Section III – Narrative Assessment of Child and Family Outcomes

Instructions

To complete the narrative assessment for each outcome item, including the data analysis, State agencies should do the following:

1. Describe and compare any changes in data over time, specifically including changes since the previous Statewide Assessment and Program Improvement Plan (PIP), the reasons for those changes, the factors affecting the numbers, and the effect on the safety, permanency, and well-being outcomes.
   
   
2. Describe the additional data, case review, or interview results that could explain the reasons for the numbers or outcomes.
   
   
3. Discuss each item even if no change is detected, and describe whether or not the lack of change is a desirable outcome.
   
   
4. For the outcome items that are to be measured against the national standards and composite measures, discuss the State's performance as indicated in the data profile provided for the Statewide Assessment, compare it with the national standard and individual data elements in the composite measure, and determine its level of conformity on the basis of the most recent year included in the profile. Describe the issues or factors that may have affected the item's level of conformity, including changes since the first Statewide Assessment and PIP.
   
   
5. Use the exploratory issues to thoroughly address the factors that affect each item and to evaluate how effectively the State is performing with regard to each outcome.

A. Safety

Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect.

Item 1: Timeliness of initiating investigations of reports of child maltreatment. How effective is the agency in responding to incoming reports of child maltreatment in a timely manner?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item, including alternative response policy requirements, if applicable
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about the timeliness of investigations
  
  
• Factors that are affecting the State's performance on safety data profile elements XIII and IX concerning response time, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as the availability of bilingual caseworkers
• Factors affecting the rate of substantiated versus unsubstantiated reports, and factors that influence decisionmaking regarding the disposition of incoming reports
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Item 2: Repeat maltreatment. How effective is the agency in reducing the recurrence of maltreatment of children?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about repeat maltreatment
  
  
• Factors that are affecting the State's performance on safety data profile elements VI and XI; reasons that the State either exceeds or does not meet the national standards, including factors that affect the rates of absence of maltreatment recurrence in the State; and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as the availability of services to families
  
  
• System used by the State for tracking and analyzing repeat maltreatment
  
  
• Patterns in the circumstances, characteristics, and demographics of children who experience repeat maltreatment
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Safety Outcome 2: Children are safely maintained in their homes whenever possible and appropriate.

Item 3: Services to family to protect child(ren) in the home and prevent removal or re-entry into foster care. How effective is the agency in providing services, when appropriate, to prevent removal of children from their homes?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about services to protect children and prevent removal or re-entry into foster care
  
  
• Other changes, such as service availability, policy, practice, staffing, or external factors such as consent decrees or other court issues
• Factors that are affecting the State's performance on safety data profile elements III and IV concerning cases opened for services and children entering care based on a maltreatment report, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as consistency in following up with families receiving preventive services
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 4: Risk assessment and safety management. How effective is the agency in reducing the risk of harm to children, including those in foster care and those who receive services in their own homes?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about reducing risk to children
  
  
• Factors that are affecting the State's performance on safety data profile elements VII and XIII concerning absence of maltreatment in foster care, reasons that the State either exceeds or does not meet the national standards, and possible data quality issues
  
  
• The incidence of children in foster care maltreated by a parent, safety data profile element XI, what has been learned, and subsequent actions taken, as needed
  
  
• Casework practices and resource issues that affect this item, such as (1) use of an adequate risk assessment process, (2) how the State ensures that safety issues are assessed continually while families receive services and at key decisionmaking points throughout the case (for example, when unsupervised visits are permitted, at reunification, or at case closure), (3) how the State ensures that children remain safe after they are placed in foster care, and the effectiveness of this approach, and (4) how the State handles reports of suspected child maltreatment for cases already being investigated or open for services
  
  
• The incidence of child fatalities due to maltreatment in the State, the agency's process for reviewing such cases, what has been learned from the reviews, and subsequent actions taken, as needed
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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B. Permanency

Permanency Outcome 1: Children have permanency and stability in their living situations.

Item 5: Foster care re-entries. How effective is the agency in preventing multiple entries of children into foster care?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about foster care re-entries
  
  
• Factors that are affecting the State's performance on permanency data profile element IX [Permanency Composite 1, including Component B, measure b(1)], reasons that the State either exceeds or does not meet the national standards, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as adequate screening of relative placements
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Item 6: Stability of foster care placement. How effective is the agency in providing placement stability for children in foster care (that is, minimizing placement changes for children in foster care)?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about the stability of foster care placements
  
  
• Factors that are affecting the State's performance on permanency data profile element XII [Permanency Composite 4, including measures (1), (2), and (3)] and first-time entry cohort data profile element IV, including reasons that the State either exceeds or does not meet the national standards, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as the use of shelters or temporary placements
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Item 7: Permanency goal for child. How effective is the agency in determining the appropriate permanency goals for children on a timely basis when they enter foster care?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about permanency goals
  
  
• Factors that are affecting the State's performance on permanency data profile element III and first-time entry cohort profile data element III concerning placement goals for children in care, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as (1) the use of long-term foster care as a permanency goal, (2) how the State establishes initial and subsequent permanency goals for children in foster care, particularly those with the goal of other planned permanent living arrangement, and the timeliness of establishing goals, and (3) how the State uses, or does not use, concurrent planning (simultaneously working toward two different goals, such as adoption and reunification)
  
  
• The role of the courts in determining the permanency goal
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 8: Reunification, guardianship, or permanent placement with relatives. How effective is the agency in helping children in foster care return safely to their families when appropriate?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about reunification, guardianship, or permanent placement with relatives
  
  
• Factors that are affecting the State's performance on permanency data profile element IX [Permanency Composite 1, including Component A, measures a(1), a(2), and a(3)], reasons that the State either exceeds or does not meet the national standards, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as the agency's strategies for supporting reunification, as appropriate
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  

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Item 9: Adoption. How effective is the agency in achieving timely adoption when that is appropriate for a child?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about achieving timely adoptions
  
  
• Factors that are affecting the State's performance on permanency data profile element X [Permanency Composite 2, Component A, measures a(1) and a(2), Component B, measures b(1) and b(2), and Component C, measure c(1)], including reasons that the State either exceeds or does not meet the national standards, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as the availability of adoptive families for children with special needs
  
  
• Factors pertaining to the recruitment and retention of adoptive families, and support services for adoptive families, that affect performance on this item
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Item 10: Other planned permanent living arrangement. How effective is the agency in establishing planned permanent living arrangements for children in foster care, who do not have the goal of reunification, adoption, guardianship, or permanent placement with relatives, and providing services consistent with the goal?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about establishing planned permanent living arrangements for children in foster care, as appropriate, and providing services to achieve that goal
  
  
• Factors that are affecting the State's performance on permanency data profile element XI [Permanency Composite 3, including Component A, measures a(1), a(2), and Component B, measure b(1)], including reasons that the State either exceeds or does not meet the national standards, and possible data quality issues
  
  
• Casework practices and resource issues that affect this item, such as (1) the availability of independent living services for adolescents in group homes or (2) the effectiveness in providing services to children to ensure a permanent home consistent with the goal
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Permanency Outcome 2: The continuity of family relationships and connections is preserved for children.

Item 11: Proximity of foster care placement. How effective is the agency in placing foster children close to their birth parents or their own communities or counties?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about placement proximity
  
  
• Casework practices and resource issues that affect this item, such as (1) the availability of placement options, or (2) the circumstances under which the agency places children out of the State or county or at long distances from their parents, and the number of children placed out of State
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Item 12: Placement With Siblings. How effective is the agency in keeping brothers and sisters together in foster care?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about placement with siblings
  
  
• Casework practices and resource issues that affect this item, such as the availability of placement options
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 13: Visiting with parents and siblings in foster care. How effective is the agency in planning and facilitating visitation between children in foster care and their parents and siblings placed separately in foster care?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about visits with parents and siblings
  
  
• Casework practices and resource issues that affect this item, such as the availability of transportation for visits
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 14: Preserving Connections. How effective is the agency in preserving important connections for children in foster care, such as connections to neighborhood, community, faith, family, tribe, school, and friends?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about preserving connections
  
  
• Casework practices and resource issues that affect this item, such as emphasis on placing children in their own communities
  
  
• How the State's processes, practices, and policies ensure compliance with Indian Child Welfare Act (ICWA) provisions concerning identifying tribal children, notifying tribes, observing placement preferences, and involving tribes in decisions regarding Native American children in foster care
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 15: Relative Placement. How effective is the agency in identifying relatives who could care for children entering foster care, and using them as placement resources when appropriate?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about relative placement
  
  
• Casework practices and resource issues that affect this item, such as when and how relatives and noncustodial parents are identified and assessed
  
  
• How the State conducts searches for both paternal and maternal relatives
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 16: Relationship of child in care with parents. How effective is the agency in promoting or helping to maintain the parent-child relationship for children in foster care, when it is appropriate to do so?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about relationships of children in care with their parents
  
  
• Casework practices and resource issues that affect this item, such as how the agency works with noncustodial parents of children in foster care
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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C. Child and Family Well-Being

Well-Being Outcome 1: Families have enhanced capacity to provide for their children's needs.

Item 17: Needs and services of child, parents, foster parents. How effective is the agency in assessing the needs of children, parents, and foster parents, and in providing needed services to children in foster care, to their parents and foster parents, and to children and families receiving in-home services?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about assessment and service provision
  
  
• Casework practices and resource issues that affect this item, such as (1) how and when the agency assesses needs, including those of the noncustodial parent, or (2) differences in practice or policy in this area between foster care cases and in-home services cases, if any
  
  
• How and when the agency assesses needs and provides services for all youth (ages 16 and older) to prepare them to be independent, regardless of their permanency goal
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 18: Child and family involvement in case planning. How effective is the agency in involving parents and children in the case planning process?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about parental and/or child/youth involvement in case planning
  
  
• Casework practices and resource issues that affect this item, such as (1) how and when the agency engages parents and children in case planning, (2) efforts made to locate and engage absent parents, and (3) differences in practice or policy in this area between foster care and in-home services cases, if any
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency

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Item 19: Caseworker visits with child. How effective are agency workers in conducting face-to-face visits as often as needed with children in foster care and those who receive services in their own homes?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item, including policies regarding visitation of children placed out of State
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about the frequency and quality of caseworker visits with children
  
  
• Casework practices and resource issues that affect this item, such as (1) how, when, and where caseworkers visit with children, (2) whether travel out of State by caseworkers is supported financially, (3) strategies for improving the quality of contact between staff and children, (4) differences in practice or policy in this area between foster care and in-home services cases, and between cases handled by the State agency and those handled by private agencies under contract with the State, if any
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 20: Worker visits with parents. How effective are agency workers in conducting face-to-face visits as often as needed with parents of children in foster care and parents of children receiving in-home services?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about the frequency and quality of caseworker visits with parents
  
  
• Casework practices and resource issues that affect this item, such as (1) how, when, and where caseworkers visit with parents, (2) differences in practice or policy between visits with fathers and visits with mothers, or with either parent that may be absent from the home, if any, and (3) differences in practice or policy in this area between foster care and in-home services cases, and between cases handled by the State agency and those handled by private agencies under contract with the State, if any
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Well-Being Outcome 2: Children receive appropriate services to meet their educational needs.

Item 21: Educational needs of the child. How effective is the agency in addressing the educational needs of children in foster care and those receiving services in their own homes?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about educational assessments and services
  
  
• Casework practices and resource issues that affect this item, such as (1) how educational needs are assessed, (2) inclusion of educational needs in the case plan and documentation in the child's record, (3) the services that the agency provides, (4) the role of the foster parents in working with the educational system, (5) the agency's involvement of birth parents in education-related issues, and (6) differences in practice or policy in this area between foster care and in-home services cases, if any
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Well-Being Outcome 3: Children receive adequate services to meet their physical and mental health needs.

Item 22: Physical health of the child. How does the State ensure that the physical health and medical needs of children are identified in assessments and case planning activities and that those needs are addressed through services?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item, including (1) the requirements for conducting initial health examinations of children entering foster care and for conducting ongoing or periodic examinations, including Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), and for including medical information in the child's record, (2) the role and responsibility of foster parents in obtaining medical care, and (3) the system for sharing medical information with foster and/or birth parents
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about physical health assessments and services
  
  
• Casework practices and resource issues that affect this item, such as how health needs are assessed and the services that the agency provides
  
  
• Differences in practice or policy in this area between foster care and in-home services cases, if any
  
  
• Resource issues, such as the structure and scope of the State's health care system, and the effects on the State's capacity to provide health care services to children in foster care and children receiving in-home services
  
  
• The system for identifying and addressing dental health care needs of children in foster care
  
  
• Influences or issues specific to a particular region or county
  
  
• Key collaborators with the agency on this item, where applicable
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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Item 23: Mental/behavioral health of the child. How does the State ensure that the mental/behavioral health needs of children are identified in assessments and case planning activities and that those needs are addressed through services?

Address the relevant exploratory issues below in discussing this item:

• Brief description of/update on the State's policy requirements regarding this item, including the requirements for conducting initial mental health evaluations of children entering foster care and ongoing or periodic evaluations
  
  
• How the policy requirements described above are reflected in practice
  
  
• Changes in performance and practice regarding this item since the previous Statewide Assessment; these might include (1) changes resulting from PIP implementation and/or other initiatives or strategies implemented by the State and (2) patterns or trends in, or statewide or local factors affecting, those changes
  
  
• Measures of effectiveness that demonstrate the State's functioning for this item, including quality assurance results, if available, and other data about mental health assessments and services
  
  
• Casework practices and resource issues that affect this item, such as (1) how mental health needs are assessed, (2) the services that the agency provides, (3) the availability and accessibility of services, and (4) the differences in practice or policy in this area between foster care and in-home services cases, if any
  
  
• Collaborative efforts with the State mental health system, other mental health service providers, and other service providers to address the mental health needs of children in the child welfare system
  
  
• Resource and funding issues, such as the structure and scope of the State's mental/behavioral health care system, and the effects on the State's capacity to provide mental/behavioral health services to children in foster care and children receiving in-home services
  
  
• Influences or issues specific to a particular region or county
  
  
• Strengths that the State has demonstrated in addressing or implementing this item, including factors external to the agency
  
  
• Promising approaches in this area
  
  
• Barriers that the State faces with regard to successfully addressing or implementing this item, including factors external to the agency
  
  

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