Child Welfare
States Face Challenges in Developing Information Systems and Reporting Reliable Child Welfare Data Gao ID: GAO-04-267T November 19, 2003To better monitor children and families served by state child welfare agencies, Congress authorized matching funds for the development of statewide automated child welfare information systems (SACWIS) and required that the Department of Health and Human Services (HHS) compile information on the children served by state agencies. This testimony is based on our July 2003 report and addresses the following: (1) states' experiences in developing child welfare information systems and HHS's role in assisting in their development, (2) factors that affect the reliability of data that states collect and report on children served by their child welfare agencies and HHS's role in ensuring the reliability of those data, and (3) practices that child welfare agencies use to overcome challenges associated with SACWIS development and data reliability. For the July 2003 report, we surveyed all 50 states and the District of Columbia regarding their experiences developing and using information systems and their ability to report data to HHS. We also reviewed a variety of HHS documents and visited five states to obtain firsthand information. Finally, we interviewed HHS officials and child welfare and data experts and reviewed relevant literature.
HHS reported that 47 states are developing or operating a SACWIS, but many states continue to face challenges developing their systems. Most state officials said they recognize the benefit their state will achieve by developing SACWIS, such as contributing to the timeliness of child abuse and neglect investigations; however, despite the availability of federal funds since 1994, states reported a median delay of 2 1/2 years beyond the time frames they set for completion. States reported that they encountered some difficulties during SACWIS development, such as challenges receiving state funding and creating a system that reflected their work processes. In response to some of these challenges, HHS has provided technical assistance to help states develop their systems and conducted on-site reviews of SACWIS to verify that the systems meet federal requirements. Despite efforts to implement comprehensive information systems, several factors affect the states' ability to collect and report reliable adoption, foster care, and child abuse and neglect data. States responding to GAO's survey and officials in the five states GAO visited reported that insufficient caseworker training and inaccurate and incomplete data entry affect the quality of the data reported to HHS. In addition, states reported technical challenges reporting data. Despite HHS assistance, many states report ongoing challenges, such as the lack of clear and documented guidance on how to report child welfare data. In addition, although states were mandated to begin reporting data to the Adoption and Foster Care Analysis Reporting System (AFCARS) in 1995, few reviews of states' AFCARS reporting capabilities have been conducted to assist states in resolving some of their reporting challenges. Some states are using a variety of practices to address the challenges associated with developing SACWIS and improving data reliability. For example, 28 states reported using approaches to help caseworkers identify and better understand the data elements that are required for federal reporting. In a related report, we recommended that the Secretary of HHS consider ways to enhance the guidance and assistance offered to states to help them overcome the key challenges in collecting and reporting child welfare data. These efforts could include a stronger emphasis placed on conducting AFCARS reviews and timelier follow-up to help states implement their improvement plans or identifying a useful method to provide clear and consistent guidance. HHS generally agreed with our findings but, in response to our recommendation, said that we did not recognize the longterm efforts to provide AFCARS and National Child Abuse and Neglect Data System related guidance. HHS also noted that the data definitions need to be updated and revised and said it was in the process of revising regulations. HHS added that it is firmly committed to continue to support the states and to provide technical guidance and assistance as resources permit.
GAO-04-267T, Child Welfare: States Face Challenges in Developing Information Systems and Reporting Reliable Child Welfare Data
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Testimony:
Before the Subcommittee on Human Resources, Committee on Ways and
Means, House of Representatives:
United States General Accounting Office:
GAO:
For Release on Delivery Expected at 2:00 p.m. EST:
Wednesday, November 19, 2003:
CHILD WELFARE:
States Face Challenges in Developing Information Systems and Reporting
Reliable Child Welfare Data:
Statement of Cornelia M. Ashby, Director, Education, Workforce, and
Income Security Issues:
GAO-04-267T:
GAO Highlights:
Highlights of GAO-04-267T, a testimony for the Subcommittee on Human
Resources, Committee on Ways and Means, House of Representatives
Why GAO Did This Study:
To better monitor children and families served by state child welfare
agencies, Congress authorized matching funds for the development of
statewide automated child welfare information systems (SACWIS) and
required that the Department of Health and Human Services (HHS)
compile information on the children served by state agencies. This
testimony is based on our July 2003 report and addresses the
following: (1) states‘ experiences in developing child welfare
information systems and HHS‘s role in assisting in their development,
(2) factors that affect the reliability of data that states collect
and report on children served by their child welfare agencies and
HHS‘s role in ensuring the reliability of those data, and (3)
practices that child welfare agencies use to overcome challenges
associated with SACWIS development and data reliability. For the July
2003 report, we surveyed all 50 states and the District of Columbia
regarding their experiences developing and using information systems
and their ability to report data to HHS. We also reviewed a variety of
HHS documents and visited five states to obtain firsthand information.
Finally, we interviewed HHS officials and child welfare and data
experts and reviewed relevant literature.
What GAO Found:
HHS reported that 47 states are developing or operating a SACWIS, but
many states continue to face challenges developing their systems. Most
state officials said they recognize the benefit their state will
achieve by developing SACWIS, such as contributing to the timeliness
of child abuse and neglect investigations; however, despite the
availability of federal funds since 1994, states reported a median
delay of 2½ years beyond the time frames they set for completion.
States reported that they encountered some difficulties during SACWIS
development, such as challenges receiving state funding and creating a
system that reflected their work processes. In response to some of
these challenges, HHS has provided technical assistance to help states
develop their systems and conducted on-site reviews of SACWIS to
verify that the systems meet federal requirements.
Despite efforts to implement comprehensive information systems,
several factors affect the states‘ ability to collect and report
reliable adoption, foster care, and child abuse and neglect data.
States responding to GAO‘s survey and officials in the five states GAO
visited reported that insufficient caseworker training and inaccurate
and incomplete data entry affect the quality of the data reported to
HHS. In addition, states reported technical challenges reporting data.
Despite HHS assistance, many states report ongoing challenges, such as
the lack of clear and documented guidance on how to report child
welfare data. In addition, although states were mandated to begin
reporting data to the Adoption and Foster Care Analysis Reporting
System (AFCARS) in 1995, few reviews of states‘ AFCARS reporting
capabilities have been conducted to assist states in resolving some of
their reporting challenges.
Some states are using a variety of practices to address the challenges
associated with developing SACWIS and improving data reliability. For
example, 28 states reported using approaches to help caseworkers
identify and better understand the data elements that are required for
federal reporting.
In a related report, we recommended that the Secretary of HHS consider
ways to enhance the guidance and assistance offered to states to help
them overcome the key challenges in collecting and reporting child
welfare data. These efforts could include a stronger emphasis placed
on conducting AFCARS reviews and timelier follow-up to help states
implement their improvement plans or identifying a useful method to
provide clear and consistent guidance. HHS generally agreed with our
findings but, in response to our recommendation, said that we did not
recognize the long-term efforts to provide AFCARS and National Child
Abuse and Neglect Data System related guidance. HHS also noted that
the data definitions need to be updated and revised and said it was in
the process of revising regulations. HHS added that it is firmly
committed to continue to support the states and to provide technical
guidance and assistance as resources permit.
www.gao.gov/cgi-bin/getrpt?GAO-04-267T.
To view the full product, including the scope and methodology, click
on the link above. For more information, contact Cornelia M. Ashby at
(202) 512-8403 or ashbyc@gao.gov.
[End of section]
Mr. Chairman and Members of the Subcommittee:
Thank you for inviting me here today to discuss states' development of
automated child welfare information systems. As you are aware, the
Congress required that the Department of Health and Human Services
(HHS) compile information on the children served by state agencies and
authorized federal funds to match those of states for use in the
development of state child welfare information systems. Since 1994,
designated federal matching funds have been available to states to
develop and implement comprehensive case management systems--statewide
automated child welfare information systems (SACWIS)--to manage their
child welfare cases as well as to report child abuse and neglect,
foster care, and adoption information to the federal government. States
have the option to implement a SACWIS or develop different information
systems without using SACWIS funds to support their child welfare
agencies and collect information on their child welfare cases.
Regardless of the type of system a state develops, child welfare
caseworkers at the county or local level are the key personnel who
collect and document information on children and families served by
child welfare agencies, in addition to performing a wide range of
services to protect children--such as investigating child abuse or
neglect reports or providing support services to maintain the children
in their homes.
Currently, HHS compiles state-reported child welfare data in two
databases: the Adoption and Foster Care Analysis and Reporting System
(AFCARS) and the National Child Abuse and Neglect Data System (NCANDS).
HHS relies on the information available in its databases to analyze and
track children's experiences in the child welfare system, to determine
states' performance on federal child welfare outcome measures, and to
report to Congress on children's well being and child welfare
experiences.
My testimony today will focus on three key issues: (1) states'
experiences in developing child welfare information systems and HHS's
role in assisting in their development; (2) factors that affect the
reliability of data that states collect and report on children served
by their child welfare agencies, and HHS's role in ensuring the
reliability of those data; and (3) practices that child welfare
agencies use to overcome challenges associated with SACWIS development
and data reliability. My comments are based on the findings from our
July 2003 report, Child Welfare: Most States Are Developing Statewide
Information Systems, but the Reliability of Child Welfare Data Could Be
Improved (GAO-03-809, July 31, 2003). Those findings were based on our
survey of all 50 states and the District of Columbia regarding their
experiences in developing and using information systems and their
ability to report data to HHS. We received responses from 49 states and
the District of Columbia,[Footnote 1] although some states did not
respond to every question. We also reviewed a variety of HHS documents,
including the protocol and reports for its reviews of SACWIS systems
and states' AFCARS reporting capabilities and visited five states--
Colorado, Iowa, New York, North Carolina, and Oklahoma--to obtain
firsthand information on their experiences developing SACWIS and
reporting data to HHS. We selected these states to represent geographic
diversity and different stages of SACWIS implementation. Finally, we
interviewed HHS officials and child welfare and data experts and
reviewed relevant literature.
In summary, HHS reported that 47 states were developing or operating a
SACWIS, but many states continue to face challenges developing their
systems. Most state officials said they recognize the benefit their
state will achieve by developing SACWIS, but added that they have
encountered difficulties in receiving state funding and in creating a
system that reflected their work processes. Despite the availability of
federal funds since 1994, states reported a median delay of 2½ years
beyond the time frames they set for completion. Several factors affect
the states' ability to collect and report reliable adoption, foster
care, and child abuse and neglect data. For example, insufficient
caseworker training and inaccurate and incomplete data entry affect the
quality of data reported to HHS. States also reported technical
challenges reporting data. Despite HHS's assistance, many states
reported ongoing challenges, such as the lack of clear and documented
guidance from HHS on how to report child welfare data. In addition,
although states were mandated to begin reporting data to AFCARS in
1995, few reviews of states' AFCARS reporting capabilities have been
conducted. Some states are using a variety of practices to address the
challenges they face in developing SACWIS and improving data
reliability. For example, 28 states reported using approaches to help
caseworkers identify and better understand the data elements that are
required for federal reporting. To improve the reliability of state-
reported child welfare data, we recommended in our July 2003 report
that the Secretary of HHS consider ways to enhance the guidance and
assistance offered to states to help them overcome the key challenges
in collecting and reporting child welfare data.
Background:
ACF's Children's Bureau is responsible for the administration and
oversight of federal funding to states for child welfare services under
Titles IV-B and IV-E of the Social Security Act. However, the
monitoring of children served by state child welfare agencies is the
responsibility of the state agencies that provide the services to these
children and their families. Child welfare caseworkers at the county or
local level are the key personnel responsible for documenting the wide
range of services offered to children and families, such as
investigations of abuse and neglect, treatment services offered to keep
families intact and prevent the need for foster care, and arrangements
made for permanent or adoptive placements when children must be removed
from their homes. Caseworkers are supported by supervisors, who
typically assign new cases to workers and monitor caseworkers' progress
in achieving desired outcomes, analyzing and addressing problems and
making decisions about cases.
To qualify for federal funding for SACWIS, states must prepare and
submit an advance planning document (APD) to the Children's Bureau, in
which they describe the state's plan for managing the design,
development, implementation, and operation of a SACWIS that meets
federal requirements and state needs in an efficient, comprehensive,
and cost-effective manner. In addition, the state must establish SACWIS
and program performance goals in terms of projected costs and benefits
in the APD. States are required to submit separate APDs for the
planning and development phases, in addition to periodic updates.
Since the administration and structure of state child welfare agencies
vary across the nation, states can design their SACWIS to meet their
state needs, as long as states meet certain federal requirements.
Federal funding is available to states for SACWIS that:
* meet the requirements for reporting AFCARS data to HHS;
* to the extent practicable, are capable of linking with the state data
collection system that collects information on child abuse and neglect;
* to the extent practicable, are capable of linking with, and
retrieving information from, the state data collection system that
collects information on the eligibility of individuals under Title IV-
A--Temporary Assistance for Needy Families; and:
* provides for more efficient, economical, and effective administration
of the programs carried out under a state's plans approved under Titles
IV-B and IV-E of the Social Security Act.
A SACWIS must operate uniformly as a single system in each state and
must encompass all entities that administer programs provided under
Titles IV-B and IV-E. In some cases, HHS will allow the statewide
system to link to another state system to perform required functions,
such as linking to financial systems to issue and reconcile payments to
child welfare service providers. The state's APD must describe how its
SACWIS will link to other systems to meet the requirements in the
SACWIS regulations.
In addition to monitoring the APDs of the states that are developing
SACWIS, HHS reviews state information systems through formal SACWIS
assessment reviews and the Child and Family Services Reviews (CFSR)--a
federal review process to monitor states' compliance with child welfare
laws and federal outcome measures. The formal SACWIS reviews are
conducted by the Children's Bureau to determine if a state has
developed and implemented all components detailed in the state's APD
and if the system adheres to federal requirements. The CFSR assesses
statewide information systems, along with other systemic factors, to
determine if the state is operating a system that can readily identify
the status, demographic characteristics, location, and goals for
placement of every child who is in foster care. This systemic factor is
reviewed in all states, regardless of whether the state is developing a
SACWIS or the stage of system development. For the 40 CFSR reports that
are available, HHS found that four states were not in substantial
conformity on the statewide information system indicator.[Footnote 2]
These four states must address how they will come into conformity with
this factor in a program improvement plan. HHS has also conducted
SACWIS reviews in two of these states.
Most States Are Developing SACWIS, But Challenges Remain Despite HHS's
Oversight and Technical Assistance:
While 47 states are developing or operating a SACWIS, many challenges
remain despite HHS's oversight and technical assistance. Since 1994,
states reported that they have spent approximately $2.4 billion in
federal, state, and local funding on SACWIS. While most state officials
we interviewed and those responding to our survey said that they
recognize the benefits their state will achieve by developing a
statewide system, many states reported that the development of their
SACWIS is delayed between 2 months and 8 years beyond the time frames
the states set for completion, with a median delay of 2½ years. Most
states responding to our survey faced challenges, such as obtaining
state funding and developing a system that met the child welfare
agency's needs statewide. In response to some of these challenges, HHS
has provided technical assistance to help states develop their systems
and conducted on-site SACWIS reviews to verify that the systems meet
all federal requirements.
States Are Using Federal and State Funds and Various Participants to
Develop Multicomponent SACWIS:
Currently, 47 states are developing or operating a SACWIS and are in
various stages of development--ranging from planning to complete. The
states responding to our survey reported using approximately $1.3
billion in federal funds[Footnote 3] and approximately $1.1 billion in
state and local funds[Footnote 4] for their SACWIS. However, HHS
estimated that it allocated approximately $821 million between fiscal
years 1994 and 2001 in SACWIS developmental funds[Footnote 5] and $173
million between fiscal years 1999 and 2001 in SACWIS operational
funds.[Footnote 6] The total amount of federal funding provided to
states for SACWIS is unknown because states claimed operational costs
as a part of their Title IV-E administrative expenses prior to
1999.[Footnote 7] Although the federal government matched state funding
at an enhanced rate of 75 percent beginning in 1994, many states did
not apply for federal funding or begin SACWIS development until 1996 or
1997, when more than $467 million--the bulk of federal funds--were
allocated. Most states were still developing their SACWIS by the time
enhanced funding expired in 1997, after which states could receive a 50
percent federal financial participation for SACWIS development and
operation. Although 47 states are currently developing or operating a
SACWIS, all states except Hawaii received some federal SACWIS funds.
For example, according to figures provided by HHS, North Carolina and
North Dakota received some developmental funds but encountered
difficulties that prevented them from completing their systems.
In order to track states' SACWIS development, HHS places them in six
categories that identify their stage of development (see table 1). HHS
sometimes recategorizes states into a lower stage of development when
problems are encountered. In addition, while HHS may classify a state
system as complete following an assessment of the state's SACWIS, a
state may make additional changes to the system since SACWIS, like
other computer systems, continually evolve as technology and child
welfare practices change. States can claim federal funding for these
changes as operational expenses. An HHS official reported that such
changes do not need prior approval unless they are in excess of $5
million.
Table 1: Number of States in Various Stages of SACWIS Development:
Stage: Complete[A]; Number of states: 5.
Stage: Operational[B]; Number of states: 24.
Stage: Partially operational[C]; Number of states: 9.
Stage: Implementation[D]; Number of states: 2.
Stage: Planning[E]; Number of states: 7.
Stage: No SACWIS[F]; Number of states: 4.
Source: HHS.
Note: Status is as of October 13, 2003.
[A] The SACWIS assessment process is completed, and all functional
requirements and specifications set forth in the APD are either
included in the system or in an accepted corrective action plan.
[B] All functional requirements and specifications in the APD are
included in the system, and the system is functional statewide, but
state has not completed a SACWIS assessment or is working on other
issues.
[C] The state is still rolling out a system to field sites or still
adding functions to systems that are operational statewide.
[D] In active design and development, even if delayed while waiting to
resolve problems such as funding.
[E] Working through options for a SACWIS.
[F] Have never pursued SACWIS funding or have abandoned plans to
develop a system.
[End of table]
States have considerable flexibility in the design of their SACWIS.
According to HHS officials, a state should be using its SACWIS as a
case management tool that uses automation to support the various
aspects of state child welfare programs, such as recording child
protection, out-of-home care, and foster care and adoption services. To
further assist child welfare practice, states have designed their
systems to follow the natural flow of child welfare practice in their
state and have added design features to help track key events during a
case. For example, in Iowa child welfare work is divided between child
abuse and neglect investigations and ongoing case management for
children brought into the care of the child welfare agency. As a
result, Iowa designed a SACWIS to reflect this work process by linking
two databases--one to record child abuse and neglect information and
one to record ongoing case records--that share information with each
other.[Footnote 8]
Since many states are in different phases of SACWIS development, their
systems currently support to varying degrees a variety of child welfare
and administrative components (see table 2). According to HHS, while
the components listed in table 2 are required for a state's SACWIS to
be considered compliant with federal guidance--either through an
interface or built within the system--some of the subcomponents, such
as a function that helps caseworkers manage their caseloads, are
optional. HHS has encouraged states to automate as many functions as
possible in the SACWIS in an effort to cut down on the additional
paperwork or duplicative steps inherent in manual data collection.
Table 2: Selected SACWIS Child Welfare and Administrative Services:
Service: Child welfare services:
Service: Child protection[A]; Fully or partially operational in SACWIS:
38; Planned for SACWIS: 5.
Service: Out-of-home care[B]; Fully or partially operational in SACWIS:
35; Planned for SACWIS: 8.
Service: Adoption; Fully or partially operational in SACWIS: 34;
Planned for SACWIS: 9.
Service: Independent living; Fully or partially operational in SACWIS:
27; Planned for SACWIS: 14.
Service: Intensive home-based services[C]; Fully or partially
operational in SACWIS: 27; Planned for SACWIS: 13.
Service: Administrative services:
Service: Workload management; Fully or partially operational in SACWIS:
32; Planned for SACWIS: 8.
Service: IV-E eligibility[D]; Fully or partially operational in SACWIS:
29; Planned for SACWIS: 14.
Service: Foster care maintenance payments; Fully or partially
operational in SACWIS: 28; Planned for SACWIS: 14.
Service: Adoption assistance payments; Fully or partially operational
in SACWIS: 25; Planned for SACWIS: 17.
Service: Contract provider payment; Fully or partially operational in
SACWIS: 24; Planned for SACWIS: 15.
Source: GAO survey.
Note: This table is based on responses from 46 states developing or
operating a SACWIS. The rows for the columns "fully or partially
operational" and "planned" do not add to 46 because the respondents may
have answered "not supported," "don't know," or "no answer.":
[A] Child protection includes services such as intake and screening,
investigation, and disposition.
[B] Out-of-home care includes things such as foster care, group homes,
and residential placement.
[C] Intensive home-based services include efforts to avoid placing a
child in foster care.
[D] IV-E funding is available for foster care, adoption, and
independent living services.
[End of table]
To assist with the design of their SACWIS, states relied on a number of
different participants, including internal users, such as caseworkers
and managers, information technology (IT) staff, and contractors. In
Oklahoma, for example, 150 child welfare staff from the field worked
closely with the contractor in intensive work group sessions to design
and test the system. To complement the caseworkers' knowledge of child
welfare practice, 43 states relied on IT staff. Finally, 42 states
reported that they hired private contractors to conduct a large part of
SACWIS design and development.
At the time of our review, HHS reported that four states were not
pursuing SACWIS development, and most of these states reported various
reasons in our survey for not developing a system. In Hawaii, for
example, the child welfare agency chose not to pursue SACWIS because it
already had a statewide system in place that it believed was adequately
meeting its needs and which was collecting and reporting federal child
welfare data.
States Accrue Benefits from Using SACWIS, but Several Issues Create
Delays in Completing States' Systems:
While most state child welfare agency officials said they recognize the
benefits the state will achieve by developing SACWIS, such as enhancing
their ability to track the whereabouts of foster children, 31 state
agencies lag behind the time frames they set for completion, with 26
states reporting delays ranging from 2 months to 8 years. According to
survey results, automated systems provided easier access to data and
allowed caseworkers to better monitor children in their care, a fact
that may contribute to additional child welfare and administrative
benefits, such as decreased incidences of child abuse and neglect,
shortened length of time to achieve adoption, timeliness of payments to
foster families, and timeliness of payments to foster facilities. New
Jersey, which is in the planning stage, reported in our survey that its
goal in developing a SACWIS is to integrate the more than 40 stand-
alone systems that currently capture information on the children served
by their child welfare agency.[Footnote 9] By pulling all of these
systems together into a uniform SACWIS, the state hopes to improve the
recording of casework activities in a timely manner and to develop a
tool to better target resources and services. Effectively integrating
these systems will require the state to use a disciplined IT management
approach that includes (1) detailed analyses of users' needs and
requirements, (2) a clearly defined strategy for addressing information
needs, and (3) sufficient technical expertise and resources to support
the effort.
Despite the benefits that many states have accrued with SACWIS, 31
states reported in our survey that they have been delayed in system
completion beyond their initial deadline and identified a number of
challenges that have led to the delay (see table 3).[Footnote 10] Some
of the common difficulties states reported in developing SACWIS
included receiving state funding approval, reaching internal agreement
on system development, and creating a system that reflects child
welfare work processes and is user-friendly. Vermont officials, for
example, reported that the state legislature declined to provide the
matching state funds needed to secure federal funding for SACWIS. As a
result, the state could not pursue development.
Table 3: Number of Months States Delayed in SACWIS Development:
State: Alabama; Length of delay in months[A]: 36.
State: Arkansas; Length of delay in months[A]: 6.
State: California; Length of delay in months[A]: 36.
State: Colorado; Length of delay in months[A]: 26.
State: Connecticut; Length of delay in months[A]: 96.
State: District of Columbia; Length of delay in months[A]: 36.
State: Georgia; Length of delay in months[A]: 25.
State: Idaho; Length of delay in months[A]: 21.
State: Illinois; Length of delay in months[A]: 79.
State: Indiana; Length of delay in months[A]: 6.
State: Kansas; Length of delay in months[A]: 72.
State: Louisiana; Length of delay in months[A]: 12.
State: Maryland; Length of delay in months[A]: 12.
State: Michigan; Length of delay in months[A]: 26.
State: Minnesota; Length of delay in months[A]: 12.
State: Mississippi; Length of delay in months[A]: 12.
State: New Jersey; Length of delay in months[A]: 42.
State: New Mexico; Length of delay in months[A]: 3.
State: Ohio; Length of delay in months[A]: 36.
State: Oregon; Length of delay in months[A]: 70.
State: Rhode Island; Length of delay in months[A]: 14.
State: South Carolina; Length of delay in months[A]: 47.
State: Tennessee; Length of delay in months[A]: 36.
State: Utah; Length of delay in months[A]: 48.
State: Virginia; Length of delay in months[A]: 2.
State: Washington; Length of delay in months[A]: 36.
Source: GAO survey.
Note: While 31 states reported in the survey that they have experienced
a delay in SACWIS development, only 26 states reported the length of
their delay. The survey was issued in October 2002 and completed by
states as late as December 2002.
[A] States were asked to report the number of months the delays
exceeded the time line outlined in their APD.
[End of table]
Despite user involvement in system design, some states still faced
challenges trying to reach internal agreement among agency officials
and caseworkers on the design of a system, resulting in a delay in
development. In New York--a state where the counties are responsible
for administering child welfare services--the development of SACWIS was
stalled when significant frustration with the system's design led
commissioners from five large counties and New York City to request
that the state stop SACWIS development until a reassessment of the
design of and plans for the implementation of the system was completed.
Similarly, despite states' heavy reliance on contractors, many reported
that securing contractors with knowledge of child welfare practice was
a challenge for timely SACWIS development. Contractors are hired by the
state for their system development knowledge but often are unfamiliar
with child welfare policies and practices, especially since they vary
from state to state. A contractor who has worked with seven states to
develop their SACWIS reported that contractors are asked to learn the
child welfare business practices of a state in a short amount of time
and that states cannot devote many resources, such as caseworkers, to
help in the design process because caseworkers need to devote their
time to providing services to children and families.
Many states reported that creating a system that reflects child welfare
work processes and is user-friendly was a challenge in developing
SACWIS. These issues were also identified in the federal reviews of
states' SACWIS. For example, one state explained in the SACWIS review
that it had designed a system to meet the caseworkers' needs and
reflect the nature of the child welfare work processes by developing a
system that required events to be documented as they occurred. However,
this design limited the SACWIS's functionality because it did not allow
the caseworkers to go back and enter information after an event
happened. The state explained that caseworkers do not use the system in
real time, but provide services to the children and families and then
record the information in the system. The state had to redesign the
system to correct for this design flaw.
HHS Provides Some Assistance to Help States Meet SACWIS Requirements:
HHS has assisted states in a variety of ways in developing and
completing their SACWIS.[Footnote 11] As a part of its regulatory
responsibilities, HHS must review, assess, and inspect the planning,
design, development, installation, and operation of SACWIS. In addition
to reviewing and monitoring states' APDs, HHS conducts on-site SACWIS
reviews to comply with these responsibilities. HHS officials told us
that these reviews are a detailed and thorough assessment of state
systems to ensure the systems' compliance with SACWIS requirements. In
addition, officials reported that they provide technical assistance
during the on-site review to help states that do not fully conform with
the applicable regulations and policies. As of October 2003, HHS had
reviewed 27 SACWIS--5 of which were determined as meeting all the
requirements and classified as complete. HHS officials told us that
since states have the flexibility to build a SACWIS that meets their
needs, a large portion of the formal reviews concentrate on ensuring
that the systems conform to state business practices. For example,
while SACWIS regulations require that a state report all AFCARS data
from their SACWIS, one state HHS reviewed relied on a separate state
system to report data on the children served by the juvenile justice
agency who are eligible for IV-E foster care funds. The state proved it
had developed an automated process to merge data from both systems to
compile a single AFCARS report that included children captured in both
their SACWIS and juvenile justice systems. Therefore, HHS recognized
that this process best met the state's needs and determined the SACWIS
to be complete and meeting all requirements.
Few systems have been determined complete after an on-site review
because of unresolved issues, such as not being able to build links to
other state information systems or not implementing certain eligibility
determination functions. To help states address some of these
development challenges, the SACWIS review team provides the state with
recommendations for complying with SACWIS requirements. In addition,
HHS officials reported that once the draft report with the results of
the SACWIS review is completed, federal staff schedule a conference
call with the state officials to walk through the system's deficiencies
and offer guidance on how the state can move forward.
HHS facilitates the sharing of information between states developing
SACWIS through an automated system users' group that allows state and
federal officials to exchange information, ideas, and concerns. In
addition to the users' group, HHS officials also sponsor a Listserv--an
electronic mailing list--that allows state officials to exchange
information and a monthly conference call with state information
technology directors. [Footnote 12] Technical assistance for SACWIS
development is also available to states through the National Resource
Center for Information Technology in Child Welfare (Resource Center),
which opened in 1999. According to survey results, 9 states said they
used the Resource Center for assistance in developing SACWIS and 14
states reported using it for help with SACWIS maintenance and
improvements. According to Resource Center officials, they assist
states with SACWIS development by helping states understand the
technology that is available for use, providing information on the
automation of child welfare work and converting data, and reviewing the
APD documentation.
Several Factors Affect the States' Ability to Ensure Reliable Data on
Children's Experiences, and Some of HHS's Oversight and Assistance Is
Problematic:
Several factors affect states' ability to collect and report
reliable[Footnote 13] data on children served by state child welfare
agencies, and some problems exist, such as a lack of clear and
documented guidance, with HHS's oversight and technical assistance.
Almost all of the states responding to our survey reported that
insufficient caseworker training and inaccurate and incomplete data
entry affect the quality of the data reported to HHS.[Footnote 14] In
addition, 36 of the 50[Footnote 15] states that responded to our survey
reported that technical challenges, such as matching their state data
element definitions to HHS's data categories, affected the quality of
the data that they report to the federal government. Despite the
assistance that HHS offers to states, such as testing state data
quality and providing the results to states to aid them in resubmitting
data, states report ongoing challenges receiving clear and documented
guidance and obtaining technical assistance.
Insufficient Caseworker Training and Inaccurate and Incomplete Data
Entry Are the Most Common Factors That Affect Data Reliability:
Almost every state responding to our survey and all the states we
visited reported that insufficient training for caseworkers and
inaccurate and incomplete data entry affect the quality of the data
reported to AFCARS and NCANDS (see fig. 1). Although most states
reported these as separate factors, HHS and the states we visited found
that insufficient training and inaccurate and incomplete data entry are
often linked. In official reviews of states' information systems'
capability to capture data and report them to AFCARS, HHS advised
states to offer additional training to caseworkers on several AFCARS
data elements, such as recording the reasons for a child leaving foster
care, to improve the accuracy of the data submitted. However, state
officials told us that training is typically one of the first programs
cut when states face tight budget restrictions. For example, Iowa
officials told us that training has been significantly reduced in
recent years because of budget cuts and new workers may wait 2 to 3
months before being trained how to enter data appropriately into their
SACWIS.
Figure 1: Most Common Caseworker Issues That Affect Data Quality:
[See PDF for image]
Notes: Based on responses from 50 states.
[End of figure]
The results reported in the figure are a sum of the states that
reported the issue had a very great affect, great affect, moderate
affect, or some affect on the quality of state data submitted to HHS.
Very great and great affect responses are represented in the top
section of each bar. Moderate and some affect responses are represented
in the bottom section of each bar. States not included answered "no
affect," "don't know," or "no answer.":
Inaccurate and incomplete data entry can also result from a number of
other factors, such as caseworkers' hesitation to ask families for
sensitive information. For example, caseworkers in Oklahoma reported
that they did not feel comfortable asking if a child's mother was
married at the time of birth or if a child is of Hispanic origin--both
of which are required AFCARS data elements. In commenting on a draft of
this report, Oklahoma added that caseworkers did not understand why the
data elements were required and how the federal government used the
information. HHS noted similar issues in five states that have had an
AFCARS review.[Footnote 16] Caseworkers were inaccurately recording a
child's race as "unable to determine" even though this option should be
selected only if the child's parents or relatives cannot provide the
information, such as when a child is abandoned.[Footnote 17]
Caseworkers, supervisors, and managers in the 5 states we visited
reported that additional factors, such as difficulties balancing data
entry with the time that they spend with the families and children,
contributed to inaccurate or incomplete data entry. Supervisors in Iowa
explained that since caseworkers are responsible for ensuring that
children and their families receive the services they need, the
caseworkers tend to initially limit data entry to the information that
is necessary to ensure timely payment to foster care providers and
complete all other data elements when they have time. In addition,
caseworkers in Colorado said that they are between 30 and 60 days
behind in their data entry, so the information in the automated system
may not accurately reflect the current circumstances of children in
care. HHS's Inspector General recently issued a report in which more
than two-thirds of the states reported that caseworkers' workloads,
turnover, a lack of training, and untimely and incomplete data entry
affected the reporting of AFCARS data.[Footnote 18]
Technical Challenges, such as Matching State Definitions to Federal
Definitions, Affect Data Reliability:
In addition to data quality being affected by caseworker issues, many
states experienced technical challenges reporting their data to HHS.
The problems reported by states are typically a result of challenges
associated with data "mapping"--matching state data elements to the
federal data elements. For example, 36 states reported in our survey
that matching their state-defined data to HHS's definitions affected
the quality of the data reported to NCANDS and AFCARS. Similarly, 24
states reported that matching the more detailed data options available
in their states' information systems to the federal data elements
affected the quality of the data reported to NCANDS. Twenty-nine states
reported that this issue created challenges in reporting data to
AFCARS. For example, following an AFCARS assessment, HHS instructed a
state that collects detailed information on children's disabilities,
such as attention deficit disorder and eating disorders, to map the
information to the more limited options in AFCARS, such as mental
retardation and emotionally disturbed.
In many cases, states have to balance state policy with federal
requirements to ensure that they are reporting accurate data to AFCARS
and NCANDS, but are not contradicting their state policies. For
example, Texas officials reported that although the findings of their
AFCARS review instructed them to modify their SACWIS to collect, map,
and extract data on guardianship placements, the state does not support
guardianship arrangements.[Footnote 19] In addition, a recent report
from the Child Welfare League of America (CWLA) found that when
reporting the number of times children move from one foster care
placement to another, states varied in the type of placements included
in that count.[Footnote 20] For example, 29 percent of the states
responding to CWLA's survey included respite,[Footnote 21] 25 percent
included runaways, and 16 percent included trial home visits when
reporting the number of placements a child had during the AFCARS report
period. According to federal guidance, the "number of placements"
element is meant to gather information on the number of times the child
welfare agency found it necessary to move a child while in foster care
and that by including runaways or trial home visits, a state is
inflating the number of moves a child experienced.
Although HHS Has Taken Steps to Help States Improve Their Data, Some
Problems with Its Efforts Exist:
HHS provides technical assistance for AFCARS and NCANDS reporting
through a number of resources. HHS officials in the central office and
NCANDS contractor staff serve as the points of contact for states to
ask questions and seek guidance on reporting child welfare data. The
officials in three of the five states that we visited said that the
one-on-one focused technical assistance was useful when provided in a
timely fashion. Most state officials found the NCANDS data easier to
report, in part because more people were available for consultation and
they were more accessible and responsive. For example, states have
access to four NCANDS specialists and staff in the contractor's central
office when they need assistance reporting child abuse and neglect
information. However, some of the states we visited reported that only
one or two staff in HHS's central office are available to assist with
AFCARS reporting.
In addition, the Resource Center offers states assistance with
improving data quality. However, Resource Center staff reported that
the assistance is geared more toward improving the limited data used in
the federal review process to monitor states' compliance with child
welfare laws and federal outcome measures--CFSR--rather than all the
data reported to HHS. The Resource Center also sponsors an annual
information technology conference during which sessions covering all
data-related issues are held, including practices for ensuring data
quality and outcome evaluation in child welfare. In conjunction with
this conference, the HHS officials and the contractors that operate
NCANDS hold an annual technical assistance meeting for states to share
ideas with one another, discuss data elements that pose difficulties,
and explore ways to address these problems. In addition, an NCANDS
state advisory group meets annually to talk with HHS officials about
NCANDS data and their experiences reporting data. From these meetings,
the state advisory group proposes changes or improvements to NCANDS.
HHS and state officials reported that this partnership has helped ease
some of the challenges in reporting child abuse and neglect data.
HHS has also made available to states the software it uses to examine
states' AFCARS and NCANDS submissions for inconsistencies and invalid
data. Officials in all the states we visited said that they regularly
use this software, and an HHS official said that nearly every state has
used the software at least once. When the data are submitted to HHS,
they are run through the same software, and HHS notifies the states of
areas where data are missing or inconsistent and allows the states to
resubmit the data after errors are corrected. HHS officials reported
that these tests help them to identify some data quality errors, such
as missing data, and said that they believe that, in general, data have
improved in recent years. However, they indicated that the tests cannot
pinpoint the underlying problems contributing to these errors.
Furthermore, one official reported that no specific efforts have been
conducted to track the individual data elements, and therefore HHS
cannot report on how data quality has changed over time.
In an attempt to help states comply with the reporting standards and
address some of the factors that contribute to data quality problems,
HHS performs comprehensive reviews of state information systems'
ability to capture AFCARS data to identify problems associated with
data collection and reporting and to ensure that the information in the
automated system correctly reflects children's experiences in care. The
assessments include a technical review of the states' computer code, a
comparison of the data from selected cases available in the information
system to the case files, and an improvement plan to resolve any
errors. In addition, HHS officials offer guidance to the states on
improvements that can be made to the information system and changes to
program code used to report the AFCARS data. HHS conducted pilot
reviews in eight states between 1996 and 2000. By October 2003, HHS had
conducted 11 official reviews--even though states began reporting to
AFCARS in 1995. According to results from 6 of the 11 official AFCARS
assessments we reviewed, no state met the reporting requirements for
all AFCARS data elements. The problems noted in the reviews are similar
to those of states responding to our survey and those we visited. For
example, most states received ratings of 2 or 3, indicating technical
and/or data entry errors that affect the AFCARS data quality.[Footnote
22] For the current placement setting data element,[Footnote 23] for
instance, 4 states received a rating of 2, 1 state received a rating of
3, and 1 state received a rating of 4. In Connecticut, which received a
rating of 2, HHS found that, among other things, workers were not
consistently entering placement information in a timely way. It also
found that workers entered placement data only into a narrative field,
which resulted in placement history gaps and incomplete AFCARS reports.
State officials in the six states for which we reviewed the HHS AFCARS
assessments reported that they found the reviews useful for improving
their AFCARS data submissions. In particular, they valued the thorough
review by HHS officials of the computer code states use to report the
data. Some of these officials reported that if all states were
reviewed, the quality of data available in AFCARS would improve
tremendously. However, HHS officials reported that they are not
mandated to conduct the AFCARS reviews and that priority is placed on
other reviews, such as the CFSR and SACWIS reviews. In addition,
officials explained that the AFCARS reviews are not conducted in states
developing SACWIS until the systems are operational. HHS expects to
complete approximately four reviews each year, depending on available
resources, and has scheduled states through 2006. Similar to the SACWIS
reviews, HHS officials offer recommendations and technical assistance
to states during the review on how they can improve the quality of the
data reported to AFCARS.
Although the states we visited appreciated some of HHS's efforts to
assist with improving state data quality, they and most states
responding to our survey agreed that the assistance is not always
consistent or easily accessible (see fig. 2). States reported similar
information to the Inspector General--AFCARS data elements were not
clearly and consistently defined and technical assistance is effective
but difficult to access.
Figure 2: Federal Practices That Affect Data Quality:
[See PDF for image]
Notes: Based on responses from 50 states.
[End of figure]
The results reported in the figure are a sum of the states that
reported the issue had a very great affect, great affect, moderate
affect, or some affect on the quality of state data submitted to HHS.
Very great and great affect responses are represented in the top
section of each bar. Moderate and some affect responses are represented
in the bottom section of each bar. States not included answered "no
affect," "don't know," or "no answer.":
The primary concerns reported by the states we visited were delays in
receiving clear written guidance on defining and reporting certain data
elements and the lack of state input in suggesting changes to AFCARS.
Despite the written guidance available to states in the form of
regulations and an online policy manual, states reported that the
variation in state policies and practices makes it difficult to
interpret how to apply the general guidance. As a result, states
consult with HHS to ensure they are applying the regulations
appropriately. However, in commenting on a draft of this report,
officials in Oklahoma told us that a common concern among the states is
the lack of timely response from HHS when seeking guidance on how to
report data. In addition, officials in New York explained they have
made it a practice to check the HHS Web site on a regular basis for
current guidance but have not found it a useful tool, and may turn to
other states for guidance on AFCARS reporting. In commenting on a draft
of this report, HHS explained that it first refers states to its Web
site for information and believes that the available guidance addresses
states' concerns in most instances. In addition, the states that have
had an AFCARS review experienced delays in obtaining guidance on how to
proceed following the on-site review. For example, Texas officials
reported that the state sought clarification on its improvement plan
and submitted additional questions to HHS following the review.
However, when we spoke with the state officials, they said that they
had been waiting 3 months for a response on how to proceed. An HHS
official told us that since the review process is relatively new, the
agency is still developing a process to respond to the states and
recognizes that it has not been responsive to the states already
reviewed. In addition, HHS is taking steps to gather feedback from
states and other users of AFCARS data to determine how to improve the
system to make the data more accurate and usable. As a part of these
efforts, HHS has published a Federal Register notice soliciting
comments and held focus group meetings at national conferences. The
difficulties states face in receiving federal guidance and assistance,
as well as the other challenges they face in reporting data, may
negatively affect the reliability of the data available in AFCARS and
NCANDS.
States Are Using Various Practices to Overcome System Development
Challenges and Improve Data on Children's Experiences:
Some states are using a variety of practices to address the challenges
associated with developing SACWIS and improving data reliability,
although no formal evaluations of their effectiveness are available. To
address the challenge of developing a system to meet statewide needs,
states relied on caseworkers and supervisors from local offices to
assist in the design and testing of the system. Few states reported in
our survey strategies to overcome the other key challenges, such as
limited funding and the difficulty of securing knowledgeable
contractors, but some states we visited have devised some useful
approaches. To improve data reliability, the five states we visited
routinely review their data to identify data entry errors so that
managers can ensure that the missing data are entered appropriately.
States Are Primarily Relying on SACWIS Users to Overcome Some of the
Challenges to Completing Their Systems:
To overcome development challenges, survey respondents emphasized the
importance of including system users in the various phases of
completing SACWIS--planning, design, development, testing, and
implementation. Past GAO work and other research efforts have
determined similar approaches as best practices in building information
systems.[Footnote 24] Forty-four of the 46 states responding to our
survey that they are developing or operating a SACWIS indicated that
they relied on internal users, such as caseworkers and supervisors, in
the development of their systems and 34 of these states said that they
were extremely helpful participants. The extent to which the users were
involved in development differed across the states. For example, in
Texas, caseworkers from all of their child welfare regions were
recruited to provide input on design and development, as well as during
initial testing, pilot testing, and implementation of the system.
Arkansas reported establishing a committee made up of users to review
the work plan and sign off on recommended changes.
Ten states noted that user input should not be limited to frontline
workers, such as caseworkers, but should include representatives from
other areas of the agency, such as the financial staff, and other
agencies that serve children, such as child support
enforcement.[Footnote 25] While not one of the most common challenges
reported in our survey, New Hampshire reported that one of its
challenges with meeting its SACWIS timeframe was not working
collaboratively with other agencies, such as Temporary Assistance for
Needy Families (TANF)[Footnote 26] and child support enforcement, to
develop the payment component of SACWIS. To attempt to overcome this
challenge, 26 of the 46 states responding to our survey that they are
developing or operating a SACWIS indicated that they included external
public agency users, and 23 reported using representatives from other
state agencies that serve children in developing their SACWIS.
In addition to seeking input from caseworkers and other system users
while developing SACWIS, many states continue to include users as a
part of the implementation teams, to serve as contacts in the field and
provide ongoing assistance, and to provide input on system
enhancements. Alabama responded in our survey that the state had
"mentors" in each county to help caseworkers adjust to the new system.
These mentors continue to provide ongoing support now that the system
is implemented. Oklahoma recruits experienced child welfare field staff
for its SACWIS help desk because of their knowledge of the system and
child welfare policy and practice.
Although states faced other challenges in completing their SACWIS, few
reported implementing approaches to overcome the barriers. According to
survey results, a common problem states faced in developing SACWIS was
receiving insufficient state funding for development. States did not
report in our survey, however, approaches for obtaining more funding
for developing SACWIS, and few states reported developing strategies in
an attempt to overcome the challenges associated with tight budgets for
maintaining their systems. For example, Iowa officials engaged in
careful planning with system users to ensure that they addressed the
highest priorities when enhancing the system. In particular, the
officials reported that maintaining tight control over the development
and maintenance processes helps them avoid investing inordinate amounts
of resources to make corrections to the system. Similarly, few states
reported on approaches to overcome the challenge of finding contractors
with knowledge of child welfare practice. However, Iowa officials
explained that once the contract staff are hired, they are required to
attend the same training as new caseworkers to ensure that they are
familiar with the state's child welfare policies and to familiarize
themselves with casework practices.
States Use Strategies, such as Producing Reports That Identify Missing
Data, in an Attempt to Improve the Reliability of the Data Reported to
HHS:
Twenty-eight states reported using approaches to help caseworkers
identify the data elements that are required for federal reporting and
to help them better understand the importance of entering timely and
accurate data. Ten states responding to our survey reported reviewing
the federal reporting requirements in training sessions as a way to
improve data quality. For example, Tennessee reported that the state
added a component about AFCARS to the initial and ongoing training
workers receive about using SACWIS. The curriculum addresses the AFCARS
report in general and the individual data elements to help the
caseworkers better understand the purpose of collecting the
information. In Nebraska, a "desk aid" that explains the data elements
and where and why to enter them in the system is available on the
caseworkers' computer desktops. In addition, New York has developed a
step-by-step guide explaining to workers how NCANDS data should be
entered, with references to the policy or statute requiring the
information.
To improve data reliability, some states have designed their
information systems with special features to encourage caseworkers to
enter the information. Four states responding to our survey and three
states we visited designed their SACWIS with color-coded fields to draw
attention to the data elements that caseworkers are required to enter.
Colorado, Iowa, New York, and Oklahoma have built into their systems
alerts--also known as "ticklers"--to remind caseworkers and supervisors
of tasks that they need to complete. For example, in Oklahoma, a
stoplight icon on the caseworker's computer desktop reminds the worker
when tasks are due. A green light indicates that nothing is due within
5 days; a yellow light means that something is due within 5 days; and a
red light means that something is overdue. Caseworkers and supervisors
in the states we visited had mixed responses about the usefulness and
effectiveness of the alerts. Some caseworkers found them to be a
nuisance, while other caseworkers and supervisors found them to be
useful tools in managing workloads and prioritizing daily tasks.
Six states reported that the best way to improve data quality was to
use the data in published reports and hold the caseworkers and
supervisors accountable for the outcomes of the children in their care.
In addition, six states responding to our survey reported using the
data available in their information systems to measure state outcomes
similar to the CFSR. State officials reported that this approach is an
effective way to get local offices invested in the quality of the data.
For example, North Carolina publishes monthly reports for each county
comparing their performance on state data indicators, such as the
length of time children spend in care, to counties of similar size and
the state as a whole. County officials reported that these reports
encourage workers to improve the quality of the data collected and
entered into the state system since their performance is being widely
published and compared with that of other counties.
In addition, all the states we visited reported that frequent review of
their data, such as using software from HHS to test their AFCARS and
NCANDS data to pinpoint data entry errors prior to submitting them to
HHS, has helped improve data quality. When the states identify poor
data, they alert the caseworkers and supervisors of needed corrections
and data entry improvements. For example, Colorado runs these reports
about four to five times a year, with one run occurring approximately 6
weeks before each AFCARS submission. When the data specialists find
errors, they notify the caseworker to clean up the data.
Concluding Observations:
While most states are developing statewide information systems,
challenges with data reliability remain. Although SACWIS development is
delayed in many states, state officials recognize the benefits of
having a uniform system that enhances the states' ability to monitor
the services provided and the outcomes for children in their care.
Although states began reporting to NCANDS in 1990 and were mandated to
begin reporting to AFCARS in 1995, most states continue to face
challenges providing complete, accurate, and consistent data to HHS. In
addition, the results of more recent HHS efforts, such as conducting
AFCARS-related focus groups, are unknown. Reliable data are essential
to the federal government's development of policies that address the
needs of the children served by state child welfare agencies and its
ability to assist states in improving child welfare system
deficiencies. Without well-documented, clearer guidance and the
completion of more comprehensive reviews of states' AFCARS reporting
capabilities, states are limited in overcoming challenges that affect
data reliability. Because these challenges still remain, HHS may be
using some questionable data as the foundation for national reports and
may not have a clear picture of how states meet the needs of children
in their care.
To improve the reliability of state-reported child welfare data, we
recommended in our July 2003 report that the Secretary of HHS consider,
in addition to HHS's recent efforts to improve AFCARS data, ways to
enhance the guidance and assistance offered to states to help them
overcome the key challenges in collecting and reporting child welfare
data. These efforts could include a stronger emphasis placed on
conducting AFCARS reviews and more timely follow-up to help states
implement their improvement plans or identifying a useful method to
provide clear and consistent guidance on AFCARS and NCANDS reporting.
ACF generally agreed with our findings and commented that the report
provides a useful perspective of the problems states face in collecting
data and of ACF's effort to provide ongoing technical assistance to
improve the quality of child welfare data. In response to our
recommendation, ACF said that we categorized its efforts as "recent"
and did not recognize the long-term efforts to provide AFCARS-and
NCANDS-related guidance to the states. Although we did not discuss each
effort in depth, we did mention the agency's ongoing efforts in our
report. ACF also noted in its comments that the data definitions need
to be updated and revised and said it is currently in the process of
revising the AFCARS regulations to further standardize the information
states are to report--which we acknowledged in our report. ACF also
commented that it is firmly committed to continue to support the states
and to provide technical assistance and other guidance as its resources
will permit. ACF commented that it provided increased funding to the
National Resource Centers in fiscal year 2003, and it believed that
this increase will improve ACF's ability to provide assistance to the
states. After receiving the draft report for comment, HHS separately
provided information on an additional service the National Resource
Center for Information Technology in Child Welfare provides to states.
More recently, HHS said that it would be creating policy guidance that
will delineate what will happen if a state fails to complete its SACWIS
within a reasonable time frame. For example, funding may become
contingent on successful completion of specific milestones.
Mr. Chairman, this concludes my prepared statement. I would be pleased
to respond to any questions that you or other members of the
Subcommittee may have.
GAO Contact and Acknowledgments:
For further contacts regarding this testimony, please call Cornelia M.
Ashby at (202) 512-8403. Individuals making key contributions to this
testimony include Diana Pietrowiak and Sara Schibanoff.
[End of section]
Related GAO Products:
Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide
States Additional Information to Improve Services. GAO-03-956.
Washington, D.C.: September 12, 2003.
Child Welfare: Most States Are Developing Statewide Information
Systems, but the Reliability of Child Welfare Data Could Be Improved.
GAO-03-809. Washington, D.C.: July 31, 2003.
Child Welfare and Juvenile Justice: Several Factors Influence the
Placement of Children Solely to Obtain Mental Health Services. GAO-03-
865T. Washington, D.C.: July 17, 2003.
Child Welfare and Juvenile Justice: Federal Agencies Could Play a
Stronger Role in Helping States Reduce the Number of Children Placed
Solely to Obtain Mental Health Services. GAO-03-397. Washington, D.C.:
April 21, 2003.
Child Welfare: HHS Could Play a Greater Role in Helping Child Welfare
Agencies Recruit and Retain Staff. GAO-03-357. Washington, D.C.: March
31, 2003.
Human Services: Federal Approval and Funding Processes for States'
Information Systems. GAO-02-347T. Washington, D.C.: July 9, 2002.
Foster Care: Recent Legislation Helps States Focus on Finding Permanent
Homes for Children, but Long-Standing Barriers Remain. GAO-02-585.
Washington, D.C.: June 28, 2002.
Human Services Integration: Results of a GAO Cosponsored Conference on
Modernizing Information Systems. GAO-02-121. Washington, D.C.: January
31, 2002.
District of Columbia Child Welfare: Long-Term Challenges to Ensuring
Children's Well-Being. GAO-01-191. Washington, D.C.: December 29, 2000.
Child Welfare: New Financing and Service Strategies Hold Promise, but
Effects Unknown. GAO/T-HEHS-00-158. Washington, D.C.: July 20, 2000.
Welfare Reform: Improving State Automated Systems Requires Coordinated
Federal Effort. GAO/HEHS-00-48. Washington, D.C.: April 27, 2000.
Foster Care: States' Early Experiences Implementing the Adoption and
Safe Families Act. GAO/HEHS-00-1. Washington, D.C.: December 22, 1999.
Foster Care: HHS Could Better Facilitate the Interjurisdictional
Adoption Process. GAO/HEHS-00-12. Washington, D.C.: November 19, 1999.
Foster Care: Effectiveness of Independent Living Services Unknown. GAO/
HEHS-00-13. Washington, D.C.: November 5, 1999.
Foster Care: Kinship Care Quality and Permanency Issues. GAO/HEHS-99-
32. Washington, D.C.: May 6, 1999.
Juvenile Courts: Reforms Aim to Better Serve Maltreated Children. GAO/
HEHS-99-13. Washington, D.C.: January 11, 1999.
Child Welfare: Early Experiences Implementing a Managed Care Approach.
GAO/HEHS-99-8. Washington, D.C.: October 21, 1998.
Foster Care: Agencies Face Challenges Securing Stable Homes for
Children of Substance Abusers. GAO/ HEHS-98-182. Washington, D.C.:
September 30, 1998.
Managing Technology: Best Practices Can Improve Performance and Produce
Results. GAO/T-AIMD-97-38, January 31, 1997.
Child Welfare: HHS Begins to Assume Leadership to Implement National
and State Systems. GAO/AIMD-94-37. Washington, D.C.: June 8, 1994.
Executive Guide: Improving Mission Performance Through Strategic
Information Management and Technology. GAO/AIMD-94-115. Washington,
D.C.: May 1, 1994.
FOOTNOTES
[1] Throughout this testimony, references to state survey responses
include the District of Columbia. Forty-six of these states reported
that they are developing or operating a SACWIS. Nevada, which HHS
reported has an operational SACWIS, did not respond to our survey.
[2] We are currently conducting an engagement on states' and HHS's
experiences in conducting the CFSRs.
[3] Forty-four states provided information on the total amount of
federal funds they received to develop and operate SACWIS. Alaska,
Hawaii, Missouri, North Carolina, Texas, and Vermont did not report
federal funding information. Nevada did not respond to our survey.
State-reported figures may include some funding allocated in fiscal
year 2003, since the survey was issued in October 2002 and completed as
late as December 2002.
[4] Forty-four states provided information on the total amount of state
funds used to develop and operate SACWIS. Arkansas, Hawaii, Missouri,
North Carolina, Texas, and Vermont did not report state funding
information. Nevada did not respond to our survey. State-reported
figures may include some funding allocated in fiscal year 2003 since
the survey was issued in October 2002 and completed as late as December
2002.
[5] This figure includes developmental funds allocated by HHS to 49
states and the District of Columbia. Hawaii did not take any federal
money for SACWIS development.
[6] This figure includes operational funds allocated to 35 states.
States begin claiming operational costs when some or all components of
their SACWIS are operating in local offices. Operational activities
include routine maintenance, minor enhancements, and other changes that
do not significantly increase or modify the functionality of the
system.
[7] According to HHS officials, prior to fiscal year 2000, states
reported SACWIS operational expenses as part of their Title IV-E
administrative expenses because the claims sheet states used for
reporting did not have a separate column for SACWIS operational
expenditures. In fiscal year 2000, states were required to use a claims
sheet that was reformatted to provide space for SACWIS operational
expenditures. In addition, an HHS official explained that the
difference between the state-reported figures and the federal figures
may be due to states claiming some SACWIS expenses under different
programs, such as Title IV-E administrative funds, rather than
separately as SACWIS expenses.
[8] Although the Iowa state officials described their SACWIS as
including the child abuse and neglect system, HHS commented on a draft
of the July 2003 report that it does not view the child abuse and
neglect system as part of the state's SACWIS. However, HHS said that
the state has met the SACWIS requirement in this area by building an
interface between the two systems.
[9] New Jersey reported in our survey that it had spent approximately
$9 million in federal funds and $4 million in state and local funds on
system development. According to HHS, New Jersey first received federal
funds in 1996.
[10] Twelve of the 46 states reporting that they are developing or
operating a SACWIS reported that they have not experienced delays in
developing their systems. In response to the length of the delays
reported by 26 states in our survey, ACF commented on a draft of the
July 2003 report that these states may be using different definitions
in defining their delays. However, ACF did not provide further
information on how the delays represented in that report differ from
its perception of states' experiences. In our survey, we asked states
to report on the delays that exceeded the time line outlined in their
initial APD.
[11] With regard to the budget difficulties that states reported
facing, since 1994 the federal government has made a commitment to help
states develop and maintain their SACWIS by matching 75 percent of
states' development funds through 1997 and providing an ongoing match
of 50 percent of state funding for the development and maintenance of
their systems. However, since the states' legislatures must make the
initial commitment to fund SACWIS, the federal government cannot assist
state child welfare agencies with this challenge.
[12] In commenting on a draft of the July 2003 report, HHS indicated
that a Web resource is available to states interested in learning about
other states' efforts to develop human services--child welfare, food
stamps, Temporary Assistance to Needy Families, child care, and child
support enforcement--information systems at http://www.acf.hhs.gov/
nhsitrc.
[13] Data are reliable when they are complete and accurate. A
subcategory of accuracy is consistency. Consistency refers to the need
to obtain and use data that are clear and well defined enough to yield
similar results in similar analysis. See U.S. General Accounting
Office, Assessing the Reliability of Computer-Processed Data,
GAO-02-15G (Washington, D.C.: Sept. 2002).
[14] States were asked the extent to which certain problems may
decrease the quality of the data submitted to AFCARS and NCANDS using
the following scale: very great, great, moderate, some, and no affect.
[15] The analysis of survey responses about reporting data to HHS is
based on responses from 49 states and the District of Columbia. All
states, regardless of SACWIS development, were asked to complete these
questions.
[16] For the July 2003 report, we reviewed AFCARS reports from six of
the eight states that had been assessed by HHS--Arkansas, Connecticut,
New Mexico, Texas, Vermont, and Wyoming. HHS conducted reviews in
Delaware and West Virginia after we completed our analysis. As of
October 2003, HHS had completed three additional reviews for North
Dakota, Rhode Island, and Washington.
[17] In commenting on a draft of the July 2003 report, ACF said that
the finding from the AFCARS reviews indicates that information is often
defaulted to the response "unable to determine" in order for the
element not to fail the missing data standard, not that workers are
recording "unknown"; however, the report findings we used in this
analysis instruct states to fix the defaults and address caseworker
practice by enhancing training on the correct use of "unable to
determine" when noting a child's race.
[18] Department of Health and Human Services, Office of Inspector
General, Adoption and Foster Care Analysis and Reporting System
(AFCARS): Challenges and Limitations, OEI-07-01-00660 (Washington,
D.C.: Mar. 2003).
[19] Guardianship arrangements occur when permanent legal custody of a
child is awarded to an individual, such as a relative, but the child is
not legally adopted.
[20] Child Welfare League of America. National Working Group
Highlights, "Placement Stability Measure and Diverse Out-of-Home Care
Populations" (Washington, D.C., Apr. 2002).
[21] Respite care provides temporary child care for children away from
their caretakers.
[22] HHS rates each data element using a four-point scale: (1) the
AFCARS requirement(s) has not been implemented in the information
system; (2) the technical system requirements for AFCARS reporting do
not fully meet the standards; (3) the technical system requirements for
AFCARS reporting are in place, but there are data entry problems
affecting the quality of the data; (4) all of the AFCARS requirements
have been met. According to an HHS official, data elements that have a
combination of technical and data entry problems are rated as 2 until
the technical issues are resolved. HHS will then rate the element as a
3 until the data entry practices are changed.
[23] Current placement setting refers to a pre-adoptive home, foster
family home-relative, foster family home-nonrelative, group home,
institution, supervised independent living, runaway, or trial home
visit.
[24] See U.S. General Accounting Office, Executive Guide: Improving
Mission Performance Through Strategic Information Management and
Technology, GAO/AIMD-94-115 (Washington, D.C.: May 1, 1994); Center for
Technology in Government, University of Albany, SUNY. Tying a Sensible
Knot: A Practical Guide to State-Local Information Systems. Albany,
N.Y., June 1997.
[25] The Child Support Enforcement Program is a joint federal, state,
and local partnership that was established in 1975 under Title IV-D of
the Social Security Act. Each state runs a child support program, which
provides four major services: locating noncustodial parents,
establishing paternity, establishing child support obligations, and
collecting child support for families.
[26] In 1996, the Congress created the block grant Temporary Assistance
for Needy Families program replacing the Aid to Families with Dependent
Children (AFDC) and related welfare programs. States were given
increased flexibility in designing the eligibility criteria and benefit
rules, which require work in exchange for time-limited benefits.
