PROGRESS AND ACCOMPLISHMENTS

In FY97, the Department of Children and Family Services developed and adopted a comprehensive strategic plan--the consolidated Child and Family Services Plan (CFSP). This new charter subsumed major agency planning processes, and now serves as their core. The CFSP requires that all activities performed by DCFS and its contractors be directed toward achieving one or more of three primary goals:

* Safety--protect children from abuse and neglect

* Permanency--provide children with permanent, stable living arrangements

* Well-being--strengthen families and children and enhance their well-being.

In accordance with Title IV-B of the Social Security Act and the Adoption and Safe Families Act of 1997, the Department’s paramount concern is always for the health and safety of the children being served.

In FY97 and FY98, the Department published an Annual Progress and Services Report (APSR) on its progress and accomplishments related to the above goals and statutory requirements. In FY99, the Department is publishing a Final Review for the FY95-99 period. The Final Review has been consolidated into the FY2000-FY2004 Child and Family Services Plan (CFSP) to reduce the duplication of both information and collaborative development involved in related but separate documents written within the same time period of time.

The Final Review shares Appendices with the CFSP which include background statistical reports, a detailed Training Plan for the Department, an update of progress on the Action Steps in the FY97-99 CFSP, an update of progress on the corrective actions identified in the HHS Pilot Audit, FY99 CAPTA report, and the IV-E Independent Living Program FFY98 Report and FFY2000 application information.

 Background

Each year from FY91 through FY95, the number of calls to the DCFS child abuse hotline increased sharply. This translated into significant increases in the number of investigations completed and in more children being taken into custody. As a result, there was double digit growth in the substitute care population for each of those years. That trend was broken in FY96 when the number of children in care grew by just 5%. This downward trend continued in FY97 when the substitute care caseload grew by only 1.4%, from 50,038 to 50,727. In fact, the number of cases peaked at 51,595 in March 1997, with a steady decline since then. With the introduction of performance contracting for Cook County home of relative cases in FY98 and the expansion statewide to all cases in FY99, the substitute care caseload ended FY98 at 46,103 and stood at 41,259 in May 1999.

In 1995, Illinois had the highest substitute care rate in the nation. Home of relative reform started the process of bringing the state back in line with the rest of the country. However, the reform of child welfare in Illinois has involved dozens of different changes to almost every aspect of the Department's work, from better prevention work at points of entry into care to the huge increases in the number of children leaving substitute care for permanent homes. The following descriptions catalog the most significant of these changes and, where possible, some of their results.

While reviewing this progress, it should be noted that child welfare in Illinois is a system, not just the workings of the Department of Children and Family Services. The operations of this system are dictated by federal laws, state laws passed by the General Assembly and signed by the Governor, judicial consent decrees, and case law. The Permanency Initiative, which became state law in 1997, gave child welfare the clear mandate that every child deserves our best efforts to find them with a safe and permanent home. It was critical that the court, particularly in Cook County, embrace this mission quickly and they did.

We should also recognize that three-quarters of foster care, all residential care and most independent living cases are managed by the private sector. A substantial portion of the credit for the improvement in the system's performance should be given to their hard work in embracing the changes needed to improve the lives of abused and neglected children.

 The Goal of Safety

Child safety is the paramount goal of DCFS, from the initial call to the hotline to the day a case is closed. Partnerships with law enforcement through Child Advocacy Centers are vital. Timely and accurate investigations with immediate connections to services are critical. The Department has also enhanced the tools that are used to assess risk and deal with particular problems. Additional changes to further improve child safety are underway.

• Assuring All Public And Private Agency Staff Can Assess Safety and Risk Issues – Over 7,000 Department and private agency child protection workers, child welfare workers and direct service supervisors were trained and certified on the Child Endangerment Risk Assessment Protocol (CERAP) in FY96 and FY97, who were required to pass a stringent certification test. This protocol was developed by a statewide multi-disciplinary team and the American Humane Association. A study presented to the General Assembly in May 1999 found that in the first two years following implementation of the CERAP, recurrences of maltreatment dropped 28.6%.
• Front End Redesign - The Department is comprehensively restructuring services that families and children receive when they first become known to the Department. The intent is to provide more timely and appropriate services that work together to ensure the safety of children and respond to family needs. In combination with HMR reform, these early intervention and prevention efforts have helped reduce intake of children into substitute care by almost half since FY95, from a peak of 1,299 cases per month to about 658 today. Furthermore, recurrences of maltreatment have been reduced (see previous point).

• Family Centered Services Initiative - Through this federally funded initiative, DCFS funds Local Area Networks to offer family support and family preservation services in non-categorical ways. In FY00, the funding will also include family reunification and adoption preservation in the service mix, in keeping with revised federal regulations.

• Increased Day Care Licensing Staffing - Rapid growth in the need for child day care resulted in increase in the number of applications for day care homes and centers that overwhelmed the existing staff the Department had to carryout this function. A large backlog in applications built-up. To resolve this problem, the Department increased the workforce handling day care licenses by 73. This was done without increasing overall agency headcount by taking advantage of decreasing substitute care caseloads to eliminate casework and support positions. Licensing applications are once again being processed in a timely manner.

• Child Death Review Teams - Child death review teams are operating in each of the seven downstate sub-regions and two in Cook County. They consist of professionals from a wide variety of disciplines who review all factors involved in child deaths. They make recommendations for improving the identification of high-risk situations and the investigations of child abuse and neglect. New changes in state law are expanding the role of death review teams. In July 1998, the Child Death Review Team Act was amended to mandate the review of the death of any child whose death is reported to SCR and which report is subsequently indicated. Child Death Review Teams may review at their discretion other sudden, unexplained, unexpected child deaths.

• Second Opinions of ^"Unfounded" Reports of Abuse and Neglect: Mandated Reporters by Multi-disciplinary Teams - The Department has established multi-disciplinary teams in each region to afford mandated reporters of child abuse and neglect the opportunity to obtain a second opinion on reports that they feel were inappropriately determined as "unfounded." This is to assure mandated reporters that their concerns about child abuse victims they report are fully addressed.

• Citizen Review Panels - Four active Department advisory groups have agreed to take on the additional responsibility of Citizen Review Panels. In addition, the Department is forming a Steering Committee made up of the Chairs of these groups and other key persons. The Citizen Review Panels conducted preliminary meetings this Spring and are formulating their plans for operation.

Substitute care is often necessary to protect children who would otherwise face harm from abusive or neglectful parents. However, it also can keep children from feeling certain about their futures. Until recently, long-term foster care was one of the acceptable permanency goals for wards. However, long-term foster care cannot and should not be considered a permanency goal with reunification with parents, adoption, and subsidized guardianship. Significant efforts by DCFS in the past two years to increase permanency for children include:

• Increased Emphasis on Adoptions - Between FY91 and FY95 number of finalized adoptions grew roughly in line with growth in the foster care caseload. In FY96, when growth in substitute care fell to just 5%, special efforts by the Department increased the number of finalized adoptions by 34.3%. In FY97, another record was set as 2,229 adoptions were finalized. With the start of performance contracting and the passage of permanency legislation by the General Assembly, 4,293 adoptions were finalized in FY98, an increase of 92.6%. In addition, more adoptions were finalized in the first half of FY99 than were finalized in the same period in FY98.

• Performance Contracting - In recent years Illinois had one of the nation's worst records in the movement of children from substitute care to permanent homes. To address this problem, the Department initiated a performance contracting system in FY98 for all Cook County home of relative cases, and in FY99 performance contracting was extended to regular foster care in Cook County and to both relative and regular foster care downstate. Under performance contracting, providers receive additional up-front resources and financial incentives to move children safely and appropriately out of the system. In return, private agencies agree to a three-fold improvement in the movement of children to permanent homes and a substantial reduction in the movement of children into higher intensity settings, compared to what existed in FY96 and the first half of FY97. This program increased the number of children moved to permanency for this population from about 2,200 in FY97 to about 5,300 in FY98. In FY99 performance contracting was extended to regular foster care in Cook County and to both relative and regular foster care Downstate.
• Guardianship-Progress in the Section 1130 SSA Demonstration - For a variety of reasons, many foster parents, particularly relatives, do not feel comfortable legally adopting their foster children even though they will make a commitment to raising the child to adulthood. To provide a permanency alternative for such families, the state has received a federal waiver to offer subsidized guardianship for children who have been in care for at least two years and who have lived with the same family for at least one year. Reunification and adoption must have been ruled out as options for the child. Under this program, foster parents assume guardianship of children and DCFS oversight is removed, but the family still may receive a monthly stipend to care for these children.

During FY98, the Department’s research director oversaw implementation and initial evaluation of the program. This included working with the Governor?s African-American Family Commission to convene an advisory research group to the program. As co-chair of that group, the research director oversaw the Request for Proposal process for the evaluation. After a vendor, Westat, was selected, the director worked with them to develop evaluation and data collection instruments. Another vendor, HuTech of Chicago, was selected to provide training and post guardianship services for child welfare staff as well as those who assume guardianship. In addition, the advisory group met three times with community groups to review the proposed program. The first cases were converted to subsidized guardianship status in May 1997. The Department converted 185 children to this new status by the end of FY97 and another 1,301 children were moved to guardianship in FY98. The Department estimates there will be over 1,741 children moved to this status during FY99.

Regarding the Section 1130 demonstration, in addition to the information reported in this CFSP Final Review, the Department submits an annual waiver evaluation report, an interim and a final evaluation report, semi-annual progress reports, and an implementation status report on the demonstration.

• Reunification - New permanency legislation passed in 1997 and Department policy lay out clearer criteria for deciding if children can be returned to their families and for services that must be provided to support the family and ensure the child's safety. Under traditional contracting agencies could only get paid for a limited amount of aftercare staff support but no other services were covered. Under performance contracting they receive more funding for aftercare staff support and can spend up to an average of $3,000 per child to provide other supports and services, depending on the individual family's needs. Reunifications as a proportion of newly opened cases increased from 44.9% in FY97 to 55.2% in FY98.

 The Goal of Well-Being

Child abuse and neglect are the triggers that bring DCFS into a family's life. However, abuse and neglect are usually the symptoms of other family problems. In addition, children who are abused and neglected tend to experience disproportionate problems in areas such as education and health. Abuse and neglect cannot be addressed in a vacuum. If the goal is to keep a family intact or to reunify it, the problems of parents that interfere with safety and permanency for a child, such as drug abuse, must be addressed in order for them to be achievable. When the Department places children in substitute care, those same underlying problems must be addressed or wards may continue to suffer the adverse consequences of abuse and neglect longer than necessary. Major steps DCFS has undertaken in recent years to address these problems include:

• Health Care Network - The Department has created the HealthWorks of Illinois program to serve the wards placed in substitute care. Prior to the creation of HealthWorks, it was difficult to find physicians who would serve wards, and it was even harder to maintain continuity of health care. Since the implementation of the program, over 3,000 physicians have agreed to provide care for wards on a timely basis and provide documentation of this care in a standardized format. Due to HealthWorks, no children have been turned out of school due to lack of necessary immunizations and all children coming into the state's custody have access to initial health screenings, comprehensive health evaluations, and on-going primary and specialty health care. Enrollment currently is at 96% of wards.

• Improvements in Diagnosis and Treatment of Alcohol and Other Drug Abuse (AODA) - The Department is developing and implementing numerous pilot projects to address the challenges faced by families confronted with alcohol and other drug abuse. The Intact Family Recovery and Healthy FIT demonstration projects in Cook County emphasize engaging and re-engaging parents in treatment, ensuring child safety, and imposing graduated sanctions when needed. In a new initiative by DCFS, Cook County Juvenile Court judges can refer parents suspected of having alcohol or other drug problems for immediate assessment and same-day AODA treatment. The Department is also completing the final states of developing a treatment support project for families identified in Cook County Temporary Custody hearings as needing AODA treatment.

• The Department of Human Service's (DHS) Services for DCFS Clients - The DHS Office of Alcoholism and Substance Abuse (OASA) and Children and Family Services are involved in an ongoing, joint initiative to assess and treat substance abusing parents of children for whom DCFS is responsible when the goal is to return the child home. DHS is responsible for funding providers for assessment and treatment, while DCFS is responsible for funding for support services. The support services include case management and outreach services provided by Project SAFE programs, family life educators in residential treatment programs, and child care services for women while they attend outpatient and intensive outpatient treatment. During FY97, 15 Project SAFE sites became a part of the program, and OASA began funding four additional SAFE sites. In FY00, OASA and DCFS will jointly fund two more, raising the total to 21. Per DHS data, more than 9,900 unduplicated individual Department clients were served in these programs in FY96. More than 10,000 were served FY97 and more than 11,800 in both FY98 and FY99. For FY00, plans call for services to more than 12,000 clients.

• Enhancements in Services for Sexually Aggressive Children and Youth (SACY) – DCFS has put systems in place to identify wards who may be sexually aggressive. Each child is assessed to decide if a safety plan is needed to keep that child and others safe. If a safety plan is implemented, the child is tracked and monitored through any changes in placement to continue to ensure safety. Standards for services and treatment of sexually aggressive children and youth were created and implemented in the fall of 1996, as was training for providers. Site visits to assess the level of provider compliance or improvements needed have been ongoing.

• Education Initiatives - The Department's education initiatives emphasize early identification and remediation of problems that affect children's future school success. DCFS has developed a comprehensive system of technical assistance and support-in-place designed to improve educational outcomes for children of all ages. This includes developmental screens to all wards under age five in collaborative projects with schools and health departments.

The majority of the state's foster children live within the boundaries of the Chicago Public School (CPS) System. To address student educational problems, DCFS has entered into a series of collaborative agreements with the CPS. One of the most important of these projects is ensuring school attendance by all Department wards. On a monthly basis, CPS provides DCFS with data of students under DCFS’ care who have been identified as truant. This information is sent to the youth’s caseworker so that problem-solving can occur between the caseworker, school, foster parents, and child to re-enroll and stabilize the youth in school. In addition, a truancy protocol has been developed whereby DCFS workers can contact CPS Regional Truancy Staff when school-based efforts have been unsuccessful.

• Emergency Cash Assistance Program - This program has provided short-term assistance to families when the only reason children would be taken into custody or the only reason a child cannot otherwise be returned home is environmental. It has proved to be extremely cost effective. Small short-term expenditures prevent the need to spend the substantial sums that would be needed if the same children were placed in state custody. In FY98, 3,534 families received emergency cash assistance and 1,033 received housing locator services. In FY99, an estimated 4,600 families received emergency cash assistance while 1,400 received locator services.

A commitment to the delivery of quality services is critical to producing good results. In recent years, the Department has made major strides in fulfilling this commitment. They include: 

• Accreditation - The Department continues to pursue its efforts to be accredited by the Council on Accreditation of Services for Families and Children. So far 23 of 65 field sites and all central office functions have been accredited. The Department is committed to having all sites and functions accredited. If successful, Illinois will be only the second state agency in the nation, and the largest agency, public or private, to achieve accreditation. In addition to Department is moving to have all the private agencies who manage foster care cases become accredited. Sixty-one private agencies are accredited already and all the remaining have submitted applications.

• Office of Quality Assurance - An Office of Quality Assurance was created in response to the Department's need to ensure that child welfare services are delivered in a timely manner which complies with Department standards. The staff of this office is responsible for conducting comprehensive reviews of direct service operations and for producing and evaluating performance and outcome information.

• Worker Certification - Legislation passed in 1998 requires that all child welfare workers be certified. The Department is in the process of developing the requirements for achieving certification at this time.

• Regional Quality Assurance Plans – The Department has developed Regional Quality Assurance Plans which include: structured supervision requirements to meet Council on Accreditation standards, peer review of casework performance, and implementation of Regional Quality Councils. These ensure that information obtained through various quality assurance processes helps improve service quality.

• Upgrading Training for Both the Public and Private Sectors - A major initiative has been undertaken to retrain all DCFS caseworkers and supervisors on the Model of Practice, adopted by the Department as the foundation of child welfare practice. The training is a six week program which includes 120 hours of classroom instruction. In addition, the FY99 budget included funds to bring private agencies into the Department's training program. This will allow private agencies to buy into core and other regular DCFS training programs. (Bringing private agencies into the DCFS training program fully is dependent on reaching agreement with federal reviewers and the private agencies on how to account for match.)

• Social Work Education Program - To professionalize the level of supervision in the Department, all direct service supervisors must now possess a master's degree in Social Work or a master's degree in a related field as recognized by the Council on Accreditation for Services to Children and Families. Over 100 supervisors went back to school under this program. All will have completed their degrees by the end of FY99.

DCFS recognizes the importance of increasing its accountability to clients and policy makers. This has meant increased measurement and assessment of the work completed by DCFS and the work completed by others on its behalf It has also meant greater dissemination of information about service outcomes. Other steps toward greater accountability include:

• Purchase of Service (POS) Redesign - Most DCFS regular and relative caseload management administrative fees are now based on 22.5:1 child to worker ratio. Until FY96, DCFS also monitored private agencies through liaisons that each monitored 100 individual cases held by private agencies. There was little coordinated review of the overall performance of individual agencies. To address this, DCFS created Agency Performance (AP) Teams in Cook County. These teams are better able to monitor the overall performance of agencies. More attention is paid to performance measures such as the movement of wards to permanency. Agencies with good performance records receive more of the new cases. Conversely, agencies that are performing poorly are approached to take corrective actions. Input from the Cook County Public Guardian's Office is encouraged, and specialized monitors are used in certain cases. POS redesign was implemented downstate during FY98, with local variations as appropriate. More recently, the Department restructured private agency oversight into a single unit within the Department.

• Children and Family Research Center - The Child and Family Research Center was established in FY96 at the University of Illinois at Urbana-Champaign. Housed at the School of Social Work, it is intended to research and evaluate the outcomes of services delivered by DCFS and private agencies. It conducts research on critical issues impacting the performance of the child welfare system, pursues new areas of inquiry that directly inform child welfare policy and practice in Illinois, and develops additional capacity within the state to support worker training and policy-related research in child welfare. The Center also encourages research through partnership with other Illinois universities.

• Foster Parent Bill of Rights and Responsibilities - As part of the means of implementing the bill of rights, all agencies and DCFS regions submit annual plans on how they will adhere to its requirements. Regional Foster Parent Advisory Councils help assess each plan utilizing a standardized review format. When an agency plan is found deficient they receive a letter outlining the problems. They are required to submit changes to their plans to bring them into compliance.

Community-based services involve a wide range of individuals and agencies. They make it possible to customize service plans to children's needs by wrapping services around them. This process heightens a community's awareness of its needs and capacities. The alternatives it produces are more community and family based and less expensive than institutional care. Following are some of the special initiatives the Department has undertaken to promote the community-based approach:

• Local Area Networks (LAN's) - Front End Redesign allows LANs to develop and organize resources so that community-based services can be delivered to intact families. The Department is working with LAN conveners and a statewide work group to develop a variety of models for ensuring that immediate, appropriate services are available. Families will be referred by either child protective investigators or intact family workers. They will build on lessons learned in the Family Centered Services Initiative.

• Improving Service Opportunities for Adolescents Through Local Area Networks -Wraparound services are programs constructed by LANs for individual children who are ready to step down from more intensive treatment services or who would have to move to more intensive and restrictive settings unless they receive localized, individually tailored programs. Service packages may include counseling, advocacy, mentoring, psychological or psychiatric services, therapeutic recreation, short term residential and other services. This allows increased local control and a more normal community life for the child.

• Extended Family Support (EFS) - EFS provides services to relatives who are already caring for children at the time they come to the attention of DCFS. While the children may not be abused or neglected, social services may still be needed to stabilize the family or prevent a later placement away from the relatives. During FY98, this program served 685 families, and 99% of the children involved did not come into custody during the service period.

• Service Coordination for TANF Recipients – The Illinois Department of Human Services (DHS) and the Illinois Department of Children and Family Services (DCFS) are implementing a new, statewide policy of coordinating service delivery to all intact families receiving Temporary Assistance to Needy Families (TANF) cash assistance from DHS. Interagency case coordination is intended to ensure that DCFS-mandated family-preservation activities and IDHS-mandated work-readiness activities are complementary and not conflicting or duplicative. Under the new policy the family-preservation caseworker is primarily responsible for identifying dual-involved families by running a computer check of DHS’s client information system when a new DCFS intact family case is opened and also during the six-month review of open cases. Whenever either a family-preservation or work-readiness caseworker identifies a dual-involved family, one is to notify the other caseworker and commence the case coordination process.

Between FY91 and FY95, the total substitute care caseload grew by 108.7%, from 22,841 to 47,673. The bulk of that growth came in home of relative care, which rose by 160.9%, from 10,370 to 27,051.

During that same period, increases in the use of higher intensity services raised the average cost per child even faster than the caseload was growing. The use of specialized foster care, which is about two and a half times more expensive than regular foster care, grew by 129.3%, from 3,016 to 6,917. The number of children in institutions, whose care is almost nine times more expensive than regular foster care, increased 102.2%, from 2,049 to 4,144. The Department is obligated to assure that such services are available and appropriately target children who truly need them. Failure to do this is not only more expensive, but squanders the limited human and physical capital available to deliver such services. Therefore, DCFS has undertaken a series of reforms and initiatives to manage the use of higher intensity services for wards. Some of these steps are outlined below and in other sections.

• Home of Relative Care - After growing by 160.8% in the prior five years, the number of children in home of relative care grew by just 3.0% in FY96, following implementation of home of relative reform measures. In FY97 this caseload actually declined by 0.8%, or 221 children. With implementation of performance contracting in Cook County this caseload fell by 12.9% in FY98 and continues to fall at least as rapidly in FY99.

• Better Screening for Special Needs Determinations - The Department found that use of specialized foster care was increasing faster than any indication of need for it. At the same time, it was noted that there was no tool to objectively assess whether a child had special needs which justified the decisions to provide more intensive specialized services and higher rates. Thus, in May 1996, the Department implemented a level of care protocol. This requires that an assessment be completed before the movement of a child into specialized care and that there be regular reviews to assure that specialized services are still justified. As a result, use of specialized care, which had grown more rapidly than substitute care overall every year prior to the implementation of the protocol, grew by just 21 cases in FY97 and fell by 7.6%, 559 cases, in FY98. This caseload has continued to fall steadily in FY99.

• Regular Foster Care Growth Reduced – In addition to HMR and specialized foster care, regular foster care grew as well. Since FY96, the Department has improved its handling of cases at the front end of the system. This has reduced intake into substitute care across the board. There has also been an increased emphasis on moving children to permanency more quickly. As a result, the non-relative Foster Care caseload fell by 1.8% in FY98, compared to the 13.2% increase in FY97.

• Appropriate Use of Residential Treatment - Department sponsored studies of the use of residential care found that many children were kept longer than necessary due to limited monitoring and step-down planning and that some institutionalization could be avoided through the use of alternative care arrangements. To assure institutional placements are made only when necessary, DCFS implemented a series of reforms including: Placement Review Team assessments, increased use of Local Area Networks and wraparound services, and special efforts to move children back into their communities. As a result, the number of residential placements decreased by 6.7% in FY96, 15.1% in FY97 and by 11% in FY98. The number of children in residential placements has continued to decline from 3,204 at the end of FY98 to 2,920 at the end of FY99.

• Fewer Children in Institutions Outside of Illinois – Based on Department trends, it was once estimated that there would be 1,105 children in institutions outside of Illinois by the end of FY95. However, as a result of concerted efforts, a peak of 792 was reached in May 1995, and the number has fallen sharply since. There were 624 children outside of Illinois at the end of FY96, but only 325 at the end of FY97, an astounding 47.9% reduction. The number fell to just 189 at the end of FY98, another 41.8% decrease. The number has since fallen to just 153 (as of June 1999) of which 53 were non-ward, GYSI cases ordered to DCFS by the courts. This effort was successful partially due to a public-private partnership, where Illinois residential care providers and in-home services providers developed individual care plans to bring children back to Illinois.

• Expenditure Growth Brought Under Control - For eight years in a row, between FY89 and FY96, DCFS total and General Revenue expenditures increased each year at double-digit rates. In each of these years, DCFS spending grew far faster than the rate of state government revenues. This string was broken in FY97, when GRF spending grew by 5.0%. For FY98, GRF expenditures actually decreased by 2%. For FY99 GRF appropriations decreased but total expenditures will increase slightly based on increased federal receipts and the beginning of full scale development of the Statewide Automated Child Welfare Information System (SACWIS) project.