�V. State Performance on the Seven National Child Welfare Outcomes
This chapter provides an overall summary of State performance and discussions of key findings reported in chapters II, III, and IV.
Summary of State Performance in 2000, 2001, 2002, and 2003
Table V-1 provides the median across States regarding performance on selected outcome measures in 2000, 2001, 2002, and 2003. The States included in the calculation of the median are those that provided acceptable data for a given outcome measure in all 4 years.20 Changes in State performance were assessed by calculating the percent change from 2000 to 2003 of the median percent across States.
| Outcome measure and number of States included in the analysis | Year | ||||
|---|---|---|---|---|---|
| 2000 (median) | 2001 (median) | 2002 (median) | 2003 (median) | ||
| 1.1 | Percent of children who were victims of substantiated or indicated child abuse and/or neglect during the first 6 months of reporting period who had another substantiated or indicated report within a 6-month period (N=34 States). | 7.9% | 7.5% | 7.8% | 7.7% |
| 2.1 | Percent of children in foster care who were the subject of substantiated or indicated maltreatment by a foster parent or facility staff member (N=27 States). | 0.47 | 0.55 | 0.52 | 0.40 |
| 3.1 | Percent of children exiting foster care who were discharged to a permanent home (adoption, legal guardianship, or reunification) (N=44 States). | 85.7 | 85.4 | 86.4 | 86.7 |
| 3.2 | Percent of children exiting foster care who had a diagnosed disability who were discharged to a permanent home (adoption, guardianship, or reunification) (N= 37 States). | 79.6 | 78.6 | 79.8 | 78.2 |
| 3.3 | Percent of children exiting foster care who were older than 12 at the time of entry into foster care who were discharged to a permanent home (adoption, guardianship, or reunification) (N=40 States). | 72.8 | 72.9 | 72.0 | 72.2 |
| 3.4 | Percent of children exiting foster care to emancipation who were age 12 or younger at the time of entry into foster care (N=50 States). | 25.3 | 28.3 | 26.7 | 29.6 |
| 4.1 | Percent of children reunified with their parents or caretakers at the time of discharge from foster care who were reunified within 12 months from the time of entry into foster care (N=43 States). | 71.5 | 71.9 | 68.3 | 72.1 |
| 4.2 | Percent of children entering foster care who were re-entering care within 12 months of discharge from a prior foster care episode (N= 46 States). | 10.6 | 11.2 | 10.8 | 9.8 |
| 5.1 | Percent of children exiting foster care to a finalized adoption who exited within 24 months from the time of the latest removal from home (N=34 States). | 19.7 | 20.3 | 21.9 | 22.9 |
| 6.1 | Percent of children in foster care for less than 12 months who experienced two or fewer placements (N=51 States). | 84.2 | 83.3 | 84.3 | 84.0 |
| 7.1 | Percent of children age 12 or younger at the time of their most recent placement who were placed in a group home or institution (N= 49 States). | 9.6 | 8.6 | 8.6 | 8.3 |
As shown in the table, there is evidence of performance improvement from 2000 to 2003 with regard to several measures. The following are the findings pertaining to improved performance.
- The median percentage of children in foster care who were maltreated by a foster parent or facility staff member (outcome measure 2.1) decreased from 2000 to 2003 (-14.8 percent change).
- The median percentage of children entering foster care who were re-entering within 12 months of a prior episode (outcome measure 4.2) decreased from 2000 to 2003 (-7.5 percent change).
- The median percentage of adoptions occurring within 24 months of a child's entry into foster care (outcome measure 5.1) increased from 2000 to 2003 (+16.2 percent change).
- The median percentage of children age 12 and younger who were placed in group homes or institutions (outcome measure 7.1) decreased from 2000 to 2003 (-13.5 percent change).
The only measure that exhibited a performance decline from 2000 to 2003 was measure 3.4. For this measure, the median percentage of children emancipated from foster care who were age 12 or younger when they entered foster care increased from 2000 to 2003 (+17.0 percent change). Performance on the remaining outcome measures did not change from 2000 to 2003 (i.e., the percent change did not exceed 5.0 in either direction).
The sections below discuss State performance on the national child welfare outcomes and measures with regard to keeping children safe, achieving permanency for children, and providing stable and age-appropriate placements.
Key Findings Regarding Keeping Children Safe
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) pertain to State performance with regard to keeping children safe. State performance on these outcomes is summarized and discussed below.
Outcome 1—Reduce recurrence of child abuse and/or neglect
Outcome 1 reflects the primary responsibility of State child welfare agencies to protect children who have been found to be victims of abuse or neglect from further harm. The measure developed to assess State performance on this outcome is the following: Of 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 findings regarding performance on this outcome measure suggest that, in 2003, protecting child maltreatment victims from further harm was a challenge for many States. In 35 of the 45 States reporting data for the measure, at least five percent of the children who were victims of child maltreatment in the first 6 months of the reporting year experienced another maltreatment incident within a 6-month period. Also, as noted in chapter II, for some States, the incidence of maltreatment reported to the National Child Abuse and Neglect Data System (NCANDS) Child File may be less than the actual incidence. This is due to the fact that child protective services agencies in these States often do not formally investigate maltreatment allegations involving children in open child protective services case, and therefore they do not report these allegations to the NCANDS Child File.
Despite the continued challenge of preventing maltreatment recurrence, 53 percent of the States achieved outcome 1 because the incidence of maltreatment recurrence declined between 2000 and 2003. For some States this decline was extensive. However, for 29 percent of the States, the incidence of child maltreatment recurrence increased from 2000 to 2003, and for some of these States, the increase was considerable.
The findings indicate that in 2003, State performance on the measure of maltreatment recurrence was not related to the age or race/ethnicity of child victims, but was related to the types of maltreatment experienced by child victims. In 2003, States with a relatively high percentage of children who were victims of sexual abuse tended to have a relatively low incidence of maltreatment recurrence within a 6-month period (Pearson's r = -0.40). In comparison, States with a relatively high percentage of children who were victims of neglect in 2003 tended to have a relatively high incidence of maltreatment recurrence within a 6-month period (Pearson's r = 0.40).
Although additional information is necessary for a detailed interpretation of these findings, one possible explanation may be found in the different responses that typically occur to substantiated sexual abuse and neglect allegations. A substantiated allegation of sexual abuse, for example, often involves legal action against the perpetrator and legal action to ensure that the perpetrator does not have contact with the child, which may include placement of the child in foster care. These efforts may be effective in preventing the recurrence of sexual abuse within a 6-month period. In contrast, a child welfare agency response to a substantiated allegation of neglect usually does not involve legal action against the perpetrator and usually does not prohibit contact between the child and the perpetrator. Consequently, there may be a greater opportunity for neglect to recur within a 6-month period.
Understanding differences among States in performance on the measure of maltreatment recurrence requires consideration of the potential effect on performance of State definitions of child abuse and neglect and State laws governing evidentiary requirements for substantiation. For example, in some States, the statutory definition of child maltreatment does not include psychological or emotional abuse; in other States, this type of abuse is part of the definition of child maltreatment. In one State (Pennsylvania), the definition of child maltreatment does not include neglect, unless it is "severe neglect."
Also, in some States, substantiation of a maltreatment allegation requires evidence "beyond a reasonable doubt." In other States substantiation requires a "preponderance of evidence." Elsewhere, an allegation can be substantiated if there is "reasonable suspicion" that the maltreatment occurred or an allegation can be substantiated if the risk of maltreatment is confirmed. These differences affect both the number of children who are found to be victims of maltreatment in a State and the incidence of maltreatment recurrence. A key finding reported in chapter II relevant to this issue is that, in 2003, States with a relatively high rate of child victims (i.e., the number of child victims per 1,000 children in the population) tended to have a relatively high incidence of maltreatment recurrence within a 6-month period (Pearson's r = 0.63).
Outcome 2—Reduce the incidence of child abuse and/or neglect in foster care
Outcome 2 reflects the obligation of a State child welfare system to ensure that children who are removed from their homes by the State do not experience maltreatment by their State-appointed caretakers. The measure developed to assess State performance on this outcome is the following: 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 findings pertaining to performance on this outcome measure in 2003 indicate that States are reasonably effective in keeping most children in foster care safe from maltreatment by foster parents or a facility staff member. For many States, less than 0.20 percent of children in foster care were maltreated by foster parents or facility staff members in 2003. However, in all States, there were some children who were victims of maltreatment by their State-appointed caretakers, which suggests that there is an ongoing need for improvement in this area.
The findings also indicate that in the majority of States included in the analysis of performance on this measure (73 percent), there was a reduction between 2000 and 2003 in the incidence of child abuse and/or neglect by a foster parent or facility staff member. Only 19 percent of the States exhibited a decline in performance on this measure over that time period.
State performance on the measure of maltreatment of children in foster care was not found to be related to the age of child victims, their race/ethnicity, or the type of maltreatment they experienced.
Achieving Permanency for Children in Foster Care
Outcome 3 (Increase permanency for children in foster care), outcome 4 (Reduce time in foster care to reunification without increasing re-entry), and outcome 5 (Reduce time in foster care to adoption) were established to assess State performance with regard to achieving permanency for children in foster care. State performance on these outcomes is summarized and discussed below.
Outcome 3—Increase permanency for children in foster care
Outcome 3 reflects the responsibility of State child welfare agencies to ensure that foster care is a temporary situation for children and that when children leave foster care they are discharged to a permanent home. A child in foster care is determined to have achieved permanency when any of the following occurs: (1) the child is discharged from foster care to a reunification with his or her family, either a parent or other relative; (2) the child is discharged from foster care to a legally finalized adoption; or (3) the child is discharged from foster care to the care of a legal guardian.
The measures developed to assess State performance on this outcome emphasize the importance of achieving permanency for all children regardless of their characteristics. Consequently, the measures developed for outcome 3 pertain not only to achieving permanency for all children exiting foster care (measure 3.1), but also to achieving permanency for children with a diagnosed disability (measure 3.2), children who are adolescents when they enter foster care (outcome measure 3.3), and children of all races/ethnicities (measure 3.5). Another measure pertaining to outcome 3 (measure 3.4) is intended to capture the percent of children who "grow up" in foster care and are discharged without having found a permanent home.
The findings presented in chapter III indicate that most children exiting foster care in 2003 were discharged to a permanent home. However, in the majority of States, children exiting foster care who had a diagnosed disability or who were older than age 12 when they entered care were less likely to be discharged to a permanent home than were all children exiting foster care. These findings suggest that, in many States, achieving permanency for all children in foster care remains a challenge.
An additional finding is that in 2003, in the majority of States, the percentages of children exiting foster care who were discharged to a permanent home did not vary as a function of children's race or ethnicity. In these States, Black (non-Hispanic) children, Hispanic children, Alaskan Native/American Indian children, and White (non-Hispanic) children exiting foster care were about equally likely to be discharged to a permanent home.21
The findings reported in chapter III also demonstrate that, in 2003, there were a substantial number of children in some States who entered foster care when they were younger than age 12 and eventually emancipated from foster care, having never found a permanent home. In fact, in 10 States, more than 40 percent of the children emancipated from foster care in 2003 were age 12 or younger when they entered foster care.
Most States did not achieve outcome 3 in that they did not increase permanency for children in foster care from 2000 to 2003. This finding is not surprising for outcome measure 3.1 (the percent of all children exiting foster care who were discharged to a permanent home) because most States were already performing at a very high level on this measure in 2000. Of concern, however, are the findings that: (1) 41 percent of the States exhibited a decline in performance from 2000 to 2003 with regard to achieving permanency for children with a diagnosed disability and, (2) 51 percent of the States exhibited a decline in performance with regard to the percent of children emancipated from foster care who were age 12 or younger when they entered foster care.
Outcome 4—Reduce time in foster care to reunification without increasing re-entry
Outcome 4 reflects the emphasis of the Department and the Adoption and Safe Families Act (ASFA) on reunifying children in a timely manner. The findings reported in chapter III indicate that, in many States, the majority of children reunified in 2003 were in foster care for less than 12 months at the time of reunification. However, the median of 72.0 percent across States suggests that for about one-half of the States, there is a need for improvement with regard to timely reunifications. In particular, in five States, less than 50 percent of reunifications occurred within 12 months of the child's entry into foster care.
Outcome 4 also addresses the Department's emphasis that reunifications must occur in a manner that promotes the "permanency" of the reunification and prevents children from re-entering foster care. The findings reported in chapter III raise concerns about the permanency of reunifications occurring within 12 months of a child's entry into foster care. One key finding is that 50 percent of the States exhibiting an increase from 2000 to 2003 in the percentage of reunifications occurring within 12 months of entry into foster care (outcome measure 4.1) also exhibited an increase in the percentage of children entering foster care who were re-entering within 12 months of a prior episode (outcome measure 4.2). Only four States exhibited improved performance on both measures (Arizona, Illinois, Tennessee, and Vermont). Another key finding is that in 2003, States with a relatively high percentage of reunifications occurring within 12 months of a child's entry into foster care also tended to have a relatively high percentage of entries into foster care of children re-entering within 12 months of a prior foster care episode (Pearson's r = 0.49). Taken together, these findings suggest that some children are being reunified before sufficient changes have occurred in the family or the child to prevent another removal episode and/or that insufficient post-reunification services were provided to assist families in the reintegration process.
The findings reported in chapter III also indicate that the relationship between reunification and re-entry reported in the prior paragraph may be particularly relevant for children who enter foster care as older adolescents. In general, States with a relatively high percentage of children entering foster care who were age 16 or older tended to have a relatively high percentage of children entering foster care who were re-entering within 12 months of a prior episode (Pearson's r = 0.52). Almost all of the States with a high percentage of children age 16 and older entering foster care are States in which children can enter foster care through the juvenile justice system or through the courts as "children in need of supervision." Because these children do not enter foster care as victims of maltreatment, and therefore are viewed as not having safety concerns, child welfare agencies may experience challenges in meeting their treatment needs. This finding suggests that States experiencing relatively high percentages of children re-entering foster care within 12 months of a prior episode should examine their data to identify the ages of the children who are re-entering in order to determine how to best address the problem.
Outcome 5—Reduce time in foster care to adoption
Outcome 5 is intended to emphasize the responsibility of child welfare agencies to find adoptive families for children who cannot be returned to their families and to finalize the adoption process as quickly as possible. For most States, the percent of adoptions in 2003 that were finalized within 24 months of a child's entry into foster care was not high (median = 23.9 percent), and in some States it was quite low. However, 70 percent of States exhibited improved performance on this measure, suggesting that States are making concerted efforts to expedite the adoption process for children.
One finding reported in chapter III is somewhat difficult to interpret. In 2003, States with a relatively high percentage of Black (non-Hispanic) children in their foster care populations tended to have a relatively low percentage of adoptions occurring within 24 months of a child's entry into foster care (Pearson's r = -0.47). Although it is possible to provide some speculations on the reasons why this relationship may occur, additional information is needed to explore the nature of this relationship.
Achieving Stable Placements and Appropriate Placements for Young Children
Outcome 6—Increase placement stability
This outcome reflects the Department's belief that State child welfare agencies are responsible for ensuring that children who are removed from their homes are placed in settings that are stable. Placement stability is defined as "two or fewer placement settings."
States are generally effective in achieving placement stability for children in foster care for less than 12 months. The median performance in 2003 on this measure was 84.2 percent. Performance on this measure did not change from 2000 to 2003 for 74 percent of the States, primarily because most States were already at a high level of performance in 2000.
In contrast, States are far less effective in achieving placement stability for children in foster care for at least 12 months but less than 24 months. The median performance in 2003 on this measure was only 59.1 percent. In 10 States, placement stability declined by 30 percent or more for children in foster care from 12 to 24 months compared to children in foster care for less than 12 months. Additional research is needed to identify the factors associated with this decline in placement stability to help support States in achieving placement stability for children, regardless of how long they are in foster care.
Outcome 7—Reduce placements of young children in group homes or institutions
In the majority of States, a fairly small percentage of young children are placed in group homes or institutions. Fifty-five percent of the States achieved outcome 7 in that they reduced placements of young children in group homes or institutions. However, for a few States, there is an ongoing need for improvement in this area. In six States, for example, 20 percent or more of the children age 12 and younger who entered foster care in 2003 were placed in group homes or institutions. In addition, 37 percent of the States exhibited a decline in performance on this measure from 2000 to 2003.
Summary
Overall, State performance with regard to keeping children safe generally improved from 2000 to 2003, particularly with regard to maltreatment of children in foster care. However, more efforts are needed to ensure that child victims do not experience additional maltreatment, whether they are in their own homes, in the home of a foster family, or in a group home or institution. The findings suggest that our understanding of State performance with regard to keeping children safe would be enhanced by research pertaining to the following:
- How definitions of child maltreatment and statutory requirements pertaining to substantiation affect the reported incidence of maltreatment recurrence within a 6-month period.
- Why the percentage of child victims who experience neglect appears to be positively related to the incidence of child maltreatment recurrence.
- Why the percentage of child victims who experience sexual abuse appears to be negatively related to the incidence of child maltreatment recurrence.
State performance with regard to achieving permanency for children varied. The strongest area of improvement from 2000 to 2003 pertained to adoptions within 24 months of a child's entry into foster care. Although the percentage of adoptions that are finalized within this time period continues to be somewhat low (median = 23.9 percent), 70 percent of the States exhibited improved performance on this measure.
Many States (33 percent) also improved with respect to achieving reunifications within 12 months of a child's entry into foster care. However, there is some indication that expediting reunifications may be related to increased re-entry, particularly for children who enter foster care as older adolescents. This suggests that States with high rates of re-entry into foster care with 12 months of a prior episode should examine the ages of those children who are re-entering in order to better understand how to respond to the problem.
States also continued to experience challenges in 2003 in achieving permanency for children who enter foster care as adolescents (i.e., older than age 12). In the majority of States, the percentage of these children exiting foster care who were discharged to a permanent home was substantially lower than the percentage of all children exiting foster care who were discharged to a permanent home. Finally, in many States, more than one-third of the children emancipated from foster care had entered foster care when they were age 12 or younger, and the overall median for this measure was close to 30 percent.
Additional information in the following areas would enhance understanding of State performance with regard to achieving permanency for children in foster care and help identify strategies for improving performance in this area:
- How State differences with regard to policies and practices governing reunification and adoption affect performance on the outcome measures.
- The factors associated with very long-term stays in foster care.
- The reasons for entry into foster care for children age 13 and older and the factors associated with attaining permanency for these children.
- Why a high percentage of older adolescents entering foster care is associated with a high percentage of re-entry into foster care.
- The nature of the relationship between reunifications within 12 months and re-entries within 12 months in individual States.
The findings regarding State performance pertaining to placement stability raise serious concerns about children in foster care for 12 months or longer. Although most children in foster care for less than 12 months generally experience two or fewer placement settings, this is not true for children in foster care for at least 12 months but less than 24 months. Additional research is needed to understand why this decline in placement stability occurs. This information would assist in identifying strategies for increasing placement stability for all children.
For most States, the majority of young children entering foster care are placed in family settings rather than in group homes or institutions. However, there are a few States where this is an area needing ongoing improvement.
The findings reported in Child Welfare Outcomes 2003: Annual Report to Congress suggest that for the most part States are exhibiting improvements in achieving positive outcomes for children who come into contact with public child welfare systems. However, there continue to be many areas in which additional improvements are needed and some in which State performance is declining. As States complete their program improvement plans resulting from the first round of Child and Family Services Reviews, the Department will be able to gather more specific information to identify the direction of change and the strategies associated with positive change.
20 Because this table includes only States that provided acceptable data for each measure in all 4 years, the medians reported in this table for State performance in 2003 may be slightly different than those reported in earlier chapters. For example, as shown in table II-1 in chapter II, in 2003, 45 States provided data for outcome measure 1.1. The median across these States was 7.1 percent. Because only 34 States provided data for this measure in all 4 years, in table V-1 above, the median is 7.7. Back
21 This applies only to those States in which at a particular racial/ethnic category accounted for at least 10 percent of the children exiting foster care. Back
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