[Federal Register Volume 79, Number 78 (Wednesday, April 23, 2014)]
[Proposed Rules]
[Pages 22604-22615]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-09001]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
45 CFR Part 1355
Statewide Data Indicators and National Standards for Child and
Family Services Reviews
AGENCY: Children's Bureau (CB), Administration on Children, Youth and
Families (ACYF), Administration for Children and Families (ACF),
Department of Health and Human Services (HHS).
ACTION: Notice of Statewide Data Indicators and National Standards for
Child and Family Services Reviews.
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SUMMARY: The Children's Bureau reviews a state's substantial conformity
with titles IV-B and IV-E of the Social Security Act through the Child
and Family Services Reviews (CFSRs). Statewide data indicators are used
to inform the Children's Bureau's determination of a state's
substantial conformity relative to certain safety and permanency
outcomes. This document advises the public of the Children's Bureau's
plan to replace the statewide data indicators and the methods for
calculating associated national standards on those indicators. We
invite the public to comment on these indicators and methods before
their use in CFSRs scheduled for Federal Fiscal Years (FFY) 2015
through FY 2018.
DATES: Written comments must be submitted to the office listed in the
ADDRESSES section below on or before May 23, 2014.
ADDRESSES: Interested persons may submit written comments by any of the
following methods:
Federal eRulemaking Portal: http://www.regulations.gov.
Follow the instructions for submitting comments.
[[Page 22605]]
Mail or Courier Delivery: Miranda Lynch Thomas, Children's
Bureau, Administration on Children, Youth and Families, Administration
for Children and Families, 1250 Maryland Avenue SW., 8th Floor,
Washington, DC 20024.
Instructions: If you choose to use an express, overnight, or other
special delivery method, ensure that delivery may be made at the
address listed under the ADDRESSES section. We urge interested parties
to submit comments electronically to ensure that they are received in a
timely manner. All comments received will be posted without change to
http://www.regulations.gov. This will include any personal information
provided.
FOR FURTHER INFORMATION CONTACT: Miranda Lynch Thomas, Children's
Bureau, 1250 Maryland Ave. SW., 8th Floor, Washington, DC 20024, (202)
205-8138.
SUPPLEMENTARY INFORMATION:
Background
The Children's Bureau implemented the CFSRs in 2001 in response to
a mandate in the Social Security Amendments of 1994 for the Department
of Health and Human Services to issue regulations for the review of
state child and family services programs under titles IV-B and IV-E of
the Social Security Act (see section 1123A of the Social Security Act).
The reviews are required for the Children's Bureau to determine whether
such programs are in substantial conformity with title IV-B and IV-E
plan requirements, implementing regulations, and relevant title IV-B
and IV-E plans. The review process, as regulated at 45 CFR 1355.31-37,
grew out of extensive consultation with interested groups, individuals,
and experts in the field of child welfare and related areas.
The Children's Bureau conducted the first round of CFSRs from 2001
through 2004 and the second round from 2007 through 2010. The third
round is scheduled to begin in FFY 2015. Information about the
initiation of this latest round can be found in CFSR Technical Bulletin
7 issued in March 2014 (see http://www.acf.hhs.gov/programs/cb/resource/cfsr-technical-bulletin-7).
The CFSRs enable the Children's Bureau to: (1) Ensure conformity
with federal child welfare requirements; (2) determine what is actually
happening to children and families as they are engaged in child welfare
services; and (3) assist states to enhance their capacity to help
children and families achieve positive outcomes. The Children's Bureau
conducts the reviews in partnership with state child welfare agency
staff and other stakeholders involved in the provision of child welfare
services. We have structured the reviews to help states identify
strengths as well as areas needing improvement within their agencies
and programs.
The CFSR assesses state performance on seven outcomes and seven
systemic factors. The seven outcomes focus on key items measuring
safety, permanency, and well-being. The seven systemic factors focus on
key state plan requirements of titles IV-B and IV-E that provide a
foundation for child outcomes. States that the Children's Bureau
determines have not achieved substantial conformity in all the areas
assessed in the review are required to develop and implement a program
improvement plan within two years addressing the areas of
nonconformity. The Children's Bureau supports the states with technical
assistance and monitors implementation of their program improvement
plans. States that are unable to complete their plans successfully have
some of their federal child welfare funds withheld.
Most relevant to this document is the element of the reviews that
provides for the Children's Bureau to determine whether the state is in
substantial conformity with certain child outcomes based on national
standards we set for state performance on statewide data indicators.
The regulations at 45 CFR 1355.34(b)(4) and (5) authorize us to add,
amend, or suspend any of the statewide data indicators when
appropriate, and to adjust the national standards when appropriate.
Statewide data indicators are aggregate measures and we calculate them
using administrative data available from a state's submissions to the
Adoption and Foster Care Analysis and Reporting System (AFCARS),\1\ the
National Child Abuse and Neglect Data System (NCANDS),\2\ or a
Children's Bureau-approved alternate source for safety-related data. If
a state is determined not to be in substantial conformity with a
related outcome due to its performance compared to the national
standard for an indicator, the state will include that indicator in a
program improvement plan. The Children's Bureau establishes performance
goals for each indicator included in a program improvement plan, based
on the state's prior performance, that the state is expected to reach
by the end of the program improvement plan period. The goal to be
achieved is relative to the state's baseline performance at the
beginning of the program improvement plan period.
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\1\ AFCARS collects case-level information from state and Tribal
title IV-E agencies on all children in foster care and those who
have been adopted with title IV-E agency involvement. Title IV-E
agencies must submit AFCARS data to the Children's Bureau twice a
year.
\2\ NCANDS collects child-level information on every child who
receives a response from a child protective services agency due to
an allegation of abuse or neglect. States report this data to the
Children's Bureau voluntarily. In FFY 2013, all 50 states, the
District of Columbia, and Puerto Rico submitted NCANDS data.
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The Children's Bureau views the CFSR as a dynamic process and has
made ongoing improvements in the process to best meet state and federal
needs. Most recently, we solicited feedback from the public (see 76 FR
18677, published April 5, 2011) about how they would envision a federal
review process that meets the statutory requirements in section 1123A
of the Social Security Act and holds child welfare agencies accountable
for achieving positive outcomes for children and families and
continuously improving the quality of their systems for doing so. In
addition, we hired a consultant that specializes in child welfare
measurement to work with Children's Bureau data specialists. In 2013 we
also tasked a contractor to the Children's Bureau to convene a panel of
child welfare administrators and data measurement experts to develop
recommendations and feedback about specific aspects of the review
process, including the statewide data indicators, national standards,
and program improvement. The information from these experts along with
public comments has shaped our plan for replacing the statewide data
indicators that will be used in the CFSRs.
Existing Statewide Data Indicators and Composite Measures and Planned
Improvements To Address Feedback
For CFSR Round 2, the Children's Bureau developed six statewide
data indicators and measures: two indicators related to safety and four
composite measures related to permanency. The two safety-related
statewide data indicators focused on recurrence of maltreatment and
maltreatment of children in foster care and were used to inform an
assessment of the state's substantial conformity with the safety
outcome that children are, first and foremost, protected from abuse and
neglect. The four permanency-related data composites were used to
inform the assessment of a state's substantial conformity with the
permanency outcome that children have permanency and stability in their
living situations. The four permanency composites used during CFSR
Round 2 were related to measures of timeliness and permanency
[[Page 22606]]
of reunification; timeliness of adoptions, permanency for children in
foster care for extended time periods, and placement stability.\3\ The
Children's Bureau established national standards for each of the six
data indicators and composites. The Children's Bureau thoroughly
considered the alternatives available to us at the time and had a clear
rationale for supporting the statewide data indicators, composites and
methods chosen. However, we believe there is reason to make further
improvements now given the additional concerns raised by stakeholders
and the Children's Bureau that we summarize below and throughout this
document as we describe the proposed new indicators.
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\3\ More detailed information on the CFSR Round 2 measures can
be found on the Children's Bureau Web site at http://www.acf.hhs.gov/sites/default/files/cb/data_indicators_for_the_second_round_of_cfsrs.pdf.
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Cohorts Used for Statewide Data Indicators: The Children's Bureau
is planning to calculate several statewide data indicators using entry
cohorts to address concerns about the measurement techniques that
relied on multiple exit cohorts in prior CFSR rounds. Some stakeholders
noted that relying on exit cohorts and cross-sectional (also referred
to as point-in-time) cohorts, rather than prospective entry cohorts,
can statistically distort system performance outcomes because they
represent biased sub-samples of all children who are served.\4\ For
example, looking only at children who exit foster care in a given year
ignores those children who did not leave; it is therefore not
representative of all children in foster care who would be affected by
state improvement efforts. Looking only at those children in foster
care at the end of the year biases the sample to include more children
with long lengths of stay in foster care. Entry cohorts, which include
all children entering foster care in a given year, avoid these problems
and provide a more complete assessment of overall system performance
and recent practice trends.
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\4\ See Testa, M., Poertner, J. Koh, E. (2008). Can AFCARS be
rescued? Fixing the statistical yardstick that measures state child
welfare performance. Urbana, IL: CFRC; and Testa, M. & Poertner, J.
(Eds.). (2010). Fostering accountability: Using evidence to guide
and improve child welfare policy. Oxford: Oxford University Press.
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While entry cohorts have methodological advantages, they have
limitations in terms of assessing state performance with regard to
children who have been in foster care for a long time because of the
length of time we measure for state improvements. For example, with an
entry cohort approach, children who had already been in foster care for
two or more years could only start being tracked in a third year. To
address this limitation, the Children's Bureau will still use other
cohorts in some of its indicators.
Composites: The Children's Bureau plans to use individual
indicators rather than composite measures for the purpose of
establishing national standards in this round of review. We implemented
the composite approach in CFSR Round 2 after consultation with states
and national experts to support a more holistic approach to measuring
state performance. The expansion to composites from the one-dimensional
measures used in CFSR Round 1 allowed state performance on a particular
domain to reflect broader performance, accounting for both strengths
and weaknesses within the domain. Criticism of the composite measures
used during CFSR Round 2 included the complexity of the composite
scores for interpretation purposes.
To address these concerns and clarify expectations with regard to
national performance, the Children's Bureau proposes to measure state
performance with simplified statewide data indicators. We propose to
maintain some of the advantages found with the composite approach by
implementing companion measures during the program improvement plan
period to provide an expanded and more effective measurement of a
domain.
New Proposed Statewide Data Indicators and Methods
The Children's Bureau plans for the new statewide data indicators
to measure maltreatment in foster care and re-report of maltreatment as
a component in evaluating Safety Outcome 1: Children are, first and
foremost, protected from abuse and neglect. We also plan for statewide
data indicators to measure the achievement of permanency in 12 months
for children entering foster care, permanency in 12 months for children
in foster care for 2 years or more, re-entry to foster care, and
placement stability. These four permanency indicators will be used as a
component in evaluating Permanency Outcome 1: Children have permanency
and stability in their living situations. Below is a description of
each of the six proposed indicators including their definition,
justification for inclusion, calculation and a discussion of relevant
issues. Following the description of the indicators is information on
the methods the Children's Bureau plans to use for calculating the
national standards and our approach to measuring a state's program
improvement on the indicators should we find that the state is not able
to meet the national standard. We also provide additional information
on how the Children's Bureau will share data information with states
through profiles and data quality issues that impact these indicators
and methods.
Attachment A provides a summary of each planned indicator including
numerators, denominators, exclusions, and adjustments. Attachment B
provides a comparison of the data measures used during CFSR Round 2
with the statewide data indicators we propose to use during Round 3.
Attachment C provides information on the AFCARS and NCANDS data
elements that are used to calculate the proposed indicators and
national standards.
Statewide Data Indicators for CFSR Safety Outcome 1: Children Are,
First and Foremost, Protected From Abuse and Neglect
Proposed Safety Performance Area 1: Maltreatment in Foster Care
Indicator Definition: Of all children in foster care during a 12-
month period, what is the rate of victimization per day of foster care?
\5\ The indicator includes all cases of substantiated or indicated
maltreatment while in foster care and all days for all children in
foster care at any point during a 12-month period. The denominator is
all child days in foster care over a 12-month period, and the numerator
is the number of instances of substantiated or indicated maltreatment
among children in foster care over that same period. The definition of
``children'' for this indicator (and all indicators) includes those
under the age of 18. This indicator includes all maltreatment types by
any perpetrator, which may include foster parents, facility staff
members, parents, or others. In addition, this indicator includes all
days for all children in foster care at any point during a 12-month
period.
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\5\ Rates are calculated per day of foster care. However, we
will multiply the rate by 100,000 to produce larger and more
meaningful numbers.
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Some states provide incident dates in their NCANDS data
submissions. If a state provides incident dates, records with an
incident date occurring before the date of removal will be excluded.
Children in foster care for less than 8 days and any report that occurs
within the first 7 days of removal are excluded from this indicator.
This indicator is calculated using data that match
[[Page 22607]]
children across AFCARS and NCANDS using the AFCARS identifier.
Justification for Inclusion: This indicator provides a measure of
whether the state child welfare agency is able to ensure that children
do not experience abuse or neglect while in the state's foster care
system. The indicator holds states accountable for keeping children
safe from harm while under the responsibility of the state, no matter
who perpetrates the maltreatment in foster care.
Relevant Issues and Discussion: During CFSR Round 2, the Children's
Bureau had a safety data indicator related to maltreatment in foster
care. For that indicator, the counts of children not maltreated in
foster care were derived by subtracting the NCANDS count of children
maltreated by foster care providers from the total count of all
children in foster care on the last day of the year, as reported in
AFCARS. Because of improved reporting by states, we can now link AFCARS
and NCANDS data using the child identifier and determine whether
maltreatment occurred during a foster care episode, improving accuracy
on this indicator by using entry cohorts instead of the retrospective
method used in CFSR Round 2.\6\ This technique also allows us to expand
the indicator to include maltreatment regardless of the perpetrator
type. This measure uses the report date reported in NCANDS to determine
if a child is victimized while in foster care, discounting the first
week to allow for a potential lag time between an incidence of
maltreatment and report of maltreatment. For those states that provide
incident dates, an adjustment will be made if the data indicates that
the incident occurred prior to the foster care episode. We encourage
states to report incident dates in NCANDS, which will improve the
accuracy of this indicator. The Children's Bureau made this change in
response to a suggestion from stakeholders with regard to the
indicators used for the last round of reviews that we are now able to
address.
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\6\ Almost all states report AFCARS identifiers in the NCANDS
data. For those states that do not, a Children's Bureau-approved
alternate source will be required to assess performance on this
indicator.
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Proposed Safety Performance Area 2: Re-Report of Maltreatment
Indicator Definition: Of all children who received a screened-in
report of maltreatment during a 12-month period (regardless of
disposition type), what percent were reported again within 12 months
from the date of initial report? The denominator is the number of
children with at least one screened-in report of alleged maltreatment
in a 12-month period and the numerator is the number of children in the
denominator that had another screened-in report with a disposition
within 12 months of their initial report. Screened-in reports that have
a disposition reported are included, regardless of whether the
disposition is that the child is a victim or a non-victim. This
indicator is calculated using data from NCANDS.
Justification for Inclusion: This indicator is included to provide
an assessment of whether the agency took the necessary actions to
prevent a future report of maltreatment for children previously the
subject of a screened-in report to the agency.
Relevant Issues and Discussion: During CFSR Round 2, the Children's
Bureau had a safety performance area related to repeat maltreatment.
That measure was derived from calculating what percent of all children
who were victims in a substantiated or indicated maltreatment
allegation during the first 6 months of the reporting period were not
victims in another substantiated or indicated maltreatment allegation
within a 6-month period. We are expanding this measure to count all
children with screened-in reports of alleged maltreatment. The
Children's Bureau believes that multiple reports regardless of whether
maltreatment is substantiated or indicated is a viable measure of the
agency's attempts to prevent maltreatment based on research indicating
that families with screened-in but unsubstantiated reports are at a
high risk of re-report, in some cases as high as substantiated
cases.\7\ Because reports are included regardless of disposition, this
indicator includes both victims and non-victims. In addition, this
indicator expands the time period examined to 12 months to include more
children. The indicator also tracks such children for 12 months, as
opposed to 6 months as in the prior indicator.
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\7\ See Drake, Jonson-Reid, Way, & Chung (2003). Substantiation
and Recidivism. Child Maltreatment. Vol. 8, No. 4, 248-260.
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The Children's Bureau made this change in response to a suggestion
from stakeholders with regard to the indicators used for the last round
of reviews that we are now able to address with the improved quality of
data reported in NCANDS. In addition, the contractor's recommendations
based on the expert panel convened in 2013 expressed support for a
measure of screened-in reports to capture repeat maltreatment.
Previous CFSR data measures focused on substantiated and indicated
reports of maltreatment. The growing implementation of differential
response in the states (sometimes referred to as alternative response
programs) where a substantial percentage of cases may bypass formal
investigation altogether, however, makes a comparison of differential-
response and non-differential-response states difficult. In addition,
states that initiate or expand differential response during an
improvement period could show improvement on a substantiation-based
measure of repeat maltreatment merely as an artifact of adopting
differential response. An indicator based only on screened-in reports
is not affected by differential response which contributed to our
selecting this indicator.
CFSR Permanency Outcome 1: Children Have Permanency and Stability in
Their Living Situations
The permanency-related statewide data indicators exclude children
entering foster care at age 18 and older or who are already 18 and
older on the first day of the period under review. Although the
amendments to title IV-E of the Social Security Act made by the
Fostering to Success and Increasing Adoptions Act of 2008 (Pub. L. 110-
351) permit states to provide foster care to youth who are age 18 and
older, all states have not exercised such an option. Some states
provide foster care to youth age 18 and older, however, there is no
consistent inclusion of this population of youth across states and no
consistent construct at this time for what achieving permanency means
for such older youth. Therefore, the Children's Bureau believes that it
is appropriate to limit the permanency statewide data indicators to
children under age 18 in this way to maintain consistency as we have in
prior rounds.
Proposed Permanency Performance Area 1: Permanency in 12 Months for
Children Entering Foster Care
Indicator Definition: Of all children who enter foster care in a
12-month period, what percent discharged to permanency within 12 months
of entering foster care? The denominator is the number of children who
enter foster care in a 12-month period and the numerator is the number
of children in the denominator who discharged to permanency within 12
months of entering foster care. For the purposes of this indicator,
permanency includes a child's discharge from foster care to parent(s),
living with relatives, guardianship, or adoption. Children who are in
foster care for less than 8 days are excluded from this indicator. For
children with multiple episodes during the same 12 month period, this
[[Page 22608]]
measure will only evaluate the first episode within the period. This
indicator is calculated using data from AFCARS.
Justification for Inclusion: This indicator provides a focus for
the child welfare agency's responsibility to reunify or place children
in safe and permanent homes as soon as possible after removal.
Relevant Issues and Discussion: During CFSR Round 2, the Children's
Bureau included a similar measure as part of one of the permanency
composites. That measure assessed the percent of all children entering
foster care for the first time in a 6-month period that left foster
care to reunification (or living with a relative) within 12 months of
entering foster care. For CFSR Round 3, the indicator will stand alone
and not be combined into a composite measure. The indicator is also
more expansive than the prior to include: (1) All permanency outcomes,
including guardianship or adoption; (2) all children entering foster
care rather than first removals only; and (3) children entering foster
care over the course of 12 months rather than 6 months.
The Children's Bureau made this change in response to suggestions
from stakeholders with regard to the indicators used for the last round
of reviews that we are now able to address. The indicator's expanded
set of permanency outcomes recognizes that all forms of permanency
represent equally successful outcomes for children. Although all
permanency outcomes are included within this one indicator, states will
still be able to analyze their data to determine which types of
permanency they are achieving for children. The indicator's expanded
population recognizes the Children's Bureau's desire to measure
performance for all children entering foster care rather than first
removals only. The expansion to 12 months, as opposed to 6 months in
the prior indicator will yield more stable estimates of performance. A
12 month period is important for this indicator as this cohort will
also serve as the basis for the denominator in the re-entry into foster
care indicator (discussed further below). Re-entry into foster care
after a discharge from foster care is a rarer event that is better
captured over a longer period to accommodate variability. In addition,
including a full 12 month period lessens the effect of potential
seasonal differences between 6 month periods.
Please see the section on program improvement plans for more
information on how this indicator may be used in program improvement.
Proposed Permanency Performance Area 2: Permanency in 12 Months for
Children in Foster Care for 2 Years or More
Indicator Definition: Of all children in foster care the first day
of the year who had been in foster care (in that episode) for 2 years
or longer, what percent discharged to permanency within the next 12
months? The denominator is the number of children in foster care on the
first day of a 12-month period who had been in foster care (in that
episode) for 2 or more years, and the numerator is the number of
children in the denominator who discharged to permanency within 12
months of the first day. Permanency includes discharge to parent(s),
living with relatives, guardianship, or adoption. Children in foster
care for less than 8 days are excluded from this indicator. This
indicator is calculated using data from AFCARS.
Justification for Inclusion: The Children's Bureau is committed to
maintaining focus on the key outcome of achieving permanency for all
children in foster care and shortening the time to permanency. With a
second indicator of permanency in 12 months specifically focused on the
cohort of children who have been in foster care for 2 or more years,
the Children's Bureau can monitor the effectiveness of the state child
welfare agency in ensuring that states continue to emphasize permanency
for children who have been in foster care for longer periods of time,
to ensure they achieve permanency during the period under review.
Relevant Issues and Discussion: During CFSR Round 2, this same
individual measure was evaluated as a part of a composite. There are
substantial numbers of children that cannot achieve permanency in 12
months, and those children may present different challenges. Such
children may have a higher likelihood of achieving permanency goals
such as adoption and guardianship than those achieving permanency in
the first year. The Children's Bureau continues this measure because of
a commitment to monitor performance for children and youth who were
already in foster care, and hold states accountable for attaining
permanency for them, as well.
Proposed Permanency Performance Area 3: Re-Entry to Foster Care
Indicator Definition: Of all children who entered foster care in a
12-month period who were discharged within 12 months of that entry to
reunification, living with a relative, or guardianship, what percent
re-entered foster care within 12 months of their discharge? The
denominator is the number of children who entered foster care in a 12-
month period who discharged within 12 months to reunification, living
with a relative, or guardianship, and the numerator is the number of
children in the denominator who re-entered foster care within 12 months
of their discharge from foster care. Children in foster care for less
than 8 days are excluded from this indicator. If a child re-enters
foster care multiple times within 12 months of when they left, only the
first re-entry into foster care is selected. This indicator is
calculated using data from AFCARS.
Justification for Inclusion: Although the Children's Bureau
believes that it is important to reunify children with their families
as quickly as possible, we also believe that children should be
reunified when safe and appropriate and with sufficient supports in
place to prevent a subsequent removal. This indicator enables the
Children's Bureau to monitor the effectiveness of programs and practice
that support reunification and other permanency goals.
Relevant Issues and Discussion: During CFSR Round 2, this
performance area was evaluated using a similar measure as a part of a
composite. That measure was derived by calculating what percent of all
children discharged from foster care to reunification or living with a
relative in a 12-month period re-entered foster care in less than 12
months from the date of discharge. This indicator differs from the
measure used for CFSR Round 2 by limiting the children eligible for re-
entry to the entry cohort. The CFSR Round 2 measure counted all
children who left foster care to reunify or live with a relative,
regardless of when they entered foster care. The purpose of this focus
on current practice is in keeping with the rationale that new
interventions may best be monitored in an entry cohort. We also
expanded the denominator to include children who leave foster care for
guardianship in an effort to reflect a more comprehensive definition of
permanency.
The Children's Bureau made this change in response to suggestions
from stakeholders with regard to the indicators used for the last round
of reviews that we are now able to address. The indicator attempts to
capture the rate of ``permanency'' for children who leave foster care
by measuring whether children re-enter foster care. For this indicator,
adoption is not included as a permanency outcome because it is not
[[Page 22609]]
always possible to identify children who re-enter foster care following
adoption.
Please see the section on program improvement plans for more
information on how this indicator may be used in program improvement.
Proposed Permanency Performance Area 4: Placement Stability
Indicator Definition: Of all children who enter foster care in a
12-month period, what is the rate of placement moves per day of foster
care? \8\ The denominator is, among children who enter foster care in a
12-month period, the total number of days these children were in foster
care as of the end of the 12-month period. The numerator is, among
children in the denominator, the total number of placement moves during
the 12-month period. The initial placement in foster care is not
counted, but all subsequent moves occurring within the 12-month period
are included in the calculation. Children in foster care for less than
8 days and other settings a child may be placed in, that are not
considered as placement settings for AFCARS purposes such as trial home
visits, are not included in this indicator. This indicator is
calculated using data from AFCARS.
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\8\ Rates are calculated per day of foster care. However, we
will multiply the rate by 1,000 to produce larger and more
meaningful numbers.
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Justification for Inclusion: Placement stability is a critical
component of the permanency and well-being of children in foster care.
States are responsible for ensuring that children who are removed from
their homes by the state experience stability while they are in foster
care.
Relevant Issues and Discussion: During CFSR Round 2, this
performance area was evaluated using a similar measure as a part of a
composite. That measure was derived from calculating what percent of
all children served in foster care during the 12-month period had two
or fewer placement settings. The new indicator controls for the length
of time children spend in foster care so that we can examine moves per
day of foster care, rather than children as the unit of analysis, as
was employed during CFSR Round 2. The measure used for CFSR Round 2 was
unable to differentiate between children who moved twice from children
who moved more. The new indicator counts each move to accurately
capture the rate of placement moves, rather than the number of children
affected.
The Children's Bureau believes that placement stability is
important to the permanency and well-being of children in foster care
regardless of how long they have been in foster care. Even so, our
analysis of AFCARS data indicates that most placement moves occur
within a child's first 12 months of foster care, which is why we plan
to focus this indicator on that time period. With this refined focus,
the Children's Bureau and states can monitor the period during which
placement moves are most likely to occur and the state's most recent
performance. In the CFSR Round 2 measure, placement moves were
monitored over the life of the case which meant that placement
instability for a child in the early years of foster care placement
would affected the assessment of the state's CFSR performance in a more
recent period under review. We also believe that by confining the
indicator to this period of time, we are better able to measure a
state's improvement in a subsequent 12-month period. The Children's
Bureau made this change in response to suggestions from stakeholders
with regard to the indicators used for the last round of reviews that
we are now able to address.
National Standards
National standards will be established for all indicators. By
measuring state performance against national standards on statewide
data indicators, the Children's Bureau can assist states in
continuously monitoring their performance on child outcomes and help
practitioners and administrators better understand the entirety of
their child welfare systems.
We propose that the national standard for each indicator be set at
the national observed performance for that particular indicator. The
national standards will remain constant over the entire round of
review, as has been the case in prior rounds. In CFSR round 2, national
standards were based on the 75th percentile (approximately) of all
states' performance, with an adjustment for sampling error. For this
round, we believe that the national observed performance, which will be
similar to the average performance across all states, is a more
reasonable benchmark and would appropriately challenge states to
improve their performance.
The national standard set at the national performance level for
each indicator is a benchmark that is easily communicated to and
understood by stakeholders, and a reasonable goal given the reality
that states still need to improve practice in multiple areas. Setting
the national standard at the national performance for each indicator is
rooted in strategies central to an effective performance management
system focused on continuous quality improvement.
Methodology: We propose that state performance on each statewide
data indicator be assessed using a multi-level (i.e., hierarchical)
model that risk-adjusts for select child- and state-level
characteristics. Multi-level modeling is a widely accepted statistical
method that enables fair evaluation of relative performance among
states with different case mixes. The technique calculates how much
variance in performance is due to (1) children's individual risk
factors; (2) random measurement errors (due to modest sample sizes);
and (3) the state's long-run ability to achieve the desired outcome.
Risk Adjustment: The model we propose to use will incorporate some
risk adjustment. By incorporating risk adjustment, the multi-level
model takes into account and controls for factors that differ across
the states and that can affect outcomes regardless of the quality of
services the state provides. The goal of risk adjustment is to minimize
differences in outcomes that are due to factors over which states have
little control, such as the age of children coming into foster care.
For example, for the statewide data indicator of permanency in 12
months for children entering foster care, a state may discharge 40% of
its children to permanency by 12 months. Forty percent is the state's
observed performance, and is simply the number of children discharged
to permanency by 12 months divided by the number of children eligible
for such an exit. But this state's risk-adjusted performance might be
45%. That the state's risk-adjusted performance is higher than its
observed performance means permanency was achieved for more children
than expected, given the state's case mix and how other states, on
average, performed with a similar case mix.
The Children's Bureau will finalize risk adjustment variables after
receiving public comments on this document. The contractor's
recommendations to us based on feedback from the expert panel convened
in 2013 support the use of risk adjustment. The Children's Bureau's
consideration of particular risk-adjustment variables will be based
initially on the research literature, recommendations based on feedback
from the expert panel and expert consultants, and the availability of
data. The Children's Bureau will test proposed variables and retain
only those variables that have a statistically significant relationship
to the outcome for each statewide data indicator. For example, the
Children's Bureau has
[[Page 22610]]
tested for possible inclusion child's age, sex, number of prior
removals, and interactions among these with the proposed statewide data
indicators. The Children's Bureau will consider risk-adjustment
variables at both the level of the child (e.g., age at entry) and the
state (e.g., foster care entry rate).
Assessing State Performance
To assess state performance, the Children's Bureau proposes to
estimate each state's risk-adjusted performance and the corresponding
95% interval estimate. The Children's Bureau can be 95% confident that
a state's true performance lies somewhere between the lower and upper
limit of this interval. This interval also provides a way to judge
whether a state's performance is above or below the national average in
a statistically meaningful way.
The Children's Bureau plans to compare each state's interval
estimate to the national observed performance, and assign each state to
one of three groups:
``No different than national performance'' if the 95%
interval estimate surrounding the state's risk-adjusted performance
includes the national observed performance.
``Higher than national performance'' if the entire 95%
interval estimate surrounding the state's risk-adjusted performance is
higher than the national observed performance.
``Lower than national performance'' if the entire 95%
interval estimate surrounding the state's risk-adjusted performance is
lower than the national observed performance.
Whether it is desirable for a state to be higher or lower than the
national performance depends on the indicator. For the two permanency
measures, a higher value is more desirable; for the remaining measures,
a lower value is desirable.
The methodology described above is similar to that used by the
Centers for Medicare & Medicaid Services to measure hospital
performance as part of its Hospital Inpatient Quality Reporting
program.\9\ The methodology is also consistent with the use of such
models in education and health care to distinguish statistically high-
and low-performing schools and hospitals.\10\
---------------------------------------------------------------------------
\9\ Yale New Haven Health Services Corporation, & Center for
Outcomes Research & Evaluation. (2013). 2013 Measures Updates and
Specifications Report: Hospital-Level 30-Day Risk-Standardized
Readmission Measures for Acute Myocardial Infarction, Heart Failure,
and Pneumonia (Version 6.0). Retrieved from http://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic/Page/QnetTier4&cid=1219069855841.
\10\ See Goldstein & Spiegelhalter (2007). League Tables and
Their Limitations. 159(3), 385-443; Normand & Shahian (2007).
Statistical and Clinical Aspects of Hospital Outcomes Profiling.
Statistical Science, 22(2), 206-226.
---------------------------------------------------------------------------
Data
Data Profiles: The Children's Bureau will provide data profiles of
state performance to each state before the state's CFSR on the
statewide data indicators and other contextual data available from
AFCARS and NCANDS. This data profile will assist the state to develop
its statewide assessment. In addition, the Children's Bureau will
provide data profiles semi-annually to assist states in measuring
progress toward the goals identified in the program improvement plan.
Data Quality: Setting national standards and measuring state
performance on statewide data indicators for CFSR purposes relies upon
the states submitting high-quality data to AFCARS and NCANDS. The
Children's Bureau has provided states with consultation and technical
assistance before and throughout both rounds of reviews to address data
quality issues. Additionally, the Children's Bureau has provided states
with tools for AFCARS and NCANDS that allow the agency to examine its
data for accuracy and encourages states to incorporate these in their
ongoing quality assurance process to review data.
During the first two rounds of the CFSR, there have been occasions
in which the Children's Bureau cannot use a state's data in aggregate
calculations of the national standard. In isolated circumstances, these
data quality issues have been significant enough to prevent us from
relying on the state's data as an accurate assessment of its
performance on a statewide data indicator. The Children's Bureau would
like to be clear about the level of data quality issues that prevent
state data from being used for CFSR purposes as described below.
Data Quality: Excluding States From National Standards or State
Performance
We analyzed every data element from AFCARS and NCANDS that is
relevant to each statewide data indicator (as listed in Attachment C)
and performed data quality checks across files both over time as well
as between files.\11\ Examples of these checks included looking for the
presence of the same child identifier in the AFCARS and NCANDS file and
reviewing for consistent reporting of a child in AFCARS from the time
the child entered foster through discharge and with an associated
reason for discharge. This analysis revealed the scope of data quality
issues present in current AFCARS and NCANDS submissions.
---------------------------------------------------------------------------
\11\ This data quality analysis is specific to indicators
proposed for CFSR Round 3. It is a separate analysis from the
standard data quality checks or validation that are performed when
states submit their AFCARS or NCANDS data.
---------------------------------------------------------------------------
Based on this analysis, we developed thresholds to identify data
quality concerns and either accept or exclude the files when
calculating national standards and state performance. For those data
quality issues that are contained to one data file submission, we will
consider a threshold of 5%. In other words, any state that has more
than 5% of data missing or invalid \12\ will be excluded from the model
used to calculate the national standard (i.e., the national observed
performance) and estimate states' risk-adjusted performance. For cross-
file checks, we are setting a higher threshold for exclusion. For the
maltreatment in foster care measure, a state will be excluded from the
national standards calculation and performance estimate if more than
10% of NCANDS victims are missing an AFCARS identifier. For the
permanency indicators, a state will be excluded if it has more than 10%
of dropped cases across two six month file submissions.
---------------------------------------------------------------------------
\12\ For example, the date of birth is greater than the date of
latest removal.
---------------------------------------------------------------------------
Data Quality: Case-Level Exclusions
For those states that do not exceed the data quality thresholds but
still have identified data quality problems, we will include the state
in national standards calculations and measure state performance but we
will exclude child-level records with missing or invalid data on
elements needed to determine the child's outcome and perform the risk-
adjustment. For example, if the risk-adjustment for an indicator
includes age at entry, a child whose age at entry cannot be determined
(due to a missing date of birth) will not be include in the analysis.
We believe this exclusion will result in more accurate estimates of
performance for those states with minor data quality issues. For each
indicator, the Children's Bureau will provide each state with a list of
records that were excluded from the analyses.
Program Improvement Plans
States that fall below the national standard on any given indicator
will be required to include that indicator in a program improvement
plan. Regardless of which indicators a state is required to include in
its program improvement plan, the Children's Bureau will provide each
state with a data profile that
[[Page 22611]]
includes information on the state's performance on all of the statewide
data indicators.
Companion Measures: For two of the statewide data indicators,
permanency in 12 months for children entering foster care and re-entry
to foster care, the Children's Bureau proposes to consider performance
for program improvement purposes in concert with the other indicator.
This means that if a state has a program improvement plan that includes
improving on the indicator permanency in 12 months for children
entering foster care, the Children's Bureau's determination of whether
the state has improved successfully will take into consideration its
performance on the re-entry to foster care indicator as a companion
measure. Specifically, the state must stay above a threshold for the
companion re-entry to foster care indicator as well as achieve its goal
on the permanency in 12 months for children entering foster care
indicator, to successfully complete the program improvement plan. The
reverse is also true. For details about threshold calculations, please
see the section below. If a state must improve on the re-entry to
foster care indicator in its program improvement plan, it must also
include the permanency in 12 months for children entering foster care
indicator as a companion measure. Although the Children's Bureau
believes that it is important to reunify children with their families
as quickly as possible, we also believe that children should be
reunified when safe and appropriate and sufficient supports are in
place to prevent a subsequent removal. The recommendations to us based
on the expert panel convened in 2013 also support the use of companion
measures in program improvement.
Methods for Setting State Performance Baselines, Goals, and
Thresholds: The key components for setting performance goals and
monitoring progress over the course of a program improvement plan
involve calculating baselines, goals, and thresholds. The Children's
Bureau methodology for specifying state improvement goals is
statistically grounded, producing goals that are programmatically
challenging, yet attainable. In addition, goals and thresholds should
reflect each state's own performance history and demonstrated capacity
for change. In CFSR Round 2, the percent of improvement required for
each state was the same for all states, and was applied to state-
specific baselines. While this standardization was easy to communicate
how it applied to each state, it also meant that high-performing states
were asked to make larger absolute improvements than lower-performing
states. This approach did not take into account the variability in
performance that states have shown over time. For CFSR Round 3, the
Children's Bureau plans to set improvement goals relative to each
state's past performance.
Setting Baselines: The Children's Bureau plans to set the baseline
for each statewide data indicator included in a program improvement
plan at the state's observed performance on that indicator for the most
recent year of data available before the beginning of program
improvement plan implementation. We also considered using the state's
three-year average in this calculation, but that approach occasionally
produced goals that fell below the state's performance in the most
recent year. Consistent with CFSR Round 2, we will use the most recent
year as the baseline, because it represents a reasonable estimate of
the state's current performance.
Setting Goals and Thresholds: We plan to set performance goals and
thresholds will be based on the variability in the state's observed
performance in the three most recent years of data. There will be
improvement factors, as in CFSR Round 2, but these will be driven by
the variability in performance that the particular state has shown in
the last three years. We will apply the improvement factors to the
baseline to produce the concrete performance goal. The state's amount
of improvement required for a program improvement plan will be more
than what is likely, in a statistical sense, to occur by chance alone.
Conversely, we plan to set thresholds as the inverse of goals, which
will identify a point by which a state is demonstrating a performance
decline for companion measures that is more statistically than what
might be expected by chance.
We will use a technique called bootstrapping to develop goals and
thresholds. The method calls for the Children's Bureau to repeatedly
sample a state's past three years of performance estimates to construct
a larger sample, and from that the calculation of a grand mean and
standard deviation. The grand mean reflects that state's ``average''
performance and the standard deviation reflects how much normal
fluctuation in performance the Children's Bureau might expect for that
state, given its past performance. Then the standard deviation is used
to calculate an estimate that would represent a level of change above
and beyond the typical fluctuation that would otherwise be expected.
The Children's Bureau will set the magnitude at four standard
deviations from the grand mean. At that level we can say with
confidence that--if we were to randomly estimate a state's performance
on the indicator (using their past performance), and did so 100 times--
we would expect to see performance at this level less than 6% of the
time (or fewer than 6 times out of 100). Six times out of 100 is rather
rare, which is why we can treat it as representing a statistically
meaningful change has occurred in the program.\13\
---------------------------------------------------------------------------
\13\ These guidelines are based on a theorem known as
Chebyshev's inequality. When all you have is an overall mean and
standard deviation (which is what we have for each state's
performance), the theorem guarantees that a certain percent of
values will be k standard deviations away from the mean.
Specifically, at least 75% of the values will be within two standard
deviations of the mean, at least 89% within three standard
deviations, at least 94% within four standard deviations, at least
96% within five standard deviations, and at least 97% within six
standard deviations (Chong et al. (2012). Improving Generalization
Performance in Co-Evolutionary Learning. IEEE, vol. 16, no. 1, 70-
85; Sheppard (2011). Environmental Study-Soil Sample Analysis for
the Department of Ecology at Hanford).
---------------------------------------------------------------------------
To determine exactly how much a state will need to improve, we must
first calculate an improvement factor, which is the percentage
difference between the grand mean and four standard deviations above
the grand mean. We then apply that to the baseline, which is the
observed performance in the most recent year. To demonstrate a sample
calculation:
A state may have a grand mean of 50%, a grand mean plus four
standard deviations = 52%, and a year 3 value of 51. This will give
us an improvement factor of 52/50 = 1.04. If that is applied to the
baseline of 51%, the program improvement plan goal will be 51% x
1.04 = 53.04%.
We will use a comparable technique to set thresholds for companion
measures, subtracting rather than adding four standard deviations to
the grand mean (when higher performance on an indicator is better),
which can be used to identify a state's decline in performance. To
provide an example, if a goal was calculated to be three percentage
points higher than the baseline percent, the threshold would be three
percentage points below it. Thresholds are only relevant to companion
measures.
By design, states with less variation in performance from year to
year have more modest goals, while those showing greater variation have
more aggressive goals. Overall, we believe that the goals are
reflective of each state's own prior experience and performance levels,
with goals that are achievable and substantively meaningful. We
acknowledge that a few states with the
[[Page 22612]]
lowest variation in performance for each indicator are assigned very
modest goals, while a few states with the highest variation in
performance are assigned very aggressive goals.
To address these problems at the extreme ends, we propose to
establish minimum and maximum improvement factors. Specifically, a
floor will be set at the top of the bottom fifth, and the bottom of the
top fifth, ordered by the size of the improvement factor. While the
impact of this rule varies somewhat from indicator to indicator,
overall we believe it provides a consistent basis for producing goals
that are achievable and substantively meaningful. The inverse would be
done for the thresholds. The contractor's recommendations to us based
on the feedback from the expert panel convened in 2013 support the
setting of maximum and minimum thresholds for improvement goals at the
level of performance of top and bottom quintiles.
Process for Final Indicators
We are interested in comments on all aspects of the statewide data
indicators proposed and the methods to calculate national standards and
program improvement. After considering the feedback to this docuemnt,
we plan to publish a final list of indicators and methods that will be
used in the CFSRs along with the actual national standards.
(Authority: 42 U.S.C. 1320a-1a; 45 CFR 1355.31-37.)
Mark Greenberg,
Acting Commissioner, Administration on Children, Youth and Families.
Attachment A: Proposed Statewide Data Indicators
--------------------------------------------------------------------------------------------------------------------------------------------------------
Category Measure title Measure description Denominator Numerator Exclusions Notes
--------------------------------------------------------------------------------------------------------------------------------------------------------
Safety............. Maltreatment in Of all children in (From AFCARS) Among (From NCANDS) Among --If a state Cases are matched
foster care. foster care during children in foster children in the provides incident across AFCARS and
a 12-month period, care during a 12- denominator, total dates, records with NCANDS using AFCARS
what is the rate of month period, total number of an incident date ID.
victimization per number of days substantiated or occurring before
day of foster care? these children were indicated reports the date of removal
in foster care as of maltreatment (by will be excluded.
of the end of the any perpetrator) --Children in foster
12-month period \a\. during the 12-month care <8 days.
period \b\. --Any report that
occurs within the
first 7 days of
removal.
Safety............. Re-report of Of all children with (From NCANDS) Number (From NCANDS) Number None................ Reports are included
maltreatment. a screened-in of children with at of children in the regardless of the
report of alleged least one screened- denominator that type of
maltreatment in a in report of had another disposition, so
12-month period alleged screened-in report this indicator
(regardless of maltreatment in a within 12 months of includes both
disposition), what 12-month period. their initial victims and non-
percent had another report. victims.
screened-in report
within 12 months of
their initial
report?
Permanency......... Permanency in 12 Of all children who (From AFCARS) Number (From AFCARS) Number --Children in foster Youth who turn 18
months for children enter foster care of children who of children in the care <8 days. while in foster
entering foster care. in a 12-month enter foster care denominator who --Children who enter care who were
period, what in a 12-month discharged to foster care at age included in the
percent discharged period. permanency within 18 or more. denominator will
to permanency 12 months of not be counted as
within 12 months of entering foster having achieved
entering foster care or by the time permanency,
care? \c\ they reached 18. regardless of
discharge reason.
Permanency......... Permanency in 12 Of all children in (From AFCARS) Number (From AFCARS) Number --Children age 18 or Youth who turn 18
months for children foster care on the of children in of children in the more on the first while in foster
in foster care 2 first day of a 12- foster care on the denominator who day of the year. care who were
years or more. month period, who first day of a 12- discharged to included in the
had been in foster month period who permanency within denominator will
care (in that had been in foster 12 months of the not be counted as
episode) for 2 or care (in that 1st day or by the having achieved
more years, what episode) for 2 or time they reached permanency,
percent discharged more years. 18. regardless of
to permanency discharge reason.
within 12 months of
the first day?
[[Page 22613]]
Permanency......... Re-entry to foster Of all children who (From AFCARS) Number (From AFCARS) Number --Children in foster If a child has
care. enter foster care of children who of children in the care < 8 days. multiple re-entries
in a 12-month enter foster care denominator who re- --Children who enter to foster care
period who in a 12-month enter foster care or exit foster care within 12 months of
discharged within period who within 12 months of at age 18 or more. their discharge,
12 months to discharged within their discharge. only his first re-
reunification, live 12 months to entry is selected.
with relative, or reunification, live
guardianship, what with relative, or
percent re-entered guardianship.
foster care within
12 months of their
discharge? \a\
Permanency......... Placement Stability.. Of all children who (From AFCARS) Among (From AFCARS) Among --Children in foster The initial removal
enter foster care children who enter children in the care < 8 days. from home (and into
in a 12-month foster care in a 12- denominator, total --Children who enter foster care) is not
period, what is the month period, total number of placement foster care at age counted as a
rate of placement number of days moves during the 12- 18 or more. placement move.
moves per day of these children were month period \e\.
foster care? in foster care as
of the end of the
12-month period \d\.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\a\ For example, if during the 12-month period there were two children in foster care, one child for 10 days (1st episode), the same child for 40 days
(2nd episode), and the other child for 100 days (his only episode), the denominator would = 150 days (10+40+100).
\b\ For example, if during the 12-month period there were two children in foster care, and one child with 3 substantiated or indicated reports and the
other with 1 such report, the numerator would = 4 reports (3+1).
\c\ If a child has multiple entries during the year, only his or her first entry is selected.
\d\ For example, if during the 12-month period two children entered foster care, one child for 10 days and the other child for 100 days, the denominator
would be 110 days (10+100).
\e\ For example, if during the 12-month period two children entered foster care, and one child had 3 moves and the other had 1 move, the numerator would
= 4 moves (3+1).
Attachment B: Comparison of Data Measures--CFSR Round 2 and Round 3
----------------------------------------------------------------------------------------------------------------
Proposed CFSR round Comparable CFSR
Category Measure title 3 indicator round 2 measure How and why it's changed
----------------------------------------------------------------------------------------------------------------
Safety............. Maltreatment in Of all children in Of all children in In the CFSR 2 measure,
foster care. foster care during foster care during counts of children not
a 12-month period, the reporting maltreated in foster
what is the rate of period, what care are derived by
victimization per percent were not subtracting the NCANDS
day \a\ of foster victims of count of children
care? substantiated or maltreated by foster
indicated care providers from the
maltreatment by a total count of all
foster parent or children placed in
facility staff foster care, as reported
member? in AFCARS. Because of
improved reporting by
states, we now link
AFCARS and NCANDS data
using the child ID and
determine if
maltreatment occurred
during a foster care
episode, improving
accuracy on the
indicator.
This also allows us to
expand the measure to
include all types of
perpetrators (including,
for example, parents)
under the assumption
that states should be
held accountable for
keeping children safe
from harm while in the
care of the state, no
matter who the
perpetrator is.
Safety............. Re-report of Of all children with Of all children who We are expanding the
maltreatment. a screened-in were victims of measure to count all
report of alleged substantiated or children with screened-
maltreatment in a indicated in reports of alleged
12-month period, maltreatment maltreatment, because
what percent had allegation during research suggests
another screened-in the first 6 months children with prior
report within 12 of the reporting reports are at greater
months of their period, what risk.
initial report? percent were not In addition, by limiting
victims of another only to victims, we
substantiated or could face measurement
indicated challenges as states
maltreatment implement Differential
allegation within a Response during a
6-month period? monitoring cycle, which
could have an impact on
numbers of
substantiations.
We also propose using a
full 12-month period
rather than only 6
months to capture the
denominator, to create
more stable estimates.
[[Page 22614]]
Permanency......... Permanency in 12 Of all children who Composite 1.3: Of We now count all types of
months for children enter foster care all children permanency
entering foster in a 12-month entering foster (reunification, live
care. period, what care for the first with relative, adoption
percent discharged time in a 6-month or guardianship) as
to permanency period, what having `met' the
within 12 months of percent discharged indicator.
entering foster to reunification We also expanded the
care? (or live with measure to include all
relative) within 12 children who entered
months of entering foster care that year;
foster care or by not just those on their
the time they first removal episode.
reached 18? We also expanded the
window of time for the
entry cohort to a full
year instead of 6
months; this will yield
more stable estimates.
Permanency......... Permanency in 12 Of all children in Composite 3.1: Of Same measure; no change.
months for children foster care on the all children in The difference is that
in foster care for first day of a 12- foster care on the it is now evaluated on
2 years or more. month period who first day of a 12- its own, rather than as
had been in foster month period who just one part of a
care (in that had been in foster composite measure.
episode) for 2 or care (in that By including the Entry
more years, what episode) for 2 or Cohort Permanency
percent discharged more years, what indicator (listed above)
to permanency percent discharged as well as the Legacy
within 12 months of to permanency Cohort Permanency
the first day? within 12 months of indicator, we hold
the first day or by states accountable not
the time they only for children in
reached 18? their first year of
foster care, but also
those children/youth who
have been in foster care
for long periods of
time.
Permanency......... Re-entry in 12 Of all children who Composite 1.4: Of The new indicator is
months. enter foster care all children limited to those
in a 12-month discharged from children who entered
period and foster care to foster care during the
discharged within reunification or year, whereas the CFSR
12 months to live with a Round 2 measure counted
reunification, live relative in a 12- all children who
with relative, or month period, what discharged to
guardianship, what percent re-entered reunification or live
percent re-entered foster care in less with relative,
foster care within than 12 months from regardless of when they
12 months of their the date of entered foster care. The
date of discharge? discharge? purpose of this focus is
in keeping with the
rationale that new
interventions may best
be monitored in an entry
cohort. This indicator
will also be used as a
companion measure with
permanency in 12 months,
to ensure that states
working to improve
permanency rates in
their entry cohort do
not see worsening
performance on rates of
re-entry to foster care.
We also expanded the
denominator to allow
discharges to
guardianship, in an
effort to capture more
discharges to
permanency. Exits to
adoption are not
included because they
cannot be tracked
reliably, as some states
issue new child
identifiers if a child
who was previously
adopted enters foster
care.
Permanency......... Placement stability. Of all children who Composite 4.1: Of The proposed indicator
enter foster care all children served controls for length of
in a 12-month in foster care time in foster care, so
period, what is the during the 12-month we are looking at moves
rate of placement period, what per day of foster care,
moves per day \b\ percent had two or rather than children as
of foster care? fewer placement the unit of analysis.
settings? The rationale for using
an entry cohort rather
than all children served
is that our analysis
shows children entering
foster care tend to move
much more than those
children/youth in foster
care for longer periods
of time, whose
placements may have
stabilized.
In CFSR Round 2 measure,
moves that took place
prior to the monitoring
period were counted. Now
we only count those
moves that occur during
the monitoring period.
The initial placement is
not counted.
The CFSR Round 2 measure
treated children who
moved 2 times in an
episode the same as
children who moved 15
times; both were a
failure to meet the
measure. The new
indicator counts each
move, so it continues to
hold states accountable
for those children/youth
who have already moved
several times.
----------------------------------------------------------------------------------------------------------------
\a\ The rate may be expressed per 100,000 days because it is such a rare event. Using this metric gives us
numbers greater than zero, which are easier to communicate.
\b\ The rate is expressed per 1,000 days to convert the rate to a metric that gives us numbers greater than
zero.
[[Page 22615]]
Attachment C: Data Elements Required for Statewide Data Indicators
For instruction regarding AFCARS data elements, refer to http://www.acf.hhs.gov/programs/cb/resource/afcars-tb1.
For instruction with regard to NCANDS data elements, refer to
http://www.ndacan.cornell.edu/datasets/pdfs_user_guides/178-NCANDS-child2012v1-User-Guide-and-Codebook.pdf.
----------------------------------------------------------------------------------------------------------------
Primary data elements required Permanency by Re-entry by 12 Placement Re-report of Maltreatment
for calculation 12 months months stability maltreatment in foster care
----------------------------------------------------------------------------------------------------------------
AFCARS FC Element 1: [check] [check] [check] NA [check]
\a\ Title IV-E Agency..........
AFCARS FC Element 4: [check] [check] [check] NA [check]
Record Number..................
AFCARS FC Element 21: [check] [check] [check] NA [check]
Date of Latest Removal.........
AFCARS FC Element 23: NA NA [check] NA NA
Date of Placement in Current
Foster Care Setting............
AFCARS FC Element 24: NA NA [check] NA NA
Number of Placement Settings
during this Removal Episode....
AFCARS FC Element 56: [check] [check] [check] NA [check]
Date of Discharge from FC......
AFCARS FC Element 58: [check] [check] NA NA NA
Reason for Discharge...........
NCANDS CF Element 4: NA NA NA [check] NA
Child ID.......................
NCANDS CF Element 6: NA NA NA [check] [check]
Report Date....................
NCANDS CF Element 27: NA NA NA NA [check]
Child Maltreatment 1--
Disposition Level \b\..........
NCANDS CF Element 29: NA NA NA NA [check]
Child Maltreatment 2--
Disposition Level..............
NCANDS CF Element 31: NA NA NA NA [check]
Child Maltreatment 3--
Disposition Level..............
NCANDS CF Element 33: NA NA NA NA [check]
Child Maltreatment 4--
Disposition Level..............
NCANDS CF Element 34: NA NA NA NA [check]
Maltreatment death.............
NCANDS CF Element 145: NA NA NA NA [check]
AFCARS ID......................
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\a\ The elements are numbered by their position in the flat ASCII files submitted by states to these reporting
systems. These numbering schema are specific to the files utilized by ACYF. Files obtained through the
National Data Archive on Child Abuse and Neglect (NDACAN) may have a slightly different order.
\b\ Definition of `victim' includes all children with a disposition level (for any of up to four maltreatments
per child) of: a) Substantiated, or b) Indicated. These do not propose including differential response
victims. Victims also include children who died as a result of maltreatment.
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Additional data elements
required for risk-adjusted Permanency by Re-entry by 12 Placement Re-report of Maltreatment
Analysis \c\ 12 months months stability maltreatment in foster care
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AFCARS FC Element 6: [check] [check] [check] NA [check]
Child's Date of Birth..........
AFCARS FC Element 7: [check] [check] [check] NA [check]
Child Sex......................
AFCARS FC Element 19: [check] [check] [check] NA [check]
Total of Removals....
NCANDS CF Element 14: NA NA NA [check] NA
Child Age......................
NCANDS CF Element 17: NA NA NA [check] NA
Child Sex......................
US Census Bureau: Child [check] [check] NA [check] [check]
Population, by State...........
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\c\ In addition to those data elements used for risk adjustment, a few more are used to make necessary
adjustments to outcomes; for example, we use the child's current placement setting to determine if he or she
is in Trial Home Visit before Reunification and, if so, time in foster care is adjusted consistent with
adjustments for trial home visits used in CFSR Round 2. If a state provides NCANDS CF Element 146,
Incident Date, an adjustment will be made to the maltreatment in foster care indicator to improve accuracy.
[FR Doc. 2014-09001 Filed 4-22-14; 8:45 am]
BILLING CODE 4184-25-P