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Child Welfare Outcomes 2001: Annual Report to Congress (Outcomes Report) is the fourth annual report from the U.S. Department of Health and Human Services (the Department). This report depicts the performance of States on the following seven national child welfare outcomes:
Child Welfare Outcomes 2001 presents data for each State (the term "State" as it is used in this report, includes the 50 States and the District of Columbia and Puerto Rico) on each of the 13 measures developed to assess the 7 national outcomes. The report also provides key findings of a cross-State data analyses and a discussion of overall State performance on the outcome measures.
The discussion of State performance incorporates information from the Department's Child and Family Services Reviews (CFSR) for the 32 States reviewed in fiscal years 2001 and 2002. Although the Outcome Reports and the CFSR represent separate activities within the Department, both are designed to provide information that the Department can use to assist States in improving child welfare services. The CFSR is the Department's results-oriented, comprehensive monitoring system implemented in fiscal year (FY) 2001. The CFSR examines State child welfare system operations through case reviews and interviews with stakeholders and assesses each State's conformity with seven outcomes and seven systemic factors. The CFSR also assesses each State's performance on 6 outcome measures that the Department selected from the 13 measures developed for the Outcomes Reports. Prior to implementation of the CFSR, the Department established national standards for these six measures, and States are assessed with respect to whether their Statewide data for the measure meets the national standard.
Child Welfare Outcomes 2001 is organized as follows:
Chapter I. Assisting States in Attaining Positive Outcomes for Children and Families. This chapter focuses on how the Department can and does use information from the Outcomes Reports and the CFSR to assist States in improving their efforts to achieve positive outcomes for children and families.
Chapter II. Key Findings: State Performances on the Child Welfare Outcomes for 2001 and Changes in Performance from 1999 to 2001. This chapter presents the findings of the analyses of State data with regard to the seven outcome measures. The analyses focus on performance in 2001 and changes in performance from 1999 to 2001.
Chapter III. Assessment of State Performance on the Seven Child Welfare Outcomes. This chapter provides a discussion of the key findings and the implications of the findings for assessing State performance. The discussion incorporates relevant information from the analysis of CFSR findings for the 32 States that participated in a CFSR during FYs 2001 and 2002.
Chapter IV. State Data Pages. The data pages for each State are provided in this Chapter. For each State, the data pages are followed by a State comment page (for those States providing comments) and a Federal comment page.
The data analyses conducted for Child Welfare Outcomes 2001 focused on State performance on the outcomes in 2001 and changes in performance from 1999 to 2001. The data analyses address State performance in the following areas:
Key findings pertaining to State performance with regard to each of these areas are summarized below.
State Performance Pertaining to Preventing Further
Maltreatment of Children
Children's safety is the primary concern of all child welfare
services, particularly the safety of children who have already been
identified as maltreatment victims —i.e., children who were
the subjects of substantiated or indicated maltreatment reports.
The Department established the following outcomes to address this
concern: outcome 1: reduce recurrence of child abuse and/or
neglect, and outcome 2: reduce the incidence of child abuse and/or
neglect in foster care.
To assess outcome 1, outcome measure 1.1 was developed: For all children who were victims of substantiated or indicated child abuse and/or neglect during the first 6 months of the reporting period, what percentage had another substantiated or indicated report within a 6-month period? The Department established the following national standard related to this measure as part of the CFSR: Of all children who were victims of substantiated or indicated child abuse or neglect during the first 6 months of a specified year, 6.1 percent or fewer children had another substantiated or indicated report within 6 months.
To assess outcome 2, outcome measure 2.1 was developed: Of all children who were in foster care during the reporting period, what percentage was the subject of substantiated or indicated maltreatment by a foster parent or facility staff member? The Department established the following national standard related to this measure for the CFSR: Of all children in foster care in the State during a specified time period, 0.57 percent or fewer were the subject of substantiated or indicated maltreatment by a foster parent or facility staff member.
A key finding with regard to outcome measure 1 is that many States experience challenges in preventing maltreatment recurrence. In 2001, of the 40 States reporting data for the outcome measure assessing maltreatment recurrence within 6 months, only 13 (32.5 percent) met the national standard of 6.1 percent or less. Ten States (25 percent) had a maltreatment recurrence rate that was greater than 10 percent. In contrast to these findings, States appear to be experiencing greater success in preventing maltreatment of children in foster care. In 2001, for example, of the 38 States reporting data for the measure assessing maltreatment in foster care, 25 (66 percent) met the national standard of 0.57 percent or less. There were only four States in which the incidence of maltreatment of children in foster care in 2001 exceeded one percent. In addition, there was a substantial increase from 1999 to 2001 in the percentage of States meeting the national standard for this measure (52 percent in 1999 compared to 66 percent in 2001).
Information from the analysis of data from the CFSR Final Reports suggests that the difficulties States experience in preventing maltreatment recurrence may be due to one or more of the following:
In addition, information from the analysis of the 32 CFSR Final Reports suggests that a State's success in preventing maltreatment in foster care may be attributed in part to efforts to establish licensing standards for foster homes and care facilities that require adequate training for foster parents and facility staff and that ensure children's safety.
State Performance in Achieving Permanency for Children in
Foster Care
A primary goal of child welfare services is to find permanent homes
for children, through reunification with their families, adoption,
or legal guardianship. The Department assesses State performance in
achieving permanency for children in foster care through five
measures developed for outcome 3 —increase permanency for
children in foster care. The five measures are listed below (no
national standards are related to measures of outcome 3):
A key finding pertaining to permanency for children in foster care is that the vast majority of children who exit foster care are discharged to a permanent home (i.e., through reunification, adoption, or guardianship). Children who are not included in this group are those who were emancipated from foster care, transferred to another system (such as mental health, juvenile justice, or adults with disabilities), died, or ran away and were no longer considered by the State to be in out-of-home care. The mean percentage of children exiting foster care to a permanent home declines when the children have a diagnosed disability or when they entered foster care as adolescents. In FY 2001, the mean percentage of all children exiting foster care to a permanent home was 84.6. In comparison, the mean percentage of children with a diagnosed disability exiting foster care to a permanent home was only 78.4, and for children who entered foster care when they were adolescents, the mean percentage of children exiting to a permanent home declined even further, to 69.7. These findings suggest that achieving permanency for children with disabilities and children who entered foster care as adolescents is a challenge for many States.
The analyses of CFSR Final Report information identified the following potential barriers to attaining permanency for older children:
Another key finding relevant to outcome measure 3.4 is that in many States a substantial percentage of children may be said to have "grown up" in foster care. That is, they were emancipated from foster care between the ages of 18 and 21 after having entered foster care when they were age 12 or younger. In FY 2001, there were 25 States in which more than 28 percent of the children emancipated from foster care were age 12 or younger when they entered foster care and in 15 of these States, over 50 percent of the children exiting to emancipation had entered foster care when they were age 12 or younger. Nationally, at least 30 percent of all children exiting foster care to emancipation in FY 1999, 2000, and 2001 were age 12 or younger when they entered foster care.
Information from the analysis of CFSR Final Reports suggests that young children are put at risk for "growing up" in foster care when the child welfare agency and/or the courts decide to maintain reunification as a permanency goal for long periods of time, even when parents have not exhibited progress in moving toward reunification and the prognosis for reunification is poor. Although some of the provisions of the Adoption and Safe Families Act (1997) are intended to address this problem, the CFSR findings suggest that not all States are fully implementing these provisions.
A final key finding relevant to outcome measure 3 is that Black (non-Hispanic), White (non-Hispanic), and Hispanic children are no more or less likely to be discharged from foster care to a permanent home. However, in five States, White (non-Hispanic) children exiting foster care were considerably more likely than Alaska Native/American Indian children to be discharged to a permanent home. In one of these States, 91.9 percent of White (non-Hispanic) children exiting foster care were discharged to a permanent home compared to 65.3 percent of Alaska Native/Native American children exiting foster care.
Information from the CFSR Final Reports suggests that success in achieving positive outcomes for Native American children is promoted when States and Tribes establish written agreements about the roles and responsibilities of each entity for Native American children who come into contact with the child welfare system, and when the State child welfare agency and the courts adhere to the requirements of the Indian Child Welfare Act. However, information from the CFSR also indicates that some Tribes are unwilling to seek termination of parental rights for Native American children because it is not consistent with their cultural values and traditions, although they support permanency through long-term foster care in a stable home.
State Performance in Achieving Permanency in a Timely Manner A primary goal of child welfare services is to achieve permanency for children in foster care as quickly as possible after a child enters foster care, without jeopardizing the child's continued safety. To address the issue of timely permanency, the Department established two outcomes: outcome 4 —reduce time in foster care to reunification without increasing re-entry, and outcome 5 —reduce time in foster care to adoption.
The measures developed to assess State performance in attaining outcome 4 are the following:
The Department established the following national standard for the CFSR related to outcome measures 4.1: Of all children who were reunified with their parents or caretakers at the time of discharge from foster care (in a specified fiscal year), 76.2 percent or more were reunified in less than 12 months from the time of the latest removal from home. The Department established the following national standard for the CFSR related to outcome measure 4.2: Of all children who entered foster care during a specified fiscal year, 8.6 percent or fewer re-entered foster care within 12 months of discharge from a prior foster care episode.
The measure developed to assess State performance with regard to outcome 5 is the following: outcome measure 5.1. Of all children who exited foster care to a finalized adoption, what percentage exited care in the following time periods?
The Department established the following national standard related to this measure for the CFSR: Of all children who exited foster care to a finalized adoption during the specified fiscal year, 32 percent or more exited foster care in less than 24 months from the time of the latest removal from the home.
A primary finding pertaining to the attainment of permanency in a timely manner is that States appear to be more successful in achieving reunifications in a timely manner (in less than 12 months) than they are in achieving adoptions in a timely manner (in less than 24 months). In FY 2001, 19 (37 percent) of the 52 States (which includes the District of Columbia and Puerto Rico) met the national standard (76.2 percent or more) for the measure assessing the percentage of exits to reunification that occurred within 12 months of the child's entry into foster care. In comparison, only 14 States (27 percent) met the national standard (32 percent or more) for the measure assessing the percentage of finalized adoptions that occurred within 24 months of the child's entry into foster care. In addition, there was a substantive increase from FY 1999 to FY 2001 (+23 percent change) in the percentage of States meeting the national standard for reunifications within 12 months, but there was a substantive decline from FY 1999 to FY 2001 (-12.9 percent change) in the percentage of States meeting the national standard for finalized adoptions within 24 months. Finally, the data pertaining to adoptions within 24 months revealed a decline in both the mean and the median performance of States from FY 1999 to FY 2001.
Information from the analyses of the 32 CFSR Final Reports suggests that finalizing adoptions in a timely manner is a considerable challenge in most States. The identified barriers to expediting the adoption process included the following:
There is another finding that underscores the importance of interpreting State performance pertaining to timely reunification in conjunction with performance regarding foster care re-entry. Reunifying too rapidly sometimes results in re-entries to foster care. Conversely, States may maintain very low re-entry rates if they keep children in care for extended time periods. In fact, the data demonstrate this relationship clearly. States with a relatively high percentage of reunifications within 12 months also exhibit a relatively high rate of re-entries into foster care within 12 months of a prior foster care episode; and many States with a relatively low percentage of reunifications within 12 months exhibit a relatively low rate of re-entry into foster care. In fact, in FY 2001, only four States met the national standards for both measures.
Information from the CFSR Final Reports indicates that re-entries into foster care may occur because many States lack sufficient post-reunification services to support children's reintegration into the family and to monitor their safety on an ongoing basis. In many States, moreover, the CFSR found that some reunifications occur before adequate changes have been made in the family to ensure children's safety.
State Performance in Ensuring Stable and Age-Appropriate
Placements for Children in Foster Care
Another goal of the child welfare system is to ensure that children
in foster care experience placement stability and are in placements
that are appropriate for their age. The Department established the
following two outcomes to address these concerns: outcome 6
—increase placement stability, and outcome 7 —reduce
placements of young children in group homes or institutions.
The measure developed to assess State performance with regard to outcome 6 is the following: Outcome measure 6.1: Of all children served who had been in foster care for the time periods listed below, what percentage had no more than two placement settings during that time period?
The Department established the following national standard related to this measure for the CFSR: Of all children who have been in foster care for less than 12 months from the time of the latest removal from the home, 86.7 percent or more have had no more than 2 placement settings.
The measure developed to assess State performance with regard to outcome 7 is the following: outcome measure 7.1: For all children who entered foster care during the reporting period and were age 12 or younger at the time of their most recent placement, what percentage was placed in a group home or institution?
A key finding with regard to placement stability is that only 13 of the 52 States (25 percent) met the national standard for the percentage of children in foster care for less than 12 months who experienced no more than 2 placements. The analyses of CFSR information identified the following concerns with respect to State effectiveness in ensuring placement stability for children:
A key finding pertaining to age-appropriate placements (outcome measure 7.1) is that, in FY 2001, there were 7 of the 52 States in which more than 20 percent of children entering foster care who were age 12 or younger were placed in a group home or institution, and 1 State in which 45 percent of these children were placed in a group home or institution. In addition, information from the CFSR Final Reports indicates that, in some States, children as young as 2 or 3 years old experience extended stays in "shelter placements" that are equivalent to group homes or institutions.
Assessing Change in Performance Over Time
The findings of the analyses conducted for Child Welfare
Outcomes 2001 with regard to change in performance from FY 1999
to FY 2001 suggest that it is too early in the outcome assessment
process to identify trends in performance over time, either for
individual States or for States as a group. The most common finding
of the analyses of change is that, for individual States, a change
in one direction from 1999 to 2000 was offset by a change in the
other direction from 2000 to 2001. The shift in direction of the
States from one year to the next is not unexpected given the fact
that some States have implemented improvements in collecting and
reporting data in recent years, and that some States have been in
the process of implementing a change to a State Automated Child
Welfare Information System from a legacy system.
It also is difficult at this time to differentiate changes over time that can be attributed to performance from those that are the result of improvements in data quality. Through the CFSR process, and in response to the data for the Outcomes Reports, many States re-examined the data they reported to the national data systems and discovered errors in their reporting procedures. In some instances, this has resulted in resubmissions of prior years' data to the Adoption and Foster Care Analysis and Reporting System and the National Child Abuse and Neglect Data System. However, in other instances, States have chosen not to resubmit data from prior years, but to make the corrections in future years. Consequently, for some States, changes over time will not reflect the corrections made in the reporting procedures, while for other States, changes may be attributed to corrected reporting procedures.
Summary
The findings summarized above suggest that there is much room for
improvement with regard to State performance on the seven national
child welfare outcomes. The Department's role in helping States to
improve their performance in attaining positive outcomes for
children and families is one of providing the necessary information
and technical assistance. Information about the effectiveness of
various strategies, practices, policies, and procedures is critical
to help ensure the success of the States in their efforts to
enhance outcomes. The Department's comprehensive network of
resource and information centers is geared to meeting this demand,
as is the research funded through discretionary grants. As the
Department works with States in developing their
program-improvement plans as part of the CFSR, it is anticipated
that performance on the outcome measures will improve.
