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September 2023Vol. 24, No. 7The Child and Family Services Review: Catalyst for Change

Written by Linda Mitchell, Team Leader (retired), Child and Family Services Review Unit, Children's Bureau and Jennifer Haight, Director, Division of Performance Measurement and Improvement

Anyone who has worked at any level of child welfare for any length of time will tell you it is incredibly difficult work. Whether in a public or private agency, the demands of keeping children safe, strengthening families, and navigating multiple complex systems are often frustrating and easily dispiriting. The core of everyday work for caseworkers, supervisors, administrators, and judges is the ability to accurately assess the challenges families encounter and to provide necessary and adequate services to create enduring change for those in our communities who are the most vulnerable and disenfranchised.

Congress wanted an improved oversight process when it passed Public Law 103-432 in 1994. In the 23 years since the Child and Family Services Review (CFSR) process was created, the federal government has articulated a clear role for the Children’s Bureau (CB) in assisting states to look deeply into their practice and develop plans and opportunities for meeting federal child welfare requirements and improving critical outcomes for children and families in need. Specifically, the CFSR process has enabled states to develop and improve continuous quality improvement frameworks, data collection standards, and hone their use of data. With these improved capacities, states are able to understand performance, observe where there is notable variation, offer feedback, strengthen communication mechanisms with community partners, build staff training models, and perhaps most importantly, identify leadership strategies to manage the sometimes-overwhelming complexities of the child welfare landscape.

The 23 years of the CFSR process has taught us the importance of having a common language to discuss where we have succeeded and where we need to do more creative thinking and exercise more collective will to make needed changes. Engaging in a process of mutual respect for each other’s best intentions can open pathways for change and innovation. Using the CFSR process as a diagnostic and planning tool has given state child welfare agencies a durable foundation on which to build and improve. Interpretations of the evidence and opinions on what to do can often differ, but at the end of the day most will agree that a process that provides a format for improvement is better than none at all.

Through the CFSRs, we have had the opportunity to see first-hand the successes of agencies as they promote innovative practices and implement positive change, often with few resources or uncertain supports. We’ve also seen dedicated frontline staff working to help parents care for their children, while challenged with making difficult decisions that balance the safety of children and with the prospect of removal from home. The CFSRs are part of a process that opens records, engages with case participants, and interviews community partners to identify what’s working—and what is not working—in meeting federal requirements and getting positive outcomes for children and families. During those reviews, we’ve also seen the gaps and the poor practices that need to be addressed in order to achieve better results.

We’re often asked why, after 23 years of CFSRs, we aren’t seeing better results; the answer is complex. At the end of Round 1 CFSR, CB implemented Program Improvement Plans (PIP) and established national data standards. We undertook qualitative interviews with states that had achieved the most improvement in outcomes to identify PIP strategies employed, as well as contextual factors in PIP development and implementation. This was not a rigorous research project, but it gave the child welfare field an understanding of critical factors, such as: engaging local offices, courts, tribes, and youth in change; the importance of leadership and agency culture; the need to consider budgets and allocation of resources; and intentionally managing and sustaining change. There are also other common and current challenges impacting improvements, including workforce challenges; constant leadership changes; and shortage of appropriate, available, and culturally sensitive mental/behavioral health treatment and other services that address the increasingly complex and variable needs of children and families coming to the attention of child welfare. Improvement can sometimes seem like a slippery slope. When positive change is made, sustaining it can be derailed by economics, politics, leadership change, and other factors.

There is much more to learn and always improvements to be made. CB can offer guidance and technical assistance to states, but the responsibility to address the findings of the CFSR and implement practice and systems change rests with each state. And the work requires leadership that engages broadly with state and community partners, representative community members, legislatures, and policymakers to provide the necessary supports to improve the lives of families. We are often humbled by the dedication of states and their staff as they diligently and relentlessly work with families and implement innovative practices and changes to improve their outcomes. As part of their PIPs, states have embraced the need to better engage parents in case planning and services, improve outreach and support to relatives, ensure comprehensive training for staff, and include the voice of youth with lived experience. 

In the end, we’re only as strong as our collective efforts to listen to and learn from the children, youth, and families being served by child welfare. The CFSR continues to be a mechanism that allows us to do just that. But we must have the courage of our conviction to act on what we learn so that we can make positive changes to the system. If we do not, then we are not only failing those from whom we learned, but also, we risk abandoning the improvement principles we say we value.