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March/April 2001Vol. 2, No. 2Children's Bureau Unveils New Outcomes-Oriented State Program Reviews

New Federal reviews of State child and family service programs, now under way in 17 States, focus on improving outcomes for children and families.

The 1994 Amendments to the Social Security Act (SSA) authorize the U.S. Department of Health and Human Services (DHHS) to review State child and family service programs to ensure conformance with the requirements in Titles IV-B and IV-E of the SSA.

Traditionally, reviews have focused primarily on assessing State agencies' compliance with procedural requirements, as evidenced by case file documentation, rather than on the results of services and States' capacity to create positive outcomes for children and families. In addition, reviews have not provided States with opportunities for making improvements before penalties have been imposed.

On January 25, 2000, DHHS published a final rule in the Federal Register to establish a new approach to monitoring State child welfare programs. Under the rule, which became effective March 25, 2000, States will be assessed for substantial conformity with certain Federal requirements for child protective, foster care, adoption, family preservation and family support, and independent living services. The Children's Bureau, part of the Administration for Children and Families (ACF) within DHHS, is administering the new review system.

Purpose

The new child and family services reviews are an important tool that will enable the Children's Bureau to accomplish the following:

  • Ensure conformity with Federal child welfare requirements
  • Determine what is actually happening to children and families as they are engaged in child welfare services
  • Assist States to enhance their capacity to help children and families achieve positive outcomes.

Ultimately, the goal of the reviews is to help States to improve child welfare services and achieve the following outcomes for families and children who receive services:

  • Safety: Children are, first and foremost, protected from abuse and neglect. Children are safely maintained in their homes whenever possible and appropriate.
  • Permanency: Children have permanency and stability in their living situations. The continuity of family relationships and connections is preserved for families.
  • Family and Child Well-Being: Families have enhanced capacity to provide for their children's needs. Children receive appropriate services to meet their educational needs. Children receive adequate services to meet their physical and mental health needs.

The Federal government will conduct the reviews in partnership with State child welfare agency staff and other State representatives who are not staff of the State child welfare agency; peer consultants will round out the review teams. The reviews are structured to help States identify strengths and areas for improvement within their agencies and programs. Technical assistance will be provided to the States to help them make improvements in identified areas.

The Review Process

Each child and family services review is a two-stage process that comprises a statewide assessment and an onsite review of child and family service outcomes and program systems. For the statewide assessment, the Children's Bureau prepares and transmits to the State the data profiles that contain aggregate data on the State's foster care and child protective service populations. The data profiles allow each State to compare certain safety and permanency data indicators with national standards determined by the Children's Bureau.

After the statewide assessment, an onsite review of the State child welfare program is conducted by a joint Federal-State team. The onsite portion of the review includes the following:

  • Case record reviews
  • Interviews with children and families engaged in services
  • Interviews with community stakeholders, such as the courts and community agencies, foster families, and caseworkers and service providers.

At the end of the onsite review, States determined not to have achieved substantial conformity in any of the areas assessed will be required to develop and implement program improvement plans addressing the areas of nonconformity. The Children's Bureau will support the States with technical assistance and monitor implementation of their plans. States that do not achieve their required improvements successfully will sustain penalties as prescribed in the Federal regulations.

The guiding principles of the new child and family service reviews include:

  • Accountability with the opportunity to make program improvements before having Federal funds withheld due to non-compliance
  • Collaboration between State and Federal governments with review teams composed of staff from both agencies
  • Use of information from multiple sources in making decisions about a State's performance
  • Review of outcomes of services provided to children and families and systemic factors that affect the agency's ability to produce positive outcomes
  • Identification of both the strengths and the needs of State programs, using reviews to drive program improvements
  • Promotion of practice principles that support improved outcomes for children and families.

Jerry Milner, Supervisory Children and Family Program Specialist at the Children's Bureau, observes that the new system "underscores the real commitment to program improvement."

Since 1995, 14 pilot reviews have taken place. With the final regulation becoming effective in March 2000, the Children's Bureau received the green light to go ahead with formal reviews, which have already begun in 17 States. In the first phase, staff of the Children's Bureau, ACF Regional Offices, and State child welfare agencies have been reviewing State data reported to Adoption and Foster Care Analysis and Reporting System (AFCARS) (http://www.acf.hhs.gov/programs/cb/dis/afcars/) and the National Child Abuse and Neglect Data System (NCANDS) (http://www.ndacan.cornell.edu) or other approved source for the statewide assessments. The first onsite reviews began in March 2001, with Delaware being the first stop. A tentative schedule of reviews for FY2001-FY2004 is available online at: http://www.acf.hhs.gov/programs/cb/hotissues/staterev.htm.

Look for these new products related the Children and Family Services Reviews on the Children's Bureau website (http://www.acf.hhs.gov/programs/cb):

  • Detailed Procedures Manual with instruments used to evaluate cases
  • National Standards on six statewide data indicators that will be used in the reviews to determine, in part, whether or not States are operating in substantial conformity (Information Memorandum ACYF-CB-IM-00-11).

The Child Welfare Review Project is disseminating information on the reviews on behalf of the Children's Bureau. Visit the Project's website at http://www.childwelfarereview.com for documents on the review process or call 301-495-1080, ext. 3249, for a print copy of the Procedures Manual and the Review Instruments and Instructions. (Editor's note: the Project's website link is no longer available. Go to the Child Welfare Reviews page of the Children's Bureau website at http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm#cfsr.)

Related Item

See related article about a teleconference series on the child and family service reviews under Spotlight on the National Resource Centers in this issue of the Children's Bureau Express (http://www.calib.com/cbexpress).

cbexpress.acf.hhs.gov

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