Purpose of the Reviews
The 1994 Amendments to the Social Security Act authorized the Department of Health and Human Services to review State child and family service programs in order to assure compliance with the State plan requirements in titles IV-B and IV-E of the Social Security Act. The reviews cover child protective services, foster care, adoption, family preservation, family support, and independent living. They 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.
The child and family service reviews are based on a set of central principles and concepts, including the following:
- The reviews emphasize accountability. The review process includes opportunities for States to make program improvements before having Federal funds withheld due to non-compliance, although there are significant penalties associated with the failure to make the improvements needed to attain compliance.
- The reviews are conducted in collaboration between the State and Federal governments. A review team composed of both State and Federal staff conducts the reviews and evaluates State performance.
- The reviews rely on information from multiple sources in making decisions about a State's performance, including a statewide assessment, onsite reviews of a sample of children and families served by the State, statewide aggregate data, and interviews with State and community representatives.
- The reviews examine State programs from two perspectives: the outcomes of services provided to children and families served by the State agency, and systemic factors that affect the agency's ability to help children and families achieve positive outcomes.
- The reviews identify both the strengths and needs of State programs with a strong emphasis on using the reviews to drive program improvements.
- The reviews promote practice principles that support improved outcomes for children and families, such as family-centered practice, community-based services, strengthening parental capacity to protect and provide for their children, and individualizing services that respond to the unique needs of children and families.
Structure of the Reviews
The reviews examine outcomes and systemic factors in each State's child and family service program, using a process that consists of two phases: the statewide assessment and the onsite review.
The statewide assessment is completed during the six-month period prior to the onsite review by a team of State agency staff and other State representatives who are not staff of the State agency. It includes an analysis of data indicators that address safety and permanency issues for children served by the agency, and helps to guide certain decisions about the onsite review, such as the locations in the State where onsite review activities will occur and the composition of the sample of cases to be reviewed onsite.
The onsite review is carried out by a team of State and Federal staff, State representatives who are not State agency staff, and expert peer reviewers. It consists of an intensive review of 65 cases per State, interviews with the parties to the cases reviewed, and other interviews with State and community representatives who inform the review team about the State's child and family services programs.
The reviews examine outcomes for children and families in three areas: safety, permanency, and child and family well-being. Within these three areas, seven outcomes are assessed through statewide data and reviews of cases, as follows:
Children are, first and foremost, protected from abuse and neglect. Children are safely maintained in their homes whenever possible and appropriate.
Children have permanency and stability in their living situations. The continuity of family relationships and connections is preserved for children
- Family & Child Well-Being
Families have enhanced capacity to provide for their children's needs. Children receive appropriate services to meet their educational needs.
The reviews also examine seven systemic factors that affect the quality of services delivered to children and families and the outcomes they experience. The statewide assessment includes the State's evaluation of Federal requirements related to each systemic factor. During the onsite review, selected State and community stakeholders are interviewed to determine how well each of the systemic factors functions in the State. The systemic factors are:
1. Statewide Information System
2. Service Array
3. Case Review System
4. Staff Training
5. Quality Assurance System
6. Agency Responsiveness to the Community
7. Foster & Adoptive Parent Licensing, Recruitment, & Retention
The Administration for Children and Families (ACF) makes a separate determination about the State's conformity with each of the seven outcomes and seven systemic factors following the onsite review, and confirms the determination of conformity to the State in a written report issued within 30 days of the onsite review.
Program Improvement Plans
For any of the outcomes or systemic factors in which the State is determined not to be in substantial conformity, the State must develop and implement a program improvement plan (PIP) designed to correct the area of non-conformity. The PIP must be developed and submitted to the Regional Office for approval within 90 days of the State receiving written notification of non-conformity. Penalties associated with non-conformity are suspended while the State implements the approved PIP, and are rescinded if the State is successful in ending the non-conformity through completion of the PIP.