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June 2014Vol. 15, No. 6Third Round of Child and Family Services Reviews

Background

Since 2001, the Children's Bureau (CB) has completed two rounds of Federal monitoring known as the Child and Family Services Reviews (CFSRs). Between each review cycle, CB solicited input from public and private child welfare agencies, States, advocacy groups, and the public on improvements to the process. In April 2011, CB sought public comment on improvements to the process for reviewing titles IV-B and IV-E of the Social Security Act through the CFSR. 

While improvements will be incorporated into the next round of monitoring, the overall goals of the reviews remain the same: 

  • Ensure conformity with title IV-B and IV-E child welfare requirements using a framework focused on safety, permanency, and well-being through seven outcomes and seven systemic factors
  • Determine what is happening to children and families as they are engaged in child welfare services
  • Assist States in helping children and families achieve positive outcomes 

Since 2011, CB has worked on changes to the CFSRs based on suggestions received through the public comment process. Improvements fall into three major areas: 

  • Support the States' capacity to self-monitor for child and family outcomes, systems functioning, and improvement practices
  • Better integrate the monitoring process with States' 5-year title IV-B Child and Family Services Plans (CFSPs) and Annual Progress and Services Reports (APSRs)
  • Ensure that data measures and methods used to establish national standards better reflect State practices and improvement efforts

Similar to the first two rounds of CFSRs, the third round will continue the partnership of Federal and State staff and involve a two-level process: (1) a statewide assessment, and (2) an onsite review as required by 45 CFR 1355.33(a). After receiving the results of the review, States that are not in substantial conformity with title IV-B and IV-E requirements must enter into a Program Improvement Plan (PIP) to address areas that CB determines require improvement (45 CFR 1355.34 and 1355.35). States must still continue to engage Tribes, courts, and stakeholders in their efforts to assess and improve their programs.

The following is a brief summary of changes to the next round of monitoring. Readers can find more detailed information in the March 14, 2014, CFSR Technical Bulletin #7 (http://www.acf.hhs.gov/programs/cb/resource/cfsr-technical-bulletin-7).

Integration of Planning

State child welfare agencies must submit either their 5-year CFSPs or APSRs to CB regional offices by June 30th of each year. In addition, as part of the CFSR, States must submit a Statewide Assessment outlining performance on the seven safety, permanency, and well-being outcomes, the national data standards for safety and permanency, as well as the seven systemic factors. In the next round of monitoring, CB will more fully integrate the CFSP and the APSR with the CFSR Statewide Assessment process to reduce States' burden and align Federal planning and monitoring efforts. In the new Statewide Assessment process, States will be able to refer to their CFSP/APSR and update information only as needed. In addition, in the past monitoring cycles, States found to be in non-conformity with CFSR outcomes or systemic factors would need to develop a PIP. In the new monitoring approach, while States will still need to address nonconformity in a PIP, States will be encouraged to address PIP goals and progress through the CFSP/APSR submissions rather than developing separate plans for program improvement.     

Onsite Reviews

CB has made substantial changes to the onsite portion of the CFSR, which involved case reviews and stakeholder interviews to determine conformity with systemic factors. CB was encouraged to build on States' efforts to establish comprehensive continuous quality improvement (CQI) systems, including case reviews. In this round of reviews, States meeting CB criteria may conduct their own case reviews using a revised Federal CFSR onsite review instrument and submit the results to CB. At a minimum, CB participation will include observing the State's case review process while present in the State and reviewing completed instruments. CB will then use these results to make an initial determination of substantial conformity on the seven CFSR outcomes.

If a State does not meet the necessary criteria to use their case review process, or chooses not to do their own case reviews, CB will work with the State to prepare for a more traditional weeklong case review conducted jointly by the State and CB.

There will also be changes to the way that systemic factors are addressed. States will be required to provide specific data in the Statewide Assessment to demonstrate that a systemic factor is functioning. CB may then determine that the State sufficiently demonstrates systemic factor functioning and not require additional stakeholder interviews onsite for each systemic factor. Alternatively, where the Statewide Assessment data are insufficient to determine substantial conformity, the joint Federal-State team will determine which stakeholder interviews are necessary to gather additional information during the onsite review.

Statewide Data Indicators and National Standards

Statewide data indicators are used to inform the determination of substantial conformity on safety and permanency outcomes. The statewide data indicators are based on data available in States' Adoption and Foster Care Analysis and Reporting System (AFCARS) and National Child Abuse and Neglect Data System (NCANDS) submissions. In the Round 2 CFSR, CB developed six statewide data indicators—two indicators for safety and four data composites for permanency. CB established methodologies for calculating the national standards, which varied depending on the indicator.

Public feedback suggested a number of challenges with the statewide data indicators that ranged from methodological issues related to use of exit cohorts, the lack of ease in interpreting composite numbers, and concerns about the comparability of States' data. CB has modified its approach by making greater use of entry cohorts, eliminating composites, and incorporating risk adjustment to help account for differences in case mixes and policies across States. Although indicators continue to use data from AFCARS and NCANDS, CB is developing a refined set of CFSR statewide data indicators based on a different approach to calculating the associated national standards. 

The proposed indicators are detailed in a recent Federal Register announcement for public comment:
https://www.federalregister.gov/articles/2014/04/23/2014-09001/statewide-data-indicators-and-national-standards-for-child-and-family-services-reviews


Public comment closed in late May. Feedback gathered during this process is currently being reviewed and analyzed, after which CB will finalize the statewide data indicators and publish them in a Federal Register announcement. States scheduled for a 2015 CFSR will begin receiving their data profiles this year.

Implementation of Round 3 CFSR

Since the release of the CFSR Technical Bulletin #7, CB has hosted national calls with States and other public and private child welfare agencies, advocacy groups, and others to begin discussions regarding rollout of the next round of monitoring and to respond to initial questions from participants. CB is posting questions and answers on the CFSR portal, as well as instruments and other related documents, accessible to State child welfare staff here: https://www.cfsrportal.org/

In May and June, CB will hold five regionally based trainings with Federal and State child welfare staff to discuss further details regarding the case review process, instruments, and data measures. 

Also, beginning with the release of the Information Memorandum on CQI (http://www.acf.hhs.gov/programs/cb/resource/im1207) in August 2012, CB Regional Office and CFSR unit staff have engaged in conversations with States on how to assess, improve, and strengthen CQI functions. Since the CFSR Technical Bulletin was released, the discussions have been more focused on improving States' ability to conduct case reviews in accordance with requirements outlined in the Technical Bulletin.

Tentative CFSR Schedule

  • 2015: Delaware, North Carolina, Vermont, New Mexico, Georgia, Kansas, Massachusetts, and Arizona
  • 2016: South Dakota, Indiana, Oregon, Oklahoma, Minnesota, Florida, Arkansas, California, Texas, Idaho, Kentucky, New York, District of Columbia, Wyoming, and North Dakota
  • 2017: Nebraska, Pennsylvania, Montana, Ohio, Tennessee, Hawaii, West Virginia, Connecticut, Colorado, New Jersey, Maine, Alaska, Missouri, Virginia, and South Carolina
  • 2018: Illinois, Nevada, Michigan, Louisiana, Wisconsin, Rhode Island, Mississippi, Maryland, Utah, Puerto Rico, New Hampshire, Iowa, Washington, and Alabama