ATTENTION: Notice of final publication of final phase I research and evaluation tools and metrics will be effective October 1, 2022. All foster care case management teams should review these tools and metrics and implement them by October 1, 2022.

No additional comments or changes will be made at this time to the published materials set forth in this notice. Pursuant to 13 CSR 35-35.100(3)(B), the Children’s Division published its proposed Phase I evaluation tool and metrics on April 1, 2022, and solicited comments from providers, stakeholders, and the public. The division received two comments regarding the proposed Stakeholder Feedback Tool. The Response and Evaluation Team met and agreed that the Stakeholder Feedback Tool required further development. The proposed Stakeholder Feedback Tool published by the division on April 1, 2022 will be used to collect data from stakeholders during Phase I, and a revised tool will be published in April 2023 to be proposed for use in Phase II.

All materials below are effective for use on October 1, 2022 by all case management providers.

You can submit any questions by email to CD.RESPONSEEVALTEAM@dss.mo.gov or contact the Children’s Division’s Operations Project Manager, Kayla Ueligger, at 816-387-2036.

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

Pursuant to 13 CSR 35-35.100(3)(E), the Children’s Division must implement its Phase II metrics and performance goals no later than October 1, 2023. The Children’s Division anticipates publishing its proposed Phase II evaluation tool, metrics, and stakeholder feedback tool by April 1, 2023 to solicit comments from stakeholders in advance of Phase II implementation. The division encourages stakeholders to submit comments, concerns, and questions concerning Phase I implementation to the division at CD.RESPONSEEVALTEAM@dss.mo.gov so that such feedback may be considered in preparing the proposed Phase II evaluation tool, metrics, and stakeholder feedback tool.