[Federal Register Volume 64, Number 21 (Tuesday, February 2, 1999)]
[Notices]
[Pages 5063-5066]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-2361]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Invitation To Comment on Child Welfare Outcomes and Measures

AGENCY: Administration on Children, Youth and Families, ACF, HHS.

ACTION: Notice of plan to report on outcomes and performance of State 
child welfare programs, and invitation to comment.

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SUMMARY: Section 203 of the Adoption and Safe Families Act (ASFA), 
signed into law in November 1997, requires the Secretary of the 
Department of Health and Human Services (DHHS) ``* * * in consultation 
with Governors, State legislatures, State and local public officials 
responsible for administering child welfare programs, and child welfare 
advocates * * * to develop a set of outcome measures (including length 
of stay in foster care, number of foster care placements, and number of 
adoptions) that can be used to assess the performance of States in 
operating child protection and child welfare programs * * *.'' In 
addition, the law requires that ``* * * to the maximum extent possible, 
the outcome measures should be developed from data available from the 
Adoption and Foster Care Analysis and Reporting System.'' Section 203 
of ASFA also directs the Secretary to prepare and submit to Congress a 
report on the performance of each State on each outcome measure on May 
1, 1999, and annually thereafter.
    To meet these requirements, the Children's Bureau, the Federal 
agency charged with the task of implementing ASFA, engaged in a 
consultation process with various stakeholders. The outcomes presented 
in this notice are the result of the Children's Bureau's consultation 
process and reflect widely-held performance objectives for child 
welfare program practice. This notice is to advise the public of DHHS's 
plan to report on these outcomes for State child welfare programs and 
to invite public comment on them. This notice can be found at http://
www.acf.dhhs.gov/programs/cb/special/index.htm.

DATES: Written comments must be submitted to the office listed in the 
ADDRESS section below on or before March 4, 1999.

ADDRESS: Mail written comments (in duplicate) to Marianne Rufty at the 
address below.

FOR FURTHER INFORMATION CONTACT: Marianne Rufty, Children's Bureau, 330 
C Street, SW, Washington, DC 20447.

SUPPLEMENTARY INFORMATION: The Nation's child welfare systems are 
designed to protect children who have suffered maltreatment, who are at 
risk for maltreatment, or who are under the care and placement 
responsibility of the State because their families are unable to care 
for them. These systems also focus on securing permanent living 
arrangements for children who are unable to return home. The Children's 
Bureau is the agency within the Federal Government that is responsible 
for assisting State child welfare systems by promoting continuous 
improvement in the delivery of child welfare services.
    The Adoption and Safe Families Act (ASFA) represents a significant 
effort on the part of the Federal Government to improve child welfare 
service systems. The ASFA establishes clear goals for children served 
by the Nation's child welfare systems--safety, permanency, and well-
being. It calls on the Department of Health and Human Services (DHHS), 
State officials, advocates, and other experts in the field to work 
together to identify useful outcome measures to gauge State and

[[Page 5064]]

national progress in reaching those goals.
    The ASFA also requires that DHHS prepare and submit to Congress a 
Report on the performance of each State on each outcome measure on May 
1, 1999, and annually thereafter. This Report is intended to encourage 
continued improvements in State child welfare systems. It will provide 
an overview of system effectiveness by focusing on performance related 
to particular outcome measures. Additional data will be presented that 
pertain to system characteristics, some of which were requested in 
Section 203 of ASFA, to provide a context for the outcome measures. 
These data will address characteristics of a State's child welfare 
system such as the number of children reported for abuse or neglect, 
the number of children found to be victims of maltreatment, the number 
of children in out-of-home care, the number of adoptions, etc.
    The first Report to Congress will include outcome measures that are 
based on data already available through the Adoption and Foster Care 
Analysis and Reporting System (AFCARS) and the National Child Abuse and 
Neglect Data Systems (NCANDS) to avoid additional reporting by the 
States. The AFCARS, which was implemented in December 1993, is the 
first federally-mandated data collection program for the collection of 
foster care and adoption data. The data are case-level data 
representing children in foster care under the responsibility of the 
State child welfare agencies and those children adopted with the 
involvement of those agencies. A list of the AFCARS data elements for 
foster care and adoption can be found at http://www.acf.dhhs.gov/
programs/cb/special/elements.htm.
    The NCANDS, which is a voluntary data collection system established 
in 1990, is the primary source of national information on abused and 
neglected children known to State child protective services agencies. 
The NCANDS is comprised of two parts: (1) A Summary Data Component, 
which is a compilation of key aggregate indicators of State child abuse 
and neglect statistics, and (2) a Detailed Case Data Component, which 
is a compilation of case-level data about individual children who are 
are the subjects of child maltreatment reports. A list of the data 
elements for the Summary Data Component can be found at http://
www.acf.dhhs.gov.programs/cb/special/ncands.htm. The data elements for 
the Detailed Case Data Component can be found at http://
www.acf.dhhs.gov.programs/cb/special/casedata.htm.
    One consequence of focusing on outcomes that can be measured 
through AFCARS and NCANDS is that the outcomes to be included in the 
first Annual Report do not address the goal of child well-being. In the 
first Annual Report to the Congress, the Children's Bureau intends to 
discuss issues pertaining to the development of future child well-being 
outcomes and possible procedures for collecting data pertaining to 
those outcomes. It is anticipated that these outcomes will relate to 
the educational and health status of children served by the foster care 
system.
    Because of the extensive variation among State child welfare 
systems with respect to policies, definitions, resources, capacities, 
and demographic characteristics, future Annual Reports to the Congress 
will assess State performance by recording changes in each State's 
performance on each outcome measure. The ultimate objective will be to 
document either a pattern of continuous improvement or performance 
problems relevant to particular outcomes.
    In order to ensure that the outcomes presented in the Annual Report 
would be meaningful with respect to the performance of a child welfare 
system, the Children's Bureau engaged in a consultation process to 
assist in developing the outcome measures. This consultation process 
included:
     Establishing a Consultation Group comprised of 
representatives from State, Tribal, county, and municipal child welfare 
agencies; private non-profit child and family services agencies; State 
legislatures; State Governors' offices; juvenile and family courts; 
local child advocacy organizations; and a public employee organization;
     Inviting national organizations to serve as resources to 
the Consultation Group, including the American Bar Association Center 
on Children and the Law, the American Public Human Services 
Association, the Child Welfare League of America, the Children's 
Defense Fund, the National Association of Child Advocates, the National 
Center for Juvenile Justice, the National Child Welfare Resource Center 
for Organizational Improvement, the National Conference of State 
Legislatures, the National Council of Juvenile and Family Court Judges, 
and the National Governors's Association;
     Convening a meeting of the Consultation Group in September 
1998 during which multiple outcomes were proposed and discussed;
     Conducting a review of the outcomes proposed during the 
Consultation Group meeting by a Children's Bureau staff to identify 
those outcomes that reflect desired goals and objectives and could be 
measured using data from the AFCARS and the NCANDS;
     Preparing and disseminating a report on the outcome 
measures to the Consultation Group and resource organization 
representatives for their review and comment;
     Convening telephone conference calls and meetings to 
obtain feedback on the outcome measures from Consultation Group members 
and resource organization representatives;
     Presenting the outcome measures to participants of three 
focus groups at the 12th National Conference on Child Abuse and Neglect 
in Cincinnati, Ohio, to obtain feedback from the larger child welfare 
community;
     Conducting a review of comments from reviewers and focus 
group participants to determine areas for revision; and
     Disseminating the revised outcome measures to Consultation 
Group members and resource organization representatives for review and 
comment during the second meeting of the Consultation Group in December 
1998.
    The following outcome measures are the result of this consultation 
process. The Children's Bureau of DHHS invites your comment on these 
outcome measures. Revisions resulting from the comment process will be 
reflected in the final list of outcome measures, which will be used as 
the basis for the first and subsequent Annual Reports to the Congress 
on the performance of each State in meeting the goals and objectives of 
the child welfare system.

Safety-Related Outcome 1: Reduce Recurrence of Child Abuse and/or 
Neglect

    During a specified reporting period:

--Of all children who were victims of substantiated child abuse and/or 
neglect, what percentage had another substantiated report within 12-
month period?
--Of all children who were victims of substantiated child abuse and/or 
neglect, who were not placed in foster care, and whose families 
received services from the agency, what percentage had another 
substantiated report within a 12-month period?
--Of all children who were victims of substantiated child abuse and/or 
neglect, who were not placed in foster care, and whose families did not 
receive services from the agency, what

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percentage had another substantiated report within a 12-month period?

    Note: This outcome addresses a primary objective of all child 
welfare systems-to prevent the recurrence of child abuse or neglect 
once it has come to the attention of the system. It is acknowledged 
that recurrence is the result of multiple factors and that child 
welfare interventions cannot prevent all recurrence. This outcome 
may be modified or expanded in the future to include a measure that 
addresses all reports referred for investigation, not solely those 
that are substantiated. In the current measure, ``substantiated'' 
reports include those that are classified by some States as 
``indicated.''

Safety-Related Outcome 2: Reduce Child Fatalities Due to Child 
Maltreatment

    During a specified reporting period:

--Of all child fatalities resulting from abuse or neglect, what 
percentage of child victims had been the subject of a substantiated 
report of child abuse or neglect within 12 (24) months prior to the 
reported fatality?

    Note: This outcome reflects a fundamental goal of child welfare 
systems--to prevent child fatalities as a result of abuse or 
neglect. The measure focuses on fatalities among children who were 
known to the child welfare system.

Safety-Related Outcome 3: Improve the Child Welfare System's 
Response Time To Investigate Abuse or Neglect Reports

    During a specified reporting period:

--Of all child protection investigations initiated, what was the mean 
length of time between the report and the initiation of the 
investigation?

    Note: The selection of this outcome was based on the assumption 
that a rapid response to an abuse or neglect report can be used as 
at least one measure of a system's performance in protecting 
children. The outcome may be modified in the future to incorporate 
State response standards for various types of maltreatment reports. 
The Summary Data Component of NCANDS recently incorporated data 
elements pertaining to response time information for different 
categories of reports.

Permanency-Related Outcome 1: Reduce Time in Foster Care To 
Reunification Without Increasing the Rate of Foster Care Re-Entry

    During a specified reporting period:

--Of all children who were reunified with their parents or caretakers 
from foster care placements, what percentage was reunified in less than 
12 months from the time of latest removal from home?
--Of all children who were reunified with their parents or caretakers 
from foster care placements, what percentage was reunified in 12 to 24 
months from the time of latest removal from home?
--Of all children who were reunified with their parents or caretakers 
from foster care placements in less than 12 months from the time of 
removal, what percentage re-entered foster care in less than 12 months 
from the time of reunification?

    Note: The term ``foster care'' as used in this outcome refers to 
all out-of-home care arrangements for children for whom the State 
child welfare agency has responsibility for placement, care, or 
supervision. The term ``reunification'' refers to children who are 
returned to their parents as well as those who are discharged to 
other relatives (i.e., the child's case is closed, but the relatives 
are not the child's legal guardians).
    This outcome reflects the objective of returning children in foster 
care to their families as soon as possible. The third measure is 
designed to address the concern that by expediting reunifications a 
child welfare system may risk increasing re-entries into foster care. 
Distribution of time-in-care information for all children in foster 
care may be provided as context information.

Permanency-Related Outcome 2: Reduce Time in Foster Care to 
Adoption Finalization Without Increasing the Number of Adopted 
Children Who Re-Enter Foster Care

    During a specified reporting period:

--Of all children who were younger than age 3 at the time of foster 
care entry and who exited foster care to finalized adoptions, what 
percentage exited to finalized adoptions in less than 24 months from 
entry?
--Of all children who were age 3 or older at the time of foster care 
entry and who exited foster care to finalized adoptions, what 
percentage exited to finalized adoptions in less than 36 months from 
entry?
--Of all children entering foster care, what percentage had been 
previously adopted when they were older than 2 years of age?

    Note: This outcome addresses the objective that children who 
cannot be reunified with their families should be adopted as quickly 
as possible. The first two measures reflect a decision to track 
adoptions of children younger than 3 years of age separately from 
adoptions of older children. Research findings indicate that 
adoptions can be achieved more frequently and quickly for children 
who are under age 3 at the time of entry into care than for children 
who enter foster care at age 3 or older. The third measure is 
designed to reflect concerns that expedited adoptions may result in 
re-entries into the foster care system. By only including children 
older that age 2 at the time of adoption, we expect to reduce the 
number of private agency or international adoptions that may be 
included in the data.

Permanency-Related Outcome 3: Reduce Time in Foster Care to Legal 
Guardianship

    During a specified reporting period:

--Of all children who were discharged with a legal guardianship, what 
percentage was discharged in less than 24 months from time of removal?

    Note: This outcome reflects the objective of establishing a 
timely permanency option for children when reunification and 
adoption have been ruled out as permanency options.

Permanency-Related Outcome 4: Reduce the Disparity of Length of 
Time in Foster Care Between Children of Color and Caucasian 
Children

    During a specified reporting period:

--For children in non-relative foster care who exited care, what was 
the median length of time in care for African American children, 
American Indian/Alaska Native children, Asian and Pacific Islander 
children, Caucasian children, and Hispanic children?
--For children in relative foster care who exited care, what was the 
median length of time in care for African American children, American 
Indian/Alaska Native children, Asian and Pacific Islander children, 
Caucasian children, and Hispanic children?

    Note: This outcome reflects concerns that children of color may 
receive differential treatment in many of National's foster care 
systems. The measures are designed to track both the disparity of 
length of time in foster care and the impact of relative foster care 
on length of time in care.

Permanency-Related Outcome 5: Increase Permanency for Disabled and 
Older Children

    During a specified reporting period:

--For all children who were identified as disabled and who exited care, 
what percentage exited to reunification, adoption, or legal 
guardianship?
--For all children who were 12 years of age or older at the time of 
their most recent entry into care and who exited care, what percentage 
exited to reunification, adoption, or legal guardianship?
--For all children exiting care through emancipation, what percentage 
was younger than 12 years of age at the time of their most recent entry 
into care?

    Note: These measures address general concerns in the field about 
permanency for disabled children, children who enter care when they 
are adolescents, and older children for who efforts to achieve 
permanent homes are lacking or ineffective.

[[Page 5066]]

Permanency-Related Outcome 6: Increase Placement Stability

    During a specified reporting period:

--For all children who had been in foster care for longer than 3 
months, what percentage had not more than two placement settings during 
their most recent episode?

    Note: This outcome addresses the objective of reducing the 
number of placement settings in a single-foster care episode. The 
measure acknowledges that in many States a large percentage of 
children will experience at least two placements because of the use 
of emergency foster care services at the time of removing a child 
from the home.

Permanency-Related Outcome 7: Reduce Placements of Children in 
Group Homes, Institutions, and Out-of-State Care

    During a specified reporting period:

--For all children who were younger than age 12 when they were placed 
in their current foster care settings, what percentage had a current 
placement in a group home? What percentage had a current placement in 
an institution?
--For all children who were 12 years of older when they were placed in 
their current foster care settings, what percentage had a current 
placement in a group home? What percentage had a current placement in 
an institution?
--For all children whose current placement settings are group homes or 
institutions, what percentage is placed out of State?

    Note: This outcome reflects the objective of placing most 
children in family foster homes and in placements that are in close 
proximity to their families. It is acknowledged that for some 
children, particularly adolescents, group homes, institutions, or 
out-of-State placements may be appropriate.

    Dated: January 26, 1999.
Patricia Montoya,
Commissioner, Administration on Children, Youth and Families.
[FR Doc. 99-2361 Filed 1-29-99; 8:45 am]
BILLING CODE 4184-01-M