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Part II: Program Description and Performance Analysis
| 6. | INCREASE SAFETY, PERMANENCY, AND WELL-BEING OF CHILDREN AND YOUTH |
Approach for the Strategic Objective: Help children and youth while they are living with their own families, when appropriate. When necessary, place children and youth in stable, family-like settings consistent with the needs of each child or youth. Support children and youth with developmental disabilities in individual and small group dwellings that will include them in community life.
| 6. 1 | CHILD WELFARE |
| Request, Full Costs, & Annual Measures ($ in millions) |
FY 2003 | FY 2004 | FY 2005 |
| Budget Request (Program Level) | $7,546.4 | $7,758.3 | $7,897.4 |
| Estimated Full Cost | $7,547.2 | $7,759.2 | $7,898.3 |
| Program Goal: Improve the Welfare of Children Incorporates measure: FY 2003-2005: 6.1a-f |
$5,735.9 |
$5,897.0 |
$6,002.7 |
* The distribution of full costs to performance measures may not equal the full cost of the performance program area.
ALLOCATION METHODOLOGY EXPLANATION: Performance measures represent 76% of full cost of program based on including costs associated with abuse and neglect, foster care children’s permanency/stability, and adoptions. Funding for the Independent Living Training Vouchers, Abandoned Infants Assistance Programs, and Infant Adoption Awareness Program were not included.
PROGRAM DESCRIPTION AND CONTEXT
The purpose of ACF’s Child Welfare programs is to prevent maltreatment of children, find temporary placements for children who must be removed from their homes, and find permanent placements for those children who cannot be safety returned to their homes. Programs such as Foster Care, Adoption Assistance, and Independent Living provide stable environments for those children who cannot remain safely in their homes, assuring children’s safety and well-being while their parents attempt to resolve the difficulties that led to the out-of-home placement. When the family cannot be reunified, foster care provides a stable environment until the child can be placed permanently with an adoptive family or in a guardianship arrangement. Adoption Assistance funds are available for a one-time payment for the costs of adopting a child as well as for monthly subsidies to adoptive families for care of the child.
ACF has undertaken a number of activities designed to improve overall performance in child welfare. Most significant is the publication in January 2000 of final regulations pertaining to aspects of the Adoption and Safe Families Act of 1997 (ASFA), including regulations about foster care eligibility reviews and state plan reviews. Central and Regional Office staff and the ten Child Welfare Resource Centers continue to provide training and technical assistance to states and local agencies around issues pertaining to the implementation of ASFA. The Resource Centers focus on permanency planning, adoption, family-centered practice, youth development, legal issues, abandoned infants, organizational development, child maltreatment, community-based family resource services, and information technology.
On January 25, 2000, HHS published a final rule in the Federal Register to establish new approaches to monitoring state child welfare programs. Of particular note are the Child and Family Services (CFS) reviews, which focus on outcomes for children and families in the areas of safety, permanency, and child and family well-being; and systemic factors that directly impact the states’ capacity to deliver services leading to improved outcomes. By FY 2005, at least one CFS review will have been completed in each state and all states, where applicable, will be implementing their Program Improvement Plans. The specific outcomes and their associated indicators are as follows:
Safety Outcomes:
- Children are, first and foremost, protected from abuse and neglect.
- Children are safely maintained in their homes whenever possible and appropriate.
Permanency Outcomes:
- Children have permanency and stability in their living situations.
- The continuity of family relationships and connections is preserved for children.
Child and Family Well-Being Outcomes:
- Families have enhanced capacity to provide for their children's needs.
- Children receive appropriate services to meet their educational needs.
- Children receive adequate services to meet their physical and mental health needs.
The systemic factors being reviewed are related to the state's ability to deliver services leading to improved outcomes. The systemic factors include: 1) statewide information systems; 2) case review system; 3) quality assurance system; 4) staff and provider training; 5) service array; 6) agency responsiveness to the community; and 7) foster and adoptive parent licensing, recruitment, and retention.
In addition to the outcomes measured through the CFS reviews, ACF publishes an annual report on Child Welfare Outcomes for the states, as required by section 479a of the Social Security Act, and awards adoption incentive funds to states that increase their number of finalized adoptions over their baselines. In FY 2001, ACF was one of 15 finalists out of 3,000 applicants in Harvard University’s Innovations in American Government competition for its focus on outcomes in child welfare activities.
Program Partnerships
Children in the child welfare system have many medical and mental health difficulties, while chronic substance abuse, mental health problems, homelessness, limited education, and other problems incapacitate many of their parents. The availability of services from other sectors to meet these needs is uneven. ACF works closely with the Department of Justice, the Substance Abuse and Mental Health Services Administration, the Temporary Assistance for Needy Families program, and other national agencies and organizations to coordinate the provision of these services.
ACF’s ability to promote improvement in child welfare services is dependent on working collaboratively with state child welfare agencies that are responsible for providing direct services to children and their families. This relationship has been significantly strengthened through the state-Federal partnership required and promoted by the CFS reviews.
PROGRAM PERFORMANCE ANALYSIS
| Performance Measures | Targets | Actual Performance | Reference (Relevant strategic goal in the HHS Strategic Plan) |
|---|---|---|---|
| LONG-TERM STRATEGIC GOAL: By FY 2008, the Child and Family Services Review (CFSR) process will have resulted in the states’ demonstrating continuous improvement by having 90% (328) of the individual outcomes that they are expected to achieve (364 total) remaining penalty free. [O] | |||
| PROGRAM GOAL - SAFETY: Children are protected from abuse and neglect in their homes. The risk of harm to children will be minimized. | |||
| 6.1a. Decrease the percentage of children with substantiated reports of maltreatment that have a repeated substantiated report of maltreatment within 6 months. [O] | CY
05: 7% CY 04: 7% CY 03: 7% CY 02: 7% CY 01: 7% CY 00: NA |
CY
05: CY 04: CY 03: 9/04 CY 02: 9% CY 01: 9% CY 00: 9% CY 99: 8% CY 98: 8% |
HHS 7.4 |
| PROGRAM GOAL - PERMANENCY: Provide children in foster care permanency and stability in their living situations. | |||
6.1b. Increase the percentage of children who exit foster care within two years of placement either through guardianship or adoption. [O] [E] |
FY
05: 35% FY 04: 33% |
FY
05: FY 04: FY 03: 6/04 FY 02: 31% |
HHS 7.4 EFFICIENCY MEASURE |
| Former Measure: Increase the percentage of children who exit care through adoption within two years of placement. | FY
04: Replaced FY 03: 25% FY 02: 25% FY 01: 28% FY 00: 27% FY 99: NA |
FY
03: 6/04 FY 02: 25% FY 01: 23% FY 00: 20% FY 99: 19% FY 98: 23% |
HHS 7.4 EFFICIENCY MEASURE |
| Former Measure: Maintain percentage of children who exit foster care through guardianships within two years of placement. | FY
04: Replaced FY 03: 60% FY 02: 60% FY 01: 67% FY 00: 67% FY 99: NA |
FY
03: 6/04 FY 02: 62% FY 01: 57% FY 00: 59% FY 99: 64% FY 98: 70% |
HHS 7.4 EFFICIENCY MEASURE |
| 6.1c Maintain the percentage of children who exit the foster care system through reunification within one year of placement. [O][E] | FY
05: 68% FY 04: 67% FY 03: 67% FY 02: 67% FY 01: 67% FY 00: 67% FY 99: NA |
FY
05: FY 04: FY 03: 6/04 FY 02: 68% FY 01: 68% FY 00: 67% FY 99: 65% FY 98: 63% |
HHS 7.4 EFFICIENCY MEASURE |
| 6.1d. Decrease the percentage of children who exit foster care through emancipation. [O] | FY
05: 5% FY 04: 6% |
FY
05: |
|
| LONG-TERM STRATEGIC GOAL: Three hundred and twenty-seven thousand (327,000) children will be adopted with public child welfare involvement between FY 2003 and FY 2008. [O] | |||
| 6.1e. Increase the number of adoptions. 1 [O] | FY
05: 54,000 FY 04: 53,000 FY 03: 58,500 FY 02: 56,000 FY 01: 51,000 FY 00: 46,000 FY 99: 41,000 |
FY
05: FY 04: FY 03: 9/04 FY 02: 51,000 FY 01: 50,000 FY 00: 51,000 (50,000) FY 99: 47,000 (46,000) FY 98: 37,000 (36,000) FY 97: 31,000 FY 96: 28,000 FY 95: 26,000 |
HHS 7.4 |
| PROGRAM GOAL - FAMILY AND CHILD WELL-BEING: Minimize the disruption to the continuity of family and other relationships for children in foster care. | |||
6.1f. For those children who had been in care less than 12 months, maintain the percentage that had no more than two placement settings. 2 [O] |
FY
05: 80% FY 04: 80% FY 03: 62% FY 02: 60% FY 01: 72% FY 00: NA FY 99: NA |
FY
05: FY 04: FY 03: 6/04 FY 02: 81% FY 01: 83% (60%) FY 00: 82% (58%) FY 99: 78% (60%) FY 98: 71% (70%) |
HHS 7.4 |
| COSTS ASSOCIATED
WITH MEASURES 6.1a – f % of Full Costs FY 2003: 76% FY 2004: 76% FY 2005: 76% OTHER: 24% (This percentage includes funding for the Independent Living Training Vouchers, Abandoned Infants Assistance Programs and Infant Adoption Awareness Program.) |
|||
1
The revised figures reported above are based on data reported
as of October 1, 2003. States are encouraged to report finalized
adoptions at any time. (back) |
|||
Total Funding (includes Independent Living/Foster Care/Adoption-dollars in millions) See detailed Budget Linkage Table in Appendix A-12 for line items included in funding totals. |
FY
05: $7897.4 FY 04: $7758.4 FY 03: $7546.2 FY 02: $7522.9 FY 01: $7197.8 FY 00: $6463.4 FY 99: $5639.7 |
||
Summary of Program Performance
|
[D] |
ACF met or exceeded the goals for four of the measures. Specifically, the measures: “Maintain the percentage of children who exit the foster care system through reunification within one year of placement” was exceeded by one percentage point (68 percent compared to 67 percent); “Increase the percentage of children who exit care through adoption within two years of placement” was met at 25 percent; “Maintain percentage of children who exit foster care through guardianships within two years of placement” was exceeded by two percentage points (62 percent compared to 60 percent); and “For those children who had been in care less than 12 months, maintain the percentage that had no more than two placement settings” was exceeded by 21 percentage points (81 percent as compared to 60 percent). It is likely that these accomplishments have played at least some role in the consistent decline in the number of children in foster care over the past few years as depicted in the accompanying graph. In addition, although the number of children adopted has remained relatively flat over the past three years, the total number of children adopted from FY 1999 through FY 2002 exceeded by 6,000 the total encompassed by the targets. Unfortunately, “Decrease the percentage of children with substantiated reports of maltreatment that have a repeated substantiated report of maltreatment within 6 months” continues to have an ambitious target of 7% which has not been met. With 42 states reporting, the actual percentage has remained stable at 9% for the most recent three years.
Data Quality: Both AFCARS and the National Child Abuse and Neglect Data System (NCANDS) conduct extensive edit-checks for internal reliability. For AFCARS, more than 700 edit-checks are conducted each time data are submitted, a minimum of two times a year per state, to improve data quality and the results are sent to the states. In addition, all edit-check programs are shared with the states. Finally, compliance reviews for AFCARS are currently being piloted, and state SACWIS systems are undergoing reviews to determine the status of their operation. To speed improvement in these data, the agency funds the National Resource Center for Information Technology in Child Welfare. This Resource Center provides technical assistance to states to improve reporting to AFCARS and NCANDS, improve statewide information systems, and better utilize their data. Finally, within the past year and half, ACF has implemented the AFCARS Project that includes a detailed review of all aspects of AFCARS by Federal staff and participation of the field in identifying possible changes to improve the system. All of these activities should continue to generate additional improvements in the data over the next few years.
Data Availability: AFCARS foster care data are not available until nine months after the September 30 point-in-time date. AFCARS foster care data for September 30 of any year, under regulation, are reported by the states to ACF electronically by November 14. The data are processed, assessed for errors and compliance with regulatory standards, and the results are transmitted back to the states. Based on these results and other information provided by the Department, many states submit revised data to insure that accurate data are submitted. There are two other times states may re-submit data. First, AFCARS foster care data are used in the statewide assessment portion of the CFS reviews. When some states examine these data provided to them by the Department, they chose to re-submit more accurate data. In addition, AFCARS foster care data are used in the implementation of Program Improvement Plans, which result from the CFS reviews. States may resubmit data to insure that the data used for this purpose are accurate. The resubmitted data are then processed and the data are made available to the statistical analysts in May. The analysts review the data to determine which states’ data are useable in this plan.
Adoption Data: States can submit AFCARS adoption data on any finalized adoption at any time and still meet the requirements of the regulation. Frequently, adoption data are not entered into state information systems for some time after the adoption because the entry does not occur until the final paperwork is received from the court. For example, over 2,800 adoptions finalized in FY 2000 were not reported until the first reporting period in FY 2001 (May 15, 2001). Because of the requirement of the Adoption Incentive Program that only adoptions reported by the first reporting period in the following fiscal year can be counted for incentive awards, almost all adoptions are now reported within that timeframe, though there are still a small number which are reported in subsequent reporting periods. After data are received (in this case by May 15 of the following year), they must be downloaded, converted to analytical files and cleaned before they can be included in the plan, usually by September of the fiscal year following finalization.
Measure by Measure Presentation of Performance
| LONG-TERM STRATEGIC GOAL: By FY 2008, the Child and Family Services (CFS) Review process will have resulted in the States’ demonstrating continuous improvement by having 90% (328) of the individual outcomes that they are expected to achieve (364 total) remaining penalty free. Rationale: The CFS reviews assesses the performance of state (including the District of Columbia and Puerto Rico) child welfare programs on 7 outcomes and 7 systemic factors. The proposed long-term child welfare outcome target will focus on the 7 outcomes. When states are deemed not in conformity with a particular outcome, they are provided an opportunity to improve their performance. If they fail to improve, a financial penalty is taken. By FY 2008, all states will have completed their first reviews and the time period available to improve performance will have passed. The 90 percent target of 328 ((7 x 52) x .9)) is very ambitious. Prior to the CFS reviews, the Federal government had not conducted systematic on-site monitoring of state child welfare programs in over 5 years. Given this extensive lapse of time and the fact that this target is for the first cycle of reviews, the achievement of a 90 percent non-penalization rate is very rigorous. The first report on this long-term strategic goal will be included in the FY 2004 Report and will include the cumulative total of the number individual outcomes determined to be remaining penalty free between FY 2001 and FY 2003. Subsequent reports will include the cumulative total number of individual outcomes remaining penalty free between FY 2001 and the year prior to the report year. |
PROGRAM GOAL - SAFETY: Children
are protected from abuse and neglect in their homes. The risk of harm
to children will be minimized.
| 6.1a. | Decrease the percentage of children with
substantiated reports of maltreatment that have a repeat substantiated
report of maltreatment within 6 months. Data Source: NCANDS. |
Tracking the rate of repeat maltreatment is critical in determining
how well the public child welfare system is addressing the needs of
maltreated children. This measure focuses on children already known
to the agency, children who already have a substantiated report of
maltreatment and whose safety needs have already been addressed. Unfortunately,
they again have a substantiated report within the following six months.
Changes in this measure can result from changes in the effectiveness
and/or availability of services provided for the first incident, changes
in surveillance of the child by the agency and changes in parenting
behavior. All of these factors are important in assessing the ability
of agencies to serve this population. ACF began using this measure
in Calendar Year (CY) 2001. It has proven to be stable over time,
ranging between 8 percent and 9 percent for the years CY 1998 through
CY 2001. Forty states reported useable data for the CY 2001 calculation.
PROGRAM GOAL - PERMANENCY: Provide children in foster care permanency and stability in their living situations.
| FY 2004-2005 Plan | |
| 6.1b. | Increase the percentage of children who exit
foster care within two years of placement either through guardianship
or adoption (New). Data Source: AFCARS |
ACF has combined and replaced the following two measures. ACF expects
that there will be an increase in the use of guardianships over the
next few years, as well as an increase in the number of adoptions,
as discussed below. ACF believes that these two outcomes are comparable
in their relationship to permanency and should be merged. The two
year timeframe is appropriate for the merged measure. ACF expects
to increase from 31 percent in FY 2002 to 35 percent in FY 2005 in
the percentage of children exiting to adoption or guardianship doing
so within two years of placement.
| FY 2003 Plan | |
| Increase the percentage of children who exit
care through adoption within two years of placement. Data Source: AFCARS |
|
|
[D] |
When reunification with parents or relatives is not possible, the preferred permanency outcome for most children is adoption. ASFA and other Federal legislation enacted during the last 25 years have promoted the adoption of children from the public child welfare system for whom reunification was not possible. Specifically, ASFA created a timeline for seeking termination of parental rights for children in foster care. It was presumed that this timeline would result in children being adopted more swiftly. If a state intends to have a child adopted, it should be done within a reasonable time frame. The goal is that 25 percent of children who exit to adoption should do so within two years. ACF met this goal for FY 2002. As the accompanying graph indicates, this percentage has been consistently increasing since FY 1999 when it was 19 percent. It is possible that the 23 percent reported for FY 1998 is a result of the data weaknesses experienced in the early years of the AFCARS system.
| FY 2003 Plan | |
| Of the children who exit foster care through
guardianships, increase the percentage of children who do this
within 2 years. Data Source: AFCARS |
|
Guardianship is rapidly becoming a preferred discharge option for
certain children who cannot return home and for whom adoption is not
appropriate. The reports of discharges to guardianship have grown
over the past few years to almost 10,000 in FY 2002 from a little
over 4,000 in FY 1998. There are a number of factors that have contributed
to this increase in reporting. First, the use of guardianship as an
exit strategy for relative foster care appears to be growing, primarily
for children who may have been in a relative care placement for a
long period of time, and many states wish to track it. Second, AFCARS
reviews have identified problems in the coding of guardianships in
a limited number of states and those states have taken action to correct
the problems. Third, the Data Profile component of the Statewide Assessment
used in the CFS emphasizes discharge reasons.
The percentage of children who exited foster care through guardianships within two years of placement has been unstable from FY 1998 to FY 2002, although the 62 percent reported for FY 2002 exceeds the target of 60 percent. Some of the instability of the measure over time may be a reflection that guardianship, as a reason for discharge, has generally been under-reported and is not listed as a discharge reason in some states.
ACF expects the use of guardianships to continue to increase if the Administration’s Child Welfare Program Option proposal is passed by the Congress. Currently, only states with specific demonstration waivers have access to Federal matching funds for assisted guardianships. It is expected that states that choose the Child Welfare Program Option, which provides flexibility in the use of some title IV-E funds, will choose to use those funds to support assisted guardianship thereby increasing the number of children for whom that exit strategy is chosen.
States that identify problems with the reporting of guardianships or other discharge reasons in their profile frequently resubmit their data. Early indications are that this process has generated improved data for those states that underwent CFS reviews in FY 2001 and FY 2002. The ACF-funded National Resource Center for Information Technology in Child Welfare is providing intensive technical assistance to states undergoing CFS reviews, particularly in relation to the Data Profile in the Statewide Assessment. ACF expects this technical assistance to result in an overall improvement in the reporting of discharge reasons.
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