Overview
Factsheet The 1994 Amendments to the Social Security Act authorized the U.S. Department of Health and Human Services to review State child and family service programs in order to ensure substantial conformity with the State plan requirements in titles IV-B and IV-E of the Social Security Act. Title IV-B of the Social Security Act and 45 Code of Federal Regulation (CFR) 1357.15 require States to submit child and family services plans (CFSP), i.e., State title IV-B plans, to the Administration for Children and Families (ACF) that include many of the requirements included in the child and family services reviews.
The reviews cover child protective services, foster care, adoption, family preservation and family support, and independent living. In addition to reviewing for the State's substantial conformity with applicable requirements, the reviews are designed to help States improve child welfare services and the outcomes for families and children who receive services by identifying strengths and needs within State programs, as well as areas where technical assistance can lead to program improvements. Other purposes of the reviews include the following:
- Ensure that Federal funds are spent in accordance with Federal statute, regulation, and policy
- Link the reviews to the joint planning, technical assistance, and program improvement processes that exist between States and Regional Offices
- Assist States to become self-evaluating over time
- Assemble data that will inform national policy
- Provide timely and specific feedback to States that is directly related to program performance and outcomes
There are two phases included in the child and family services reviews: the statewide assessment, which the State completes during the 6-month period prior to the onsite review, and the onsite review.
In examining outcomes, State child and family services programs are reviewed in both phases of the review process, with the information gathered from both phases contributing to the overall evaluation plan and plan for program improvement. The outcomes included in the reviews fall into three domains: safety, permanency, and child and family well-being. Within each domain, specific outcomes are assessed through the onsite review and statewide assessment. The outcomes are as follows:
Safety - Children are, first and foremost, protected from abuse and neglect.
- Children are safely maintained in their homes whenever possible and appropriate.
Permanency - Children have permanency and stability in their living situations.
- The continuity of family relationships and connections is preserved for children.
Child and Family Well-Being - Families have enhanced capacity to provide for their children's needs.
- Children receive appropriate services to meet their educational needs.
- Children receive adequate services to meet their physical and mental health needs.
In the first phase of the review, the State members of the review team complete a statewide assessment, using statewide aggregate data to evaluate the programs under review, and address the other requirements subject to review. In the second phase, the onsite review examines outcomes for a sample of children and families served by the State. The onsite review addresses specific outcomes through a focus on the quality of services and practice.
A set of performance indicators is used to evaluate each of the outcomes listed above (see appendix A), based on information from each case reviewed onsite and data in the statewide assessment. The performance indicators are in two forms: one includes qualitative items that are evaluated through case reviews conducted onsite in the State, and the other includes statewide aggregate data obtained from the Adoption and Foster Care Analysis and Reporting System (AFCARS) and the National Child Abuse and Neglect Data System (NCANDS).
A combination of performance indicators is used to assess the achievement of each outcome. For example, in evaluating the outcome "children are, first and foremost, protected from abuse and neglect," the performance indicators for this outcome include the following statewide aggregate data:
- The recurrence of maltreatment statewide
- The incidence of child abuse and/or neglect in foster care statewide
In addition, the reviewer considers the following performance indicators gathered on each individual case during the onsite review to evaluate this same outcome:
- The timeliness of initiating investigations following the receipt of a report of suspected abuse or neglect
- The recurrence of maltreatment of the child
In a similar manner, the review of systemic factors occurs at two levels. First, the statewide assessment includes an evaluation by the State members of the review team of the requirements related to each systemic factor covered in the review. Second, during the onsite review, members of the review team interview selected community stakeholders to determine how well each of the systemic factors functions in the State.
The systemic factors examined in the reviews include the following:
- Statewide information system
- Case review system
- Quality assurance system
- Staff training
- Service array
- Agency responsiveness to community
- Foster and adoptive parent licensing, recruitment, and retention
The reviews evaluate a set of State plan requirements and other program requirements for each of the systemic factors. Decisions about the State's substantial conformity with the systemic factors are based on the satisfactory implementation of those requirements in the State.
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