Testimony of Robert McKeagney, CWLA Vice President for Program Operations, before the House Subcommittee on Human Resources of the Committee on Ways and Means for the Hearing on Improved Monitoring of Vulnerable Children
November 19, 2003
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My name is Robert McKeagney, I am the Vice President for Program Operations for the Child Welfare League of America (CWLA). CWLA welcomes this opportunity to testify on behalf of our 1,000 public and private nonprofit child-serving member agencies nationwide for the hearing on "Improved Monitoring of Vulnerable Children." We appreciate the interest this Subcommittee and other members of Congress have demonstrated to better ensure the safety of children. As underscored by the recent case in New Jersey, as well as other instances of abuse and deprivation that have come to public attention, we have not yet implemented a national child welfare system that offers sufficient assurance that all children will be protected.
The focus of today's hearing is on the capacity of state child welfare agencies to effectively monitor the status of children in their care through the use of data within automated information systems, and to consider necessary improvements.
I am going to speak to you today from the combined perspectives of four vantage points. I have been fortunate during my career to have worked as a:
Within the context of each of these roles, I have had the opportunity to be involved with the design and use of child welfare information systems. These experiences have led me to believe that the most useful and accurate understanding of the challenges we face in this area must be based on these multiple perspectives.
- National consultant during which time I have had in-depth working relationships with a substantial number of state child welfare programs and have been engaged in numerous reviews of national data quality;
- State administrator with responsibility for a broad range of federally funded programs;
- Child welfare program manager and supervisor at a local level; and
- Caseworker who investigated abuse and neglect complaints and managed foster care cases.
CWLA is engaged on a daily basis with states in efforts to improve data management in support of a standard of direct service practice that will lead us to a consistently high level of safety and care for all children. Under contract to the Children's Bureau, CWLA hosts the National Resource Center for Information Technology in Child Welfare (NRCITCW). This national resource center works with states around the implementation of SACWIS systems and their preparation for the federal Child and Family Service Reviews (CFSR). CWLA's National Data Analysis System (NDAS) works with states in cooperation with the U.S. Children's Bureau to create better understanding of the information that is already being reported on an annual basis. All fifty states (plus the District of Columbia) have been involved in an NDAS National Working Group that has conducted intensive reviews of federal reporting requirements and the comparability of information being reported by the states.
Most recently, CWLA has begun work on a federal grant to examine questions that have been generated by cases of children reported missing from foster care. In cooperation with the National Center for Missing and Exploited Children, the state of Florida, and representatives of other states, we will examine policies and practices to develop models that will aid states in maintaining more effective tracking systems. This will include strategies to ensure adequate tracking of the location of children and youth in care and that regular visits occur. We will examine the use of SACWIS systems, the effectiveness of state reporting procedures, and the roles of casework staff and foster parents in overseeing the well-being of children.
Our work in this area will attempt to address a number of issues. As part of this project, we are examining definitions such as when a child is considered "missing" or "runaway"; looking at cases of children missing from foster care; parental abductions; and situations where a child's location may be unknown to the child welfare agency but may be known by the local law enforcement agency. Prevention issues will also be examined, including a child's risk for abduction, the stresses that may cause a child in foster care to leave, and the supports that may help these children at risk. Workforce issues will also be reviewed to ensure that caseworkers can monitor children and are properly trained so that incidents of runaways can be prevented.
Influences on the Information Systems
State child welfare information systems are largely defined by two major factors.
This results in a national child welfare information system that is actually a collection of fifty-one different systems bound together principally by the need to report a core set of data elements to the federal government. Otherwise, the systems have evolved to be responsive to such things as unique state case practice standards; differing levels of authority between state and local jurisdictions; varying roles among state agencies; and the demands of well-established state finance and management systems. This has certainly reflected a sound strategy, given the differences among states. However, it has increased the overall complexity associated with the design and implementation of improved systems.
- Federal reporting requirements that include the broad framework within which specific data elements are defined and the overall functional capacity of an acceptable system. In relationship to these requirements, the implementation of the Child and Family Services Reviews (CFSR) as part of a heightened national effort at measurement and accountability, has reinforced the already powerful influence of this mandate.
- The unique needs of individual states, particularly as they apply to the demands of case management and individual financial record keeping.
This degree of difficulty is reflected by the current status of state implementation of federally mandated SACWIS systems. Only five states have completed their SACWIS systems, despite the availability of federal funding at 75% of costs in 1993-1997, and the ongoing availability of 50% cost sharing. Another twenty-one states have achieved operational status but are at various stages within the assessment process. An additional twenty-one states are in planning, implementation, or pre-assessment status. Four states have not initiated any SACWIS activity.
Current Requirements of a State Information System
A quick review of the specific requirements that states must meet highlight the inherent complexities they face. Each system must incorporate at least eight different categories or "modules". Within each of these categories or modules there is additional information that is gathered or recorded.
The eight areas of data include: intake such as the initial screening, investigation and assessment; eligibility, which also includes future re-determination of eligibility; case management, including a service plan, a review and on-going monitoring of the case; resource management which includes support for facilities, foster homes, and adoptive homes; court processing requirements which includes court documents notifications, tracking in the courts, and interaction with the Indian Child Welfare Act (ICWA); financial management of funds being spent; administration of the program; and interfaces with other systems and programs such as TANF, child support, Medicaid, and the child abuse and neglect data system. There are also optional features or systems that may be linked, such as state licensing, the state education system, and juvenile justice systems.
When all of this is put into practice, a system must have an effective operational capacity to do three principal things. It must support:
The requirement to perform case management functions is perhaps the most important thing to appreciate about state information systems, particularly those designed to comply with SACWIS requirements. These systems are not simply for reporting purposes. They also must be fully integrated into the daily work of thousands of direct service staff as tracking and decisionmaking tools. Complete, accurate, and timely information about the status of individual children is essential to the process of providing supervision and care to children. The need to bring this capacity to life places a much higher demand on states at both the design and maintenance levels than would be the case if their information systems were simply reporting tools.
- State compliance with federal reporting requirements, including documentation of the states ability to meet federal outcome standards under Adoption and Safe Families Act (ASFA).
- Program management and decisionmaking, including provision of data necessary to track and analyze both short and long term indicators of individual and system performance.
- Case management on an ongoing daily basis.
This level of information is exactly what an effective system of care demands, whether it is provided electronically or otherwise. A principal benefit of automated information systems, however, is to make it far more difficult to overlook a missing data element or step in a process. Consequently, the real cost of securing and maintaining this information becomes much clearer as the systems begin to generate long lists of missing information. This has heightened our awareness of the need to get beyond the admittedly complex technological aspects of the systems and to meet the even greater challenge of integrating these mandated information components into the ongoing casework process.
Each system is ultimately dependent on the skill and sophistication of the thousands of front-line caseworkers and supervisors, who are their principal users. This essential fact is at the root of both the effective use and the misuse of state information systems as tools in ensuring the safety and well-being of children. Individual children are protected through the actions of responsible adults, including child welfare caseworkers. Therefore, responsible and competent use of the data is the critical element in all information systems.
State tracking and case management systems are only as good as the information entered by caseworkers. The quality of this information is, in turn, a product of two key variables:
An information system becomes an effective tool when high quality information is produced and applied to future decisionmaking, both in terms of children's needs and system accountability. Through a lens of child safety, this means that caseworkers must refer to prior records and place their current observations in the informed context of past patterns. Supervisors must do the same, but apply the same principles to the conduct of their staff as well as to children in their care. Finally, state administrators need to review timely reports of key system activities and events. They need to supplement this with solid longitudinal outcomes information in order to assure themselves that ongoing performance is consistent with both state and federal policy standards. Most importantly, everyone from caseworker to department head should be seeing comparable information and be fully aware that they are all managing to the same outcomes. This requires considerable skill at all levels, investments of time in analysis and communication, and a reasonably sophisticated institutional ability to package and present information. However, it also serves to transform data to increased knowledge and accountability.
- capability of the caseworker, with support from a supervisor, to observe, gather, and evaluate pertinent information.
- investment of sufficient time, with complementary skill, to enter accurate and complete information into the automated system.
I would like to share just a few examples of all too common SACWIS issues that negatively impact the ability of the case manager to make well informed decisions about the safety of children in out of home care and their needs for services and supports.
In many states (because definitions are state-specific), relatives are not licensed foster care providers and as such do not receive provider payments for the care of a child. Placements needing provider payments are entered into the computer in a more timely fashion that those placements not receiving payments. When caseloads are high, workers are forced to triage their time and children placed with relatives can, frequently, receive less attention from the case manager than is given to the paid providers resulting in service needs not being met and, possibly, unaddressed safety issues.
Data entry also occurs to support the generation of a payment to doctors and psychologists who provide services to a child. Again, when a worker prioritizes his/her time, a note about a visitation with a child may be delayed, as it does not directly affect a payment. Delayed entry could endanger the safety of a child if patterns of caretaker behavior are not promptly recorded and viewed in conjunction with prior notations.
All systems, regardless how well planned, developed and implemented, rely on the input provided by the human case manager. "Garbage in, garbage out" is an issue in the use of any automation system, but is proportionally increased when a system is not completely and fully utilized to its designed capabilities. When a child death, for example, is reported for a Child Protective Services investigation there are detailed procedures for the steps to take in the investigation of the death. Most procedures, however, do not include specific direction to make certain data entry notations in the automated computer system. Data entry can easily be neglected entirely or entered days, weeks, or even months later which calls into question the quality of the information. Incorrect, delayed or non-entry of information could endanger the life of other children in a family if an alleged perpetrator is not properly identified with the computer.
Due to the high level of case manager turnover, more reliance is put on the "memory" capacity of the computer system. When a child who is removed from home re-enters care the decisionmaking about placement options, services, and treatment is enhanced by the information about the prior experience in care. A properly trained case manager with a well designed computer system and time can find the prior record on a child and link the information, thus creating an accurate historical record to use in decisionmaking. A case manager with a poorly designed system, with little or no training and time, may not properly search within the computer records Or not search at all and create a new record, making it appear as this is the first time the child has entered care. The history trail of a child is lost when a duplicate record is created, and needed medical, social, psychological, and educational records are not available to support the case manager's worker efforts.
The practical challenges facing state child welfare systems are well represented by the dynamics behind the well-publicized issue of children missing from foster care. 1 In the spring of 2002, the issue of children missing from care received national attention as a result of a case in Florida. After that, additional states began to survey their systems and also concluded that not all their children in care were accounted for. Michigan determined that 302 children were missing. In California over 700 children were unaccounted for. In the fall of 2002, the 393 children under the supervision of the Florida Department of Children and Families who were unaccounted for and classified as missing were separated into two major categories: 86% were identified as runaway [voluntary] and 14% were identified as endangered/parental abductions/involuntary. These represent two very different types of practice challenges. However, the information management needs are similar.
Unfortunately, current administrative data on foster care does not answer many questions about children missing from care. First, is the issue of definitional clarity. Different definitions result in different conclusions about the scope of the problem. These definitions vary by type of absence, type of out-of-home care, duration of the absence from care, and avenues of exiting care. With attainment of greater definitional clarity, agencies could develop the capacity and methodology to capture, analyze and share the individual, environmental, and systemic factors that increase and diminish the risks of children missing from care. This would lead to greater clarity about the practice responses that would be effective.
Research highlights the need for detailed recording and monitoring of all unauthorized absences and for improved coordination between child welfare and law enforcement to develop more effective reporting, response, and tracking procedures. The development of formal protocols at the local level may help to establish clear procedures, including explicit criteria for risk assessment; assist the development of an integrated practice framework consistent with child protection principles; and provide a basis for monitoring and reviewing patterns of absences. This is a significant challenge, not only in regard to design of information systems, but also in terms of interagency and inter-jurisdictional coordination, development of effective intervention strategies, and in staff training.
States, even those with currently approved SACWIS systems, have a great deal more to accomplish in fully implementing information systems that meet all of the demands of federal reporting, agency management and accountability, and case management. There are still significant technological challenges, both for those states still designing systems and others who are in need of upgrades for existing systems. The most daunting challenges, however, remain with the "human factor." Caseworkers are the most important ingredient in achieving success with these systems. Additional investments in reducing workloads and improving the capacity of frontline staff to integrate information management methods into sound case practice are necessary.
Given the complexity of these systems, it will be necessary to maintain strong federal leadership for years to come. States will continue to require support in the form of funding, technical assistance, training, and development of clear standards for both practice and data management.
Recommendations for Improving the Monitoring of the Safety and Well-Being of Children in the Child Welfare System
The many efforts in which CWLA engages with the states and the private child welfare agencies have led us to draw several primary conclusions about actions that can be taken to strengthen the national approach to monitoring the safety and well-being of children in foster care.
- The U.S. Children's Bureau should be encouraged in its continuing efforts to improve the quality and consistency of federal child welfare reporting. It should continue its consultation with CWLA's National Working Group and other groups representing the states.
- The U.S. Children's Bureau should continue its work with states through the CFSR and Program Improvement Plan process to improve the quality of child welfare services. It should continue to examine current outcome indicators and standards to further strengthen the connection between the CFSRs and child outcomes.
- States should be provided with additional support in their development of practical management reports and integration of SACWIS data into their operational management and quality assurance systems. Enhanced resources should be provided to support training in the use of various data analysis methods and the application of data-driven decisionmaking techniques.
- Front-line staff should have access to ongoing training and enhanced resources to support the integration of case reporting into the casework process. This should include:
- basic and advanced use of automated systems;
- caseworker and supervisor case and caseload management reporting functions;
- development of policies and skills to support integration of data-driven techniques into casework process; and
- access to new technology (PDAs; voice recognition recording equipment, etc.)
- Caseloads should be reduced to acceptable standards. Caseworkers and their supervisors must have sufficient time to do rigorous, high quality work. Data quality and the effective application of information to case management and decisionmaking depend on thoughtful, thorough work. Too many caseworkers are still forced to cut too many corners. In general, the quality of case data is the first victim of an overburdened staff. The U.S. Children's Bureau should work with the states to develop a clear set of standards to serve as reference points for quality work and acceptable caseloads.
Additional Systems Improvements Needed
The child welfare system, as currently constructed, cannot protect all children adequately. Failures occur. They are not limited to any single state. These failures to protect children will continue to occur until we put into place a comprehensive child protection system.
In addition to improving the ability of child welfare agencies to keep reliable data on the children they serve, the national child welfare system continues to be in need of:
- A reliable, responsive, and predictable method of guaranteed funding, for a full range of essential services, as well as placement and treatment services.
- A means of maintaining consistent focus on safety, permanency, and well-being as outcomes for children.
- Rigorous standards combined with strong federal and state accountability mechanisms.
- Recruitment and support of adequately trained child welfare professionals, foster and adoptive parents, mentors, and community volunteers.
- Resources that enable parents to provide adequate protection and care for their own children.
New Resources are Needed for an Array of Services
Child welfare agencies need to be able to provide a broad range of services to children who have been abused or neglected and to help ensure stability for them while they are in foster care and after they leave foster care.
- Increased support for primary prevention services can prevent many families from ever reaching the point where is child is removed from the home.
- Support for reunification services is needed. Forty-three percent (239,552) of children in care on September 30, 2000 had a case plan goal of reunification with their parents or other principal caretaker while 57% (157,712) of the children who exited care during FY 2000 returned to their parent's or caretaker's home.
- A federally funded guardianship permanency option should be available to allow states to provide assistance payments on behalf of children to grandparents and other relatives who have assumed legal guardianship of the children for whom they have committed to care for on a permanent basis.
- Post permanency services are needed to support permanency when children have been reunified with their families, adopted, or when relatives have assumed legal guardianship and permanent care. To accomplish this for all children and families requires a system of service delivery which will ensure that sufficient funding is available to ensure that services will be available as the needs of the families and children change; and that an appropriate range of services are developed to meet the varying needs of adoptive families, birth families, and adopted children. The provision of these services would support reunification, prevent recidivism of children reentering foster care, and maintain permanency for adopted children and those in guardianship arrangements.
- Families in the child welfare system need access to appropriate substance abuse treatment. A common thread in child protection and foster care cases is the high percentage of children, their parents, or both who have a substance abuse problem. Up to 80% of the children in the child welfare system have families with substance abuse problems.
- Children in the in the child welfare system need better access to mental health services. It is estimated that 20%, or 13.7 million American children have a diagnosable mental or emotional disorder. Nearly half of these children have severe disorders, but only one-fifth receive appropriate services. For children living in foster care today, the problem is even more serious. Eighty-five percent of the 547,000 children living in foster care have a developmental, emotional, or behavioral problem. Most of these children have experienced abuse and/or neglect and are at high risk of emotional, behavioral, and psychiatric problems. Upon entering foster care some children already have a diagnosed serious emotional disturbance and require significant services.
- Native American children need better access to services. Allowing Native American tribes and tribal consortia to apply to the U.S. Department of Health and Human Services to directly administer the Title IV-E foster care and adoption assistance program would increase opportunities for Native American children to find permanent families and receive the supports they need.
Workforce Supports are a Fundamental Building Block to an Improved Child Welfare System
Supports to improve the child welfare workforce are greatly needed. Successful outcomes for children and families in child welfare depend heavily on the quality of services received, and in turn, on the ability of the workforce delivering them. Yet, child welfare agencies across the country are facing a workforce crisis on many fronts. Attracting, training, and retaining qualified staff at all levels has become increasingly challenging.
CWLA believes that important and necessary reforms must be enacted to ensure a consistent level of safety and care for all of America's children. We look forward to working with this subcommittee to develop a comprehensive child welfare reform proposal that meets all the needs of America's the most vulnerable children and families and ensures that every child is protected. A part of that reform must include improvements to systems designed to monitor the status of children.
- According to the U.S. Department of Health and Human Services (2003), of the 542,000 children in foster care on September 30, 2001, 9,112 children in care or 2% were identified as runaway. Of the 263,000 children who exited foster care during FY 2001, 5,219 children (2%) exited the system as runaways, and 437 of the 126,000 children classified as waiting to be adopted on September 30, 2001 were runaways.
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