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From June 11-15, 2007, staff of the Children's Bureau, Central and Regional Offices, and the Office of Information Services (OIS) conducted an assessment review of Alaska's Adoption and Foster Care Analysis and Reporting System (AFCAR) data collection in the State's system ORCA (Online Resource for the Children of Alaska). The AFCAR data used for the review was from the report period April 1, 2006 through September 30, 2006 (2006B). I have summarized the major findings from the AFCAR review in this letter. Enclosed please find the full report.
The AFCAR assessment review evaluates two areas: the AFCAR general requirements (reporting populations and technical standards) and the data elements. Information collected on these areas is combined and a rating factor is assigned to the general requirements and each data element. The rating factors are: "1," the system is not collecting the AFCAR data elements and the data are not transmitted to ACF; "2," technical corrections are required; "3," improvement in data quality is needed; and "4," the State fully meets the AFCAR standards. The report provides a more detailed explanation of each of the rating factors.
General Requirements (26)
Data Elements (103)
The State is mostly in compliance with the reporting population requirements for the foster care and adoption fields. One significant issue is that the State is incorrectly reporting those youth over the age of 18 in the AFCAR reporting populations. The only youth over the age of 18 that are to be included are those for whom the State claims title IV-E funds. The other issues is that the State does not include in the AFCAR adoption file those adoptions that occur through a private agency, even though the child welfare agency is involved due to an adoption assistance agreement.
Also for the General Requirements Standards, the State received ratings of "2" and "3" for the technical requirements related to data conversion specific to the AFCAR elements. While the State continues to work on converting the data, it particularly needs to focus on improving the accuracy of the data for removal episodes and placement counts. Not all removal episodes were entered into the system at the time of conversion. Also, for those cases open at the time of conversion, not all placement settings were entered for the current removal episode. These are areas that are crucial to the evaluation of a State's child welfare practices. In order to determine if the number of children re-entering foster care is actually increasing or decreasing, a complete removal history is needed in the information system. The State will have to address this by reviewing cases and ensuring that all removal episodes experienced by a child are entered into the system, as well as placement episodes.
There are a significant number of data elements (52%) that will require technical modifications for both the data entry screens and the program code that extracts the data. As noted in the attached report, there are areas that require enhancements to the screens in order for the AFCAR data to be collected more accurately and in accordance with the AFCAR requirements. These changes will require more time and resources, but should lead to better data collection. Some of the technical modifications affecting the data elements are described below.
There is one significant area that the State needs to place on a high priority status. This is in the area of the financial data elements. The State needs to complete the interfaces with the titles IV-A and Social Security information systems. However, regardless of the status of these interfaces the State must be reporting in AFCAR whether these two financial sources are a source of income to the child. If the implementation of the interfaces is not expected th occur for some time, then the State must devise a method to collect and report this information in AFCAR. The other financial data element has to do with whether there are other sources of income for the child, other than those required for AFCAR reporting, either State, Federal, or another source. Currently, the State has no means to report this data in AFCAR.
An area that involves a change to the design of the system is in the collection of data identifying whether a child has been diagnosed with a disability and, if so, those diagnosed disabilities. This was also an area found needing improvement during the State's Statewide Automated Child Welfare Information System (SACWIS) Assessment Review in 2005. For AFCAR reporting purposes, the information reported for these elements reflect chronic and/or significant diagnosed conditions that the child may have. Alaska's AFCAR data indicates an underreporting of this data. According to the State's data reported for the period under review, only 17% of the children in foster care were diagnosed as having a disability that is reportable to AFCAR (such as, attention deficit disorder, reactive attachment disorder, etc.). The case file review supported the finding that this number is underreported.
There are two sections of the system that case workers must complete related to the health of a child. One is on the "person management" screen. Here the system contains the AFCAR question and responses. The second is a "Medical Profile" section that records exam dates and diagnoses, and is a more comprehensive module of the system. The midi cal profile section appears to be a good section for the recording of the child's health and mental health conditions. This section would allow for the recoding of the actual diagnosed condition, which then can be mapped to the appropriate AFCAR category. However, the diagnoses fields on the medical profile screens are not captured in a database table; they are only textfields. These should be stored in a table for reporting purposes. Lastly, there needs to be additional oversight by supervisors to ensure that case workers do enter the diagnosed conditions into the system.
Once these changes are made, underlying data quality issues may surface. These elements and those that received a rating factor of "3" will require additional training and supervisory oversight for the timeliness and accuracy of data entry. Also, the State's semi-annual data submission may fail to meet the "missing data" standard. In order to ensure the data are complete, the agency must increase supervisory oversight and require worriers to enter the data in a timely manner. Assessment of the validity of the data prior to submitting it to the ACF will also be required. To do so, the State may utilize the management reports created by the agency, as well as the Data Quality Utility and the Frequency Utility posted on the Children's Bureau's website. It is important that the AFCAR data accurately reflect the circumstances of children in foster care and under the agency's responsibility.
The enclosed documents include the final report of the on-site review, the final findings of the general requirements and data elements, and the AFCAR Improvement Plan for the data elements. Within 30 calendar days after the receipt of this report and the attached AFCAR Improvement Plan, the State staff must submit the Improvement Plan electronically to the Regional Office and the Children's Bureau with estimate due dates for completing the tasks identified in the Improvement Plan. An electronic copy of the final matrices will be e-mailed to your staff. The State should provide electronic quarterly updates of its progress to the Regional Office and the Children's Bureau.
Once ACF and the State agree that the quality of the data is acceptable, the AFCAR Improvement Plan will be considered finished, and a letter will be sent to the State from the Children's Bureau confirming this fact. The letter will include a summary of the actions taken by the State and the completed AFCAR Improvement Plan.
Additionally, the State's plan for implementing the changes to the system and for caseworker training must be included in the State's title IV-B Annual Progress and ServiceReporttt as part of the information required in 45 CFR 1357.15(t) and 45 CFR 1357.16(a)(5).
The ACF Regional Office will work with the State to determine if technical assistance is needed, and available, to implement that AFCAR Improvement Plan. The State may obtain technical assistance from the Children's Bureau's National Resource Center for the Child Welfare Data and Technology (NRC-CWDT). If you wish to request on-site technical assistance from the NRC-CWDT, please contact your Regional Office.
In closing, I would like to thank the staff who participated in the review for their hard work and commitment to collecting accurate anreliablele AFCAR data. If you have any questions regarding the report, please contact Angelina Palmiero at (202) 205-7240.
cc: Tammy Sandoval, Deputy Commissioner, Office of Children's Services; Juneau, AK
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