Jan Rothstein, Children's Bureau, 1250 Maryland Ave., SW., 8th Floor, Washington, DC 20024, (202) 401-5073.

Child and Family Service Review Background: Section 1123A of the Social Security Act (the Act) requires the Secretary of the Department of Health and Human Services to issue regulations for the review of programs under titles IV-B and IV-E 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. ACF issued regulations implementing such reviews, known as the CFSRs, in the Federal Register on January 25, 2000 (65 FR 4020). The review process, as regulated, grew out of extensive consultation with interested groups, individuals and experts in the field of child welfare and related areas. The consultation affirmed that the broad goals of child welfare systems are to: Assure safety for all children; to assure permanent, nurturing homes for all children; and to enhance the well-being of children and their families. The reviews reinforce those goals.

The existing CFSRs enable CB 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. CB 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.

Each CFSR is a two-stage process consisting of a Statewide Assessment and an onsite review of child and family service outcomes and program systems. For the Statewide Assessment, CB prepares and transmits data profiles that contain aggregate data on the State's foster care and in-home service populations. The data profiles allow each State to compare certain safety and permanency data indicators with national standards determined by CB. The on-site review includes case record reviews, interviews with children and families engaged in services and interviews with other stakeholders. States determined not to have achieved substantial conformity in all the areas assessed are required to develop and implement Program Improvement Plans (PIPs) within two years addressing the areas of nonconformity. CB supports the States with technical assistance and monitors implementation of their plans. States that are unable to complete their PIPs successfully have some of their Federal child welfare funds withheld until they are found to be in substantial conformity or have successfully completed a PIP as prescribed in the Federal regulations.

We believe that the CFSR has been a factor contributing to increased State and local attention to child welfare practice improvement and a renewed focus on child and family outcomes and the systems supporting positive outcomes. Stakeholders have also noted that there are areas where the CFSRs could contribute to even more positive changes. To that end, we are interested in learning from stakeholders in response to the questions below how they would envision a Federal review process that meets the statutory requirements in section 1123A of the 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 to the foregoing, we would like to clarify that, although several of the questions below address Tribal involvement in Federal reviews of title IV-B and IV-E plan requirements, until regulations are in effect otherwise, Indian Tribes operating title IV-E programs of their own are not subject to CFSRs. However, Indian Tribes have participated in CFSRs in the past and Indian children are part of the CFSRs. Therefore, we are interested at this time in gaining their insight into how the process could be improved.

Questions

Please identify the question to which you are responding. If you have additional comments, please identify them by citing to the appropriate section of the regulations or review process, if appropriate:

1. How could ACF best promote and measure continuous quality improvement in child welfare outcomes and the effective functioning of systems that promote positive outcomes for children and families?
2. To what extent should data or measures from national child welfare databases (e.g., the Adoption and Foster Care Analysis and Reporting System, the National Child Abuse and Neglect Data System) be used in a Federal monitoring process and what measures are important for State/Tribal/local accountability?
3. What role should the child welfare case management information system or systems that States/Tribes/local agencies use for case management or quality assurance purposes play in a Federal monitoring process?
4. What roles should State/Tribal/local child welfare agencies play in establishing targets for improvement and monitoring performance towards those targets? What role should other stakeholders, such as courts, clients and other child-serving agencies play?
5. In what ways should targets and performance goals be informed by and integrated with other Federal child welfare oversight efforts?
6. What specific strategies, supports, incentives, or penalties are needed to ensure continued quality improvement and achievement of positive outcomes for children and families that are in substantial conformity with Federal child welfare laws?
7. In light of the ability of Tribes to directly operate title IV-E programs through recent changes in the statute, in what ways, if any, should a Federal review process focus on services delivered to Indian children?
8. Are there examples of other review protocols, either in child welfare or related fields, in which Tribal/State/local governments participate that might inform CB's approach to reviewing child welfare systems?

The Children's Bureau welcomes any other comments you have about Federal review of child welfare programs, including the current CFSR process.