**Comments to Adoption and Foster Care Analysis and Reporting System;
Proposed Rule, January 11, 2008**

**I. Introduction.**

The U.S. Department for Health and Human Services-Administration for
Children and Families (ACF) released the proposed final rule for the
Adoption and Foster Care Analysis and Reporting System (AFCARS) on
January 11, 2008. The Kentucky Cabinet for Health and Family Services
(CHFS) submits the following comments concerning the proposed rule. Our
analysis is highlighted in the following sections and followed by a
table displaying specific responses. In each section, we make
recommendations of what should be retained, eliminated, refined or
clarified and identify items that impose excessive burdens.

Kentucky developed these responses with input from Statewide Automated
Child Welfare Information System (SACWIS), finance, leadership, policy
development, protection and permanency, quality assurance, and research
personnel. We participated in phone conferences with federal consultants
and child welfare organizations. **In summary, Kentucky\'s child welfare
agency, CHFS, retains significant concerns about the direction and
fundamental purpose of the proposed AFCARS changes, and recommends
extensive reconsideration of the proposed rule.**

**II. Data collection systems should conform to principles of good
measurement.**

Finding a balance between the competing purposes of a data system is
compounded by the emotionally charged needs of abused and neglected
children and the related intense scrutiny of child welfare. This
emotional situation mandates that child welfare leaders guide any
additions or changes to the data system using agreed upon principles
rather than responding to the demands of powerful special groups. As
Lyons (2004) outlines, data collection systems serve three primary
purposes: practice decision supports, quality improvement, and outcomes
measurements. AFCARS adds a fourth purpose of payment management. CHFS
staff believes, as does Lyons, that data collection systems be developed
by balancing these purposes for every data entry task. Without balance
and recognizable supports for case management in every data entry task,
data collection is seen as diverting from direct care, a paper-work
add-on, and a barrier to quality work rather than a support. We
evaluated the proposed rule in light of this principle: **Does the
proposed rule enhance our first priority to support practice decisions
and excellence in case management for front line work?**

**III. Commentary on major revisions to AFCARS.**

***A. Restructuring data collection to support longitudinal analysis is
consistent with principles of good measurement.***

**Kentucky supports the submission of existing data regarding the timing
and circumstance of each removal, each permanency plan decision, each
living arrangement, and each exit from out-of-home care for the [child
welfare population]{.underline}.** However, we do not support the
expansion of data elements or the expansion to Juvenile Justice in these
longitudinal data submissions. We support longitudinal data submission,
because these currently collected data are important to case management,
and Kentucky finds them very useful for quality improvement and
statewide outcomes measurement. Submission of all data collected on
children is critical in federal reporting. Although the enhanced
collection for each child will require restructuring the AFCARS
submission, it does not impose any additional burden on front line staff
and, in fact, validates and honors staff\'s work. Although we recognize
that the use of longitudinal data is labor intensive and requires
careful management, such additional data will provide opportunities for
several years to further understand and refine child welfare practice.
**Best practices in research show that it is prudent to delay collecting
additional data until the results of longitudinal data analysis suggest
the specific need for additional categorical data.**

***B. Expanding reporting populations will require reconfiguring
agencies and expanded federal and state supports to implement.***

**We support collecting and submitting data on youth in state custody
through age 19 years** and the reporting of all living arrangements for
children and youth in [state child welfare custody]{.underline}.
Kentucky currently collects detailed information on placements for all
children in state custody regardless of age of majority. We sponsor
children through state tuition reimbursement programs until age 21.

**We oppose the inclusion of all children placed in juvenile justice
facilities.** This addition imposes undue burden on the state and will
be virtually impossible to implement in a reasonable timeframe. The
proposed rule requires data sharing among multiple agencies and cabinets
outside CHFS jurisdiction.

CHFS, like other child welfare agencies, struggles in our relationship
with juvenile justice to fulfill existing reporting requirements.
Collection of data on all children placed with juvenile justice
facilities will require coordination between two cabinets with competing
demands, divergent policies, limited system capacity, confidentiality
provisions, and no funding supports. Currently, there are regulations
and other barriers to integration of data. For example, the Kentucky
Department of Juvenile Justice shares with CHFS data concerning only
Title IV-E eligibility. CHFS cannot ensure that a child will have the
same identification number in the child\'s longitudinal data as required
by the proposed rule, because CHFS does not receive records of all
children placed with juvenile justice. The proposed rule dramatically
expands the definition of \"child welfare\" and blurs the distinction
between juvenile justice and child welfare systems. Juvenile Justice has
no funding incentive or motivation for complying; they will not face
penalties imposed on CHFS for non-compliance.

This change will require extensive federal and state supports and
commitment to restructuring the barriers to collaboration. Further
guidance and support would be necessary to ensure cooperation, effective
development, and the enforcement of inter-agency agreements concerning
data sharing. To implement such a rule ACF will need to implement years
of ongoing collaboration, extensive funding, and fundamental changes in
regulations and laws. Without these supports, implementing this rule
will be virtually impossible in Kentucky.

**We are unsure of the definition of children in subsidized guardianship
and need clarification of this ruling.** In Kentucky, children with
substantiated abuse and neglect at imminent risk of removal or in OOHC
may be placed with relatives. If a relative seeks permanent custody of a
child, the relative may be eligible for a \$300.00 monthly Temporary
Assistance for Needy Family Block Grant (TANF) stipend to support that
child until the age majority. Once a child is in the permanent custody
of a relative, child welfare has no further jurisdiction and does not
track the child. The rule implies that this population will be included
in the expanded population. Per the proposed rule, CHFS would be
required to submit general information, demographics, dates of
implementation and termination, and type of and dollar amounts of
support. Currently, this information is supplied through TANF data, and
such a submission would be redundant. **We also oppose this expansion
due to the implication that these children are in the child welfare
system** **when they are, in fact, under the jurisdiction of their
relatives who have eligibility and receive benefits through family
support (i.e., public assistance programs).** These children are no
longer involved with child welfare, and such an expansion damages
distinctions.

The proposed expansion of AFCARS reporting is partially unclear. **We
support the reporting of children receiving Title IV-E or state adoption
assistance if these children were adopted from the child welfare
system**. Dispersed throughout the proposed rule are references to
adoption reporting on children with prior adoptions in other states or
through private agencies or international adoptions that have no
relevance to child abuse and neglect. This language is confusing; the
overall sense is that we will be able to collect such data only
inconsistently. **We oppose expanding the long-term collection of data
on international and private agency adoptions.**

Data for this portion of proposed rule may exist in other data systems,
and States must be able to share through interfaces or portals rather
than create redundant systems. In consideration, the sharing of data
between agencies through web-interfaces and other portals to the SACWIC
may be a solution. These considerations may entail the relaxation of
SACWIS requirements to ensure AFCARS reporting can be most efficiently
met.

***C. Capturing greater detail.***

CHFS retains the greatest concerns and objections to the proposed
expansion of details in data collection. While we support collecting
additional data elements that contribute to case management and
understanding, **we oppose this aspect of the proposed rule on the
grounds that:**

-   The additional dichotomous data fields have limited value to case
    management.

-   The expanded data triple the current AFCARS data to be collected,
    imposing an enormous burden on case managers.

-   Many of the data elements are redundant with National Child Abuse
    and Neglect Data System (NCANDS) requirements.

*1. Expanded details prioritize outcomes measurement over case
management.*

The expanded data elements do not support practice decisions or
contribute to case management. For example, expanded data collection on
all prior adoptions may not be available or relevant to the current
situation. The number of siblings living with the child at removal is
problematic due to the interpretation, definition, or instructions
pertaining to "siblings" and "living with" in blended and unstable
families. Annual updates on circumstances of removal will be biased by
the fact that the child is not living with the parent. Such repeat
assessment using the indicators shown will fail to portray the family
stresses or improvements. A checklist of conditions present at removal
is hardly a rigorous assessment, but is being used here as a repeated
measure like an annual assessment.

CHFS supports a structured annual assessment that would provide a
nuanced view of the child's well being and, thus, add value to case
management. We recommend that each data element be viewed from the
perspective of a frontline social service worker for intrinsic value and
that data are collected to support case decisions. For example,
determining whether or not the child has repeated grades is an
unreliable measure of educational status and outside the purview of
child welfare for children in care short periods of time. A brief
functional child assessment will contribute to better understanding and
management of well being indicators.

The proposed rule places a double burden on the already taxed frontline
social services workers through requirements for collecting additional
case information and the expansion of data entry per case, for multiple
triggers, during the course of a child\'s out-of-home-care experience or
experiences. The proposed rule will negatively alter the social service
worker's abilities to engage with families and balance demands from
funding sources, families, community partners, and self. The change in
focus will be detrimental to staff and, eventually, children and
families, if the proposed rule is implemented as written. Social service
workers should not feed research rather research should work in tandem
with child welfare agencies in support of children, families, and social
service workers.

*2. Expanded details conflict with federal law and established
priorities.*

According the 42 U.S.C. 679 that governs the collection of data relating
to adoption and foster care:

"Any data collection system developed and implemented under this section
shall---

*(1) avoid unnecessary diversion of resources from agencies responsible
for adoption and foster care...\"*

ACF has emphasized numerous times the priority focus on case management
over any processes that drain or deflect from business operations. The
proposed rule poses a significant impact to child welfare\'s core,
service delivery, through the real burden to be placed on social service
workers, state administrators, and technology staffs. The proposed rule
is in conflict with the authorizing federal law, previous messages and
established priorities, and specifically the welfare of children and
families. More specifically, the proposed rule exceeds federal law
requirements for adoption and foster-care reporting. ACF is raising
standards for states, though no state has substantially conformed to the
CFSR measures, and many have yet to meet SACWIS operational standards.

*3. The proposed rule prioritizes compliance monitoring (on the quality
improvement continuum) and financial penalties over case management and
service delivery.*

The tone of the proposed rule seems punitive in nature with repeated
references to how the data will be used to understand the state's
performance rather than the child's needs or to support expanding
resources for child welfare. The proposed rule fails to convey the
ultimate goal: services to families and children, over the pursuit of
data for data collection and research alone. Given that the proposed
data elements are more suited for research than case management, one
would expect a well developed research and analytical plan. There is
none. If the proposed rule is driven by the understandable needs for
more child welfare research, then a more reasonable plan would be to
pull representative samples to ensure that the additional data elements
are fruitful for research.

The underpinning design seems overly vague, if it is known, and
uncoordinated with other reporting burdens on child welfare agencies,
inclusive of reporting required under the NCANDS and the rule under the
Chafee Foster Care Independence Act. Justification for such a radical
change and drastic resource impact (e.g., personnel, systems, and
financial) has not been provided. Rather, federal reporting should be
tempered with incremental change to minimize negative impacts and foster
a partnership with state child welfare agencies on the needs of states.

4\. *The proposed rule triples AFCARS data collection and creates
redundancy with NCANDS data collection.*

Currently, approximately one hundred data elements are captured in
AFCARS and about 2/3rds are used in the federal Child and Family
Services Review (CFSR) indicators. The proposed rule increases the
number of data elements to nearly three hundred. Moreover, some data
elements are redundant with NCANDS. For example, \"child problem, drugs
or alcohol\" (NCANDS) is virtually the same as \"child alcohol use\"
(AFCARS).

Although ACF rationalizes this overlap in data collection as necessary,
the data are redundant from a frontline social service worker\'s
perspective and fail to contribute additional understanding to the case
dynamics or improve case management. The definitions are confusing, and
the result will be poor quality of data entry.

More importantly, duplicative data entry is wasteful and incongruent
with 45 C.F.R. 1355.53. CHFS urges ACF to purge the proposed rule of any
redundancy and establish a strategic plan for common data collection
rather than evolving AFCARS and NCANDS in isolation. Also, to eliminate
or better manage these burdens, CHFS encourages ACF to develop and
manage a national shared data warehouse that crosses state agencies.

***D. Improving data quality.***

**CHFS supports the improved definitions of AFCARS and finds these
helpful.** However, there are numerous other definitions expanded in
this rule that require clarification, such as \"sibling groups\". The
proposed rule imposes more ambiguity than it clarifies given the
dramatic expansion in data collection. Other AFCARS terms also require
clarification; for example, the term \"respite care\" is still vague,
yet such a placement has important implications for children.
Definitions across systems and federal review processes should be
analyzed for congruency, elimination of any redundancies and caseworker
confusion, and duplication of data entry. Although worthwhile, these
changes will require changes in policy, training, and other data
submission pulls.

**CHFS opposes the reduction of the time to enter the exit day from
sixty to fifteen days.** We agree that this information is critical;
however, the ACF analysis found that only 67% of dates are currently
entered in this time frame. The standard of 90% is unachievable based on
the ACF analysis and does not seem to have value to states or child
welfare, but rather subjects both to additional penalty and burden.

**CHFS opposes the reduction from forty-five days to fifteen days for
submission of the data file.** This is simply unrealistic due to the
greatly expanded data submission, lags in data entry, data required from
multiple agencies and across programs, and data integrity. Rather than
reducing the time to submission, the expanded data submission will
require additional time; we suggest a sixty day submission window.

***F. Eliminating unnecessary features.***

Integrating the foster care and adoption file and eliminating the
summary are consistent with reducing data collection burden. **CHFS
supports this aspect of the rule.**

**IV. Penalties are excessive and feedback is too slow.**

Another concern regarding timeframes pertains to the federal feedback on
a State\'s AFCARS submission. A state\'s ability to avoid penalty is
heavily contingent upon timely federal response. If the state is out of
compliance in more than 10% of its submitted data, a corrective action
plan is required prior to the next AFCARS submission from the state.
States have experienced delays in feedback on submissions to the point
that subsequent corrected submissions have to be generated in a matter
of weeks or days. Federal feedback must adhere to federal timeframes and
courtesies to allow states time for correction of the previous AFCARS
submission and generation of the next AFCARS submission in the same six
month period. CHFS retains concerns that, at present, ACF cannot keep
current and timely on existing responsibilities as evidenced by the
tardy issuance of final reports for federal reviews. Considerations in
federal feedback, particularly its timeliness and construction, will
improve relationships with States and send a message that ACF is equally
accountable for child welfare data.

Although penalties are seen as motivating, they are only motivating if
they are potentially avoidable. With the many funding reductions to
child welfare already on the horizon, these penalties become
overwhelming and demoralizing. CHFS simply cannot accomplish all
standards of performance without support from the federal government and
state partners. Further, states that just miss complying will face the
same penalty as states that fail to submit AFCARS or work towards
compliance at all. CHFS suggests incentives for compliance and data
quality rather than penalties.

**V. Additional Objections.**

***A. Diversion from program enhancements.***

The technological changes and staff impact of the proposed rule will
require States to re-prioritize existing programmatic and technological
initiatives. The proposed rule will then curtail states\' abilities to
fulfill requirements \"on the ground\" and program improvement efforts
resulting from the CFSR. In Kentucky, this means postponing for up to
five years the modernization of the state's SACWIS and the
implementation of the Dynamic Family Assessment. These plans were
designed to support front line practice through enhanced decision
supports that we find more valuable than compliance with the proposed
rule.

***B. Timeframes and priorities.***

The proposed rule does not provide the federal timeline for
implementation or the projected effective date of the rule. The amount
of change necessitated and associated burden are unnerving, even for
Kentucky, a state compliant with SACWIS requirements. CHFS encourages
ACF to prioritize the more critical elements of the proposed AFCARS rule
and/or elements requiring fewer burdens for implementation in the nearer
future and allow less prioritized items or elements requiring more
burdens more time. In other words, CHFS encourages ACF to incrementally
implement the proposed rule over years and to adjust implementation
plans to situational/circumstantial factors (e.g., federal grant
appropriations, economic conditions, uniformity of all states with
SACWIS), if the proposed rule stands as written.

**C. Unintended consequences to states.**

The proposed rule suggests data changes that will have a negative,
possibly fiscal, impact to states. The first data change with such an
impact involves a child remaining with a particular foster home, but the
foster home type or level of care changing. Per the proposed rule, a
change in foster home type or level of care would calculate in the data
collection as a placement move, though there was technically no
placement move. This calculation will negatively impact states\'
abilities to achieve conformity with the national standard concerning
placement stability. The second data change includes children on trial
home visits, as these children would be exited from care. An exit from
care would eliminate a state\'s abilities to make administrative claims
under Title IV-E, though the state is still providing services to the
child on trial home visit. The greater unintended consequence is the
disincentives to good child welfare practice, including responding to a
child\'s changing needs in care and fostering a child\'s safe return to
the child\'s home of origin.

***D. Underestimated financial burden.***

The proposed rule underestimates both the financial and manpower
implementation burdens for several reasons. The proposed rule triples
the required number of AFCARS data elements, adds enormous amounts of
data to submit for each child based on longitudinal data submission, and
vastly expands the populations included in the submission. The proposed
rule requires significant changes to the state\'s SACWIS, including
restructuring the underlying data structure, building new and
reconfiguring existing data entry screens, expanding data storage and
retrieval capacity, building interagency access, and modifying existing
management reports. Additionally, the proposed rule obscures the
distinctions between child welfare, juvenile justice, mental health, and
the Temporary Assistance for Needy Families Block Grant (TANF) and holds
child welfare fiscally responsible for implementing this integration.
The Cabinet anticipates that the proposed rule\'s implementation will
require the full-time efforts of CHFS-Office of Information Technology
and extensive commitment of all administrative staff for three to five
years.

Based on what the CHFS can calculate from the proposed rule, the true
costs of information system implementation alone will be well in excess
of one million dollars annually for three to five years. Labor intensive
and expensive cross-cabinet partnerships and legal authorizations are
also required with changes to all policies, training, and social service
worker supports. Kentucky's costs may be lower than other states that
have not achieved full compliance with the existing AFCARS requirements.
The best predictor of tripling data collection is the past expenditure
for implementing the original AFCARS rules that cost millions for
Kentucky over several years. We were successful with reasonable
expenditures; other States spent far more.

The proposed rule also greatly underestimates the time burden to each
State. It estimates an additional 5,556 hours per foster care submission
and 918 hours per adoption submission. Using these numbers for two
reports per year, CHFS stands to hire: 12,948 hours divided by 1950
(total hours of full-time employee for year) equals [7
employees]{.underline} for data management at an annual cost of
\$400,000. This estimate falls short of recognizing daily impacts to
administrators, technology staff, and social service workers and,
thereby, the well being children and families.

Our internal analysis shows that the additional data entry, research and
data finding from other data systems, management of the reporting burden
and data integrity monitoring will require the equivalent of one worker
per team of six employees. With 1600 front line staff, [266 additional
employees]{.underline} are needed at \$52,000 (with fringe) each. Annual
costs for staff expansion to meet the proposed would exceed \$13.8
million. The private child care providers (of foster and residential
care) will also incur additional costs for sharing and entering child
data that are not included under the proposed rule\'s Regulatory
Flexibility Analysis.

Because the proposed rule is mammoth and complex with confusing wording,
the comment period allotted to the public does not allow for a
value-to-value analysis of the proposed rule. Despite the limitations of
this analysis, the following statement in the proposed rule (p. 2126),
'"We have determined that the costs to the States as a result of this
rule will not be significant", is misinformed.

Kentucky currently is in a dire budget shortfall and is unable to match
the federal funds, a necessity of this proposed rule. The economic
conditions in the United States indicate a recession with lost tax
revenues as the economy slows. National media reports recount the plight
of states making drastic cuts in services to balance the states\'
budgets. Kentucky is not alone in facing some dire service and program
cuts, particularly if projections for its next budget biennium are
realized. The proposed rule does not recognize (and is not sensitive to)
the circumstantial factors that States, particularly child welfare
agencies, are facing at this point in time. More and more demands are
being placed on a system historically under-funded and a system facing
future cuts in some sources and continued flat-line funding from other
sources. The associated penalties with this rule will hamper progress
further.

These increasing demands made more unacceptable in light of proposed
cuts to child welfare through the threat of the loss of Title IV-B funds
for visitations to children and the additional threat to Title IV-E
funds through the CFSR. In addition, the anticipated prohibitions on
child welfare agencies\' ability to claim Medicaid-Targeted Case
Management and Rehabilitation have added to the financial anxiety of
nearly thirty-seven states\' child welfare agencies, inclusive of CHFS.
States with an operational SACWIS are held to a higher standard than
those states still developing, because altering the development of a
system is much easier than changing an existing system. A match rate of
50% does not alleviate these conditions. Thus, CHFS suggests that ACF
absorbs 100% of the costs to implement this proposed rule.

Summary Table of Major Responses to the Proposed AFCARS Rule (Kentucky)

  -----------------------------------------------------------------------
  Item                                         Recommendation
  -------------------------------------------- --------------------------
  Submitting longitudinal data on              Retain this concept, do
  *[current]{.underline}* AFCARS elements.     not expand the data
                                               elements.

  Data file requirements for submission and    Develop specifics with
  analysis plan for longitudinal data are      realistic fiscal impact
  unclear. The data is currently stored in     analysis and allow states
  relational datasets and will be a massive    to respond when details
  exchange of data.                            are clear.

  Include children in custody of the state     Retain.
  child welfare through age 19 years and       
  specific placements of all children in       
  [state child welfare custody]{.underline}.   

  Include children receiving IV-E or state     Retain.
  adoption subsidy IF they were adopted from   
  the state's child welfare system.            

  Language on reporting prior adoptions of     Clarify the expectations
  children in OOHC is confusing and may be     especially on
  irrelevant if the child was adopted through  international and
  resources with no child welfare involvement. interstate adoptions.

  Count children returned home or placed at    Eliminate. This is an
  home while in state custody as no longer in  attempt to compensate for
  OOHC. Without trial home visits, reentry     current ambiguities but
  rates may increase and workers may hesitate  introduces other
  to let parents try. Trial home visits are    definitional problems.
  needed to test and nurture parental capacity Children in state custody
  for child safety; failure of the trial may   living at home could be
  speed the TPR process. Trial home visits are labeled as living at home
  important interventions that need to be      through a placement type.
  retained without threats of increased        
  reentry.                                     

  Inclusion of all children placed in Juvenile Eliminate.
  Justice facilities whether or not they are   
  IV-E eligible.                               

  Including subsidized guardianship. Children  Need further
  in kinship care are not in state custody; we clarification. Oppose this
  have no control over child wellbeing or      rule based on the subtle
  placement stability outcomes.                expansion of child welfare
                                               responsibility.

  Capturing greater data details are designed  Eliminate all additional
  for research rather than supporting case     data elements.
  management.                                  

  Combine adoption and foster care file and    Retain.
  elimination of the summary.                  

  Reduce the time for entry of exit data from  Eliminate.
  60 days to 15 days.                          
  -----------------------------------------------------------------------

Lyons, J.S. (2004). *Redressing the emperor: improving our children's
public mental health service.* Westport, CN: Praeger