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Federal Register: February 2, 1999 (Volume 64, Number 21)]
[Notices]
[Page 5063-5066]
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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.
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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
[[Page 5064]]
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:
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;
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;
Convening a meeting of the Consultation Group in September
1998 during which multiple outcomes were proposed and discussed;
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;
Preparing and disseminating a report on the outcome
measures to the Consultation Group and resource organization
representatives for their review and comment;
Convening telephone conference calls and meetings to
obtain feedback on the outcome measures from Consultation Group members
and resource organization representatives;
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;
Conducting a review of comments from reviewers and focus
group participants to determine areas for revision; and
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
[[Page 5065]]
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.
[[Page 5066]]
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.
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