using data to plan waiver strategies and drive improvements: key indicators and trends april 11,...
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Using Data to Plan Waiver Strategies and Drive Improvements: Key Indicators and Trends
April 11, 2012
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ASSESSING READINESS AND APPLICATION PLANNING
Managing with Data in Child Welfare
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Align Program Design with Existing Priorities
• Preventing Abuse and Neglect• Keeping children safe and improving well-
being through in-home services (including post-permanency supports to reduce re-entry)
• To facilitate a child or youth’s move to swift & certain permanency; promote successful transition to adulthood
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Describe your Current System
• Review current data and trends – who are the children and families being served? What services are they getting? What is the ratio of placement expenditures to in-home expenditures?
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Review Performance Measures – Assess your Strengths and Needs
• Consider National Context and Regional Characteristics
• Keep in mind case mix and the inter-relatedness of measures – states with very low entry rates may have longer lengths of stay
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Consider all Available Data Sources
• CWS/CMS• NCANDS, AFCARS and Federal CFSR Outcomes• Longitudinal Data – timeliness and likelihood of
achieving permanency• Structured Decision Making • Case Review Results (CFSR and local QA Activities)• Contract monitoring• Financial Data• Qualitative data and feedback from stakeholders• Research
OVERVIEW OF KEY CHILD WELFARE INDICATORS
Managing with Data in Child Welfare
Trends in Out of Home Care
Throughout these slides, CA data are from the CWS/CMS Dynamic Report System at http://cssr.berkeley.edu/ucb_childwelfare/default.aspx National data are from NCANDS and AFCARS
Nationwide, and in CA, the number of children in out of home care is declining
Nationally, the decreasing number of children in out-of-home care has been driven by declining entries into care. This trend is starting to flatten out (or reverse)
In CA, entries into care have been declining since FY08. Exits have been exceeding entries consistently.
In CA, the number of children in care has been declining as entries decline and exits continue to exceed entries
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2005 2006 2007 2008 2009 2010 2011 2012
State of CA In Care on Jan 1 Entries Exits
0
5
10
15
20
25
2005 2006 2007 2008 2009 2010 2011 2012
Number of Children in Care Ages 0-17Child Welfare Cases
Alpine County Modoc County Mono County Sierra County Inyo County
Point in Time Count of Children in Care On Jan 1st
0
10
20
30
40
50
60
70
2005 2006 2007 2008 2009 2010 2011 2012
Number of Children in Care Ages 0-17Child Welfare Cases
Amador County Colusa County Plumas County
Trinity County Mariposa County
Point in Time Count of Children in Care On Jan 1st
0
20
40
60
80
100
120
140
2005 2006 2007 2008 2009 2010 2011 2012
Number of Children in Care Ages 0-17Child Welfare Cases
Calaveras County Del Norte County Glenn County
Lassen County Nevada County San Benito County
Point in Time Count of Children in Care On Jan 1st
0
50
100
150
200
250
2005 2006 2007 2008 2009 2010 2011 2012
Number of Children in Care Ages 0-17Child Welfare Cases
Lake County Siskiyou County
Tehama County Tuolumne County
Point in Time Count of Children in Care On Jan 1st
While the number of children in care has declined substantially, the absence of repeat maltreatment (a measure of child safety) has increased slightly in CA
80%82%84%86%88%90%92%94%96%
Absence of Repeat Maltreatment (within 6 mos)
CA National Standard 20 Small (Grouped)
Indicators
Absence of Repeat
Maltreatment (Jan11-Jun11
National Standard is 94.6%)
Statewide - California 93%Alpine County * 100%Amador County 96%Calaveras County 73%Colusa County 100%Del Norte County 94%Glenn County 84%Inyo County 93%Lake County 98%Lassen County 100%Mariposa County 86%Modoc County * 100%Mono County * 100%Nevada County 98%Plumas County 84%San Benito County 89%Sierra County * 88%Siskiyou County 72%Tehama County 96%Trinity County 97%Tuolumne County 93%Total 20 Small 90%*Very small n limits analysis
Among the 20 small counties, the absence of repeat maltreatment has remained relatively stable, but remains below state performance and below the national standard
Repeated Substantiated Maltreatment is only a fraction of the families who are repeatedly referred to Child Welfare services
Substantiated Inconclusive UnfoundedAssess
OnlyNo repeat allegations
Substantiated 36,682 2,566 947 2,654 2,586 27,929 8,753 24%Inconclusive 30,823 1,853 1,549 2,075 1,921 23,425 7,398 24%Unfounded 101,152 3,245 2,212 9,110 4,908 81,677 19,475 19%Assessment Only 58,941 2,268 1,878 5,157 4,953 44,685 14,256 24%
Total Children with Allegations 227,598 9,932 6,586 18,996 14,368 177,716 49,882 22%
All Children with Allegations 0ct 10 to March 11: Any Repeat Allegations within 6 Months
Any repeat allegations
Original Allegation
Disposition
Additional Allegation within 6 MonthsTotal
Base #California
The current placement system*(highly simplified)
*adapted from Lyle, G. L., & Barker, M.A. (1998) Patterns & Spells: New approaches to conceptualizing children’s out of home placement experiences. Chicago: American Evaluation Association Annual Conference
CHILD INa bunch of
stuff happens CHILD OUT
the foster care system
CHILDREN ENTERING CAREManaging with Data in Child Welfare
Entry rates are highest for infants. Among all ages, entries are higher for Native American and African American children (National Data FY10, per 1000)
0.0
5.0
10.0
15.0
20.0
25.0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Age (years)
All children
American Indian or Alaska NativeBlack/African American
Latino(a)
White
Key Questions: Entries
• What is the entry rate – by age/race?• Are entries increasing/decreasing? for all
groups?• What strategies are in place/planned to
reduce entries (and re-entries) into care?
Trends in the Number of Children Entering Care
2005 2006 2007 2008 2009 2010 2011% change
05_11% change
10_11California (state) 38,758 38,502 37,196 33,812 32,549 31,445 30,271 -21.9% -3.7%Alpine County 3 4 0 0 0 0 0 -100.0% no changeAmador County 29 23 31 32 30 31 31 6.9% 0.0%Calaveras County 61 54 45 54 57 55 51 -16.4% -7.3%Colusa County 55 39 24 7 20 26 19 -65.5% -26.9%Del Norte County 107 96 72 75 78 63 58 -45.8% -7.9%Glenn County 52 59 61 58 64 72 45 -13.5% -37.5%Inyo County 8 5 9 4 8 6 14 75.0% 133.3%Lake County 94 102 72 61 51 53 53 -43.6% 0.0%Lassen County 53 35 44 45 39 35 23 -56.6% -34.3%Mariposa County 26 25 23 19 10 30 31 19.2% 3.3%Modoc County 17 32 25 13 8 17 3 -82.4% -82.4%Mono County 4 3 3 4 2 3 0 -100.0% -100.0%Nevada County 90 68 46 34 45 77 79 -12.2% 2.6%Plumas County 33 64 45 37 33 36 40 21.2% 11.1%San Benito County 76 49 64 105 53 54 100 31.6% 85.2%Sierra County 4 5 13 4 4 2 3 -25.0% 50.0%Siskiyou County 94 64 56 100 93 73 84 -10.6% 15.1%Tehama County 180 164 127 144 179 186 166 -7.8% -10.8%Trinity County 26 30 17 22 47 25 40 53.8% 60.0%Tuolumne County 102 83 49 61 83 79 85 -16.7% 7.6%Total 20 Small 1,114 1,004 826 879 904 923 925 -17.0% 0.2%
Total Entries - Child Welfare Only (Ages 0-17 at Entry) January to December
Entry rates vary by county and may vary substantially over time in small counties.
The entry rate for the 20 small group is considerably higher than the state.
CountyTotal Child Population
Children with Entries
CY2011
Incidence per 1,000 Children
What happens if
you add two families of 4
kids?
New Rate
California 9,295,040 29,695 3.2 29,703 3.2
Alpine 256 0 0.0 8 31.3Amador 6,393 30 4.7 38 5.9Calaveras 8,943 50 5.6 58 6.5Colusa 6,410 19 3.0 27 4.2Del Norte 6,138 54 8.8 62 10.1Glenn 7,865 45 5.7 53 6.7Inyo 3,900 14 3.6 22 5.6Lake 13,672 53 3.9 61 4.5Lassen 6,293 23 3.7 31 4.9Mariposa 3,242 31 9.6 39 12.0Modoc 2,124 3 1.4 11 5.2Mono 2,979 0 0.0 8 2.7Nevada 19,106 79 4.1 87 4.6Plumas 3,601 40 11.1 48 13.3San Benito 16,066 100 6.2 108 6.7Sierra 552 3 5.4 11 19.9Siskiyou 9,325 84 9.0 92 9.9Tehama 16,160 159 9.8 167 10.3Trinity 2,520 40 15.9 48 19.0Tuolumne 9,682 85 8.8 93 9.6
20 small 145,227 912 6.3 920 6.3
By grouping all 20 counties, we are able to do more detailed analysis. Entry rates in the 20 small counties are highest for Native American and African American children
3.8 3.7 3.6 3.3 3.2 3.3 3.2
0
2
4
6
8
10
12
14
2005 2006 2007 2008 2009 2010 2011
Rate
(per
1,0
00 c
hild
ren)
California - Entry Rates
All Children
African Amer
White
Latino(a)
Asian/P.I.
Nat Amer
7.2 6.7 5.6 6.2 6.4 6.2 6.3
0
5
10
15
20
25
30
35
2005 2006 2007 2008 2009 2010 2011
Rate
(per
1,0
00 c
hild
ren)
20 Small Counties (Grouped) - Entry Rates
All Children
African Amer
White
Latino(a)
Asian/P.I.
Nat Amer
Entry rates in the 20 small counties are highest for infants
7.2 6.75.6 6.2 6.4 6.2 6.3
0
5
10
15
20
25
2005 2006 2007 2008 2009 2010 2011
Rate
(per
1,0
00 c
hild
ren)
20 Small Counties (Grouped) - Entry Rates
All Children
Under 1
1-2
3-5
6-10
11-15
16-17
Possible reasons for county differences in entry rates:
• Service array – preventive and in home • Standard of evidence• Law enforcement removals• Demographic risk factors• Use of standardized risk assessment tools• A variety of other policy/practice differences
What strategies would safely reduce entry rates for infants? School aged children? Teens? Are services culturally relevant for African American and Native families?
CHILDREN IN CAREPOINT IN TIME
Managing with Data in Child Welfare
Key Questions: Children in Care
• What groups of children are in care NOW• What types of placements?• How long have they been in care?• What is needed to move them to
permanency?
Possible reasons for differences in in-care rates
• Length of stay and Placement type• Service array• Caseloads (agencies, courts)• Case mix (age/service needs)
Variation over time in small counties.
CountyTotal Child Population
In Care on July 1,
2011
Prevalence per 1,000 Children
California 9,295,040 53,606 5.8
Alpine 256 0 0.0
Amador 6,393 31 4.8
Calaveras 8,943 72 8.1
Colusa 6,410 27 4.2
Del Norte 6,138 96 15.6
Glenn 7,865 70 8.9
Inyo 3,900 15 3.8
Lake 13,672 165 12.1
Lassen 6,293 44 7.0
Mariposa 3,242 25 7.7
Modoc 2,124 5 2.4
Mono 2,979 2 0.7
Nevada 19,106 97 5.1
Plumas 3,601 54 15.0
San Benito 16,066 86 5.4
Sierra 552 4 7.2
Siskiyou 9,325 87 9.3
Tehama 16,160 200 12.4
Trinity 2,520 39 15.5
Tuolumne 9,682 97 10.0
20 small 145,227 1,216 8.4
As a group, the 20 small counties have a slightly smaller proportion of children in kinship and congregate care placements than the statewide average – the use of kinship care has improved
0
5
10
15
20
25
30
35
40
2005 2006 2007 2008 2009 2010 2011 2012
Perc
ent
% In Care on Jan 1 by Placement Type
CA - Kinship Care
20 Small - Kinship Care
CA - Congregate Care
20 Small - Congregate Care
Placement Type in the 20 Small Counties: Older youth are more likely to reside in group care, infants are less likely than other young children to be placed with kin
25.8
42.5 39.7 38.626.4
18.5 16.7
45.5
33.9 38.4 36.9
38.8
28.3
16.7
0
20
40
60
80
100
120
Under 1 1 to 2yrs 3 to 5yrs 6 to 10yrs
11 to 15yrs
16-17 18-20
Perc
ent o
f all
in c
are
20 Small Counties: In Care on Jan 1, 2012
Non-FC
Trial Home Visit
Other (?)
Transitional Housing
Court Specified Home
Runaway
Pre-Adopt
Guardian - Dependent
Guardian - Other
Group
Foster
FFA
Kin
OUTCOMES: EXITS AND LENGTH OF STAY
Managing with Data in Child Welfare
Key Questions: Permanency Outcomes
•What proportion of children entering care will eventually reunify?•How does this differ by age at removal?•What percent of children remain in care after 3 years?•Are there differences by race or in different counties?•Is this trend changing over time?
Reunification in 12 MonthsAs a group, the 20 small counties reunify a larger proportion of children within 12 months. Infants and older teens are less likely to reunify in 12 months
0
10
20
30
40
50
60
70
<1 mo 1-11 mo 1-2 yr 3-5 yr 6-10 yr 11-15 yr 16-17 yr% o
f Fir
st E
ntri
es in
Car
e 8
Day
s or
Mor
e
Reunification within 12 Months
20 Small California
Entered care for the first time between July and Dec 2010 and remained in care at least 8 days.
Re-Entry After Reunification – As a group, the 20 small counties have slightly higher re-entries than the state average.
CountyExiting to
reunification CY2010
Number reentering
within 12 mos%
California 19,171 2,274 11.9%Alpine 0 0 0.0%Amador 24 3 12.5%Calaveras 30 3 10.0%Colusa 16 3 18.8%Del Norte 39 5 12.8%Glenn 64 10 15.6%
Inyo 10 1 10.0%Lake 18 1 5.6%Lassen 19 4 21.1%Mariposa 8 3 37.5%Modoc 12 0 0.0%Mono 3 1 33.3%Nevada 21 8 38.1%Plumas 14 2 14.3%San Benito 35 3 8.6%Sierra 3 0 0.0%Siskiyou 61 4 6.6%Tehama 124 15 12.1%
Trinity 25 5 20.0%Tuolumne 58 13 22.4%20 Small 584 84 14.4%
New Entries: Percent Exiting Over Time – 89% of the children who entered care for the first time achieved permanency within 36 months. This is higher than the statewide average of 83%
Entered care for the first time between July and Dec 2008 and remained in care at least 8 days.
0
20
40
60
80
100
3 months
6 months
12 months
18 months
24 months
30 months
36 months
20 Small - Exits to Permanency Over Time
Still in care
Other
Emancipated
Guardianship
Adopted
Reunified
Achievement of permanency for longer stayers is Improving, (CFSR Measure C3.1)
0%
20%
40%
60%
80%
100%
0
50
100
150
200
250
300
350
400
450
2005 2006 2007 2008 2009 2010 2011
Of all children/youth in care for 2 yrs or more on Jan 1, what % will exit to permanency by Dec 31?
# in care 2yrs or more on Jan 1 - 20 Small
% Exit to permanency by Dec 31 - 20 Small
% Exit to Permanency by Dec 31 - California
HTTP://CSSR.BERKELEY.EDU/UCB_CHILDWELFARE/
Review Your Data Here!