• March 2010
  • Vol. 11, No. 2

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Building Accountability in Child Welfare: The CFSRs

The establishment of the Child and Family Services Reviews (CFSRs) in 2000 marked the beginning of a new era in Federal monitoring and in State and agency accountability for child welfare services. While previous monitoring efforts, such as the Section 427 reviews, focused on process and paperwork, the CFSRs introduced the concept of conformity with specific desired outcomes for children and families. In fact, the leap from earlier types of reviews to the CFSRs involved the adoption of a number of significant changes, including:

  • A focus on practice and outcomes, including safety, permanency, and well-being outcomes for children and families
  • Meaningful use of national data, including data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) and the National Child Abuse and Neglect Data System (NCANDS)
  • Opportunities for States to improve through their individualized Program Improvement Plans (PIPs)
  • Inclusion of a wide variety of stakeholders, such as families and youth involved in the child welfare system and representatives from the courts, Tribes, State agencies, mental health services, law enforcement, foster care, education, and more

What led to such dramatic changes in Federal monitoring of State child welfare systems? There was a general consensus by the 1990s that the monitoring and accountability processes in place at the time were not oriented to helping States achieve outcomes for children and families and did not provide Congress or the Federal agencies with clear information regarding State performance. In 1994, Amendments to the Social Security Act authorized the U.S. Department of Health and Human Services to develop a new system to evaluate States for conformity to positive outcomes for children and families. The Children's Bureau was responsible for designing and conducting the reviews. In preparation, the Bureau consulted with a broad array of national stakeholders in the child welfare field about the best ways to carry out the new monitoring process. Focus groups and consultations were followed by 12 pilots of what would become the CFSRs. With each pilot study, the Bureau used State feedback to refine the review process.

At the Children's Bureau headquarters and Regional Offices, the responsibility for the new monitoring process required the addition of new staff with more State child welfare experience and knowledge of the field, which was necessary to assist States in program improvement. A National Review Team was formed that spanned the divisions of the Children's Bureau and the Regional Offices to focus leadership for reviews in a concentrated group of staff. Since the first CFSRs in 2001, the review teams have always included members of the National Review Team, as well as State officials, State-designated stakeholders, and consultant reviewers drawn from a pool of reviewers with child welfare experience and training.

The CFSRs had an additional, unanticipated impact at the national level: They provided a unifying direction for the Children's Bureau and its staff from all divisions. Staff were mobilized around this new monitoring process and the potential it had for improving real outcomes for children and families. Eventually, this was reflected in funding initiatives through discretionary grants and in the expansion of the Training and Technical Assistance Network. As the CFSR results pointed to areas of need (e.g., in-home services, caseworker visits), the Bureau was often able to direct discretionary funding toward programs and research to meet those needs.

Throughout the implementation of the CFSRs, the Children's Bureau has continued to maintain its focus on achieving better outcomes for children and families and holding States accountable for these improved outcomes. While the first round of CFSRs (2001–2004) served as an initial assessment of States' performance on the CFSR outcomes and systemic factors, the second round of reviews (2007–2010) and second round of PIPs provide continuing opportunities for the CFSR process to have a positive impact on children and families. There is evidence in many cases that States have made improvements in their systems, and these improvements have often been reflected in measures associated with the safety, permanency, and well-being outcomes. Additional benefits have emerged, including the following:

  • States have become more effective at self-evaluation and at collecting and analyzing data to then make improvements in their practice.
  • Youth and the youth voice have become more prominent in child welfare policy and training at local and national levels.
  • The CFSR process has empowered frontline workers and supervisors by focusing on what practices they need to improve in their work with families.
  • Establishing and training a pool of consultant reviewers from around the country, as well as using State staff to review cases, has led to improved practices at the State and local level as reviewers take "lessons learned" from reviews back to their own States and local offices.
  • The child welfare field has developed more agreement around outcomes for children and families being served by child welfare.

The last 10 years have seen enormous leaps forward not only in terms of more accurate Federal monitoring of State child welfare systems, but also in the real impact that the review process has had on child and family outcomes. Going forward, the goal of the CFSRs will continue to be helping States improve the safety, permanency, and well-being of children and families involved with the child welfare system.

Many thanks to Will Hornsby and Linda Mitchell, from the National Review Team, who contributed the content for this article.

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