Questions & Comments

Any questions or comments may be submitted to the following:

Research and Evaluation Team
Missouri Children’s Division
P.O. Box 88
Jefferson City, MO 65103-0088

Comments may also be submitted by e-mail to CD.RESPONSEEVALTEAM@dss.mo.gov

Quarterly Reporting

Response & Evaluation Team Semiannual Reporting

What is House Bill 1414?

In 2020, the Missouri General Assembly and the Governor enacted House Bill 1414 into law. The law requires several reforms to Missouri’s Child Protection System, including establishing a Research and Evaluation Team to review and evaluate foster care case management in Missouri. The purpose of this law is to implement objective metrics to measure the quality of services for Missouri’s children in foster care. The key components of the law are the requirements for the Children’s Division to:

  • Consider the safety and welfare of children the most important goal
  • Establish a Research and Evaluation Team composed of representatives from the Children’s Division and key stakeholders
  • Establish a uniform, transparent, objective, and consistent tool to evaluate foster care case management services
  • Maximize successful outcomes for children and families served by the Children’s Division

Another key component, which has been successfully completed, is the promulgation of regulations to implement the law’s provisions.

Phase I Metrics

The Phase I metrics measure child welfare and safety and are divided into four domain categories: Safety, Well-Being, Permanency, and Service. The tabs below include information about each metric and how it will be measured:

Safety Domain

Metric - Worker/Child Visit Completion

  • Definition: This measures the number of foster children seen by a worker each month.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on worker/child visits through the preexisting FACES system.
  • The expected performance benchmark for Phase I is 95% as defined that 95% of all children are seen by the worker as outlined in policy.
  • Weight: The weight given to this metric in Phase I is 25%. This is the weight given to the metric in calculating the overall score of contracted case management providers.

Metric - Reports of Child Abuse/Neglect in Foster Care

  • Definition: This measures the incidents of abuse and/or neglect reports to children in foster care.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on incidents of child abuse or neglect in foster care. To calculate this rate, the number of children who were in foster care during a 12-month period is divided by the number of substantiated reports, by any perpetrator during that same 12-month period multiplied by 100,000 for the rate of victimization.
  • The expected Phase I performance benchmark is .00967% or less of children in the care of the provider having a substantiated report of child abuse or neglect while in care of the provider.
  • Weight: The weight given to this metric in Phase I is 20%. This is the weight given to the metric in calculating the overall score of contracted case management providers.

Well-Being Domain

Metric - Parent/child visits completion to the extent that the visits are not contrary to the orders of the court

  • Definition: This measures the current requirement to facilitate at least one visit a month for each child for parents that are eligible to receive visits.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on through the preexisting FACES system.
  • The expected Phase I performance benchmark is 60%.
  • Weight: The weight given to this metric in Phase I is 0%. This is the weight given to the metric in calculating the overall score of contracted case management providers. The weight was determined to be 0% during Phase I implementation as the entry and data system does not allow for this to be easily examined. The Division and the Research and Evaluation Team will be utilizing the data gathered during Phase I on this metric to assess and refine the system’s ability to gather data on this metric so that a decision based on a year’s worth of data can drive future decision making on how data on this metric will be evaluated, benchmarked and weighted. The weight will be reexamined after Phase I implementation.

Metric – Healthy Child & Youth Exam (HCY/EPSDT) Completion

  • Definition: Every child is required to have a Healthy Child and Youth Exam within 30 days of entering into care which includes eye, hearing and dental examinations.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on timely HCY/EPSDT exam completion in the preexisting FACES System.
  • The expected performance benchmark for Phase I is 98% of children or more will have completed a HCY exam within the time periods specified in policy
  • Weight: The weight given to this metric in Phase I is 25%. This is the weight given to the metric in calculating the overall score of contracted case management providers.

Permanency Domain

Metric - Worker/Parent Visit Completion

  • Definition: This is measured by each parent having a minimum of one visit per month with the worker.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on worker/parent visit completion in the pre-existing FACES system
  • The expected performance benchmark in Phase I is 50%.
  • Weight: The weight given to this metric in Phase I is 15%. This is the weight given to the metric in calculating the overall score of contracted case management providers.

Metric – Re-entries into foster care

  • Definition: This measures children who have exited foster care who reentered care within 12 months of their exit from care.
  • Data Source: The Children’s Division will utilize data that the Division already collects and analyzes in the pre-existing FACES System
  • The expected performance benchmark for Phase I is 8.1% or lower of children who have exited foster care re-enter into foster care.
  • Weight: The weight given to this metric in Phase I is 20%. This is the weight given to the metric in calculating the overall score of contracted case management providers.

Service Domain

Metric – Caseload Changes for Foster Children

  • Definition: This measure looks at the average number of workers assigned for CD and FCCM for kids in foster care less than 12 months and over 12 months.
  • Data Source: The Children’s Division will utilize data that the Division already collects and analyzes in the pre-existing FACES System
  • The expected performance benchmark is currently undetermined. This has not been measured previously and the Research and Evaluation Team decided that it was appropriate to collect and analyze data for 3-6 months so that an informed, data driven a baseline may be established.
  • Weight – The weight given to this metric in Phase I is 0%. This is the weight given to the metric in calculating the overall score of contracted case management providers. The weight was determined to be 0% during Phase I implementation as the entry and data system does not allow for this to be easily examined. The Division and the Research and Evaluation Team will be utilizing the data gathered during Phase I on this metric to assess and refine the system’s ability to gather data on this metric so that a decision based on one year’s worth of data can drive future decision making on how data on this metric will be evaluated, benchmarked and weighted. The weight will be reexamined after Phase I implementation.

Phase I Evaluation Tools

The Children’s Division will utilize a two-part evaluation process to ensure accuracy and consistency of data collection: a Foster Care Case Management Dashboard and the federally required Child and Family Service Review (CFSR) process.

Foster Care Case Management Dashboard

The Foster Care Case Management Dashboard will display Missouri’s data by case management provider and by county each month. The same data and metrics will apply consistently to both the Children’s Division and its contracted case management agencies. This will allow for review of the metrics to determine areas of strength and improvement. Each agency’s leadership and quality teams, along with the Children’s Division Oversight Team, will review the data and create improvement plans as needed.

Child and Family Service Review

The Child and Family Service Review (CFSR) is a federally required tool for measuring Missouri’s child welfare services. The CSFR requires the Children’s Division to select a random sample of children in foster care for a detailed review. The CFSR case review tool is comprised of questions applied to this sample, which require the assessment of 18 items falling within the outcomes of safety, permanency, and child and family wellbeing.

Consumer Surveys

Beginning October 1, 2022, the division, the Research & Evaluation Team, and all providers will be required to use a standardized stakeholder feedback tool. This tool will collect data from stakeholders pertaining to the quantity, quality, and effectiveness of case management services provided by the division and its Foster Care Case Managers. The Children’s Division and contracted case management agencies will send consumer surveys to a sample selection of the following groups:

Data Analysis & Comparability

The research and evaluation tool will collect and report a uniform set of data and metrics for both the Children’s Division and private contracted case managers. The research and evaluation process requires the Children’s Division to evaluate all providers of case management services in a uniform, transparent, objective way.

Foster Care Case Management Contracts

State law requires the Children’s Division to enter into Foster Care Case Management Contracts with private agencies to provide foster care case management services. The payments to these contractors must include performance-based incentives using the evaluation tools discussed above.

Phase II Metrics

The proposed Phase Two metrics for each Domain are as follows:

Well-Being Domain

Metric - Residential – Placement of a child in a residential or institutional setting shall be in compliance with the requirements of federal and state law1

  • Definition: This metric examines placement of all children in foster care to examine the type of placement where the child resides.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on through the preexisting FACES system.
  • The expected performance benchmark is currently undetermined. This has not been measured previously with all placements, and the Research and Evaluation Team decided that it was appropriate to collect and analyze data so an informed, data driven a baseline may be established. 
  • Weight: The weight given to this metric in Phase I is 0%. This is the weight given to the metric in calculating the overall score of contracted case management providers. The weight was determined to be 0% during implementation as there are significant challenges within the system to examine positive and negative placement moves, as well as accurate analysis of the most appropriate types of placements for children. The Division and the Research and Evaluation Team will be utilizing the data gathered during Phase II on this metric to assess and refine the system’s ability to gather data on this metric so that a decision based on a year’s worth of data can drive future decision making on how data on this metric will be evaluated, benchmarked and weighted. The weight will be reexamined after Phase II implementation.

Metric – All case managers and supervisors successfully complete training in providing trauma informed and trauma based services2

  • Definition: All case managers and supervisors have completed Trauma Toolkit training.
  • Data Source: The Children’s Division will utilize data from the Electronic Learning Center where all training completion is managed.
  • The expected performance benchmark for Phase II is undetermined as this has not been measured across both Children’s Division and all case management contractors at the same time. Recent changes in availability to the Electronic Learning Center for contractors, as well as availability of the courses has affected the ability to determine the benchmark.  The Research and Evaluation Team decided that it was appropriate to collect and analyze data so an informed, data driven a baseline may be established. 
  • Weight: The weight given to this metric in Phase I is 0%. This is the weight given to the metric in calculating the overall score of contracted case management providers. The weight was determined to be 0% during implementation as there are significant challenges with determining if the system is reporting accurate information. Ongoing data evaluation will be needed to determine the final weight of this metric.

1 13 CSR 35-35.100(3)(E)2.C
2 13 CSR 35-35.100(3)(E)2.e.

Permanency Domain

Metric - Timely Achievement of the child’s court approved permanency plan3

  • Definition: This is measured by measuring the number of children who achieve their court approved permanency goal within the designated timeframe per the benchmark for each goal.
  • Data Source: The Children’s Division will utilize data that each provider is already required to report on permanency completion in the pre-existing FACES system.
  • The expected performance benchmark in Phase II is:
    • Reunification in 12 months or less
    • Guardianship in 18 months or less
    • Adoption in 24 months or less
  • Weight: The weight given to this metric in Phase II is 50%.  This is the weight given to the metric in calculating the overall score of contracted case management providers. Per RSMo 13 35-35.130 Contracted Foster Care Case Management Costs:
    • (C) For all contracts effective on or after April 1, 2022, the provisions of subsections (6)(A), (6)(B) and this subparagraph 6(C) shall apply. To receive an incentive the Contractor must first qualify to receive an incentive by exceeding the permanency performance goal for the region as specified in this subsection. If the Contractor qualifies for an incentive by exceeding the permanency performance goal for the region, then the Contractor will qualify to receive 50% of the incentive payment. To earn the remaining 50% of the incentive payment, the Contractor must meet the performance goals and outcomes established pursuant to 13 CSR 35-35.100 as they are phased in and as further provided in this subsection.4

3 13 CSR 35-35.100(3)(E)3.c.
4 13 CSR 35-35.130(6)(C)

Service Domain

Metric – Effective ratio of supervisors to supervision of case managers5

  • Definition: This measure looks the number of case management workers to supervisors.
  • Data Source: The Children’s Division will utilize data in the pre-existing FACES System. There are extreme challenges within this data set as this information is not easily extracted from the system.
  • The expected performance benchmark is currently undetermined. This has not been measured previously and the Research and Evaluation Team decided that it was appropriate to collect and analyze data so that an informed, data driven a baseline may be established, as well to make recommendations for the data collection system.
  • Weight – The weight given to this metric in Phase I is 0%. This is the weight given to the metric in calculating the overall score of contracted case management providers. The weight was determined to be 0% during Phase II implementation as the entry and data system does not allow for this to be easily examined. The Division and the Research and Evaluation Team will be utilizing the data gathered during Phase II on this metric to assess and refine the system’s ability to gather data on this metric so that a decision based on a years’ worth of data can drive future decision making on how data on this metric will be evaluated, benchmarked and weighted. The weight will be reexamined after Phase II implementation.

Metric – Cases returned to the Children’s Division due to catastrophic costs or court order for case management by Foster Care Case Management agencies6

  • Definition: This measure looks at the costs associated with cases returned to Children’s Division by the case management contractors.
  • Data Source: The Children’s Division will utilize data that the Division already collects and analyzes for the Foster Care Case Management contracts.
  • The expected performance benchmark is currently undetermined. This has not been measured previously and the Research and Evaluation Team decided that it was appropriate to collect and analyze data for 3-6 months so that an informed, data driven a baseline may be established.
  • Weight – The weight given to this metric in Phase I is 0%. This is the weight given to the metric in calculating the overall score of contracted case management providers. The weight was determined to be 0% during Phase II implementation as the entry and data system does not allow for this to be easily examined. IN addition, significant changes to medical coverage have significantly decreased the impact of these costs. The Division and the Research and Evaluation Team will be utilizing the data gathered during Phase II on this metric to assess and refine the system’s ability to gather data on this metric so that a decision based on one year’s worth of data can drive future decision making on how data on this metric will be evaluated, benchmarked and weighted. The weight will be reexamined after Phase II implementation.

5 13 CSR 35-35.100(3)(E)4.b.
6 13 CSR 35-35.100(3)(E)4.d.