Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 67479 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Invitation To Comment on Proposed 

Data Composites and Potential 

Performance Areas and Measures for 

the Child and Family Services Review 

AGENCY: Children’s Bureau (CB), 

Administration on Children, Youth and 

Families (ACYF), Administration for 

Children and Families (ACF), 

Department of Health and Human 

Services. 

ACTION: Invitation to comment on 

proposed data composites and potential 

performance areas and measures for the 

Federal Child and Family Services 

Review (CFSR). 

SUMMARY: This notice is to advise the 

public of ACF’s plan to replace the six 

national data measures used for the 

CFSR with six data composites 

addressing the child welfare domains of 

maltreatment recurrence, maltreatment 

in foster care, timeliness of adoptions, 

timeliness of reunifications, placement 

stability, and permanency for children. 

The plan to develop data composites is 

a response to a recommendation made 

by a consultant under contract with 

ACF to study the CFSR process. The 

recommendation is based on input from 

a CFSR workgroup convened by the 

consultant at the end of the first round 

of CFSRs to assist in identifying areas 

needing improvement. 

ACF expects that each data composite 

will incorporate multiple performance 

areas and measures relevant to a specific 

domain. ACF plans to use State 

performance on the data composites as 

part of its evaluation of a State’s 

substantial conformity with specific 

outcomes assessed through the CFSR. 

National standards will be developed 

for each of the domains represented by 

the six data composites. 

ACF’s plan to replace existing 

measures with data composites is 

consistent with the final CFSR 

regulation at 45 CFR 1355.34(b)(4) and 

(5), which authorizes the Secretary of 

HHS to add, amend, or suspend any of 

the statewide data indicators when 

appropriate, and to adjust the national 

standards when appropriate. The 

proposed plan also complies with the 

requirements of section 1123A of the 

Social Security Act (the Act) for ACF to 

assess State child welfare agencies’

compliance with titles IV–B and IV–E of 

the Act as implemented in 45 CFR 

1355.31 through 1355.37. 

We invite the public to comment on 

the data composites, performance areas, 

and measures proposed in this 

announcement. 

DATES: Written comments must be 

submitted to the office listed in the 

address section below either by mail or 

e-mail on or before (30 days). 

ADDRESSES: Mail Address: Children’s 

Bureau, 370 L’Enfant Promenade SW., 

Washington, DC 20447. E-mail address: 

cfsrmeasures@acf.hhs.gov. 

FOR FURTHER INFORMATION CONTACT: John 

Hargrove, 202–205–8634. 

SUPPLEMENTARY INFORMATION: 

CFSR and Existing Outcome Measures 

The CFSR is ACF’s results-oriented 

comprehensive monitoring system 

designed to promote continuous 

improvement in the outcomes 

experienced by children and families 

who come into contact with State public 

child welfare agencies. ACF developed 

the CFSR in response to a mandate in 

the Social Security Amendments of 

1994 (see section 1123A of the Social 

Security Act) for the Department of 

Health and Human Services to 

promulgate regulations for reviews of 

State child and family services programs 

under titles IV–B and IV–E of the Social 

Security Act. ACF’s final regulations on 

the CFSR process, issued in 2000, can 

be found at 45 CFR 1355.31 through 

1355.37. Between fiscal years (FY) 2001 

and 2004, ACF conducted a CFSR of 

every State, the District of Columbia, 

and Puerto Rico. 

The CFSR assesses State performance 

on seven outcomes, seven systemic 

factors, and six national data measures 

that ACF adapted from measures 

originally developed for the Report to 

Congress on Child Welfare Outcomes 

(see attachment A for the report to 

Congress measures and the CFSR 

Outcomes). Data for the six national 

data measures come from the Adoption 

and Foster Care Analysis and Reporting 

System (AFCARS) and the National 

Child Abuse and Neglect Data System 

(NCANDS). AFCARS is a federally 

mandated data system established for 

the collection of foster care and 

adoption data. NCANDS is a voluntary 

data collection system that is the 

primary source of national information 

on abused and neglected children who 

are known to State agencies providing 

child protective services. 

ACF established national standards 

for each of the six data measures and 

used the standards as part of the 

assessment of a State’s substantial 

conformity with particular outcomes. 

ACF described these six data measures 

in the preamble to the final CFSR 

regulation, published in the Federal 

Register (65 FR 4024–4025). This same 

citation provides information on how 

ACF calculated the national standards 

associated with each of the six data 

measures. Subsequently, ACF issued 

information memoranda on the specific 

national standards that would be used 

in the initial CFSR implementation (see 

ACYF–CB–IM–00–11 and ACYF–CB–

IM–01–07). 

The following performance measures 

and national standards were used 

during the first round of CFSRs as part 

of the assessment of a State’s substantial 

conformity with CFSR Safety Outcome 

1—Children are, first and foremost, 

protected from abuse and neglect: 

• Repeat maltreatment—Of all 

children who were victims of 

substantiated or indicated child abuse 

and/or neglect during the first 6 months 

of the reporting period, 6.1 percent or 

less had another substantiated or 

indicated report within a 6-month 

period. 

• Maltreatment of children in foster 

care—Of all children who were in foster 

care during the reporting period, 0.57 

percent or less were the subject of 

substantiated or indicated maltreatment 

by a foster parent or facility staff 

member. 

The following performance measures 

and national standards were used as 

part of the assessment of a State’s 

substantial conformity with CFSR 

Permanency Outcome 1—Children will 

have permanency and stability in their 

living situations: 

• Timeliness of reunification—Of all 

children who were reunified with their 

parents or caretakers at the time of 

discharge from foster care, 76.2 percent 

or more were reunified in less than 12 

months from the time of the latest 

removal from home. 

• Re-entry into foster care—Of all 

children who entered foster care during 

the reporting period, 8.6 percent or less 

were re-entering foster care within 12 

months of a prior foster care episode. 

• Timeliness to adoption—Of all 

children who exited foster care to a 

finalized adoption, 32 percent or more 

exited foster care in less than 24 months 

from the time of the latest removal from 

home. 

• Placement stability—Of all children 

who have been in foster care for less 

than 12 months from the time of the 

latest removal from home, 86.7 percent 

or more have had no more than 2 

placement settings. 

Recommendation To Develop Data 

Composites 

ACF views the CFSR as a dynamic 

process and has made ongoing 

improvements in the process in 

response to lessons learned in the field 

67480 Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 

and to recommendations from State 

child welfare agency administrators. 

After completion of the first round of 

CFSRs in FY 2004, ACF contracted with 

a consultant to study the CFSR and 

make further recommendations 

regarding strategies for improvement. To 

assist them in this task, the consultant 

convened a CFSR workgroup of State 

child welfare agency administrators and 

child welfare researchers and, based on 

input from this workgroup, produced a 

set of recommendations for ACF. One 

recommendation was to replace the 

existing CFSR single data measures for 

which national standards were 

established with data composites that 

incorporate a wider range of 

performance areas relevant to a 

particular child welfare domain. ACF 

proposes to implement this 

recommendation for the following 

reasons: 

• The recommendation is consistent 

with our observations during the first 

round of the CFSR that expanding the 

scope of data pertaining to a particular 

child welfare domain will provide a 

more effective assessment of State 

performance. For example, expanding 

the scope of data pertaining to the 

timeliness of reunification will address 

various performance areas relevant to 

this domain, including the permanency 

of the reunification. 

• Data composites will provide a 

more holistic view of State performance 

in a particular domain than a single data 

measure can achieve. For example, the 

current CFSR measure of timeliness of 

adoption considers the percentage of 

children adopted within 24 months of 

entering foster care, but not children’s 

experiences with regard to the 

timeframes between key points in the 

adoption process, such as the time from 

termination of parental rights (TPR) to a 

finalized adoption. 

• Data composites will ensure that 

the data component of a State’s 

performance with regard to a particular 

domain will not depend on one 

measure. For example, a State’s 

performance regarding the data 

composite for the domain of timeliness 

to adoption may be uneven, with 

performance higher in one area than in 

another. However, overall performance 

on the composite may be high relative 

to other States. Thus, the data composite 

will account for both the strengths and 

weaknesses that a State exhibits within 

a particular domain. 

• Data composites will allow the 

development of national standards that 

account for variation in State practices 

and policies. For example, there are 

differences in State policies and 

practices regarding reunification. In 

some States, children are physically 

reunified with families several months 

before legal custody is transferred to 

parents or guardians. States indicate 

that this practice allows them to ensure 

that the families receive the services and 

monitoring necessary to support the 

reunification process. In contrast, in 

other States, legal custody and physical 

custody are transferred simultaneously. 

Using data composites for the domain of 

timeliness of reunification will enhance 

ACF’s ability to account for these 

variations in practice. 

• Data composites are being 

successfully used by the Federal 

government to assess other programs. 

For example, composite measures are 

being developed and used for the No 

Child Left Behind initiative. In addition, 

composite measures have been used to 

evaluate the performance of hospitals in 

various health-related domains. 

Although the methodology for 

calculating the scores for the data 

composites has not been finalized, the 

following describes the approach that is 

under consideration: 

Possible composite methodology: Six 

data composites are under consideration 

(these are described in the section 

below), with each composite pertaining 

to a different domain of child welfare 

practice (i.e., recurrence of 

maltreatment, maltreatment of children 

in foster care, timeliness of 

reunifications, timeliness of adoptions, 

placement stability, and achieving 

permanency). It is expected that each 

composite will incorporate two or more 

performance areas, with a specific 

measure developed for each 

performance area. The final 

performance areas to be included in 

each data composite will depend upon 

the following: (1) Input from the field in 

response to this announcement, and (2) 

the results of principle components 

analyses regarding the viability of 

inclusion of specific performance areas 

in a particular domain. The principle 

components analyses also will permit a 

determination of the relative 

contribution of each performance area to 

the overall domain represented by the 

data composite. Once the performance 

areas and measures are identified, a 

score will be calculated for each State 

for each data composite based on the 

appropriate weighting (as determined 

from the analyses) of a State’s 

performance in each of the performance 

areas. 

For each data composite, ACF is 

considering using the distribution of 

scores across States to establish a 

national standard (the methodology to 

be used to set the standard has not yet 

been determined). This will result in six 

separate standards, one for each 

domain. Because the primary purpose of 

a data composite is to capture overall 

performance in a particular domain, 

ACF will not establish a national 

standard for the individual performance 

areas incorporated in the composites. 

Therefore, States will not be expected to 

meet a standard for any individual 

performance area but to achieve an 

overall performance level in a particular 

domain related to safety or permanency. 

However, ACF will provide States with 

information regarding each performance 

area with regard to the mean, median, 

and range of scores across States to 

enable a State to identify the 

performance areas within a composite 

where improvements may be needed. 

ACF proposes to use the national 

standards developed for the data 

composites as part of the assessment of 

State performance in the second round 

of CFSRs. These will be used in 

conjunction with findings from the 

CFSR onsite case reviews in the overall 

determination of a State’s substantial 

conformity with specific outcomes. 

Proposed Data Composites and 

Performance Areas 

A table providing a comparison of the 

existing CFSR data measures and the 

proposed data composites and 

performance areas is provided in 

attachment B. Additional information 

regarding the data composites and 

performance areas is presented below. 

The criteria for selection of measures for 

each performance area are the following: 

(1) They must be measurable using data 

available from AFCARS and NCANDS, 

and (2) they must be measurable within 

the CFSR timeframes for assessing State 

improvement in performance. 

CFSR Safety Outcome 1: Children are 

First and Foremost Protected From 

Abuse and Neglect 

Safety Composite 1: Recurrence of 

Maltreatment 

Performance on Safety Composite 1—

Recurrence of maltreatment—will be 

part of the assessment of a State’s 

substantial conformity with CFSR Safety 

Outcome 1—Children are, first and 

foremost, protected from abuse and 

neglect. Safety Composite 1 reflects the 

responsibility of a State child welfare 

system to ensure the ongoing safety of 

children who come into contact with 

the system through a maltreatment 

allegation. 

The following performance areas are 

under consideration for this data 

composite: 

• Recurrence of substantiated or 

indicated maltreatment reports. 

Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 67481 

1 InChild Maltreatment 2003, a child victim is 

defined as a child for whom an incident of abuse 

or neglect has been substantiated or indicated by an 

investigation or assessment. 

2Fluke, J. et al. (1999). Recurrence of 

maltreatment: An application of the National Child 

Abuse and Neglect Data System. Child Abuse and 

Neglect, 23 (7), 633–650. DePanfilis, D., and 

Zuravin, S. (1998). Rates, patterns, and frequency of 

child maltreatment recurrences among families 

known to CPS. Child Maltreatment, 3 (1), 27–42. 

3The major NCANDS disposition categories are 

defined in Child Maltreatment, 2002, U.S. 

Department of Health and Human Services, 

Administration on Children, Youth and Families. 

4 Drake, B. (1996). Unraveling ‘‘unsubstantiated.’’

Child Maltreatment, 1 (3), 261–271. English et al. 

(2002). Causes and consequences of the 

substantiation decision in Washington State Child 

Protective Services. Children and Youth Services 

Review, 24 (11), 817–851. Leiter et al. (1994). 

Substantiated and unsubstantiated cases of child 

maltreatment: Do their consequences differ? Social 

Work Research, 18 (2), 67–82. 

5Hussey, J. et al. (2005). Defining maltreatment 

according to substantiation: Distinction without a 

difference? Presentation at the 15th National 

Conference on Child Abuse and Neglect, Boston, 

MA: April, 2005. 

• Multiple unsubstantiated 

maltreatment reports. 

• Timeliness of initiating 

investigations of child maltreatment 

reports. 

• Timeliness of dispositions of 

maltreatment reports. 

Safety Composite 1—Performance Area 

1: Recurrence of Substantiated or 

Indicated Maltreatment Reports 

Justification for inclusion: This 

performance area provides an 

assessment of a child welfare agency’s 

effectiveness in responding to the safety 

of children who are found to be victims 

of abuse or neglect.1 It addresses the 

question of whether the agency took the 

necessary actions to ensure that the 

children do not experience abuse or 

neglect again. 

Possible measure: Of all children who 

were victims of substantiated or 

indicated child abuse and/or neglect 

during the first 6 months of the 

reporting period, what percentage had 

another substantiated or indicated 

report within a 6-month period? This is 

the measure that was used during the 

first round of CFSRs to assess 

maltreatment recurrence. 

Relevant issues: This measure focuses 

on recurrence within a 6-month period 

because it is not possible to link 

children reported to the NCANDS Child 

File across years. In support of the 

measure, research findings suggest that 

the incidence of occurrence of a 

substantiated maltreatment report 

within 12 months of a prior 

substantiated report is not significantly 

greater than the incidence of recurrence 

within 6 months.2

Some CFSR workgroup participants 

recommended that the CFSR include 

measures designed to identify the types 

of maltreatment that recur and the 

characteristics (such as age and race/ 

ethnicity) of children who are the 

victims of maltreatment recurrence. 

ACF determined that, although these 

measures address important research 

questions about maltreatment 

recurrence and are appropriate for a 

research initiative, they are beyond the 

scope of the CFSR, which is intended to 

provide a general assessment of State 

performance in particular domains. 

However, ACF encourages States to 

examine their own data to identify the 

factors associated with maltreatment 

recurrence. 

Safety Composite 1—Performance Area 

2: Multiple Unsubstantiated 

Maltreatment Reports 

Justification for inclusion: ACF is 

seeking input from the field regarding 

the feasibility of capturing as part of 

Safety Composite 1 the child safety 

issues relevant to multiple 

‘‘unsubstantiated’’ maltreatment reports. 

(The term ‘‘unsubstantiated report’’ does 

not include maltreatment allegations 

that are not accepted for investigation 

[i.e., are ‘‘screened out], those that are 

investigated and found to be 

‘‘intentionally false,’’ or those that are 

‘‘closed without a finding.3’’) Research 

findings indicate the following: (1) 

Children who are the subject of 

unsubstantiated maltreatment reports 

are highly likely to have experienced 

abuse or neglect, (2) there is extensive 

variation across States regarding the 

criteria used to make a substantiation 

determination, and (3) the decision as to 

whether a maltreatment report is 

substantiated or unsubstantiated often is 

not based on consistent criteria even 

within a State.4 In addition, a recent 

finding of the federally funded study 

entitled Longitudinal Studies of Child 

Abuse and Neglect, found no differences 

in the behavioral and developmental 

outcomes of 8-year-old children with 

unsubstantiated and substantiated 

maltreatment reports filed when the 

children were between the ages of 4 and 

8.5

Possible measure: ACF welcomes 

comments from the field regarding 

possible measures for this performance 

area. Although research findings suggest 

that a child who is the subject of 

multiple unsubstantiated maltreatment 

reports is likely to be experiencing 

maltreatment recurrence, ACF is 

concerned that a measure developed for 

this performance area may result in 

unintended consequences. For example, 

States that have a practice of monitoring 

families in which a child is the subject 

of an unsubstantiated report or of 

providing services to these families may 

be discouraged from implementing 

these practices if the ongoing 

surveillance of the family increases the 

likelihood that a subsequent 

maltreatment allegation (either 

substantiated or unsubstantiated) may 

occur. ACF also wants to ensure that the 

measure will, for the most part, exclude 

maltreatment allegations that are 

without merit. 

Relevant issues: Although several 

participants in the CFSR workgroup 

recommended that a measure of 

recurrence of unsubstantiated reports 

should be incorporated into the CFSR 

safety assessment, a few were not in 

accord with this recommendation. 

Those that were opposed to the 

recommendation expressed the 

concerns identified above. 

Safety Outcome 1—Performance Area 3: 

Timeliness of Initiating Investigations of 

Child Maltreatment Reports 

Justification for inclusion: NCANDS 

defines the initial investigation as 

beginning when the child protective 

services (CPS) agency has face-to-face 

contact with, or attempts to have faceto-face contact with, the alleged victim. 

If face-to-face contact with the alleged 

victim is not possible, the initial 

investigation is considered as beginning 

when CPS first contacts any party who 

can provide information essential to the 

investigation or assessment. ACF’s 

proposal to include timeliness of 

initiating investigations as a 

performance area for Safety Composite 1 

is based on the following assumptions: 

• The continued risk of harm to a 

child who is the subject of a 

maltreatment report is best assessed 

through face-to-face contact with the 

child, and 

• Protection of the child is enhanced 

when this face-to-face contact occurs 

quickly after a maltreatment report is 

received by the agency. 

Possible measures: Two measures of 

this performance area are under 

consideration and are provided for 

review and comment. 

• During the reporting year, of all 

children who were the subject of an 

investigation conducted in response to a 

report alleging maltreatment, what was 

the mean (or median) length of time 

between receipt of the report and the 

initiation of the investigation? 

• During the reporting year, of all 

children who were the subject of an 

investigation conducted in response to a 

report alleging maltreatment, what 

percent had investigations that were 

initiated in the following timeframes: 

67482 Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 

Within 1 day (24 hours)?—This 

timeframe is conceptualized as a 

‘‘timely response.’’

After 7 days?—This timeframe is 

conceptualized as one that did not 

adequately address the safety of the 

child. 

Relevant issues: Because ACF believes 

that the ongoing risk of harm to a child 

is most effectively assessed through 

face-to-face contact with the child and 

family, and that this contact should take 

place quickly after a report is received, 

the proposed measures do not address 

variation across States with regard to 

required timeframes for responding to a 

maltreatment report, which range from 

a few hours to a few weeks (with a few 

States having no time requirements). 

The measures also do not take into 

account the ‘‘priority’’ systems 

established by many States that result in 

assigning different timeframes to 

different reports based on perceived risk 

of harm to the child. These timeframes 

also range from a few hours to a few 

weeks. 

Some States have established an 

‘‘alternative response’’ (also called a 

differential response) to maltreatment 

reports. Under this approach, a 

maltreatment report may be referred for 

an assessment of the family rather than 

for an investigation to determine 

whether child maltreatment did or did 

not occur. Usually, reports are referred 

for an assessment when a CPS agency 

determines that the risk of harm to the 

child is low. ACF has not yet decided 

whether the timeliness of initiating 

alternative response assessments will be 

included in the proposed measure. A 

concern is that not all States that 

implement an alternative response 

approach report these activities to the 

NCANDS Child File. ACF welcomes 

comment and suggestions from the field 

regarding this issue. 

Safety Composite 1—Performance Area 

4: Timeliness of Dispositions of Child 

Maltreatment Reports 

Justification for inclusion: This 

performance area is included in Safety 

Composite 1 for the following reasons. 

• Until an investigation is completed 

and the risk of harm to a child is fully 

assessed, States may not be in a position 

to identify the needs of the child and 

family accurately and to match services 

to the needs. This could affect the 

possibility of future maltreatment. 

• When a disposition is not made in 

a timely manner and the agency receives 

a subsequent report of alleged 

maltreatment of the child, the lack of a 

disposition may affect the agency’s 

ability to accurately evaluate the 

subsequent report since it may not have 

full information pertaining to the earlier 

investigation. 

• It is not until the disposition that an 

agency’s plan is sanctioned by the court. 

The court sanctioning ensures that the 

agency and the parents are aware that 

they are required to carry out the actions 

detailed in the plan. 

Possible measures: The following two 

measures are under consideration. 

• During the reporting year, of all 

children who were the subject of 

investigations conducted in response to 

reports alleging maltreatment, what was 

the mean (or median) length of time 

between receipt of the report and the 

disposition? 

• During the reporting year, of all 

children who were the subject of 

investigations conducted in response to 

maltreatment reports, what percent had 

investigations that reached a disposition 

in various timeframes (e.g., 60 days from 

the time of receipt of the report, 

between 60 and 90 days, longer than 90 

days). 

ACF welcomes comments on the 

decision to begin the ‘‘disposition 

timeframe’’ with the receipt of the 

maltreatment report rather than with the 

initiation of the investigation. 

Relevant issues: The proposed 

measures do not include information 

pertaining to assessments made as a 

result of an alternative response. Many 

States that implement an alternative 

response do not reach a disposition in 

these situations, even when the decision 

is made to open a case for services. 

Although the NCANDS Child File 

includes disposition categories of 

‘‘Alternative Response Victim’’ and 

‘‘Alternative Response Nonvictim,’’ only 

three States report Alternative Response 

Victims, and only nine report 

Alternative Response Nonvictims. 

CFSR Safety Outcome 2: Children Are 

Safely Maintained in Their Homes 

Whenever Possible and Approrpriate 

Safety Composite 2: Maltreatment of 

Children in Foster Care 

Performance on Safety Composite 2 

will be part of the assessment of a 

State’s substantial conformity with 

CFSR Safety Outcome 2—Children are 

safely maintained in their own homes 

whenever possible and appropriate. 

Although the wording of CFSR Safety 

Outcome 2 specifies the safety of 

children maintained in their own 

homes, the outcome also applies to 

maintaining children safely while they 

are in the ‘‘homes’’ in which they are 

placed by the child welfare agency, 

including licensed foster family homes, 

relative homes, group homes, or 

institutions. The composite reflects the 

primary responsibility of a child welfare 

system to ensure that children are not 

victims of maltreatment while they are 

under the care and placement 

responsibility of the State. 

The following two performance areas 

are under consideration for this 

composite: 

• Maltreatment of children in foster 

care by a foster parent or facility staff 

member. 

• Maltreatment of children in foster 

care by their parents. 

Safety Composite 2—Performance Area 

1: Maltreatment of Children in Foster 

Care by a Foster Parent or Facility Staff 

Member 

Justification for inclusion: ACF, and 

the public in general, expect State child 

welfare agencies to ensure that Stateappointed caregivers of children in 

foster care do not abuse or neglect the 

children placed in their care. 

Possible measure: Of all children who 

were in foster care during the reporting 

period, what percent was the subject of 

substantiated or indicated maltreatment 

by a foster parent or facility staff 

member? 

Relevant issues: This measure was 

used to assess maltreatment of children 

in foster care during the first round of 

CFSRs. Some concern was expressed by 

the field that the measure inadvertently 

includes children who were maltreated 

by foster care providers or facility staff 

members but who were not in foster 

care with the State child welfare system 

at the time of the maltreatment (i.e., the 

children were in another system or they 

were in private foster or facility care). A 

recent requirement that all children in 

an NCANDS Child File have an 

AFCARS identification number will 

permit an identification of these 

children so that they can be excluded 

from the measure. 

Some CFSR workgroup participants 

recommended that there be separate 

measures for maltreatment of children 

in foster care by a foster parents and 

maltreatment by a facility staff member. 

However, a review of the data found 

that the incidence of maltreatment by 

these ‘‘perpetrator types’’ taken 

separately is too small to constitute 

meaningful measures. 

Some CFSR workgroup participants 

also recommended that ACF develop a 

measure that identifies the extent of 

maltreatment of children who are 

placed by the State with relatives as 

foster caregivers, including relatives 

who are licensed foster parents and 

relatives who are not licensed foster 

parents. At present, the NCANDS Child 

File does not allow for this level of 

detail regarding relative perpetrators. 

Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 67483 

Although a relative may be identified in 

NCANDS as a perpetrator, it is not 

possible to determine whether the 

relative also was the child’s Stateappointed caretaker. Similarly, a 

licensed foster parent may be identified 

as the perpetrator, but it is not possible 

to determine whether the licensed foster 

parent also is a relative. 

Safety Outcome 2—Performance Area 2: 

Maltreatment of Children in Foster Care 

by Their Parents 

Justification for inclusion: State child 

welfare agencies are responsible for 

ensuring that any safety concerns 

regarding parental contacts with a child 

in foster care are appropriately 

addressed. An analysis of NCANDS 

Child File data using matching AFCARS 

identification numbers found that in FY 

2003, a substantial number of children 

who were the victims of maltreatment 

by a parent were in foster care for at 

least 30 days before the date of the 

maltreatment report. In most States, the 

number of these children was 

considerably larger than the number of 

children who were victims of 

maltreatment by foster parents or 

facility staff. 

Possible measure: Of all children who 

were in foster care for longer than 30 

days during the reporting year, what 

percent were the subject of a 

substantiated or indicated maltreatment 

report in which the perpetrator was the 

parent and the report was received after 

the child had been in foster care for at 

least 30 days? 

Relevant issues: The proposed 

measure uses the maltreatment report 

date as a ‘‘proxy’’ for the date of the 

maltreatment itself. Because children 

entering foster care sometimes report 

maltreatment events that occurred prior 

to entry, the measure excludes 

maltreatment reports involving parent 

perpetrators that were received during 

the first 30 days that the child was in 

foster care. The 30-day ‘‘exclusion’’ is 

based on analysis of NCANDS data 

demonstrating a substantial decline in 

the number of children in foster care 

reported as being maltreated by a parent 

after the first 7 days the child is in foster 

care, a more moderate decline in this 

number from 8 to 30 days after entry 

into foster care, and then a leveling off 

after 30 days. 

Although the most recent version of 

the NCANDS Child File includes a data 

element pertaining to the date of the 

maltreatment incident, States are not yet 

consistently reporting this new data 

element. When States report 

information pertaining to the 

maltreatment incident date in a 

consistent manner, the measure of 

maltreatment of children in foster care 

by their parents can be revised to 

incorporate the incident date and it will 

no longer be necessary to incorporate a 

30-day exclusion. 

CFSR Permanency Outcome 1: Children 

Have Permanency and Stability in 

Their Living Situations 

Permanency Composite 1: Timeliness 

and Permanency of Reunifications 

Performance on Permanency 

Composite 1 will be part of the 

determination of a State’s substantial 

conformity with CFSR Permanency 

Outcome 1—Children will have 

permanency and stability in their living 

situations. The composite addresses 

State child welfare system’s 

performance with regard to promoting a 

safe, timely, and permanent family 

reunification by assisting families to 

resolve the problems that resulted in the 

children being removed from the home. 

The performance areas under 

consideration for the composite are the 

following: 

• Timeliness of reunifications of 

children exiting foster care in a given 

fiscal year. 

• Timeliness of reunifications of 

children entering foster care in a given 

fiscal year. 

• Permanency of reunifications. 

Permanency Composite 1—Performance 

Area 1: Timeliness of Reunifications of 

Children Exiting Foster Care 

Justification for inclusion: Exits from 

foster care represent the outcomes 

experienced by children in foster care, 

and exits to reunification reflect an 

agency’s success with regard to its 

function of promoting the reintegration 

of the family. A primary goal of ACF 

and the Adoption and Safe Families Act 

of 1997 (ASFA) is to ensure that 

children do not remain in foster care 

any longer than is necessary to achieve 

permanency. Information about the 

timeliness of children exiting foster care 

to reunification provides a basis for 

assessing State performance in 

achieving this goal. 

Possible measures: A number of 

measures are under consideration for 

this performance area, with each 

addressing a particular variation in State 

practices and policies pertaining to 

reunification. For each measure, we are 

proposing two possible approaches to 

assessing timeliness to reunification. 

One approach that was used in the first 

round of the CFSR reflects an 

expectation that 12 months is a 

sufficient amount of time to bring about 

a reunification for most children. The 

second approach examines timeliness to 

reunification as a function of a State’s 

median length of stay in foster care for 

all children exiting foster care to 

reunification, with the expectation that 

the distribution of these median across 

States would be used to set a 

performance expectation. Both 

approaches are included in each of the 

following measures and ACF welcomes 

input from the field regarding these 

approaches. 

• During the reporting year, of all 

children reunified with their parents or 

caretakers at the time of discharge from 

foster care, (1) what percent were 

reunified in less than 12 months from 

the time of the latest removal from 

home? OR, (2) what was the median 

length of stay in foster care (in months) 

of all children exiting to reunification? 

A frequent criticism of this measure is 

that it does not account for variations in 

State practices and policies that impact 

the time between entry into foster care 

and exit to reunification. The following 

measures are designed to address these 

concerns. 

• During the reporting year, of all 

children reunified with their parents or 

caretakers at the time of discharge from 

foster care who were in foster care for 

more than 7 days (at least 8 days), (1) 

what percent were reunified in less than 

12 months from the time of the latest 

removal from home? OR, (2) what was 

the median length of stay in foster care 

(in months) for these children? This 

measure is intended to address 

variations among States with regard to 

the practice of removing a child from 

his or her home at the onset of a 

maltreatment investigation until an 

initial court hearing is held to determine 

whether the child should be returned 

home or remain in foster care. 

• During the reporting year, of all 

children reunified with their parents or 

caretakers at the time of discharge from 

foster care who were in foster care for 

more than 30 days (at least 31 days), (1) 

what percent were reunified in less than 

12 months from the time of the latest 

removal from home? OR (2) what was 

the median length of stay in foster care 

(in months) for these children? This 

measure addresses another type of 

variation among States. Some States 

tend to remove a child from his or her 

home while providing very short-term 

services to the family in response to a 

family crisis. In contrast, other States, in 

a similar situation, tend to provide 

services to resolve the crisis while the 

child remains in the home, if it is safe 

to do so. This measure is designed to 

assess timeliness of reunifications for 

children and families who may need 

more than very short-term services to 

resolve the issues leading to removal. 

67484 Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 

An analyses of the data found that when 

performance on this measure is 

compared to performance on the 

existing CFSR measure of reunification, 

five States drop out of the top quartile 

with regard to the percent of 

reunifications occurring within 12 

months of a child’s entry into foster 

care. 

• During the reporting year, of all 

children reunified with their parents or 

caretakers at the time of discharge from 

foster care, (1) what percent either were 

reunified in less than 12 months from 

the time of the latest removal from home 

or were placed in a trial home visit 

within 11 months of removal and whose 

last placement setting prior to discharge 

was a Trial Home Visit, OR (2) what was 

the median length of stay in foster care 

(in months) of children exiting to 

reunification or of children whose 

placement was a Trial Home Visit at 

least 30 days prior to reunification. 

Under the AFCARS definitions, a child 

can be reported as discharged from 

foster care to reunification only after the 

court discharges the agency’s 

responsibility for the child (or 6 months 

after the child’s return in certain 

circumstances). However, some States 

maintain placement and care 

responsibility of children for a period of 

time after physical reunification, 

usually ranging from 3 to 6 months, in 

order to provide services and ongoing 

monitoring. ACF has instructed States to 

report these children to AFCARS as 

being in a Trial Home Visit placement 

setting. This measure is designed to 

assess timeliness to reunification in a 

manner that accounts for this difference 

in State practice. An analysis of the data 

found that when this measure was used 

to assess timeliness to reunifications, 13 

States exhibited substantial 

improvements in performance, while no 

State exhibited a decline in 

performance. 

Relevant issues: Although the 

measures are presented separately for 

review and comment, ACF is 

considering the possibility of combining 

some of the variables of concern into 

one measure. For example, the measure 

incorporating children in a trial home 

visit also could include a requirement 

that the child be in foster care for more 

than 30 days. 

Permanency Composite 1—Performance 

Area 2: Timeliness of Reunifications for 

Children Entering Foster Care in a Given 

Fiscal Year 

Justification for inclusion: Assessment 

of the timeliness of reunifications of 

children who enter foster care in a given 

timeframe (i.e., an entry cohort) will 

allow ACF to capture the success of 

recently implemented State efforts to 

reunify children in a timely manner. 

Possible measures: Two measures are 

under consideration. Neither one 

include an approach involving the 

assessment of median length of stay in 

foster care because it may be several 

years before all, or even a substantial 

percentage, of the children in a 

particular cohort will have exited foster 

care. 

• Of all children entering foster care 

for the first time in the first 6 months 

of the reporting year, what percent 

exited foster care to reunification within 

12 months of entry into foster care? 

• Of all children entering foster care 

for the first time in the first 6 months 

of the reporting year, what percent 

exited foster care to reunification after 

having been in foster care for at least 30 

days but less than 12 months? 

Relevant issues: ACF believes that the 

assessment of timeliness to reunification 

of children entering foster care in a 

given year is an important component of 

assessing State performance in this 

domain. However, because not all 

children in a given entry cohort are 

destined to be reunified with their 

families, the denominator for the entry 

cohort measure often includes children 

for whom reunification is not the 

outcome. Because the percentage of 

those children will vary across States 

and over time, the measure must be 

interpreted with caution and should be 

used in conjunction with an assessment 

of timeliness to reunification of an exit 

cohort. 

Permanency Composite 1—Performance 

Area 3: Permanency of Reunifications 

Justification for inclusion: The 

permanency of reunifications may be 

assessed by the extent of a State’s reentries into foster care. A reunification, 

even if it occurs in a timely manner, 

cannot be considered as ‘‘permanent’’ if 

the child re-enters foster care within a 

12-month period after the reunification. 

A consistent finding over the years, as 

reported in the Report to Congress on 

Child Welfare Outcomes, is that States 

with a relatively high percentage of 

children reunified within 12 months 

also tend to have a relatively high 

percentage of children re-entering foster 

care within 12 months of a prior 

episode, although this is not the case for 

all States. 

Possible measure: Of all children who 

exit foster care to reunification 

(including living with a relative) in a 

fiscal year, what percent re-enter foster 

care within 12 months of the time of 

exit? 

Relevant issues: This measure is a 

revision of the one used to assess foster 

care re-entry during the first round of 

the CFSR. At the time the original 

measure was developed, it was not 

feasible through AFCARS to 

consistently and reliably link children 

across years for every State. 

Consequently the existing re-entry 

measure focused on the percentage of 

children entering foster care who were 

reported to be re-entering foster care and 

whose re-entry occurred within 12 

months of a prior episode. Because it is 

now possible to link children across 

years in AFCARS and to capture 

children re-entering foster care by an 

AFCARS identification number, the 

measure has been changed to one that 

is conceptually more meaningful. 

Permanency Composite 2: Timeliness of 

Adoptions 

Performance on Permanency 

Composite 2 will be a part of the 

determination of a State’s substantial 

conformity with CFSR Permanency 

Outcome 1—Children will have 

permanency and stability in their living 

situations. The composite reflects ACF’s 

emphasis on promoting timely 

adoptions for those children in foster 

care who cannot be reunified with their 

families. The composite also reflects the 

requirement of ASFA that States pursue 

TPR for children who have been in 

foster care for 15 of the most recent 22 

months, unless the child is placed with 

relatives, the State agency has not 

provided necessary services, or there are 

documented compelling reasons for not 

seeking TPR. 

The following performance areas are 

under consideration for Permanency 

Composite 2: 

• Timeliness of finalized adoptions of 

children discharged from foster care. 

• Timeliness of finalized adoptions of 

children who are in foster care for 17 

months or more at the start of a fiscal 

year. 

• Timeliness of finalized adoptions of 

children for whom a TPR has been 

granted. 

• Timeliness of achieving TPR for 

children who have been in foster care 

for 17 months or more at the start of a 

fiscal year. 

Although CFSR workgroup 

participants recommended that ACF 

assess timeliness to adoption using an 

entry cohort (i.e., children who enter 

foster care in a particular time period), 

the results of our analyses indicated that 

an entry cohort approach to assessing 

the timeliness of adoptions is not 

feasible for the CFSR. The key results 

were the following: 

• An extensive timeframe was 

required to a cohort of children from 

entry into foster care to a finalized 

Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 67485 

adoption and the timeframe is not 

consistent with the CFSR timeframes. 

For example, in following a cohort of 

children entering foster care in FY 2001, 

meaningful data pertaining to adoptions 

did not emerge until 3 years after the 

entry year. 

• Because not all children entering 

foster care will be adopted, and because 

the number of children waiting to be 

adopted changes each year, it is not 

possible to establish a stable 

denominator for a cohort measure. In 

following the FY 2001 cohort, we found 

that the denominator for the measure of 

timeliness to adoption kept changing on 

an ongoing basis as children in the 

original cohort were reunified or exited 

foster care for other reasons. 

Some researchers in the field using an 

entry cohort to assess a State’s 

performance with regard to the 

timeliness of adoptions have addressed 

the problems noted above by employing 

statistical methods to estimate the 

‘‘likelihood’’ of children who enter 

foster care in a given year being adopted 

within particular timeframes. ACF 

determined that because the CFSR is a 

monitoring system and not a research 

initiative, the use of estimates is not 

appropriate. A monitoring system, 

particularly one that has financial 

penalties associated with it, should be 

based on actual performance rather than 

on estimates of the likelihood of 

particular events occurring within a 

particular timeframe. 

Although we have decided that an 

entry cohort analysis is not appropriate 

for Permanency Composite 2, some of 

the performance areas proposed for this 

composite involve longitudinal 

assessments of progress toward 

adoption of a group of children that may 

be considered a cohort (i.e., all children 

who have been in foster care for 17 

months or longer at the end of a fiscal 

year; or all children whose TPR occurs 

during a given fiscal year). 

Permanency Composite 2—Performance 

Area 1: Timeliness of Adoptions of 

Children Discharged From Foster Care 

to a Finalized Adoption 

Justification for inclusion: Exits to 

adoption reflect the success of a child 

welfare agency in achieving 

permanency for those children who 

cannot be returned to their families. A 

primary goal of ACF is to ensure that 

children who are adopted do not remain 

in foster care any longer than is 

necessary to achieve a finalized 

adoption. Information about the 

percentage of children exiting foster 

care to a finalized adoption who exit in 

a timely manner as well as about the 

percentage of children who are adopted, 

but not in a timely manner, provides a 

means of assessing State performance 

with regard to achieving this goal. 

Possible measures: The following 

three measures are under consideration 

for this performance area: 

• Of all children who exited foster 

care to a finalized adoption during the 

reporting period, what percent exited 

foster care in less than 24 months from 

the time of the latest removal from 

home? This measure was used to assess 

timeliness of adoption during the first 

CFSR round. 

• Of all children who exited foster 

care to a finalized adoption during the 

reporting period, what percent was in 

foster care for 48 months or more before 

exiting to adoption? 

• Of all children who exited foster 

care to a finalized adoption during the 

reporting period, what was the median 

length of stay in foster care (in months)? 

Relevant issues: Some CFSR 

workgroup participants recommended 

that the CFSR assessment include 

measures that examine timeliness of 

adoptions for children of different age 

groups and different races/ethnicities. 

Although ACF has determined that this 

level of analysis is beyond the scope of 

the CFSR, States are encouraged to 

examine their own adoption data in 

order to understand the relationships 

between these factors and adoption 

timeliness. States vary considerably 

with regard to the distribution of ages 

and races/ethnicity among their foster 

care populations, and therefore the 

relationships between these factors and 

adoption timeliness also may vary. 

Permanency Composite 2—Performance 

Area 2: Timeliness of Adoptions of 

Children Who Are in Foster Care for 17 

Months or Longer at the Start of a Fiscal 

Year 

Justification for inclusion: This 

performance area assesses progress 

toward adoption of a cohort of children 

who have been in foster care for 17 

months or longer. ASFA requires State 

child welfare agencies to pursue 

adoption as a permanency goal for a 

child who has been in foster care for 15 

of the most recent 22 months, except in 

limited circumstances. A 17-month 

rather than a 15-month timeframe was 

chosen for the performance area 

because, in accordance with ASFA, a 

child is considered to have ‘‘entered 

foster care’’ (for purposes of starting the 

clock for 15 of 22 months) on the earlier 

of: 

(1) The first judicial finding that the 

child has been subjected to abuse and 

neglect, or 

(2) The date that is 60 days after the 

date on which the child is removed 

from home. 

The 17 months in the performance 

area reflects the latter timeframe for 

defining entry into foster care because 

AFCARS does not collect information 

pertaining to the date of the first judicial 

finding. 

Possible measure: Of all children in 

foster care on the first day of a given 

fiscal year who were in foster care for 

17 continuous months or longer, what 

percent were adopted before the end of 

the fiscal year. 

Relevant issues: The proposed 

measure is based on the assumption that 

children who have been in foster care 

for 17 months or longer represent a 

somewhat stable denominator. 

(However, even after 17 months in foster 

care the denominator is not entirely 

stable because many children in the 

cohort will exit to reunification.) 

Although it would be preferable to 

include in the measure only those 

children in foster care for 17 months or 

longer who have a case goal of adoption, 

States do not consistently report case 

goal information to AFCARS and 

AFCARS does not have a data element 

pertaining to the date that a case goal is 

established. Also, in some States, the 

goal of adoption is not formally 

established until TPR has been achieved 

although adoption may be the goal that 

the agency is working toward. 

Permanency Composite 1—Performance 

Area 3: Timeliness of Adoptions of 

Children for Whom Parental Rights 

Have Been Terminated 

Justification for inclusion: The two 

timeframes that are critical to the 

timeliness of adoptions are (1) the 

timeframe between entry into foster care 

and TPR, and (2) the timeframe between 

TPR and adoption finalization. This 

performance area addresses the latter 

timeframe and reflects ACF’s 

expectation that a finalized adoption 

should occur quickly after TPR is 

granted. An analysis of AFCARS data 

indicated that, nationally, from FY 1998 

to FY 2003, the average time from TPR 

to adoption has remained consistent at 

about 16 months. 

Possible measure: Of all children for 

whom a TPR was granted during a given 

fiscal year, what percent were adopted 

within 12 months of the TPR? 

Relevant issues: An analysis of 

existing data relevant to this measure 

resulted in the identification of the 

following data issues: (1) In their 

submissions to the AFCARS Foster Care 

File, some States are reporting a 

substantial number of TPR dates after 

the reporting period in which they 

67486 Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 

actually occurred, and (2) in FY 2003, 

States did not provide TPR dates in 

their AFCARS Foster Care File 

submissions for over one-fifth of the 

children whose discharge reason was 

adoption. Although these data problems 

do not appear in the data submitted to 

the AFCARS Adoption File, because the 

AFCARS Foster Care File will be used 

to calculate the measure for this 

performance area, it is important that 

States are more diligent, timely, and 

consistent in their reporting of the 

AFCARS Foster Care File data elements 

pertaining to TPR. 

Permanency Composite 2—Performance 

Area 4: Timeliness of TPR for Children 

Who Have Been in Foster Care for 17 

Months or Longer at the Start of a Fiscal 

Year 

Justification for inclusion: This 

performance area pertains to the 

timeframe required to achieve a TPR for 

children in foster care for 17 months or 

longer. The performance area is 

consistent with the ASFA requirement 

that TPR should be sought for children 

who have been in foster care for 15 of 

the most recent 22 months, except in 

limited circumstances. 

Possible measure: Of all children in 

foster care for 17 months or longer on 

the first day of the fiscal year who did 

not have a TPR, what percentage of 

those who remained in foster care for 

the next 6 months had a TPR within that 

timeframe? 

Relevant issues: National data 

regarding time to adoption indicates 

that the time span between the time of 

entry into foster care and the 

finalization of a TPR petition has 

decreased from FY 1998 to FY 2003 by 

an average of 10 months. Inclusion of 

this performance area in Permanency 

Composite 2 will permit an assessment 

of an individual State’s performance 

with regard to this timeframe. 

Permanency Composite 3: Placement 

Stability 

Performance on Permanency 

Composite 3 will be one component of 

the determination of a State’s 

substantial conformity with CFSR 

Permanency Outcome 1—Children will 

have permanency and stability in their 

living situations. The composite reflects 

the obligation of a State child welfare 

system to ensure that children who are 

removed from their homes by the State 

experience stable placements during 

their time in foster care. The following 

performance areas are under 

consideration for Permanency 

Composite 3: 

• Stability of children’s placement 

experience during the first year in foster 

care 

• Stability of children’s placement 

experience for children in care for 

longer than 12 months 

Proposed Stability Performance Area 1: 

Stability of Children’s Placement 

Experience During the First Year in 

Foster Care 

Justification for inclusion: This 

performance area addresses the issue of 

achieving placement stability for 

children as quickly as possible after 

entry into foster care. 

Possible measure: During the 

reporting period, of all children who 

have been in foster care for less than 12 

months from the time of the latest 

removal from home, what percent have 

had no more than 2 placement settings? 

Relevant issues: Some CFSR 

workgroup participants suggested that 

this measure does not take into account 

variations in time in care within the 12- 

month period or consider some States’

practices of routinely placing children 

in foster care for short periods of time. 

To address this concern, ACF examined 

the data for this measure in the 

following ways: (1) Excluding children 

who had been in foster care for only 1 

month, and (2) excluding children who 

had been in care for only 3 months. The 

correlations between State performance 

on the measure of placement stability 

within 12 months, and performance on 

this measure using the 1-month and 

3-month exclusion exceeded +0.95, 

indicating little variation among the 

measures. As a result, ACF decided that 

the existing measure was adequate to 

reflect variation in State performance 

regarding placement stability during the 

first 12 months in foster care. 

Permanency Composite 3—Performance 

Area 2: Stability of Children’s 

Placement Experience for Children in 

Care for Longer Than 12 Months 

Justification for inclusion: ACF 

believes that children should experience 

placement stability throughout their 

stay in foster care. However, analyses of 

the AFCARS data indicated that in most 

States, the percentage of children who 

experience no more than 2 placement 

settings declines considerably (in some 

States by half) when children have been 

in foster care for at least 12 months but 

less than 24 months, and continues to 

exhibit a substantial decline for those 

children in foster care for 24 months or 

longer. 

Possible measure: Two measures are 

under consideration for this 

performance area. 

• During the reporting period, of all 

children who have been in foster care 

for at least 12 months but less than 24 

months, what percent have had no more 

than 2 placement settings? 

• During the reporting period, of all 

children who have been in foster care 

for 24 months or longer, what percent 

have had no more than 2 placement 

settings? 

Permanency Composite 4: Achieving 

Permanency for Children 

Performance on Permanency 

Composite 4 will be part of the 

determination of a State’s substantial 

conformity with CFSR Permanency 

Outcome 1—Children will have 

permanency and stability in their living 

situations. The composite reflects the 

responsibility of the State child welfare 

systems to engage in concerted efforts to 

find permanent homes for children so 

that extended stays in foster care are 

avoided and children do not ‘‘age out’’

of the system. The following 

performance areas are under 

consideration for Permanency 

Composite 4: 

• The extent to which children are 

‘‘growing up’’ in foster care. 

• Timeliness of establishing 

permanency goals. 

• The extent to which children with 

TPR exit foster care to a permanent 

family. 

Permanency Composite 4—Performance 

Area 1: Children Growing Up in Foster 

Care 

Justification for inclusion: This 

performance area addresses the question 

of State effectiveness with regard to 

ensuring that children do not 

‘‘languish’’ in foster care—i.e., entering 

foster care at a relatively young age and 

exiting foster care only when they have 

reached the age at which the State will 

not longer provide for their care. 

Possible measure: Of all children who 

were emancipated from foster care prior 

to age 18 or who reached their 18th 

birthday while in foster care, what 

percent entered foster care when they 

were age 12 or younger and remained in 

foster care continuously since that 

entry? 

Relevant issues: This measure is a 

modification of a measure that is part of 

the Report to Congress on Child Welfare 

Outcomes. The modification adds to the 

measure children who reached their 

18th birthday while in foster care. The 

modification was established because 

Several States currently allow children 

to remain in foster care beyond age 18, 

often to complete school or college. The 

modification will ensure that these 

children are included in the measure if 

Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 67487 

they entered foster care when they were 

age 12 or younger even if they have not 

yet exited foster care. 

Permanency Composite 4—Performance 

Area 2: Timeliness of Establishing 

Permanency Goals 

Justification for inclusion: A key 

factor in moving a child toward 

permanency is the establishment of a 

permanency goal. The permanency goal 

is the basis for developing a case plan 

delineating the services to be provided 

and the objectives to be achieved to 

reach the goal. A Federal requirement is 

that a case plan be established for every 

child who is in foster care for longer 

than 60 days and that the case plan 

includes the agency’s plan for achieving 

permanency for the child. 

Possible measure: Of all children in 

foster care for longer than 12 months, 

what percentage is reported to AFCARS 

as ‘‘Not Yet Determined’’ with regard to 

the case goal? 

Relevant issues: An analysis of data 

relevant to this measure indicated that 

there are a number of States that have 

a relatively high percentage of children 

for whom the data element regarding 

case goal is reported as ‘‘not yet 

determined.’’

Permanency Composite 4—Permanency 

Area 3: Exits to Families of Children 

With TPR 

Justification for inclusion: This 

performance area is an important 

component of Permanency Composite 4 

because it addresses the issue of 

whether seeking TPR for children 

results in children becoming ‘‘legal 

orphans’’ (i.e., children with TPR who 

are not placed for adoption or 

guardianship or placed with relatives 

and eventually emancipate from foster 

care). TPR is a costly process, both 

financially and, for the child, 

emotionally. To engage in that process 

with the end result that a child does not 

exit foster care to a family would be 

contrary to the best interests of the child 

in most situations. 

Possible measure: Of all children 

exiting foster care with a TPR, what 

percentage exited to a permanent 

family? (A permanent family includes 

living with a parent, relative, guardian, 

or adoptive parents.) 

Relevant issues: Although in most 

States, the vast majority of children with 

TPR exit foster care to a permanent 

family, there are several States in which 

15 to 20 percent of these children do not 

exit to a family. This suggests that the 

child welfare agency in those States may 

not be making sufficient efforts to 

ensure that children with TPR achieve 

permanency. 

Dated: October 31, 2005. 

Joan E. Ohl, 

Commissioner, Administration on Children, 

Youth and Families. 

Attachment A: Outcomes and Measures 

Developed for the Annual Report to 

Congress on Child Welfare Outcomes 

and the Outcomes and Items Assessed 

by the Child and Family Services 

Review 

The outcomes and measures 

presented in the report to Congress are 

the following: 

Child Welfare Outcome 1 

Reduce Recurrence of Child Abuse and/ 

or Neglect 

Measure 1.1: Of all children who were 

victims of substantiated or indicated 

child abuse and/or neglect during the 

first 6 months of the reporting period, 

what percentage had another 

substantiated or indicated report within 

a 6-month period? 

Child Welfare Outcome 2 

Reduce the Incidence of Child Abuse 

and/or Neglect in Foster Care 

Measure 2.1: Of all children who were 

in foster care during the reporting 

period, what percentage was the subject 

of substantiated or indicated 

maltreatment by a foster parent or 

facility staff? 

Child Welfare Outcome 3 

Increase Permanency for Children in 

Foster Care 

Measure 3.1: For all children who 

exited foster care, what percentage left 

either to reunification, adoption, or legal 

guardianship? 

Measure 3.2: For children who exited 

foster care and were identified as having 

a diagnosed disability, what percentage 

left either to reunification, adoption, or 

legal guardianship? 

Measure 3.3: For children who exited 

foster care and were older than age 12 

at the time of their most recent entry 

into care, what percentage left either to 

reunification, adoption, or legal 

guardianship? 

Measure 3.4: Of all children exiting 

foster care to emancipation, what 

percentage was age 12 or younger at the 

time of entry into care? 

Measure 3.5: For all children who 

exited foster care, what percentage by 

racial/ethnic category left either to 

reunification, adoption, or legal 

guardianship? 

Child Welfare Outcome 4 

Reduce Time in Foster Care to 

Reunification Without Increasing 

Re-entry 

Measure 4.1: Of all children who were 

reunified with their parents or 

caretakers at the time of discharge from 

foster care, what percentage was 

reunified in the following time periods? 

(1) Less than 12 months from the time 

of latest removal from home 

(2) At least 12 months, but less than 

24 months 

(3) At least 24 months, but less than 

36 months 

(4) At least 36 months, but less than 

48 months 

(5) 48 or more months 

Measure 4.2: Of all children who 

entered foster care during the reporting 

period, what percentage re-entered care: 

(1) Within 12 months of a prior foster 

care episode? 

(2) More than 12 months after a prior 

foster care episode? 

Child Welfare Outcome 5 

Reduce Time in Foster Care to Adoption 

Measure 5.1: Of all children who 

exited foster care to a finalized 

adoption, what percentage exited care in 

the following time periods? 

(1) Less than 12 months from the time 

of latest removal from home 

(2) At least 12 months, but less than 

24 months 

(3) At least 24 months, but less than 

36 months 

(4) At least 36 months, but less than 

48 months 

(5) 48 or more months 

Child Welfare Outcome 6 

Increase Placement Stability 

Measure 6.1: Of all children served 

who had been in foster care for the time 

periods listed below, what percentage 

had no more than two placement 

settings during that time period? 

(1) Less than 12 months from the time 

of latest removal from home 

(2) At least 12 months, but less than 

24 months 

(3) At least 24 months, but less than 

36 months 

(4) At least 36 months, but less than 

48 months 

(5) 48 or more months 

Child Welfare Outcome 7 

Reduce Placements of Young Children 

in Group Homes or Institutions 

Measure 7.1: For all children who 

entered foster care during the reporting 

period and were age 12 or younger at 

the time of their most recent placement, 

what percentage was placed in a group 

home or an institution? 

67488 Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 

The outcomes and systemic factors 

assessed through the Child and Family 

Services Review are the following: 

Child and Family Outcomes 

Safety Outcome 1: Children are, first 

and foremost, protected from abuse and 

neglect. 

Safety Outcome 2: Children are safely 

maintained in their homes whenever 

possible and appropriate. 

Permanency Outcome 1: Children 

have permanency and stability in their 

living situations. 

Permanency Outcome 2: The 

continuity of family relationships and 

connections is preserved for children. 

Child and Family Well-being Outcome 

1: Families have enhanced capacity to 

provide for their children’s needs. 

Child and Family Well-being Outcome 

2: Children receive appropriate services 

to meet their educational needs. 

Child and Family Well-being Outcome 

3: Children receive adequate services to 

meet their physical and mental health 

needs. 

Systemic Factors 

Statewide Information System 

Case Review System 

Quality Assurance System 

Training (for child welfare agency staff 

and foster and adoptive parents) 

Service Array 

Agency Responsiveness to the 

Community 

Foster and Adoptive Parent Licensing, 

Recruitment, and Retention 

Attachment B: Comparison of CFSR 

Measures Used in Round 1, and 

Proposed CFSR Data Composites for the 

Next Round 

CFSR SAFETY OUTCOME 1 

Current CFSR data measures and standard associated with CFSR 

Safety Outcome 1 Proposed composite to be associated with CFSR Safety Outcome 1 

Recurrence of maltreatment: Measure and national standard: Of all 

children who were victims of a substantiated or indicated child maltreatment report during the first 6 months, 6.1 percent of fewer were 

victims of another substantiated or indicated report within a 6-month 

period.

Safety Composite 1: Recurrence of maltreatment. A national standard 

will be established from the data composite scores resulting from 

States’ performance on the areas incorporated in the composite. 

Some possible performance areas to be included in the composite 

are: 

• Performance area 1: Recurrence of substantiated or indicated maltreatment reports. 

• Performance area 2: Multiple unsubstantiated maltreatment reports. 

• Performance area 3: Timeliness of initiating investigations of child 

maltreatment reports. 

• Performance area 4: Timeliness of disposition of child maltreatment 

reports. 

Maltreatment of children in foster care: Measure and national standard—Of all children in foster care during the reporting year, 0.57 percent or less were the subject of a substantiated or indicated maltreatment by a foster parent or facility staff member.See safety composite 2. (No data composite for maltreatment in foster 

care is proposed for Safety Outcome 1. Instead, for the next CFSR 

round, State data pertaining to maltreatment of children in foster care 

will be addressed under CFSR Safety Outcome 2.) 

CFSR SAFETY OUTCOME 2 

Current CFSR data measures and standard associated with CFSR 

Safety Outcome 2 Proposed composite to be associated with CFSR Safety Outcome 2 

No data measure or national standard was associated with this Safety 

Outcome in the first CFSR round.

Safety Composite 2: Maltreatment of children in foster care. The national standard will be established from the composite scores derived 

from States’ performance on the areas included in the composite. 

Some possible performance areas for inclusion are the following: 

• Performance area 1: Maltreatment of children in foster care by a foster parent or facility staff member. 

• Performance area 2: Maltreatment of children in foster care by their 

parents. 

CFSR PERMANENCY OUTCOME 1 

Current CFSR data measures and standards associated with CFSR

Permanency Outcome 1 Proposed composites to be associated with Permanency Outcome 1 

Timeliness of reunification measure and national standard: of all children exiting foster care to reunification, 76.2 percent or more exited 

within 12 months of entry into foster care.

Re-entry into foster care measure and national standard: of all children 

entering foster care, 8.6 percent or less were re-entering within 12 

months of a prior episode.

Permanency Composite 1: Timeliness and permanency of reunification. 

A national standard will be established from the data composite 

scores resulting from States’ performance on the areas incorporated 

in the composite. Some possible performance areas to be included 

in the composite are: 

• Performance area 1: Timeliness of reunifications of children exiting 

foster care in a given fiscal year. 

• Performance area 2: Timeliness of reunifications of children entering 

foster care in a given fiscal year. 

• Performance area 3: Permanency of reunifications. 

Federal Register / Vol. 70, No. 214 / Monday, November 7, 2005 / Notices 67489 

CFSR PERMANENCY OUTCOME 1—Continued 

Current CFSR data measures and standards associated with CFSR

Permanency Outcome 1 Proposed composites to be associated with Permanency Outcome 1 

Timeliness of adoption measure and national standard: of all children 

exiting foster care to a finalized adoption, 32.0 percent or more 

achieved a finalized adoption within 24 months of the time of entry 

into foster care.

Permanency Composite 2: Timeliness of adoption. A national standard 

will be established from the data composite scores resulting from 

States’ performance on the areas incorporated in the composite. 

Some possible performance areas to be included in the composite 

are: 

• Performance area 1: Timeliness of adoptions of children discharged 

from foster care to a finalized adoption. 

• Performance area 2: Timeliness of adoptions of children who are in 

foster care for 17 months or longer at the start of a fiscal year. 

• Performance area 3: Timeliness of adoptions of children for whom 

parental rights had been terminated. 

• Performance area 4: Timeliness of achieving termination of parental 

rights for children who have been in foster care for 17 months or 

more at the start of a fiscal year. 

Placement stability measure and national standard: of all children in 

foster care who have been in care for less than 12 months, 86.7 percent or more had no more than 2 placement settings.

Permanency Composite 3: Placement stability. A national standard will 

be established from the data composite scores resulting from States’

performance on the area incorporated in the composite. Some possible performance areas to be included in the composite are: 

• Performance area 1: Stability of children’s placement experience 

during the first year in foster care. 

• Performance area 2: Stability of children’s placement experience for 

children in foster care for longer than 12 months. 

No national standard measure. Information captured in the case review 

instrument.

Permanency Composite 4: Achieving Permanency for Children in Foster Care. A national standard will be established from the data composite scores resulting from States’ performance on the areas incorporated in the composite. Some possible performance areas to be 

included in the composite are: 

• Performance area 1: The extent to which children are growing up in 

foster care. 

• Performance area 2: Timeliness of establishing permanency goals. 

• Performance area 3: The extent to which children with TPR exit foster care to a permanent family. 

[FR Doc. 05–22095 Filed 11–4–05; 8:45 am] 

BILLING CODE 4184–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Food and Drug Administration 

[Docket No. 2005G–0367] 

Guidance for Industry and Food and 

Drug Administration Staff; Class II 

Special Controls Guidance Document: 

Low Energy Ultrasound Wound 

Cleaner; Availability 

AGENCY: Food and Drug Administration, 

HHS. 

ACTION: Notice. 

SUMMARY: The Food and Drug 

Administration (FDA) is announcing the 

availability of the guidance entitled 

‘‘Class II Special Controls Guidance 

Document: Low Energy Ultrasound 

Wound Cleaner.’’ This guidance 

document has been developed as a 

special control guidance document to 

support the classification of the low 

energy ultrasound wound cleaner into 

class II (special controls). The device is 

intended for the cleaning and 

maintenance debridement of wounds. 

This guidance document describes a 

means by which the low energy 

ultrasound wound cleaner may comply 

with the requirement of special controls 

for class II devices. Elsewhere in this 

issue of the Federal Register, FDA is 

publishing a final rule to classify the 

low energy ultrasound wound cleaner 

into class II (special controls). The 

guidance document is immediately in 

effect as the special control for the low 

energy ultrasound wound cleaner, but it 

remains subject to comment in 

accordance with the agency’s good 

guidance practices (GGPs). 

DATES: Submit written or electronic 

comments on this guidance at any time. 

General comments on agency guidance 

documents are welcome at any time. 

ADDRESSES: Submit written requests for 

single copies on a 3.5′′ diskette of the 

guidance document entitled ‘‘Class II 

Special Controls Guidance Document: 

Low Energy Ultrasound Wound 

Cleaner’’ to the Division of Small 

Manufacturers, International, and 

Consumer Assistance (HFZ–220), Center 

for Devices and Radiological Health, 

Food and Drug Administration, 1350 

Piccard Dr., Rockville, MD 20850. Send 

one self-addressed adhesive label to 

assist that office in processing your 

request, or fax your request to 301–443–

8818. See the SUPPLEMENTARY

INFORMATION section for information on 

electronic access to the guidance. 

Submit written comments concerning 

this guidance to the Division of Dockets 

Management (HFA–305), Food and Drug 

Administration, 5630 Fishers Lane, 

rm.1061, Rockville, MD 20852. Submit 

electronic comments to http:// 

www.fda.gov/dockets/ecomments. 

Identify comments with the docket 

number found in brackets in the 

heading of this document. 

FOR FURTHER INFORMATION CONTACT: 

David B. Berkowitz, Center for Devices 

and Radiological Health (HFZ–410), 

Food and Drug Administration, 9200 

Corporate Blvd., Rockville, MD 20850, 

301–594–3090, ext. 152. 

SUPPLEMENTARY INFORMATION: 

I. Background 

The guidance document ‘‘Class II 

Special Controls Guidance Document: 

Low Energy Ultrasound Wound 

Cleaner’’ has been developed as a