The Child Welfare League of America (CWLA) and its members including state child welfare agencies are pleased to respond to the proposed CFSR measures outlined in the Federal Register of January 11, 2008.
CWLA acknowledges the commitment of ACF to improving AFCARS. CWLA notes that there are several positive elements to the proposed AFCARS changes. We are pleased that the proposed rule includes a longitudinal component. This was recommended by CWLA in its response to a Federal Register request for comment about AFCARS in June of 2003. Longitudinal data will allow for a more complete understanding of a child’s experience in care and provide invaluable information for use in decision-making regarding policy and practice in child welfare. We believe this will enhance quality improvement activities and strengthen front-line practice that will maximize positive outcomes for children and families. It is believed that the use of episode based data will provide a clearer picture of stability of children in care and critical elements such as the effectiveness of permanency planning for children in care. This represents a significant improvement over the current point-in-time, child based reporting.
CWLA also supports the removal of the requirement to provide summary data. We believe this information does not contribute meaningful information regarding the child welfare population and service provision.
CWLA believes it is consistent with our mission to seek greater coordination between systems and other agencies that serve child populations. We are also supportive of efforts to collect greater information and detail on the children in the child welfare population. The changes as offered in this proposal represent a significant change in the data content and the manner in which data is collected. As a result it will involve a great investment of time, training and implementation in order for these proposed changes to be carried out in a way that will yield the most useful and accurate data possible. Examined in this light, CWLA has great concerns about certain key aspects of the proposed changes. The major issues center on the way data is restructured, how best to report on children not included in the child welfare population, the rapid expansion of data elements, and potential lack of quality data that may result. Finally we have a concern regarding the use and assessment of penalties. The proposed rule, if implemented incorrectly or by requiring unsound information will not only create significant burdens for states, it will fail to provide the type of information that will improve outcomes for children in the child welfare system.
CWLA is a strong advocate for greater research and information to learn where children are, how long they are in care, the type of care received, the composition of the families, and outcomes achieved in the child welfare system. We urge a special caution: the people most responsible for gathering this data are the same individuals charged with many other duties including managing the case, attempting to reunify and evaluate the child and family, and documenting the case for the courts and other mechanisms of oversight. In recent testimony before Congress we described the challenge in the child welfare workforce. As an example we cited a New York state Workload Study conducted in 2006 that determined that caseworkers were spending between 35 to 90 minutes in face to face contact with children and their families per case per month. Other states have reported similar findings both anecdotally and in formal workload studies. This highlights the often overwhelming demands placed on caseworkers when multiple or conflicting priorities are instituted, sometimes without fully evaluating their impact on workloads and the ability to provide effective services to families. In light of recent federal government mandates requiring face to face visits monthly, something we endorse as a best practice, we feel these proposed changes must also be evaluated for their impact on the workforce.
There are also important questions in regard to an implementation schedule. These changes suggest some very significant modifications to state information systems. Some in the child welfare field have suggested the creation of a workgroup that can help in further developing these proposed changes. CWLA strongly encourages ACF to consider utilizing a workgroup approach such as that used in the formation of the NCANDS data collection process. We believe such a group could be created and could act in an expeditious way so that in the end we do reach the goals for which there seems to be common agreement.
CWLA wishes to express appreciation for the opportunity to provide feedback on this proposed rule regarding the critical task of AFCARS data collection and reporting. CWLA once again commends ACF for its efforts to facilitate a move toward longitudinal data, but as outlined here the proposed regulations offer a number of challenges and we hope that we can work together with the states to resolve these issues.
[Scope of the Adoption and Foster Care Analysis and Reporting System] (§1355.40)
While CWLA and the states acknowledge that the longitudinal nature of the data will be a benefit in providing quality services to children and families, the mechanism by which this is to be accomplished is not clearly articulated in the proposed rule. We believe that this will require a major reformation of existing data collection systems which will be very time-consuming and costly on all levels of systems development and management, service administration and service provision. The proposed changes represent a significant expansion of current data reporting, both in terms of the amount of data reported and the manner in which it is reported. The shift from child-files to episode-based reporting is a major change in approach to data recording and reporting. The paucity of detail in the proposed rule makes it impossible to evaluate the changes in collection methods required and how the newly structured files would be reported to ACF. The file size will increase significantly necessitating a change from the current flat file system of data transmission and possibly re-engineering of existing SACWIS and data collection systems. The logistics of restructuring the existing SACWIS and other data collection systems will require additional details from ACF and further research and consideration to determine the feasibility and cost of reconfiguring existing software to comply with this component. Additionally, information is needed regarding the expected timeline for completion of this component in order to adequately assess the reasonableness of this.The lack of technical specifications regarding how the electronic submission will occur precludes an assessment of the impact this will have on systems management. The proposed rule suggests that data transmission can occur via XML without clearly defining the parameters of this. In fact, the proposed rule acknowledges that some states have encountered barriers in transferring data via XML. Without specific information regarding the electronic submission, the extent of the impact is not known. It is clear that this would be a substantial adjustment for most child welfare agencies and one that has not been thoroughly explored at the federal level.
[Expanding] Reporting Populations (§1355.41)
While the rule references the inclusion of several additional populations, the level of responsibility for child welfare agencies is vague and it is not clear how this additional data is to be collected. This lack of clarity makes it impossible to fully consider the potential ramifications for state child welfare programs. Our members have noted that this blurring of distinctions between several populations creates significant philosophical implications that extend well beyond the data collection process. While the most successful approach to achieving positive outcomes in safety, permanency, and well-being for children in the foster care system is through cooperation between agencies and services, it can’t be accomplished by merely shifting the burden to child welfare. Based on the populations identified in the proposed rule, the following comments and concerns have been raised.
The proposed rule describes a significant expansion of the reporting population, including the caveat that additional populations may be added at a later date. CWLA and member agencies are extremely concerned about the feasibility of accomplishing this. While we would like to collect greater detail on children in care we are concerned that we not convert AFCARS into, for example, a juvenile justice data collection system. The addition of the populations listed will pose considerable challenges and represent a major increase in the amount of data to be reported. Several elements of the proposal for the expansion of the reporting populations are well beyond the purview of the public child welfare agencies. These include juvenile justice youth in detention and other facilities (that are not IV-E eligible nor under the child welfare agency’s care), children in psychiatric in-patient settings who are not otherwise involved with the child welfare system, and children in post-adoption or guardianship placements.The inclusion of the juvenile justice and mental health populations represents a significant expansion of the targeted reporting population. Because these children and youth may not be receiving child welfare case management services currently, the scope and depth of services that are to be reported in order to comply with the proposed rule will be a significant additional burden. We believe that, in some cases, the child welfare system will have had no previous contact with a child/family (such as those families whose interface is through TANF or Medicaid systems). Expanding the service provision to include necessary elements such as case plan development, permanency plan development, and related case management will create significant additional burden on already overextended and often under-funded public child welfare systems. The quality of the service provision and the associated data will be compromised as a result.
The fact that the rule does not clearly define ‘care and responsibility’ is problematic for states. Our members have expressed concern that, depending on the specific population and the type of information to be collected, reporting on children and youth may present conflicts with or violations of Health Insurance Portability and Accountability Act (HIPAA) regulations. Particularly those children and youth involved in substance abuse treatment programs or mental health treatment programs would be covered under HIPAA guidelines. This potential conflict could place child welfare agencies in the untenable position of violating state and federal regulations or having penalties applied due to circumstances beyond the control of the child welfare agencies. The addition of post-adoption and subsidized guardianship populations not only increases the workload as previously discussed in our opening comments, but in many states and jurisdictions, conflicts with state statutes and/or privacy laws. The rule does not acknowledge or address this potential conflict. The ability of public child welfare systems to collect this information will be limited also by the fact that many families are likely to refuse to provide the needed information to case workers.
Access and Accountability
Additionally, we are concerned that the regulation is written to suggest that the child welfare agencies will be responsible for the reporting of populations under the jurisdiction of separate entities outside of child welfare. This will create a situation in which the child welfare agencies will be dependent on other organizations to proVide the necessary data and will be held accountable for the reporting, timeliness, and quality of this data.Finally, the necessity of providing information on these populations is of questionable value in terms of providing essential services to abused and neglected children or contributing significantly to the field in evaluating and improving upon existing service provision.
Data Reporting Requirements [Capturing Greater Detail] (§1355.42 & §1355.43)
Logistics – Level of Oversight
In reviewing the proposed requirements for reporting data, a number of changes are noted that suggest a fundamental shift in the level of involvement by ACF in states’ data collection process. While CWLA acknowledges the need for quality state and national level data regarding children involved in the foster care system, the inclusion of elements of data management appear to be beyond that necessary to ensure accurate and timely data is provided to ACF. For instance, the proposed rule includes the mandate that removal information be input within 15 days of removal (a change from the previous 45 day timeliness standard) and that states collect an automatically generated, non-modifiable transaction date. The 15 day data entry standard is completely untenable as is the 15 day submission requirement. This suggests a level of oversight by ACF that goes well beyond that necessary or helpful to states in structuring data collection systems and reporting data. States noted that there are likely to be situations for which it would be nearly impossible to meet this proposed deadline. An example of this would be in circumstances where children are removed within the one to two week time period immediately prior to the submission date. The result of the 15 day entry requirement would be effectively reduced to a few days if the data is to be input in time for error clean up and the submission deadline. The quality of the data submitted will be compromised as a result of the unrealistic deadlines placed upon child welfare agencies.
Several other aspects of the data to be reported were identified as problematic for child welfare agencies. The additional requirement of a family record number poses logistical as well as practical concerns in reporting and in data file management. As previously discussed, the proposed changes will require file structure revisions and a conceptually new file transmission system. The manner in which a ‘family’ will be defined is not articulated and states noted that there are differences in how this might be reported based on the individual jurisdictional definitions of a family. For instance, the reference figure to be used in creating a file number may be the mother, father, couple, or guardian, depending on the specific state definitions of a family, circumstances at removal, and the person from whom custody is taken. Families can and do change over time and a child could move from one family or part of a family to another; when that happens have we created a new family with a new identifier? Several additional questions arise from this including how ICPC cases will be handled, reporting for county based systems, movement of families between states, and family structure issues in cases of divorce or remarriage. Additionally, the technical aspects of maintaining separate child files and family files are not clearly described in the proposed rule. Clearly, the files to be provided to ACF will be increased in size exponentially.
Number of Data Elements
Of great concern is that the federal rule proposes significant changes to some data elements and an increase in the number of data elements. The current system includes fewer than 100 data elements while this rule would increase that number to over 300. This increase will require that caseworkers spend a great deal more time collecting and recording the information. Currently, caseworkers reportedly spend much of their time completing administrative tasks which limits the available time for direct contact with children and families. This proposed rule will greatly exacerbate this challenge by necessitating that caseworkers take a checklist approach to gathering information due to the sheer volume of data required.This is counterproductive for child welfare agencies that are struggling with the issue of maximizing the amount of face-to-face contact time available and necessary to provide quality case management services to children and families. The Children’s Bureau noted the importance of this element in the evaluation of the first round of Child and Family Service Reviews. In this analysis, it was found that there is a correlation between worker visits and several outcome measures for children in care. The proposed rule triples the number of elements to be reported and requires greater complexity in the reporting of many aspects of outcomes and placement history. Much of this burden will rest squarely on the shoulders of already overwhelmed caseworkers. The impact is likely to resonate throughout child welfare agencies that already struggle to hire, train, and retain dedicated caseworkers.
Specific Data Elements
Questions arise regarding the value of adding to AFCARS many of the proposed data elements. In several cases, the concerns center around the value added compared to the additional workload involved in reporting. Concerns noted are as follows.
Immunization information: caseworkers will often be dependent on the anecdotal information provided by parents or caregivers and tracking of this will be an on-going process,
Educational information: several states noted the challenges in that
this may not be documentable when children repeated grades prior to removal;
there may be different and more accurate data on educational well-being;
last grade completed would be of more value than repeated grades;
the grade level in school must be evaluated in the larger context of individual differences, the trauma associated with removal, and other aspects of child development,
Special Education eligibility: does not contribute to understanding child welfare outcomes and the interplay between disabilities and child abuse/neglect,
Home environment at time of removal: this is problematic with families experiencing the extreme dysfunction that leads to removal of children,
Marital status of biological parents at the time of birth of a child will be difficult to collect and is of questionable value to research on desired outcomes,
Language spoken in the home: identifying the preferred language in the home would be sufficient,
Language level: if this is to be a professional determination, it would be expensive and time-consuming,
Differentiating race categories may be a challenge in states with diverse populations: in some large states with significant Hispanic populations families may not choose between the categories listed and this could result in a large percentage of declined responses. There are questions about whether these “declines” will be counted as missing data or whether states who exceed the 10 percent “declines” will be penalized,
International adoptions: gathering background information would be nearly impossible when the state agency has had no prior involvement,
Differentiating between surrenders and relinquishments is not sufficiently defined in the proposed rule,
Family circumstances at initial permanency plan, twelve month review, and discharge is not useful information in case management and may be of poor quality,
Concurrent planning information would add little value in service delivery to the child welfare agencies,
Differentiating level of care (such as therapeutic/treatmenUregular foster care) may affect the quality of data; families who provide different levels of care to different children in their home may appear to be placement changes for individual children over time and/or may create challenges for reporting on siblings placed together under different levels of care,
Sibling groups may vary depending on the point in time the information is captured (such as is the case with the birth of additional children to a parent(s) or with the adoption of children),
Adoption of sibling groups would create reporting challenges when a family adopts one group and later adopts a second set of siblings or adopts sibling groups not biologically related to one another.
Many of the newly proposed data elements appear to add little to states’ ability to monitor and enhance services for children in care. In some cases, the proposed changes conflict with other reporting practices and requirements. For instance, the categories of alcohol abuse differ from data collected for NCANDS. Additional details such as new disability categories and level of language development create an additional workload burden with limited potential for improving services to children.Some of the proposed new data elements are routinely captured in case files which are reviewed in the course of conducting quality assurance activities and the CFSR process. The proposed rule suggests that the additional items are useful in tracking child well-being. CWLA asserts that some elements will have little or no value in tracking well-being. For instance, educational wellbeing may be more appropriately assessed with the reporting of grade level and changes in school placement which are unrelated to those ordinary circumstances experienced by children outside of the child welfare system. This may provide better information than the reporting on the number of times a grade was repeated. Useful information regarding this and other well-being items are more appropriately captured through case review and supervisory functions. CWLA again emphasizes that the reporting of many of these proposed items in AFCARS will not contribute meaningfully in improving outcomes for children and families. It will, in fact, take away from time available for caseworkers to provide the face-to-face contact with families that are vital to the provision of quality services. While CWLA acknowledges that, from a research standpoint, some of this information will be useful, it would be unjustifiably burdensome to caseworkers who often manage two to three times the number of cases dictated for best practices. The shift to longitudinal reporting in and of itself represents a significant improvement over current data collection efforts. CWLA strongly encourages ACF to limit changes to this component to maximize the value of the collected data while minimizing the additional burden to caseworkers and data managers.
Adoption Assistance & Guardianship subsidy data file elements (§1355.44)
CWLA has great concerns about the inclusion of this population in the reporting of AFCARS data. As previously mentioned, this creates a conflict with state statutes regarding sealed records for many of our members. This also represents a workload burden in that the child welfare agency often may not have on-going contact with these populations. The collection of this data will likely require significant casework time, at least initially, in order to gather the necessary information. In some cases, it may require reconstructing case information from closed files and/or interviewing families not currently under the jurisdiction of the agency in order to accurately report the AFCARS data. Because child welfare agencies will not have the authority to compel families to provide this information, data quality would be questionable.An additional issue is that the on-going collection of these data may require states continue to have involvement with children and families previously considered to have achieved permanency. This seems to contradict the current emphasis on permanency and minimizing the necessity for on-going intervention by public agencies. This signals a shift in philosophy regarding the provision of services to children in the foster care system. This shift from that of a child-centered approach to serving families to that of fiscal agent and management is contrary to what we believe is best practice in the field.CWLA again asserts that the collection and reporting of this information will be of limited value in improving outcomes for children and families. Given that there are national studies being conducted regarding the adoption process and permanency for children in care by various researching organizations (some of which are funded through other federal agencies), the inclusion of this will create an unnecessary burden on public child welfare agencies without contributing meaningful information to the field.CWLA supports the exclusion from penalties for adoption assistance and guardianship files. Further remarks on penalties are included in Section 6 of this document.
Out of home care data file elements [Improving Data Quality] (§1355.43) Compliance (§1355.45)
CWLA recognizes the value in ensuring that data submitted is accurate and timely. However, the proposal to exclude details regarding internal consistency checks to ‘provide maximum flexibility to change them as needed’ is not adequate to allow states the reasonable opportunity to comment on this issue. CWLA and its members request additional information be provided in order to respond.The proposed rule states that the data file must be in a format that meets ACF specifications. However, given that these specifications are not clearly articulated in the proposed rule, it is impossible to evaluate the ability of states to comply with this requirement. CWLA and its members request that additional information be provided in order to comment on this issue. The question of past improvement plans is not addressed in this proposed rule. CWLA requests more information on how these will be handled. Given the significant changes proposed, we believe that requiring continued efforts on past improvement plans will compromise or likely conflict with states’ efforts to comply with new standards. If states are to continue improvement activities currently underway, a plan that includes clearly established start and stop dates for improvement activities is requested.The proposed change in reporting requirements from within 45 days to 15 days is of concern to the states. It is unclear as to why ACF shortened this time period especially in light of the new requirements under the National Youth in Transition Database which sets a 45 day timeframe to submit data. Since nearly 200 additional data elements are proposed, the shortened time frame for reporting will add to the burden placed on front-line casework staff and could result in the submission of questionable information.
The proposed rule states that the Adoption Promotion Act of 2003 requires penalties for lack of compliance with the AFCARS standards. Given the vast changes proposed, many states will likely be impacted by this. We continue to have concerns that a penalty structure that removes funds from a system we believe to be under-funded will result in poorer outcomes for children and will undermine efforts to make improvements. The imposition of penalties will further diminish the ability of states to comply with the standards. Additionally, the proposed rule suggests that the penalties assessed will be similar regardless of the extent of error. For instance, jf a state submitted data with an error rate of 11% (1% over the allowable error rate), the penalty would be the same as if no data were submitted at all. In light of this and the vast number of changes proposed, ACF should carefully consider what changes are realistic as well as options that may be available to ensure that states have a reasonable opportunity to comply with the requirements.
A possible alternative is to gradually phase in various aspects of the new requirements. A delay or grace period in considering penalties will allow ACF and states to negotiate the challenges of implementing the changes. The proposed changes will involve a monumental cost burden to states making it particularly critical that they are afforded the opportunity to focus on these changes without the imposition of penalties.CWLA proposes an overall change in the way that penalties are assessed in the child welfare field. We advocate for a system that is modeled more on the approach of the United States Department of Agriculture (USDA) in its governance of the food stamp program. When penalties are assessed for errors, a process has been established that allows states to take those penalties assessed and to re-invest these penalties into making corrections in the system. We feel the current system is under-funded in a range of areas including prevention at the front end through foster care. Federal penalties that are assessed will not help address this shortfall. In addition, we propose as an alternative to penalties a system of enhanced matches or bonuses which would assist in the implementation of such significant changes.
Cost and Burden
While the vagueness of the rule makes it difficult to estimate the costs associated with the proposed rule, the states unanimously concurred that their level of effort is grossly underestimated in terms of time and dollars. The state of Montana has received an estimate for revising its reporting system from its vendor. Over 14,000 hours are estimated to be needed to complete the work. This translates to a full-time effort by 9-10 programmers for one year or 5 programmers for two years. The potential overlap with efforts to implement the National Youth in Transition Database, slated for completion in 2010, is unclear, given the absence of a proposed timeline.
CWLA wishes to once again thank ACF for its efforts towards enhancements in data collection, particularly as this proposed rule advances the nation closer toward collecting longitudinal data. We believe that the continuous improvement of AFCARs in a way that is both effective and attainable is of the utmost importance. As you move forward in this process, CWLA and its members look forward to working with you in a partnership that can achieve the improvements we all seek and that will ultimately improve the lives of children and families most directly affected by this system.