• June 2014
  • Vol. 15, No. 6

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Continuous Quality Improvement in the CFSRs

The Children's Bureau (CB) is excited to start its next round of monitoring of State child welfare programs known as the Child and Family Services Reviews (CFSRs). The Children's Bureau conducts each review in partnership with the State child welfare agency to assess the State on seven outcomes and seven systemic factors. The CFSRs enable CB to:

  • Ensure conformity with Federal child welfare requirements on child protective services, foster care, adoption, family preservation, family support, and Independent Living services
  • Determine what happens to children and families engaged in child welfare services
  • Assist States in enhancing their capacity to help children and families achieve positive outcomes in safety, permanency, and child well-being through Program Improvement Plans that build on an agency's strengths and address areas of nonconformity 

Since the end of Round 2 of the CFSRs, CB has worked to implement changes to the monitoring process that reflect a more coordinated and comprehensive approach that builds on the efforts States had already made through the CFSRs to establish Quality Assurance (QA) case reviews. In August 2012, CB issued an Information Memorandum to advise States to enhance and expand their QA systems into a more continuous quality improvement approach (see ACYF-CB-IM-12-07). To support States' efforts to achieve this, CB established a Child Welfare Continuous Quality Improvement (CQI) Training Academy to develop CQI competencies and equip States to make more informed practice and program improvements, ultimately leading to better child and family outcomes.

Moving in this direction for the next round of monitoring has also required CB to consider how to integrate the work States do to develop the 5-year Child and Family Services Plans (CFSPs) and Annual Progress and Services Reports (APSRs) into the CQI process. The most recent Program Instruction for the CFSP, issued in March 2014, sets forth requirements that will more fully integrate the CFSP and CFSR (see ACYF-CB-PI-14-03). To accomplish this, the CFSP must assess State performance on the seven child and family outcomes and the seven systemic factors in the CFSR, as well as focus goals and objectives on improving State performance on CFSR outcomes related to safety, permanency, and well-being. 

When the CFSRs were officially launched in 2001, they provided State and local child welfare systems with a set of defined outcomes and indicators to target, as well as a process for reviewing frontline practice in cases and using results to drive systems and practice changes. This new round of monitoring allows the child welfare field to apply the lessons learned from 13 years of CFSRs and Program Improvement Plans (PIPs) to create a process that is better integrated and promotes a more comprehensive approach to CQI in public child welfare systems.

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