Detailed Information on the
Foster Care Assessment

Conducting ongoing Child and Family Service Reviews(CSFRs) and establishing a new set of long-term goals, based on revised performance metrics once the second round of CSFRs is complete. Milestone: Conduct second round CFSRs in 10 states in FY 2009.

Working with the Congress to enact a state option for an alternative financing system for child welfare that will better meet the needs of each state's foster care population. Milestone: Support and monitor Florida and California child welfare waivers and share results with the Congress and key constituencies.

Conducting ongoing Child and Family Service Reviews(CSFRs) and establishing a new set of long-term goals, based on revised performance metrics once the second round of CSFRs is complete. Conduct second round CFSRs in 18 states in FY 2008.

Working with the Congress to enact a state option for an alternative financing system for child welfare that will better meet the needs of each state's foster care population. Milestone: Mention support for legislation to implement President's Program Option in congressional testimony and in other settings, as appropriate.

Measure: Nine States or jurisdictions will be in substantial conformity on Safety Outcome Measure 1: "Children are first and foremost protected from abuse and neglect" by the end of 2010. To be in substantial conformity with this measure, States must achieve desired outcomes in 95% of reviewed cases as well as meet National standards for rates of maltreatment recurrence and the absence of abuse and/or neglect in foster care.

Explanation:Whether or not a State meets the requirements for substantial conformity for Safety Outcome Measure 1: "Children are first and foremost protected from abuse and neglect" is determined based on on-site reviews of State case records and interviews with key case-specific stakeholders (e.g. foster parents, case workers, children). These reviews are conducted in every State once every three years as part of the HHS administered Child and Family Service Review (CSFR). In order to receive this designation, in 95% of the reviewed cases, the State must have met the requirements for initiating investigations of child maltreatment in a timely manner and preventing the recurrence of maltreatment. In addition, the State must also meet or exceed National standards for the recurrence of maltreatment and the rate of maltreatment in foster care. During the initial cycle of CSFR reviews conducted between March 2001 and March 2004, two States met the National standards and 95% of cases threshold, the requirements for substantial conformity for Safety Outcome Measure 1. An explanation of the CSFR process can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/recruit/cfsrfactsheet.htm An explanation of the data indicators can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/data_indicators.htm A summary of State-by-State results of CSFRs can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm

Measure: Five States or jurisdictions will be in substantial conformity with Permanency Outcome Measure 1 "Children have permanency and stability in their living situation" by the end of 2010. To be in substantial conformity with this measure, States must achieve desired outcomes in 95% of reviewed cases as well as meet National standards for: rates of timeliness and permanency of reunification; timeliness of adoptions; achieving permanency for children in foster care and the rate of placement stability in foster care.

Explanation:Whether or not a State meets the requirements for substantial conformity for Permanency Outcome Measure 1 "Children have permanency and stability in their living situation" is determined based on on-site reviews of State case records and interviews with key case-specific stakeholders (e.g. foster parents, case workers, children). These reviews are conducted in every State once every three years as part of the HHS administered Child and Family Service Review (CSFR). In order to receive this designation, in 95% of the reviewed cases, the State must have met the requirements for: 1) preventing multiple entries of children into foster care; 2) minimizing placement changes in foster care; 3) determining the appropriate placement goals for children at the time of entry into foster care; 4) helping children in foster care return safely to their families; 5) achieving timely adoption when it is appropriate for the child; and 6) establishing planned permanent living arrangements for children in foster care that do not have the goal of reunification, adoption, guardianship, or permanent placement with relatives. In addition, The State must also meet or exceed National standards for foster care re-entries, placement stability/length of time until reunification, and the length of time to achieve adoption. During the initial cycle of CSFR reviews conducted between March 2001 and March 2004, no States met the requirements for substantial conformity for Permanency Outcome Measure 1. An explanation of the CSFR process can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/recruit/cfsrfactsheet.htm An explanation of the data indicators can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/data_indicators.htm A summary of State-by-State results of CSFRs can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm

Measure: Ten States will be in substantial conformity with Permanency Outcome Measure 2 "The continuity of family relationships and connections is preserved for children" by the end of 2010. To be in substantial conformity with this measure, States must achieve desired outcomes in 95% of reviewed cases.

Explanation:Five States or jurisdictions will be in substantial conformity with Permanency Outcome 2 "The continuity of family relationships and connections is preserved for children" Measure by 2010. To be in substantial conformity with this measure, States must achieve desired outcomes in 95% of reviewed cases for: 1) proximity of placement to parent's home; 2) placement in foster care with siblings; 3) frequency of visits with parents and siblings; 4) connections with family and community preserved; 5) use of relatives as a placement resource; and 5) relationship with parents maintained. Whether or not a State meets the requirements for substantial conformity for Permanency Outcome Measure 2 "The continuity of family relationships and connections is preserved for children" is determined based on on-site reviews of State case records and interviews with key case-specific stakeholders (e.g. foster parents, case workers, children). These reviews are conducted in every State once every three years as part of the HHS administered Child and Family Service Review (CSFR). During the initial cycle of CSFR reviews conducted between March 2001 and March 2004, no States met the requirement for substantial conformity for Permanency Outcome Measure 2. An explanation of the CSFR process can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/recruit/cfsrfactsheet.htm An explanation of the data indicators can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/data_indicators.htm A summary of State-by-State results of CSFRs can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm

Measure: Three States will be in substantial conformity with Well-Being Outcome Measure 1 "Families have enhanced capacity to provide for their children's needs" by the end of 2010. To be in substantial conformity with this measure, States must achieve desired outcomes in 95% of reviewed cases.

Explanation:Three States or jurisdictions will be in substantial conformity with Measure Well-Being Outcome Measure 1 "Families have enhanced capacity to provide for their children's needs" by 2010. To be in substantial conformity with this measure, States must achieve desired outcomes in 95% of reviewed cases for: 1) assessment of services needs of child, parents and foster parents; 2) involvement of child and parents in case planning; and 3) frequency and quality of caseworker visits with children and with parents. Whether or not a State meets the requirements for substantial conformity for Measure Well-Being Outcome Measure 1 "Families have enhanced capacity to provide for their children's needs" is determined based on on-site reviews of State case records and interviews with key case-specific stakeholders (e.g. foster parents, case workers, children). These reviews are conducted in every State once every three years as part of the HHS administered Child and Family Service Review (CSFR). During the initial cycle of CSFR reviews conducted between March 2001 and March 2004, no States met the requirement for substantial conformity for Well-Being Outcome Measure 1. An explanation of the CSFR process can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/recruit/cfsrfactsheet.htm An explanation of the data indicators can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/data_indicators.htm A summary of State-by-State results of CSFRs can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm

Measure: Twenty States or jurisdictions will be in substantial conformity with the systemic factor "Case Review System." Systemic factors measure a State's capacity to achieve safety and permanence for children and well-being for children and their families. This measure examines State effectiveness in five separate aspects of the Case Review Sysytem.

Explanation:Children and Family Service Reviews (CFSRs) assess state performance based on the state's policy and practice within seven federally required "systems." Ratings are based on interviews with state and local stakeholders in the child welfare system. The effectiveness of a case review system is based on the assessment of five indicators of whether a system has been implemented and is functioning properly: 1) developing written case plans jointly with the parents; 2) conducting the periodic review of the status of each child (no less frequently than every six months); 3) ensuring that each child has a permanency hearing within 12 months of entering foster care and no less frequently than every 12 months thereafter; 4) providing a process for termination of parental rights for children in foster care in accordance with the provisions of the Adoption and Safe Families Act; and 5) ensuring that foster parents, pre-adoptive parents, and relative caregivers of children in foster care receive notice of reviews or hearings and have an opportunity to be heard. Because these systems are intended to work together, a poor rating on any one system may affect a state's ability to achieve one or all of the child outcomes assessed. Case Review System was the area in which state capacity was judged weakest and this system is arguably one of the keystones of a successful child welfare program. Just thirteen states were found to be in compliance with case review system requirements during the initial cycle of CSFR reviews conducted between March 2001 and March 2004. An explanation of the CSFR process can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/recruit/cfsrfactsheet.htm An explanation of the data indicators can be found at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/data_indicators.htm A summary of State-by-State results of CSFRs can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm

Measure: Each FY, an increasing number of States with a closed out Program Improvement Plan (PIP) will be penalty free on Safety Outcome Measure 1: "Children are first and foremost protected from abuse and neglect." In order for a State to be designated penalty free it must address all findings identified in its most recent Child and Family Service Review (CFSR) by completing all agreed to actions and meeting quantifiable outcomes within specified time frames.

Explanation:Following a Child and Family Service Review, each State is required to develop a PIP to address each one of the outcomes or systems with which a state was found to be out of substantial conformity and must describe the state's specific plan for moving toward full conformity with federal policy. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. States that meet or exceed their PIP goals are determined to be "penalty free." If improvements were not made then a financial penalty is assessed. The PIP must include a measurable goal of improvement, action steps, and timeframe for addressing each outcome that has been found not to be in substantial conformity. Specifically, the PIP must address the onsite performance indicators (items) and statewide aggregate data that contributed to the low achievement level of that outcome, as noted in the final report. In prioritizing issues to be addressed in the PIP, items and outcome areas that affect child safety must be addressed first, followed by those most egregiously not in substantial conformity, through both short-term goals (to minimize the negative effects on children and families immediately) and long-term goals (plans for lasting reforms). The priority assigned to these issues is reflected in the timeframes in the PIP, rather than in the order in which those issues are identified in the PIP document. The PIP must include a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards. If the amount of progress to be achieved through the PIP does not reach the established national standards, the amount negotiated between the ACF Regional Office and the State must be significant enough to move the State toward conformance with the national standards in a reasonable period of time. The PIP must include a measurable goal of improvement, action steps, and a timeframe for addressing each systemic factor found not to be in substantial conformity. The PIP must address the State plan requirements that contributed to a determination of nonconformity for each systemic factor, as noted in the final report. The PIP must present a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress and other evidence that goals have been achieved. Individual State Program Improvement Plans can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm Program Improvement Plan Instructions and Matrix can be found at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm#instruct

Measure: Each FY, an increasing number of States with a closed out Program Improvement Plan (PIP) will be penalty free on Permanency Outcome Measure 1 "Children have permanency and stability in their living situation." In order for a State to be designated penalty free it must address all findings identified in its most recent Child and Family Service Review (CFSR) by completing all agreed to actions and meeting quantifiable outcomes within specified time frames.

Explanation:Following a Child and Family Service Review, each State is required to develop a PIP to address each one of the outcomes or systems with which a state was found to be out of substantial conformity and must describe the state's specific plan for moving toward full conformity with federal policy. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. States that meet or exceed their PIP goals are determined to be "penalty free." If improvements were not made then a financial penalty is assessed. The PIP must include a measurable goal of improvement, action steps, and timeframe for addressing each outcome that has been found not to be in substantial conformity. Specifically, the PIP must address the onsite performance indicators (items) and statewide aggregate data that contributed to the low achievement level of that outcome, as noted in the final report. In prioritizing issues to be addressed in the PIP, items and outcome areas that affect child safety must be addressed first, followed by those most egregiously not in substantial conformity, through both short-term goals (to minimize the negative effects on children and families immediately) and long-term goals (plans for lasting reforms). The priority assigned to these issues is reflected in the timeframes in the PIP, rather than in the order in which those issues are identified in the PIP document. The PIP must include a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards. If the amount of progress to be achieved through the PIP does not reach the established national standards, the amount negotiated between the ACF Regional Office and the State must be significant enough to move the State toward conformance with the national standards in a reasonable period of time. The PIP must include a measurable goal of improvement, action steps, and a timeframe for addressing each systemic factor found not to be in substantial conformity. The PIP must address the State plan requirements that contributed to a determination of nonconformity for each systemic factor, as noted in the final report. The PIP must present a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress and other evidence that goals have been achieved. Individual State Program Improvement Plans can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm Program Improvement Plan Instructions and Matrix can be found at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm#instruct

Measure: Each FY, an increasing number of States with a closed out Program Improvement Plan (PIP) will be penalty free on the systemic factor "Staff Training." In order for a State to be designated penalty free it must address all findings identified in its most recent Child and Family Service Review (CFSR) by completing all agreed to actions and meeting applicable quantifiable goals within specified time frames.

Explanation:Following a Child and Family Service Review, each State is required to develop a PIP to address each one of the outcomes or systems with which a state was found to be out of substantial conformity and must describe the state's specific plan for moving toward full conformity with federal policy. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. States that meet or exceed their PIP goals are determined to be "penalty free." If improvements were not made then a financial penalty is assessed. The PIP must include a measurable goal of improvement, action steps, and timeframe for addressing each outcome that has been found not to be in substantial conformity. Specifically, the PIP must address the onsite performance indicators (items) and statewide aggregate data that contributed to the low achievement level of that outcome, as noted in the final report. In prioritizing issues to be addressed in the PIP, items and outcome areas that affect child safety must be addressed first, followed by those most egregiously not in substantial conformity, through both short-term goals (to minimize the negative effects on children and families immediately) and long-term goals (plans for lasting reforms). The priority assigned to these issues is reflected in the timeframes in the PIP, rather than in the order in which those issues are identified in the PIP document. The PIP must include a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards. If the amount of progress to be achieved through the PIP does not reach the established national standards, the amount negotiated between the ACF Regional Office and the State must be significant enough to move the State toward conformance with the national standards in a reasonable period of time. The PIP must include a measurable goal of improvement, action steps, and a timeframe for addressing each systemic factor found not to be in substantial conformity. The PIP must address the State plan requirements that contributed to a determination of nonconformity for each systemic factor, as noted in the final report. The PIP must present a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress and other evidence that goals have been achieved. Individual State Program Improvement Plans can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm Program Improvement Plan Instructions and Matrix can be found at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm#instruct

Measure: Each FY, an increasing number of States with a closed out Program Improvement Plan (PIP) will be penalty free for Permanency Outcome 2: "The continuity of family relationships and connections is preserved for children." In order for a State to be designated penalty free it must address all findings identified in its most recent Child and Family Service Review (CFSR) by completing all agreed to actions and meeting quantifiable outcomes within specified time frames.

Explanation:Following a Child and Family Service Review, each State is required to develop a PIP to address each one of the outcomes or systems with which a state was found to be out of substantial conformity and must describe the state's specific plan for moving toward full conformity with federal policy. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. States that meet or exceed their PIP goals are determined to be "penalty free." If improvements were not made then a financial penalty is assessed. The PIP must include a measurable goal of improvement, action steps, and timeframe for addressing each outcome that has been found not to be in substantial conformity. Specifically, the PIP must address the onsite performance indicators (items) and statewide aggregate data that contributed to the low achievement level of that outcome, as noted in the final report. In prioritizing issues to be addressed in the PIP, items and outcome areas that affect child safety must be addressed first, followed by those most egregiously not in substantial conformity, through both short-term goals (to minimize the negative effects on children and families immediately) and long-term goals (plans for lasting reforms). The priority assigned to these issues is reflected in the timeframes in the PIP, rather than in the order in which those issues are identified in the PIP document. The PIP must include a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards. If the amount of progress to be achieved through the PIP does not reach the established national standards, the amount negotiated between the ACF Regional Office and the State must be significant enough to move the State toward conformance with the national standards in a reasonable period of time. The PIP must include a measurable goal of improvement, action steps, and a timeframe for addressing each systemic factor found not to be in substantial conformity. The PIP must address the State plan requirements that contributed to a determination of nonconformity for each systemic factor, as noted in the final report. The PIP must present a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress and other evidence that goals have been achieved. Individual State Program Improvement Plans can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm Program Improvement Plan Instructions and Matrix can be found at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm#instruct

Measure: Each FY, an increasing number of States with a closed out Program Improvement Plan (PIP) will be penalty free for Well-Being Outcome 1: "Families have enhanced capacity to provide for their children's needs." In order for a State to be designated penalty free it must address all findings identified in its most recent Child and Family Service Review (CFSR) by completing all agreed to actions and meeting quantifiable outcomes within specified time frames.

Explanation:Following a Child and Family Service Review, each State is required to develop a PIP to address each one of the outcomes or systems with which a state was found to be out of substantial conformity and must describe the state's specific plan for moving toward full conformity with federal policy. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. States that meet or exceed their PIP goals are determined to be "penalty free." If improvements were not made then a financial penalty is assessed. The PIP must include a measurable goal of improvement, action steps, and timeframe for addressing each outcome that has been found not to be in substantial conformity. Specifically, the PIP must address the onsite performance indicators (items) and statewide aggregate data that contributed to the low achievement level of that outcome, as noted in the final report. In prioritizing issues to be addressed in the PIP, items and outcome areas that affect child safety must be addressed first, followed by those most egregiously not in substantial conformity, through both short-term goals (to minimize the negative effects on children and families immediately) and long-term goals (plans for lasting reforms). The priority assigned to these issues is reflected in the timeframes in the PIP, rather than in the order in which those issues are identified in the PIP document. The PIP must include a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards. If the amount of progress to be achieved through the PIP does not reach the established national standards, the amount negotiated between the ACF Regional Office and the State must be significant enough to move the State toward conformance with the national standards in a reasonable period of time. The PIP must include a measurable goal of improvement, action steps, and a timeframe for addressing each systemic factor found not to be in substantial conformity. The PIP must address the State plan requirements that contributed to a determination of nonconformity for each systemic factor, as noted in the final report. The PIP must present a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress and other evidence that goals have been achieved. Individual State Program Improvement Plans can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm Program Improvement Plan Instructions and Matrix can be found at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm#instruct

Measure: Each FY, an increasing number of States with a closed out Program Improvement Plan( PIP) will be penalty free for the systemic factor "Foster & Adoptive Parent Licensing, Recruitment and Retention." In order for a State to be designated penalty free it must address all findings identified in its most recent Child and Family Service Review (CFSR) by completing all agreed to actions and meeting applicable quantifiable goals within specified time frames.

Explanation:Following a Child and Family Service Review, each State is required to develop a PIP to address each one of the outcomes or systems with which a state was found to be out of substantial conformity and must describe the state's specific plan for moving toward full conformity with federal policy. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. States that meet or exceed their PIP goals are determined to be "penalty free." If improvements were not made then a financial penalty is assessed. The PIP must include a measurable goal of improvement, action steps, and timeframe for addressing each outcome that has been found not to be in substantial conformity. Specifically, the PIP must address the onsite performance indicators (items) and statewide aggregate data that contributed to the low achievement level of that outcome, as noted in the final report. In prioritizing issues to be addressed in the PIP, items and outcome areas that affect child safety must be addressed first, followed by those most egregiously not in substantial conformity, through both short-term goals (to minimize the negative effects on children and families immediately) and long-term goals (plans for lasting reforms). The priority assigned to these issues is reflected in the timeframes in the PIP, rather than in the order in which those issues are identified in the PIP document. The PIP must include a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards. If the amount of progress to be achieved through the PIP does not reach the established national standards, the amount negotiated between the ACF Regional Office and the State must be significant enough to move the State toward conformance with the national standards in a reasonable period of time. The PIP must include a measurable goal of improvement, action steps, and a timeframe for addressing each systemic factor found not to be in substantial conformity. The PIP must address the State plan requirements that contributed to a determination of nonconformity for each systemic factor, as noted in the final report. The PIP must present a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress and other evidence that goals have been achieved. Individual State Program Improvement Plans can be found at: http://basis.caliber.com/cwig/ws/cwmd/docs/cb_web/SearchForm Program Improvement Plan Instructions and Matrix can be found at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm#instruct

Measure: Increase the adoption rate.

Explanation:

Measure: Decrease the percent of foster children in care 12 or more months with no case plan goal (including case plan goal "Not Yet Determined").

Explanation:This measure functions as both an outcome and an efficiency measure.

Measure: Decrease improper payments in the title IV-E foster care program by lowering the national error rate.

Explanation:

Is the program purpose clear?

Explanation: The title IV-E Foster Care program has a clear focus and a well-defined mission. It is intended to help States (the 50 States, District of Columbia and Puerto Rico) provide board and care payments for eligible children when they are under the supervision of the State and placed in foster family homes or childcare institutions that are safe and licensed. The program is authorized by title IV-E of the Social Security Act, as amended, and implemented under the Code of Federal Regulations (CFR) at 45 CFR parts 1355, 1356, and 1357. The program's focus, which is articulated in statute, is children who are eligible under the Aid to Families with Dependent Children program and removed from their homes as the result of maltreatment, lack of care or lack of supervision. The program is administered at the Federal level by the Children's Bureau of the Administration for Children and Families (ACF), in the Department of Health and Human Services (HHS). In addition to staff located in the Central Office in Washington, DC, the Children's Bureau also has staff in 10 Regional Offices around the country. The Regional Office staff serves as the first point of contact for information and assistance for States and Tribes operating child welfare programs.

Evidence: Title IV-E, Sections 470 - 472, 474 and 475 of the Social Security Act. Available online at: http://www.ssa.gov/OP_Home/ssact/title04/0400.htm Parts 1355, 1356 and 1357 of the Code of Federal Regulations. Available online at: http://www.access.gpo.gov/nara/cfr/waisidx_02/45cfr.htm

Does the program address a specific and existing problem, interest, or need?

Explanation: The title IV-E Foster Care program provides States with critical financial assistance to support children who must be removed from their homes due to child abuse and neglect or other problems. Specifically, the program permits States to claim reimbursement for a portion of foster care expenditures only for children removed from homes that were eligible for the pre-welfare reform Aid to Families with Dependent Children program and placed in foster care. Federal reimbursement may be claimed as long as these children's stay in foster care comport with all of the rules and regulations governing the title IV-E program. In addition to providing States with critical financial resources to ensure the safety of children in foster care, the program establishes key requirements intended to promote the safety, permanency and well-being of children. Examples include provisions mandating that States make reasonable efforts to prevent the removal of children from their homes and that they make reasonable efforts to return or move the child to a permanent home when they must be removed; provisions requiring the development of caseplans specifying a permanency goal and services needed by the child and family to achieve that goal; and requirements relating to the timing of permanency hearings and the oversight of courts. In addition, the law requires all States to collect and report data on all children in foster care, thus ensuring the availability of information that can be used to track outcomes at the State and national levels For Federal fiscal year 2005 (the most recent year for which we have data), an estimated 3.6 million children were the subject of reports alleging abuse or neglect and received investigations or assessments by State and local child protective services agencies. Of these children, approximately 899,000 were determined to be victims of child maltreatment and approximately one-fifth of these victims were placed in foster care as a result of a child protective services investigation. As of the last day of FY 2005, an estimated 513,000 children were in foster care. Approximately 46 percent of the children in foster care are title IV-E eligible. The Federal government assists States with a significant portion (50-76 percent) of the costs related to an eligible child's out-of-home care, as well as 50 percent of the associated administrative costs and 75 percent of the costs related to staff and provider training. The total State claims of the title IV-E Foster Care program in FY 2005 was $8.6 billion, of which $4.5 billion was the Federal share.

Evidence: Child Maltreatment Annual Reports: Reports from the States to the National Child Abuse and Neglect Data Systems - National statistics on child abuse and neglect. The FY 2005 data will be published in April 2007. It will be available online at: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm Trends in Foster Care and Adoption. Available online at: http://www.acf.hhs.gov/programs/cb/stats_research/afcars/trends.htm

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: The title IV-E Foster Care program is an open-ended, grant-in-aid program in which the Federal government provides funds to augment the State's costs for an eligible child's daily out-of-home care and for the administration of the program. States are entitled to receive unlimited reimbursement for the Federal share of all allowable expenses for maintenance payments, which consist of a child's food, clothing, shelter, daily supervision, school supplies, personal incidentals and liability insurance as well as travel to the child's home (50-76 percent Federal match); administrative costs to manage the program (50 percent Federal match); and staff and foster parent training (75 percent Federal match). No other Federal program of a similar nature exists. At the State level, the program is not, by design, duplicative. State child welfare agencies have statutory authority and responsibility to remove children to foster care. This authority does not exist in the private sector. In addition, the law and regulations implementing the program contain provisions designed to ensure the safety, permanency and well-being of children by establishing consistent national standards for the treatment of children in foster care, requiring, for instance, the development of case plans for all children in care and the implementation of a case review system, requiring court oversight of all foster care cases, and establishing timetables to facilitate children's movement toward permanent homes. The program also establishes requirements for the timely and consistent reporting of data on children in foster care which is critical for program oversight and accountability and assessment of outcomes.

Evidence: Part E of the Social Security Act. Available online at: http://www.ssa.gov/OP_Home/ssact/title04/0400.htm

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: Many researchers and advocates have shown that the program's financial structure does not provide appropriate incentives for the timely, permanent placement of children. The structure of the title IV-E Foster Care program has continued without major revision since it was created in 1961, despite major changes in child welfare practice. The result is a funding stream driven by process rather than outcomes that constrains States' efforts to achieve improved results for children. The Child Welfare Program Option, proposed in the President's Budget, would address this program design flaw by allowing States to choose a fixed allocation of funds over a five year period rather than the current entitlement funding for the title IV-E Foster Care program. Participating States would receive their Foster Care funds in the form of annual, flexible grants which could be used for a variety of child welfare purposes including foster care maintenance payments, case management and administrative activities now supported by the title IV-E foster care program, as well as other types of services and supports to promote the safety, permanency and well-being of children, such as child abuse and neglect prevention efforts, subsidized guardianship, and family preservation, support and reunification services. As a result, States would have the flexibility to design service responses that could help prevent child maltreatment, avoid unnecessary removals of children from their homes, shorten lengths of Stay for children who must be removed and expand efforts to secure permanent, loving homes for children in foster care.

Evidence: See 1) U.S. Department of Health and Human Services (2005). ASPE Issue Brief on "How and Why the Current Funding Structure Fails to Meet the Needs of the Child Welfare Field". Washington, DC: Office of Human Services Policy. Available online at: http://aspe.hhs.gov/hsp/05/fc-financing-ib/; 2) Courtney, Mark. 1998. 'The Cost of Child Protection in the Context of Welfare Reform.' The Future of Children, Vol. 8, No 1; and 3) Waldman, William. 2000. Hearing before the Subcommittee on Human Resources of the Committee on Ways and Means, House of Representatives, October 3, 2000.

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: The program is effectively targeted to ensure that the intended beneficiaries receive the appropriate resources to address the purpose of the title IV-E Foster Care program. Program statute clearly defines eligibility requirements, and the purpose of payments (food, clothing, shelter, etc.). The Children's Bureau ensures that funds are expended for intended use through the eligibility reviews, financial claim reviews and audits conducted by the Office of the Inspector General (OIG). Eligibility reviews are routinely and systematically conducted by the Children's Bureau in each of the 50 States, the District of Columbia, and Puerto Rico to ensure that foster care maintenance payments are made only for program-eligible children. The eligibility review determines a State's level of compliance in meeting the Federal eligibility requirements and validates the accuracy of a State's claim for reimbursements of foster care payments. Each eligibility review specifies the number of cases in error, underlying error causes and amount of payment in error determined from the examination of a sample drawn from the State's overall title IV-E caseload for an identified six-month period. Each eligibility review also details the strengths and weaknesses of each State's program and identifies technical assistance for program improvement. The foster care eligibility review effort enables the Federal government to provide more accurate financial assistance to States as well as provide timely and specific feedback to States that can improve program administration and implementation. At the beginning of FY 2006, 72 percent of the 85 State reviews (including reviews conducted between FYs 2000-2005) were determined to be in substantial compliance with Federal requirements. States that did not meet the compliance threshold were required to complete a Federally-approved plan that addressed non-compliant program areas and undergo a more extensive, secondary level of program review. For the stated period, 16 secondary reviews were conducted and 88 percent of these eligibility reviews were determined to meet the compliance threshold.

Evidence: Social Security Act, sections 472 and 475(4) and 45 CFR 1355.20, 1356.21, 1356.22, 1356.30, 1356.71. Available online at: http://www.ssa.gov/OP_Home/ssact/title04/0400.htm Title IV-E State Reports. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/final/index.htm Improper Payments Report - HHS Performance and Accountability Report. Available online at: http://www.hhs.gov/of/reports/account/acct06/pdf/section4/improper.pdf

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The long-term measures support Foster Care's primary goal of ensuring the safety, permanency and well-being of children and families and mirror and/or complement measures for related programs authorized under title IV-B of the Social Security Act. These measures are based on the results of State-level Child and Family Service Reviews (CFSRs), the primary mechanism to measure performance in the child welfare system. The CFSRs measure current State performance and require progress toward improvements through Program Improvement Plans (PIPs). The CFSR assesses outcome achievement across three broad domains of safety, permanency, and well-being, divided into seven outcome measurements. The reviews assesses State activities associated with maintaining children safely in their own homes whenever possible, minimizing the risk of harm to children through placement in foster care, and moving children in foster care to adoptive families or to other planned, non temporary, living arrangement. The reviews also assess State performance on seven systemic factors. The long-term goals establish targets for the number of States that will be determined to be in "substantial conformity" for key outcome measures of child safety, permanency and well being. The PART also establishes a long-term goal for improving State Case Review Systems (one of the seven systemic factors assessed by the CFSRs), an area that is closely linked to child outcomes and identified as needing improvement. Substantial conformity is determined by the extent to which a State meets federal requirements for each of the seven outcomes and seven systemic factors. Substantial conformity is determined separately for each area, therefore, a State may be in substantial conformity with some, but not all, of the 14 areas. For outcomes, substantial conformity is based only on case review findings and data indicators. (There are only two outcomes - Safety 1 and Permanency 1 - that have data indicators associated with them). Thus, for example, in evaluating Safety Outcome 1, "Children are, first and foremost, protected from abuse and neglect," the reviewers examine a sample of cases onsite and as part of the evaluation of each case determine whether the investigation of reports of child maltreatment were initiated in a timely manner and whether there were any instances of repeat maltreatment in the case. In addition, statewide data relating to recurrence of maltreatment and abuse or neglect of children in foster care are examined to determine if the State's performance meets national standards. A State is determined to be in substantial conformity with an outcome if at least 95 percent of the cases reviewed during an onsite review meet federal requirements and the State meets all of the data indicators associated with the outcome. Substantial conformity for systemic factors is based on information from Statewide Assessments and interviews with State and community stakeholders in order to determine whether the requirements of the State plan are in place and functioning.

Evidence: FY 2008 HHS ACF Congressional Justification (pages 397-401). Available online at: http://www.acf.dhhs.gov/programs/olab/budget

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: The long-term measures use data from Child and Family Services Reviews (CFSR), which assess State-level outcome achievement across three broad domains of safety, permanency, and well-being, divided into seven outcome measurements. In doing so, the Children's Bureau assesses State activities associated with maintaining children safely in their own homes whenever possible, minimizing the risk of harm to children through placement in foster care, and moving children in foster care to permanency. The long-term goals establish targets for the number of States that will be determined to be in substantial conformity with key outcome measures. The determinations of substantial conformity in the CFSR are based on the extent to which a State meets federal requirements for each of the seven outcomes and seven systemic factors. For outcomes, substantial conformity is based on case review findings and applicable data indicators. Substantial conformity for systemic factors is based on information from Statewide Assessments and Stakeholder interviews, and is further determined by whether the requirements of the State plan are in place and functioning. To achieve substantial conformity on outcomes during the initial round of reviews, a State had to meet the national standard for any applicable national data indicators and 90 percent of cases reviewed onsite needed to be rated as a "strength." Baselines for long-term measures are based on the initial round of CSFR reviews and progress towards long-term goals will be based on the second round of reviews. During the second round of CFSRs the standard for the onsite portion has been raised from 90 percent of cases rated a "strength" to 95 percent of cases. The long-term measures based on CFSR performance are tied to the year FY 2010 at which time data from the second round of reviews for all States will be available. In setting targets for the long-term measures, ACF has taken into account the number of States that were in substantial conformity during the first round and the increase in the standards that will be in effect during the second round. For example, a target was set that by the end of 2010, nine States or jurisdictions will be in substantial conformity on Safety Outcome Measure 1: "Children are first and foremost protected from abuse and neglect" (up from six States in round one). In addition, another target was set to have five States or jurisdictions be in substantial conformity with Permanency Outcome Measure 1 "Children have permanency and stability in their living situation" (up from zero States in round one). Given the high standards for meeting substantial conformity and the multiple elements that comprise the reviews, these are ambitious targets. The alternative to goals based on the second round of reviews to be completed in 2010 would be to look at measures tied to the third round of reviews which would likely not be completed until FY 2016. Adopting measures tied to the third round would be problematic because (1) it would be very difficult to set realistic targets for the third round without complete data on state performance in the second round of the CFSR, and (2) it would result in a lack of synchronicity with goals for the related title IV B goals which are also based on the second round of reviews. After the assessment of State performance in FY 2010, the Children's Bureau will update and re submit measures tied to the third round of the CFSR.

Evidence: The results of completed Child and Family Service Reviews for each State are available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/results

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The Children's Bureau has established quantifiable annual performance measures directly linked to the program's long-term goals. The short-term measures support Foster Care's primary goal of ensuring the safety, permanency and well-being of children and families and mirror and/or complement measures for related programs authorized under title IV-B of the Social Security Act. The annual performance measures, like the long-term measures, rely largely on information collected through State-level Child and Family Service Reviews (CFSRs). Six annual measures establish targets for the number of States that will have successfully implemented procedures in response to findings from the second round of CFSRs. Successful implementation of these procedures is a key first step in promoting improved child outcomes that are measured in the long-term goals. After a CFSR, each State is required to develop a Program Improvement Plan (PIP) to address any outcome or systemic factor on which the State was not in substantial conformity. The PIP sets improvement goals unique to each State to be achieved over a one- or two-year improvement period and define the terms for measurable progress. At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. If improvements were not made then a financial penalty is assessed. States that meet or exceed their PIP goals are determined to be "penalty free." An additional two annual measures are based on State-reported data and focus on ensuring that children in foster care move to a permanent family home in a timely manner. Because identifying an appropriate goal is a crucial first step in moving a child to permanency, the outcome/efficiency measure seeks to decrease the percentages of cases reported as lacking a case plan goal. Federal law requires that every child in foster care have a case plan that specifies the permanency goal for the child (e.g., reunification or adoption) and that details the types of services the child and parents will receive to facilitate achievement of that goal. The measure is computed from the number of foster children in care at least 12 or more months with either a missing or "Not Yet Determined" case goal divided by the total number of foster children who were in foster care at least 12 months or more. The adoption rate is an outcome measure of permanency for children in foster care that takes into account the size of the pool of children in foster care from which those children for whom adoption is the appropriate permanency plan are identified.

Evidence: FY 2008 HHS ACF Congressional Justification (pages 397-409). Available online at:. http://www.acf.hhs.gov/programs/olab/budget/2008/cj2008.html Child and Family Service Reviews. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/results Program Improvement Plan instructions/information, available at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/general_info/pipstatus.htm Adoption and Foster Care Statistics. Available online at: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm

Does the program have baselines and ambitious targets for its annual measures?

Explanation: The targets for annual measures present ambitious progress in light of two important considerations. First, many States and their counties will need to improve performance significantly, and in a variety of areas, in order for their program improvement plans to be deemed "penalty free" for the most recent round of CSFRs. States that fail to do so face a financial penalty. Second, the targets are set with care to ensure that they do not encourage States to act in a manner that would not be in the best interests of child and families in the child welfare system. There is a danger of unintended consequences that needs to be carefully considered. The targets for Child and Family Services Reviews (CFSR) related annual measures are an ambitious 90 percent of States will be determined to be penalty-free for specific outcomes and systemic factors when the Program Improvement Plans (PIPs) are closed out. The program improvement plan activities and time frames are negotiated between the Children's Bureau and State staff and address all outcomes that require improvement in order to be found penalty-free. As of January 2007, 45 States had completed their 2-year PIP implementation period. The Children's Bureau completed its evaluation of 23 of these 45 PIPS, determining that 21 States achieved all of their PIP goals and implemented all required PIP activities, thus rescinding penalties for these 21 States. On four of the six outcomes and systemic factors noted above, 100 percent of the 23 evaluated States were determined penalty free, which exceeded the target of 90 percent of closed out PIPS being penalty free. As of January 2007, one State (out of 23) had a penalty applied for Permanency Outcome 1 and for Well-Being Outcome 1 (meaning that 96 percent of closed out PIPS have been penalty free on these outcomes). While the measures based on the close-out of CFSR PIPs are ambitious, the cycle of the CFSR process presents some challenges for their use as an annual measure. ACF anticipates completing the close-out of all PIPs from the first round of CFSRs by FY 2008. The second round of CFSRs will occur from FY 2007 and FY 2010 and the first set of PIPs from the second round will be closed out in FY 2010. Thus during FY 2009, no PIPs will be closed out. Since the data reported for these measures are cumulative, the Children's Bureau proposes to report the FY 2008 performance data (which will reflect the close out of all 52 PIPs) for FY 2009. Beginning in FY 2010, however, the baseline will be re-set with data on the close-out of PIPs from the second round. From FY 2010 forward the data on PIP close-outs will be reported cumulatively (as is being done for round one), but data from round two will not be combined with or added to data from round one. The measures based on state data submitted to the Adoption and Foster Care Analysis and Reporting System (AFCARS) reflect an improvement rate or a maintenance rate that reflects current trends. Both measures will be reported in each fiscal year (including FY 2009 - the year in which no new data for CFSR PIP close-outs will be available) and will not be affected by the CFSR timetables described above. The no case plan goal measure reflects ambitious and steady progress of a .5 percentage point annual decrease reflecting the Children's Bureau's goal that all children be assigned a case plan goal within the first year of entry. Finally, the adoption rate measure calls for continued increases in the adoption rate during a period when a number of trends continue to make it challenging to increase adoptive placements, including the fact that the age of children "waiting" to be adopted continues to increase. Almost half of "waiting" children are over the age of nine. Simultaneously, the proportion of children in foster care with a case plan goal of adoption has declined. At its current FY 2005 rate (9.86 percent), the program appears to be on track to meet its FY 2006 target rate.

Evidence: Child and Family Service Reviews: Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/results Program Improvement Plan instructions/information, available at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/general_info/pipstatus.htm Adoption and Foster Care Statistics. Available online at: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: All States support program planning efforts by participating in the Child and Family Services Reviews (CFSR), which require States to report data on outcomes annually. States also commit to and work toward performance goals by developing Program Improvement Plans (PIPs) when improvements are required due to substandard performance (defined as performance levels below the National Standards). States also report data annually to the National Child Abuse and Neglect Data Systems (NCANDS) and the Adoption and Foster Care Analysis and Reporting System (AFCARS) and their progress towards their goals is reported in the Administration for Children and Families annual budget, Department of Health and Human Services reports, and CFSR reports annual Congressional Justification for the Administration for Children and Families. To achieve performance goals, States have enhanced their case review, training, and supervisory procedures. Many have established quality assurance systems to measure the impact of child welfare services on children and families. Also, in anticipation of the title IV-E foster care eligibility review, States have initiated program assessments and improvements to achieve performance standards during the reviews. Following the reviews, they develop and implement program improvements based on review results.

Evidence: The Child Abuse Prevention & Treatment Act (CAPTA); sections 479 and 479A of the Social Security Act; section 1123A of the Social Security Act; section 203 of P.L. 105-89. Available online at: http://www.acf.hhs.gov/programs/cb/laws_policies/cblaws/capta/index.htm http://www.ssa.gov/OP_Home/ssact/title04/0400.htm Child and Family Services Reviews (CFSR). Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#cfsr Program Improvement Plan instructions/information, available at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/general_info/pipstatus.htm AFCARS & NCANDS Data. Available online at: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#afcars The FY2008 ACF Congressional Justification (pages 397-409). Available online at: http://www.acf.hhs.gov/programs/olab/budget/2008/cj2008.html HHS Performance and Accountability Reports. Available online at: http://www.hhs.gov/of/reports/account/index.html

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: There have been many independent evaluations examing the foster care program, including the National Survey on Child and Adolescent Well-Being (NSCAW) and the Child Welfare Waiver Demonstration Projects. These efforts are of sufficient scope, independence, and frequency to aid in regular program improvement. For example, results from waiver demonstrations provide evidence that allowing States greater flexibility in the use of title IV-E funds can result in improved outcomes for children and families, as well as reduced costs. NSCAW is the first nationally representative study to include a longitudinal component that follows child welfare cases for a period of several years, collecting data on the types of abuse or neglect involved, agency contacts and services, out-of-home placements, as well as reliable State-level data. Data are drawn from first-hand reports from children, parents, foster parents and other caregivers, caseworkers, teachers, and data from administrative records. NSCAW examines child and family well-being outcomes in detail and relates those outcomes to their experience with the child welfare system and to family characteristics, community environment, and other factors. The study is intended to address crucial program, practice, and policy issues in the areas of dynamics of the child welfare system, and outcomes for children and families. NSCAW includes a nationally representative Child Welfare Services investigation sample of 5,501 reported child victims from 92 different communities in 36 states. NSCAW also includes a long-term foster care sample of an additional 727 children who had been in out-of-home care for about 12 months. To ensure good representation of the population, first county child welfare agencies and then children within agencies were randomly sampled. Collected by field interviewers, NSCAW data come from well-known standardized child instruments as well as interviews with children, caregivers, caseworkers and teachers. Baseline data collection took place an average of four months following the child maltreatment investigation, and follow-ups were conducted at 1, 1??, 3, and 5+ years afterward. The oldest children in NSCAW were young adults at the 5+ year follow-up, when they were asked additional questions about employment, housing, family formation, and adult functioning. Most data are longitudinal, providing up to four time points for analysis. NSCAW data are available to the larger research and policy community to encourage secondary analysis, additional research, and timely policy decisions. Consequently, a number of independent investigations have occurred including the planned publication (June 2007) of Child Protection: Using Research to Improve Policy and Practice by the Brookings Institution Press. ACF has also funded 14 research grants to conduct secondary analyses of NSCAW data. Child Welfare Waiver Demonstration Projects have also provided evaluations of a variety of interventions, comparing results of these interventions to the current title IV-E Foster Care system. Conceived as a strategy for generating new knowledge about innovative and effective child welfare practices, waivers grant States flexibility in the use of Federal funds for alternative services and supports that promote safety and permanency for children in the child protection and foster care systems. All waiver demonstrations are required to undergo rigorous program evaluation to determine their efficacy. The use of a control group is strongly encouraged, and if not feasible, a justification of the study's methodology and design must be provided. The results of the waiver evaluations have been used in policy decisions such as the proposal of the Child Welfare Program Option mentioned above. As of March 2007, 15 States have active title IV-E waiver agreements.

Evidence: For more information about NSCAW: http://www.acf.hhs.gov/programs/opre/abuse_neglect/nscaw/index.html For more information about NSCAW data availability: http://www.ndacan.cornell.edu/NDACAN/Datasets_List.html For more information about the Brookings Institution Publication Child Protection Using Research to Improve Policy and Practice: http://cbexpress.acf.hhs.gov/articles.cfm?article_id=1011&issue_id=2005-09 For more information about ACF-supported NSCAW secondary analysis http://www.acf.hhs.gov/programs/opre/abuse_neglect/nscaw_sad/index.html For examples of GAO audits: http://www.gao.gov/ ?? GAO-07-75 CHILD WELFARE Improving Social Service Program, Training, and Technical Assistance Information Would Help Address Long-standing Service-level and Workforce Challenges ?? GAO-06-944 CHILD WELFARE Federal Action Needed to Ensure States Have Plans to Safeguard Children in the Child Welfare System Displaced by Disasters ?? GAO-06-942 HUMAN SERVICES PROGRAMS Demonstration Projects Could Identify Ways to Simplify Policies and Facilitate Technology Enhancements to Reduce Administrative Costs ?? GAO-06-649 FOSTER CARE AND ADOPTION ASSISTANCE Federal Oversight Needed to Safeguard Funds and Ensure Consistent Support for States' Administrative Costs ?? GAO-05-839R Administrative Expenditures and Federal Matching Rates ?? GAO-05-292 CHILD WELFARE Better Data and Evaluations Could Improve Processes and Programs for Adopting Children with Special Needs ?? GAO-05-290 INDIAN CHILD WELFARE ACT Existing Information on Implementation Issues Could Be Used to Target Guidance and Assistance to States ?? GAO-04-781T CHILD AND FAMILY SERVICES REVIEWS States and HHS Face Challenges in Assessing and Improving State Performance ?? GAO-04-333 CHILD AND FAMILY SERVICES REVIEWS Better Use of Data and Improved Guidance Could Enhance HHS's Oversight of State Performance ?? GAO-04-267T CHILD WELFARE States Face Challenges in Developing Information Systems and Reporting Reliable Child Welfare Data ?? GAO-04-809 CHILD WELFARE Most States Are Developing Statewide Information Systems, but Reliability of Child Welfare Data Could Be Improved ?? GAO-03-397 CHILD WELFARE AND JUVENILE JUSTICE Federal Agencies Could Play a Stronger Role in Helping States Reduce the Number of Children Placed Solely to Obtain Mental Health Services ?? GAO-03-357 CHILD WELFARE HHS Could Play a Greater Role in Helping Child Welfare Agencies Recruit and Retain Staff ?? GAO-02-585 FOSTER CARE Recent Legislation Helps States Focus on Finding Permanent Homes for Children, but Long-Standing Barriers Remain For more information about the Waiver Demonstration Projects: http://www.acf.hhs.gov/programs/cb/programs_fund/index.htm#child

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: The Department of Health and Human Services supports budget performance integration, and the budget request to Congress includes an analysis of performance. The use of performance measures for budget planning is discussed in the overview of the "Justification of Estimates for Appropriations Committees." In addition, the Congressional Justification reports on all of the performance goals identified for the Foster Care program through the PART and GPRA processes (pp. 391-409), and highlights goals under Mandatory Programs - Foster Care and Adoption Assistance (pp. 281-282). However, the program does not report all direct and indirect costs needed to meet performance targets, including costs that may be budgeted elsewhere. The Foster Care program is a mandatory program under title IV-E of the Social Security Act. It is an annually appropriated entitlement program with specific eligibility requirements and fixed allowable uses of funds. It provides funds to States for Foster Care maintenance payments; administrative costs to manage the program, including costs for statewide automated information systems; and training of staff and foster and adopting parents. While funds are allocated to States based on an amount equal to the State's Medicaid percentage of the total amount of foster care maintenance payments expended for eligible children, all States are required to participate in the foster care eligibility reviews and Child and Family Services Reviews (CFSR) to ensure that they are in substantial conformity with requirements relating to both achievement of outcomes and adherence to fiscal and program requirements. Through the CFSR process, a State is required to implement a Program Improvement Plan (PIP) to address outcomes and systemic factors on which it is not in substantial conformity. If at the end of the PIP implementation period (usually two years) the State has not completed required actions or achieved specified targets of improvement, it is subject to financial penalties. (See Question 1.5 for discussion of the foster care eligibility reviews). The annual performance measures for the Foster Care program set targets for the number of States that successfully complete PIPs to correct problems identified during CFSRs. The Foster Care legislative proposals included in the budget aim to make further progress on annual and long-term performance goals (pp. 271-282). In addition, through its monitoring and oversight, the Children's Bureau identified two significant programmatic areas under which certain states' administration of the title IV-E foster care maintenance was flawed. The Bureau's work with Congress resulted in legislative amendments that unequivocally supported the Bureau's interpretations of the statute.

Evidence: The FY2008 ACF Congressional Justification (pages 271-282 and 391-409). Available online at: http://www.acf.hhs.gov/programs/olab/budget/2008/cj2008.html

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: The Children's Bureau has used the results of the Child and Family Services Reviews (CFSR) and foster care eligibility reviews as well as improved data from the AFCARS to set long-term measures and ambitious performance targets. The selection of these goals is based on trend data derived from the Adoption and Foster Care Analysis and Reporting System (AFCARS) and on the findings from States being reviewed through the CFSRs. In addition, the Children's Bureau conducts the monitoring reviews and provides training and technical assistance to States. The Child and Family Services Reviews and title IV-E foster care eligibility reviews are designed to enable the Children's Bureau to ensure that State child welfare agency practice is in conformity with Federal child welfare requirements; to determine what is actually happening to children and families as they are engaged in State child welfare services; and to assist States to enhance their capacity to help children and families achieve positive outcomes. Ultimately, the goal of the reviews is to help States to improve child welfare services and achieve the safety permanency and well-being for families and children who receive services. Finally, as noted previously, the Children's Bureau is using information from various evaluations to support program improvements. Results from waiver demonstrations provide evidence that allowing States greater flexibility in the use of title IV-E funds can result in improved outcomes for children and families, as well as reduced costs. The Child Welfare Program Option, proposed in the President's Budget, would address this program design flaw. This proposed option would allow States to choose a fixed allocation of funds over a five year period rather than the current entitlement funding for the title IV-E Foster Care program. States that choose the child welfare program option would receive their Foster Care funds in the form of annual, flexible grants which could be used for a variety of child welfare purposes including foster care maintenance payments, case management and administrative activities now supported by the title IV-E foster care program, as well as other types of services and supports to promote the safety, permanency and well-being of children, such as child abuse and neglect prevention efforts, subsidized guardianship, and family preservation, support and reunification services.

Evidence: Child and Family Services Reviews (CFSR)s. Available on-line at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#cfsr Foster Care Eligibility Reviews. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#cfsr Adoption and Foster Care Analysis and Reporting System (AFCARS) Data. Available online at: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#afcars

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: The Children's Bureau has established a number of systems to collect timely and credible performance information from State partners in order to assess compliance with Federal requirements and child and family outcomes. The Children's Bureau monitors State child welfare services through the Child and Family Services Reviews (CFSR), Adoption and Foster Care Analysis and Reporting System (AFCARS) review, title IV-E foster care eligibility review, and the Statewide Automated Child Welfare Information System (SACWIS) Assessment Reviews. Each CFSR is a two-stage process consisting of a Statewide Assessment and an onsite review. The CFSRs examine key areas of State child welfare agency practice, review individual cases, interview key program stakeholders and collect data on key program outcomes. States determined not to have achieved substantial conformity in all the system and outcome areas assessed are required to develop and implement Program Improvement Plans (PIPs) addressing the areas of nonconformity. The Children's Bureau provides technical assistance and monitors implementation of State plans. States that do not achieve their required improvements successfully will sustain penalties as described in the Federal regulations. By the end of FY 2004, all 50 States, the District of Columbia, and Puerto Rico completed their first review. Because no State was found to be in substantial conformity in all of the seven outcome areas or seven systemic factors, all States were required to develop PIPs to correct those outcome areas and systemic factors found not in substantial conformity. The on-site portion of the second round of Child and Family Services Reviews (CFSRs) will be completed in 2010. CFSR uses data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) which collects case level information on all children in foster care as well as children who are adopted under the auspices of the State's public child welfare agency. Foster Care program eligibility reviews determine whether children in foster care meet the statutory eligibility requirements for foster care maintenance payments. These reviews validate the accuracy of a State's reimbursement claims by examining case records of the child and provider and payment documentation. The fiscal accountability promoted by these reviews leads to reductions in case errors and program improvements. Between FYs 2000-2006, 105 State reviews were conducted. Once a State's child welfare automated system is operational, the Children's Bureau conducts a review to assess the system's functionality, which includes a system walk-through and interviews with local and State-level users. A detailed report is generated, providing the State with all of the review team's findings including recommendations. The review process is finalized when the State has either modified the system or created an acceptable corrective action plan.

Evidence: Child Welfare Monitoring. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm Program Improvement Plan instructions/information, available at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/general_info/pipstatus.htm

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: Federal Managers: The division director and eligibility monitoring team leader in the Program Implementation Division of the Children's Bureau have responsibility for the implementation and oversight of the Foster Care program. This is in collaboration with the ACF regional offices, in accordance with ACF's Statement of Organization and Functions. Performance standards are defined in employees' performance plans. Staff performance plans specify relevant objectives and performance is rated accordingly. In addition, responsibility for the follow-up actions identified in OMB's Program Assessment Rating Tool has been added into the Associate Commissioner's performance plan. States and Sub-grantees: States are held accountable through the monitoring as indicated in Section 3.1. The Children's Bureau ensures that States comply with title IV-E requirements. For example, it delays approval of Child and Family Services Plans (CFSPs) until States meet the terms of Federal requirements and meet required standards. The Children's Bureau also withholds funds accordingly, by contacting grantees who's Adoption and Foster Care Analysis and Reporting System data submissions do not substantially comply with regulatory standards, and assesses penalties if the grantees fail to successfully implement their Program Improvement Plans (PIPs). The Child and Family Services Reviews (CFSR) are used to hold the States accountable for performance results. The CFSR assesses seven outcome measures and seven systemic factors that inform all stakeholders whether the State is functioning satisfactorily in regards to the safety, permanency, and well-being of children and their families. Because the title IV-E program (as well as the other funding streams in the Child and Family Services Program) is the bulk of the service dollars for child welfare services, the CFSR is able to ascertain how well States are managing their programs by measuring outcomes against performance targets. Further, the CFSR and title IV-E foster care program review processes include a PIP process whereby the State is challenged to enhance their programs and activities for better outcomes or be financially penalized. The Children's Bureau provides extensive information about its programs on its website including the statute and regulations, services provided, program instructions, and research and technical assistance resources. The Children's Bureau also contracts the Child Welfare Information Gateway website which includes volumes of information regarding best practices, evidence-based practice, cultural sensitivity issues, and other information about child welfare practice. The Children's Bureau expects that States will utilize the readily available information to increase their efficiency, effectiveness and performance. There are many publications available to help managers, grantees and contractors administer programs, and as such, they are accountable for well-run programs. States monitor sub-grantees to ensure these entities comply with Federal fiscal and program regulations, use funds for authorized purposes, and achieve performance goals. The Children's Bureau, in turn, ensures sub-grantees are sufficiently monitored by States. In a 2004 report, the HHS Office of the Inspector General raised concerns about the monitoring of Foster Care sub-grantees. In response, ACF agreed to consider (1) highlighting grants management requirements and the importance of subrecipient monitoring in award letters, (2) adopting a qualitative version of the monitoring criteria as part of its field reviews, (3) including specific reference to subrecipient monitoring responsibilities in the Foster Care program's Compliance Supplement to Office of Management and Budget, (4) possibly issuing a program instruction to State grantees distinguishing between "subrecipients" and "vendors," (5) strengthening the Single Audit, and (6) providing technical assistance for States' monitoring systems.

Evidence: Child Welfare Information Gateway. Available online at: http://www.childwelfare.gov Electronic copy of staff performance plans specifying relevant objectives, including the scheduling of and participation in on-site reviews; performance is rated accordingly. Child Welfare Monitoring. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm HHS/OIG Report, "Oversight of States' Subgrantee Monitoring in the Foster Care Program" (OEI-05-03-00060). Available online at: http://www.oig.hhs.gov/oei/reports/oei-05-03-00060 HHS/OIG Report, "States' Monitoring of Subgrantees in the Foster Care Program, A Description of Six States' Systems" (OEI-05-03-00061). Available online at: http://www.oig.hhs.gov/oei/reports/oei-05-03-00061

Are funds (Federal and partners') obligated in a timely manner, spent for the intended purpose and accurately reported?

Explanation: Funds are obligated in a timely manner. The Children's Bureau also issues policy guidance to address inappropriate claiming issues, as is evidenced by ACYF-CB-PA-01-02 and ACYF-CB-PI-06-06. Title IV-E is an entitlement program whereby States are reimbursed for allowable expenditures made on behalf of eligible children. Federal funds are only dispersed as they are claimed. Funds are paid quarterly to States through a letter of credit and are substantiated through quarterly expenditure reports submitted by the State to the Administration for Children and Families. It is not possible for funds to go unobligated, since Federal payments reimburse States for allowable costs the State has already expended. The Children's Bureau ensures that funds are expended for intended use through title IV-E eligibility reviews, State and OIG audits, and regional office assessment of claims. ACF issues grant awards based on financial data submitted by States on the financial expenditure form (ACYF-IV-E-1). Quarterly expenditure reports are scrutinized to ascertain what costs are being claimed by grantees, and if they are being expended appropriately. Funds that are expended inappropriately are disallowed. If the disallowance is appealed and sustained, the disallowance is adjusted in a subsequent grant award sent to the State. As part of the audit resolution process, grantees must agree to implement recommendations made in the audit disallowance letter sent to them by the ACF Grants Office and indicate when required corrective action has occurred.

Evidence: Title IV-E Foster Care Eligibility Reviews. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#title Children's Bureau - Child Welfare Laws and Policies. Available online at: http://www.acf.hhs.gov/programs/cb/laws_policies/index.htm

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: The program does have procedures in place to promote efficiency gains. Federal law requires that every child in foster care have a case plan that specifies the permanency goal for the child (e.g., reunification or adoption) and that details the types of services the child and parents will receive to facilitate achievement of that goal, a crucial first step in moving a child to permanency. Despite this requirement, a significant proportion of cases are reported as having no case goal or "case plan goal not yet determined" even when children have been in care for a year or more. This outcome/efficiency measure tracks the percentages of cases reported as lacking a case plan goal after being in care a year. In 2005, the target of 7.4 percent was exceeded with an actual rate of 6.5 percent. A second efficiency measure focuses on reducing erroneous payments. The Children's Bureau calculates a national payment error rate and develops an improvement plan to strategically reduce, or eliminate where possible, improper payments (See Question 1.5). State-level data generated from the title IV-E eligibility reviews were used to establish a baseline national error rate for the title IV-E foster care program in FY 2004. The estimated composite baseline IV-E payment error rate of 10.33 percent is based on data obtained from FYs 2002-2004 (States are reviewed on a three year cycle). For FY 2005, the estimated national error rate (based on the three year average from FYs 2003-2005) is 8.6 percent. Through implementation of a comprehensive corrective action plan, the Children's Bureau has reduced the national foster care error rate below target levels and the progress in reducing the error rate has been maintained in FY 2005 and FY 2006. Baseline estimates of national improper payments and payment error rate for the program are developed and reported on annually. Recently, the Children's Bureau made additional progress towards refining and expanding its efforts to address improper payments in the title IV-E foster care program. The Children's Bureau has begun measuring underpayments in the reviews that were conducted in FY 2006 and will continue to measure error cases and begin implementing its plan to measure foster care administrative cost payment errors. The amount of any underpayments identified is added to disallowances to yield the amount of the national improper payments and payment error rate in accordance with feedback from OMB. The steps taken to monitor and reduce erroneous payments enables the Children Bureau to identify and redirect these resources as well as ensures that Federal resources are spent in the most strategic way possible. After determining an acceptable national error rate, and exploring the reasons behind the most frequent types of errors, the Children's Bureau can streamline its support to States in implementing effective practices to reduce the number of cases in error and improve child welfare systems.

Evidence: Title IV-E of the Social Security Act, Section 473A. Section 13713 of the Omnibus Budget Reconciliation Act of 1993 (OBRA 93) (Pub. L. 103-66); Adoption Assistance and Child Welfare Act of 1980 (Pub. L. 96-272); Statewide Automated Child Welfare Information Systems (SACWIS) provisions under title IV-E of the Social Security Act at Section 474(a)(3); 45 CFR 1355 and 1356; 45 CFR 95 Subparts E, F, and G; HHS Performance and Accountability Reports. Available online at: http://www.hhs.gov/of/reports/account/index.html

Does the program collaborate and coordinate effectively with related programs?

Explanation: The Children's Bureau seeks to provide for the safety, permanency and well-being of children through leadership, support for necessary services, and productive partnerships with States, Tribes, and communities. It has primary responsibility for administering Federal programs that support State child welfare services. It is the conduit agency for providing matching Federal funds to States, Tribes, and communities to help them operate every aspect of their child welfare systems--from prevention of child abuse and neglect to adoption--and the information systems necessary to support these programs. The Children's Bureau encourages collaboration at the Federal, State, and individual program levels both through regulation and through modeling collaboration. At the Federal level, the Children's Bureau works to coordinate programs in a seamless manner. The Bureau partners within ACF and HHS, as well as with colleagues in other Federal agencies, to maintain ongoing coordination and collaboration. Examples include: hosting the Federal Interagency Work Group on Child Abuse and Neglect; co-funding research initiatives with other HHS agencies such as the Early Head Start and Child Welfare initiative; participating in a Department of Labor initiative on older foster youth and employment training issues; and co-funding with the Substance Abuse and Mental Health Services Administration (SAMHSA) the National Center on Substance Abuse and Child Welfare (NCSACW), a technical assistance resource to improve outcomes for families in the child welfare system who are affected by substance use disorders. Also, the Children's Bureau recognizes that it is imperative to work with other federally funded programs in order to secure adequate services. The Children's Bureau has been working, and will continue to work, with the Office of Child Support Enforcement (OCSE) and Centers for Medicare and Medicaid (CMS) to involve State directors for these programs in regional meetings sponsored by ACF and CMS. The goal of the meetings is to improve the cross program collaboration and coordination between OCSE, Child Welfare and Medicaid so that all programs can better achieve national goals and outcomes. Federal regulations at 45 CFR 1357.15 (d), (l) and (m) require State-level collaboration and coordination of services with stakeholders and other Federal programs that involve child welfare and require a description of the collaboration(s) in the Child and Family Services Plan (CFSP). The State's CFSP must describe the consultation process, both internal and external, used to obtain involvement of others across the entire spectrum of the child and family service delivery system in the development of the plan. The description must explain how the collaboration process was coordinated with, or was a part of other planning processes in the State, and the resultant expected outcome. 45 CFR 1357.15(t) also requires that the State's "training content must support the cross-system coordination consultation basic to the development of the CFSP." One of the factors that Child and Family Service Reviews (CFSRs) of State agencies assess is the "responsiveness of the agency to the community." The initial round of CSFR reviews found that a high proportion of State agencies were found to be responsive to the needs of the community (94 percent) and coordinated their services well with other Federal programs (87 percent). Through the passage of the Deficit Reduction Act, Congress added a provision that States describe their activities "to demonstrate substantial, ongoing and meaningful collaboration with State courts" in their CFSPs and added two programs for State Court improvements. This provision will foster additional coordination and collaboration between State child welfare programs and State Courts.

Evidence: Title IV-E of the Social Security Act at Section 45 CFR 1357 Children's Bureau Programs and Funding. Available online at: http://www.acf.hhs.gov/programs/cb/programs_funds/index.htm Child Welfare Monitoring. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/genfindings04/genfindings04.pdf

Does the program use strong financial management practices?

Explanation: Financial management practices presently in place for the foster care maintenance payments program include annual audits of the U.S. Department of Health and Human Services (HHS), title IV-E foster care eligibility reviews, and regional office assessment and resolution of State claims. The Administration for Children and Families (ACF) submits to an audit annually. The annual audit of HHS programs conducted by Price Waterhouse Coopers in 2006 found no material weaknesses specific to ACF or any of its programs. ACF's financial management systems meet statutory and regulatory requirements and financial information is accurate and timely. Under OMB Circular A-133, independent auditors audit grantees annually. The Compliance Supplement available to auditors for the title IV-E programs of the Social Security Act detail the financial management requirements of the program and State auditors examine the day-to-day systems based on financial and programmatic requirements to include financial reporting. The Regional Office reviews and analyzes the related Form ACF-IV-E-1 (title IV-E financial report) and expenditure patterns to ensure all funds are being spent. If necessary, the regulations at 45 Code of Federal Regulations 1355.20 allows for a "partial review" that may be conducted at any time when it is discovered based on any information, regardless of the source, that a State may not be operating in conformance with state plan requirements. An inquiry to the State precedes a request for additional information that, if it confirms the non-conformity, will result in the State having to implement a program improvement plan. For title IV-E foster care eligibility reviews, the Children's Bureau employs a 10 percent error threshold. If a State exceeds the error threshold for both case and dollar error rates in a secondary review, the State is assessed an additional extrapolated disallowance, which is equal to the lower limit of a 90 percent confidence interval for the State foster care population's total dollars in error during the six-month period under review. The extrapolation increases geometrically the resulting disallowance. At the beginning of FY 2006, 72 percent of the 85 State regulatory foster care eligibility reviews (including reviews conducted in each of FYs 2000-2005) were determined to be in substantial compliance with Federal requirements. States that did not meet the compliance threshold were required to complete a Federally-approved plan that addressed non-compliant program areas and undergo a more extensive, secondary level of program review. For the stated period, 16 secondary reviews were conducted and 88 percent of these eligibility reviews were determined to meet the compliance threshold. In addition, ACF develops and publishes a national payment error rate for title IV-E and publishes State performance with respect to it on an annual basis.

Evidence: HHS Performance and Accountability Report (includes audit and error rate information). Available online at: http://www.hhs.gov/of/reports/account/index.html Title IV-E Foster Care Eligibility Reviews. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#title

Has the program taken meaningful steps to address its management deficiencies?

Explanation: The ACF Central and Regional Offices work on a continuous basis to encourage States and Tribes to administer their programs in the most effective and efficient manner possible. Regional Office staff consults with the Children's Bureau staff to address questions and/or problems that arise within their regions. For example, the Children's Bureau convenes a monthly conference call with its Regional Office program and fiscal staff to discuss management issues. Feedback from various Regional Offices alerts the Children's Bureau staff to what may be a pervasive problem, enabling them to develop a response appropriate to the issue. Responses may be in the form of policy development and issuance or other actions as needed. The Children's Bureau also offers training as needed such as the cost allocation training which was provided to Regional program specialists in late April of 2006 as well as the Child and Family Services Reviews (CFSR) trainings that are offered frequently. Technical assistance providers also present information about their expertise and services in these calls. Research and demonstration grants, best practices documents, conferences, and National Resource Center information about effective programs helps States determine efficiencies; however, the Bureau allows States latitude in designing and operating the programs under the guidance of governing Federal rules and regulations. The effectiveness of the States' strategies is shown in the progress reported in the Annual Progress and Services Reports (APSR) and Program Improvement Plans (PIP). For the CFSP/APSR process, States are to evaluate their strategies and programs against their own baselines and adjust programs/processes to improve progress toward their own goals. The CFSR/PIP process is much more elaborate, with national standards that the State must meet. Specific activities and benchmarks are identified for improvement in the PIP and quarterly progress reports that identify interim progress steps are required. If progress is not adequate or goals are not met within one year (with an extension to two years if necessary), penalties are assessed based on a formula written in regulation. The Children's Bureau conducts title IV-E foster care eligibility reviews (45 Code of Federal Regulations 1356.71) in the 50 States, Washington DC and Puerto Rico every three years. The regulatory foster care eligibility review provides a systematic method for reviewing foster care services and identifying and recovering erroneous payments, as well as a mechanism for determining State compliance with applicable Federal eligibility requirements. These reviews are intended to recover title IV-E funds claimed by States for ineligible cases and, with the required PIP for those States determined to be non-compliant, to help change their behavior so that subsequent reviews will result in lower error rates. In conjunction with the foster care eligibility review, the Children's Bureau annually calculates a national payment error rate and develops a corrective action to strategically reduce, or eliminate where possible, improper payments. State-level data generated from the title IV-E foster care eligibility reviews are used as the basis for establishing a baseline national error rate and annual targets for the title IV-E foster care program. Through implementation of a comprehensive corrective action plan, the Children's Bureau has reduced the national foster care error rate below target levels and the progress in reducing the error rate has been maintained in FY2005 and 2006.

Evidence: Child Welfare Monitoring. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm Children's Bureau's Technical Assistance Network. Available online at: http://www.acf.hhs.gov/programs/ccb/ta/index.htm Child Welfare Policy Manual. Available online at: http://www.acf.hhs.gov/programs/cb/laws_policies/index.htm#cwpm Program Improvement Plan instructions/information, available at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/general_info/pipstatus.htm

Does the program have oversight practices that provide sufficient knowledge of grantee activities?

Explanation: The Children's Bureau has a number of oversight requirements related to reporting, financial management, and program implementation. The ACF Regional Office (RO) designates responsibility for each program among available staff, either by State or by program area. RO program staff is responsible for providing program guidance and direction. The RO receives annual reports from States and Tribes, and quarterly reports if the State is under a Program Improvement Plan (PIP) that gives some description as to how they implement programs and the nature of the services that are being provided (children and families served, number and types of providers, etc.) Through review of these reports, ACF staff monitors the grantees on a regular basis and work with grantees where problems arise. Federal oversight includes a reading, analyzing, commenting on and requiring improvements in the yearly Annual Progress and Services Report (APSR). States update plans and report on activities through this document and Regional Offices, who work with States on an ongoing basis, are able to accurately and adequately assess State activities and determine whether Federal funds are being spent on allowable activities. Also, the overall Child and Family Services Reviews (CFSR) process allows the Regional and Central Offices to assess in depth, through week-long, on-site reviews, the quality of States' child welfare systems and adherence to the Child and Family Services Plan (CFSP) and the title IV-E State plans by reviewing and analyzing actual cases and assessing outcomes and performance measures. For example, in the outcome measures category, CFSR findings indicated that a very large number of States were not meeting their mental health well-being measure, but many were meeting the education well-being measure. In the systemic factors category, CFSR findings indicated 45 States (87 percent) achieved substantial conformity in the item rating their Statewide Information System (SACWIS).

Evidence: Child and Family Services Reviews (CFSR)s. Available online at: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#cfsr http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/pip_presentation_final/sld001.htm Federal Reporting Systems. Available online at: http://www.acf.hhs.gov/programs/cb/systems/index.htm Program Improvement Plan instructions/information, available at: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2002/im0204a1.htm http://www.acf.hhs.gov/programs/cb/cwmonitoring/general_info/pipstatus.htm

Does the program collect grantee performance data on an annual basis and make it available to the public in a transparent and meaningful manner?

Explanation: As described in Answer 3.1, data on the activities and expenditures of grantees is collected on a regular basis and made available to the public. Program performance is publicized, usually on an annual basis, in the following ways: CFSR Reports, Child Welfare Outcomes Report, AFCARS data, annual Congressional Justification, the Report to Congress, and meetings with stakeholders, such as the State/Tribal Meeting. This information is published through the Children's Bureau website and Child Welfare Information Gateway. These websites are accessible to the public and receive millions of "hits" per year. In addition, States are required to make their CFSP/APSR available to the public and most have them on their State websites. Child Welfare Information Gateway connects child welfare, foster care, adoption, and related professionals and concerned citizens to timely, essential information on programs, research, legislation, and statistics regarding the safety, permanency, and well-being of children and families. It provides access to print and electronic publications, websites, and online databases covering a wide range of child welfare topics. The website, www.childwelfare.gov, serves as Child Welfare Information Gateway's primary source of information dissemination, with approximately 3 million visitors in FY 2005. Website visitors have access to more than 6,500 pages of content and can search 48,000 documents in the online library. Among the many resources available from the Gateway are publications on family-centered practice, prevention of child abuse and neglect, out-of-home care, family reunification, and adoption from foster care.

Evidence: The CFSR Final Reports, Child Welfare Outcomes Report and AFCARS data reports are available on the Children's Bureau website: www.acf.dhhs.gov/programs/cb The FY2008 ACF Congressional Justification (pages 397-409). Available online at: http://www.acf.hhs.gov/programs/olab/budget/2008/cj2008.html Child Welfare Information Gateway is available online at: http://www.childwelfare.gov Example of CFSP/APSR available on States websites (State of Oklahoma Child and Family Services Plan Annual Progress and Services Report) http://www.okdhs.org/cfsd/CQI/okchildwelfare/apsr6_03.htm

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: All of the foster care long-term goals demonstrate progress towards meeting long-term However, to determine whether the first round of program improvement has resulted in an increased number of States being in substantial conformity, it will be necessary to complete the second round of onsite reviews, which began in March 2007. The targets for the foster care long-term goals are to be achieved by FY 2010. The Child and Family Services Reviews (CFSR) assess outcome achievement across three broad domains of safety, permanency, and well-being, in addition to systemic factors. Foster Care's long-term goals reflect States' progress in achieving substantial conformity in the domains of permanency and safety, as well as their progress on one systemic factor. Substantial conformity is determined by the extent to which a State meets federal requirements for each of seven outcomes and seven systemic factors. Substantial conformity is determined separately for each area, therefore, a State may be in substantial conformity with some, but not all, of the 14 areas. For outcomes, substantial conformity is based on case review findings and, for two of the outcomes, State performance on data indicators. For systemic factors, determination of substantial conformity is based on information from Statewide Assessments and interviews with key stakeholders, and is further determined by whether the requirements of the State plan are in place and functioning. During the first round of the CFSR, for a State to be found in substantial conformity on an outcome, the State needed to have met the national standard for any applicable national data indicators associated with the outcome and 90 percent of cases reviewed onsite needed to be rated as a strength. Any outcome on which the State was not in substantial conformity was required to be addressed through a Program Improvement Plan (PIP). At the conclusion of the PIP, a determination is made on whether all actions required by the PIP were completed and whether agreed upon improvements in quantifiable outcomes were met. If so, then the State is determined to be "penalty free." Currently, only two States will be penalized for not improving enough to meet their PIP goals. Other States are in various stages of implementing their PIP. PIP completion in all States will occur by the end of FY 2008. The success of most States remaining penalty free to date indicates that States are making improvements which will be needed to achieve the foster care long-term goals. However, the second round of CFSRs will be even more rigorous than the first. The standard for the onsite portion will be raised from 90 percent of cases being rated a strength to 95 percent of cases, and national standards for data indicators will be changed, with the standards of performance on safety being raised and new composite measures relating to permanency used for the first time.

Evidence: Child and Family Services Review Technical Bulletin #2. Available online at: http://www.acf.dhhs.gov/programs/cb/cwmonitoring/general_info/tech_bull2.htm Child and Family Services Reviews Fiscal Year 2007 Review Schedule. Available online at: http://www.acf.dhhs.gov/programs/cb/cwmonitoring/general_info/fy2007.htm Child Welfare Review Project Fact Sheet. Available online at: http://www.acf.dhhs.gov/programs/cb/cwmonitoring/general_info/fact_sheet.htm

Does the program (including program partners) achieve its annual performance goals?

Explanation: Foster Care has exceeded its annual targets for Adoption and Foster Care Reporting and Analysis System (AFCARS), Child and Family Services Reviews (CFSR) and Title IV-E Foster Care program-based performance measures with an established baseline. For the AFCARS measure, "Decrease the percent of foster children in care 12 or more months with no case plan goal (including case plan goal "Not Yet Determined")" the goal of 7.4 percent was exceed with a rate of 6.5 percent. In addition, while adoption rate measure is new (changing from the previous measure of total number of adoptions) and has thus just set a baseline for a FY 2005 rate, the program appears to be on track to meet its FY 2006 target of 9.85 percent. Foster Care has also surpassed its annual goals on all annual performance measures relating to the number of States with a closed out Performance Improvement Plan (PIPs) that have been designated "penalty-free." In 2006 all of Foster Care's annual measures, based on CFSR outcomes, Foster Care surpassed the goal of 18 "penalty free" States with an actual result of 20 "penalty free" States. The CFSR measures current State performance in operating child protection and child welfare systems and requires progress towards improvements through PIPs. States determined not to be in conformity with a particular outcome are provided an opportunity to improve their performance through their PIPs. However, if they fail to improve, a financial penalty is assessed. States that demonstrate continuous improvement are termed "penalty free." Foster Care's annual measures reflect States' progress in achieving "penalty free" status in the domains of permanency and safety, as well as their progress on one systemic factor. The annual targets reflect an expectation that at least 90 percent of the cumulative number of States with closed out PIPs will be designated "penalty free." Finally, the annual national error rate estimates established for reducing improper payments in the title IV-E Foster Care program decreased from 10.33 percent (baseline) to 8.60 percent (FY 2005) to 7.68 percent (FY 2006), which represents a reduction of the rate by over a quarter since establishing the baseline for FY 2004. Estimated national erroneous payments were reduced by over $20 million since the FY 2005 estimate and by over $50 million since the baseline estimate. Following this steady, positive trend toward reducing improper payments in the program, the error rate is projected to decrease from 7.57 percent to 6.65 percent during the period from FY 2007 to FY 2010.

Evidence: Child and Family Services Review Technical Bulletin #2. Available on-line at: http://www.acf.dhhs.gov/programs/cb/cwmonitoring/general_info/tech_bull2.htm Child and Family Services Reviews Fiscal Year 2007 Review Schedule. Available on-line at: http://www.acf.dhhs.gov/programs/cb/cwmonitoring/general_info/fy2007.htm Child Welfare Review Project Fact Sheet. Available online at: http://www.acf.dhhs.gov/programs/cb/cwmonitoring/general_info/fact_sheet.htm Improper Payments Report - HHS Performance and Accountability Report. Available online at: http://www.hhs.gov/of/reports/account/acct06/pdf/section4/improper.pdf

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: Foster Care is meeting its targets for its efficiency measures. For the efficiency measure, "Decrease the percent of foster children in care 12 or more months with no case plan goal (including case plan goal "Not Yet Determined")," ACF exceeded its target of 7.4 percent with a rate of 6.5 percent. In addition, the program has introduced a new efficiency measure: to decrease improper payments under the title IV-E foster care program by lowering the national error rate. The rate decreased from 10.33 percent (baseline) to 8.60 percent (FY 2005) to 7.68 percent (FY 2006), which represents a reduction of the rate by over one-fourth since establishing the baseline for FY 2004. Estimated national erroneous payments were reduced by over $20 million since the FY 2005 estimate and by over $50 million since the baseline estimate. ACF developed a methodology for estimating the national payment error rate for the title IV-E Foster Care Program using data gathered in the eligibility reviews conducted in FY 2001 - 2004 (See Question 1.5). Under the regulatory review promulgated at 45 CFR 1356.71, title IV-E Foster Care Eligibility Reviews are conducted in each State every three years by teams who review 80 cases selected from the State's title IV-E foster care population. These reviews are intended to recover title IV-E funds claimed by States for ineligible cases and, in conjunction with the required program improvement plan (PIP) for those States determined to be non-compliant, to help change their behavior so that subsequent reviews will result in lower error rates.

Evidence: Title IV-E of the Social Security Act, Section 473A. Section 13713 of the Omnibus Budget Reconciliation Act of 1993 (OBRA 93) (Pub. L. 103-66); Adoption Assistance and Child Welfare Act of 1980 (Pub. L. 96-272); Statewide Automated Child Welfare Information Systems (SACWIS) provisions under title IV-E of the Social Security Act at Section 474(a)(3); 45 CFR 1355 and 1356; 45 CFR 95 Subparts E, F, and G; Improper Payments Report - HHS Performance and Accountability Report. Available online at: http://www.hhs.gov/of/reports/account/acct06/pdf/section4/improper.pdf

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: It is difficult to compare Title IV-E Foster Care to other programs with similar purpose and goals. The Foster Care program is unique within the Federal government. It is an open-ended, grant-in-aid program in which the Federal government provides funds to augment the State's costs for an eligible child's daily out-of-home care and for the administration of the program. At the State level, State child welfare agencies have statutory authority and responsibility to remove children to foster care. This authority does not exist in the private sector. While States also provide foster care services for children who are not eligible for Federal aid, Federal requirements and oversight encompasses child safety, permanency, and well-being for all children in out-of-home care??not just the children for whom States receive Federal financial participation. As a result, it is nearly impossible to parse out differences between the State and Federal foster care programs.

Evidence: N/A

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: A number of evaluations on the title IV-E foster care program have examined specific components of the program. In general the findings of these studies have been mixed, demonstrating positive results, but with more progress to be made. The Children's Bureau has made many efforts to respond to the ongoing assessment of the Foster Care program. Although limited to some degree by the design of the program, a number of new initiatives, policy changes, and additional trainings are planned or are underway that directly address the issues raised. An Administration for Children and Families (ACF)-published volume of NSCAW research results, authored by many of the top researchers in the field, will be published in early 2008. The results are expected to: (1) describe the child welfare system and the experience of children and families involved in the system; (2) examine outcomes for these children and families; and (3) describe the interaction of the child welfare system and services with other service systems. While the results from NSCAW are still pending, ACF is actively soliciting information from researchers involved in secondary analysis of the data to determine program effectiveness. As noted in Question 3.6, the Government Accountability Office (GAO) has published a number of reports on various components of the Foster Care program. In response to the GAO's findings, the Children's Bureau has undertaken a number of activities that address many of the concerns raised. For example, concerns about inadequate disaster planning were addressed in the Children's Bureau publication "Coping with Disasters and Strengthening Systems: A Framework for Child Welfare Agencies," which was distributed over the child welfare listserv to all Child Welfare Administrators in February 2007. The issues GAO cited on the use and reliability of AFCARS and NCANDS data have been, and continue to be, addressed at the annual National Child Welfare Data and Technology Conference hosted by the Children's Bureau. Pre-conference sessions entitled "AFCARS 101" and "NCANDS 101" have been designed for those unfamiliar with these data collection efforts, in particular State staff who are newly assigned to report NCANDS and AFCARS data. Additionally, many of GAO's concerns about the CFSRs have been addressed. There has been an expansion of the CFSR training available to Children's Bureau regional staff. This includes additional targeted training calls to provide both basic orientation to the CFSR for ACF staff with no or only limited CFSR experience and advanced training for staff with specific CFSR review responsibilities. ACF has also made ongoing improvements to the CFSR instrument, including replacing the existing CFSR single data measures with data composites that incorporate a wider range of performance areas relevant to a particular child welfare domain. Finally, as reported in Question 2.6, the Child Welfare Waiver Demonstration Projects allow States to experiment with title IV-E funding to improve programming and efficiencies. All States with waiver demonstrations are required to conduct process and outcome evaluations, as well as a cost analysis. Although not all projects have concluded or have published their findings, findings are available on the Children's Bureau website for the State Assisted Guardianship Waiver Demonstration Projects; the Flexible Funding Waiver Demonstration Projects; and the State Substance Abuse Demonstration Projects. These syntheses of findings include process findings, outcome findings, and lessons learned which suggest how the program may use the findings in guiding policy decisions. As mentioned in Question 2.6, the findings of many of the Waiver Demonstration Projects have led to a proposed change in title IV-E program policy (the Child Welfare Program Option) which would allow States additional flexibility in how they use their title IV-E funds.

Evidence: Please see evidence listed under Question 2.6.