ILLINOIS DEPARTMENT OF CHILDREN AND FAMILY SERVICES

CHILD AND FAMILY SERVICES PLAN
FY2000-FY2004

PERMANENCY

ISSUE

What program or process changes does the Department need to make in order to shorten the length of time for a child to achieve a safe and permanent placement?

Achieving permanency for its wards in substitute care is a key component of the Department’s mission. Children are brought into substitute care when their safety and well being cannot be maintained within their birth families. Once children are in substitute care, the challenge to the Department and its private partners is to reestablish a permanent family environment for children as quickly as possible.

BACKGROUND

Illinois’ Permanency Options

Each child in substitute care is assigned a permanency goal. The Department has focused increased attention on the three primary permanency options described below:

  • Reunification - Returning children home after completion of a successful plan of care is the preferred permanency goal. A child is returned when the circumstances that resulted in their removal have been addressed, and the agency and the courts believe reunification would be safe.

  • Adoption - When children cannot be reunified with their families, adoption is the permanency plan of choice. Parental rights must be terminated or parents must surrender the child for adoption before this can take place. Subsidies are available for children age three and older, children with mental, emotional or physical disabilities, and sibling groups, when at least one of the siblings meets the above criteria. More than 95% of families who adopt Department wards receive subsidies for the children’s care.

  • Guardianship - Guardianship is when an individual or couple assumes legal responsibility for a child until the child reaches age 18. It can be extended until age 21 if the child’s needs merit it. Parental rights need not have been terminated. Guardianship without subsidy has always been a permanency option for DCFS wards. However, in October 1996 the federal government granted Illinois a waiver to allow subsidized guardianship of DCFS wards. Subsidies are identical to the adoption subsidy available for the same child. To be eligible for subsidized guardianship, it must be determined that the child cannot return home and adoption must be ruled out. The child must be 12 years old, unless with a relative, and must have been in state custody for two years and in the same foster home for one year. Siblings of eligible children may also be converted to guardianship with the same family. Savings achieved by moving children from the foster care system into guardianship are used to fund support services for post-guardianship families and to allow for guardianship subsidies for non-IV-E eligible families. Since adoption makes the guardian the legal parent of the child for life, not just until their 18th birthday, adoption remains the preferred permanency option when reunification is not possible. As this is a demonstration project, there are control groups who are not eligible for Guardianship status.

When permanency options of adoption, reunification, or guardianship have been ruled out, a goal of independence can be established for a child. In most cases where the permanency goal is independence, The child is an adolescent over the age of 16 with other considerations that make finding foster homes for them difficult. Youth whose permanency goal is independence may receive services in their foster home that teach personal finance skills, help with enrollment in education or trade programs, or help them obtain other skills needed to live independently. Youth with a goal of independence may also reside in an Independent Living setting, a state supported living arrangement in which they receive some supervision but have no formal family support system. Many adolescents participating in this type of living arrangement have complicating factors making foster care placements difficult, and many are pregnant or parenting teens. Under performance contracting, Independent Living is considered a neutral outcome.

The Growth of Substitute Care in Illinois
In 1990, Illinois had 20,753 children in substitute care, which is a rate of 7 children in care per 1,000 children in the population. By 1995 there were 53,342 children in substitute care and Illinois’ substitute care rate of 17.1 per thousand was the highest in the nation. During the same time period the national median rate of substitute care rose only from 4.9 to 6.3 per 1,000 (Statistics from the Child Welfare League of America).

One explanation of Illinois’ caseload growth is that DCFS simply took more children into substitute care. In one sense that is true: DCFS did take more children into substitute care each year from FY 1990 to FY 1995, peaking in FY 1995. Much of this rise is attributable to the practice of opening relative foster care (HMR) cases in instances where children were cared for by relatives in the parents’ absence, but were not at risk of abuse or neglect. A series of high profile abuse and neglect cases accentuated the growth of intake by creating a climate of fear among caseworkers and other professionals in the child welfare system. Nobody wanted to be responsible for making a decision that might not only harm a child, but end up in national headlines as well. HMR Reform, implemented in 1995, ended the practice of opening the aforementioned "non-removal" HMR cases. Other changes at the "front end," along with partnership with the juvenile courts have also brought the intake of new foster care cases under control. However, even at the peak of intake in 1995, Illinois placed children in substitute care at a rate comparable to the national median (2.6 placed per 1,000 in Illinois vs. the median of 2.3).

The decline in permanency achievement explains why Illinois’ caseload grew so quickly between 1990 and 1995. When intake began to grow, DCFS and private agencies focused their attention on hiring staff and otherwise coping with growing caseloads. This consumed human and financial resources that might otherwise have gone toward moving children out of foster care. Whether a case is carried by a public or private case manager, moving a child to permanency is time consuming, and traditionally the only reward to providers was to receive a new case with all the complications involved with "starting from scratch."

During this time the growing crisis in permanency was hidden because the absolute number of children leaving the system was increasing slowly. However, the rate of permanency achievement was falling dramatically. As a percent of beginning-of-year foster care cases, 35% of DCFS’ wards reached permanency in 1990. By 1995 the permanency rate had dropped to 17% statewide, with Cook wards only moving to permanency at a rate of 8%. At the same time, the average child in foster care stayed in care longer. In FY 1997, downstate children were remaining in substitute care an average of 30 months. In Cook County, the average was 60 months -- twice as long as in other major metropolitan areas in the United States.

Illinois’ Response
To help address this situation, landmark legislation was passed in the 1997 session of the Illinois General Assembly that required courts, as well as the Department, to move children to permanency more quickly. Most of the package went into effect January 1, 1998. Among the highlights of the legislation are:

  • Child Health and Safety Paramount

  • Front-End Redesign Linkages to Attain Permanency

  • Expedited Court Timelines

  • Concurrent Planning

  • Reunification Services

  • New Permanency Goals and Elimination of Long Term Care as a Goal

  • Timelines to Reach Permanency Decisions

  • Guardian ad Litem (GAL) Certification

  • Diligent Searches for Parents and Relatives

  • Responses to Parental Inquiries

  • Licensing Waivers of Criminal Convictions

  • Interstate Compact on Adoption and Medical Assistance (ICAMA)

Administrative actions also supported the legislative reform. Before and after the legislative package passed, DCFS undertook its own reform effort. Extensive training was provided to DCFS and private agency staff to enable them to implement the new legislative and administrative reforms. Programming was developed to track services based on new legal requirements. In Cook County, unprecedented cooperation, joint planning, training, and coordination by the Juvenile Court and the Department helped produce significant improvements in service delivery. Performance contracting and other financial reforms dovetailed with the legislative reform.

Performance Contracting
In 1996, private foster care providers and the state came together to address two critical issues confronting the state’s child welfare system: 1) the alarmingly low number of children leaving foster care for permanent homes; and 2) the instability resulting from moving children in and out of different foster care placements. Emerging from this dialogue was an agreement to make 85 percent of the state’s child welfare caseload (relative care and traditional foster care) subject to Performance Contracting. Performance contracting was announced in the last quarter of FY 1997 and was first implemented in Cook County’s kinship care program July 1, 1997. On July 1, 1998 performance contracting was expanded to include traditional foster care and the rest of the state.

The move to performance contracting signaled a commitment to system-wide accountability and securing results in the best interests of children. Under performance contracting a major shift has taken place: outcomes for children matter, not just activities. By outlining and contracting for specific outcomes for children in DCFS care, a powerful tool has been introduced which is moving child welfare practice from a bureaucratic and centralized system to one that is energized and regulated by competition and performance. This is a means for shifting our governing principles from administration through policy and procedural directive to management through financial incentives.

By securing an agreement that system-wide performance would increase three-fold (from a yearly average rate of 8 percent to a minimum of 24 percent), the Department was able to use the savings from achieved permanencies to make significant investments in performance-enhancing services. The contracts invested substantially in staffing, services and maximized agency flexibility to ensure results.

With performance contracting, DCFS did more than set outcome goals for foster care. The Department built performance expectations into the contract and payment structure. The heart of this structure is a mechanism guaranteeing results. DCFS contracts and pays for child welfare services by building in an expectation that agencies will meet specific permanency outcomes. Within this framework, agencies have a clear incentive to perform. They benefit directly from exceeding performance expectations by retaining savings from lowered caseloads. Conversely, they also bear the risk of not meeting their contracted performance level, and suffering financially.

Throughout the implementation of performance contracting, DCFS has had on-going dialogue with private and public child welfare service providers. Monthly meetings between program directors and DCFS staff representing contract administration, operations, legal, agency monitoring and central management are used as regular opportunities to problem solve and plan for the future. All parties use a standardized, interactive process for evaluating results.

Even though outcomes are now emphasized, best practice continues to be the goal. Performance contracting requires POS agencies to become accredited by the Council on Accreditation of Services for Families and Children. Also, Agency Performance Teams monitor each private agency.

Promoting Reunification
The combined efforts of performance contracting and legislative and administrative reform have produced significant improvements in permanency achievement. Most notably, the recent increases in permanencies achieved have mostly come in the form of adoptions and subsidized guardianships, while the number of children reunified has been relatively stable. It should be noted that one of the results of the Department’s Front End Redesign is that children that historically would have been removed from their families and subsequently reunified are now not removed at all, but instead are served in intact families whenever it can be done safely. This improvement is one that cannot be measured through reunification figures, but the Department still seeks improved reunification performance.

The Department made a number of policy changes to help guide interviewers, assure safety, and build confidence and coordination with the courts and Guardians ad Litem.

To remove barriers to reunification, performance contracting was modified to include resources for reunification services following a child’s return home to ensure safety, stability, and well being. Services are individualized to the specific needs of each family, and may last up to a year.

Promoting Adoption & Guardianship
Prior to recent reforms, the procedures and staffing around adoption services presented some barriers to efficient performance. In agencies that did not have adoption contracts, adoptive cases were transferred to specialized DCFS adoption units for completion. This system had the effect of 1) concentrating adoption expertise at the expense of general caseworkers; 2) taking some of the most gratifying work away from regular caseworkers; 3) creating a bureaucratic bottleneck in the adoption process; 4) exacerbating other fiscal disincentives that inhibited private agencies from moving children to adoption; and 5) adoption workers had to assume all casework duties, not just those relating to the adoption process, which further reduced their efficiency.

To address this and other adoption issues, the Department changed the case responsibilities of adoption workers so that they could concentrate on adoption/guardianship assessment and decision-making functions, including:

  • Identifying prospective adoption and guardianship cases.

  • Working with children and adoptive families to lay the groundwork for adoption/guardianship even before the permanency goal becomes adoption or guardianship.

  • Working with placement staff and caregivers to explore adoption/guardianship.

  • General casework duties remain with the regular caseworker.

Because of the success in preparing children for adoption and permanency, it is important to ensure that there are permanent homes for these children. To this end, each Region has developed a specific plan for the recruitment of permanent homes. A statewide recruitment plan to target both minority and non-minority homes will be launched in late May of this year.

The Department has undertaken statewide efforts to attract permanent homes targeting groups or industries whose members may be likely to adopt. The Department launched a Corporate Partnership for Recruitment of Adoptive Families in April of 1998. Its first partner was the Illinois Hospital & Healthsystems Association and their member hospitals across the state. Since the initiation, 26 hospitals have signed onto the project, 21 licensing applications have been completed, 18 licenses have been issued and 5 families have been matched with a child.

Other changes in the adoption process include:

  • In Cook County, performance contracts include funding for one adoption worker for each team of seven workers.

  • All Downstate foster care contracts now have corresponding adoption contracts so those providers are paid for finalized adoptions.

  • Cook County now has a centralized DCFS adoption unit that handles all adoption/guardianship subsidies, all expedited adoptions, and monitors POS program development and POS program accreditation.

  • Wide-ranging reforms were implemented through partnership with Juvenile Courts, State’s Attorneys, and other parties. Without this partnership and the cooperation of the Cook County Juvenile Court, many of the Department’s efforts to improve adoption would have been ineffective.

  • Increased funding of and referral to the Adoption Information Center of Illinois/Adoption Listing Service of children in need of an adoptive family.

Terminating Parental Rights
Prior to consummating an adoption and thus securing a permanent home for a child, it is first necessary to terminate parental rights. The Department has focused efforts in recent years on improving the process and length of time necessary to complete this judicial process. Throughout the state, regional attorneys screen cases ready to go to the courts for termination of parental rights and adoption to assure that all appropriate steps have been taken and sufficient grounds exist to move the child to permanency. In Cook County, the office of legal counsel conducts pre-screenings of adoption cases and then participates in a screening process with the Cook County State’s Attorney’s Office.

Department staff have stepped up their efforts in preparing for termination hearings. Staff are meeting more frequently with individual judges and State’s Attorneys to work on moving children to permanency. DCFS attorneys are assisting staff in preparing cases and training them on juvenile court issues.

The Courts have played a major role in Illinois’ improved rate at terminating rights and moving children to permanency. In the early 1990’s, people were hesitant to terminate rights. The state’s Permanency Initiative legislation served to clarify when rights should be terminated and under what circumstances. Rights were terminated in less than 1,000 cases in Cook County as recently as 1994. In 1998 the court took this action in 5,106 cases, more than a five-fold increase.

CURRENT AND FUTURE STEPS

Currently, the Department’s biggest challenge is to increase the rate of permanency achievement and reduce the average length of stay for children in foster care, especially relative care. State and federal laws necessitate timelines of no more than 2 years for children in care. Meanwhile, every indication is that in order for the size of our foster care system to again reflect national norms, the rate at which children are returned home, adopted, or placed in subsidized guardianship must increase.

New Cook HMR performance contracting requirements for FY2000:

  • Agencies with a Cook HMR contract achieving a 24% permanency rate or better will be on full intake for FY 2000
  • FY 2000 Cook HMR permanency expectation is 33% (an increase of 38%)
  • FY 2000 Cook HMR caseloads funded at 22.5:1 (a reduction of 10%)
  • By meeting the permanency expectations of the Cook HMR FY 2000 Performance Contracts, contracted agencies will have the opportunity to earn down to a funded caseload ratio of 20.5:1. This is accomplished by contracting for 7.5 permanencies per caseload (33%) but only referring 5.5 children per caseload.
  • .25 non-permanencies will be replaced per caseload, with every placement change reviewed by the managing agency, and verified by the Department
  • Neutral caseload exits from FY98 and cases paid as part of Bonus Option 2 will be replaced by 10/1/99
  • Movements of children from HMR into specialized foster care will not be counted as non-permanencies so long as the step-up does not involve a placement change.
  • No add-on referrals will be given to agencies on hold, and sibling groups associated with add-on referrals will be consolidated with agencies receiving intake
  • For those agencies performing close to the 24% permanency standard in FY99, the Department will make every effort allow add-on referrals, and not remove the associated siblings.
  • Most of the very low performers will be given the opportunity to re-tool in order to provide other needed services in their community, and their HMR contracts will be phased out over the course of FY 2000
  • DCFS will not fund the QA/Court Liaison positions
  • If intake levels are sufficient, the Department will explore the opportunity of allowing add-on referrals, and opening agencies on hold for intake.

One of the most striking features inherent in the performance contracting model is its flexibility in adapting to changing dynamics in the foster care system. Essentially, the same process that secured system-wide results for the HMR caseload in FY98 can be readily employed in FY2000 and beyond. The key in this undertaking is identifying both the opportunities for improving outcomes and resources necessary to make the increased expectations a reality.

  • Supporting performing agencies with declining referral. In FY2000, the Department will need to meet the demand for about 75% of system providers that are likely to meet the required 24-percent permanency threshold to be on full-intake. Better scrutiny of add-ons assigned to agencies on hold, transfer of out-of-state cases from DCFS to the private sector, modifications of compensation, and identification and transfer of "uncompensated care" cases create referrals for DCFS.

Discussions within the private and public sectors consistently single out a few key challenges in the immediate future:

 

  • Reunification. A look at Illinois’ permanency trend makes obvious our continued struggle with returning children home, particularly in Cook County. Despite dramatic increases in the average per family spending for reunification services during SFY98 and the leverage of performance contracting, reunifications increased less than half of 1 percent. Much of this problem can be linked to substance abuse. A 1998 GAO report showed that 74 percent of Cook County, Illinois parents with children in foster care have AODA problems. More troubling is the fact that 76 percent of parents with children in the system for at least one year either failed to complete or never entered drug treatment.

  • Alcohol and Other Drug Abuse (AODA) IV-E Waiver. The waiver request specifically seeks to improve child welfare services to families impacted by AODA by providing an improved integration and interface between the child welfare and AODA treatment systems in Illinois. Services delivered through the IV-E waiver will be provided to assigned groups of open DCFS cases in Cook County, including Chicago, and the enhanced package of treatment and support services will be added to the existing state funded service mix aimed at addressing the needs of substance affected families. By addressing AODA problems of families, the services will assist in allowing for the safe reunification or achievement of other permanency options for children of families whose children are in DCFS custody. The program enhancements would be claimable at the same IV-E rate as for families in the control group not receiving enhanced services.

  • Permanency for High End Children in HMR. Our own research demonstrates that relatives are durable and effective caregivers. Despite caring for children with significant emotional and behavioral problems, these families tend to stick with the child. Their willingness support that child permanently without the proper supports for the child’s needs is limited, however, and a concerted effort needs to be made by the Department to provide families the supports necessary to care for the child.

  • Guardianship for Older Relative Caregivers. Providers consistently report that older caregivers are concerned about their ability to manage caregiving alone. Added to this is the fact that several agencies have moved up to 50% of the eligible demonstration cases in their caseload into subsidized guardianship. Those families that remain will profile differently, and are likely to need additional service supports after guardianship to commit to permanency.

  • Supported Adoptions and Guardianship. Developing community-based supports for caregivers such as counseling, mentoring and after school programs, tutoring and other services which could be readily accessed and facilitated by child welfare agencies could potentially alleviate the concerns caregivers have about their ability to continue without support as the children age.

  • Post-Adoption Supports. With the dramatic increase in the number of adoptions and guardianships achieved, the Department needs to increase the support given to the adoptive and guardianship families. Beginning in FY00, 20 percent of federal family center services will be dedicated to adoption preservation and support through the LANs and other community groups. The increase will allow the Department to respond to the increasing adoption/guardianship caseload through programs to make adoptive parents more familiar with what they can generally expect in raising an adoptive child as well as more knowledgeable about the adoption preservation system. Support groups and outreach groups will provide emotional support to adoptive parents. Funds will be used to allow some families who may benefit from longer services to receive services beyond the current five-month time limit.

  • Adoption Incentive Payments. The federal government initiated a program to provide states with incentive payments based upon increased special needs adoptions or adoptions from the foster care system over the baseline years. Illinois has drastically increased the number of eligible adoptions, and stands to receive a sizable grant ward. While the exact amount or timing of funds to be received is not currently available, the Department plans to use these funds to further expand the adoption preservation programs, assist with concurrent planning for children in foster care, and make other improvements to achieve permanency.

LONG RANGE GOALS AND OBJECTIVES

Illinois’ long-term goal is to achieve permanency for most children within a two-year time frame. If successful, the size of our foster care system should shrink to below 20,000 children by the year 2003—a substantial change from 1995 when over 50,000 children swelled the state’s foster care system. Specific goals include:

  • Maximum of a 2 year length of stay with median length of stay of one year

  • Minimize placement disruptions

  • Improve outcomes for populations that have historically been difficult to move to permanency, especially older wards.

To reach these goals, the Department will continue to identify and overcome the barriers to permanency and stability that face Illinois’ most vulnerable children.