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Home > Statistics & Research > Child Welfare Outcomes 2003 > Executive Summary

Child Welfare Outcomes 2003: Annual Report to Congress
Executive Summary

Child Welfare Outcomes 2003: Annual Report to Congress (Report to Congress) is the sixth in a series of annual reports from the U.S. Department of Health and Human Services (the Department).1 The reports are developed in accordance with section 479A of the Social Security Act (as amended by the Adoption and Safe Families Act of 1997) and provide information pertaining to State performance on the following national child welfare outcomes:2

The Department established these national outcomes in consultation with State and local child welfare agency administrators, child advocacy organizations, child welfare researchers, and other experts in the child welfare field. The outcomes reflect widely accepted performance objectives for child welfare practice and adherence to a set of guiding principles.

The purpose of the Report to Congress is to provide information that may lead to improved outcomes for children and families served by the Nation's child welfare system by informing Congress, the States, and the public about State performance on key child welfare outcomes and change in performance over time. To this end, the Report to Congress presents data for each State regarding the following: (1) 12 measures developed to assess the national outcomes listed above, and (2) contextual factors regarding the number and characteristics of children who are the subject of substantiated child abuse or neglect reports and of children in the State's foster care system. The report also presents key findings across States on the relationship between contextual factors and State performance on the outcome measures. Data pertaining to the measures and the contextual factors come from the Federal Adoption and Foster Care Analysis and Reporting System (AFCARS) and the National Child Abuse and Neglect Data System (NCANDS).

The following table provides information regarding median State performance on key measures pertaining to the seven national outcomes. The States included in the calculation of the median are those that provided acceptable data for a given outcome measure in all 4 years.

Table 1. Median of State performance on key outcomes and measures in 2000, 2001, 2002, and 2003*
Outcomes and Measures Median Performance by Year
2000 2001 2002 2003
Outcome 1: Reduce recurrence of child abuse and/or neglect
Measure 1.1—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? (N=34 States). 7.9% 7.5% 7.8% 7.7%
Outcome 2: Reduce the incidence of child abuse and/or neglect in foster care
Measure 2.1—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? (N=27 States) 0.47 0.55 0.52 0.40
Outcome 3: Increase permanency for children in foster care
Measure 3.1—Of all children who exited foster care during the reporting period, what percentage left to either reunification, adoption, or legal guardianship (i.e., were discharged to a permanent home)? (N=44 States) 85.7 85.4 86.4 86.7
Measure 3.2—Of all children who exited foster care and were identified as having a diagnosed disability, what percentage left to either reunification, adoption, or legal guardianship (i.e., were discharged to a permanent home)? (N=37 States) 79.6 78.6 79.8 78.2
Measure 3.3—Of all children who exited foster care and were older than age 12 at the time of their most recent entry into care, what percentage left to either reunification, adoption, or legal guardianship (i.e., were discharged to a permanent home)? (N=40 States) 72.8 72.9 72.0 72.2
Measure 3.4—Of all children exiting foster care to emancipation, what percentage was age 12 or younger at the time of entry into foster care? (N=50 States) 25.3 28.3 26.7 29.6
Outcome 4: Reduce time in foster care to reunification without increasing re-entry
Measure 4.1—Of all children who were reunified with their parents or caretakers at the time of discharge from foster care, what percentage was reunified in less than 12 months from the time of entry into foster care? (N=43 States) 71.5 71.9 68.3 72.1
Measure 4.2—Of all children who entered foster care during the reporting period, what percentage re-entered care within 12 months of a prior foster care episode? (N=46 States) 10.6 11.2 10.8 9.8
Outcome 5: Reduce time in foster care to adoption
Measure 5.1—Of all children who exited foster care to a finalized adoption, what percentage exited foster care less than 24 months from the time of the latest removal from home? (N=34 States) 19.7 20.3 21.9 22.9
Outcome 6: Increase placement stability
Measure 6.1—Of all children served who had been in foster care for less than 12 months, what percentage had no more than two placement settings during that time period? (N = 51 States) 84.2 83.3 84.3 84.0
Outcome 7: Reduce placements of young children in group homes or institutions
Measure 7.1—Of 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? (N=49 States) 9.6 8.6 8.6 8.3

* In order to depict meaningful change in State performance over time, this table includes only those States that provided acceptable data for each measure in all 4 years. Therefore, the medians reported in this table for State performance in 2003 may be slightly different than those presented in the Report chapters. For example, in 2003, 45 States provided data for outcome measure 1; the median performance of these States was 7.1 percent. However, only 34 States provided data for measure 1.1 in all 4 years (2000, 2001, 2002, and 2003). The median State performance in 2003 for these 34 States is 7.7 percent. Back


Changes in median State performance from 2000 to 2003 were assessed by calculating the percent change in the median from 2000 to 2003.3 There was evidence of considerable performance improvement from 2000 to 2003, as indicated by the following findings:

There was only one measure in which median performance declined from 2000 to 2003. The median percentage of children emancipated from foster care who were age 12 or younger when they entered foster care (outcome measure 3.4) increased from 2000 to 2003 (+17.0 percent change). The median percentages for all other outcome measures did not change from 2000 to 2003 (i.e., the percent change did not exceed 5.0 in either direction).

How successful are States in protecting child maltreatment victims from further maltreatment?

A primary objective of State child welfare systems is to ensure that children who have been found to be victims of maltreatment are protected from further abuse or neglect whether they are in their own homes, in a foster home, or in a residential facility. For the Report to Congress, a child is considered to be a victim of maltreatment if he or she is the subject of a substantiated or indicated allegation of child abuse or neglect. In 2003, State child maltreatment victim rates ranged extensively from 1.6 child victims per 1,000 children in the State's child population in Pennsylvania to 42.2 child victims per 1,000 children in the population in Alaska. The median across States was 10.6 child victims per 1,000 children in the population.

The Department established the following safety-related national outcomes and measures to assess State performance with regard to protecting child victims from further abuse or neglect:

Outcome 1—Reduce recurrence of child abuse and/or neglect

Outcome measure 1.1—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?4

Outcome 2—Reduce the incidence of child abuse and/or neglect in foster care

Outcome measure 2.1—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 of the data analyses indicate that some States appear to be more effective than others in protecting child maltreatment victims from further maltreatment. In 2003, for the 45 States reporting data to NCANDS pertaining to outcome measure 1, the percent of children in a State who experienced a recurrence of maltreatment ranged from 2.1 to 14.4, with a median of 7.1 percent. In 35 of the 45 States at least 5 percent of the children who were victims of child maltreatment in the first 6 months of the reporting year were victims of another maltreatment incident within a 6-month period. For 29 percent of the 45 States, the incidence of maltreatment recurrence increased from 2000 to 2003. However, in 53 percent of the 45 States, the percent of children experiencing maltreatment recurrence decreased from 2000 to 2003.

Understanding differences among States with regard to the incidence of maltreatment recurrence requires a consideration of various contextual factors. For example, a substantial positive correlation (Pearson's r = 0.63) was found between a State's child maltreatment victim rate in 2003 and the percentage of children in the State who experienced maltreatment recurrence. In general, States with a relatively high victim rate also tended to have a relatively high percentage of maltreatment recurrence within a 6-month period. This suggests that differences in State statutes and policies regarding definitions of child maltreatment and evidentiary requirements for substantiation of a child maltreatment allegation may contribute to State variation in the incidence of maltreatment recurrence.

Differences in State practices regarding investigating maltreatment allegations also may contribute to State variation in the incidence of maltreatment recurrence. For example, in some States, the percent of maltreatment recurrence reported to NCANDS may be less than the actual percent because maltreatment allegations involving children in child protective services cases already open for services often are reported to the current caseworker and supervisor rather than being formally investigated to determine the validity of the allegation. Because there is no disposition, these children are not included in the NCANDS Child File, which is the data source for the measure of maltreatment recurrence (outcome measure 1.1). As another example, many States are adopting an alternative response approach to responding to maltreatment allegations. In these States, maltreatment allegations that are determined to involve very low risks for child safety are not formally investigated. Instead, the allegation is referred for a family assessment and no disposition is reached regarding the validity of the maltreatment allegation. Again, because there is no disposition, States do not submit the NCANDS Child File for children who are the subject of these allegations.

The data analyses also found that State variation in performance on the measure of maltreatment recurrence was moderately 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 meaningful interpretation of these findings, one possible explanation may be that child welfare agencies typically respond differently to substantiated sexual abuse and neglect allegations. A substantiated allegation of sexual abuse, for example, often involves legal action against the perpetrator and 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 (unless it is severe neglect or medical neglect), and usually does not prohibit contact between the child and the perpetrator. Consequently, there may be a greater opportunity for recurrence of neglect within a 6-month period.

States also varied in 2003 in their effectiveness in protecting children in foster care from maltreatment by their foster parents or a facility staff member (as assessed by measure 2.1). In 2003, for the 41 States that provided data to NCANDS for this measure, the percent of children in foster care who were victims of maltreatment by a foster parent or facility staff member ranged from 0.02 to 1.53, with a median of 0.39 percent. There were only four States in which more than one percent of the children in foster care were reported to be victims of maltreatment by a foster parent or facility staff member. In addition, most States (73 percent) exhibited improvement in this area from 2000 to 2003; only 19 percent of the States exhibited a decline in performance on this measure.

How successful are States in achieving permanency for children in foster care?

The Adoption and Safe Families Act (ASFA) of 1997 emphasized permanency as a primary goal for children in foster care and provided guidelines for achieving this goal in a timely manner. 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 Department established the following national outcomes and measures to assess State performance with regard to achieving permanency for children in foster care:

Outcome 3—Increase permanency for children in foster care

Outcome measure 3.1—Of all children who exited foster care during the reporting period, what percentage left either to reunification, adoption, or legal guardianship?

Outcome measure 3.2—Of all children who exited foster care and were identified as having a diagnosed disability, what percentage left either to reunification, adoption, or legal guardianship?

Outcome measure 3.3—Of all children who exited foster care and were older than age 12 at the time of their most recent entry into foster care, what percentage left either to reunification, adoption, or legal guardianship?

Outcome measure 3.4—Of all children who exited foster care to emancipation, what percentage was age 12 or younger at the time of entry into foster care?

Outcome measure 3.5—Of all children who exited foster care, what percentage by racial/ethnic category left either to reunification, adoption, or legal guardianship?

The data analyses findings suggest that most States were successful in achieving permanency for the majority of children exiting foster care in 2003.5 The percent of all children exiting foster care in 2003 who were discharged to a permanent home ranged across States (N = 51 States) from 71.9 to 96.1, with a median of 86.3 percent (measure 3.1). For 67 percent of the 51 States, there was no change from 2000 to 2003 in the percentage of all children exiting foster care who were discharged to a permanent home; performance on this measure was already quite high in 2000. Only seven percent of the States exhibited a decline in performance on this measure.

The range of State performance was greater when the assessment of permanency focused on children exiting foster care who had a diagnosed disability (measure 3.2). For the 48 States included in this analysis, the percent of children with a diagnosed disability exiting foster care who were discharged to a permanent home ranged from 36.4 to 96.5 with a median of 79.5 percent. In addition, 41 percent of these States showed a decline in performance on this measure from 2000 to 2003; only 24 percent of the States exhibited improved performance on this measure.

Many States also appeared to experience challenges with regard to achieving permanency for children who are older than age 12 when they enter foster care (measure 3.3). For the 48 States included in this analysis, the percent of children exiting foster care who entered foster care when they were older than age 12 and who were discharged to a permanent home ranged from 37.8 to 90.9, with a median of 72.2 percent. For 49 percent of these States, there was no change in performance on this measure from 2000 to 2003. However, 31 percent of these States exhibited improvement in performance from 2000 to 2003.

States varied considerably with regard to their success in ensuring that children do not grow up in foster care (measure 3.4). For the 52 States included in this analysis, the percent of all children who emancipated (including legal emancipation and children reaching the age of majority) from foster care who entered foster care when they were age 12 or younger ranged from 5.1 to 65.1, with a median of 29.6 percent. In 10 States, more than 40 percent of the children who emancipated from foster care in 2003 were age 12 or younger when they entered foster care. In addition, for 51 percent of the States, there was a decline in performance on this measure from 2000 to 2003. However, 34 percent of the States exhibited performance improvement over that time period.

In most 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 almost all of the 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.6

How successful are States in achieving permanency for children in a timely manner?

State child welfare agencies are responsible not only for achieving permanency for children in foster care, but also for ensuring that children are discharged to a permanent home as soon as possible after entering foster care. The Department established the following national outcomes and measures to assess State performance with regard to achieving permanency for children in foster care:

Outcome 4—Reduce time in foster care to reunification without increasing re-entry

Outcome measure 4.1—Of all children who were reunified with their parents or caretakers at the time of discharge from foster care, what percentage was reunified in the following time periods?

Outcome measure 4.2—Of all children who entered foster care during the reporting period, what percentage re-entered care:

Outcome 5—Reduce time in foster care to adoption

Outcome measure 5.1—Of all children who exited foster care to a finalized adoption, what percentage exited care in the following time periods?

Outcome 4 reflects the Department's emphasis on timely reunification of children who are able to be returned to their families. The results of the data analysis indicate that in 2003, States varied considerably with regard to their success in achieving reunifications within 12 months of a child's entry into foster care (measure 4.1). Of the 51 States included in this analysis, the percent of reunifications that occurred within 12 months of a child's entry into foster care ranged from 40.6 to 92.3, with a median of 72.0 percent. In five States, less than 50 percent of the reunifications occurred within 12 months of entry into foster care; in five other States, 85 percent or more of the reunifications occurred within 12 months of a child's entry into foster care. The assessment of change in performance on this measure included 43 States. Most of these States did not change from 2000 to 2003 with regard to their performance on this measure (49 percent), although almost one-third of the States showed improvement.

Understanding differences in State performance with regard to the timeliness of reunifications requires a consideration of State statutes, policies, and practices that may affect performance. For example, some States, either by law, policy, or practice, require the child welfare agency to maintain its placement and care responsibilities for a period of time (usually between 3 to 6 months) after a child is physically reunified with his or her family. Because this practice means that the child continues to be reported to AFCARS as being in foster care, it affects performance on the outcome measure pertaining to time in foster care prior to reunification.

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 (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 (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.

Outcome 5 addresses the Department's focus on expediting adoptions for those children who cannot be returned to their families. States are generally less successful in achieving adoptions in a timely manner than they are in achieving reunifications in a timely manner. In 2003, for the 47 States included in this analysis, the percent of adoptions finalized within 24 months of a child's entry into foster care ranged from 5.0 to 75.8, with a median of 23.9 percent. The percent of adoptions that were finalized after a child had been in foster care for at least 48 months had a somewhat similar range (3.2 percent to 65.6 percent), and a similar median (21.9 percent).

The analysis of change in performance on this measure from 2000 to 2003 included only 34 States. Many States were excluded from the analysis because of data quality issues in the 2000 data. Although most of these States corrected these issues in the 2003 data, it was not feasible to include them in the analysis of change over time. A key finding with regard to the timeliness of adoptions is that 70 percent of these States exhibited improved performance on this measure, and for many of these States, the improvement was substantial. Only 18 percent of the 34 States exhibited a decline in performance on this measure.

How successful are States in achieving stable placements for children in foster care and appropriate placements for young children?

It is the responsibility of a State child welfare agency to ensure that children are in stable placements while they are in foster care. An additional agency responsibility is to ensure that children are in placements appropriate to their age. For many young children (i.e., age 12 years or younger), an appropriate placement is a family setting rather than a group home or institution. The Department established the following outcomes and measures to assess State performance with regard to meeting these responsibilities.

Outcome 6—Increase placement stability

Outcome measure 6.1—Of all children served during the reporting period 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?

Outcome 7—Reduce placements of young children in group homes or institutions.

Outcome measure 7.1—Of 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?

The analysis of outcome measure 6.1 found that States were generally effective in achieving placement stability for children in foster care for less than 12 months. In 2003, the median percent of children in foster care for less than 12 months who experience two or fewer placement settings was 84.2. For 74 percent of the States, performance on this measure did not change substantively from 2000 to 2003, primarily because most States were already at a high level of performance in 2000.

The analyses also found that children in foster care for at least 12 months but less than 24 months are less likely to experience placement stability than children in foster care for less than 12 months. In 2003, the median percent of children in foster care for at least 12 months but less than 24 months who experienced two or fewer placement settings was 59.1, more than 25 percentage points less than the median performance on placement stability for children in foster care for less than 12 months.

State child welfare agencies also are responsible for ensuring that children are placed in foster care settings that are age-appropriate. For the 49 States included in this analysis, the percent of children entering foster care in 2003 at age 12 or younger who were placed in a group home or institution ranged from 1.4 to 28.8, with a median of 8.3 percent. Fifty-five percent of these States exhibited improvement on this measure from 2000 to 2003. However, there are a few States that have not been successful in ensuring that young children are not routinely placed in group homes or institutions. 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, the data indicate that greater 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.

State performance with regard to achieving permanency for children was more variable than it was for keeping children safe. 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 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 rates of re-entry, particularly for children who enter foster care as older adolescents.

States continued to experience challenges in 2003 with regard to 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; the median for this measure across States was close to 30 percent.

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.

Finally, in most States, the majority of young children entering foster care are placed in family settings rather than in group homes or institutions. However, there is room for improvement in this area in several States.

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 Department's 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.


1 The unit of the Department that has primary responsibility for this report is the Children's Bureau within the Administration on Children, Youth and Families, in the Administration for Children and Families. Back

2 In the Report to Congress, the designation of "State" includes the District of Columbia and Puerto Rico. Therefore the Report provides information on 52 "States." Back

3 Change in performance across years was assessed by calculating the percent change. This is calculated by subtracting "old" data from "new" data, dividing by "old" data and multiplying by 100. In this report, a percent change in performance on any measure from 2000 to 2003 that is less than 5.0 in either direction (i.e., positive or negative) is considered to reflect "no change" in performance. Because the outcome measures are assessed using percentages, small fluctuations across years are to be expected. Rather than identifying any percent change as a performance change, it was decided that a percent change greater than 5.0 would be a practical indicator of actual performance change. Back

4 The Child File of the National Child Abuse and Neglect Data System (which is the data source for the measure of maltreatment recurrence) cannot track children from one year to the next. Therefore, a 6-month time frame for maltreatment recurrence was established to ensure that the measure captured the actual incidence of maltreatment recurrence rather than estimating the incidence. In addition, multiple research findings indicate that the highest incidence of maltreatment recurrence tends to occur within 6 months of a prior incident. Therefore, the Department determined that the 6-month time frame was sufficient to assess State performance in this area. Back

5 The number of States varies for each analysis. States were excluded from an analysis if they did not report the necessary data or if there were substantive data quality issues in any given year, usually related to missing data or data discrepancies. Back

6 This applies only to those States in which a particular racial/ethnic category accounted for at least 10 percent of the children exiting foster care. Back


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