Protecting Children from Abuse and Neglect: Trends and Issues

Protecting Children From Abuse And Neglect: Trends and Issues MAC TAylor • l e g i s l A T i v e A n A l y s T • AugusT 8, 2013 An LAO RepORt 2 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt CoNTeNTs Figure List .........................................................................................................................5-6 executive summary ............................................................................................................7 Introduction ........................................................................................................................9 Chapter 1: Child Abuse and Neglect—What It Is and How It Is Identified.....................11 Defining Child Maltreatment ...........................................................................................11 Reporting and Investigating Child Maltreatment ..........................................................11 Who Are the Victims and Perpetrators of Child Maltreatment? ....................................14 Risk Factors for Child Maltreatment ................................................................................14 Issues for Legislative Consideration ................................................................................16 Chapter 2: The CWs system..............................................................................................17 Responsibilities of Federal, state, and County Governments .......................................17 CWs Program Components ..............................................................................................18 Juvenile Dependency Courts— Determining Child Movement Through the CWs system ..............................................20 Various Pathways Through the CWs system ...................................................................20 Trends in Child Maltreatment Allegation, substantiation, and Foster Care entry Rates ..................................................................22 Chapter 3: Foster Care Caseload Trends and Demographics..........................................25 Foster Care Placements ....................................................................................................25 Foster Care Caseload Trends ............................................................................................29 Foster Children Demographics ........................................................................................32 Issues for Legislative Consideration ................................................................................34 www.lao.ca.gov Legislative Analyst’s Office 3 An LAO RepORt CoNTeNTs CoNTINUeD Chapter 4: Child Welfare Funding.....................................................................................37 Funding overview .............................................................................................................37 Federal Funding ................................................................................................................38 state and County Funding ................................................................................................39 Issues for Legislative Consideration ................................................................................40 Chapter 5: Child Welfare outcomes..................................................................................41 Performance evaluation in CWs ......................................................................................41 Federal Performance standards and evaluation ............................................................41 Comprehensive Analysis of CWs Performance Trends .............................................................................................46 Variation in County-Level outcomes ...............................................................................53 Issues for Legislative Consideration ................................................................................55 Glossary .............................................................................................................................58 4 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt FIGURe LIsT Chapter 1: Figure 1: Most Child Maltreatment Reports Come From Mandated Reporters ...........12 Figure 2: Child Maltreatment Reports by Case Disposition ...........................................13 Figure 3: Reported Versus substantiated Child Maltreatment by Maltreatment Type ....................................................................14 Figure 4: Victims and Perpetrators of Child Maltreatment ............................................15 Chapter 2: Figure 1: Average Monthly Caseloads by Program Component ...................................19 Figure 2: Juvenile Dependency Court Hearings .............................................................20 Figure 3: Pathways Through the Child Welfare services system ...................................21 Figure 4: Reduced Rates of substantiated Maltreatment in Ten Largest Counties ......22 Figure 5: Comparing County Reporting, substantiation, and Foster Care entry Rates ..................................................................24 Chapter 3: Figure 1: Monthly Foster Care Provider Rates ................................................................26 Figure 2: Group Home Beds by Rate Classification Level (RCL) .....................................27 Figure 3: Kin-GAP and Fed-GAP Caseload .......................................................................28 Figure 4: Placements as a Percentage of Total Foster Care Caseload ............................28 Figure 5: Percent of Foster Care Placements by Distance From Child’s Home .............29 Figure 6: Foster Children Placed With siblings by Placement Type ..............................30 Figure 7: Foster Care Caseload Has Declined significantly ............................................31 Figure 8: Foster Care entries by Maltreatment Type ......................................................31 Figure 9: Children exiting Foster Care by Reason for exit ..............................................32 Figure 10: Demographics of Foster Children ..................................................................33 Figure 11: substantiation and Foster Care entry Rates Vary by Race/ethnicity...........33 Chapter 4: Child Welfare Funding Figure 1: Child Welfare services (CWs) Funding in 2011-12 ..........................................37 Figure 2: 2011 Realignment Funding for CWs ................................................................40 www.lao.ca.gov Legislative Analyst’s Office 5 An LAO RepORt FIGURe LIsT CoNTINUeD Chapter 5:9 Text Box: Federal Child Welfare services outcome Measures .......................................42 Figure 1: Performance evaluation Through Federal and state Child and Family service Reviews (CFsR) .........................................43 Figure 2: state outcome Performance Relative to National standards ........................44 Figure 3: Children With subsequent Maltreatment Allegations ...................................47 Figure 4: Timeliness of Investigations and Monthly Home Visits ..................................47 Figure 5: Foster Children Reunified, Adopted, or in Guardianship by Time .................49 Figure 6: Median Time to Reunification ...........................................................................49 Figure 7: Number of Foster Care Placements Per Child ..................................................51 Figure 8: Foster Children Receiving Timely Medical/Dental exams ..............................52 Figure 9: exit outcomes for emancipated Foster Youth .................................................53 Figure 10: Reunification and Foster Care Reentry Rates Among Ten Largest Counties ...................................................................54 Text Box: suggested Indicators of Child Well Being ..................................................56-57 6 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt exeCUTIVe sUMMARY Protecting children from abuse and neglect changes in the CWS system—such as the is a critical and challenging responsibility of introduction of standardized and more robust government in California. Each day, county risk assessment tools—there are close to half the child welfare agencies investigate reports of child number of children in foster care today than there abuse and neglect and make decisions whether were in 2000. However, while foster care caseloads children will enter or exit foster care, the latter have fallen dramatically (generally considered a by reunification, adoption, or guardianship. positive trend), the CWS system still has many This report provides an overview of child abuse areas where it can improve upon child safety, and neglect in California and the Child Welfare permanency, and well-being outcomes—the three Services (CWS) system that was developed to domains of child welfare outcomes under law. address it. The report explains the federal, state, We raise the following issues (among others in and county government roles in the CWS system, the report) for the Legislature to consider. how the system is funded, and how foster care • Group Home Provider Rate Reform and providers are paid. The report also describes Accreditation. The Legislature could the trends and outcomes of children in foster consider (1) replacing the existing group care, and analyzes how child welfare outcomes home provider rate system (which is have changed over the last decade. The primary provider-focused) with one that better purpose of this report is to provide the reader links the individual needs of children with an overview of the trends and issues in child with the funds given to providers and welfare and an understanding of how children (2) requiring group homes to obtain fare in the CWS system. Through our analysis of national accreditation with the goal of child welfare trends and outcomes, we also raise improving group home quality standards. several issues for future legislative consideration that present opportunities to improve child • Incentivizing County Performance welfare outcomes. Through Realignment Growth Revenues. In general, child welfare outcomes have The Legislature could consider revising improved steadily over the last decade. As the allocation of realignment growth compared to earlier years, children spend revenues that support county child on average less time in foster care, are more welfare programs to provide incentives frequently reunified with their families, and for improved county performance in child have more permanency in their living situations. welfare. County child welfare agencies have also removed • Establishing Outcomes Evaluation of fewer children from their homes than in prior Foster Care Providers. The Legislature years, making greater use of community-based could consider creating capacity in the methods for addressing child abuse and neglect. child welfare information system for the In part due to several policy and operational collection and reporting of child welfare www.lao.ca.gov Legislative Analyst’s Office 7 An LAO RepORt outcomes at the foster care provider • Expanding Evaluation of Child level (beyond the current reporting of Well-Being Outcomes. The Legislature outcomes at the state and county levels). could consider expanding the collection This information would better inform the and reporting of data on how children fare CWS system on the relative performance in the CWS system in the areas of physical of providers and could be useful in and mental health and educational efforts to improve the quality of provider attainment. Currently, very few indicators services. of child well-being exist in the CWS system. 8 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt INTRoDUCTIoN Child abuse and neglect affects many of the This report is organized into five chapters, state’s children and can have lifelong consequences. each providing an overview of issues and most (In this report, we refer to child abuse and neglect raising issues for future legislative consideration. collectively as “child maltreatment.”) In 2012, there Chapter 1 defines child maltreatment and provides were reports of child maltreatment for over 487,000 background information on related trends. children in California. Of this total, county child Chapter 2 provides an overview of the CWS system welfare agencies substantiated cases for nearly and how the system interacts with children and 82,000 children. In that same year, about 60,000 their families. Chapter 3 provides information on children were in foster care and 109 children died foster care trends and demographics, details the last of suspected child maltreatment. decade’s trend of declining foster care caseloads, This report provides an overview of child explains where children are placed in foster maltreatment in California; how the Child care, and discusses issues related to foster care Welfare Services (CWS) system responds to child placements. Chapter 4 describes the federal, state, maltreatment; and the state’s trends, demographics, and county funding sources for the CWS system and outcomes for children in the CWS system. The and highlights recent major changes in the state- purpose of the report is to provide an overview of county fiscal relationship. Chapter 5 provides an issues related to child maltreatment and also raise overview of federal and state outcome measures for issues for the Legislature to consider for improving CWS and describes how the state’s CWS system has outcomes in the CWS system. performed in recent years. For reference, we have also included a glossary of commonly used terms at the end of the report. www.lao.ca.gov Legislative Analyst’s Office 9 An LAO RepORt 10 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt CHAPTeR 1 CHILD ABUse AND NeGLeCT— WHAT IT Is AND HoW IT Is IDeNTIFIeD DeFINING CHILD MALTReATMeNT State law defines three categories of child • Emotional abuse is unjustifiable mental abuse: physical abuse, sexual abuse, and emotional suffering inflicted upon a child that abuse. The law also defines child neglect as either endangers the child’s health and results “general” or “severe” neglect. The following in certain behavioral disorders such as is a description of the different types of child severe anxiety, depression, withdrawal, or maltreatment as defined in statute. aggressive behavior. • Physical abuse is willful bodily injury • General neglect is the failure of a parent or inflicted upon a child. caretaker to provide a child with adequate • Sexual abuse is victimization of a child food, clothing, shelter, medical care, or supervision. by sexual assault or exploitation. Sexual assault includes child molestation, • Severe neglect is negligent care by a parent fondling, rape, or incest. Sexual or caretaker of a child that results in a exploitation includes promoting, assisting, child’s medically diagnosed poor physical or coercing a minor to engage in obscene or emotional development. Severe neglect acts (such as prostitution or participating includes a parent’s or caretaker’s failure to in pornographic material). protect a child from severe malnutrition. RePoRTING AND INVesTIGATING CHILD MALTReATMeNT Reporting Comes From Mandated aware of in the course of their employment. The and Nonmandated Reporters list of mandated reporters has grown over time, and consists of a broad range of individuals State law requires individuals in certain that work with children, including: (1) school professions, called “mandated reporters,” to staff, (2) healthcare professionals, (3) clergy, report to law enforcement or county child welfare (4) certain public safety staff, (5) social workers, agencies (the latter hereafter referred to as “Child and (6) therapists. In addition to mandated Welfare Services [CWS] agencies”) suspected reporters, law enforcement and CWS agencies cases of child maltreatment that they become www.lao.ca.gov Legislative Analyst’s Office 11 An LAO RepORt receive reports of child maltreatment from child from the home. In addition to substantiated nonmandated reporters, such as family, friends, reports, state law and CWS practice also define and neighbors who have witnessed or have various types of unsubstantiated reports— knowledge of suspected child maltreatment. As “inconclusive,” “unfounded,” and “evaluated out” shown in Figure 1, the majority (72 percent) of reports. The following are descriptions of the child maltreatment reports come from mandated possible case dispositions following a report of reporters. child maltreatment. • Evaluated Out—based upon the Reports Are Investigated to information in the initial referral, the substantiate Allegations CWS agency determGinerda pthhati cn oS cihgilnd Off When a CWS agency receives a report of maltreatment (as defined in statute) has suspected child abuse or neglect (which is also Secretary occurred, and no further investigation called a “referral”), county CWS social workers Analyst is conducted. (This category of case investigate the report to determine if the alleged Director disposition is not defined in statute, but is child maltreatment is “substantiated” as defined Deputy used in practice.) in state law. Substantiated reports require further action by the CWS agency, and can result in either • Unfounded—the investigator determined the agency providing supportive services to the that the referral was false, improbable, child and family or, if there is imminent risk to or otherwise did not meet the statutory the child’s safety, the CWS agency removing the definition of child maltreatment. • Inconclusive— Figure 1 the investigator did Most Child Maltreatment not determine that Reports Come From Mandated Reportersa the alleged child 2012 maltreatment was Neighbor Family/Friend unfounded, but there was insufficient Child Welfare Staff Education evidence to substantiate the report. Reporter Type Medical • Substantiated— Nonmandated the investigator Mandated determined, based upon available evidence, that child Therapist Law maltreatment more Enforcement likely than not occurred. Other Mandated a Data exclude cases where reporter type is unknown. 12 Legislative Analyst’s Office www.lao.ca.gov ARTWORK#130195 An LAO RepORt Many Child Maltreatment Reports Certain categories of child maltreatment, such Are Not substantiated as sexual abuse or physical abuse, have lower substantiation rates than other types of child A relatively small percentage of child maltreatment, such as general neglect. As shown maltreatment reports (18 percent in 2011) are in Figure 3 (see next page), sexual and physical substantiated. For the last several years, CWS abuse accounts for 28 percent of all allegations agencies have determined that nearly half of all of child maltreatment, but only 14 percent of child maltreatment reports are unfounded, and substantiated cases. Conversely, general neglect nearly 20 percent of cases were evaluated out (the most frequent report of child maltrGeartampenht)i,c Sign Off without any formal CWS investigation. Since the accounts for 46 percent of all allegations while last decade, there has been a decline in the rate of Secretary accounting for 62 percent of substantiated cases. substantiated/inconclusive reports and an increase Analyst It is possible that the higher substantiation rate of in the rate of unfounded reports. Figure 2 shows Director general neglect is partially attributed to the fact the trends in CWS case disposition since 2000. Deputy that CWS agencies investigate all possible types Variation in Case substantiation of child maltreatment when visiting a family Rates by Child Maltreatment Type reported to the CWS system. In some cases, a CWS social worker may not find evidence of the The rate of child maltreatment cases that are reported category of child maltreatment, but may substantiated varies by type of maltreatment. find evidence of general neglect. Figure 2 Child Maltreatment Reports by Case Dispositiona Evaluated Outb Unfounded 600,000 Inconclusive Substantiated 500,000 400,000 300,000 200,000 100,000 2000 2002 2004 2006 2008 2010 2012 a Excludes cases where case disposition is not yet determined. b “Evaluated out” reports are cases that are determined not to be child maltreatment prior to a full investigation. www.lao.ca.gov Legislative Analyst’s Office 13 ARTWORK#130195 An LAO RepORt WHo ARe THe VICTIMs AND PeRPeTRAToRs oF CHILD MALTReATMeNT? Figure 4 displays a summary of the victims and vary significantly by race. African-American and perpetrators of substantiated child maltreatment Native American children are significantly more by demographic data and, for perpetrators, by likely to be reported as victims of child maltreatment relationship to the child victim. Close to half of all than White or Asian/Pacific Islander children (as victims reported for child maltreatment are five compared to their respective proportion of the total years old or younger. Two-thirds of perpetrators state population). While White children have an are between the ages of 20 and 39, and most average (substantiated) child maltreatment victim perpetrators (89 percent) are the child’s parent. Child rate of 7.4 per 1,000 children in the population, maltreatment allegation and substantiation rates African-American children have a victim rate of 20.1 per 1,000 children. RIsK FACToRs FoR CHILD MALTReATMeNT Identifying risk factors for maltreatment is typically at greater risk of child maltreatment, and important because it helps policymakers and child certain risk factors predict a higher probability of welfare professionals direct resources for health and child maltreatment. human services programs that prevent or reduce Parent Risk Factors. Researchers have found the risk of child maltreatment (such as for substance that children of parents with substance abuse abuse treatment or counseling) towards the most problems, mental health disorders, and low at-risk families. Researchers have identified many educational attainment have a higher risk of child parent, child, and family risk factors that increase maltreatment. Additionally, children of young the likelihood of child maltreatment in a family. parents or parents with a history of childhood Children in families with multiple risk factors are abuse have been shown to have increased risk of child maltreatment. Some Figure 3 parent risk factors can reported versus substantiated Child be addressed through Maltreatment by Maltreatment Type services such as substance abuse and mental health 2012 treatment. Parenting All Allegations substantiated Cases classes, particularly for Sexual abuse 9% 5% Physical abuse 19 9 young parents, can be Severe neglect 2 4 effective in addressing General neglect 46 62 some risk of child Emotional abuse 9 8 Caretaker absence/incapacity 2 5 maltreatment. As we Sibling abuseda 14 7 discuss in Chapter 2, a “Sibling abused” represents cases where a subject child’s sibling was allegedly or actually abused and these types of services are the subject is therefore potentially at risk for abuse. 14 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt typically used after a family has come in contact other social issues such as substance abuse or mental with the CWS system to prevent future child health disorders. maltreatment. Family Risk Factors. Researchers have shown Child Risk Factors. Researchers have shown that there are also family risk factors for child that young children (particularly infants), children maltreatment including families with: (1) single- with a low birth weight, and children with mental parent heads of household, (2) low socioeconomic or physical disabilities are at increased risk of child status, (3) domestic violence, and (4) multiple maltreatment. Children with these risk factors siblings. Families with these risk factors tend to typically require higher levels of parental care and have higher family stress levels that can affect a supervision, and are thus more vulnerable to child child’s safety and well-being. Some of these issues maltreatment in a family with high stress levels or can be addressed with services such as programs Figure 4 victims and Perpetrators of Child Maltreatmenta Federal Fiscal Year 2010-11 victims Perpetrators Percent of victim rate Percent of Total (Per 1,000 Children) Total Age Age Less than 1 13% 20.9 6 to 15 1% 1 to 5 32 10.1 16 to 19 4 6 to 10 25 7.9 20 to 29 34 11 to 14 18 7.0 30 to 39 34 15 to 17 12 5.7 40 to 49 18 statewide 100% 8.6 50 to 75 7 Unknown 2 100% gender gender Male 48% 8.2 Male 45% Female 52 9.1 Female 55 statewide 100% 8.6 statewide 100% race/ethnicity race/ethnicity Latino 54% 9.1 Latino 46% White 23 7.4 White 30 African-American 13 20.1 African-American 14 Asian/Pacific Islander 2 1.9 Asian/Pacific Islander 3 Native American 1 13.0 Native American 1 Other/unknown 7 — Other/unknown 7 statewide 100% 8.6 statewide 100% relationship to Child Parent b, c 89% Non-parent 11 statewide 100% a Data reflect substantiated cases. b Includes biological, adoptive, and step parents, but excludes foster parents. c Approximately three-fourths of all perpetrators of child maltreatment are biological parents. www.lao.ca.gov Legislative Analyst’s Office 15 An LAO RepORt providing aid to families living in poverty and families with these risk factors are already services for domestic violence treatment. Many receiving some of these services prior to CWS system contact. IssUes FoR LeGIsLATIVe CoNsIDeRATIoN Collection of Case-Level Data on system to evaluate what risk factors are most Maltreatment Risk Factors prevalent in the system and would provide insight into what services are most needed by children Extensive research has identified many parent, and families involved in the CWS system. This child, and family characteristics that increase the information could help guide the allocation of risk of child maltreatment. The state, however, resources in various health and human services does not collect and report data on risk factors programs in furtherance of a policy objective to present in CWS cases. The collection of data on reduce the risk of child maltreatment occurrences certain maltreatment risk factors—such as family in the state. Given the relatively simple technology poverty, substance abuse, mental health issues, and required to implement the data collection (through domestic violence—at the individual case-level CWS-CMS), and the fact that CWS agencies could be integrated in the state’s information already observe the information required to collect system for CWS case management, the CWS-Case the data, we believe the data collection would be a Management System (CWS-CMS), and used to relatively minor expense. Additionally, the existing evaluate CWS outcomes for children affected by CWS-CMS is in the process of being replaced and these risk factors. The data would allow the CWS the new system could potentially incorporate the additional data capacity at little additional expense. 16 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt CHAPTeR 2: THe CWs sYsTeM ResPoNsIBILITIes oF FeDeRAL, sTATe, AND CoUNTY GoVeRNMeNTs The Child Welfare Services (CWS) system works administered, California’s CWS program is state to protect children by investigating reports of child supervised and county administered. The Department maltreatment, removing children from unsafe homes, of Social Services (DSS) is the state agency responsible providing services to children and families to safely for oversight of the CWS program. The DSS develops reunify foster children with their families, and finding program and fiscal policies for CWS, provides safe placement options for children that cannot be technical assistance and training to counties, receives safely reunified with their families. The principal federal CWS funding and distributes these funds goals of the CWS system are to promote the safety, to the counties, monitors county CWS program permanency (in family placements), and well-being performance, and collaborates with counties to of children affected by child maltreatment. The establish program improvement goals. CWS system spans across federal, state, and county County Administration government agencies. Under the supervision of DSS, county welfare Federal Policy and oversight agencies provide the front-line administration of the The federal government enacts child welfare CWS program, including: (1) investigating reports laws and policies that require (or provide incentive of child maltreatment, (2) removing children from funding for) state compliance. As will be discussed unsafe homes, (3) finding placements for children in Chapter 5, the federal government evaluates each in foster care, (4) providing services to families for state’s CWS program outcomes based on several reunification, and (5) finding permanent adoptive performance measures. The federal government parents or guardians for children that cannot be safely also audits state spending of federal CWS funds, sets reunified with their families. In addition to county policy priorities and requirements for using federal welfare agencies, county probation agencies perform CWS funds, establishes program improvement goals case management (including family reunification for states that fail to reach federal performance targets, and placement services) for foster children who are and issues funding penalties for noncompliance with also involved in the juvenile justice system. The state federal policies and program performance targets. provides county CWS agencies with some flexibility in how they operate their local CWS program, and state Policy and oversight therefore there is some variation in administration The federal government gives states some and services offered among county CWS agencies. flexibility in how they operate their CWS programs. Unlike many state CWS programs which are state www.lao.ca.gov Legislative Analyst’s Office 17 An LAO RepORt Juvenile Dependency Court decisions for children involved in the CWS system. Juvenile dependency courts hold a series In addition to county CWS agencies, juvenile of hearings (described later in the chapter) that dependency courts (a division within each county’s determine how a child moves through the CWS superior court) have jurisdiction over the removal, system. foster care placement, and permanent placement CWs PRoGRAM CoMPoNeNTs The CWS agencies serve children in the CWS home. The CWS agencies provide FM system when they are the subject of a maltreatment services following a maltreatment report report and when children are placed in foster care. when there is concern about potential The CWS system serves these children through future harm to the child, but the county four main program components. Depending on a believes that the child can safely remain child’s or family’s situation, the CWS system may in his or her home with supportive serve abused or neglected children in some or all of services. Examples of FM services include these four program components. counseling, parent training, temporary daycare, and mental health or substance • Emergency Response (ER) is the initial abuse treatment. contact component of the program. County social workers receive reports of • Family Reunification (FR) provides child maltreatment through a reporting time-limited support services to the family, “hotline” and determine if an in-person while the child is in temporary foster investigation is necessary. For cases care, with the goal of safely reunifying the requiring an in-person investigation, child and family. Examples of FR services social workers visit the subject child and include counseling, parent training, family and make a determination if the and mental health or substance abuse child should be removed from the home, treatment. State policy is to return children if voluntary supportive services should to their families whenever safe and be provided, or if the case should be possible, and FR services are designed to closed without further action. In other address family issues that led to the child’s cases, the initial assessment determines removal and provide an opportunity for that no investigation is necessary, most the child’s safe return home. often because the reported maltreatment did not meet the statutory definition of • Permanent Placement (PP) provides maltreatment. The CWS agencies refer to case management and placement services these cases as being “evaluated out.” to foster children who cannot be safely reunified with their families. Placement • Family Maintenance (FM) provides services include facilitating a child’s time-limited support services to children adoption, guardianship, or, in some cases, and families to prevent child maltreatment long-term foster care placement. When while allowing the child to remain in the a child cannot be safely reunified with 18 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt their family, state policy is to provide a caseloads, cases that were evaluated out increased child with a permanent adoptive parent by nearly 50 percent from 2002-03 to 2011-12. or guardian as soon as possible (with (These cases are a subset of the ER component.) placement preference with other members This increase largely reflects the CWS system’s of the child’s family). implementation of standardized risk-assessment tools that have been used to screen out a higher Declining overall CWs Caseloads, percentage of reports prior to investigation. These especially in PP Program Component risk-assessment tools measure risk to the child based upon the information provided in a child Total CWS caseloads have declined over the last maltreatment report, and evaluate whether an decade, but have leveled off in recent years. As will Graphic Sign Off investigation is necessary. In many cases, CWS be discussed in Chapter 3, CWS caseload declines agencies receive reports of activities thatS eiethcerre tary are primarily the result of children spending less do not meet the definition of child maltreatment time in foster care and more children exiting Analyst or the reports contain insufficient information to than entering foster care each year. As shown in Director conduct an investigation. In recent years, nearly a Figure 1, the largest decrease in CWS caseloads Deputy third of new CWS cases have been closed without over the last decade occurred in the PP program any in-person investigation, and the bulk of the component. From 2002-03 to 2011-12, PP caseloads remaining new cases have been closed shortly after declined by 54 percent. investigation (or after the provision of short-term Most CWS Cases Are Closed Shortly After services to the child and family). Initial Evaluation. In contrast to declining overall Figure 1 Average Monthly Caseloads by Program Component Permanent Placement Family Reunification 200,000 Family Maintenance Emergency Response 180,000 160,000 140,000 120,000 100,000 80,000 60,000 40,000 20,000 2002-03 2004-05 2006-07 2008-09 2010-11 www.lao.ca.gov Legislative Analyst’s Office 19 ARTWORK#130195 An LAO RepORt JUVeNILe DePeNDeNCY CoURTs—DeTeRMINING CHILD MoVeMeNT THRoUGH THe CWs sYsTeM Juvenile dependency courts have jurisdiction services children and families receive, (4) where over children in the CWS system and make the children in foster care are placed, (5) when or if final decision for how these children are cared for parental rights are terminated, and (6) permanent in foster care. Through case review and a series placement plans for foster children where of hearings, juvenile dependency courts decide: reunification is not possible. Figure 2 describes the (1) if child maltreatment occurred as alleged by the major hearings held in juvenGilrea dpepheincd eSnicgy nco uOrtfsf county welfare agencies, (2) if children removed and how they affect a child’s movement through Secretary from their home due to maltreatment should be the CWS system. Analyst returned home or remain in foster care, (3) what Director Deputy VARIoUs PATHWAYs THRoUGH THe CWs sYsTeM Children involved in the CWS system move child maltreatment report in different ways. Some through different stages of the system depending cases require an in-person investigation, while on the circumstances of their case. As illustrated others do not based upon the information in the in Figure 3, the CWS system responds to each maltreatment report. Some children are removed from their home based Figure 2 on imminent harm to the Juvenile Dependency Court Hearings child’s safety, while other children remain in their Dependency Petition and Detention Hearing home (potentially with Child Welfare Services agency files a petition with the court when removing a child from his or her home, and a hearing is held to referrals to services that approve the child's temporary home removal. help the child remain in Jurisdictional Hearings the home). Each CWS Determine whether or not child maltreatment has occurred and whether or not the child will come under the court’s case is different, and jurisdiction. the ability of a parent to Dispositional Hearings maintain custody of their Held when the court has determined child maltreatment has occurred. The court orders Family Maintenance (FM) or Family child depends upon the Reunification (FR) services to address the child and family’s needs and decides who will care for the child. CWS system’s assessment of future risk to the Review Hearings Held every six months to review the parents’ progress with FM child in the home and or FR services and how the child is faring in foster care. The child could be ordered to return home at this stage or continue the ability of parents to in foster care. address issues resulting in Permanency Planning Hearings child maltreatment. Held to review if a child can be safely returned home, or if FR services should be terminated and a permanent placement plan (such as adoption/guardianship) established. ARTWORK#130195 20 Legislative Analyst’s Office www.lao.ca.gov Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt Figure 3 Pathways Through the Child Welfare Services System Report of Child Maltreatment Case Closed Initial Screening NO Investigation Required? YES Emergency Response (Investigation) Child Maltreatment NO Substantiated? YES CChhiilldd RReemmoovveedd?? YES NO Child Placed in Foster Care Family Maintenance Family Reunification Services Services YES Services Successful? NO Child Returns Home YES Services Successful? NO Long-Term Adoption or Guardianship YES Foster Care ARTWORK#130195 www.lao.ca.gov Legislative Analyst’s Office 21 An LAO RepORt TReNDs IN CHILD MALTReATMeNT ALLeGATIoN, sUBsTANTIATIoN, AND FosTeR CARe eNTRY RATes The rate of child maltreatment allegations in (Below, we provide further detail on what is driving the state has changed very little in the last several the downward trend in substantiation and foster years. From 2002 to 2012, there was an average care entry rates.) As shown in Figure 4, there is also of 51 child maltreatment allegations per 1,000 large variation in the decline in substantiated case children in the population. However, during this rates by county. Many of the state’s largest counties same time period, the rate of child maltreatment have reduced the rate of cases they substantiate by reports substantiated by the CWS system declined over 40 percent over a ten-year period since 2002. Graphic Sign Off significantly (27 percent) and the rate of children Multiple Causes of ReduceSde scurbestatarnytiation entering foster care declined by 13 percent. and Foster Care entry RateAsnalyst The relatively consistent rate of maltreatment allegations in recent years indicate a consistent rate Some information appeaDrsi rtoe cintodricate that in the “perception” of child maltreatment among the cause of lower substantiaDtede pcaustey rates is individuals reporting maltreatment. However, the result of certain changes made by the CWS the significant decline in substantiated child system in how it responds to child maltreatment maltreatment and decline in foster care entry rates allegations. During the last decade, CWS agencies are in part the products of changes in how the have implemented several practice changes, such CWS system has responded to child maltreatment. as using risk assessment tools during ER and adopting community- based service responses Figure 4 to reports of child Reduced Rates of Substantiated Maltreatment in Ten Largest Counties maltreatment (in lieu of a CWS response that could substantiate 60% 2002 maltreatment). 2012 Additionally, in 50 response to the 2007 40 legal settlement in Gomez v. Saenz, which 30 related to due process in CWS investigations, 20 CWS agency staff have taken training and have 10 updated investigation protocols that may have lowered the rate of California Alameda Contra Fresno Los Orange RiversideSacramento San San Santa Costa Angeles Bernardino Diego Clara substantiated cases. Also, Chapter 842, Statutes ARTWORK#130195 22 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt of 2004 (SB 1313, Kuehl), raised the evidentiary effect the CWS system’s greater focus on family threshold for substantiating child maltreatment preservation has had on families reported for from “credible evidence” to a “preponderance of child maltreatment, and whether child safety has evidence” that maltreatment occurred. been affected by the new investigation practices. The direct cause(s) of reduced rates of foster The data appear to suggest that in the past the care entries is somewhat less clear than the CWS system may have substantiated too many explanations for reduced substantiation rates. cases and placed too many children in foster care. However, certain practices implemented in the Therefore, the current system trends may reflect a CWS system in recent years, such as standardized more appropriate level of CWS system response to risk assessment tools, may have reduced the reports of maltreatment. number of children that CWS agencies placed in County Variation foster care. Additionally, since CWS agencies have to substantiate child maltreatment prior to placing There is significant variation in child children in foster care, the overall effect of lower maltreatment allegation, substantiation, and substantiation rates may also have led to lower foster care entry rates among the counties at foster care entry rates. any point in time. Various factors, including the The recent changes in how the CWS system prevalence of child maltreatment risk factors in a responds to allegations of child maltreatment have county population (such as poverty and substance not only lowered the substantiation and foster care abuse) and county administrative practices and entry rates, but have in effect more broadly resulted policies can affect how often children are abused in a system that more significantly emphasizes or neglected in a particular county and how family preservation (in addition to safety) as a often counties bring children into foster care. For goal during investigations. It is unclear what illustrative purposes, we display the variation in county rates for 2012 in Figure 5 (see next page). www.lao.ca.gov Legislative Analyst’s Office 23 Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt Figure 5 Comparing County Reporting, Substantiation, and Foster Care Entry Ratesa Per 1,000 Children, 2012 Reporting Rates Substantiation Rates Foster Care Entry Rates Greater Than 76 Greater Than 11 Greater Than 5 51 to 76 Between 7 to 11 Between 3 to 5 Less Than 51 Less Than 7 Less Than 3 Statewide - 53 Statewide - 8.9 Statewide - 3.3 a The rate bands reflect the top, middle, and bottom percentile rankings (in equally divided thirds). ARTWORK #130195 24 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt CHAPTeR 3: FosTeR CARe CAseLoAD TReNDs AND DeMoGRAPHICs FosTeR CARe PLACeMeNTs When children are removed from their home In order of the state’s placement priority, due to maltreatment, Child Welfare Services (CWS) the following are the most common foster care agencies place these children in one of several placement types. types of foster care “placements.” State law requires • Kinship care refers to when a foster child CWS agencies to place foster children in the least is placed with a relative for care and restrictive, most family-like setting possible (thus supervision. Kinship care is preferred over avoiding institutional/group care settings when other foster care placement types. possible). State law also requires CWS agencies to place foster children as close as possible to the • Foster Family Homes (FFHs) are county home from which they were removed to facilitate licensed foster homes where foster parents reunification with their parents and maintain provide care and supervision for foster the children within their community and school. children in their home. State law further requires CWS agencies to • Foster Family Agencies (FFAs) recruit give placement preference to relative caretakers foster parents to provide care and (including a noncustodial parent) and to place supervision of foster children in the siblings together when possible. parents’ home. The FFAs are licensed by the Given the sometimes conflicting priorities county (or state) and certify foster parents of placing foster children and the availability of to operate an FFA home. These homes foster care placements in any given community, were designed as a placement option for it is difficult to find an appropriate foster care foster children with elevated needs relative placement for every child that meets all placement to those placed in FFHs. These children priorities. As an example, while state policy is would otherwise be at-risk for group home to place foster children with relatives, a relative placement. The FFAs provide more services caretaker may not be within the immediate area to the foster parents and more frequent of the home from which the child was removed. In home visits than counties provide to FFHs. this case, county social workers have to balance the benefits of placing a child with a relative caregiver • Group homes provide 24-hour care, against the ability of the child to reunify with their supervision, and services to foster children parent(s) over a longer placement distance and with significant emotional or behavioral the benefits of maintaining the child in his or her problems that require a more restrictive community and school. environment than a foster home. Group www.lao.ca.gov Legislative Analyst’s Office 25 An LAO RepORt homes vary in size, services provided, and social work costs that are in addition to the care level of supervision provided by group and supervision payment made to parents in FFA home staff. Group homes are the most homes. Figure 1 displays an overview of foster care restrictive placement type (excluding foster provider rates. children supervised by probation agencies). Group Home Rate structure As of January 2013, there were 61,000 children Group home rates—due to the level of care, in foster care. Of the total, one-third were placed in supervision, and social work activities required for kinship care and one-fourth were placed with FFA children with serious emotional and behavioral homes. About 10 percent of children were placed issues—are significantly higher than other foster each with group homes and FFHs. The remaining care provider rates. As displayed in Figure 1, there children were placed in various other placement is a wide range of group home provider rates, which types (such as supervised independent living and is a product of the state’s complex rate classification certain legal guardian placements). level (RCL) system for reimbursing group home Payments to Foster providers. Implemented beginning in 1991, the Care Providers RCL system established a monthly per child rate for each group home provider based upon a 14-level Foster care providers receive monthly payment scale. Higher-level RCL providers receive payments (per child) for the care and supervision higher reimbursement rates. To determine which of children. These rates vary by placement type and level of payment a group home provider receives, supplemental payments are available for certain DSS uses a complicated scoring system that children with special needs. State law establishes calculates the number of staff hours that group parameters for how the Department of Social home providers propose to provide to children Services (DSS) sets rates for foster care providers. placed in their facility. Group home providers Due to provider-initiated lawsuits, foster care receive additional “points” for staff with higher provider rates are adjusted for inflation each year levels of experience and education. Group home based upon the California Necessities Index. providers receive a provisional rate initially and are Providers in foster homes and kinship care audited periodically to determine if they meet the homes receive roughly equivalent monthly requirements of their RCL. payments for care and supervision. The FFAs Since group home providers are given a receive a payment for their administration and monthly per child rate (based upon their RCL), they receive the same Figure 1 monthly payment for each Monthly Foster Care Provider Rates child they have in their Rate Per Child, by Placement Type, 2012-13 facility, without regard to Kinship differences in child needs. Rate Type Carea,b FFHa FFAa Group Home (There is an exception Care/supervision rate $640 - $799 $640 - $799 $829 - $988 $2,223 - $9,419 for RCL 13 and 14 group Administration/social work rate — — 868 - 968 — homes, which can only a Excludes supplemental care payments available for eligible children. b take seriously emotionally Kin caregivers for children who are ineligible for federal foster care funding receive a lower payment of $345 per month, per child. FFH = Foster Family Home and FFA = Foster Family Agency. disturbed [SED] children.) 26 Legislative Analyst’s Office www.lao.ca.gov Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt Given the relatively high proportion of Figure 2 fixed costs in group homes (particularly Group Home Beds by with small providers), group home Rate Classification Level (RCL) providers have a strong financial incentive 2012-13 to maintain high occupancy levels. Over RCL-10 time, there has been a general shift from smaller providers to larger ones, many of which operate several group homes across the state. RCL-11 Consolidation of Group Home Providers at Higher End of RCL System. RCL-12 As shown in Figure 2, very few group home “beds” are operated by lower- RCL-14 level RCL providers. For 2012-13, out of nearly 8,000 total group home beds, RCL-9 only 6 percent were with RCL-1 to RCL-8 providers. The largest amount of group RCL-1 to RCL-8 home beds (54 percent) was with RCL-12 providers. In general, a very large portion (Kin-GAP) created in 2000. The Kin-GAP provides of the group home beds operated by group home a monthly payment to the caregiver, equal to the providers are classified at the higher end of the RCL FFH monthly rate, to support the child. When system. In fact, there are currently no group home children enter Kin-GAP, they exit foster care. beds operated by group homes at RCLs 1, 2, 3, 5, or In 2012, nearly 1,20A0R chTiWldrOenR eKxi#te1d3 f0o1st9er5 care 13. While there are over 700 group home beds that through Kin-GAP. In 2011, the federal government can serve SED children (that could be operated as began paying for a portion of newly eligible either RCL 13 or 14), all of them are operated by Kin-GAP cases under the Federal Guardianship RCL-14 group home providers. Assistance Program. As shown in Figure 3 (see Foster Children Are often next page), the Kin-GAP caseload peaked at about Placed With Relative Caregivers 14,700 cases in 2004-05 and has since declined to just over 13,000 cases. Kinship care has consistently been the most frequently used foster care placement type in Growth in FFA Placements recent years, which aligns with state policy to place The second most frequent placement for foster children with relatives when possible. As of January children after kinship care is in FFA homes, which 2013, nearly 35 percent of foster children were have increased as a percentage of all placements placed with relative caregivers. over the last decade. This increase appears to be Subsidized Relative Guardianships. In largely attributed to the shortage of county licensed addition to kinship care placements, relative FFHs (which have declined as a percentage of all caregivers are encouraged to become legal placements in recent years) and CWS agencies guardians for their relatives in foster care through using FFA homes as a substitute for FFHs. Figure 4 the Kinship Guardianship Assistance Program (see next page) shows the decline in the rate of www.lao.ca.gov Legislative Analyst’s Office 27 Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt FFH placements and Figure 3 the increase in FFA Kin-GAP and Fed-GAP Caseload placements over time. The FFAs were originally 16,000 Kin-GAP Fed-GAPa designed to provide 14,000 foster homes for children with elevated service 12,000 needs as an alternative to 10,000 group home placements. Graphic Sign Off While it appears many 8,000 hSigehecrr enetaedrys children arAen palalcyesdt with FFAs, 6,000 CDWirSe acgteonrcies have also 4,000 pDlaceepdu cthyildren without higher service needs in 2,000 FFA homes. Varied 2000-01 2002-03 2004-05 2006-07 2008-09 2010-11 2012-13 Placement a Portion of Kin-GAP population receiving federal assistance. Distances in KIN-GAP = Kinship Guardianship Assistance Program and Fed-GAP = Federal Guardianship Assistance Program. Foster Care Figure 4 Due to the care, ARTWORK#130195 Placements as a Percentage of Total Foster Care Caseloada supervision, and services (such as Kinship Care counseling services) Foster Family Agency needed by foster Group Home/Shelter 40% Foster Family Home children in a placement; the availability of placements that meet 30 these needs; and the location of relative caregivers, children 20 are not always placed within their immediate 10 community. However, long distances between a child’s foster care placement and his or her 2001 2003 2005 2007 2009 2011 2013 family’s home makes a Data as of January 1 in the years displayed. family reunification more difficult, disrupts a ARTWORK#130195 28 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt child’s education when moving between schools, and placement. However, given the challenges of finding removes a child from community and supportive appropriate placements for all foster children, and family resources. the variation in child service needs, many siblings in In January 2013, 82 percent of foster children foster care live apart from each other. As displayed overall were placed within their home county. Due in Figure 6 (see next page), the rate at which foster to child-specific treatment needs and provider children are placed with their siblings varies availability, however, only 68 percent of foster significantly by placement type. In total, 54 percent children placed in group homes were placed in their of children in foster care are placed with all of home county. Figure 5 provides information on the their siblings and 74 percent are placed with either distances between where foster children are placed some or all of their siblings (excluding probation- and the homes from which they were removed. supervised cases). Sibling placement rates are highest in kinship care, which demonstrates one of sibling Placements the benefits of kinship care as a priority placement in Foster Care option. The FFA and FFH placements have similar State law requires the CWS system to help sibling placement rates (particularly for all sibGlinrgasp hic Sign Off children maintain family connections (including being placed together), with somewhat higher Secretary those with siblings) while in foster care in support sibling placement rates in FFAs. Group homes, Analyst of child well-being. When possible, the CWS system because of their nature of providing specialized care Director attempts to place siblings in the same foster care for children with serious emotional or behavioral issues, have very low sibling placement rates. Deputy FosTeR CARe CAseLoAD TReNDs In 1999, there were approximately 117,000 care caseload may have ended and that caseloads children in foster care. By 2012, the number of have stabilized. In fact, the foster care caseload foster children declined almost Figure 5 by half—to Percent of Foster Care Placements by Distance From Child’s Homea approximately 2011 60,000. (Figure 7 on page 31 displays the foster care caseload and the entry/exit <1 Mile: 19% trends over time.) 1-5 Miles: 30% Based upon the 6-10 Miles: 14% latest caseload 11+ Miles: 37% information, it appears that the consistent decline a Data are for foster children in 2011 who were on their first removal and remained in foster care after 12 months of removal. Percentages displayed are based on the cases where placement distance was known. in the foster www.lao.ca.gov Legislative Analyst’s Office 29 ARTWORK#130195 An LAO RepORt increased by about 1,800 children (3 percent) in results in lower foster care entries. In addition to January 2013 from the same time period a year these practice reforms and changes in law that have earlier. led to lower maltreatment substantiation rates, CWS agencies have made greater use of family Multiple Factors Related to preservation services (both CWS agency and Foster Care Caseload Reduction community-based services) when maltreatment Part of the explanation of the substantial cases are substantiated. TheG CrWaSp ahgiecn cSieisg hnav eO ff reduction in foster care caseloads is attributed to used these family preservation services to address Secretary the state’s 2000 creation of Kin-GAP, which moved child safety without removing children from their Analyst children out of the foster care system and into homes in lower-risk cases. The CWS system has Director permanent relative guardianships. Also during the also reduced the amount of time children spend in Deputy last decade, CWS agencies enacted a number of foster care waiting for adoptions and reunification, practice and program changes that have reduced the and has overall reduced the average amount of time number of children that enter foster care and the children spend in foster care. amount of time children spend in care. For example, Foster Care entry the previous chapter discussed some of the reasons and exit Trends why the CWS system has been substantiating lower rates of child maltreatment—a practice that Neglect Is the Most Figure 6 Common Reason for Foster Children Placed With Siblings by Placement Typea Foster Care entry January 2013 As shown in Figure 8, three-fourths of the 90% Some or All Siblings Placed Together children who entered foster All Siblings Placed Together 80 care in 2012 were removed from their family home due 70 to neglect. Child neglect has been the most frequent 60 reason for child entry into 50 foster care for many years, and has steadily increased 40 as a percentage of total 30 foster care entries since 2000. Children entering 20 foster care due to neglect are less likely to reunify 10 with their families than children entering foster All Placements Kinship Care Foster Foster Group Homes Family Family care due to certain types Home Agency of abuse. This finding a Data exclude probation-supervised cases. may reflect what can be 30 Legislative Analyst’s OAffiRceT W wOwRwK.l#ao1.3c0a.1g9o5v Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt the persisting nature of neglect (especially Figure 7 as it relates to poverty Foster Care Caseload Has Declined Significantlya and substance abuse). In contrast, incidents 140,000 of abuse can be more Foster Care Caseload one-time in nature or can 120,000 Exits Entries be mitigated by removing 100,000 the abusive adult from the child’s household. 80,000 exits From Foster Care 60,000 Figure 9 (see next Graphic Sign Off page) displays the 40,000 Secretary proportions of children who exit foster care Analyst 20,000 by reason for exit. The Director majority (60 percent) of Deputy children who exit foster 1999 2001 2003 2005 2007 2009 2011 care do so by reunifying a Caseload data are point in time as of January 1 for the year specified. Entry/exit data reflect the total number of entries/exits in the year specified. with their parent(s). After reunification, adoption is the next most frequent reason for a child’s exit from ARTWORK#130195 foster care and accounts for 18 percent of foster care exits. A number of children, Figure 8 approximately 2,700 in 2012, exit foster Foster Care Entries by Maltreatment Type care without reunification, adoption, or guardianship. These children are the ones 2012 Other who “emancipate” from the system without any permanent placement. Foster youth Physical emancipate from the system when they Abuse reach age 18 or, due to recent changes in Sexual law, when they reach age 21 should they Abuse elect to continue in foster care beyond age 18. A disproportionate amount of children Neglect who emancipate from foster care were in group homes at the time of emancipation. Foster children in group homes make up approximately 10 percent of the total foster care caseload, but make up 29 percent of foster care emancipations. www.lao.ca.gov Legislative Analyst’s Office 31 ARTWORK#130195 An LAO RepORt FosTeR CHILDReN DeMoGRAPHICs Figure 10 provides a breakdown of the foster in the state’s total population. Most notably, Asian/ care population by age, gender, and race/ethnicity. Pacific Islanders make up approximately 11 percent Foster Care Population by Age and Gender. of the state population but only 2.5 percent of the As shown in Figure 10, almost a third of all foster foster care population. children are age five or less, and approximately Foster Care Outcomes by Race/Ethnicity. 10 percent of foster children are non-minors There are also differences in foster care outcomes between the ages of 18 and 20. Foster children are when comparing one race/ethnicity to another, about evenly split between males and females, with some of which are displayed in Figure 11. As a slightly higher population of females. shown in the figure, African-American and Native Foster Care Population by Race/Ethnicity. As American children are significantly more likely shown in Figure 10, African-American and Native to be the subject of a substantiated maltreatment Graphic Sign Off American children make up a disproportionately report and enter foster care as compared to high amount of the foster care population relative White, Latino, or Asian/Pacific IslanSdeerc crheitldarreyn. to their share of the total state population (for Additionally, African-American chilAdrnean layrset more those ages 20 or younger). The rates of African- likely to emancipate from the systemD (sirtaeycitnogr Americans in foster care are four times that of in the system long enough to age-outD weipthuotuyt a the rates of African-Americans in the state’s permanent placement) than other children. In total population, and similar disproportionality 2012, 13 percent of African-American children exists for Native Americans. Conversely, there are that exited foster care emancipated from the lower rates of Whites, Latinos, and Asian/Pacific system as compared to only 9 percent of all foster Islanders in the foster care population as there are children. African-American and Native American children are also less likely to reunify with their families Figure 9 Children Exiting Foster Care by Reason for Exit than White, Latino, and Asian/ Pacific Islander children. Further, 2012 Adopted African-American children 18% have less stability in their foster care placements on average than children of all other races/ Emancipated ethnicities. 8% Reasons for Racial/ethnic Other Differences in Foster Care Guardianship Reunified 5% 60% Population and outcomes Other Several research studies have 5% controlled for the underlying Kin-GAP 4% risk factors of CWS involvement (such as poverty) and found Kin-GAP = Kinship Guardship Assistance Program. 32 Legislative Analyst’s Office www.lao.ca.gov ARTWORK#130195 An LAO RepORt that it was the higher Figure 10 prevalence of CWS risk Demographics of Foster Children factors among certain January 2013 racial/ethnic groups that Age Foster Care Population contributed towards the disproportionate amount Less than 1 5.6% 1 to 5 26.6 of children of certain 6 to 10 19.4 races/ethnicities in foster 11 to 15 22.5 care. For example, in 16 to 17 15.9 Graphic Sign Off 18 to 20 10.1 one recent study using Secretary gender Foster Care Population California birth record Analyst Male 48% data and controlling for Female 52 Director poverty and other risk California Deputy factors, the researchers race/ethnicitya Foster Care Population Population found that White children Latino 47.6% 50.7% were actually more at White 24.4 27.9 risk of CWS involvement African-American 23.4 5.7 Asian/Pacific Islander 2.5 11.0 than African-American Native American 1.5 0.4 children. When a Data exclude children of other/unknown race/ethnicity and do not total to 100 percent. evaluating differences in foster care outcomes Figure 11 among Substantiation and Foster Care Entry Rates Vary by Race/Ethnicity children of different Substantiation and Foster Care Entry Rates Per 1,000 Children in 2012 races/ ethnicities, 25 recent Maltreatment Substantiation Rate research 20 Foster Care Entry Rate also suggests the need 15 to consider the higher prevalence 10 of CWS risk factors in 5 the subject population. African-American Native American White Latino Asian/Pacific Islander www.lao.ca.gov Legislative Analyst’s Office 33 ARTWORK #130195 An LAO RepORt IssUes FoR LeGIsLATIVe CoNsIDeRATIoN Group Home Provider Consider Fiscal Incentives for Improved Rate Reform outcomes in New Rate system In addition to linking group home payments The current group home rate structure, the with child needs, the Legislature could also RCL system, is a provider-centric reimbursement consider providing fiscal incentives for improved system that does not consider the individual outcomes in a new rate-setting system. The current needs of children entering group homes. As the system provides the same level of reimbursement RCL system currently operates, children with to group home providers regardless of how long the significantly different care, supervision, and social child has been in their care and without regard to work needs could be placed in the same group the child’s outcomes after he or she leaves the group home, and yet the provider would receive the same home. The Legislature could consider providing monthly payment for each child. Given the varied higher rates of reimbursement when a child first levels of care/supervision and social work services enters a group home and lower rates when a child needed by children in group homes, we believe the has remained in the group home for longer periods state’s system of group home reimbursement could of time. This could encourage greater amounts of be revised to better reflect individual child needs. treatment in a child’s initial period in group home Consider Child-Based Rate structure care and could result in children spending less time in group homes overall. The Legislature could consider adopting a The Legislature could also consider paying child-based group home rate structure that better higher reimbursements to group home providers links the individual needs of children in group that achieved certain outcomes for children in homes (and the services provided to address their care, such as higher permanent placement those needs) with the group home provider rates or greater placement stability after leaving payment. The new group home rate structure the provider’s care. These incentives could be could establish a “base” rate for each child placed considered in the context of the provider’s overall in group homes, with additional supplemental outcome performance, as opposed to the outcomes rates based upon individual child needs. These of a single child. rates could be based on a standardized rating scale (with perhaps three to four supplemental rate Cost Considerations levels). These rates could be based upon average In evaluating a new group home rate system, provider costs and calculated using provider the costs of the new system will be a significant cost data. The CWS agencies could determine consideration. A new rate structure could be each child’s supplemental rate (as applicable). developed in a method that was relatively cost Further, providers could be given an opportunity neutral, although there are many factors, such to provide input into the CWS agencies’ as changes in provider behavior, which would supplemental rate determination. be difficult to model in a new rate structure. Additionally, to the extent that the Legislature adopted fiscal incentives that resulted in improved 34 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt child outcomes, these incentives could result in system, and could improve the quality of all overall foster care cost savings (due to shorter stays providers through a more rigorous group home and less reliance on costly group home care). operating requirement. Group Home Accreditation Clarifying the Role of FFAs in Foster Care Placements Currently, there are only very minimal health, safety, and program requirements to operate a Over time, FFAs have evolved from their group home. There is no existing function in the originally intended role of providing foster homes CWS system to evaluate group home provider for children that would otherwise be at risk of performance or determine if group homes are group home placement to also finding foster addressing child needs in an appropriate manner. homes for children without higher-level needs. As While data are lacking to provide a complete discussed in this chapter, FFA placements have picture of the issue, there is general evidence grown as a portion of total foster care placements that group home quality varies by provider. For over time. In some counties, very significant instance, a 2013 report from the state Foster Care amounts of children are placed in FFA homes. Ombudsman’s office evaluated several dozen group Given reports from counties about the homes across the state and identified significant shortage of foster homes in the locations needed disparities in group home quality by provider. across the state and the demonstrated ability of As a first step towards better evaluation of FFAs to recruit foster parents, the Legislature group home provider quality, the Legislature could consider amending current law to explicitly could consider requiring group home providers authorize FFAs to recruit foster parents for children to become accredited from a national accrediting of all levels of service needs. These amendments organization. There are currently several national would modernize the law as it relates to FFAs and organizations that operate accreditation programs more fully reflect the role FFAs can reasonably for foster care providers, and many of the state’s play in foster parent recruitment. However, FFAs existing providers are already accredited by these are currently paid to provide social work services organizations. The accrediting process in the to children in FFA homes (services that are not private accrediting organizations goes beyond provided to children in county-licensed foster basic health and safety standards (as performed homes) because of the original presumption that by the state), and requires group home providers FFAs would only serve children with higher-level to establish and maintain more rigorous program service needs. The Legislature could consider quality standards. Provider accreditation is establishing a separate rate for children that require relatively inexpensive (the costs of which would social work services and a rate for those that do not be borne by the provider), has the potential to to better align with the placement role of an FFA in eliminate poor quality providers from the CWS any particular circumstance. www.lao.ca.gov Legislative Analyst’s Office 35 An LAO RepORt 36 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt CHAPTeR 4: CHILD WeLFARe FUNDING FUNDING oVeRVIeW The Child Welfare Services (CWS) system The CWS system requires funding for both is funded through a mix of federal, state, and the administrative costs of operating the system county funding sources. Historically, the state and for “assistance payments.” Administrative and counties have shared funding responsibility costs include those related to investigating child for the nonfederal share of costs in the CWS maltreatment, case management of children system. (As discussed further below, 2011 in the CWS system, placing children in foster Realignment significantly changed the state- care, finding permanent placements for foster local fiscal relationship in CWS. Under this children, child abuse prevention, and other realignment, the fiscal responsibility for the activities. Assistance payments are monthly nonfederal share of costs shifted largely to the payments made to foster care providers for the counties.) State and county funds have been care and supervision of children. Assistance used as a match for federal funds or to pay for payments also include payments made to parents costs in the system that cannot be paid with who have adopted foster children through federal funds. The state receives federal funding the state’s subsidized adoptions program, the directly and then passes this funding through to Adoption Assistance Program (AAP), or for the counties. A summary of total CWS agency relative guardians of foster children who receive funding is provided in Figure 1. payments through the Kinship Guardianship Assistance Program (Kin-GAP). Figure 1 Child Welfare services (CWs) Funding in 2011-12 (In Millions) Federal state County Total CWS administrationa $1,630 $53 $1,148 $2,831 DSS state oversight 13 20 — — Foster care assistance payments 545 — 997 1,542 Adoption Assistance Program 359 — 507 866 Kin-GAP — 45 12 57 Child abuse prevention 9 4 13 26 Totals $2,557 $122 $2,676 $5,321 a Includes administrative funding for foster care, adoptions, and general CWS administrative costs. DSS = Department of Social Services and Kin-GAP = Kinship Guardianship Assistance Program. www.lao.ca.gov Legislative Analyst’s Office 37 An LAO RepORt FeDeRAL FUNDING Title IV-E Funding. The federal government for Needy Families, and Medicaid, that provide provides several funding sources for CWS. funding for a variety of programs, including The main dedicated source of federal funding CWS. The state has discretion in using these for CWS administration and foster care costs funds for CWS, and in some cases has used these is “Title IV-E” funding authorized under the funds to offset General Fund costs in CWS. Social Security Act. In 2012-13, Title IV-E Limitations of Federal Funding funding was approximately 70 percent of all federal funding for CWS agencies in the state. Title IV-E “Waiver.” One of the biggest Title IV-E funding is uncapped federal funding criticisms of how the federal government funds that requires nonfederal matching funds equal child welfare is the inflexible use of Title IV-E to 50 percent of total costs. Title IV-E funding funds. Title IV-E funds can be used for CWS is restricted to CWS administrative costs (such investigations, case management, and foster care as case management) and foster care assistance provider payments, but not for direct services payments, and it can also be used for assistance that could reduce the need to bring children payments to caretakers who have adopted into foster care in the first place or expedite or assumed guardianship for foster children a child’s safe return home from foster care. (through the AAP and Kin-GAP). Title IV-E Since 2007, Los Angeles and Alameda Counties funding cannot be used for service-related have been participating in a “Title IV-E waiver activities such as family preservation services, demonstration project,” referred to as the even though these services could reduce the capped allocation project (CAP), which caps number of children in foster care (and thus the amount of federal funding Los Angeles and reduce the overall need for Title IV-E funding). Alameda receive under Title IV-E (in contrast to Title IV-B Funding. Title IV-B funding is nonwaiver counties which have no cap on Title a dedicated source of federal funding for CWS, IV-E funds), but gives the waiver counties more requires nonfederal matching funds equal to funding flexibility. The purpose of this federal 25 percent of total costs, and provides a capped pilot project, which is operating in several states, funding allocation that can be used to provide a is to evaluate the effect providing more flexible range of services for children in the CWS system. Title IV-E funds has on child welfare outcomes. Title IV-B funding, while a comparatively small As participants in the CAP, Los Angeles and funding source (approximately $30 million Alameda Counties are able to direct more of annually), provides flexible funding that can their CWS activities towards reducing the be used on services such as counseling, parent number of children that come into foster care training, and substance abuse treatment that are and the time that children spend in foster care. ineligible for funding under Title IV-E. The state is currently seeking approval from Non-Dedicated Federal Funding. There are the federal government to participate in the other federal funding sources, such as the Social second round of the CAP, which would begin in Services Block Grant, Temporary Assistance 2014-15 and end in 2018-19. In addition to Los 38 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt Angeles and Alameda Counties, there are several of the requirements is that the child’s parents other counties that have expressed interest in (from the home of removal) would have been participating in the second CAP. While there eligible under 1996 federal income guidelines are some financial risks involved with a capped for public assistance (“cash aid”) benefits. Due allocation of Title IV-E funding (potential to household income increases since 1996, an caseload increases without additional federal increasing number of CWS cases are ineligible funding), more flexible Title IV-E funding could for Title IV-E funding. In 2000-01, 82 percent potentially improve child welfare outcomes by of CWS cases were eligible for federal funding, allowing Title IV-E dollars to be invested in as opposed to an estimated 66 percent of cases services that reduce the number of children in 2013-14. When cases are ineligible for Title that need to come into foster care or reduce the IV-E funds, children still receive CWS agency amount of time foster children spend in the services, but the costs of these services are paid system. through nonfederal sources (state/county funds). Declining Title IV-E Eligibility. In order for As a greater percentage of CWS cases have the state to receive Title IV-E funds for children become ineligible for federal funding, the state in the CWS system, foster children must meet and counties have assumed a larger share of total certain federal eligibility requirements. One CWS costs. sTATe AND CoUNTY FUNDING Prior to 2011-12, the state and counties each costs to implement new changes in state or shared a statutory percentage of the nonfederal federal laws and policies and the payment of costs for the CWS program. The state and county federal penalties. share of nonfederal costs varied by CWS funding How Did Realignment Change the component, such as CWS administration and state/Local Funding Relationship? foster care assistance payments. The state share of costs was paid by the General Fund, and Prior to 2011 Realignment, when CWS counties used local funds to pay their share caseloads increased, the state and the counties of costs. In 2011, the state enacted legislation would share in these increased costs. Under 2011 known as 2011 Realignment, which transferred Realignment, counties bear the primary financial most of the nonfederal funding responsibilities responsibility of increased caseloads, thereby for CWS and a dedicated portion of the state placing greater financial pressure on the counties sales tax (in lieu of General Fund dollars) to the to contain CWS costs. 2011 Realignment funding counties. Counties receive “growth” revenues will grow over time due to growth revenues, but when sales tax revenues increase year over year. not necessarily at the rate of growth in CWS Certain components of CWS, such as costs for which counties are responsible. In the Kin-GAP, were not realigned, and the state short term, counties will likely benefit from General Fund still has a share of these costs. additional growth revenues that would not likely Additionally, the state still has a share of CWS have been available through the General Fund www.lao.ca.gov Legislative Analyst’s Office 39 An LAO RepORt allocation process prior to 2011 Realignment (see time, variability in annual sales tax revenues Figure 2 for an estimate of 2011 Realignment (realignment revenues) and CWS caseloads revenues from 2012-13 to 2014-15). Over could cause an imbalance between realignment revenues and CWS costs. IssUes FoR LeGIsLATIVe CoNsIDeRATIoN Revising the Allocation of 2011 performance against that county’s prior-year Realignment Growth Funding performance (as opposed to comparing relative performance among the counties). The current methodology for allocating 2011 Realignment growth funding to individual option for Incentive-Based Growth counties is based largely upon historical Funding Allocation Process funding allocations. As such, the allocation of The Legislature could adopt an incentive- new growth revenue does not provide a fiscal based growth funding process based on incentive for counties to improve CWS outcomes. improved performance on a cross-section The Legislature could consider modifying the of existing CWS outcomes. There are many current CWS-related growth funding allocation existing federal and state outcomes/performance process to require that a small percentage of total indicators that relate to child safety, permanency, growth funding (say, 10 percent to 15 percent) and well-being (as we discuss in detail in the be based upon improved county outcomes. (We next chapter). County performance on these provide more detail on this option immediately outcome measures could be calculated in an below.) This would still allow all counties to index score, and certain outcome measures receive additional growth funding over time, could be weighted more heavily than others. The but would direct a small portion of total growth relative weighting of each outcome measure in funding based on improved performance. The the overall allocation process could change over determination of which counties would receive time and reflect legislative priorities for outcome incentive-based growth funding could be improvements in CWS. The specific outcomes based upon a comparison of individual county included in the incentive-based growth funding allocation process could Figure 2 be determined based 2011 realignment Funding for CWsa, b upon input from the administration and the (In Millions) counties. 2012-13 2013-14 2014-15 Base funding $1,640 $1,818 $1,971 Growth revenue 157 137 198 Totals $1,798 $1,955 $2,169 a As estimated in the 2013-14 Governor’s Budget. b Includes approximately $50 million in funding for Adult Protective Services (elder/dependent adult abuse investigations). 2011 Realignment funding for CWS/Adult Protective Services is made as a single allocation for both programs. CWS = Child Welfare Services. 40 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt CHAPTeR 5: CHILD WeLFARe oUTCoMes PeRFoRMANCe eVALUATIoN IN CWs The Child Welfare Services (CWS) system performance data beyond that provided by federal measures performance in California through a outcome measures. combination of state and federal outcome measures This chapter focuses on the outcomes of and performance data indicators that have evolved children in the CWS system and how the federal, over time. The federal government requires states state, and county governments measure these to track performance on federal outcome measures outcomes through administrative data collection and establishes national performance standards and standardized evaluation systems. This for these measures. The state has also developed chapter also shows the trends in CWS program performance indicators that provide CWS performance in recent years through an analysis of a cross-section of performance indicators. FeDeRAL PeRFoRMANCe sTANDARDs AND eVALUATIoN As part of the implementation of the federal Federal outcomes: safety, Adoption and Safe Families Act (AFSA) of 1997, the Permanency, and Well-Being federal government created a series of child welfare At the highest level, federal CWS outcomes outcome measures to evaluate the performance of relate to child safety, permanency (in a child’s each state CWS system. Prior efforts by the federal living situation), and child and family well-being. government to evaluate state CWS performance The federal government has developed a series of were focused on compliance with administrative outcome measures to evaluate performance on processes and not on the outcomes of those these high-level outcomes. The federal outcome processes. Through AFSA, the federal government measures form the basis of federal reviews of state adopted an outcomes-based approach to CWS performance, and the state uses these outcome program evaluation to improve national CWS measures to track state performance relative to outcomes, with an emphasis on continuous quality national standards. The federal government’s improvement. outcomes for safety, permanency, and well-being are in the box on the next page. www.lao.ca.gov Legislative Analyst’s Office 41 An LAO RepORt Federal Child Welfare services outcome Measures Safety Outcomes • Children are protected from maltreatment. • Children are safely maintained in their homes whenever possible and appropriate. Permanency Outcomes • Children have permanency and stability in their living situations. • Children’s family relationships and connections are preserved. Well-Being Outcomes • Families have enhanced capacity to provide for their children’s needs. • Children receive appropriate services to meet their educational needs. • Children receive appropriate services to meet their physical and mental health needs. Child and Family service Reviews parent licensing and recruitment standards, and staff and foster care provider training. The federal government created the Child Program Improvement Plans (PIP). If the and Family Service Review (CFSR) process to federal government finds the state failed to meet standardize federal evaluation of state performance the national standards on the federal outcome on the federal outcome measures. The federal measures, the federal government assesses a government uses the CFSR process to periodically financial penalty (based on the state’s level of review each state’s performance on the federal noncompliance) and the state is required to develop outcome measures and sets performance a PIP that outlines the actions the state will take to improvement targets when a state fails to meet the improve performance. If the state meets its target national outcome standards. The CFSR process performance during the timeframe established begins with the state’s self-assessment of CWS during the adopted PIP, the federal government outcomes, where the state identifies areas needing waives federal penalties. Because of the high improvement. Following state self-assessment, the standards set by the federal government, states are federal government conducts a review of a small likely to enter into a PIP for at least some of the sample of the state child welfare cases (in a small federal outcome measures. In California, the state sampling of counties) and determines if the state and counties share the financial obligation of federal is in compliance with federal outcome standards. PIP penalties. During the CFSR process, the federal government also evaluates state compliance with seven CWS County-Level Program evaluation system standards, which includes requirements Because California’s CWS system is county- for CWS system components such as a statewide administered, improving child welfare outcomes in information system for case management, a the state requires program reforms and evaluation standardized case review process, foster/adoptive at the county level. The federal CFSR evaluates 42 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt summary outcomes from the state’s entire CWS public online). The C-CFSR process begins with system, but does not directly evaluate CWS peer case review, where counties review cases from performance issues at the county level. To address other counties to identify ways to improve CWS the need for county-level program evaluation and outcomes and share information on best pGracrtaicpehs. ic Sign Off supplement the federal CFSR process, Chapter 678, Following peer case review, each county performs Secretary Statutes of 2001 (AB 636, Steinberg), created a self-assessment of its performance and identifies Analyst the California Child and Family Service Review areas that need improvement. The final stage of the Director (C-CFSR) process. C-CFSR is the system improvement plan process, Deputy The C-CFSR. The state conducts the C-CFSR on where DSS and each county develop specific action a five-year cycle (staggered by county). Throughout steps and performance improvement targets to the entire C-CFSR process, the Department of improve outcomes. Social Services (DSS) sends quarterly data reports to As displayed in Figure 1, the C-CFSR works in the counties that summarize county performance conjunction with the federal CFSR. The C-CFSR, on a series of outcome measures (a version of these through county self-assessment, helps the state and other related data are also available to the conduct the state self-assessment required under Figure 1 Performance Evaluation Through Federal and State Child and Family Service Reviews (CFSR) California CFSR 1 - Peer Case Review Quarterly 3 - System 2 - County Self- Performance Improvement Plan Assessment Reports Federal CFSR 1 - State Self Assessment Safety 3 - Program 2 - Federal Improvement Plan Case Review Well- Permanency Being www.lao.ca.gov Legislative Analyst’s Office 43 ARTWORK #130195 An LAO RepORt the federal CFSR. The C-CFSR process, as a county- a series of CWS program and practice changes to based performance improvement process, also helps improve federal outcome measure performance the state meet performance goals set under the during both PIP periods. federal CFSR process. Improved state Performance state Performance on Federal The state made progress in improving outcome Measures performance on the federal outcome measures The federal government has reviewed California during both CFSR rounds and was able to avoid in two CFSR “rounds,” completing federal review paying any federal PIP penalties. In CFSR round Graphic Sign Off during CFSR round one in 2003 and round two in two, the federal government used a series of 2008. In both CFSR rounds, the state was required “composite” outcome measures, which combined Secretary to enter into a PIP because the state did not meet the several outcome measures into a single composite Analyst national standards on the federal outcomes during score, to measure state performance. In Figure 2, Director the CFSRs and was compliant with only a few of we display the state’s performance on the composite Deputy the CWS system standards. During both rounds scores relative to the national standards (as of the CFSR, the state negotiated performance established in CFSR round two) for reunification, improvement targets that were lower than the adoption, children in long-term foster care (“long- national standards but higher than the state’s term care”), and stability in foster care placements performance during federal review in the CFSR. (“placement stability”). While the state made The state and counties subsequently implemented progress on all of the composite measures, the most significant improvement Figure 2 occurred in the State Outcome Performance Relative to National Standardsa adoption composite. As shown in the figure, 110% improvement in federal adoption outcome National Standard 100 measures began in 2002, the same year that the state completed its 90 statewide assessment during CFSR round 80 one. While the CFSR Reunification process focused state 70 Long-Term Care and county efforts Adoption on improving certain Placement Stability 60 outcomes, the state had already initiated 50 a number of CWS 2000 2002 2004 2006 2008 2010 2012 reforms prior to the a The national standards displayed are those established during Child and Family Service Review (CFSR) round two CFSR. (beginning in 2008). The CFSR round two standards were retroactively applied to pre-2008 data. 44 Legislative Analyst’s Office www.lao.ca.gov ARTWORK#130195 An LAO RepORt How Did the state Improve Performance There is also a concern with the potential for on the Federal outcome Measures? increasing performance on some outcome measures at the expense of others. For example, there are Due to the significant number of CWS practice national standards for the rate of foster children that and program changes that were developed as part are reunified within specified time periods. A state of the CFSR process as well as reforms that were could improve reunification rates at the expense of developed to improve CWS practices prior to federal the recurrence of child maltreatment (by unsafely review in the first CFSR, it is difficult to identify a returning children to their parent’s home), and direct correlation between specific CWS practice/ therefore improvements in certain outcomes could program changes and performance improvements. lead to poor outcomes in other areas. The practice reforms and program changes enacted More Comprehensive Program Evaluation during both CSFR periods included activities such Through State Performance Indicators. Pursuant to as adopting standardized risk assessment tools; Chapter 678, the state developed and tracks several expanding the use of community-based services CWS performance indicators that are in addition to children and families in the CWS system; and to, or supplement, the federal outcome measures. reform efforts to increase reunifications, adoptions, The state collects data through CWS-Case and guardianships for foster children (including Management System (CWS-CMS)—the state’s CWS expansion of the Kinship Guardianship Assistance case management system—and produces quarterly Program and the Adoption Assistance Program). reports on the performance indicators at the state While it is difficult to determine the extent to which and county level. As compared to the federal individual CWS practice/program changes led to outcome measures alone, the state performance the improved outcomes, state and county reform indicators provide more information on CWS efforts overall appear to have had a positive effect performance, allow for more robust performance in general on the state’s performance on the federal analysis, and address some of the methodological outcome measures. flaws in the federal outcome measures. Issues With Federal While the state has to meet the performance outcome evaluation goals set by the federal government to avoid federal penalties, the entire focus of CWS performance in Many researchers have been critical of the California should not be on the state’s performance federal government’s outcome measures and the on the federal outcome measures alone. The federal national standards for these measures. Frequent outcome measures are a work-in-progress, and criticisms about the federal outcome measures the federal government is likely to modify the range from the appropriateness of equal weighting existing federal outcome measures in the coming of states relative to the national standards (without years. While new federal outcome measures may regard to differences in state CWS populations, be an improvement over the existing measures, the caseloads, or child welfare laws), concerns about state can and should continue to develop its own the methodology used by the federal government to performance indicators that advance CWS program measure CWS outcomes, and issues related to data quality improvements and are consistent with the quality. state’s priorities for the CWS system. We discuss trends in CWS performance based on the state indicators in the next section. www.lao.ca.gov Legislative Analyst’s Office 45 An LAO RepORt CoMPReHeNsIVe ANALYsIs oF CWs PeRFoRMANCe TReNDs As discussed in the previous section, a exist where no report is made to the CWS system comprehensive analysis of the state’s performance or where the CWS system does not substantiate in CWS requires more than an evaluation of reported maltreatment that has actually occurred the state’s performance on the federal outcome (due to reasons such as insufficient evidence or measures alone. This section evaluates CWS investigation errors), there is no way to know the performance in recent years by analyzing a cross- number or severity of these cases. section of state performance indicators in the areas Fairly Consistent Rates of Recurring of child safety, permanency, and well-being. As Maltreatment Reports we will discuss, the performance data alone do not explain why CWS performance changes are Children who have been the victim in a occurring, but rather they provide an indicator of substantiated maltreatment report are often how effectively the CWS system addresses child reported as victims in subsequent maltreatment safety, permanency, and well-being. reports. Without addressing the underlying causes of child maltreatment in a family, cycles Child safety of maltreatment tend to continue. Over the last In some regards, child safety is the most decade, a fairly consistent proportion (between important aspect of the CWS system in that it 42 percent to 44 percent) of children who were measures the CWS system’s ability to protect the victim in a substantiated report of child children from abuse and neglect—sometimes maltreatment have been reported as victims from very serious and recurring abuse from their in subsequent maltreatment reports. However, caretakers. However, there are relatively few as shown in Figure 3, a decreasing amount of performance indicators related to child safety. Most these recurring maltreatment reports have been of the performance data available on child safety substantiated over the last decade as more have relate to the recurrence of child maltreatment been determined to be either unfounded or (following a previous episode of maltreatment), the evaluated out. rate of children abused in foster care, and certain Higher Rates of Recurring Maltreatment process measures (such as the compliance rate of for Children Reunified. For children exiting required social worker visits). foster care, the recurrence of child maltreatment The CWS system works to prevent further is significantly higher among children who are child maltreatment once the system has received reunified with their parents than for children a report that child maltreatment has already who exit foster care through guardianship. (We occurred and a CWS agency has substantiated note there are no data available for children maltreatment. Therefore, state data on child safety exiting foster care through adoption.) In 2010, relate to the system’s interaction with children approximately 11 percent of children who exited that come to the attention of the CWS system foster care through reunification were the subject through a maltreatment report. While it is likely of a substantiated CWS report of maltreatment that there are cases of child maltreatment that within 18 months of leaving foster care—twice 46 Legislative Analyst’s Office www.lao.ca.gov Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt the rate of children Figure 3 who exited foster care Children With Subsequent Maltreatment Allegationsa through guardianship. Within 24 Months of Previously Substantiated Report While reunification is 50% the statutorily preferred alternative for children exiting foster care 40 and supports a child’s emotional need to 30 stay connected with Graphic Sign Off their families, it is not Secretary without the potential 20 Analyst for increased risk to the Director child’s future safety. Evaluated Out 10 Unfounded Deputy More Timely CWs Inconclusive Substantiated Investigations and Home Visits 2000 2002 2004 2006 2008 2010 State law requires a Data represent the percentage of children who were the subject of a substantiated report of maltreatment from January to CWS agencies to June (in the year specified) that were the subject of a subsequent report of maltreatment within 24 months of the first report. Case disposition data are reported for the subsequent maltreatment allegations. investigate reports of child maltreatment either Figure 4 ARTWORK#130195 immediately (within 24 Timeliness of Investigations and Monthly Home Visits hours) or within ten days, Cases That Complied With Statutory Timelines for Completion based upon the severity of the allegations and risk 100% to the child. Federal and state law also require CWS agency social workers to 80 visit foster children in their homes on a monthly basis. 60 The state tracks county and statewide performance Immediate Investigation Response on the timeliness of CWS 40 Ten-Day Investigation Response investigations and monthly Monthly Foster Child Home Visits home visits with foster children. (Figure 4 displays 20 the state’s performance in these areas since 2000.) While these data do not 2000 2002 2004 2006 2008 2010 2012 provide information on www.lao.ca.gov Legislative Analyst’s Office 47 ARTWORK#130195 An LAO RepORt the quality of these investigations and home visits, (with preference towards family placements). timely investigations and home visits can improve Measuring the state’s effectiveness in achieving child safety through early and regular detection of positive permanency outcomes for children can risks to child safety. be difficult because of the unique circumstances As shown in Figure 4, over the last of each child in the CWS system. The CWS decade, there has consistently been greater system does not establish the same permanency CWS agency compliance with the immediate goal (such as reunification or adoption) for every response investigations than with the ten-day child in the system. Therefore, the CWS system’s investigations. The data appear to reflect a higher effectiveness in child permanency should be priority among CWS agencies to meet immediate evaluated on a variety of components related response investigations deadlines as opposed to to reunification, foster care reentry, adoptions/ ten-day response investigation deadlines. This guardianships, and stability in foster care priority is appropriate given the higher risks to placements. children in immediate response investigations. shorter stays in Foster Care In 2000, approximately 93 percent of immediate response investigations were completed in a Over the last decade, the CWS system has timely manner as opposed to only 80 percent decreased the amount of time that children of ten-day response investigations. In recent spend in foster care by decreasing the time it years, however, the state has made progress on takes for children to be reunified with their compliance with ten-day response investigations. families, adopted, or placed with a permanent As of 2012, 94 percent of these investigations guardian. As previously discussed, multiple were completed within statutory timelines. CWS practice and program reforms have Increased Frequency of Monthly Foster led to improved outcomes (including those Child Home Visits. As shown in Figure 4, in related to permanency), and the state’s shift to 2000, only half of the state’s foster children an outcomes-based system of CWS program were visited on a monthly basis as required by evaluation also appears to have had a measurable statute. As also shown in the figure, the state effect on performance improvements. significantly increased the frequency of home Improved Permanency Outcomes. To visits with foster children over the decade—by evaluate the improvements in permanency 2012, 94 percent of monthly home visits were outcomes for children in foster care over the completed within statutory timelines. The last decade, we analyzed data for three cohorts federal government evaluated the state’s rate of of children entering foster care during the years timely foster child home visits in both rounds 2000, 2005, and 2010. As shown in Figure 5, of the CFSR, and this may help explain the the state made significant progress in more CWS system’s efforts during this time period to quickly finding permanent homes for foster increase home visit frequency. children through reunification, adoption, and guardianship from 2000 to 2010. For children Permanency entering foster care during 2000, 59 percent In general, the state’s permanency goal for were reunified with their families, adopted, or foster children is to place children in permanent, entered guardianship within 24 months in foster safe, and nurturing homes as quickly as possible care. For children entering foster care in 2010, 48 Legislative Analyst’s Office www.lao.ca.gov Graphic Sign Off Secretary Analyst Director Deputy An LAO RepORt the comparable number Figure 5 was nearly 70 percent—a Foster Children Reunified, Adopted, or in Guardianship by Time significant improvement Cohorts of Children Entering Foster Care in 2000, 2005, and 2010 over the 2000 cohort. After 30 months in 100% foster care, 24 percent 2000 Cohort of children in the 2000 2005 Cohort cohort still remained in 80 2010 Cohort foster care as opposed to 17 percent of children in Graphic Sign Off 60 the 2010 cohort. Secretary The CWS system’s Analyst improvements in 40 Director permanency outcomes Deputy over the last decade 20 have resulted in a foster care population that is smaller and spends 3 6 12 18 24 30 on average less time Months in foster care. While system improvements are still needed and the Figure 6 ARTWORK#130195 state should continue its Median Time to Reunification progress in improving In Months permanency outcomes for children in the CWS 14 system, the state has done a much better job 12 of achieving permanency for children in foster 10 care in recent years. 8 Faster Reunifications but Higher Reentry 6 Rates for Children Reunified 4 As shown in 2 Figure 6, over the last decade, the CWS system has reduced the time it 2000 2002 2004 2006 2008 2010 2012 takes for foster children wwAwR.TlaWo.OcaR.gKov# 1 3L0eg1i9sl5ative Analyst’s Office 49 An LAO RepORt to reunify with their families. However, as noted CWS agencies locate relatives who are able to and previously, CWS outcomes often interact with willing to care for a foster child after a child has each other, and CWS practice changes that lead to already been placed in another home. In such cases, positive outcomes in one area can sometimes lead a subsequent placement in the relative’s home may to negative outcomes in another area. One example be appropriate as it could be in the child’s best of this are the trends over the last decade of shorter interest. However, a major criticism of the CWS reunification times and higher reunification rates system is that foster children are often moved from that are counterbalanced with higher foster care one foster care placement to the next and are unable reentry rates among children who reunified with to maintain any stability in their living situation. their families. Specifically, the median time to Frequent foster care placement changes make it reunification for foster children declined from a difficult for foster children to continue in their high of 13 months in 2000 to less than 9 months in current school, thus affecting their educational 2010. During the same time period, however, the outcomes. Frequent foster care placement changes percentage of children who reentered foster care also affect children’s ability to stay connected with (within 24 months following reunification) increased their families and other supportive individuals by approximately 12 percent—from about 14 percent and make it difficult for a child to identify with a in 2000 to 16 percent in 2010. “home.” The emotional effects and harm to a child’s We note that CWS performance data alone do educational performance resulting from frequent not provide sufficient information to determine if foster care placement changes can have long-lasting shorter reunification times and higher reunification consequences for children who have already suffered rates in the CWS system have directly led to higher childhood trauma due to maltreatment. reentry rates following reunification. However, given Increased Placement Stability Over the Last the higher rates of recurring child maltreatment Decade. As shown in Figure 7, the CWS system has among children who are reunified with their made significant progress in increasing placement families (as discussed earlier), it is likely that as the stability for foster children over the last decade. CWS system reunifies greater numbers of foster For children taken into foster care in the first half children, the overall foster care reentry rate will of 2001, 28 percent of the children who were still increase. There is a delicate balance in the CWS in foster care 18 months later had been in five or system between expediting reunification between more foster care placements. In 2011, this number foster children and their families and ensuring that decreased to 10 percent of children. children are not returned home before it is safe and Well-Being in the child’s best interest to do so. Child well-being in the CWS system generally Increased Foster Care Placement stability relates to the physical/mental health and educational Children in foster care are often moved from status of children in foster care. While well-being one foster care placement to the next, sometimes is an important outcome for children in the CWS multiple times in a single year. These placement system, performance indicators for well-being are changes are sometimes in the child’s best interest generally lacking. This lack of well-being indicators and could be to move the child from a less makes it difficult to fully evaluate how well children’s family-like setting (such as a group home) to a physical/mental health and educational needs are foster or relative home. Additionally, sometimes met in the CWS system. 50 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt State Collects Some Information on of foster children received a timely medical exam Well-Being. The state collects and reports as opposed to 76 percent of children who received a information on the timeliness of medical and timely dental exam. dental exams for children in foster care, but does Limited Utility of Psychotropic not have a performance indicator for actual foster Medication Performance Indicator child physical health status or how effectively physical health needs are addressed for children The state has a performance indicator that in foster care. Similarly, there are no performance measures the number of foster children who are indicators that evaluate foster child behavioral authorized for psychotropic medication. According health, although the state does collect and report to DSS, 13 percent of foster children (excluding Graphic Sign Off data for the number of children who have been probation-supervised children) were authorized Secretary approved for medications treating disorders such for psychotropic medication in the first quarter of Analyst as depression, anxiety, and psychosis (referred to 2013. However, due to data quality issues, the rates Director collectively as “psychotropic” medication). The of children authorized for psychotropic medication Deputy state also collects and reports data that relate to use reported in the performance indicator appear outcomes for a sample of foster children who to significantly understate the number of children emancipate from foster care (such as education, that were authorized for psychotropic medication employment, and housing status after leaving foster use prior to 2008. Additionally, psychotropic care). medication claiming data from the Department More Timely Medical and Dental exams The state measures Figure 7 timeliness of medical/ Number of Foster Care Placements Per Child dental visits based upon Percentage of Foster Care Population by Number of Placementsa an age-specific schedule of 70% visits for medical exams 1-2 and for annual dental 3-4 60 exams for children age 5 or More three or older. As shown 50 in Figure 8 (see next page), the state significantly 40 increased the percentage 30 of foster children who receive a timely medical 20 or dental exam over the last decade. However, the 10 rates of timely exams are significantly higher for 2001 2003 2005 2007 2009 2011 medical as opposed to dental exams. In the first a The foster care placements reported are for children taken into foster care in the first six months of the quarter of 2012, 91 percent year specified, who were still in foster care 18 months later. www.lao.ca.gov Legislative Analyst’s Office 51 ARTWORK#130195 An LAO RepORt of Health Care Services reflect a decline over the changes in pediatric practices could cause higher or last decade in the rates of psychotropic medication lower rates of psychotropic medication use among among foster children—which conflicts with foster children—a change occurring from outside DSS’s performance indicator data which show an the CWS system. The existing data on psychotropic increase in psychotropic medication use over the medication use among foster children do little last decade. This conflict likely results from the data more than provide the rates of medication use at quality issues with the performance indicator. specified points in time. Without the development Even without the data quality issues, it is of additional performance indicators that better unclear what findings can be made from the measure the mental well-being of foster children, psychotropic medication use data. Higher or lower the CWS system has little inGforrampahtioicn oSni gthne Off rates of psychotropic medication use could indicate mental health outcomes of foster children. Secretary either positive or negative outcomes for foster Limited Data on exit outcAonmaelyss ftor children. For example, higher rates of psychotropic emancipated Foster YoutDhirector medication use in recent years could possibly Deputy indicate that foster children were not receiving The state collects some information about psychotropic medication at high enough rates in education, employment, housing, and other prior years. On the other hand, higher use rates (in outcomes for children that emancipate from (“age recent years) could alternatively indicate that foster out of”) foster care. Data are not available for all children are receiving psychotropic medication too foster youth that emancipate from foster care, but frequently as compared to prior years. Additionally, available data represent a sample of emancipated foster youth (the summary data available Figure 8 are displayed in Figure 9). Foster Children Receiving Timely Medical/Dental Examsa For the emancipated foster youth who exited 100% foster care in 2010, 2011, Timely Medical Exam and 2012 (where data 80 were available), the vast majority of youth had Timely Dental Exam a housing arrangement 60 established, received services for independent living, and had a 40 “permanency connection” (an adult who they could 20 go to for support and guidance). However, only about 57 percent of these youth had completed high 2000 2002 2004 2006 2008 2010 2012 school or an equivalency, a Data are for first quarter in the year specified and exclude probation-supervised cases. and only a quarter of these 52 Legislative Analyst’s Office www.lao.ca.gov ARTWORK#130195 An LAO RepORt youth had obtained employment. Comparatively, education students. Educational (and by extension the statewide high school graduation rate in employment) outcomes for emancipated foster 2011-12 was 79 percent for all students, 62 percent youth appear concerning based on the limited for English learners, and 61 percent for special available data. VARIATIoN IN CoUNTY-LeVeL oUTCoMes This chapter has thus far focused on state-level children in a small county can have a large effect on performance outcomes, but we note that there is the county’s overall outcomes. It is difficult to draw significant variation in CWS outcomes at the county many conclusions about county outcome variation level. The reasons for this variation relate primarily when dealing with the small sample sizes in small to differences in: (1) county demographics and rates counties. of individuals in the county population with risk County-Level outcome Variation—examples factors for CWS involvement and (2) programs, services, and administrative policies at the county To provide an example of the variation in level. County populations have different levels county-level outcomes, Figure 10 (see next page) of need for CWS involvement, stemming largely displays the percentage of children in the ten largest from the prevalence of risk factors in the local counties in 2011 who (1) were reunified within community (such as the prevalence of poverty and 12 months of entering foster care and (2) reentered substance abuse). There are also differences in how foster care within 12 months of reunification. local CWS agencies operate, with some counties The range of reunification rates varied between utilizing certain programs and services that others 22 percent (Fresno County) and 48 percent (Santa do not. Both population and county administrative Clara County), with the statewide average at practices and policies can affect CWS outcomes 41 percent. There was also a wide range of foster at the county level. There also may be differences care reentry rates among the ten largest counties in county outcomes based upon the quality of in 2011. The smallest rate of children reentering services, staff, and leadership in certain counties, foster care within 12 months of reunification was although the degree to which this is a major factor 6.2 percent (Fresno County) and the largest was in the differences in county-based CWS outcomes is 15 percent (Alameda County). unknown and difficult to measure. Figure 9 It is also difficult to exit outcomes for emancipated Foster youtha compare the performance Youth Emancipating From Foster Care From 2010 to 2012 of small counties against 2010 2011 2012 larger counties because of the small sample of Completed high school or equivalency 58% 57% 56% Obtained employment 29 27 21 children involved with Housing arrangement established 92 91 91 CWS in small counties. Received independent living services 87 85 78 Changes in outcomes for Permanency connection established 91 91 91 a Data do not represent the entire population of emancipated foster youth during the time periods specified, a small number of foster but for the youth where data were available. www.lao.ca.gov Legislative Analyst’s Office 53 An LAO RepORt Reunification and foster care reentry rates are there are not valid reasons to look at other “higher only two of many examples of the variance in CWS performing” counties as an example of how to outcomes by county. As we discuss below, there are improve performance in a lower performing many reasons why CWS outcomes vary by county, county. There are many things that counties can and there are a number of factors that must be and do learn from each other when comparing considered prior to making any conclusions about county practices and policies. However, when variation in county-level outcomes. comparing performance county by county, it should be done in a manner that considers theG raphic Sign Off exercise Caution When Making County- full range of factors that affect county-level CWS Level Performance Comparisons Secretary performance, and not just those related to the Analyst It is difficult to compare one county’s organization. Additionally, evaluating a county’s Director performance against another’s due to the performance over time, as opposed to county- Deputy significant variation in both the prevalence of versus-county performance, may yield more CWS risk factors and the administrative practices relevant results for identifying factors that either and policies among the counties. Certain counties increase or decrease CWS performance. Finally, have a population with higher-level service needs, county-level performance comparisons should which can contribute to poorer outcomes when include all relevant outcome measures because of compared to counties with less significant social the interaction certain outcome measures have with and economic challenges. This is not to say that other measures. Figure 10 Reunification and Foster Care Reentry Rates Among Ten Largest Countiesa Reunification Within 12 Months 50% Reentry Within 12 Months of Reunification 40 30 20 10 California Alameda Contra Fresno Los Orange Riverside Sacramento San San Santa Costa Angeles Benardino Diego Clara a Reunification rates are calculated based upon the proportion of children who entered foster care for the first time in 2011 and were reunified with their families within 12 months of foster care entry. Reentry rates are calculated based upon the proportion of children who reunified in 2011 and reentered foster care within 12 months of reunification. 54 Legislative Analyst’s Office www.lao.ca.gov ARTWORK #130195 aFootnote. An LAO RepORt IssUes FoR LeGIsLATIVe CoNsIDeRATIoN Creating Capacity for Provider- provider’s care, and placement stability and Level Performance evaluation timeliness of permanent placements following a stay in a provider’s care, would be particularly Currently, the CWS system does not collect valuable to foster care placement decision-making. and report foster care provider performance Without these provider-level data, state and data. While there is a significant amount of counties have no systematic way of determining information on county and state CWS outcomes, which providers facilitate the best outcomes for the state lacks a system for evaluating the effect foster children. individual foster care providers have on foster children. These performance data would be expanding Performance useful to the state and counties in evaluating Indicators of Child Well-Being provider performance and would better inform While there are many performance indicators child placement decisions at the county level. for permanency, and a sufficient number of Specifically, the state and counties could identify indicators related to child safety, the state has poorly performing providers and either work few performance indicators of child well-being. with these providers to improve performance or As previously discussed, the well-being measures cease placing children with these providers. To that do exist are primarily process-oriented address the need for provider-level performance performance indicators and, in the case of data, the Legislature could consider adopting the performance indicator for psychotropic provider-level performance indicators that the medication, provide very little information CWS system would use to evaluate provider from which to evaluate child well-being. To outcomes. Given that the state is currently in the address this issue, the Legislature could consider process of replacing and upgrading CWS-CMS, adopting a more comprehensive and effective these provider-level performance indicators could set of child well-being performance indicators. be incorporated in the new CWS-CMS, or the These indicators could more effectively assess new system could be developed with capacity to the physical/behavioral health and educational incorporate these indicators in the future. outcomes for children involved in the CWS What Could Provider Performance system. While there may be many indicators that Indicators Measure? would be helpful in more fully understanding the well-being of children in foster care, there Provider-level performance indicators could are data and cost constraints that the Legislature largely mirror the existing state and county would need to consider when developing these indicators in the areas of child safety, permanency, performance indicators. Recognizing these and well-being. However, certain provider-level constraints, the box on the next page includes performance indicators may be more valuable our suggestions for the development of child to foster care placement decision-making than well-being measures in the areas of physical/ others. For instance, child safety while in a behavioral health and education. www.lao.ca.gov Legislative Analyst’s Office 55 An LAO RepORt Balancing Priorities optimally have in order to fully evaluate child well-being. Additionally, depending upon the While we provide an extensive list of costs and challenges of collecting the information, well-being performance indicators, this list the Legislature would need to set and balance its does not necessarily encompass the full scope of priorities from among the performance indicators. performance data that the CWS system would suggested Indicators of Child Well-Being Physical Health Indicators • Cigarette and Alcohol/Drug Use—The Department of Social Services could develop surveys that give foster youth the opportunity to self-identify with cigarette, alcohol, and drug use. The Child Welfare Services (CWS) agencies could administer these surveys periodically—perhaps annually. • Healthy Weight and Immunizations—The CWS agencies could collect and report information on foster child body mass index and the number of children with up-to-date immunizations. This information could be collected at the time of the regularly required medical visits for foster children. • Teen Pregnancy—The CWS agencies could collect and report information on the number of foster children who become pregnant while in foster care or are parents while in foster care. • Caregiver Assessment of Access to Medical Care—The CWS agencies could periodically survey foster care providers on their assessment of access to necessary medical care for foster children in their care (as based on a rating scale). emotional Health Indicators • Provider-Based Behavioral/Emotional Assessment—The CWS agencies could utilize existing surveys from the behavioral health field (such as the Child Behavior Checklist) to periodically assess the behavioral and emotional issues of foster children in their care. Ideally, such a survey would have a standardized index score that could be reported in a behavioral/emotional health performance indicator. These surveys could be utilized at the beginning and end of a child’s stay with a foster care provider (particularly with children placed in group homes). • Youth Self-Assessment—Similar to the provider behavioral/emotional assessment, CWS agencies could utilize existing surveys from the behavioral health field (or develop a simplified survey form that can be used to calculate a standardized index score) for foster children to self-report an assessment of their behavioral and emotional health. 56 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt • Juvenile Arrests—The CWS agencies could collect and report data on how many children in the CWS system are arrested while in foster care. • Mental Health Services—The CWS agencies could collect and report data on the number of children that receive certain specialty mental health services, such as inpatient psychiatric care and outpatient psychiatrist/psychologist services. educational Indicators • School Behaviors—The CWS agencies could collect and report data on the number of foster children who are suspended or expelled from school, and the number of truancy days for foster children. • Grade Level Proficiency—The CWS agencies could collect and report data on the number of foster children who are grade-level proficient. • School Stability—The CWS agencies could collect and report data on how frequently foster children change schools while in foster care. • High School Graduation or Equivalency Rates—The CWS agencies could collect and report data on the number of children who graduate from high school (or obtain equivalency). www.lao.ca.gov Legislative Analyst’s Office 57 An LAO RepORt GLossARY Term Description Adoption Assistance Program A payment assistance program for adoptive parents for the care and supervision of children formerly in foster care. Child Abuse See definitions of physical, sexual, and emotional abuse. Child Maltreatment Intentional or negligent harm inflicted on children due to abuse or neglect (see child abuse and neglect definitions). Child Maltreatment report An individual’s report (from both mandated and nonmandated reporters) of suspected child maltreatment to a child welfare agency (also called a “referral”). Child neglect Failure of a parent or caretaker to provide a child with adequate needs such as food, clothing, shelter, medical care, or supervision. Child Welfare services The array of public agency services to protect children at risk of child maltreatment (sometimes referred to as “Child Protective Services”). emancipation (From Foster Care) When a foster child leaves the foster care system due to reaching the maximum age (21 in California) for foster care services. emotional Abuse Unjustifiable mental suffering inflicted upon a child that endangers the child’s health. evaluated out A report of child maltreatment which was “screened out” prior to a full investigation and determined by the investigating agency not to meet the definition of child maltreatment. Foster Care The temporary placement of children in a foster home when they have been removed from their families’ homes due to child maltreatment. Foster Care Placement The placement of a child with a specified foster care provider for care and supervision while the child remains in foster care. Foster Family Agency Private agencies that recruit foster parents to provide residential care for foster children. Foster Family Home The homes of county-licensed foster parents that provide care and supervision to foster children. group Home Residential foster care facility that provides care and supervision for foster children with significant emotional or behavioral problems in a group setting. 58 Legislative Analyst’s Office www.lao.ca.gov An LAO RepORt GLossARY Term Description Kinship Care Care and supervision by a child’s relatives while in foster care. Kinship guardianship Assistance Program A payment assistance program for relative guardians for the (Kin-gAP) care and supervision of children formerly in foster care. Mandated reporter Professional required to report child maltreatment based on his or her occupation. Physical Abuse Willful bodily injury inflicted upon a child. Permanent Placement Permanent placement of a foster child with a family—thus removing the child from foster care—through adoption, guardianship, or reunification with his or her family. Providers (in Foster Care) Individuals or organizations that provide care and supervision of foster children (see Foster Family Agency, Foster Family Home, Kinship Care, and Group Home). reunification When a foster child returns from foster care to his or her family’s care. sexual Abuse Sexual assault or exploitation of a child. substantiated Maltreatment A report of child maltreatment that, based upon the available evidence, more likely than not occurred. www.lao.ca.gov Legislative Analyst’s Office 59 AN LAO REPORT LAO Publications This report was prepared by Eric Harper, and reviewed by Mark C. Newton. The Legislative Analyst’s Office (LAO) is a nonpartisan office that provides fiscal and policy information and advice to the Legislature. To request publications call (916) 445-4656. This report and others, as well as an e-mail subscription service, are available on the LAO’s website at www.lao.ca.gov. The LAO is located at 925 L Street, Suite 1000, Sacramento, CA 95814. 60 Legislative Analyst’s Office www.lao.ca.gov