moves during the 12-month period.
Notes: The first measure is an addition meant to ensure that states are not removing children from one bad situation and putting them into another one. The strength of the data is directly connected to a state’s efficacy when it comes to investigating maltreatment in its foster placements.
Interestingly, the proposal notes that this would include maltreatment by “any perpetrator, which may include foster parents, facility staff members, parents or others.” It will be interesting to see if public feedback on this has anything to say about inclusion of abuse by another youth.
The second measure would replace the current placement stability indicator, which tallied the percentage of youths served in a 12-month window who had more than two placements. Instead, HHS would create a number of placements-to-days-in-care ratio within a 12-month time frame.
The rationale is that national data ““indicates that most placement moves occur within a child’s first 12 months of foster care, which is why we plan to focus this indicator on that time period.”
This could shed light on the extent to which youths are placed more than twice in the first year, since that seems to be what HHS believes is happening in many cases.
John Kelly is editor-in-chief of The Chronicle of Social Change.