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Outcomes in the Long Run: Ingredients for Children’s Protection and Welfare Outcomes Programs (the good, the bad, and the ugly). John D. Fluke, Ph.D. Director Child Protection Research Center American Humane Association. The Second Canadian Roundtable on Child Welfare Outcomes
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Outcomes in the Long Run: Ingredients for Children’s Protection and Welfare Outcomes Programs (the good, the bad, and the ugly) John D. Fluke, Ph.D. Director Child Protection Research Center American Humane Association The Second Canadian Roundtable on Child Welfare Outcomes Center for Research on Children and Families, Centres of Excellence for Children’s Well-Being: Child Welfare, Montreal, Canada 8 – 9 October, 2009
Overview • Brief History of National US Data Collection • State and National Data • Outcome Policy and Trends: an Example • Building and Maintaining Infrastructure Sustainability/Overcoming Inertia • The Value of Data/Outcomes Systems
US National Child Maltreatment Data: Brief History and Context • Early Studies in the US • Incidents Extracted from Media Reports (1950s – 1970s) • National Reporting Study on Child Abuse and Neglect • 1976 – 1988 • Other Studies of Incidence • Strauss and Gelles • Finkelhor • Prevent Child Abuse America • Major US National Data Collection Activities • National Child Abuse and Neglect Data System (NCANDS) • 1988 -
US National Foster Care Data: Brief History and Context • Early program conducted by the American Public Human Services Association (then the American Public Welfare Association), Voluntary Cooperative Information System (VCIS) • Established 1982 • Aggregate data only • Chapin Hall Center for State Foster Care and Adoption Data (State Data Center) and the Multistate Foster Care Data Archive • Established circa 1989 (three states) • Case level multi-year longitudinal data • 20 States are now participating • Federal Adoption and Foster Care Analysis and Reporting System (AFCARS) • Regulations published in 1993 for mandatory reporting • First data collection 1995
Other Key US Data Prgrams • Other Major NationalData Collection and Analysis Programs • National Incidence Study (NIS) • Four Studies to Date (first released in 1980, most recent data to be released 2009?) • National Study of Child and Adolescent Well Being (NSCAW) • Two cohort cycles of data collection (1999 & 2008) • Multiple rounds of data collection up to a seven year follow-up • Chafee National Youth in Transition Database (NYTD) • Under development (final regulations published)
Key US Legislation • Adoption and Safe Families Act of 1997 P.L. 96-272 • First to Identify Safety, Permanency and Well Being as Outcomes of the US Child Welfare System • Basis for Outcomes Regulations and the Child and Family Services Review Process (CFSR) • State Automated Child Welfare Information System (SACWIS) • Enhanced funding available for state child welfare agencies enacted in 1993 under Title IV-E funding provisions • Originally 75% match by US govt., as of 1997 at 50% • Critical impetus for the feasibility of data collection (e.g., NCANDS, AFCARS) • Fostering Connections Act of 2008 • Improvements to kinship & subsidized guardianship regulation • Allows tribes direct access to Title IVE funding
State Data • Several States and Localities Have Strong Data Collection and Analysis Programs Coupled with Research Centers • Examples: • All Use Data for Program Management and Outcomes, but add contextualizing analysis
Outcome Policy and Trends: an Example National Child Abuse and Neglect Data System (NCANDS)
Scope, Goals and Purposes of the NCANDS Data Collection Program • Meets US legal requirements to collect child maltreatment data • Provides data that are critical to policymakers and administrators of CPS programs • Data are used to support a range of US initiatives, notably • ASFA Outcome Measures • Child and Family Services Review Process • Office of Management and Budget Program Assessment Rating Tool (PART) • Contribute to the understanding of child maltreatment and the impact of intervention policy
How Did NCANDS Get to the Current Stage? • Facilitators of Case Level Data Collection in the US • US Legislation • Related Programs • State Automated Child Welfare Information Systems (SACWIS) • Child and Family Service Review Process (CFSR) • System has evolved • Almost all States are Now Providing Case Level Data (48 in 2007) • Data are timely and available annually • Range of applications has expanded dramatically
NCANDS Characteristics/Features • Action (regulations, policy, programs) • Data collection program is authorized by US Office of Management and Budget (OMB) • Supports US HHS Children’s Bureau Child and Family Services Review Process (CSFR) • Support Children’s Bureau OMB Program Assessment Rating Tool (PART) measures • Evaluation • Contract is competitively bid by the US HHS Children’s Bureau • Feedback loop • Project convenes a State Advisory Group each year • Data program is reviewed for revision every three year by the US Office of Management and Budget (OMB)
NCANDS Data Collection and Analysis Methods • Longitudinal • Aggregate data since 1990; case level data since 1993. • Encrypted unique child and perpetrator identifiers. • Time Period • Data are collected annually • Mapping and Validation of Data • Data are mapped to national categories • Data are validated for coding, internal consistency, and analytical accuracy and comprehensiveness
NCANDS Data Collection and Analysis Methods • Measures of Maltreatment • Six major categories (Physical, neglect, medical neglect, sexual, emotional, other). • Analytic Environment • Comprehensive Data Quality Assessment Process • OLAP Reporting Tools • Specialty Ad-hoc Research and Analysis Capacity
Policy and Trends (Example) :Child and Family Service Review (CFSR) Maltreatment Recurrence • In August 2001, the US Children’s Bureau set the first national standard for recurrence : • A State meets the national standard if of all children who were victims of substantiated or indicated child abuse and/or neglect during the first 6 months of the period under review, 6.1 percent or fewer children had another substantiated or indicated report within 6 months.
Child and Family Service Review (CFSR) Maltreatment Recurrence (continued) • As of June 2006 the Standard was revised • Of all children who were victims of a substantiated or indicated maltreatment allegation during the first 6 months of FY 2004, what percent were not victims of another substantiated or indicated maltreatment allegation within the 6-months following that maltreatment incident? • National Standard Based on 45 States: 94.6% or higher
Survival Analysis Plot for 2002 CM Data:Recurrence During a 12 Month Period, Over 75% Recurred Within 6 Months (n = 210,641 – 26 States) EUROPEAN SEMINAR ON MONITORING SYSTEMS OF CHILD ABUSE
Policy and Trends :How is Outcome Data Translated Into Policy and Programs via Federal Standards? The Child and Family Service Review • In addition to Indicators Based on Federal Data Collection Programs a Sample of Cases is Reviewed to Address Other Standards (30 to 50) • States not meeting standards must implement a 3 year Program Improvement Plan (PIP) approved by the US government • Plans address a range of programmatic and intervention strategies, for example: • Multiple maltreatment and chronic neglect • Alternative response systems • Safety and risk assessment systems • Required child and family visits for placed children • Large Investment in Federal Resource Centers to Assist States in Developing and Implementing PIPs • States not in compliance may be subject to penalties • After each three year cycle the US standards are reviewed and revised.
Considerations for Next Steps: In Search of the Magic Data Button It’s been more than 30 years, haven’t we finished that yet? Power to Change the World for Children and Families
Building and Maintaining Infrastructure Sustainability/Overcoming Inertia: • Stages or Transitions
Building and Maintaining Infrastructure Sustainability/Overcoming Inertia • Data Analysis/Utilization Stages or Transition
Explaining Removals at the Worker Level - - - - + AA Only + +
Building and Maintaining Infrastructure Sustainability/Overcoming Inertia • Infrastructure • Enabling Legislation and Regulatory Framework for Data • Strong Information Technology and Operational Systems Architecture • Key Analytic Design Components (e.g., OLAP capacity) • Data Quality Improvement Processes • Research/Evaluation Capacity • Mechanisms for insuring data integrity • Documentation
Building and Maintaining Infrastructure Sustainability/Overcoming Inertia • Sustainability • Recognition of Long-Term Benefits/Minimal Short Term Expectations • Long Term Funding • Data use agreements and confidentiality • Workforce • Dissemination • Archives • Reports and Publications • Technical Assistance
Building and Maintaining Infrastructure Sustainability/Overcoming Inertia “Total physical and mental inertia are highly agreeable, much more so than we allow ourselves to imagine.” – John Kenneth Galbraith • Inertia Avoidance • Key Issues:
The Value of Data/Outcomes Systems • Value of outcome data supporting policy: • Problem Recognition/Definition & some examples • Re-entry (rereporting, recurrence, recidivism, foster care reentry, disruptions, etc.) • Racial Disproportionality and Disparity • Standard Setting • Child and Family Services Review Standard Setting • Information System Guidelines (SACWIS) • Monitoring • Child and Family Services Review • Alternative Response Implementation
Current and timely policy support Data Turnaround Rapid data quality assessment Continuity Ability to monitor trends Outcomes and performance Research Longitudinal design Special populations Infrequent events Decision making Simulation Sampling frames Assess Resources Staffing Workload Costing/Cost Effectiveness The Value of Data/Outcomes Systems
Contact John D. Fluke Director Child Protection Research Center American Humane Association USA (303) 810 1934 johnf@americanhumane.org