AFCARS Assessment Review Report - Administration for Children ...

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The State will also have to modify the collection of this information to meet the new NationalYouth in Transition Database (NYTD) race requirements. Guidance on these options and how tomap them for AFCARS purposes is provided in the attached matrices.Child’s Diagnosed ConditionsThis also is an area with a significant amount of missing data; 40% of the records in the 2008Areport were missing information. For AFCARS reporting purposes, the information reported forthese elements reflects chronic and/or significant diagnosed conditions that the child may have.CHESSIE contains several screens that include information pertaining to these elements (see theFindings document for more information). One area is a health section that contains severalitems related to these elements. Caseworkers are supposed to complete each screen/field.Consequently, this results in duplicative data entry, which results in issues related to dataaccuracy and SACWIS compliance. The State needs to make modifications to consolidate allthis information into one section of the system and make the corrections as noted above.Additionally, this correction will address the issue of data duplication raised by the Children’sBureau for SACWIS compliance. A resource list of conditions to be mapped to AFCARS islisted on the Children’s Bureau’s web page athttp://www.acf.hhs.gov/programs/cb/systems/afcars/resourcesIn addition, the system does not contain the question “has this child been diagnosed with adisability?” The AFCARS responses to this question have specific definitions. These are:“Yes” indicates that a qualified professional has clinically diagnosed thechild as having at least one of the disabilities listed below.“No” indicates that a qualified professional has conducted a clinicalassessment of the child and has determined that the child has no disabilities.“Not Yet Determined” indicates that a clinical assessment of the child by aqualified professional has not been conducted.Another significant issue with the State methodology for collecting these data is that there are nodates associated with the child’s diagnosed conditions. Consequently, a complete history is notmaintained to reflect the time frame the child may have each condition. This is especiallyproblematic for files that the State resubmits.Removal EpisodesFor AFCARS purposes, a removal episode is the period of time in which the State has care andplacement responsibility for a child. In AFCARS this is the time between the child’s “Date ofLatest Removal” (foster care element #21) and the child’s “Date of Most Recent Discharge”(foster care element #56). A child may have more than one episode if he or she was removedfrom home more than once. This is not to be confused with the number of placement settingsthat a child has experienced. Within one removal episode, a child may have multiple placementsettings.US DHHS/ACF/ACYF/Children’s Bureau 7
In CHESSIE, there are two screens on which the child’s discharge date and reason may beentered. The worker may enter a placement end date with a placement end type of “permanentlyleaving custody,” and enter a placement end reason that is identical to a custody end reason. Theworker may also enter a custody end date and reason on a separate screen. However, the workermay end a placement setting with a reason of “adoption” while the custody remains open.Therefore, the worker may think that the removal episode has been end-dated, when in fact it isstill open. Maryland staff indicated that they would develop a plan to streamline this process.We recommend that the placement end date be kept separate from the removal episode (orcustody end date) to the extent possible. This may mean that if a worker ends a placement with areason that corresponds with a custody end reason, the worker is taken to the custody screen toenter that this placement end does in fact constitute the child’s discharge from the care andplacement responsibility of the State. This helps to prevent a worker from erroneously entering adischarge when a placement change should have been recorded. On the other hand, the workermay think that the child has been recorded as discharged, when really only the placement hasbeen ended in CHESSIE.Also, for AFCARS reporting purposes, when a child’s only living arrangement during a removalepisode is a placement outside the scope of the Federal definition of foster care (i.e., detention ora hospital), this child is not to be considered for the AFCARS reporting population and theremoval episode is never included when reporting AFCARS. This affects foster care elements:#18, date of first removal from home; #19, total number of removals from home; #20, date ofdischarge from the previous foster care episode; and, #21, date of current removal episode.Additionally, for AFCARS reporting purposes, if the child’s first living arrangement was onethat is outside the scope of foster care and then the child moves to a foster care setting, theremoval episode start date is the start date of the foster care living arrangement. This date wouldalways be considered the start date of the the removal episode.The State is not correctly reporting the start date of removal episodes for children/youth that areeither on runaway status when the agency received responsibility for placement and/or runs awayprior to the first placement. If the child is still on runaway status as of the end of the AFCARSreport period, the child should be included in the AFCARS population with a placement status of“runaway” (foster care element #41). Runaway is considered a temporary absence from an ongoingplacement; children whose only placement setting is runaway during the removal episodewould be reported as having zero placement settings in the current episode (foster care element#24). The date the runaway status began will be reported for the date of the current placementsetting (foster care element #23). This date is also the start date of the removal episode (fostercare element #21).Lastly, one area that serves as contextual information for why children are entering foster careand what preventive services may be needed is in the area of “circumstances associated with achild’s removal from home.” This area appears to have significant underreporting. The casefile review findings indicate there were generally more conditions present that contributed to thechild’s removal than what is being recorded in the system. The State needs to provide additionalUS DHHS/ACF/ACYF/Children’s Bureau 8
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