Want to know more about
the Child and Family Services Reviews?
Well, you're in the right place!
The Child and Family Services Reviews,
also known as the CFSRs,
were established as a way of monitoring
state child welfare programs to meet federal requirements
and promote improved outcomes for children and families.
The CFSRs enable the Children's Bureau 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 in enhancing their capacity
to help children and families achieve positive outcomes.
History and Purpose of the CFSRs.
The CFSRs date back to 1994,
when amendments to the Social Security Act
that authorized the Children's Bureau to review
state child and family services programs became law.
In 1997,
the Adoption and Safe Families Act, or ASFA,
established safety,
permanency,
and well-being,
as the national outcomes for children
in the child welfare system.
Those outcomes serve as the framework of the CFSR
Onsite Review Instrument and Instructions, or OSRI,
which is used to conduct case reviews,
a major part of the review process
that we'll discuss in greater detail later.
From 2001 through 2004, all 50 states,
as well as the District of Columbia and Puerto Rico,
completed their first review cycle, or "Round."
Each review was structured to help states
identify strengths and areas needing improvement
within their agencies and programs
by measuring substantial conformity
across seven outcome areas
in the safety, permanency, and well-being domains.
For a state to be in substantial conformity
with a particular outcome,
90 percent of the cases reviewed had to be rated
as having substantially achieved that outcome.
The reviews also measured substantial conformity
across seven systemic factors:
(1) The statewide child welfare information system;
(2) The case review system;
(3) The quality assurance system;
(4) Staff and provider training;
(5) The service array and resource development;
(6) The agency's responsiveness to the community;
and (7) Foster and adoptive parent licensing,
recruitment, and retention.
The ultimate goal was to improve outcomes
for the children and families served.
At the conclusion of Round 1, no state was found to be
in substantial conformity in all of the areas reviewed.
As a result, each state developed and implemented
a Program Improvement Plan, or PIP,
to address those areas not found in substantial conformity.
The second round of reviews
took place from 2007 through 2010.
The Round 2 reviews assessed state performance
on the same outcomes and systemic factors as Round 1.
Once again, no state was found to be in substantial conformity
across all areas reviewed.
The Children's Bureau worked with the states
to consider past improvement efforts in developing new PIPs
that would continue the work of improving outcomes.
Round 3 started in 2015 and will run through 2018.
Outcomes and Systemic Factors.
In the Safety domain, there are two outcomes.
Safety Outcome 1 states that children are,
first and foremost, protected from abuse and neglect.
Safety Outcome 2 states that children are safely maintained
in their homes whenever possible and appropriate.
In the Permanency domain, there are also two outcomes.
Permanency Outcome 1 states that children have permanency
and stability in their living situations.
Permanency Outcome 2 states that the continuity
of family relationships and connections
is preserved for children.
Finally, in the Well-Being domain,
there are three outcomes.
Well-Being Outcome 1 states that families have
enhanced capacity to provide for their children's needs.
Well-Being Outcome 2 states that children receive
appropriate services to meet their educational needs.
Well-Being Outcome 3 states that children receive
adequate services to meet their physical
and mental health needs.
The review also determines whether a state
is in substantial conformity with federal requirements
for the seven systemic factors.
To recap, the systemic factors include:
(1) The statewide child welfare information system;
(2) The case review system;
(3) The quality assurance system;
(4) Staff and provider training;
(5) The service array and resource development;
(6) The agency's responsiveness to the community;
and (7) Foster and adoptive parent licensing,
recruitment, and retention.
The Review Process.
The CFSRs are a two-phase process:
A statewide assessment
followed by an onsite review of child and family services
outcomes and program systems.
This is followed by the state's development,
if necessary, of a PIP.
The statewide assessment is the state's evaluation
of its own performance on CFSR outcomes
and systemic factors.
It provides an opportunity for the state
to gather and analyze the qualitative
and quantitative data necessary
for evaluating its child welfare programs and practices.
The statewide assessment enables each state,
as well as its tribes, partners, and other stakeholders,
to identify the areas potentially needing improvement
early in the review process.
This can allow them to begin
developing their program improvement approach
even before the review takes place.
All of this provides states with the opportunity
to build or expand their capacity
for continuous quality improvement,
or CQI,
which is the process of using data
to continuously review performance
and then make whatever adjustments are necessary
to improve programs.
The Children's Bureau transmits to the state
the Statewide Assessment Instrument,
which includes the state's data profile,
at least six months before the onsite review phase.
The state then uses the Statewide Assessment Instrument
to document the most recent assessment information available
before its scheduled onsite review.
This information is used to:
(1) Assess the effect of state policies and practices
on the children and families
being served by the state child welfare agency;
(2) Identify the state's strengths
and areas needing improvement;
and (3) Identify areas that need further examination
through the onsite review.
The state submits the completed Statewide Assessment Instrument
to the Children's Bureau,
no later than two months before the start
of the onsite review period.
The Children's Bureau then uses the completed
statewide assessment to begin making decisions
about the state's substantial conformity
with the seven systemic factors.
This includes identifying areas that need additional examination
through stakeholder interviews, and
preparing for those interviews
by determining what questions should be asked.
It also includes identifying state practice
or performance issues that may require clarification
before or during the onsite review period.
After the statewide assessment,
a review team conducts the onsite review portion
of the CFSRs.
The reviewers use the OSRI to conduct reviews
of a sample of actual child welfare cases
on which the state child welfare agency worked
during a specific period of time,
known as the period under review, or PUR.
These case reviews also include case-related interviews
with children,
families,
caseworkers,
foster parents,
and service providers
involved in the cases in the sample.
These case-related interviews are a crucial component
of the case review process,
and information obtained from them
is considered equally alongside information
from the case record
in determining substantial conformity
with the seven outcomes.
While the case reviews are happening,
the review team also interviews key stakeholders
about the seven systemic factors.
These stakeholder interviews may include
representatives from Tribes,
courts,
community agencies,
foster families,
caseworkers,
service providers,
and parents and youth served by the agency.
The extent of these interviews varies
depending on the information obtained
from the statewide assessment.
Information obtained from these stakeholder interviews
is collected in another federal instrument,
known as the Stakeholder Interview Guide, or SIG,
and is used to inform the state's systemic factor ratings.
While every CFSR will include case reviews,
case-related interviews,
and stakeholder interviews,
states actually have two different review paths
to choose from.
In a Traditional Review,
the review team consists of both state and federal members
who review a total of 65 cases
at three locations in the state.
One of those locations will be the state's
major metropolitan area.
The other two locations are selected
in partnership with the Children's Bureau
using federal or state data to determine sites
that are representative of the state.
Traditional Reviews take place over one intensive week.
The other review path is called a State Conducted Case Review,
in which the state conducts its own case reviews
using its own state reviewers.
Also, instead of conducting those case reviews
within a 1-week time frame,
states are allowed up to six months
between April 1 and September 30,
to complete the review.
They are still required to review
a minimum of 65 cases during this time,
but they can choose to review more.
Although federal staff participate
in the state's case review process,
their role is focused more on oversight
and conducting the stakeholder interviews.
States who wish to conduct their own reviews
must receive approval from the Children's Bureau to do so.
If a state requests a State Conducted Case Review
but does not receive approval,
it must undergo a Traditional Review.
Following its review, each state receives a:
Final Report from the Children's Bureau
that documents whether it is in:
Substantial conformity with the seven outcomes
and seven systemic factors.
States determined not to have achieved substantial conformity
in all the areas assessed,
must address those areas by developing and implementing
a Program Improvement Plan.
Program Improvement Plan.
A PIP must be submitted to the Children's Bureau for approval
within 90 calendar days from the date
on which the state receives its written notification
that it is not in substantial conformity
with any one of the seven outcomes
or seven systemic factors.
If the Children's Bureau does not approve
the state's initial PIP submission,
the Children's Bureau will provide additional information
to help the state revise it.
The PIP's full implementation must be complete
no later than two years from the commencement date,
although not all components of a PIP
will necessarily require this much time.
Once the PIP is complete,
the state is ready for the next round of the CFSRs.
If the state is unable to demonstrate improvement
as outlined in the PIP,
the Administration for Children and Families
is required to assess a financial penalty,
which is taken from a portion of the state's
federal child welfare funds.
At its core, the CFSRs are designed to help states
enhance their own ability to monitor, self-evaluate,
and improve their practices and programs
through a CQI process.
The ultimate goal of the CFSRs
is to help states improve their child welfare services
and achieve safety,
permanency,
and well-being,
for all the children and families
served by the system.
This concludes our overview
of the Child and Family Services Reviews.
Thank you.