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Home > Statistics & Research > Child Welfare Research > Progress Report to the Congress

 

INTRODUCTION

Overview of the Progress Report to Congress
A Review of the Department's Progress To-Date

On November 19, 1997, the President signed into law the Adoption and Safe Families Act of 1997 (P.L. 105-89). This legislation, passed by the Congress with overwhelming bipartisan support, represents an important landmark in the development of Federal child welfare law. The passage of the new law provides our nation with an unprecedented opportunity to build on the reforms of the child welfare system that have begun in recent years in order to make the system more responsive to the multiple, and often complex, needs of children and families. Perhaps most importantly, the new law establishes clear goals of what we want for children in the child welfare system -- safety, permanency, and well-being.

One of the key principles of the Adoption and Safe Families Act is that the child welfare system must focus on results and accountability. The law makes it clear that it is no longer enough to ensure that procedural safeguards are met. It is critical that child welfare services lead to positive results.

The Adoption and Safe Families Act (ASFA) calls on the Department of Health and Human Services, State officials, advocates and other experts in the field to work together to identify useful outcome measures to gauge State and national progress in meeting the needs of children and families in the child welfare system. It further challenges the Department and the field to explore the possibility of developing ways to use Federal child welfare funds to promote more strongly the goals of safety, permanency and well-being. Specifically, Section 203 of the Adoption and Safe Families Act amended title IV-E of the Social Security Act as follows:

"SEC.479A. ANNUAL REPORT.

"The Secretary, in consultation with Governors, State legislatures, State and local public officials responsible for administering child welfare programs, and child welfare advocates, shall--

1. "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 pursuant to parts B and E to ensure the safety of children;

2. "to the maximum extent possible, the outcome measures should be developed from data available from the Adoption and Foster Care Analysis and Reporting System;

3. "develop a system for rating the performance of States with respect to the outcome measures, and provide to the States an explanation of the rating system and how scores are determined under the rating system;

4. "prescribe such regulations as may be necessary to ensure that States provide to the Secretary the data necessary to determine State performance with respect to each outcome measure, as a condition of the State receiving funds under this part; and

5. "on May 1, 1999, and annually thereafter, prepare and submit to the Congress a report on the performance of each State on each outcome measure, which shall examine the reasons for high performance and low performance and, where possible, make recommendations as to how State performance could be improved."

2. DEVELOPMENT OF PERFORMANCE-BASED INCENTIVE SYSTEM.--The Secretary of Health and Human Services, in consultation with State and local public officials responsible for administering child welfare programs and child welfare advocates, shall study, develop, and recommend to Congress an incentive system to provide payments under parts B and E of title IV of the Social Security Act (42 U.S.C. 620 et seq., 670 et seq.) to any State based on the State's performance under such a system. Such a system shall, to the extent the Secretary determines feasible and appropriate, be based on the annual report required by section 479A of the Social Security Act (as added by subsection (a) of this section) or on any proposed modifications of the annual report. Not later than 6 months after the date of the enactment of this Act, the Secretary shall submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a progress report on the feasibility, timetable, and consultation process for conducting such a study. Not later than 15 months after such date of enactment, the Secretary shall submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate the final report on a performance-based incentive system. The report may include other recommendations for restructuring the program and payments under parts B and E of title IV of the Social Security Act.

This report has been prepared in response to the requirement at Section 203(b) of P.L. 105-93, cited above, that the Secretary provide a progress report to the Congress on the feasibility, timetable, and consultation process for conducting a study of performance-based incentive financing in child welfare.

Overview of the Progress Report to Congress

This Progress Report to the Congress on Conducting a Study of Performance-Based Financial Incentives in Child Welfare provides an update on the activities that the Department has undertaken in support of the mandate to conduct a study on performance-based financial incentives. The report also outlines a number of questions and issues that will need to be addressed by the Department, in consultation with key members of Congress, State and local public officials responsible for administering child welfare programs, child welfare advocates, and other experts in the field of child welfare and outcome measurement, in order to complete a study of and make recommendations on the development of a performance-based incentive system in child welfare. The report provides information gathered through preliminary consultation with the field, analysis of existing data, an examination of similar efforts in other health and human service fields, and a review of selected literature.

The Progress Report does not draw conclusions about the feasibility of developing a performance-based financial incentive system for child welfare, nor does it make recommendations on the specific way in which any new incentives might be structured. Making recommendations in these areas will require considerable additional consultation and study and will be addressed in the Department's Final Report to the Congress on Performance-Based Incentives in Child Welfare. Rather, this Progress Report presents information on a range of issues relevant to the development of outcome measures and performance-based incentives, and it identifies questions and issues that will need to be examined as the Department moves forward in working with its external partners to develop recommendations for the Final Report on this very complex and important issue.

The Department is confident that it will be able to work productively with government officials, advocates and other experts to complete a thorough and useful study of a performance-based incentive system for child welfare. We are pleased to provide this update of our activities to-date and our plans for moving into the next phase of this work.

A Review of the Department's Progress To-Date

In response to the charge laid out by the Congress in Section 203 of the Adoption and Safe Families Act, the Department has initiated a review of the feasibility, timetable and process for conducting a study on the use of performance-based financial incentives. The Department has reviewed the kinds of information that will be needed to support the exploration of performance-based financial incentives in child welfare and the development of recommendations to the Congress on this issue. The Department has also reviewed and considered how best to structure and support a consultation process that engages a broad range of stakeholders, while also ensuring the continuity of participation that will be needed to grapple with a complex set of issues. Following is a description of some of the steps that the Department has taken to-date:

• Preliminary Consultation: In January and February, 1998, the Department held a series of focus groups in Washington, D.C., and in the ten Regional Offices of the Administration for Children and Families in order to gain early insight from State officials, advocates, and child welfare practitioners on a range of issues relating to the implementation of the Adoption and Safe Families Act. The issues raised in the focus groups included a set of questions on the development of a performance-based incentive system:

  "What do you believe should be the goals of a performance-based incentive system in child welfare? What issues need to be addressed in any such system? What are the strengths of such a system? What are your concerns about the development of such a system?"

  Ideas, insights and concerns expressed by focus group participants have helped to inform the development of this report.

  • Review of Information on Child Welfare Financing: Because any proposed revision to the Federal child welfare programs must be rooted in a clear understanding of the ways in which child welfare programs are funded today, the Department has begun to compile available data and research on historic and current trends in child welfare financing and the ways in which financial incentives have been structured in the past.

  • Gathering Information on the Use of Outcome Measurement in Child Welfare: Many participants in focus groups recognized the opportunity to improve results for children and families by moving to a more outcome-focused system. But they also expressed caution about whether outcome measures and data sources are sufficiently strong to be able to support performance-based financing. To help inform further discussion on this issue, the Department has begun to assemble information on the current development and use of outcome measures in child welfare and on the availability of data to support outcome-based systems in child welfare.

  • Exploration of Performance-Based Systems in Other Health and Human Service Programs: Significant work has taken place in the past several years on the development of outcome measures and/or performance-based incentives in other health and human service programs. The Department has compiled information on lessons or strategies to be learned from other program areas, both in terms of successful models of consultation and important substantive issues to be considered in developing outcome-based systems.

  • Literature Review: Department staff have conducted a preliminary review of literature on the use of outcome measures and performance-based financial incentives in health and human service programs in order to inform future developments in child welfare.

  • Plans for Final Study: Finally, the Department has developed a plan to support development of outcome measures in child welfare, the completion of the study and the Final Report to the Congress on Performance-Based Financial Incentives in Child Welfare, and the development of the first annual report on outcome measures. The plan, detailed later in the report, includes forming a consultation work group of State officials, child welfare advocates and other experts in the field to work closely with Federal staff in developing recommendations for selection of outcome measures and performance-based financing strategies.