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2004 Jordan Institute
for Families

Vol. 9, No. 4
July 2004

The CFSR, Outcome Data, and You

In child welfare change and the power to influence things often flows from above: congress makes laws, laws affect federal policy and funding, which affect the States, which affect counties, right on down to you.

Sometimes this top-down flow is so dominant we forget that influence also goes the other way: what we do has an impact not only on our corner of the world but on the child welfare system at the state and national levels.

As the following look at the federal Child and Family Services Review illustrates, this is especially true when it comes to the power and influence frontline workers and supervisors have as generators of data.

In response to the 1997 Adoption and Safe Families Act, the federal government created the Child and Family Services Review (CFSR) to help it evaluate child welfare in all 50 States. Much of the CFSR looks at outcomes data and other sources to assess each State’s ability to achieve safety, well-being, and permanency for children.

Since it began in 2001, no State has “passed” the CFSR. In fact, 16 States—including ours—failed to meet all seven outcomes measured by the CFSR’s review of case records (GAO, 2004). (Note: NC did pass every one of the state-level systemic factors assessed by the CFSR.)

Program Improvement
States whose data do not meet the national standard in the CFSR are put on what is essentially a probationary status and required to develop a Program Improvement Plan (PIP) to address their shortcomings. The PIP allows the State to identify issues that contribute to nonconformity and plan steps to improve its performance on the data indicators in question.

North Carolina created its PIP in August 2001. As part of this plan, it agreed to meet certain federal outcome benchmarks by a certain time, or face financial sanctions. Since then the NC Division of Social Services has made significant changes to child welfare policy and procedure in an effort to comply with our PIP. Changes that have directly affected county DSS’s include:

  • Multiple Response System (MRS), an effort to make our child welfare system more consistent, effective, and family-centered.

  • Structured Decision-Making Tools. In April 2002 all county child welfare agencies began using a set of research-based assessment tools that enhanced their ability to evaluate child safety and to consistently assess families using a strengths-based approach.

  • Structured Intake. In April 2003 a mandatory tool was introduced to make screening of reports of child maltreatment more consistent across the state.

  • County-Level CFSRs. After the federal CFSR, the Division changed the way it reviews child welfare in North Carolina’s 100 counties. It changed the name and the characteristics of what was once known as the “biennial review process” to reflect the emphases of the CFSR and our State’s PIP. Now, just like the State, counties found to be out of compliance on the NC-CFSR must create their own PIP.

  • Data Support. The Division is providing support to county DSS’s that do not meet federal and state benchmarks to help them address coding errors and problems with data entry.

Where We Stand Today
When it created its PIP, North Carolina agreed to meet certain benchmarks in the statewide data indicators over the course of its PIP. The following figures reflect North Carolina’s performance as of September 30, 2003 with respect to a national set of child welfare outcomes:

1.1—Recurrence of maltreatment

NC’s PIP Benchmark: 7.1%.
NC’s Current Performance: 9.0%
Status: Needs Improvement

2.1—Incidence of child abuse and/or neglect in foster care

NC’s PIP Benchmark: 0.69%.
NC’s Current Performance: 0.95%
Status: Needs Improvement

4.1—Length of time to achieve reunification

NC’s PIP Benchmark: 60%.
NC’s Current Performance: 60.2%
Status: Substantially Achieved

4.2—Foster care re-entries

NC’s PIP Benchmark: 8.6%.
NC’s Current Performance: 1.2%
Status: Substantially Achieved

5.1—Length of time to achieve adoption

NC’s PIP Benchmark: 28.9%.
NC’s Current Performance: 32%
Status: Substantially Achieved

6.1—Stable foster care placements

NC’s PIP Benchmark: 63.2%.
NC’s Current Performance: 58%
Status: Needs Improvement

Your Role is Vital
North Carolina’s ability to get out of program improvement depends not only on its ability to correct the shortcomings identified in the federal review, but on its ability to document progress in these areas using valid outcomes data.

That’s where you come in. As frontline workers, supervisors, and data entry people, you are the ones who enter information into the county and State data systems. This information ultimately becomes part of AFCARS (Adoption and Foster Care Analysis and Reporting System), NCANDS (National Child Abuse and Neglect Data System), and other national datasets used to determine whether a State will emerge from program improvement or face financial sanctions. The data you generate is also used to guide other important funding and policy decisions.

The implications of this for practice are clear. Though the documentation connected to your work with families may sometimes seem like an unwanted and even pointless obligation, it actually gives you significant power in our child welfare system.

Thus, if you are ever filling out documentation and find yourself tempted to guess about the child’s grade in school or to skip a field altogether, think twice. Though they might not be felt for some time, the consequences of “fudging” paperwork could negatively affect decisions about law, policy—and funding—that could have a major impact on you, your agency, and the families you serve.

Your Part Matters

Providing complete, accurate, and timely case documentation:

  • Helps capture family progress
  • Ensures key data is available when caseworkers or supervisors change, become ill, or there is an emergency
  • Provides documentation for court
  • Verifies activities for which county DSS’s can claim reimbursement
  • Enables agencies to demonstrate their effectiveness to State and federal agencies, county and community representatives, and other stakeholders

Source: NCDSS, 2002; Muskie, 2001

References for this and other articles in this issue