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Department of Health and Human Services

OFFICE OF 

INSPECTOR GENERAL 

S S
TATE  TANDARDS AND 

C T
APACITY TO  RACK 

F C
REQUENCY OF  ASEWORKER 

V W C
ISITS  ITH  HILDREN IN 

F C
OSTER  ARE

Daniel R. Levinson

Inspector General 

December 2005

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Office of Inspector General 

http://oig.hhs.gov 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, 
as amended, is to protect the integrity of the Department of Health and Human Services 
(HHS) programs, as well as the health and welfare of beneficiaries served by those 
programs.  This statutory mission is carried out through a nationwide network of audits, 
investigations, and inspections conducted by the following operating components: 
Office of Audit Services 
The Office of Audit Services provides all auditing services for HHS, either by conducting 
audits with its own audit resources or by overseeing audit work done by others. Audits 
examine the performance of HHS programs and/or its grantees and contractors in 
carrying out their respective responsibilities and are intended to provide independent 
assessments of HHS programs and operations in order to reduce waste, abuse, and 
mismanagement and to promote economy and efficiency throughout HHS. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) conducts management and program 
evaluations (called inspections) that focus on issues of concern to HHS, Congress, and 
the public.  The findings and recommendations contained in the inspections generate 
rapid, accurate, and up-to-date information on the efficiency, vulnerability, and 
effectiveness of departmental programs.  OEI also oversees State Medicaid Fraud 
Control Units which investigate and prosecute fraud and patient abuse in the Medicaid 
program. 
Office of Investigations 
The Office of Investigations (OI) conducts criminal, civil, and administrative 
investigations of allegations of wrongdoing in HHS programs or to HHS beneficiaries 
and of unjust enrichment by providers.  The investigative efforts of OI lead to criminal 
convictions, administrative sanctions, or civil monetary penalties. 
Office of Counsel to the Inspector General 
The Office of Counsel to the Inspector General (OCIG) provides general legal services to 
OIG, rendering advice and opinions on HHS programs and operations and providing all 
legal support in OIG's internal operations. OCIG imposes program exclusions and civil 
monetary penalties on health care providers and litigates those actions within HHS. 
OCIG also represents OIG in the global settlement of cases arising under the Civil False 
Claims Act, develops and monitors corporate integrity agreements, develops compliance 
program guidances, renders advisory opinions on OIG sanctions to the health care 
community, and issues fraud alerts and other industry guidance.  Report Template Version  = 09-08-04  
  E X E C U T I V E   S U M M A R Y  

OBJECTIVES 
To determine (1) the written standards States have implemented for 
frequency of caseworker visits with children in foster care, (2) the extent 
to which States could provide statewide automated reports reflecting 
the frequency of caseworker visits, and (3) the extent to which statewide 
reports indicate that children were visited. 
BACKGROUND 
A critical element in maintaining the safety and well-being of children 
in foster care is face-to-face contact (visits) between caseworkers and 
children.  There is no Federal requirement regarding how often children 
in foster care are visited by caseworkers.  However, the Administration 
for Children and Families (ACF) reviews caseworker visits as part of its 
Child and Family Service Reviews (CFSR).  ACF reviewed all 50 States, 
the District of Columbia, and Puerto Rico between 2001 and 2004.  
During CFSRs, ACF determines whether the frequency of caseworker 
visits was sufficient to meet the childs needs for approximately 50 child 
welfare cases (a combination of foster care cases and those receiving in-
home services) in each State.  ACF uses monthly visits as a minimum 
benchmark when assessing the frequency of visits; however, in some 
instances, more frequent visits may be necessary to meet a childs 
needs.  If visits are less than monthly, States must present substantial 
documentation that the childs needs were being met to receive a 
positive assessment for caseworker visits.  On a national level, ACF 
summarized the CFSR results of the 35 States completed in 2002 
through 2004. Twenty-seven of the States were cited as needing 
improvement in the area of frequency of caseworker visits. 
The difference between the CFSRs and this evaluation is that CFSRs 
include a detailed review of approximately 50 child welfare cases (a 
combination of foster care cases and those receiving in-home services),  
whereas our evaluation included analysis of State frequency standards 
for children in foster care.  In contrast to the CFSRs, OIGs evaluation 
focused exclusively on children in foster care and did not examine 
standards for children receiving in-home services.  In addition to 
examining statewide frequency standards, this evaluation also analyzed 
State capacity to produce statewide reports and, when available, FY 
2003 statewide reports indicating the frequency of caseworker visits for 
at least 70 percent of States foster care caseloads.  The information in 
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this report should enhance ACFs oversight of State foster care 
programs related to the frequency of caseworker visitation.   
Many States have implemented, or are in the process of implementing, 
automated systems that may include the capacity to capture data about 
caseworker visits and produce automated reports detailing the 
frequency of visits with children in foster care. Most commonly, States 
have implemented a Statewide Automated Child Welfare Information 
System (SACWIS). Approximately $2.8 billion in Federal and State 
funds have been spent on the design, development, implementation, and 
operation (including initial and replacement hardware) of SACWIS 
since 1994. There is no Federal requirement that States produce 
statewide reports detailing how often children in foster care are visited. 
Our primary data source for this evaluation was a document review to 
determine standards for caseworker visits for all 50 States and the 
District of Columbia (referred to as 51 States throughout this report).  
In addition, the 51 States completed an e-mail data collection 
instrument and participated in structured telephone interviews between 
February and July 2004.  Since ACF uses monthly visits as a 
benchmark during its reviews of State child welfare systems, we asked 
States to submit monthly statewide caseworker visitation reports for 
Fiscal Year 2003 (FY 2003).  Our request allowed us to test States 
ability to produce reports as well as to determine how often reports 
indicated that children were visited in FY 2003.  
This report is the first in a series of three reports about caseworker 
visits with children in foster care.  In the second report, State 
Standards and Practices for Content of Caseworker Visits With 
Children in Foster Care, OEI-04-03-00351, OIG analyzed State written 
standards for the content of caseworker visits.  The third report in the 
series, Compendium of State Standards: Content of Caseworker Visits 
With Children in Foster Care, OEI-04-03-00353, provides State written 
standards guiding the content of caseworker visits with children in 
foster care.  The compendium includes standards provided by 38 States. 
FINDINGS 
Forty-three States had statewide written standards calling for 
caseworkers to visit children in foster care at least monthly.  Fifty of 
fifty-one States had statewide minimum standards regarding the 
frequency of caseworker visits with the majority of children in foster care 
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EE XX EE CC UU TT II VV EE    SS UU MM MM AA RR YY
placed in-State. Forty-three of fifty had standards for at least monthly 
visits. States reported that the CFSRs, lawsuits or consent decrees, and 
collaboration with child advocacy groups were the most common events 
that contributed to the development or enhancement of their standards. 
In addition, 33 out of 50 States had standards stating that at least some 
caseworker visits should take place specifically in the foster care 
placement. Many of these States reported about the benefits of visits in 
the placement, including the value of assessing child safety and well-
being in the home environment. 
Twenty States demonstrated their ability to produce statewide 
reports detailing the extent to which visits occurred during FY 2003. 
Nineteen of these twenty reports were produced using SACWIS. The 
remaining statewide report was produced from the results of a State 
administrative review process. We identified several impediments to 
report production for the 31 States that did not provide statewide 
automated caseworker reports. These impediments were: documentation 
in paper case files, insufficient automated system capacity, or lack of 
resources (e.g., insufficient staffing or computer time to produce the 
reports). 
Seven of the twenty statewide reports indicated on average that 
fewer than half of children in foster care were visited monthly in 
FY 2003. Seventeen of the States that provided reports had at least 
monthly visitation standards, while the remaining three States had 
standards for less frequent visitation. Among the 17 States with 
standards providing for at least monthly visits, 5 State reports indicated 
on average that fewer than half of children were visited monthly. 
The three States with standards less frequent than monthly provided a 
range of monthly and quarterly data for FY 2003. One State provided 
monthly data only, another provided both monthly and quarterly data, 
and the third provided quarterly data only. The two State reports with 
monthly data indicated on average that fewer than half of children in 
foster care were visited monthly. However, the State report providing 
both monthly and quarterly information indicated on average that 
88 percent of children were visited by the end of the quarter. In contrast, 
the State report with only quarterly data indicated that 58 percent were 
visited during the quarter. 
All 20 States reported factors that affected the visitation rates found in 
the reports. Many States reported negative factors that may have 
resulted in low visitation rates in their reports. These factors include 
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insufficient documentation of caseworker visits, high caseloads and 
insufficient staff to conduct visits, and other factors such as private 
provider visitation information not being included in the reports.  The 
range and severity of some of these factors reported by States clearly 
can result in reports that do not reflect all visits that occurred. In 
addition to these negative factors, States also cited positive areas 
affecting caseworker visitation, including that caseworker visits were a 
priority in the State or that it was an area that was closely monitored. 
Finally, five States reported that they either improved their visitation 
rates by the end of 2003 or that they were able to significantly improve 
their rates after that timeframe. 
RECOMMENDATIONS 
For States with limited or nonexistent automated capacity to record 
the frequency of caseworker visits and produce statewide reports, 
ACF should promote the development of automated systems such 
as SACWIS. We recognize that child welfare programs are complex and 
that States face challenges related to competing priorities, resource 
issues, and the implementation of automated systems.  However, in our 
evaluation, 19 States demonstrated their ability to quantify caseworker 
visits through SACWIS even though there are no requirements to have 
systems structured to produce these reports.  To the extent that ACF 
wants to strengthen States abilities to quantify how often caseworkers 
visit children, we recommend the agency work with States to ensure that 
systems are structured to both record visits and produce reports.  These 
reports could be particularly useful for States cited in the CFSRs as 
needing improvement in the area of frequency of caseworker visits.  The 
reports would also enhance ACFs ability to monitor caseworker visits, 
providing statewide, comprehensive visitation data in addition to the 
information gathered during the CFSRs. 
For States with automated system capacity to record the frequency 
of caseworker visits and produce statewide reports, ACF should 
work with States to ensure that visitation data are recorded in 
automated systems. ACF should continue to assist States to develop 
clear policies for recording caseworker visits in automated systems to 
promote the accuracy of reports.  Improved visitation data would allow 
both ACF and the States to monitor visitation frequency with enhanced 
accuracy, and thereby plan program improvements more effectively.      
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EXECUTIVE SUMMARY ........................................ i

INTRODUCTION ................................................ 1 

FINDINGS ...................................................... 10 

State Standards for Visits  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  10

States Ability to Produce StatewideReports  . . . . . . . . . . . . . . . .  12

Visits During FY 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  14

RECOMMENDATIONS ......................................... 16 

AGENCY COMMENTS ......................................... 18 

ENDNOTES ..................................................... 21 

APPENDIXES .................................................. 23 

Appendix A:  State Standards for Frequency ofVisitation. . . . . .  23

Appendix B:  State Standards for Visits Occurring in the
Foster CarePlacement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  25

Appendix C:  Percentage of ChildrenVisited  . . . . . . . . . . . . . . . .  27

ACKNOWLEDGMENTS ......................................... 34
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OBJECTIVES 
To determine (1) the written standards States have implemented for 
frequency of caseworker visits with children in foster care, (2) the extent 
to which States could provide statewide reports reflecting the frequency 
of caseworker visits, and (3) the extent to which statewide reports 
indicate that children were visited. 
BACKGROUND 
Caseworker visits are a critical element in ensuring the safety and well-
being of children in foster care. There is no Federal requirement 
regarding how often children in foster care placed in-State are visited by 
caseworkers. However, the Administration for Children and Families 
(ACF) reviews caseworker visits as part of its Child and Family Service 
Reviews (CFSR).  As part of these reviews, States are assessed to 
determine if the frequency of caseworker visits with children (both those 
in foster care and those receiving in-home services) was sufficient to 
ensure adequate monitoring of childrens safety and well-being and 
whether visits focused on substantive issues.  ACF uses monthly visits 
as a minimum benchmark when assessing the frequency of visits; 
however, in some instances, more frequent visits may be necessary to 
meet a childs needs.  If visits are less than monthly, States must 
present substantial documentation that the childs needs are being met 
to receive a positive assessment for caseworker visits.1 A positive 
assessment is referred to as a strength rating; ACF reported that a 
strength rating for caseworker visits is associated with positive 
outcomes of achieving permanency and ensuring child safety.  ACF 
reviewed all 50 States, the District of Columbia, and Puerto Rico from 
2001 through 2004. 
The difference between the CFSRs and this evaluation is that CFSRs 
include a detailed review of approximately 50 child welfare cases (a 
combination of foster care cases and those receiving in-home services),  
whereas our evaluation included analysis of State frequency standards 
for children in foster care.  In contrast to the CFSRs, OIGs evaluation 
focused exclusively on children in foster care and did not examine 
standards for children receiving in-home services.  In addition to 
examining statewide frequency standards, this evaluation also provided 
analysis of State capacity to produce statewide reports, and, when 
available, FY 2003 statewide reports indicating the frequency of 
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caseworker visits for at least 70 percent of States foster care caseloads. 
The information in this report should enhance ACFs oversight of State 
foster care programs related to the frequency of caseworker visitation. 
Concerns about State caseworkers ability to conduct visits with 
children in foster care and to meet their needs have been well  
documented.  On a national level, ACF provided a summary of all States 
with completed CFSRs, with additional information about the 35 CFSRs 
that were completed during 2002 through 2004.  For these 35 States, 
the ACF summary included details about caseworker visitation for the 
child welfare cases reviewed, which included both children in foster care 
and those receiving in-home services.  Twenty-seven of the States were 
cited as needing improvement in the area of frequency of caseworker 
visits.2  In addition, a review of 500 foster childrens case records from a 
class action lawsuit in New Jersey was released in 2003.3  The review 
indicated that 78 percent of children in foster care had at least one 
period of more than 90 days without contact from a caseworker.4 
The Foster Care Program 
The Title IV-E Foster Care Program is an entitlement program 
administered by the Childrens Bureau within ACF, part of the 
Department of Health and Human Services (HHS).  According to ACF, 
foster care is defined as twenty-four-hour substitute care for children 
placed away from their parents or guardians and for whom the State 
Agency has placement and care responsibility.5 Children in foster care 
live in a variety of placement settings, including family foster homes, 
foster homes of relatives, group homes, emergency shelters, residential 
facilities, child care institutions, and preadoptive homes.6 
The Federal budget for the foster care program in fiscal year (FY) 2005 
is $4.9 billion.7  HHS anticipates that it will provide funding for 233,000 
Title IV-E eligible children monthly during FY 2005.  States receive 
Federal matching funds under Title IV-E for children in foster care 
whose families meet income requirements.  States may also direct some 
of these funds to training and to the operation and development of a 
computer-based data and information collection system, typically the 
Statewide Automated Child Welfare Information Systems (SACWIS). 
Federal Role 
Although Federal law does not mandate how often caseworkers should 
visit children placed in-State,8 ACF assesses States as part of the 
CFSRs to determine if the frequency of caseworker visits with children 
is sufficient to ensure the adequate monitoring of each childs safety and 
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well-being. The CFSRs are one of several reviews ACF conducts as part 
of its Federal oversight role.  Other reviews ACF conducts to assess 
State compliance with Federal requirements include Title IV-E 
eligibility reviews, Adoption and Foster Care Analysis and Reporting 
System reviews, and SACWIS reviews.9  Of these reviews, only CFSRs 
address caseworker visitation. 
Pursuant to 45 CFR  1355.31-37, promulgated under section 1123A of 
the Social Security Act (the Act), ACF conducts CFSRs to ensure 
conformity with Federal child welfare requirements and to measure 
compliance with State plan requirements under Titles IV-B and IV-E.  
CFSRs, a joint Federal and State process, examine three categories of 
child welfare outcomes:  safety, permanency, and well-being.  In 
addition, the reviews address systemic factors affecting the child 
welfare system.  If States are not found to be in substantial conformity, 
they must submit to ACF within 90 days a Program Improvement Plan 
(PIP) outlining steps to correct deficiencies.  States not in substantial 
conformity in the first round of CFSRs must begin a full review 2 years 
after approval of their PIP.  None of the States (including the District of 
Columbia and Puerto Rico) were in substantial conformity after the first 
round, and therefore ACF will schedule each States subsequent review 
upon State completion and ACF evaluation of the PIP. 
As part of CFSRs, a total of approximately 50 child welfare cases (a 
combination of foster care cases and those receiving in-home services) 
are reviewed in each State from selected sites.10  One of the items 
assessed is caseworker visits with children.  Each case is rated as either 
a strength or needs improvement, and the State is given an overall 
rating for all cases reviewed.   
State Role 
Although all States must comply with Federal regulations to receive 
Federal funding, each State determines how services are provided to 
children in foster care. States develop their own standards for 
frequency of caseworker visits.  The structure of foster care systems 
varies from State to State and often varies within States.  Some have 
State-administered systems in which the State directly provides foster 
care services to children.  Other States have county-administered 
systems; the State retains responsibility for the safety and well-being of 
children in foster care while counties provide the services. Adding a 
further layer of complexity, some State and county-administered 
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programs contract a portion of or all foster care services to private 

agencies. 

To be eligible for foster care payments, States must submit a plan to be 
approved by the HHS Secretary.  Section 471(a)(22) of the Act requires 
that the plan include standards to ensure that children in foster care 
placements in public or private agencies are provided quality services 
that protect the safety and health of the children.  In addition, the 
State plan must provide for the development of a written case plan for 
each child and provide for a case review system (section 471(a)(16)).  
The case plan must include steps for ensuring that the child receives 
safe and proper care and that services are provided to the child, parents, 
and foster parents to address the needs of the child while in foster care 
(section 475(1)(B)). State case review systems must include procedures 
for ensuring that the status of each child is reviewed at least every  
6 months by either a court or by administrative review (section 
475(5)(B)). 
State Systems for Documenting Caseworker Visits 
Statewide Automated Child Welfare Information Systems.  Many States have 
implemented or are in the process of implementing SACWIS.  The 
development and implementation of SACWIS is not mandatory; 
however, many States and the District of Columbia chose to accept 
Federal matching funds to develop these systems.  Approximately  
$2.8 billion in Federal and State funds have been spent on the design, 
development, implementation, and operation (including initial and 
replacement hardware) of SACWIS since 1994.  According to the ACF 
Web site, as of May 2005, 45 States (including the District of Columbia) 
are in various stages of development, implementation, or planning of 
such systems. Six States have no SACWIS activity planned.11 
A SACWIS functions as a comprehensive case management tool for 
caseworkers foster care and adoption assistance case management.  To 
provide a unified automated tool to support child welfare services, 
States were also encouraged to structure their SACWIS to support child 
protective and family preservation services.12 In addition, pursuant to 
45 CFR  1355.53, these systems are required to produce data for the 
Adoption and Foster Care Analysis Reporting System and the National 
Child Abuse and Neglect Data System.  As specified in ACF Transmittal 
No. ACF-OISM-001, SACWIS is also required to support both case 
planning and administrative review processes.  
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States may choose to include a field to record caseworker visits with 
children in their SACWIS.  The ability to produce reports detailing how 
frequently caseworkers visit children depends on individual State 
priorities, stage of automated system development, and how States have 
developed their systems.  Even States with implemented systems may 
not have the capability to produce these reports.  States are not 
required to produce reports; however, statewide visitation reports are 
one resource States can utilize to determine the extent to which 
caseworkers are visiting children in foster care. 
Other Systems for Documentation.  States may also develop non-SACWIS 
systems to monitor caseworker visits with children; these systems may 
be eligible for Title IV-E funding.  Types of systems States can develop 
include new Web-based systems or modifications to legacy systems.   
Some States do not use any automated system to record caseworker 
visitation, relying instead on paper case files.  Due to the variation in 
States with or without automated systems, types of automated systems 
(SACWIS and other State-developed systems), and stages of automated 
system development, States may record caseworker visitation in 
automated systems, in paper case files, or in a combination of 
automated systems and paper case files.  
Related Work  
This report is the first in a series of three reports about caseworker 
visits with children in foster care.  In the second report, State 
Standards and Practices for Content of Caseworker Visits With 
Children in Foster Care, OEI-04-03-00351, OIG analyzed State written 
standards for the content of caseworker visits.  The third report in the 
series, Compendium of State Standards: Content of Caseworker Visits 
With Children in Foster Care, OEI-04-03-00353, provides State written 
standards guiding the content of caseworker visits with children in 
foster care.  The compendium includes standards provided by 38 States. 
In addition to Office of Inspector General work, the Government 
Accountability Office (GAO) released a report in 2003 detailing the 
challenges States experienced while implementing SACWIS.  GAO 
found that the reliability of child welfare data from SACWIS could be 
improved.13  GAO also examined the CFSRs in a 2004 evaluation and 
found that ACF and the States viewed the reviews as a valuable 
process. The report offered several recommendations to further improve 
the reviews.14 
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METHODOLOGY 
For the purpose of our evaluation, we defined visits as face-to-face 
contacts between caseworkers and children placed in foster care.  Visits 
can take place in a variety of locations, including but not limited to the 
foster care placement (where the child lives), school, and the child 
welfare office.  We defined standards as written procedures providing 
guidance for caseworker visitation included in State law, regulations, 
policies, memoranda, or other documents. 
We requested the 50 States, the District of Columbia, and Puerto Rico to 
provide State standards for caseworker visits.  Puerto Rico did not 
respond. To provide a comprehensive picture of how caseworker visits 
were addressed, the 50 States and the District of Columbia (referred to 
as 51 States throughout this report) also completed a structured data 
collection instrument via e-mail and participated in a structured 
telephone interview. In addition, we requested that all States provide 
statewide reports of caseworker visits.  We also interviewed 
organizations with expertise in child welfare and conducted site visits in 
two States.   
Documentation Review, E-Mail Data Collection Instrument, and Phone 
Interview 
A critical component of data collection was our review of 51 States 
written standards related to caseworker visits.  We specifically 
requested current standards from the States for the following areas: 
o 	 Frequency of caseworker visits,  
o 	 Location where caseworker visits should occur, and 
o 	 System in which caseworkers document visits (State automated 
system and/or paper case file records). 
Documentation from the 51 States was supported by responses from 
both the e-mail data collection instruments and the telephone 
interviews. The data collection instruments and interviews were 
completed between February and July 2004.  If there were discrepancies 
between State documentation and State responses, we worked with the 
States to resolve these differences. When State information was 
incomplete, we continued to follow up with States throughout the fall of 
2004. The information presented in our report regarding State written 
standards represents standards in place between February and July 
2004. 
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Although the documentation review was the primary data source for 

standards related to caseworker visits, the e-mail data collection 

instrument and interviews helped provide a comprehensive picture of

State policies and practices.  States responded to question areas 

including, but not limited to, standards for caseworker visits and the 

status of automated systems.  We developed automated databases to 

compile survey and documentation information collected from States. 

We analyzed data to compile categorizations of State responses and to 

aggregate our data. 

Statewide Monthly Reports of Caseworker Visitation With Children in Foster 
Care 
Using a benchmark of monthly visits from ACFs CFSRs, we asked all 
States to submit monthly statewide caseworker visitation reports.  We 
requested FY 2003 data (October 1, 2002, through September 30, 2003) 
since it was the most recent complete fiscal year of data available at the 
time of our evaluation.  The request allowed us to test the extent to 
which States could provide reports. In addition, monthly data allowed 
us to systematically determine the extent to which State reports 
indicated that caseworkers were visiting children in foster care. For 
each month in FY 2003, we asked States to provide the total number of 
children in foster care and the number who received caseworker visits. 
If States did not immediately provide reports or required additional 
clarification, we e-mailed them a table providing an example of the 
requested data.  
Based on these data, we calculated a monthly average of children 
visited in FY 2003 by dividing the number of children visited each 
month throughout the year by the total number of children in foster 
care. For example, if for a 6-month period there were 100 children in 
foster care each month and the numbers of children visited were 40, 50, 
60, 70, 80, and 90, then the monthly average number of children visited 
would be 65 percent ((40+50+60+70+80+90)/600).  Our report presents 
both the monthly range as well as the monthly average for each State 
when available. If States were unable to produce reports, we 
determined the reasons during our telephone interview. This type of 
statewide data had never been systematically requested from States on 
a national level before our evaluation.  
We anticipated several reasons that States would not be able to meet 
our request for monthly statewide visitation reports.  First, a statewide 
report of caseworker visitation was only available if a State recorded 
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visits in a statewide, automated system or performed and reported 
summary information from statewide reviews of foster care cases. If 
States did not have statewide data for the entire 12-month period, we 
accepted data for the months available.  Also, if a State had a previous 
report providing aggregate visitation information for FY 2003 that was 
not detailed for each month, we accepted those reports as well.  We 
requested monthly data for our analysis, and also gave States the option 
of providing quarterly information in addition to the monthly data; 
however, we did not request that States provide visitation data in 
accordance with their frequency standards.  For example, if a State had 
a biweekly visitation standard, we did not request biweekly visitation 
data. Data presented in the report are annotated to reflect any 
limitations in Appendix C. 
In addition to statewide reports that included children placed in foster 
care, we also received reports from some States that included a sample 
of their foster care cases.  Due to the limited number of cases and the 
wide variation in how this information was presented by each State, we 
only included statewide reports that included at least 70 percent of 
children in foster care. 
Interviews With Organizations and Site Visits to States 
To gain a richer understanding of how caseworker visits were addressed 
in States prior to designing our evaluation, we interviewed 
organizations and conducted site visits in two States.  The organizations 
included: Chapin Hall, the Center for Law and Social Policy, Childrens 
Defense Fund, Childrens Rights, Inc., Child Welfare League of 
America,15 the Heritage Foundation, and the Urban Institute. In 
addition, we visited one predominately urban State and one State that 
was more rural (Florida and Kentucky) to:  examine foster care records 
and determine the format in which caseworker visits were recorded, 
interview State and local administrators, conduct a focus group with 
foster parents (Kentucky only), interview caseworkers, collect State 
regulations and policies regarding caseworker visitation, and review 
computer data systems. We also solicited input from ACF staff.  
Limitations 
Safety of children in foster care is affected by many factors in addition 
to frequency of caseworker visits.  However, our evaluation focused 
specifically on frequency of caseworker visits and does not address any 
other factors.  We focused exclusively on standards and reports from the 
State level. We did not examine standards from local or county levels of 
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State child welfare systems, nor did we examine standards private 
agencies may have in place.  In addition, our review of visitation 
standards was limited to children placed in-State and did not include 
children placed out-of-State.  Also, many States have exceptions to their 
visitation standards, which are determined by factors such as how 
recently the child was placed in foster care, type of placement setting, 
needs of the child, case status, and caseworker caseload size.  We did 
not categorize exceptions to State standards.   
Regarding the reports we received, we did not verify whether the visits 
reflected in the reports actually occurred, nor did we independently 
validate that all visits were reflected in reports.  Also, we did not assess 
whether visits were meeting childrens needs. 
Standards 
We conducted this inspection in accordance with the Quality Standards 
for Inspections issued by the Presidents Council on Integrity and 
Efficiency and the Executive Council on Integrity and Efficiency. 
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Forty-three States had statewide written  Fifty of fifty-one States had 
standards calling for caseworkers to visit  minimum standards regarding the 
frequency of caseworker visits with 
children in foster care at least monthly 
children in foster care.16  Forty-
three out of fifty States had statewide written standards that call for 
caseworkers to visit the majority of children in foster care placed  
in-State at least once a month.  Of these 43 States, 39 had monthly 
standards and the remaining 4 had more frequent standards.  In 
contrast, the remaining seven States had standards that were less 
frequent than monthly. They were as follows:   
o 	 Quarterly (three States), 
o  Every 2 months (one State), 	
We define visits as face-to-face 
contacts between caseworkers and 
o 	 Every 6 weeks (one State), 
children placed in foster care.  
o 	 Between once a week and  Visits can take place in a variety of 
once every 12 weeks (one  locations, including but not limited 
to, where the child lives, school, 
State), and 
and the child welfare office. 
o 	 Range from monthly (not to 

exceed 35 days) to quarterly 

(one State). 

State standards often specified exceptions that could result in either 
more or less frequent visits.  One common exception that resulted in 
more frequent visitation standards was how recently the child has been 
placed in foster care.  Other exceptions included type of placement 
setting, needs of the child, case status, and caseworker caseload size.  
We did not report exceptions to State standards.  For a complete listing 
of State standards, please refer to Appendix A.  
States reported several events that contributed to the development or 
enhancement of their standards for both the frequency and content of 
caseworker visitation.  (States could report more than one event, 
therefore the total is higher than 50.)  States most commonly reported 
the following: 
o  Lawsuits and/or consent decrees (8 States), 
o  Collaboration with child advocacy groups (8 States),  
o  Child and Family Services Review process (10 States),  
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o 	 Other events, such as State legislative action; consultations with 
other States, ACF, or stakeholders; new leadership or 
organizational restructuring; media reports; best practice work 
groups; and a childs death (17 States). 
Eighteen States reported that their standards were not modified or 
developed due to any particular event.   
Thirty-three States had written standards detailing how often visits should 
occur in the placement setting:  15 States recommended that every visit 
occur in the placement, and 18 States recommended some visits in the 
placement  
Although there are no Federal requirements mandating that 
caseworkers visit children where they live, 33 of 50 States standards 
specified that at least a portion of visits should occur in the placement 
setting for the majority of children in foster care.  The specifications 
ranged from seeing the child in the foster care placement for every visit 
to outlining that some visits should occur in the foster care placement. 
Some State standards specified exceptions that could result in either 
more or less frequent visits in the foster care placement, such as how 
recently the child was placed in foster care and type of placement 
setting. However, we did not categorize these exceptions to State 
standards. For a complete listing of State standards, please refer to 
Appendix B. 
Fifteen of the 33 States had standards stating that children should be 
seen in their foster care placements during every visit.  These States 
most often reported that the main value in requiring visits where the 
child lives was the ability to assess child safety and well-being or the 
home environment. Other benefits cited by States included ensuring 
that the childs needs are being met 
We feel its very important for 
while in care, building caseworker 
the caseworker to see where the 
relationships with the child, ensuring 
child is living . . .  it is our 
that the child is actually at the foster 
belief that the State assumes the 
home, assessing the nature of the 	
responsibility of the parent.     
foster parents relationship with the 
West Virginia 
child, and assessing other children in 
the home. 
Eighteen out of thirty-three States had standards stating that some 
visits occur in the placement.  For these 18 States, standards for visits 
where the child lives were less frequent than the minimum visitation 
standards. We determined that State standards recommended visits: 
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o 	 Quarterly in the foster care placement (eight States),  
o 	 Every 2 months in the foster care placement (six States), 
o 	 Where the child lives, but not at a specific frequency (three 
States), or 
o 	 At least once every 6 months in the foster care placement (one 
State). 
Twenty out of fifty-one States demonstrated their 
Production of statewide visitation 
ability to produce statewide reports detailing the  reports is one method States can 
extent to which visits occurred during FY 2003  use to determine how frequently 
caseworkers are visiting children 
in foster care.  Therefore, we requested State reports detailing 
caseworker visits with children in foster care for FY 2003.  Given the 
significant Federal investment in SACWIS, we anticipated that 
SACWIS would be a likely source of State visitation reports. There are 
no specific Federal requirements for States to produce reports reflecting 
caseworker visitation.   
Of the 20 statewide reports, 19 were from States with SACWIS and 1 resulted 
from a State administrative review process 
Many States SACWIS were structured to produce reports before our 
evaluation. Some States used the reports to monitor caseworker visits.  
We are aware of at least two States that post their visitation reports 
either on the Web or on their own Intranet.  In contrast, other States 
were not producing visitation reports prior to our evaluation and 
produced these reports specifically at our request.  One such State 
produced both our requested statewide report and specific reports for 
localities within the State to be used by local foster care offices. 
Only one State, Colorado, provided a visitation report resulting from a 
review of caseworker visits during its 6-month administrative reviews of 
children in foster care. Children were reviewed 6 months after 
placement in foster care and every 6 months thereafter.  Cases were 
assigned a yes if it was determined that the caseworker had a monthly 
visit with the child after the first month.  The cases were then 
summarized in statewide reports.  In FY 2003, Colorado generated the 
case review results using its own proprietary database.  However, 
beginning in July 2004, these reports were generated from its SACWIS. 
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We identified several impediments to report production from the 31 States 
that did not provide statewide automated caseworker reports 
Based on States responses to the telephone interviews and their 
documentation standards and practices, we identified three impediments 
to State report production: 
o 	 Documentation:  States record visitation information primarily in 
paper case files. 
o 	 Insufficient capacity: State automated systems could not produce 
reports, either because systems were not implemented statewide 
or because systems were not structured to extract the information.  
o 	 Lack of resources:  States reported they did not have resources 
such as staffing or computer time to produce the reports. 
These impediments are explained below.  
Eighteen of the thirty-one States recorded caseworker visits primarily in paper 
case files during FY 2003. These States did not provide statewide reports 
detailing caseworker visitation for FY 2003.  Many of these States were 
in the process of either planning or implementing SACWIS or other 
automated systems.  However, these States reported that during  
FY 2003, caseworkers were not recording visits primarily in an 
automated system.  One of the eighteen States reported that 
caseworkers were not recording visits in their automated system in FY 
2003; however, this State reported it could produce statewide visitation 
reports starting in 2004. Four of the eighteen States reported that they 
had automated system capacity to record caseworker visits, but that 
caseworkers were still using paper case files as their primary record of 
visits in FY 2003. 
Eight of the thirty-one States reported that their systems did not have the capacity 
to produce visitation reports for FY 2003. The specific issues affecting capacity 
varied.  In one of these eight States, SACWIS had not yet been 
implemented statewide, and therefore the data were not available for all 
children.  In this State, visits were recorded in both the automated system 
and in paper case files. In another five of these eight States, visits were 
documented in the automated 
system but the system was not  [We] built the program to gather 
structured to produce the  caseworker contacts 11 months ago 
[Fall 2003] . . . still getting the bugs 
reports.  One of the eight States 
out of the system . . . Oregon 
reported that its system was not 
developed in time to produce 
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reports specifically for FY 2003, but reported that capability for 2004.  
Another State reported that it was still working through issues with its 
system. 
Five of the thirty-one States reported that they did not have the resources to 
produce the reports. These States cited issues such as limited staff 
resources or computer time as the reasons they could not produce the 
reports.  One of these States cited the competing priority of the CFSRs 
as a barrier to generating reports. 
[We] don't have the manpower to 
Two of the five States reported that 
generate reports.  New Mexico  
their systems would have the 
capability to produce visitation 
reports in 2004.  
Using the benchmark of monthly 
Seven of the twenty statewide reports 
visits from ACFs CFSRs, we asked 
indicated on average that fewer than half of 
all States to submit monthly 
children in foster care were visited monthly in 
statewide caseworker visitation 
FY 2003 
reports. Twenty States provided 
statewide reports, and these States had different visitation standards.   
States with standards for at least monthly visits 
Seventeen States with standards for at least monthly visitation 
submitted statewide reports for FY 2003.  These reports reflected on 
average that 5 of the 17 States visited fewer than half of children 
monthly.  Five other State reports detailed that on average between 
50 and 75 percent of children were visited monthly.  The remaining 
seven States provided reports indicating that between an average of 
76 and 97 percent of their children were visited monthly. 
States with standards for visits less frequent than monthly 
The three remaining States that also submitted reports did not have 
monthly visitation standards.  Virginia and Washington both had a 
quarterly minimum visitation standard.  Iowa had minimum visitation 
standards ranging from monthly (not to exceed 35 days) to quarterly, 
depending on both the placement setting and whether private agencies 
provide the foster care services. 
Virginia provided monthly reports for FY 2003 which indicated that an 
average of 45 percent of children were visited monthly.  Iowa provided 
both monthly and quarterly information.  Its report indicted that  
on average 24 percent of children were visited monthly and that, on 
average, 88 percent of children were visited by the end of the quarter. 
In contrast, Washington provided a quarterly report for April through 
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June 2003. The report showed that 58 percent of children were visited 
during the quarter.  Monthly data were not available. 
State-reported factors affecting visitation rates 
States reported multiple factors that may have resulted in lower 
visitation rates in their reports.  These factors could affect accurate 
reporting for the visitation rate and/or actual visitation frequency.  
Seven States reported that the percentages reflected in their reports 
were affected by documentation issues.  These issues included workers 
not documenting visits in the system or workers using the wrong codes 
or fields for data entry.  Five States cited other issues that negatively 
affected their visitation rate, such as private providers not entering 
visits in the system and visits only being included in the reports if they 
took place specifically in the foster care placement.  Five States reported 
that insufficient staffing/high caseloads affected their rates. These 
factors affected some States more than others. For example, of the two 
States that reported that private provider visits were not included in 
reports, one had a 44 percent monthly average visitation rate and the 
other had a 78 percent rate.  The range and severity of some of these 
factors reported by States clearly can result in reports in which not all 
visits that occurred are reflected in State monthly averages. In other 
instances, the factors affected actual visitation frequency. 
States also cited several positive areas affecting caseworker visitation.  
Seven States indicated either that conducting caseworker visits was a 
priority, or that it was something that was closely monitored.  The 
positive impact of monitoring the visitation rate was also indicated by 
States that had comparatively low rates in FY 2003.  Five States 
reported that they either improved their visitation rates by the end of 
2003 or were able to significantly improve their rates after that time.  
Two additional States reported plans to address visitation issues 
through their CFSR PIP.  For a detailed summary of each States 
visitation report and the factors affecting visitation rates, refer to 
Appendix C, Tables 1 and 2.  
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Children in foster care represent one of the most vulnerable segments of 
our society. We recognize that child welfare programs are complex and 
that States face challenges related to competing priorities, resource 
issues, and the implementation of automated systems.  However, 
caseworker visits with children in foster care are a critical element of 
ensuring child safety and well-being.  Most recently, ACF found that  
27 out of 35 States needed to improve the frequency of caseworker visits 
with children. Our study found that 50 out of 51 States have statewide 
written standards regarding the frequency of caseworker visits with 
children in foster care. Most States have implemented standards for at 
least monthly visits for the majority of children in foster care.  In 
addition, many States have developed or are in the process of developing 
statewide automated systems (both SACWIS and non-SACWIS).  For 
our evaluation, 19 States produced reports from SACWIS.  These 
systems provide the opportunity for States to quantify the extent to 
which caseworkers visit children in foster care. Therefore, to the extent 
to which ACF wants to strengthen States abilities to quantify how often 
caseworkers within their State are visiting children, we recommend the 
following: 
For States with limited or nonexistent automated capacity to record the 
frequency of caseworker visits and produce statewide reports, ACF should 
promote the development of automated systems such as SACWIS. 
These reports could be particularly useful for States cited in the CFSRs as 
needing improvement in the area of frequency of caseworker visits.  The 
reports would also enhance ACFs ability to monitor caseworker visits, 
providing statewide, comprehensive visitation data. Some States have 
already begun to examine caseworker visits through automated systems to 
ensure that visits are occurring, even though there are no requirements to 
have systems structured to produce these reports.  Several States in our 
evaluation reported that although caseworkers were recording information 
in automated systems, this information could not be extracted to produce 
reports. As SACWIS and other systems continue to develop, ACF should 
consider working with States to ensure that systems are structured to both 
record visits and produce reports. 
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For States with automated system capacity to record the frequency of 
caseworker visits and produce statewide reports, ACF should work with 
States to ensure that visitation data are recorded in automated systems. 
Seven States that provided reports indicated that their visitation rates 
were affected by documentation issues in FY 2003. ACF should continue 
to assist States to develop clear policies for recording caseworker visits in 
automated systems to promote the accuracy of reports. Improved 
visitation data would allow both ACF and the States to monitor visitation 
frequency with enhanced accuracy, and thereby plan program 
improvements more effectively. 
AGENCY COMMENTS 
In its comments to the draft report, ACF concurred with our 
recommendations. ACF plans to initiate an effort to develop direct 
guidance to States to implement management reporting capabilities to 
determine the frequency and outcomes of client visitation. 
OFFICE OF INSPECTOR GENERAL RESPONSE 
We appreciate ACFs comments to this report and are pleased that it 
will continue to provide technical assistance to States in the area of 
automation. In addition, we look forward to ACFs development of 
direct guidance that will assist States in implementing management 
reporting capabilities within current automated systems specific to 
client visitation. 
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1 http://www.acf.hhs.gov/programs/cb/cwrp/tools/onsitefinal.pdf.      
2  http://www.acf.hhs.gov/programs/cb/cwrp/results/statefindings/ 
genfindings04/index.htm, accessed November 1, 2005. 
3 http://childrensrights.org/press_releases/07-09-03.htm, accessed 
December 8, 2004.   
4 Figure applies to children in foster care longer than 90 days. 
5  http://www.acf.hhs.gov/programs/cb/publications/cm01/appendb.htm, 
accessed April 25, 2005. 
6  http://www.acf.hhs.gov/programs/cb/publications/cm01/appendb.htm, 
accessed April 25, 2005. 
7 http://www.hhs.gov/budget/05budget/acf.html, accessed April 25, 2005.   
8 For children placed in foster care out of State, the Federal Government 
requires a minimum of one annual visit either by the State in which 
the childs parents live or by the State in which the child has been 
placed.  [Section 475(5)(A)(ii) of the Social Security Act.]   
9 http://www.acf.dhhs.gov/programs/olab/legislative/testimony/2004/cw_ 
testimony.htm, accessed April 25, 2005.   
10 The cases reviewed onsite are selected from a random oversample of no 
more than 150 foster care and 150 in-home services cases.  45 CFR 
1355.33(c)(6).  The onsite review may take place in several political 
subdivisions of the State, but must include a States largest 
metropolitan subdivision. 45 CFR 1355.33(c)(2).  
11 http://www.acf.hhs.gov/programs/cb/dis/sacwis/statestatus.htm, 
accessed May 11, 2005.        
12 http://www.acf.hhs.gov/programs/cb/dis/sacwis/about.htm, accessed 
May 11, 2005.   
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13 http://www.gao.gov/new.items/d03809.pdf. 
14 http://www.gao.gov/new.items/d04333.pdf.    
15 The Child Welfare League of America (CWLA) recommends that 
caseworkers visit children in foster care monthly.  CWLAs standards 
allow for more or less visitation based on the needs of the child or as 
requested by the foster parent, but never less than once every 2 
months. 
16 Wisconsin did not have a minimum visitation standard that applied 
statewide.  This State provided monthly standards from its only State-
administered county, which were created as a result of a lawsuit. 
Wisconsin reported that most local offices/counties had standards for 
frequency. 
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Table 1 shows the caseworker visitation standards reflected in State 
documentation for the majority of children in foster care.  Table 2 
describes the standards for States classified as Other in Table 1 (Iowa 
and New Jersey). 
Table 1:  Minimum Caseworker Visitation Standards for the Majority of Children in Foster 
Care, FebruaryJuly 2004 
State  Weekly  Twice  Monthly  Every 6  Every 2  Quarterly  Other* 
Monthly  weeks  Months 
AK  X 
AL  X 
AR  X 
AZ  X 
CA  X 
CO  X 
CT  X 
DC  X 
DE  X 
FL  X 
GA  X 
HI  X 
IA  X 
ID  X 
IL  X 
IN  X 
KS  X 
KY  X 
LA  X 
MA  X 
MD  X 
ME  X 
MI  X 
MN  X 
MO  X 
MS  X 
MT  X 
NC  X 
ND  X 
NE  X 
NH  X 
NJ  X 
NM  X 
NV  X 
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Table 1:  Minimum Caseworker Visitation Standards for the Majority of Children in Foster 
Care, FebruaryJuly 2004 
State  Weekly  Twice  Monthly  Every 6  Every 2  Quarterly  Other* 
Monthly  weeks  Months 
NY  X 
OH  X 
OK  X 
OR  X 
PA  X 
RI  X 
SC  X 
SD  X 
TN  X 
TX  X 
UT  X 
VA  X 
VT  X 
WA  X 
WV  X 
WY  X 
Total  1  3  39  1  1  3  2 
*Please refer to Table 2 for a description of Other State standards. 
Source: Document review of State foster care visitation standards by OIG. 
Table 2:  Description of Minimum Visitation Standards for States Categorized as Other, 
FebruaryJuly 2004 
State  Minimum Visitation Standards 
IA  Standards vary depending on both the placement setting and whether the services are 
purchased.  Standards range from monthly (not to exceed 35 days) to quarterly.  
NJ  Between once a week and once every 12 weeks. 
Source: Document review of State foster care visitation standards by OIG. 
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Standards for How Often Caseworkers Were Instructed to Visit Children Specifically in Foster Care Placement,
FebruaryJuly 2004 
State  Minimum  Same as  Every 2  Quarterly  Every 6  Recommend  No Specifications 
Visitation  Minimum  Months  Months  Visits Take 
Standard  Visitation  Place in Home 
Guideline 
AK  Monthly  X 
AL  Monthly  X 
AR  Weekly  X 
AZ  Monthly  X 
CA  Monthly  X 
CO  Monthly  X 
CT  Monthly  X 
DC  Twice a  X 
Month 
DE  Monthly  X 
FL  Monthly  X 
GA  Monthly  X 
HI  Monthly  X 
IA Othe r*   X  
ID  Monthly  X 
IL  Monthly  X 
IN  Every 2  X 
Months 
KS  Monthly  X 
KY  Monthly  X 
LA  Monthly  X 
MA  Monthly  X 
MD  Monthly  X 
ME  Every 6 X 
Weeks 
MI  Monthly  X 
MN  Monthly  X 
MO  Twice a  X 
Month 
MS  Monthly  X 
MT  Monthly  X 
NC  Monthly  X 
ND  Monthly  X 
NE  Monthly  X 
NH  Monthly  X 
NJ Other *   X  
NM  Monthly  X 
NV  Monthly  X 
NY Quart erly   X  
OH  Monthly  X 
OK  Monthly  X 
OR  Monthly  X 
PA  Monthly  X 
RI  Monthly  X 
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Standards for How Often Caseworkers Were Instructed to Visit Children Specifically in Foster Care Placement,
FebruaryJuly 2004 
State  Minimum  Same as  Every 2  Quarterly  Every 6  Recommend  No Specifications 
Visitation  Minimum  Months  Months  Visits Take 
Standard  Visitation  Place in Home 
Guideline 
SC  Monthly  X 
SD  Monthly  X 
TN  Twice a  X 
Month 
TX  Monthly  X 
UT  Monthly  X 
VT  Monthly  X 
VA  Quarterly  X 
WA  Quarterly  X 
WV  Monthly  X 
WY  Monthly  X 
Total  15  6  8  1  3  17 
*See Appendix A, Table 2. 

Source: Document review of State foster care visitation standards by OIG. 

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The following tables provide caseworker visitation data for the 20 States that provided statewide reports.  These tables present a 
State-by-State comparison of visitation standards and rates for FY 2003.  While we were most interested in statewide data for 
foster care cases only, States track their foster care population in different ways.  Several States monitor children in foster care as 
part of their overall child welfare population and therefore include other groups in these reports, such as children receiving 
in-home care or children in independent living programs.  Some States excluded specific populations for reasons such as children 
belonging to a particular placement status (e.g., adoptive placements), children classified as runaways, or children subject to a 
different visitation standard.  In addition, some States chose to include out-of-State children, while other States excluded this 
population.  For these reasons, we have included a column entitled Data Considerations for each State, describing excluded 
populations and other important information for understanding each States visitation rate. 
Unless otherwise indicated, the visitation rates below represent face-to-face visits with all children in foster care (regardless of 
whether the visits occurred in the placement) with the exception of AR, MA, and WA, which only include visits that occurred in the 
placement in their visitation data.   
Table 1 includes the visitation information for the 17 States with at least monthly visitation standards, with the following 

columns:

o   State minimum visitation standards,  
o  FY 2003 months included in State reports, 
o   Monthly range and monthly average of children visited for FY 2003, 
o   Data considerations about populations included in State reports, and 
o   State reported factors affecting the visitation rate. 
Table 2 provides the visitation data for three States with visitation standards less frequent than monthly.  It includes the same 

information as Table 1, and also lists the type of data provided (monthly and quarterly) as well as the quarterly visitation range 

and average for FY 2003 when available.  

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Table 1:  Caseworker Visitation Reports for FY 2003 Generated by States With at Least Monthly Standards 
State  Minimum  Months  Range of Monthly State-Reported Data Considerations  State-Reported Factors Affecting 
Visitation  Included  Children in  Average  Visitation Rate 
Standard  Care Visited 
Monthly 
AR  Weekly  12 Months:  68-75%  71%  Populations excluded: Out-of-State children, children in therapeutic The State reported that the most
10/01/02-  foster homes, and children in preadoptive placements (totaling  significant factor negatively 
09/30/03  approximately 22 percent during FY 2003).  Children in the report for affecting visitation is staffing. As 
whom monthly data were not available are not included in these  time goes on, caseload [size] has 
figures (less than 1 percent).   increased. In addition, the State 
Other:  Visits reflected in the report include only those occurring in  reported that documentation issues
the placement; face-to-face visits occurring elsewhere are not counted.  may result in lower visitation rates.   
AZ  Monthly  12 Months:  55-66%  59%  Populations excluded: Out-of-State children and runaway children  AZ reported that the percentage 
10/01/02-  (totaling approximately 5 percent of caseload for April through  reflects visitation that is accurately
09/30/03  September 2003).  documented in SACWIS [if workers 
did not always accurately document
their visits, this would result in a 
visitation rate that did not reflect 
all visits conducted]. 
CA  Monthly  6 Months:   85-86%  86%  Populations excluded:  Children classified as having exceptions to  CA reported changing its
04/03-09/03  their monthly visitation standard (an average of 20 percent per methodology for generating reports
month). Exceptions included:  child contacted by another agency,  in July 2004, resulting in reporting
child placed with legal guardian, child placed with relative, child  data on more children in care (fewer
placed out of State, child receiving family reunification services/  exclusions).  
stable, child receiving permanent placement services/stable, child 
under 2 years of age, and childs whereabouts unknown. 
Population included in report in addition to children in foster care: 
Children receiving in-home care (approximately 8.7 percent of total 
children during 04/03-09/03). 
CO  Monthly  12 Months:  89-94%  91%  Populations excluded: Out-of-State children represented  CO reported that it has improved its 
10/01/02-  approximately 5 percent of the reviewed population during FY 2003.   visitation rate dramatically over
09/30/03  Other: Statistics are from the review of caseworker visits as part of  time. It is COs view that 
COs administrative case review of all children in foster care for   caseworker visits are the most 
6 months.  Children are reviewed 6 months after placement in foster critical element for ascertaining 
care and every 6 months thereafter.  child safety. 
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Table 1 (cont):  Caseworker Visitation Reports for FY 2003 Generated by States With at Least Monthly Standards 
State  Minimum  Months  Range of Monthly State-Reported Data Considerations  State-Reported Factors Affecting 
Visitation  Included  Children in  Average  Visitation Rate 
Standard  Care Visited 
Monthly 
DC  Twice a  4 Months:   42-44%  43%  Populations excluded:  Children in third-party kinship nonfoster care  In 2001, one of the Districts goals 
Month  06/03-09/03  and those placed outside DC, MD, and VA or in residential treatment  was to improve data integrity by
facilities more than 100 miles away were excluded (totaling focusing on documenting case plans
approximately 4 percent of children during 06/03-09/03).  for children in foster care in 
SACWIS.  In 2003, the focus was 
shifted to documentation of visits to 
children in foster care.  DC reported 
that as documentation improved, 
the monthly visitation rate 
increased to 81 percent by 2005. 
FL  Monthly  9 Months:  93-96%  95%  Out-of-State placements included:  Out-of-State children represented  FL stated that its monthly
01/01/03-  approximately 3 percent of children in September 2003.  visitation rate is high because of the 
09/30/03  Population included in report in addition to children in foster care:  commitment leadership has shown 
Children receiving in-home care (approximately 33 percent of children  and indicated that performance is
01/03-09/03) and children receiving young adult services (accounting measured daily.  The State 
for less than 1 percent of children 03/03-09/03).  commented that visitation is 
necessary for achieving safety and 
that resources have been dedicated 
to ensuring that children are seen 
each month. 
KY  Monthly  12 Months:  36-53%  44%  Out-of-State placements included:  Out-of State children represented  Visits from private providers are not 
10/01/02-  approximately 1.5 percent of children in FY 2003.  included in the data. KY provided
09/30/03  Other: KY reported that approximately 40-45 percent of children additional information indicating 
were receiving care from private providers. These children receive  that between 75-82 percent of all 
quarterly visits from State caseworkers, and may receive more  children received a visit from State 
frequent visits from private providers. Visits from private providers  caseworkers by the end of each 
are not reflected in these data as private provider visitation is not  quarter in FY 2003.  
tracked by the State in its visitation reports. 
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Table 1 (cont):  Caseworker Visitation Reports for FY 2003 Generated by States With at Least Monthly Standards 
State  Minimum  Months  Range of Monthly State-Reported Data Considerations  State-Reported Factors Affecting Visitation 
Visitation  Included  Children in  Average  Rate 
Standard  Care Visited 
Monthly 
MA  Monthly  12 Months:  75-80%  78%  Populations excluded: Out-of-State children represented  The report is a tool management uses to 
10/01/02-  approximately 3 percent of children in September 2003.  assist social workers to focus and prioritize 
09/30/03  Other: Visits reflected in the report include only visits casework contacts.  Visits reflected in the 
occurring in the placement; face-to-face visits occurring  report only include visits with the child in 
elsewhere are not counted. In addition, visits conducted by placement by the child's social worker;
private agencies are not included in the report. Visits are  face-to-face visits conducted by the social
recorded by those agencies and furnished to the State via  worker assigned to the foster home to work
quarterly reports.  with the foster parents are not included. In
addition, visits conducted by private 
agencies are not included in the report. 
Private agency contacts are monitored 
separately. 
NE  Monthly  11 Months:   11-68%  50%  Out-of-State placements included:  Out-of-State children  NE reported the initial monthly percentages
11/01/02-  represented approximately 1 percent of children in  were low due to the newness of 
09/30/03  September 2003.  requirements for caseworkers to enter data
Population included in report in addition to children in  into the automated system (August 30, 
foster care: Children receiving in-home care.  According to 2002).   
the State, in-home care cases represent less than 10 
percent of total children in FY 2003. 
NH  Monthly  6 Months:   NA  49%  Out-of-State placements included:  Out-of-State children  NH provided additional information
01/01/03-  represented approximately 8 percent of children in  indicating that 44 percent of children in 
06/30/03  September 2003.   foster family homes were visited at least 
Populations excluded: Children placed in residential  once a month 07/01/03-12/31/03.  However, 
facilities (approximately 26 percent of total children during  NH reported that other measures, such as
01/03-06/03) are not included in these figures, since  receiving a CFSR rating of substantially 
monthly information was not presented for them.     achieved for 74 percent of 50 cases
Other:  Report was a 6-month summary of children in reviewed, and a more recent management
foster family homes visited at least once a month and did  report indicating fewer than 10 percent were 
not include month-by-month totals.  Therefore, a range  not visited in the last 2 months demonstrate 
could not be calculated.  progress on the part of the Division for
Children, Youth and Families. 
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Table 1 (cont):  Caseworker Visitation Reports for FY 2003 Generated by States With at Least Monthly Standards 
State  Minimum  Months  Range of Monthly State-Reported Data Considerations  State-Reported Factors Affecting 
Visitation  Included  Children in  Average  Visitation Rate 
Standard  Care Visited 
Monthly 
OK  Monthly  12 Months:  92-95%  94%  Populations excluded: Out-of-State children, children in  OK reported that it considers visitation to 
10/01/02-  tribal foster care who are not in State custody, children in be a priority and that there is no way to 
09/30/03  care fewer than 14 days, and children in trial adoption  ensure safety, permanency, and well-being 
(approximately 6 percent of all children during FY 2003).  without visits to the children.  The State 
reported monitoring visitation closely at 
all levels. 
SC  Monthly  12 Months:  96-97%  97%  Out-of-State placements included: Out-of-State children  SC reported that State law requires we 
10/01/02-  represented approximately 4 percent of children in  visit every child, and the counties are good 
09/30/03  September 2003.  at that. SC includes caseworker 
Population included in report in addition to children in  visitation as one of approximately 15 
foster care: Children in the independent living program outcome measures reported to the State 
(approximately 6 percent of all children during FY 2003).  legislature. SC provided additional 
information indicating that 99 percent of 
children received a visit by the end of the 
quarter. 
TN  Twice a  12 Months:  41-81%  53%  Out-of-State placements included: Out-of-State children  TN reported that significant staff turnover 
Month  10/01/02-  represented approximately 4 percent of children in FY rates during FY 2003 were a factor
09/30/03  2003.  affecting visitation. Since then, TN
Populations excluded: Children in the placement types of  indicated it has significantly tightened 
youth development center and runawayapproximately 10 controls around caseworker visitation and 
percent of children in September 2003.  case manager responsibilities.  During the 
last 3 months of FY 2003, the monthly
visitation rate was 81 percent.  
TX  Monthly  12 Months:  69-77%  75%  Out-of-State placements included: Out-of-State children  TX reported several issues that affect
10/01/02-  represented less than 2 percent of children in September  visitation figures, including that
09/30/03  2003.  caseworkers were not entering visitation 
rates in the correct data field.  However, 
the State reported that the largest issues 
affecting its visitation rate were high 
caseloads and turnover. 
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Table 1 (cont):  Caseworker Visitation Reports for FY 2003 Generated by States With at Least Monthly Standards 
State  Minimum  Months  Range of Monthly State-Reported Data Considerations  State-Reported Factors Affecting 
Visitation  Included  Children in  Average  Visitation Rate 
Standard  Care Visited 
Monthly 
UT  Monthly  12 Months:  91-94%  93%  Out-of-State placements included: Out-of-State children  UT stated that caseworker visits are the 
10/01/02-  represented approximately 2 percent of children in  best way for the State to fulfill its
09/30/03  September 2003.    responsibility to children in care, and 
Other: Starting in May 2003, UT changed its standard that they have targeted caseworker 
from twice a month to monthly visits.  visitation for years. 
WV  Monthly  12 Months:  35-46%  42%  Populations excluded: Out-of-State children represented  The State reported that staffing and 
10/01/02-  approximately 15 percent of all children in FY 2003.  caseload issues affected its visitation 
09/30/03  rate. 
WY  Monthly  12 Months:  13-46%  27%  Populations excluded: Children placed out-of-State via  WY reported that the data reflect a
10/01/02-  Interstate Compact on the Placement of Children, in tribal  period when information was not being 
09/30/03  placements, in adoption placements, and those categorized  routinely entered into the system. 
as runaways are excluded from the report.  (Approximately However, WY reported that, since  
30 percent of all children were classified in these groups on May 2004, face-to-face visits were
September 30, 2003.)  substantially higher and reported a 
visitation rate of 82 percent for August
2004. 
Source: Document review of State visitation reports by OIG. 
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Table 2:  Caseworker Visitation Reports for FY 2003 Generated by States With Standards Less Frequent Than Monthly 
State  Minimum  Type of Months  Range of Monthly Range of Quarterly State-Reported Data  State-Reported Factors Affecting 
Visitation  Data  Provided  Children  Average  Children  Average  Considerations  Visitation Rate 
Standard  Provided  in Care  in Care 
Visited  Visited 
Monthly  Quarterly 
IA  Ranges Monthly 12  21-26%  24%  86-89%  88%  Out-of-State placements included:  IA reported that child welfare staffs
from  and  Months:  Out-of-State children represented  high caseloads made monthly visits
monthly  quarterly  10/01/02-  less than 1 percent of children in  difficult, although IA supplements
to  09/30/03  09/03.  visits by contracting with private 
quarterly  agencies to visit more frequently.  
Also, as part of its CFSR PIP and 
child welfare redesign, IA plans to 
streamline workload and utilize 
alternative services for low-risk 
children with the goal of increasing 
monthly visitation. 
VA  Quarterly  Monthly  12  41-50%  45%  NA  NA  Out-of-State placements included:  The State reported that in light of
Months:  Out-of-State children represented  quarterly standards, the 45 percent
10/01/02-  less than 3 percent of children in  monthly rate indicates that 45 
09/30/03  09/03. percent of the workers see the 
Population included in report in  importance of monthly visits.  The 
addition to children in foster care:  State plans to update its visitation 
Children receiving in-home care.  standards in its program 
According to VA, these cases were  improvement plan for the CFSRs. 
approximately 11 percent of total 
children in FY 2003. 
WA  Quarterly  Quarterly  3  NA  NA  NA  58%  Populations excluded: Children in  WA reported that its visitation rate
Months:  care for less than 60 days can be explained in large part by
04/03- (estimated to account for 13 percent documentation issues.  The State 
06/03  of all children during 04/03-06/03).  indicated that during FY 2003, some 
Out-of-State placements included:  visits were not being recorded with
Out-of State children represented  the correct code, and therefore the 
less than 2 percent of children in  rate was artificially low.  WA provided 
09/03. additional information indicating 
Other: Report reflects visits improvement in its visitation data, 
occurring in the placement only;  with an 89 percent quarterly 
face-to-face visits occurring  visitation rate in the placement 
elsewhere are not counted.  during January through March 2005. 
Source: Document review of State visitation reports by OIG. 
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  A C K N O W L E D G M E N T S  

This report was prepared under the direction of Ann OConnor, Regional 
Inspector General for Evaluation and Inspections in the Atlanta 
regional office, and Graham Rawsthorn, Assistant Regional Inspector 
General. Other principal Office of Evaluation and Inspections staff who 
contributed include: 
Stacey Bloomer, Co-Team Leader 
Peggy Daniel, Project Lead 
Linda Moody, Program Specialist 
Gerius Patterson, Data and Statistical Analyst 
Elander Phillips, Program Analyst 
Joe Townsel, Co-Team Leader 
Elise Stein, Director, Public Health and Human Services 
Michala Walker, Program Analyst 
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FOSTER CARE