A performance audit of the Department of Economic Security Foster Care Program 
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STATE OF ARIZONA
OFFICE OF THE
AUDITOR GENERAL
A PERFORMANCE AUDIT
OF THE
DEPARTMENT OF ECONOMIC SECURITY
FOSTER CARE PROGRAM
OCTOBER 1980
A REPORTTO THE
ARIZONA STATE LEGISLATURE
RE PORT 80- 5
DOUGLAS R. NORTON. CPA
AUDITOR GENERAL
STATE OF ARIZONA
OFFICE OF THE
AUDITOR GENERAL
October 2, 1980
Members of the Arizona L e g i s l a t u r e
The Honorable Bruce B a b b i t t , Governor
Transmitted herewith is a r e p o r t o f t h e Auditor General, A Performance
Audit of t h e Department of Economic Security - F o s t e r Care Program. This
r e p o r t is i n response t o t h e June 19, 1979, r e s o l u t i o n of t h e J o i n t
L e g i s l a t i v e Budget Committee.
The blue pages present a summary of t h e r e p o r t ; a response from the
Department of Economic Security is found on t h e yellow pages preceding the
appendices.
My s t a f f and I w i l l be pleased t o d i s c u s s o r c l a r i f y items i n t h e r e p o r t .
Respectfully submitted,
Douglas R. Norton
Auditor General
S t a f f : Gerald A. S i l v a
William Thomson
Steve Wallace
Martha B. R a w l s
Marsha Wallace
Sylvia Forte
Enclosure
LEGISLATIVE SERVICES WING 0 SUITE 200 STATE CAPITOL PHOENIX. ARIZONA 85007 255- 4385
O F F I C E OF THE AUDITOR GENERAL
A PERFORMANCE AUDIT OF
THE DEPARTMENT OF ECONOMIC SECURITY
FOSTER CARE PROGRAM
A REPORT TO THE
ARIZONA STATE LEGISLATURE
REPORT 80- 5
TABLE OF CONTENTS
SUMMARY
INTRODUCTION AND BACKGROUND
FINDINGS
FINDING I
Foster c a r e caseworkers do not comply with Department
of Economic S e c u r i t y ( DES) p o l i c i e s and procedures
regarding prompt and proper placement and monitoring of
f o s t e r c h i l d r e n . A s a r e s u l t , many c h i l d r e n simply
g e t l o s t i n t h e f o s t e r c a r e system.
CONCLUSION
RECOMMENDATION
FINDING I1
An apparent shortage of f o s t e r homes is r e s u l t i n g
i n p o t e n t i a l l y dangerous s i t u a t i o n s f o r some f o s t e r
c h i l d r e n and increased c o s t s t o t h e S t a t e f o r emergency
r e c e i v i n g c a r e .
CONCLUSIONS
RECOMMENDATIONS
FINDING I11
I f DES were as e f f e c t i v e a s o t h e r s t a t e s i n c o l l e c t i n g
AFDC- FC and natural- parent child- support payments, S t a t e
revenues could i n c r e a s e by a n e s t i m a t e d $ 1.3 m i l l i o n a
year.
CONCLUSIONS
RECOMMENDATIONS
FINDING I V
A lack of c o n t r o l over the f o s t e r c a r e payment system
has r e s u l t e d i n d u p l i c a t e payments, payments i n wrong
amounts, uncollected overpayments and inadequate
monitoring of c o n t r a c t s .
Page
1
7
CONCLUSIONS
RECOMMENDATIONS
FINDING V
Page
7 3
Improvements a r e needed i n t h e f o s t e r care
management information system.
CONCLUSION
RECOMMENDATIONS
OTHER PERTINENT INFORMATION
Average Stay i n Foster Care f o r Analyzed Cases was 4.5
Years.
DES Has L i t t l e Control over Many Foster Care Expenditures.
A Review of Arizona's R e s i d e n t i a l Treatment Centers.
Organizational Changes within ACYF Have Been Extensive.
Survey of ACYF Caseworkers, Supervisors and Current and
Former F o s t e r Parents
WRITTEN RESPONSE TO THE AUDITOR GENERAL'S REPORT 8 3
APPENDICES
APPENDIX I - Statewide Survey of Licensed Arizona Foster
Parents
APPENDIX I1 - Statewide Survey of Formerly Licensed Arizona
F o s t e r P a r e n t s
APPENDIX I11 - Statewide Survey of ACYF P r o f e s s i o n a l s
APPENDIX I V - Statewide Survey of ACYF D i r e c t Service
Supervisors
APPENDIX V - Case L i s t i n g of Missing, Incomplete o r
Conflicting Information
LIST OF TABLES
TABLE 1 - S t a t e Expenditures f o r Programs Administered by ACYF
f o r F i s c a l Years 1975- 76 Through 1979- 80
TABLE 2 - Reasons f o r Foster Care Placement Changes between
1975 and 1980
TABLE 3 - Ratio o f F o s t e r Homes t o Foster Children f o r Arizona
and Nine otner Western S t a t e s , July 1980
TABLE 4 - Number of Days Foster Children Remain i n Emergency
Receiving Care
TABLE 5 - Summary of Former F o s t e r P a r e n t s 1 Reasons f o r
Terminating T h e i r L i c e n s e s
TABLE 6 - A Comparison of Arizona AFDC- FC E l i g i b i l i t y Rules
With Ten other Western S t a t e s , December 1979
TABLE 7 - A Comparison of Arizona's and Utah's Assessment
and C o l l e c t i o n s f o r Natural- Parent Support during
F i s c a l Year 1978- 79
TABLE 8 - Comparison of Federal Standards f o r a Foster Care
Information System t o the C a p a b i l i t i e s of t h e Statewide
Tracking System a s of August 1980
TABLE 9 - Length of Time i n the Foster Care System f o r t h e 206
C h i l d r e n ' s Cases Analyzed
TABLE 10 - County Juvenile Court Foster Care Allocations and
Expenditures f o r F i s c a l Year 1979- 80
Page
8
2 2
3 4
4 2
4 3
52
SUMMARY
The O f f i c e o f t h e Auditor General has conducted a performance a u d i t of the
Department of Economic S e c u r i t y - Foster Care Program i n response t o a
June 19, 1979, r e s o l u t i o n of the J o i n t L e g i s l a t i v e Budget Committee. The
performance a u d i t r e p o r t presented h e r e i n was prepared under t h e a u t h o r i t y
vested i n the Auditor General by Arizona Revised S t a t u t e s ( A. R. S.)
$ 41- 1279 e t seq.
Foster care has been defined a s " . . . s u b s t i t u t e parenting and nurturance,
which is provided on a f e e f o r s e r v i c e b a s i s , t o c h i l d r e n who cannot o r
should not l i v e with t h e i r n a t u r a l f a m i l i e s f o r a period of time.. ." I n
t h e s t r i c t e s t sense, f o s t e r c a r e s e r v i c e s include placement and casework
s e r v i c e s , and l i c e n s i n g and monitoring of such f o s t e r c a r e f a c i l i t i e s a s
family f o s t e r homes, group f o s t e r homes and r e s i d e n t i a l treatment
c e n t e r s . However, s i n c e f o s t e r care is viewed as one p a r t o f a continuum
of s e r v i c e s t o c h i l d r e n , s e v e r a l o t h e r functions r e l a t e importantly t o
f o s t e r c a r e , including c h i l d p r o t e c t i v e s e r v i c e s and adoption s e r v i c e s .
The f o s t e r c a r e program is administered by the Administration f o r
Children, Youth and Families ( ACYF), a bureau i n t h e D i v i s i o n o f Aging,
Family and Children S e r v i c e s w i t h i n t h e Department of Economic S e c u r i t y
( DES). Approximately 1,900 c h i l d r e n c u r r e n t l y receive f o s t e r c a r e
s e r v i c e s through ACYF and 700 more receive s e r v i c e s from o t h e r agencies
and a r e paid through ACYF. I n f i s c a l year 1979- 80, S t a t e payments f o r
c a r e of t h e s e c h i l d r e n t o t a l e d more than 18 m i l l i o n d o l l a r s .
In reviewing the Foster Care Program we found t h a t ACYF g e n e r a l l y has
e s t a b l i s h e d a good system o f p o l i c i e s t o govern t h e program's operations.
Nevertheless, we found t h a t some s i g n i f i c a n t problems e x i s t within the
program and t h a t these problems primarily a r i s e because: a ) e x i s t i n g
p o l i c i e s a r e not followed, and/ or b) the f o s t e r c a r e d a t a system c o n t a i n s
i n a c c u r a t e and incomplete d a t a . The problems we i d e n t i f i e d a r e addressed -
i n f i v e major f i n d i n g s :
1. Foster c a r e caseworkers do not comply with DES p o l i c i e s and
procedures regarding prompt and proper placement and monitoring 4
of f o s t e r c a r e c h i l d r e n . A s a r e s u l t , many c h i l d r e n simply g e t
l o s t i n the f o s t e r c a r e system. ( page 11)
2. An apparent shortage of f o s t e r homes is r e s u l t i n g i n p o t e n t i a l l y
dangerous s i t u a t i o n s f o r some f o s t e r c h i l d r e n and increased c o s t s
t o the S t a t e f o r emergency r e c e i v i n g c a r e . ( page 33)
3. I f DES were a s e f f e c t i v e a s other s t a t e s i n c o l l e c t i n g AFDC- FC
and natural- parent child- support payments, S t a t e revenues could
i n c r e a s e by a n e s t i m a t e d $ 1.3 m i l l i o n a year. ( page 51)
4. A lack of c o n t r o l over the f o s t e r c a r e payment system has
r e s u l t e d i n d u p l i c a t e payments, payments i n wrong amounts,
uncollected overpayments and inadequate monitoring of c o n t r a c t s .
( page 63)
5. Improvements a r e needed i n the f o s t e r c a r e management information
system. ( page 73)
The r e p o r t c o n t a i n s i n f o r m a t i o n r e g a r d i n g l e n g t h of s t a y i n f o s t e r c a r e ,
DES c o n t r o l over f o s t e r c a r e expenditures, a review of Arizona's
r e s i d e n t i a l treatment c e n t e r s , DES r e o r g a n i z a t i o n and Auditor General
surveys of ACYF caseworkers, s u p e r v i s o r s and c u r r e n t and former f o s t e r
parents.
It is recommended t h a t :
- Supervisors review cases every t h r e e months t o determine i f :
1) placement plans a r e developed i n a timely manner and
implemented properly, 2) home v i s i t s a r e made as o f t e n a s
r e q u i r e d , 3) case records a r e maintained properly, and 4)
c h i l d r e n change placements only when necessary and a r e prepared
adequately f o r t h e change. When these procedures a r e not
followed, a p p r o p r i a t e ' d i s c i p l i n a r y a c t i o n should be
a
administered. ( page 30)
- D i s t r i c t Program Managers review cases on a random b a s i s t o
ensure t h a t s u p e r v i s o r s monitor t h e i r cases properly. When
Program Managers determine t h a t s u p e r v i s o r s a r e not properly
reviewing t h e i r c a s e s , a p p r o p r i a t e d i s c i p l i n a r y a c t i o n should be
administered. ( page 31)
- A manpower study be commissioned t o determine i f DZS caseworkers
have adequate time t o follow a l l procedures required of them. In
a d d i t i o n , t h e study should determine i f DES uses case a i d s ,
c l e r i c a l s t a f f and o u t s i d e p r o f e s s i o n a l s t o f u l l advantage.
( page 31)
- DES take the following s t e p s t o help reduce f o s t e r parent
turnover and improve recruitment of f o s t e r p a r e n t s : ( page 49)
1. D i r e c t a d m i n i s t r a t o r s t o implement management a c t i o n s ,
including spot- checks of case f i l e s t o ensure t h a t scheduled
worker c o n t a c t s a r e made with f o s t e r parents and t h a t f o s t e r
parents a r e consulted i n planning f o r f o s t e r c h i l d r e n .
2. Review t h e need f o r , and f e a s i b i l i t y o f , a telephone h o t l i n e
f o r f o s t e r parents.
3. Monitor and analyze f o s t e r home turnover d a t a p e r i o d i c a l l y .
4. A s a p a r t of t h e recruitment program, c o l l e c t d a t a as t o why
persons who i n q u i r e about f o s t e r p a r e n t i n g d r o p out a f t e r
i n q u i r y . Also, c o l l e c t d a t a as t o whether persons who drop
out would be i n t e r e s t e d i n f o s t e r parenting a t a l a t e r d a t e
and e s t a b l i s h a system f o r contacting these persons again.
- ACYF s u p e r v i s o r s r e c e i v e a d d i t i o n a l t r a i n i n g on t h e proper
procedures f o r i d e n t i f y i n g and r e f e r r i n g AFDC- FC c a s e s , preparing
p a r e n t a l assessments and completing claims f o r S o c i a l S e c u r i t y ,
Supplemental Security Income ( SSI) and Veterans1 Administration
( VA) b e n e f i t s , and the s u p e r v i s o r s t h e n r e t r a i n t h e i r caseworkers
i n these procedures and review each case i n t h e i r u n i t s every s i x
months t o ensure t h e procedures a r e followed c o r r e c t l y . ( page 60) -
- Assistance Payments workers receive t r a i n i n g on t h e proper
procedures f o r determining AFDC- FC e l i g i b i l i t y and t h a t
Assistance Payments d e f i n e the d a t e of a p p l i c a t i o n f o r AFDC- FC a s
the d a t e of r e f e r r a l f o r e l i g i b i l i t y determination so DES can
claim the maximum amount of AFDC- FC a v a i l a b l e . ( page 60)
- Delinquent f o s t e r c a r e p a r e n t a l assessments be c o l l e c t e d by t h e
Child Support Enforcement Administration. ( page 61)
- Foster c a r e cases be reviewed f o r possible e l i g i b i l i t y f o r S o c i a l
S e c u r i t y , SSI and VA b e n e f i t s . ( page 61)
- DES i n c o r p o r a t e t h e following c o n t r o l s i n t o its payment system:
( page 72)
1. Require itemized b i l l i n g s from agency providers of
r e s i d e n t i a l treatment, s h e l t e r c a r e and emergency receiving
care. Such b i l l i n g s e i t h e r could be incorporated as t h e
input documents t o g e n e r a t e payments through t h e Statewide
Tracking System or reconciled a g a i n s t d a t a c u r r e n t l y entered
i n t o the tracking system.
2. Make payments through the tracking system whenever
possible. I f payment is made by claim, cross- check such
payment a g a i n s t the tracking system and o t h e r claims paid
the same provider.
3. Recover overpayments owed t h e S t a t e by withholding the
amount of overpayment from subsequent payments t o the same
provider.
4. Monitor the bed- space u t i l i z a t i o n r a t e on block- purchase
c o n t r a c t s monthly and take a p p r o p r i a t e a c t i o n t o i n v e s t i g a t e
and, i f necessary, seek t o r e n e g o t i a t e c o n t r a c t s on which
u t i l i z a t i o n is low.
- By July 1, 1981, DES submit a r e p o r t t o t h e J o i n t L e g i s l a t i v e
Budget Committee ( JLBC) d e t a i l i n g improvements made t o the
information- generating c a p a b i l i t i e s of t h e Statewide Tracking
System. Upon r e c e i p t of the DES r e p o r t s , the JLBC consider
d i r e c t i n g t h e O f f i c e o f the Auditor General t o r e e v a l u a t e the
Statewide Tracking System and submit a r e p o r t t o the JLBC by
January 1, 1982. ( page 78)
- DES conduct a thorough examination of information i n the
Statewide Tracking System and make a p p r o p r i a t e c o r r e c t i o n s .
( page 78)
- The Director of DES i s s u e a memorandum t o f o s t e r c a r e
s u p e r v i s o r s , caseworkers and d i s t r i c t employees s t r e s s i n g the
importance o f t h e Statewide Tracking System and d i r e c t i n g them t o
e x e r c i s e t h e utmost d i l i g e n c e i n preparing and submitting
information t o the system. ( page 78)
INTRODUCTION AND BACKGROUND
The Office of the Auditor General has conducted a performance a u d i t of t h e
Department of Economic S e c u r i t y - Foster Care Program i n response t o a
June 19, 1979, r e s o l u t i o n of t h e J o i n t L e g i s l a t i v e Budget Committee. The
performance a u d i t r e p o r t presented herein w a s prepared under t h e a u t h o r i t y
vested i n the Auditor General by Arizona Revised S t a t u t e s ( A. R. S.)
$ 41- 1279 e t seq.
Foster c a r e has been defined as ' I . . . s u b s t i t u t e parenting and nurturance,
which is provided on a f e e f o r s e r v i c e b a s i s , t o c h i l d r e n who cannot o r
should not l i v e with t h e i r n a t u r a l f a m i l i e s f o r a period of time.. ." I n
the s t r i c t e s t sense, f o s t e r c a r e s e r v i c e s include placement and casework
s e r v i c e s , and l i c e n s i n g and monitoring of such f o s t e r c a r e f a c i l i t i e s a s
family f o s t e r homes, group f o s t e r homes and r e s i d e n t i a l treatment
c e n t e r s . However, s i n c e f o s t e r c a r e is viewed a s one p a r t o f a continuum
of s e r v i c e s t o c h i l d r e n , s e v e r a l other functions r e l a t e importantly t o
f o s t e r c a r e , including c h i l d p r o t e c t i v e s e r v i c e s and adoption s e r v i c e s .
The f o s t e r c a r e program is administered by t h e Administration f o r
Children, Youth and Families ( ACYF), a bureau i n t h e Division of Aging,
Family and Children Services within the Department of Economic S e c u r i t y
( DES). Approximately 1,900 c h i l d r e n c u r r e n t l y r e c e i v e f o s t e r c a r e
s e r v i c e s through ACYF and 700 more receive f o s t e r c a r e s e r v i c e s from o t h e r
agencies and a r e paid through ACYF.
Table 1 shows Arizona's expenditures f o r programs administered by ACYF f o r
t h e past f i v e years. The l i n e item e n t i t l e d F o s t e r Care Program c o n s i s t s
of the a c t u a l payments t o such f o s t e r c a r e f a c i l i t i e s a s family f o s t e r
homes, group homes, i n s t i t u t i o n s and r e l a t e d s e r v i c e s .
TABLE 1
STATE EXPENDITURES FOR PROGRAMS ADMINISTERED BY
ACYF FOR FISCAL YEARS 1975- 76 THROUGH 1979- 80
1975- 76
Actual
FTE* p o s i t i o n s 492.5
Operating Budget
Personal s e r v i c e s $ 4,472,300
Employee- related
expenditures 614,200
Professional &
o u t s i d e s e r v i c e s 162,700
Travel:
In- State 222,100
Out- of- State 10,200
Other operating
expenditures 401,300
Equipment 73,500
Operating s u b t o t a l 5,956,300
CMDP* * * 2,436,900
FOSTER CARE PROGRAM 8,661,200
Informational & r e f e r r a l
s e r v i c e s 48,600
Child s h e l t e r c a r e 311,500
Family planning 52,300
Day c a r e 1,029,700
Manpower s e r v i c e s 236,200
Adoption subsidy - 0 -
Child p r o t e c t i v e
s e r v i c e - 0-
1976- 77 1977- 78 1978- 79 1979- 80
Actual Actual Actual Estimatedn***
* Full- time equivalent.
** These l i n e items now a r e funded from t h e DES D i r e c t o r ' s Office.
*** Comprehensive Medical and Dental Program.
**** The f i s c a l year 1979- 80 estimates r e f l e c t a t r a n s f e r of State- funded
FTE postions t o Federal funding.
In reviewing the Foster Care Program we found t h a t ACYF generally has
e s t a b l i s h e d a good system of p o l i c i e s t o govern the program's operations.
Nevertheless, we found t h a t some s i g n i f i c a n t problems e x i s t within the
program and t h a t these problems primarily a r i s e because: a) e x i s t i n g
p o l i c i e s a r e not followed, and/ or b) the f o s t e r c a r e d a t a system c o n t a i n s
i n a c c u r a t e and incomplete d a t a . The problems we i d e n t i f i e d a r e addressed
i n f i v e major f i n d i n g s :
1. Foster care caseworkers d o n o t comply with DES p o l i c i e s and
procedures regarding prompt and proper placement and monitoring
of f o s t e r c a r e c h i l d r e n . A s a r e s u l t , many c h i l d r e n simply g e t
l o s t i n the f o s t e r c a r e system.
2. An apparent shortage of f o s t e r homes is r e s u l t i n g i n p o t e n t i a l l y
dangerous s i t u a t i o n s f o r some f o s t e r c h i l d r e n and increased c o s t s
t o the S t a t e f o r emergency receiving care.
3. I f DES were as e f f e c t i v e a s o t h e r s t a t e s i n c o l l e c t i n g AFDC- FC
and natural- parent child- support payments, S t a t e revenues could
i n c r e a s e by a n e s t i m a t e d $ 1.3 m i l l i o n a year.
4. A lack of c o n t r o l over the f o s t e r c a r e payment system has
r e s u l t e d i n d u p l i c a t e payments, payments i n wrong amounts,
uncollected overpayments and inadequate monitoring of c o n t r a c t s .
5. Improvements a r e needed i n the f o s t e r c a r e management information
system.
The Office of the Auditor General expresses its g r a t i t u d e t o the D i r e c t o r
of the Department of Economic Security and h i s s t a f f f o r t h e i r
cooperation, a s s i s t a n c e and c o n s i d e r a t i o n d u r i n g t h i s a u d i t .
FINDING I
FOSTER CARE CASEWORKERS DO NOT COMPLY WITH DEPARTMENT OF ECONOMIC SECURITY
( DES) POLICIES AND PROCEDURES REGARDING PROMPT AND PROPER PLACEMEN'I AND
MONITORING OF FOSTER CARE CHILDREN. AS A RESULT MANY CHILDREN SIMPLY GET
LOST I N THE FOSTER CARE SYSTEM.
The main g o a l s of the f o s t e r care system, a s summarized from t h e DES
s o c i a l s e r v i c e s manual, a r e t o :
- Prevent, reduce o r eliminate dependency, *
- Prevent or remedy n e g l e c t , abuse o r e x p l o i t a t i o n of c h i l d r e n ,
- Preserve, r e h a b i l i t a t e o r r e u n i t e f a m i l i e s , and
- Prevent o r reduce i n a p p r o p r i a t e i n s t i t u t i o n a l c a r e by providirg
other forms of l e s s - i n t e n s i v e c a r e .
To achieve these g o a l s t h e following o b j e c t i v e s should be met.
1. Enable c h i l d r e n who cannot remain i n t h e i r own homes t o receive
c a r e , p r o t e c t i o n and t r a i n i n g i n a s u b s t i t u t e l i v i n g arrangement.
2. Develop a permanent plan f o r the c h i l d r e n .
Although DES s t r e s s e s proper c a r e and permanency f o r f o s t e r c h i l r e n , our
a u d i t of the Foster Care Program disclosed t h a t these g o a l s and o b j e c t i v e s
a r e not being achieved.
* According t o A. R. S. $ 8- 201.10 a dependent c h i l d is one who is
adjudicated by t h e j u v e n i l e court t o be i n need of proper and
e f f e c t i v e p a r e n t a l c a r e and c o n t r o l .
Our o f f i c e reviewed 82 f o s t e r care* cases involving 206 c h i l d r e n . This
review revealed t h a t :
1. Permanent placement plans a r e not developed i n a timely manner
and a r e not implemented properly.
2. Children within the f o s t e r c a r e system a r e denied a s e n s e of
permanency because they change placements so often.
3. Foster c a r e caseworkers d o n o t make home v i s i t s as o f t e n a s
required nor do they document v i s i t s .
4. Case records i n d i c a t e s e r i o u s information gaps, c o n f l i c t i n g
information and i n c o n s i s t e n t organization.
These f a i l u r e s have r e s u l t e d i n numerous i n s t a n c e s of c h i l d r e n s i a p l y
g e t t i n g l o s t i n the f o s t e r c a r e system, with l i t t l e e f f o r t made by f o s t e r
care caseworkers t o c o r r e c t t h e s i t u a t i o n .
PERMANENT PLACEMENT PLANS ARE
NOT DEVELOPED OR IMPLEMENTED PROPERLY
The DES S o c i a l Services Manual s t a t e s t h a t it is the caseworker's
r e s p o n s i b i l i t y t o :
ItDevelop( s) placement plan f o r c h i l d within first t h r e e
months of i n i t i a l placement d i r e c t e d t o one of the
following g o a l s :
" 1. Return t o n a t u r a l p a r e n t s / l e g a l guardians,
" 2. Placement with other s u i t a b l e r e l a t i v e s ,
" 3. Adoption, o r
" 4. Permanent f o s t e r care. "
* For our a u d i t purposes, f o s t e r c a r e includes placement with f o s t e r
- a
p a r e n t s , i n s t i t u t i o n s , r e l a t i v e s and emergency receiving homes, a s
well a s unsuccessr'ul attempts t o r e u n i t e c h i l d r e n with t h e i r n a t u r a l
parents.
Adequate permanent placement plans a r e important because they c l e a r l y
enumerate t h e s t e p s necessary t o reach the c h i l d ' s u l t i m a t e placement goal
and e s t a b l i s h time parameters f o r achieving both s t e p s and goals. In
a d d i t i o n , a good permanent placement plan properly monitors a f o s t e r c a r e
case i n t h a t i t provides s p e c i f i c progress benchmarks a g a i n s t which a c t u a l
c a s e p r o g r e s s can be measured.
Our a n a l y s i s of f o s t e r c a r e case f i l e s revealed t h a t proper permanent
placement plans a r e n e i t h e r developed nor implemented a s required. For
example, the following noncompliances with the DES s o c i a l s e r v i c e s manual
were i d e n t i f i e d .
1. I n more than two- thirds of the cases reviewed, placement plans
were not e s t a b l i s h e d within t h r e e months of i n i t i a l placement,
2. F o s t e r p a r e n t s o f t e n a r e not involved i n the development of
placement plans, and
3. Placement plans have not been properly monitored and/ or e f f o r t s
t o achieve t h e plans have not been documented.
These noncompliances, combined with frequent caseworker assignment
changes," have r e s u l t e d i n c h i l d r e n remaining i n f o s t e r c a r e f o r long
periods of time with no a p p a r e n t p r o g r e s s made toward implementing t h e i r
placement goals.
-
* Caseworker assignment changes i n c l u d e t h o s e caused by caseworker
turnover as well a s a d m i n i s t r a t i v e caseworker charges.
Permanent Placement Plans Are
Not Developed i n a Timely Manner
Our review i n d i c a t e d t h a t permanent placement plans were not developed i n
t h e first t h r e e months of placement i n more than two- thirds of t h e cases
for which we could determine t h e f i r s t placement d a t e and the d a t e of the
i n i t i a l placement plan." Hhile t h e r e has been some improvement i n t h i s
a r e a during f i s c a l years 1978- 79 and 1979- 80, permanent plans still were
not developed within t h e f i r s t t h r e e months of placement f o r h a l f the
cases opened during t h a t period.
The following two cases demonstrate t n e adverse e f f e c t s of permanent
placement plans not being developed i n a timely manner.
CASE I
A one- and- a- half- year- old c h i l d was taken from her p a r e n t s i n May 1977
because o f n e g l e c t . The placement goal was t o r e t u r n t h e c h i l d t o the
p a r e n t s , but no placement plan was developed t o accomplish t h a t goal f o r
more than two years. When a placement plan f i n a l l y was developed i n June
1979, the Foster Care Review Board** disagreed with the plan and
recommended adoption as an a l t e r n a t i v e placement goal. Subsequently, the
c h i l d ' s year- old s i s t e r a l s o was removed from the p a r e n t s i n October 1979,
because o f s e v e r e n e g l e c t . A s of January 17, 1980, the Foster Care
Program had not i n i t i a t e d a severance process** x or developed a plan f o r
adoption of t h e two c h i l d r e n d e s p i t e t h e parents1 demonstrated
unwillingness and i n a b i l i t y t o c a r e f o r them.
* Such d e t e r m i n a t i o n s could not be made i n many c a s e s because of a
pervasive absence of adequate case documentation.
111
** The Foster Care Review Board was e s t a b l i s h e d by the L e g i s l a t u r e i n
1979 t o review o b j e c t i v e l y f o s t e r c a r e cases i n which c h i l d r e n a r e
i n c a r e f o r l o n g e r t h a n s i x months and t o present t h e i r f i n d i n g s t o
the j u v e n i l e c o u r t .
*** A severance process is a means t o determine i f the parent- child
r e l a t i o n s h i p should be permanently terminated and t h e c h i l d made
a v a i l a b l e f o r adoption.
CASE 2
A brother and s i s t e r were v o l u n t a r i l y placed i n t o f o s t e r c a r e by t h e i r
mother i n July 1976 because they were severely handicapped emotionally. A
dependency p e t i t i o n * was f i l e d so they could remain i n f o s t e r c a r e . The
placement goal f o r the c h i l d r e n was t o r e t u r n them t o t h e i r p a r e n t , but a
f o s t e r c a r e caseworker did n o t develop a placement plan u n t i l April 1979,
nearly t h r e e years l a t e r . The Foster Care Program did l i t t l e t o help
r e u n i t e t h e c h i l d r e n with t h e i r mother u n t i l t h e placement plan was
developed . However, once t h e placement plan was developed, the mother
received counseling and was allowed t o v i s i t the c h i l d r e n r e g u l a r l y .
It should be noted t h a t most of t h e f o s t e r c a r e c h i l d r e n who r e t u r n t o
t h e i r p a r e n t s do so within t h e first y e a r o f placement i n f o s t e r c a r e .
Thus, f a i l u r e t o plan promptly f o r t h e r e u n i t i n g of parent and c h i l d , ' o r
an a l t e r n a t i v e such a s adoption, simply i n c r e a s e s t h e l i k e l i h o o d of a
c h i l d ' s remaining i n the f o s t e r c a r e system.
Caseworkers Do Not Involve Foster
Parents i n Developing Placement Plans
According t o t h e DES S o c i a l Services Manual, f o s t e r c a r e caseworkers a r e
required t o :
" Confer( s) with n a t u r a l p a r e n t s , f o s t e r c a r e p r o v i d e r s ,
c h i l d when a p p r o p r i a t e and other involved p r o f e s s i o n a l s
t o develop placement plan.!!
An Auditor General survey o f f o s t e r p a r e n t s and a review of t h e case f i l e s
i n d i c a t e t h a t the policy is not adhered t o properly. Less than 40 percent
of t h e f o s t e r p a r e n t s responding t o t h e survey s t a t e d t h a t a f o s t e r c a r e
caseworker had involved them i n a placement plan. The same survey
revealed t h a t more than 95 percent o f t h e f o s t e r p a r e n t s f e l t t h a t t h e i r
caseworker should c o n s u l t with them i n e s t a b l i s h i n g t h e placement plan-
Comments from the surveyed f o s t e r - c a r e p a r e n t s included:
* A dependency p e t i t i o n is f i l e d with t h e j u v e n i l e court t o l e g a l l y
remove the c h i l d ' s dependency on t h e parents and place t h e c h i l d i n
the c a r e of the S t a t e .
- " How can a f o s t e r parent work with t h e c h i l d not
knowing o r having input t o t h e case plan?"
- " When a case plan is e s t a b l i s h e d f o r a c h i l d i n
our c a r e how does anyone expect the plan t o be
s u c c e s s f u l ? I cannot a s s i s t i n the unknown."
- " I ' v e given my input and i n t h e end, t h i n g s have
worked out well f o r the c h i l d but i n i t i a l l y , I
f e l t I was disregarded and ignored. My opinion
was not asked for." - We a r e considered troublemakers i f making
suggestions, and when asked t o assist with a
problem the s o c i a l worker instead w i l l remove t h e
c h i l d t o a d i f f e r e n t f o s t e r home."
- " I f e l t I was t r y i n g t o assist f o r t h e good of t h e
c h i l d but t h e caseworker told me t o ' b u t t o u t ' . "
The review of f o s t e r c a r e case f i l e s s i m i l a r l y i n d i c a t e d t h a t f o s t e r
parents a r e n o t c o n f e r r e d with when placement plans a r e developed. The
following cases i l l u s t r a t e what can and does happen when f o s t e r parents
a r e not involved i n developing a placement plan.
CASE I
In October 1974, a f o s t e r c a r e c h i l d gave b i r t h . The baby remained with
the child- mother u n t i l May 1975, at which time he was moved t o a separate
f o s t e r home, where he remained f o r almost two- and- a- half years. In
October 1977, t h e c h i l d was reunited with h i s mother; however, s i x months
l a t e r t h e c h i l d again was removed from h i s mother because of n e g l e c t . He
was placed back i n t h e f o s t e r home i n which he had stayed from May 1975
through October 1977. A t t h a t time t h e f o s t e r parents were t o l d t h a t the
goal was t o prepare t h e c h i l d f o r adoption.
Approximately eleven months l a t e r , the f o s t e r parents q u i t the F o s t e r Care
Program when they discovered t h a t t h e c h i l d ' s placement plan still was t o
r e t u r n the c h i l d t o h i s mother. Had the f o s t e r p a r e n t s been involved i n
developing the c h i l d ' s placement plan, the s i t u a t i o n could have been
avo id ed .
CASE I1
The two- month- old c h i l d of a heroin a d d i c t was placed i n a f o s t e r home i n
June 1976. The c h i l d changed f o s t e r homes i n April 1978 and remained i n
the second f o s t e r home, an emergency receiving home, u n t i l November 1979,
a t which time the f o s t e r parents refused t o help t h e c h i l d any longer.
According t o the f o s t e r p a r e n t s , they were told repeatedly by t h e f o s t e r
c a r e caseworker t h a t t h i s would be a temporary placement, and they were
concerned t h a t i f t h e y k e p t t h e c h i l d any longer, he would become too
attached t o the f o s t e r family. The f o s t e r parents were so upset about the
caseworker's f a i l u r e t o involve them i n t h e placement plan t h a t they
logged a complaint with the Governor's Office.
Placement Plans Are Not
Properly Monitored
The g u i d e l i n e s f o r monitoring placement plans and g o a l s a r e c l e a r l y s t a t e d
i n t h e S o c i a l Services Manual. The f o s t e r c a r e caseworker should:
" 1. Do( es) a complete review of progress toward t h e planned goal
every s i x months, including i n the n a r r a t i v e d i c t a t i o n the
following information:
" a. Present goal f o r t h e c h i l d ;
" b. Whether t h e g o a l has been reached;
" c. I f the goal has not been reached i n d i c a t e :
- Main f a c t o r s t h a t have hindered o r blocked progress, - Workers' a c t i v i t i e s of t h e past s i x months, and - Workers' plans f o r t h e next s i x months;
" d. I f t h e goal has been reached i n d i c a t e what, i f any,
necessary supportive s e r v i c e s a r e being provided t o
support the c u r r e n t case s t a t u s ; and
" e. Whether t h e r e is a need t o change the planned g o a l , and
why.
" 2 . Submit( s) case f o r review every s i x months beginning 18
months a f t e r d a t e of i n i t i a l placement, i f t h e planned goal
has not been reached, t o one of t h e following:
" a. Local o f f i c e s o c i a l s e r v i c e s manager;
" b. D i s t r i c t s o c i a l s e r v i c e s program manager; and
" c. Local o f f i c e s t a f f i n g , t o include:
- Supervisor,
- Permanent placement worker, - Foster c a r e s p e c i a l i s t , - Nonagency p r o f e s s i o n a l s involved i n t h e c a s e , and
- Others who may o f f e r input t o t n e placement plan."
The caseworker's supervisor should:
" Review( s) progress toward t h e goal with worker not l e s s than
once every t h r e e months and document t h i s review i n t h e case
record by i n i t i a l s o r w r i t t e n statement."
Our a n a l y s i s disclosed t h a t none of these functions were performed o r
documented properly f o r a l l of t h e case f i l e s analyzed. This f a i l u r e is
manifested i n t h e l e n g t h of time t h a t c h i l d r e n with a placement goal of
adoption remain i n f o s t e r c a r e with no apparent e f f o r t made t o achieve
t h a t goal. For example, 69 of the 206 c h i l d r e n i n our case a n a l y s i s had
a n a d o p t i o n goal during the period 1975 through 1979. O f these 69
c h i l d r e n , only t h r e e , l e s s than f i v e percent, had been adopted as of
December 1979; 14 had t h e i r placement goal of adoption cnanged; and 52
still had adoption as a placement goal. These 52 c h i l d r e n had r e t a i n e d a
goal of adoption f o r an average o f almost 500 days. F u r t h e r , only s i x of
the 52 c h i l d r e n had a severance hearing scheduled as of December 1979.
The following two c a s e s a r e i l l u s t r a t i v e of the s i t u a t i o n .
CASE I
Between February 1972 and April 1974, s i x b r o t h e r s and s i s t e r s were placed
i n f o s t e r c a r e because they were neglected by t h e i r mother. Adoption was
first mentioned i n the case record a s a placement goal i n 1976, and became
t h e o f f i c i a l goal f o r t h r e e o f t h e c h i l d r e n i n July 1977 only a f t e r it
became apparent t h a t t h e mother was not a b l e t o c a r e f o r them. A f o u r t h
c h i l d ' s placement goal was changed t o adoption i n February 1979. However,
a s of December 1979, no documented e f f o r t had been made by t h e caseworker
t o e f f e c t adoption. A s of December 1979, the F o s t e r Care Program hall not
even f i l e d a severance p e t i t i o n , t h e first of many s t e p s toward an
adoption.
CASE I1
Two s i s t e r s and a brother entered t h e Foster Care Program i n July 1977 and
were placed immediately with an adoptive family. The prospective adopting
p a r e n t s s e p a r a t e d , and the c h i l d r e n were removed i n December 1977. In
June 1978, t h e c h i l d r e n ' s mother relinquished her r i g h t s t o t h e c h i l d r e n ;
however, a s of January 1980, no e f f o r t had been made by f o s t e r c a r e t o
e f f e c t an adoption. For example, between June 1978 and January 1980, the
two c h i l d r e n had changed f o s t e r c a r e placements twice b u t t h e y had not
been placed with a n o t h e r p r o s p e c t i v e a d o p t i v e family.
These c a s e s demonstrate c l e a r l y t h a t the Foster Care Program must place
a d d i t i o n a l emphasis on monitoring placement plans t o ensure they a r e
c a r r i e d o u t e x p e d i t i o u s l y and t o determine why they a r e not i f they a r e
not.
Caseworker Reassignments
Slow Placement
A primary cause f o r placement p l a n s n o t being implemented promptly is t h e
high frequency o f f o s t e r - c a r e caseworker reassignment. Because of
numerous assignment changes, placement goals a r e f r e q u e n t l y changed by new
caseworkers thus causing the whole process t o start over. Foster c h i l d r e n
do not r e c e i v e a c o n t i n u i t y of care. The following examples a r e
r e p r e s e n t a t i v e .
CASE I
In May 1972, two s i s t e r s and a brother entered f o s t e r c a r e because t h e i r
mother neglected them. A placement goal of adoption was e s t a b l i s h e d i n
January 1973, and a severance p e t i t i o n was d r a f t e d i n p a r t . Adoption
remained t h e placement goal f o r the c h i l d r e n f o r s i x years. The Foster
Care Program made no documented attempts t o o b t a i n a severance. I n August
1979, a seventh caseworker was assigned t o the c h i l d r e n . The placement
goal was abruptly changed t o a r e t u r n of t h e c h i l d r e n t o t h e i r mother,
d e s p i t e t h e f a c t t h a t she had made i n f r e q u e n t c o n t a c t with t h e c h i l d r e n
from 1972 through 1979.
CASE I1
In February 1979, t h r e e s i s t e r s entered the Program a f t e r t h e i r mother had
abandoned them and t h e i r f a t h e r had admitted i n c e s t . A placement goal was
e s t a b l i s h e d t o r e t u r n t h e c h i l d r e n t o t h e i r p a r e n t s , b u t as of December
1979 an adequate placement plan had not been developed t o accomplish t h a t
goal. Between February 1979 and July 1979, f i v e d i f f e r e n t caseworkers
were assigned t o these c h i l d r e n . An August 1979 F o s t e r Care Review Board
r e p o r t s t a t e d t h a t caseworker turnover impeded progress of t h e case.
CHILDREN SUFFER LACK OF PERMANENCY BECAUSE
THEIR PLACEMENT IS CHANGED SO OFTEN
Because a p p r o p r i a t e f o s t e r homes simply a r e not a v a i l a b l e , " f o s t e r
c h i l d r e n i n Arizona o f t e n a r e moved from one i n a p p r o p r i a t e placement t o
another with no regard f o r permanency o r s t a b i l i t y . According t o
child- psychology s p e c i a l i s t s , a s well as the Child Welfare League of
America ( CWLA), a lack of permanency can be harmful t o c h i l d r e n .
Standards f o r Placement
Child- psychology s p e c i a l i s t s agree with the widely accepted p r i n c i p l e of
c o n t i n u i t y of c a r e . A s described by Goldstein e t a l , * * f o s t e r c a r e
placement d e c i s i o n s "... should safeguard the c h i l d ' s need f o r c o n t i n u i t y
of relationship^.'^ The a u t h o r s conclude t h a t "... each c h i l d placement be
f i n a l and unconditional and t h a t pending f i n a l placement a c h i l d must not
be s h i f t e d t o accord with each t e n t a t i v e d e c i s i o n . This means t h a t a l l
child placements, except when s p e c i f i c a l l y designed f o r b r i e f temporary
c a r e , s h a l l be a s permanent as the placement of a newborn with its
b i o l o g i c a l parents. ''
Placement Changes a r e Numerous
An a n a l y s i s of c h i l d r e n i n t h e f o s t e r c a r e system during 1975, who l e f t
the system p r i o r t o 1980, revealed t h a t on the average, f o s t e r c h i l d r e n
have a t l e a s t four placements while they a r e i n Arizona's Foster Care
System. The following f i g u r e summarizes o u r a n a l y s i s .
* See page 33 for a f u r t h e r d i s c u s s i o n of placement a v a i l a b i l i t y . -
** Goldstein, Freud and S o l n i t , Beyond the Best I n t e r e s t s of t h e Child
( New York: Free Press, 1973).
20
FIGURE 1
Number of Placements* P e r Child i n F o s t e r Care
From 1975 t o 1980
/ I 1 Placement \
1 4 O r More
3 Placements P
Figure 1 shows t h a t 42 p e r c e n t of t h e c h i l d r e n were i n f o u r o r more
placements s i n c e 1975. I n a d d i t i o n , n i n e p e r c e n t were i n ten o r more
placements. Seventy p e r c e n t o f t h e s e c h i l d r e n still were i n f o s t e r c a r e
at t h e time of our review and may change placements a g a i n .
Reasons f o r Changes I n d i c a t e
I n a p p r o p r i a t e Placement
The high number of f o s t e r c a r e placement changes m a n i f e s t s t h a t c h i l d r e n
o f t e n a r e put i n t o placements n o t a p p r o p r i a t e t o t h e i r needs. A review of
t h e reasons f o r f o s t e r c a r e placement changes from 1975 t o 1980 i n d i c a t e s
t h a t many f o s t e r c a r e placements do not meet t h e needs of t h e c h i l d r e n .
Table 2 shows t h e most f r e q u e n t c a u s e s of f o s t e r placement changes from
1975 t o 1980.
* I n i t i a l s h e l t e r - c a r e placements a r e excluded.
TABLE 2
REASONS FOR FOSTER CARE PLACEMENT CHANGES
BETWEEN 1975 AND 1980
Reason f o r Change Number Percentage
Foster home unable t o meet c h i l d ' s needs 8 8 20 %
Returned t o parent 7 3 17
Temporary placement 5 7 13
Runaway
Foster home closed - l i c e n s e changed
Placed with r e l a t i v e s
A l l o t h e r reasons
Total
Note t h a t t h e reason most o f t e n given f o r a placement change was t h a t the
f o s t e r parents were unable t o meet the needs of t h e c h i l d r e n ( 20
percent). The second most common reason was t h a t t h e c h i l d r e n were
returned t o t h e i r n a t u r a l parents ( 17 percent). While t h e l a t t e r appears
t o be an a p p r o p r i a t e placement change, it should be noted t h a t 70 percent
of the c h i l d r e n who a r e returned t o t h e i r n a t u r a l parents subsequently
re- enter t h e f o s t e r c a r e system. F u r t h e r , the Acting Program
Administrator of ACYF within DES s t a t e d t h a t :
- Caseworkers do not have the time t o do as much work a s should be
done t o prepare t h e c h i l d and t h e n a t u r a l family f o r t h e r e t u r n
home, and
- A t p r e s e n t , i f t h e c h i l d ' s ( f o s t e r c a r e ) dependency is
terminated, t h e r e is no planned followup t o ensure t h a t the
replacement ( with t h e p a r e n t s ) is working out because DES has no
l e g a l s t a t u s t o continue t o intervene.
The t h i r d most o f t e n c i t e d reason f o r a placement change was t h a t a f o s t e r
home became a v a i l a b l e . T h i s o c c u r s when a c h i l d o r i g i n a l l y is placed i n a
nonfoster home s e t t i n g ( such a s an emergency receiving home), s h e l t e r c a r e
or i n s t i t u t i o n , and subsequently is placed i n a f o s t e r home when one
becomes available."
CASEWORKERS DO NOT MAKE HOME VISITS AS OFTEN
AS REQUIRED AND DO NOT DOCUMENT VISITS
DES caseworkers do not make the minimum number of required v i s i t s t o
f o s t e r homes nor do they document v i s i t s when they a r e made. The DES
S o c i a l Services Manual s t a t e s t h a t , a t a minimum, f o s t e r homes should be
v i s i t e d every t h r e e months. Our case a n a l y s i s and a survey of f o s t e r
parents i n d i c a t e t h a t t h e s e requirements a r e not met. When caseworkers do
not make the required home v i s i t s t o see f o s t e r c h i l d r e n , abuse o r neglect
t h a t may be i n f l i c t e d on t h e f o s t e r c h i l d r e n e i t h e r w i l l not be detected
or w i l l go undetected f o r long periods. During 1979 and 1980, f o s t e r c a r e
caseworkers documented v i s i t s t o only 40 percent of t h e i r f o s t e r c h i l d r e n
every t h r e e months, a s required. I n a d d i t i o n , f o s t e r p a r e n t r e s p o n s e s t o
an Auditor General survey i n d i c a t e t h a t caseworkers did not make the
minimum required number of v i s i t s t o 30 percent of t h e f o s t e r c h i l d r e n .
MISSING OR CONFLICTING INFORMATION
AND INCONSISTENT ORGANIZATION
Foster c a r e case records d o n o t meet the requirements of t h e ACYF
operating manual or t h e s t a n d a r d s e s t a b l i s h e d by the Child Welfare League
of America ( CWLA). Many r e c o r d s c o n t a i n incomplete information o r exclude
information t h a t should be i n t h e case f i l e . I n a d d i t i o n , t h e r e a r e
i n s t a n c e s o f c o n f l i c t i n g information from two o r more sources within the
same case f i l e , and i n s t a n c e s of case f i l e s t h a t a r e improperly organized,
o f t e n r e s u l t i n g i n d u p l i c a t e paperwork.
* See page 39 f o r a f u r t h e r discussion of t h i s s i t u a t i o n .
F i n a l l y , f o s t e r home case records and Child P r o t e c t i v e S e r v i c e s ( CPS)
f i l e s , which contain information r e g a r d i n g a b u s i v e o r n e g l e c t i v e p r a c t i c e s
by f o s t e r p a r e n t s , a r e inadequate, precluding d e f i n i t e determination
t h a t : 1) f o s t e r c h i l d r e n a r e not abused or m a l t r e a t e d , and 2) i n s t a n c e s
of abuse a r e properly i n v e s t i g a t e d and resolved.
DES S o c i a l Services Manual Requirements and
Child Welfare League of America Standards
According t o the CWLA, f o s t e r c a r e case f i l e s have t h r e e main purposes:
1. To i n d i c a t e t h e goal s e t f o r t h e c h i l d , t h e s e r v i c e s t o be
provided and t h e e f f e c t i v e n e s s of those s e r v i c e s ,
2. To make it possible t o maintain a c o n t i n u i t y of s e r v i c e , and
3. To preserve e s s e n t i a l information.
The DES S o c i a l S e r v i c e s Manual p a r a l l e l s the CWLA standards. However,
f o s t e r c a r e case f i l e s a r e not maintained i n compliance with DES p o l i c i e s .
The S o c i a l Services Manual o u t l i n e s the c o n t e n t s and t h e manner i n which
f o s t e r c a r e case f i l e s should be organized. The manual s p e c i f i e s t h a t s i x
s e c t i o n s should be maintained within t h e case record, with m a t e r i a l s i n
each s e c t i o n f i l e d by d a t e .
The s i x s e c t i o n s a r e :
1. SSISf forms ( caseworker c o n t a c t s ) ,
2. Narrative summaries,
3. Court- related m a t e r i a l s ,
4. Medical/ professional m a t e r i a l s ,
5. Foster/ adoptive home s t u d i e s , and
6. Correspondence and a l l o t h e r forms.
* S o c i a l Services Information System.
The manual f u r t h e r r e q u i r e s t h a t progress e v a l u a t i o n s be completed
p e r i o d i c a l l y and f i l e d . A progress evaluation is defined a s :
' I . . . a formal review of a primary c l i e n t ' s s e r v i c e
plan. It is used t o determine i f progress was made
toward the a t t a i n m e n t o f an e a r l i e r s t a t e d o b j e c t i v e
and its r e l a t e d f e d e r a l goal. This a c t i o n e v a l u a t e s
t h e e f f e c t i v e n e s s of a case' s previous needs assessment
( a plan t o solve problems s y s t e m a t i c a l l y ) . In
a d d i t i o n , a Progress Evaluation may d e s c r i b e new a r e a s
t h a t r e q u i r e s e r v i c e a t t e n t i o n , o r show a need t o
continue, change o r c l o s e t h e primary c l i e n t ' s s e r v i c e
plan. ' I
Progress e v a l u a t i o n s a r e required a t l e a s t every s i x months f o r each
primary c l i e n t ' s s e r v i c e plan.
Incomplete or Missing Information
Our review disclosed t h a t approximately 70 percent o f f o s t e r - c a r e case
f i l e s contained incomplete information o r excluded information i n the
following a r e a s : placement d a t a , caseworker c o n t a c t s and development of
case g o a l s and plans.* Often, the forms and documents t h a t a r e included
i n the f i l e s a r e not signed or d a t e d , t h u s precluding development of a
complete f o s t e r c h i l d p r o f i l e and h i s t o r y . I n a d d i t i o n , a n automated
tracking system which the Foster Care Program developed t o monitor
movement of c h i l d r e n through t h e program f r e q u e n t l y c o n t a i n s d a t a t h a t
c o n f l i c t s w i t h i n f o r m a t i o n i n f o s t e r c a r e case f i l e s . * * The following
cases i l l u s t r a t e t h e lack of adequate documentation within f o s t e r c a r e
case f i l e s and c o n f l i c t i n g information i n the Statewide Tracking System
and f o s t e r c a r e case f i l e s .
* Appendix V is a d e t a i l e d l i s t i n g o f t y p e s o f information t h a t was -
missing i n the f i l e s f o r t h e 206 f o s t e r c h i l d r e n we analyzed.
** See page 73 f o r a complete d i s c u s s i o n o f t h i s t o p i c .
CASE I
On March 5, 1973, a brother and s i s t e r were placed i n f o s t e r care. A s of
December 1979, they have been returned t o t h e i r mother f i v e times and
placed i n a t l e a s t e i g h t d i f f e r e n t f o s t e r c a r e s e t t i n g s . The f o s t e r care
tracking system, however, showed the i n i t i a l f o s t e r c a r e placement d a t a
f o r t h e s e c h i l d r e n a s November 9, 1977, and t h e r e a r e no tracking system
forms f o r t h r e e o f s i x placements made between November 1978 and December
I n a d d i t i o n , t h e r e is no documentation i n t h e c h i l d r e n ' s case f i l e t o
i n d i c a t e why they were removed from t h e i r mother on two occasions.
F i n a l l y , many of t h e SSIS c o n t a c t s h e e t s i n t h e c h i l d r e n ' s case f i l e do
not c o n t a i n r e q u i r e d i n f o r m a t i o n such a s who was contacted o r what
t r a n s p i r e d during t h e c o n t a c t .
CASE I1
On March 22, 1978, seven s i b l i n g s entered f o s t e r care. Each c h i l d had a
s e p a r a t e c a s e f i l e and t h e n a r r a t i v e s e c t i o n s of each case f i l e were
incomplete. Between September 1979 and January 1980, only one document
was entered i n each o f t h e case f i l e s . That document was a court report
which i n d i c a t e d t h a t t h e placement goal f o r the c h i l d r e n had been changed
from r e t u r n t o parent t o adoption. However, t h e caseworker had not
developed a placement plan t o achieve t h e new goal.
CASE I11
Two s i s t e r s and a brother were placed i n f o s t e r c a r e i n i t i a l l y i n 1973;
however, the tracking system showed the i n i t i a l d a t e of placement as June
1978. Placement information i n the boy's case f i l e f o r t h e period
February 1979 through October 1979 was confused because d a t a i n t h e case
f i l e n a r r a t i v e , the f o s t e r c a r e tracking system and various correspondence
did n o t a g r e e . I n a d d i t i o n , r e p o r t s t o and from t h e Foster Care Review
Board ( FCRB) were not included i n t h e case f i l e . The FCRB had t o request
a d d i t i o n a l information when a r e p o r t d i d not c o n t a i n s u f f i c i e n t
information t o allow the Board t o evaluate the case.
Required information f r e q u e n t l y is missing from f o s t e r c a r e case records.
A primary cause of noncompliance appears t o be t h a t caseworkers a r e not
f a m i l i a r with the DES S o c i a l Services Manual. An Auditor General survey
of ACYF caseworkers showed t h a t more than 45 percent of t h e caseworkers do
not use t h e manual r e g u l a r l y .
The lack of information i n t h e f o s t e r c a r e c a s e r e c o r d s is s i g n i f i c a n t
p a r t i c u l a r l y i n view of the high frequency of f o s t e r c a r e caseworker
reassignment. It seems u n l i k e l y t h a t a new caseworker can serve a f o s t e r
c h i l d adequately i f important information about t h a t c h i l d is missing from
h i s case f i l e .
Information is Incomplete Concerning
Complaints Against F o s t e r P a r e n t s
We reviewed f o s t e r l i c e n s i n g worker records from D i s t r i c t I* and Child
P r o t e c t i v e S e r v i c e ( CPS) records t h a t a l l e g e d l y involved complaints
against f o s t e r parents. We i d e n t i f i e d :
- Sixteen apparent i n s t a n c e s of f o s t e r c h i l d r e n abuse o r neglect
B t h a t were reported t o CPS not r e f l e c t e d i n f o s t e r l i c e n s i n g
worker case f i l e s a s required.
- Eight apparent i n s t a n c e s of f o s t e r c h i l d r e n abuse o r neglect t h a t
were r e f l e c t e d i n f o s t e r l i c e n s i n g worker f i l e s but f o r which no
apparent CPS r e f e r r a l was made.
I n a d d i t i o n , a review of f o s t e r c a r e case f i l e s , l i c e n s i n g worker and CPS
records revealed s e v e r a l i n s t a n c e s of f o s t e r c a r e caseworker o r CPS
i n v e s t i g a t i o n s not r e s u l t i n g i n a p p r o p r i a t e a c t i o n when alleged abuse or
neglect was reported.
* Maricopa County.
The following cases a r e r e p r e s e n t a t i v e .
CASE I
On November 5, 1979, a c h i l d t o l d her caseworker t h a t her f o s t e r mother
h i t t h e o t h e r f o s t e r c h i l d r e n i n the home with a b e l t and t h a t she was
a f r a i d it would happen t o her. The home was not v i s i t e d u n t i l t h r e e weeks
l a t e r , on November 26, 1979, a t which time the f o s t e r mother admitted
spanking t h e c h i l d r e n . The worker arranged f o r t h e f o s t e r p a r e n t s t o
a t t e n d a workshop on a l t e r n a t i v e s t o physical punishment, which they did
- not a t t e n d ; y e t no f u r t h e r a c t i o n was taken. On January 4, 1980, the same
c h i l d who i n i t i a t e d t h e previous complaint now alleged sexual abuse. An
i n v e s t i g a t i o n on the same day s u b s t a n t i a t e d t h e a l l e g a t i o n and a l l f o s t e r
c h i l d r e n were removed. The f o s t e r f a m i l y ' s l i c e n s e was revoked i n July
1980.
CASE I1
On December 4, 1979, a n a t u r a l f a t h e r contacted a CPS caseworker and
s t a t e d t h a t h i s son was bruised as a r e s u l t o f a spanking administered by
the f o s t e r parents. The CPS worker t o l d t h e n a t u r a l f a t h e r t o take
photographs and t o w r i t e a l e t t e r explaining the circumstances. A p r i v a t e
agency f o s t e r c a r e caseworker, who did not l e a r n of t h e CPS r e f e r r a l u n t i l
January 2 , 1980, requested CPS t o conduct a n i n v e s t i g a t i o n . CPS contacted
the f o s t e r parents on January 12, 1980. In an attempt t o e x p l a i n why CPS
did not conduct an immediate i n v e s t i g a t i o n , t h e CPS caseworker assigned t o
t h e c a s e s t a t e d t h a t t h e n a t u r a l f a t h e r had a " . . . p r o c l i v i t y towards f a l s e
a l l e g a t i o n s and anger regarding CPS involvement."
CASE I11
On June 6, 1979, a CPS worker was told by a c h i l d t h a t her f o s t e r mother
was h i t t i n g t h e f o s t e r c h i l d r e n w i t h a s t i c k . A CPS i n v e s t i g a t i o n was
i n i t i a t e d the following day and t h e a l l e g a t i o n s were confirmed by t h e
f o s t e r mother, who a l s o admitted punishing the c h i l d r e n with an extension
cord. Only one o f t h e four c h i l d r e n i n the f o s t e r home was removed. On
June 15, 1979, the Foster Care Program recommended t h a t the home be
r e s t r i c t e d t o the f o s t e r c h i l d r e n a l r e a d y t h e r e . On September 20, 1979,
t h e f o s t e r f a t h e r was accused of abusing a f o s t e r c h i l d sexually. Six
days l a t e r an i n v e s t i g a t i o n was made but it proved t o be inconclusive. On
October 10, 1979, the F o s t e r Care Program recommended t h a t t h e f o s t e r
parents undergo p s y c h o l o g i c a l e v a l u a t i o n . The e v a l u a t i o n i n d i c a t e d t h a t
t h e f o s t e r f a t h e r was capable of abusing c h i l d r e n sexually and recommended
the home not be licensed a s a f o s t e r home. The f o s t e r p a r e n t s v o l u n t a r i l y
relinquished t h e i r l i c e n s e on December 13, 1979, and the remaining f o s t e r
c h i l d r e n were removed.
Reasons DES P o l i c i e s
Are Not Followed
Our a n a l y s i s of f o s t e r c a r e cases and a survey of f o s t e r c a r e caseworkers
revealed t h a t a lack of proper supervision over f o s t e r c a r e caseworkers
and heavy workloads f o r those caseworkers a r e primary c a u s e s o f DES
p o l i c i e s and procedures not being followed.
For example, a n a l y s i s of f o s t e r c a r e c a s e s disclosed numerous i n s t a n c e s of
lack of progress toward the case goal. This is a c l e a r i n d i c a t i o n of
inadequate supervision i n t h a t t h e supervisor is u l t i m a t e l y r e s p o n s i b l e
f o r the attainment o f t h e s e goals. DES procedures r e q u i r e s u p e r v i s o r s t o
review cases a t l e a s t every t h r e e months and t o determine i f progress
toward t h e case goal is being made. We i d e n t i f i e d numerous i n s t a n c e s of
these supervisory reviews a p p a r e n t l y n o t made.
The absence of adequate s u p e r v i s i o n was a l s o c i t e d by f o s t e r c a r e
caseworkers i n an Auditor General survey a s a primary o b s t a c l e t o d e l i v e r y
of s e r v i c e . I n t h a t same survey, caseworkers a l s o noted t h e following
o b s t a c l e s t o d e l i v e r y of s e r v i c e .
- lack of time t o do casework properly,
- too many paperwork r e s p o n s i b i l i t i e s f o r caseworkers,
- t r a n s p o r t a t i o n problems,
- l a c k o f adequate placements, and
- caseworker turnover.
CONCLUSION
DES p o l i c i e s and procedures are not followed i n t h a t :
- Permanent placement plans a r e not developed i n a timely manner or
implemented p r o p e r l y ,
- Home v i s i t s a r e not made a s o f t e n as r e q u i r e d , and
- Case records e x c l u d e i n f o r m a t i o n , c o n t a i n c o n f l i c t i n g i n f ormation
or a r e improperly organized.
These problems combined with frequent placement changes are, at l e a s t i n
p a r t , t h e r e s u l t of i n a d e q u a t e s u p e r v i s i o n . Another p o s s i b l e cause is
t h a t caseworkers lack t h e time t o follow a l l procedures required of them.
RECOMMENDATIONS
It is recommended t h a t :
- Supervisors review c a s e s every t h r e e months t o determine i f :
1) permanent placement plans a r e developed i n a timely manner and
implemented p r o p e r l y , 2) home v i s i t s a r e made a s o f t e n a s
r e q u i r e d , 3) c a s e records a r e maintained p r o p e r l y , and 4)
c h i l d r e n change placements only when necessary and a r e prepared
adequately f o r t h e change. When t h e s e procedures a r e not
followed, a p p r o p r i a t e d i s c i p l i n a r y a c t i o n should be administered.
- D i s t r i c t Program Managers review cases on a random b a s i s t o
ensure t h a t s u p e r v i s o r s monitor t h e i r c a s e s properly. When
Program Managers determine t h a t s u p e r v i s o r s a r e n o t p r o p e r l y
reviewing t h e i r c a s e s , a p p r o p r i a t e d i s c i p l i n a r y a c t i o n should be
administered.
- A manpower study be commissioned t o determine i f DES caseworkers
have adequate time t o follow a l l procedures required of them. In
a d d i t i o n , t h e study should determine i f DES u s e s c a s e a i d s ,
c l e r i c a l s t a f f and o u t s i d e p r o f e s s i o n a l s t o f u l l advantage.
FINDING I1
AN APPARENT SHORTAGE OF FOSTER HOMES IS RESULTING I N POTENTIALLY DANGEROUS
SITUATIONS FOR SOME FOSTER CHILDREN AND INCREASED COSTS TO THE STATE FOR
EMERGENCY RECEIVING CARE.
Arizona may be approaching a c r i s i s l e v e l i n a t l e a s t one d i s t r i c t with
regard t o the a v a i l a b i l i t y of f o s t e r homes. Our review of the
a v a i l a b i l i t y of f o s t e r homes revealed t h a t :
- There is an apparent shortage of f o s t e r homes Statewide,
- The shortage of f o s t e r homes is leading t o p o t e n t i a l l y dangerous
s i t u a t i o n s f o r some f o s t e r c h i l d r e n ,
- The shortage of f o s t e r homes c a u s e s i n c r e a s e d c o s t s t o t h e S t a t e
because of overuse of more expensive emergency receiving c a r e
f a c i l i t i e s , and
- The Foster Care Program needs t o do a d d i t i o n a l work i n order t o
i n c r e a s e the number o f a v a i l a b l e f o s t e r homes.
Shortage o f F o s t e r Homes
Arizona's shortage of f o s t e r homes is evident i n t h a t : 1) t h e r a t i o of
f o s t e r homes t o f o s t e r c h i l d r e n i n Arizona is lower than the average of
nine western s t a t e s , 2 ) a s u b s t a n t i a l number of r e q u e s t s f o r f o s t e r home
placements cannot be s a t i s f i e d , 3) homes of marginal q u a l i t y a r e not
eliminated a s f o s t e r homes by DES, and 4) f o s t e r homes t h a t a r e a v a i l a b l e
a r e o v e r u t i l i z e d .
Ratio o f F o s t e r Homes
t o Foster Children
Arizona's r a t i o of f o s t e r homes t o f o s t e r c h i l d r e n is low i n comparison t o
nine o t h e r western s t a t e s . Table 3 shows t h a t only one o t h e r s t a t e
( Colorado) has a lower r a t i o of f o s t e r homes t o f o s t e r c h i l d r e n than
Arizona a s of July 1980.
TABLE 3
State*"
Colorado
ABIZONA***
C a l i f o r n i a
Washington
Wyoming
Oregon
Idaho
Montana
Nevada
Utah
RATIO OF FOSTER HOMES TO FOSTER CHILDREN FOR
ARIZONA AND NINE* OTHER WESTERN STATES
JULY 1980
Total Foster
Care Population
Total Foster
Homes Available
Ratio of Foster
Homes t o F o s t e r Children
A S u b s t a n t i a l Number of Requests f o r
Foster Home Placement Cannot Be S a t i s f i e d
Eighty percent of DES caseworkers and 70 percent of DES s u p e r v i s o r s
responding t o an a u d i t survey s t a t e d t h a t t h e r e a r e not enough f o s t e r
homes a v a i l a b l e f o r t h e c h i l d r e n i n t h e i r caseloads. I n a d d i t i o n ,
a v a i l a b l e d a t a i n d i c a t e s t h a t f o s t e r - c a r e caseworker r e q u e s t s for
placements could not be s a t i s f i e d 61 percent of t h e time i n Maricopa
County during 1979 and 48 percent o f t h e time i n Pima County between June
1979 and February 1980.****
The shortage of f o s t e r homes is aggravated by the f a c t t h a t not a l l
e x i s t i n g fost- er homes a r e a v a i l a b l e t o t h e general f o s t e r - c h i l d population.
* New Mexico was not included because of a lack of d a t a on t h e number
of f o s t e r homes a v a i l a b l e .
** Listed i n order from the lowest t o t h e highest r a t i o of f o s t e r homes
t o f o s t e r c h i l d r e n .
*** A s of April 1980.
**** Includes some i n s t a n c e s o f m u l t i p l e r e q u e s t s f o r f o s t e r c a r e - a
placements.
F o s t e r p a r e n t s a r e licensed according t o t h e c h i l d r e n they w i l l accept i n
regard t o such d e s c r i p t i o n s a s a g e , s e x or race. In a d d i t i o n ,
approximately 28 percent of f o s t e r homes a r e l i c e n s e d w i t h the i n t e n t of
caring only f o r a s p e c i f i c c h i l d , such a s a r e l a t i v e .
Therefore, t h e f a c t t h a t a home is licensed a s a f o s t e r home does not mean
it is n e c e s s a r i l y a v a i l a b l e f o r use by t h e g e n e r a l f o s t e r - c h i l d population.
F i n a l l y , today's f o s t e r - c h i l d population i n c l u d e s o l d e r ( h a l f a r e a t l e a s t
13 years old) and more d i f f i c u l t t o manage* ( 18 percent) c h i l d r e n than i n
past years. Many f o s t e r parents a r e not w i l l i n g t o accept c h i l d r e n who
f a l l i n t o e i t h e r of these c a t e g o r i e s .
Homes of Marginal Q u a l i t y
Are Not Eliminated as Foster
Homes by DES
One adverse consequence of t h e f o s t e r home shortage is t h a t DES is
r e l u c t a n t t o eliminate homes already i n t h e program, even homes of
marginal q u a l i t y o r bad hones. The s i t u a t i o n is dangerous f o r f o s t e r
c h i l d r e n .
In an Auditor General survey o f f o s t e r - c a r e caseworkers and s u p e r v i s o r s ,
79 percent rated e x i s t i n g f o s t e r homes a s adequate o r b e t t e r . However,
the responses were o f t e n q u a l i f i e d t o note t h a t homes of marginal q u a l i t y
do e x i s t . A s one caseworker responded:
" We have a few e x c e l l e n t homes, many mediocre ones and
a few r e a l l y bad ones ( which workers f e e l they
sometimes have t o use.) If
The survey responses were s u b s t a n t i a t e d by a review of the l i c e n s i n g
records f o r 51 f o s t e r homes. Nine of the 51 contained information
concerning repeated complaints a g a i n s t t h e f o s t e r homes. The following
case examples were taken from foster- home l i c e n s i n g records t o demonstrate
t h e t y p e s o f complaints.
* See footnote regarding Special I1 c h i l d r e n on page 37.
CASE I
In A p r i l 1974, the Foster Care Program recommended t h a t a f o s t e r home be
closed a f t e r a c h i l d was removed because of an abuse complaint. The
police department a l s o recommended c l o s u r e due t o unsanitary conditions
and the i n a b i l i t y of the f o s t e r parent t o manage t h e c h i l d r e n . In
December 1974, the l i c e n s i n g worker reported t h a t t h e care given t o two
previously placed f o s t e r c h i l d r e n was inadequate and t h a t housekeeping
standards were poor, and recommended t h a t under no circumstances should
a d d i t i o n a l f o s t e r c h i l d r e n be placed i n t h e home. I n September 1976, the
l i c e n s i n g caseworker found t h e house f i l t h y and u n h e a l t h f u l , and
recommended c l o s u r e i f the home were found i n t h e same c o n d i t i o n again.
In January and April 1977, the f o s t e r home f a i l e d Department of Health
Services h e a l t h and s a f e t y i n s p e c t i o n s . In a 1978 r e l i c e n s i n g s t u d y , t h e
DES l i c e n s i n g worker reported t h a t t h e f o s t e r home has had obvious
problems i n t h e past and w i l l continue t o have problems. The home is
c u r r e n t l y l i c e n s e d .
CASE I1
A f o s t e r home was licensed i n i t i a l l y on October 31, 1977, although s e v e r a l
foster- home l i c e n s i n g s t u d i e s reported such problems a s emotional abuse
and not enough food i n the home. A March 29, 1978, entry by a f o s t e r - c a r e
caseworker s t a t e d t h a t If.. . t h e family does not l i v e within t h e standards
a s s e t by t h i s agency and should be c l o s e l y watched." The same
caseworker, however, recommended r e l i c e n s i n g on September 18, 1978. The
home is c u r r e n t l y l i c e n s e d .
O v e r u t i l i z a t i o n o f F o s t e r Homes
Licensing s u p e r v i s o r s interviewed claimed t h a t foster- home shortages have
r e s u l t e d i n tremendous pressure on l i c e n s i n g caseworkers n o t o n l y t o keep
marginal f o s t e r homes open, but t o o v e r u t i l i z e f o s t e r homes a s well. A
recent DES r e p o r t s t a t e d , " The l o s s of c o n t r o l due t o heavy and continuous
c h i l d case r e s p o n s i b i l i t i e s may be r e f l e c t i v e of t h e number of c h i l d r e n
t h a t a home is licensed f o r or may be i n d i c a t i v e o f t h e common p r a c t i c e s
of keeping a f o s t e r family c o n s t a n t l y a c t i v e with l i t t l e or no r e s p i t e . " *
Currently t h e r e is a DES r e s p i t e policy; however, i n r e a l i t y , t h e f a m i l i e s
a r e never a b l e t o t a k e a r e s p i t e .
The o v e r u t i l i z a t i o n of f o s t e r homes is not infrequent. A recent DES study
of the reasons f o r foster- home turnover revealed t h a t s i x of e i g h t closed
f o s t e r homes had l i c e n s e l i m i t a t i o n s extended because of agency request o r
p r e s s u r e . Recently, t h e c r i s i s s h o r t a g e o f f o s t e r homes i n Maricopa
County has r e s u l t e d i n l i c e n s i n g workers asking r e s t r i c t e d f o s t e r homes t o
r e v i s e t h e i r l i c e n s e s t o permit t h e c a r e of more c h i l d r e n .
The following case example is t y p i c a l o f t h e problem of o v e r u t i l i z a t i o n of
f o s t e r homes.
EXAMPLE CASE
In 1979, a f o s t e r p a r e n t r e p o r t e d t o DES Child P r o t e c t i v e S e r v i c e s
personally, s t a t i n g t h a t he had h i t t h e f o s t e r c h i l d r e n . He requested a
r e s p i t e from having f o s t e r c h i l d r e n i n h i s home. Information contained i n
the l i c e n s i n g record noted t h a t i n 1974 t h e r e had been too many c h i l d r e n
i n the home f o r adequate care. The r e l i c e n s i n g study f o r 1974 s t a t e d t h a t
the f o s t e r home should harbor no more than f o u r c h i l d r e n ; however, i n 1975
the f o s t e r home was r e l i c e n s e d f o r f i v e c h i l d r e n . In 1977, approval was
obtained t o overload the home with s i x f o s t e r c h i l d r e n . I n a 1979
r e l i c e n s i n g study, t h e l i c e n s i n g worker assessed t h a t t h e family was not
a b l e t o handle more than two S p e c i a l I1 children#* a t one time, but
recommended t h a t the home be licensed f o r f i v e such c h i l d r e n .
* R e s p i t e i n v o l v e s n o t r e p l a c i n g c h i l d r e n i n a home f o r a period of time
t o g i v e t h e f o s t e r family a h i a t u s . /
** S p e c i a l I1 c h i l d r e n a r e harder- to- handle c h i l d r e n , u s u a l l y having
emotional or physical problems.
POTENTIALLY HARMFUL SITUATIONS FOR SOME CHILDREN
The foster- home s h o r t a g e h a s r e s u l t e d i n some c h i l d r e n ' s placement i n
s i t u a t i o n s t h a t a r e p o t e n t i a l l y harmful, both p h y s i c a l l y and emotionally.
Remaining i n Physically
Dangerous Environments
The shortage of f o s t e r homes c o n t r i b u t e s t o s h o r t a g e s o f o t h e r types of
placements f o r some f o s t e r c h i l d r e n . Nhen no f o s t e r homes a r e a v a i l a b l e ,
s h e l t e r c a r e f a c i l i t i e s a r e used t o house f o s t e r c h i l d r e n . T h i s , i n t u r n ,
l i m i t s the number of s h e l t e r c a r e placements a v a i l a b l e f o r children
needing immediate, temporary s h e l t e r .
According t o A. R. S. $ 8- 546.01. C. 4:
" A p r o t e c t i v e s e r v i c e s worker s h a l l : . . . t a k e a c h i l d
i n t o temporary custody i f t h e r e a r e reasonable grounds
t o believe t h a t t h e c h i l d is s u f f e r i n g from i l l n e s s or
i n j u r y or is i n immediate danger from h i s surroundings
and t h a t h i s removal is necessary. If
Currently, however, some c h i l d r e n are l e f t i n p o t e n t i a l l y abusive and
n e g l e c t f u l home environments because t h e r e a r e few placements f o r them. A
p r o t e c t i v e s e r v i c e s supervisor interviewed reported t h a t one day i n April
t h e r e were seven c h i l d r e n needing immediate emergency placements f o r whom
no placements were a v a i l a b l e . A l l t h e s e c h i l d r e n remained where they were
u n t i l placements were a v a i l a b l e which, f o r one c h i l d , was ten days l a t e r .
Surveyed caseworkers a l s o reported t h a t c h i l d r e n sometimes a r e l e f t i n
p o t e n t i a l l y dangerous environments. One caseworker reported:
" We f r e q u e n t l y l e a v e c h i l d r e n i n i n a p p r o p r i a t e and
dangerous s e t t i n g s due t o a lack of placements."
Cited below a r e two recent examples of c h i l d r e n l e f t " a t r i s k u * a t home,
although removal was v i t a l f o r t h e i r protection.
* A t r i s k o f n e g l e c t or abuse.
CASE I
Four c h i l d r e n , t h r e e t o nine years o l d , were l e f t alone with an
eleven- year- old b a b y s i t t e r . A Child P r o t e c t i v e Services ( CPS) worker
i d e n t i f i e d t h a t : 1) t h e c h i l d r e n had a communicable d i s e a s e , 2) one
c h i l d had a n u n t r e a t e d scalp wound, 3) no food was i n t h e home, 4) the
c h i l d r e n reported they had n o t e a t e n t h a t day, and 5) the house was
f i l t h y and had c a t and dog feces on the f l o o r . The CPS worker, because of
the lack of s h e l t e r c a r e placements, was forced t o leave t h e c h i l d r e n
t h e r e with the eleven- year- old s i t t e r .
CASE I1
In April 1980, a f a t h e r requested immediate emergency help from DES Child
P r o t e c t i v e Services t o remove h i s c h i l d r e n because he was f e a r f u l t h a t he
was going t o h u r t them. The f a t h e r had a h i s t o r y o f abusing h i s
c h i l d r e n . However, because t h e r e were no f o s t e r home placements
a v a i l a b l e , CPS t o l d t h e f a t h e r t h a t t h e c h i l d r e n would have t o remain i n
t h e home u n t i l placements were a v a i l a b l e . The f i r s t a v a i l a b l e placement
was l o c a t e d n i n e day l a t e r .
Not only a r e placement o p p o r t u n i t i e s l i m i t e d , but DES has n e i t h e r
g u i d e l i n e s nor options f o r workers faced with t h e c r i s i s s i t u a t i o n s of
c h i l d r e n a t r i s k , needing emergency removal from t h e home, when no
placements a r e a v a i l a b l e . DES caseworkers and s u p e r v i s o r s have, however,
developed t h e i r own informal p r i o r i t y g u i d e l i n e s t o determine which
c h i l d r e n a t r i s k a r e placed f i r s t . CPS s u p e r v i s o r s and caseworkers we
interviewed declared t h a t p r i o r i t i e s hinge on placement a v a i l a b i l i t y ,
urgency of the home s i t u a t i o n and age of t h e c h i l d .
For example, o l d e r c h i l d r e n who need t o be removed frequently a r e advised
by CPS t o seek refuge i n a runaway halfway house or a neighbor's o r
r e l a t i v e 1 s home. Younger c h i l d r e n i n similar s i t u a t i o n s more l i k e l y would
be placed. Interviewed s u p e r v i s o r s a l s o reported t h a t c h i l d r e n who a r e
abused physically a r e removed sooner than c h i l d r e n who a r e abused
sexually. The theory advanced is t h a t sexual abuse is more d i f f i c u l t t o
s u b s t a n t i a t e than physical a b u s e , . and t h a t sexual abuse is l e s s l i k e l y t o
r e s u l t i n severe physical i n j u r y t o t h e c h i l d t h a n p h y s i c a l abuse.
P o t e n t i a l Emotionally
Harmful S i t u a t i o n s
Another r e s u l t of the shortage of f o s t e r homes is t h a t c h i l d r e n a r e placed
i n s e t t i n g s t h a t may not be a p p r o p r i a t e t o t h e i r needs. Such placements
may lead u l t i m a t e l y t o s e r i o u s emotional damage t o a c h i l d .
The Child Welfare League of America ( CWLA), i n its Standards For Foster
Family Service, s t a t e s :
" It is never j u s t i f i a b l e t o place a c h i l d i n a home
deemed u n s u i t a b l e f o r h i s continuing c a r e , except when
a s i n g l e placement f o r a limited period of emergency o r
i n t e r i m c a r e is required. The p r a c t i c e of moving a
c h i l d from one f o s t e r home t o another i n the hope of
improving t h e s i t u a t i o n should be avoided, s i n c e each
a d d i t i o n a l placement r e p e a t s f o r a c h i l d t h e p a i n f u l
experience of s e p a r a t i o n ...."
D r . Ner L i t t n e r , a n a t i o n a l l y known c o n s u l t a n t p s y c h i a t r i s t , has noted
t h a t each move or replacement:
"... merely pyramids the traumatic e f f e c t s , i n c r e a s e s
t h e problems t h e c h i l d must master, i n t e n s i f i e s the
c h i l d ' s f e a r of and need t o fend o f f c l o s e
r e l a t i o n s h i p s , and adds t o the d i f f i c u l t i e s i n
adjustment i n the next home. A s you know, t h e end
r e s u l t of frequent replacements is t h e t y p i c a l ,
agency- created psychopath whose f e a r of closeness is so
g r e a t t h a t he can t o l e r a t e only shallow and s u p e r f i c i a l
r e l a t i o n s h i p s . "
The shortage of f o s t e r homes apparently l e a d s t o placements of c h i l d r e n
i n t o homes unable t o meet t h e i r needs and then t o subsequent
replacements. More than half t h e f o s t e r - c a r e s u p e r v i s o r s and caseworkers
surveyed f e l t t h a t , o v e r a l l , t h e needs of f o s t e r c h i l d r e n were not met
adequately by f o s t e r p a r e n t s . T h e i r b e l i e f is supported by s t a t i s t i c s
from Pima County, i n d i c a t i n g t h a t from June 1979 t o February 1980, 155
f o s t e r homes i n Pima County alone were unable t o c a r e f o r t h e c h i l d r e n
placed with them. F u r t h e r , an Auditor General review of the case records
of 206 f o s t e r c h i l d r e n revealed 88 i n s t a n c e s of f o s t e r c h i l d r e n moved - a
from one home t o another because the homes were unable t o meet t h e i r
needs. A s one caseworker surveyed explained:
ttInappropriate f o s t e r homes a r e the b i g g e s t r e a s o n s
kids move around so much.
Another worker commented:
ttYou place c h i l d r e n i n inadequate homes and j u s t count
t h e days u n t i l placement d i s r u p t s . "
INCREASED COSTS OF CARE
The s h o r t a g e o f f o s t e r homes is t r a n s l a t e d i n t o increased c o s t s t o the
S t a t e f o r c h i l d c a r e , because f o s t e r c h i l d r e n must be placed i n more
expensive forms of c a r e , such as emergency receiving c a r e f a c i l i t i a s and
i n s t i t u t i o n s .
Foster c a r e c o s t s an average of $ 7 a day f o r each c h i l d . Emergency
receiving c a r e c o s t s average $ 25 a day f o r each c h i l d and i n s t i t u t i o n a l
care ranges from $ 27 t o $ 80 a day f o r each c h i l d . Cases of c h i l d r e n l e f t
i n emergency receiving c a r e because f o s t e r homes were not a v a i l a b l e
revealed t h a t the foster- home shortage may have c o s t t h e S t a t e a s much a s
$ 400,000 i n 1979.
Emergency receiving c a r e is meant t o be short- term emergency c h i l d c a r e i n
a s a f e environment u n t i l DES c a n a r r a n g e a l t e r n a t i v e placement. Because
of the intended use, DES r e g u l a t i o n s s t i p u l a t e t h a t a c h i l d may remain i n
receiving c a r e a maximum of 21 days.* We found, however, t h a t because of
the s h o r t a g e o f f o s t e r homes, c h i l d r e n remain i n emergency receiving c a r e
much longer.
We examined computerized emergency receiving c a r e payment records f o r 53
of 159 c h i l d r e n i n receiving c a r e on December 1, 1979. We tracked the
c h i l d r e n from the d a t e they f i r s t e n t e r e d a n emergency receiving c a r e
f a c i l i t y u n t i l December 31, 1979. Table 4 shows t h e l e n g t h s of time these
c h i l d r e n remained i n emergency r e c e i v i n g c a r e .
* The j u v e n i l e court must i s s u e a court order t o extend an emergency
receiving home placement beyond 21 days and must review t h e court
order weekly u n t i l t h e c h i l d is removed from the receiving home.
TABLE 4
NUMBER OF DAYS FOSTER CHILDREN REMAIN
I N EMERGENCY RECEIVING CARE
Number of Number of Percentage of
Days Children Total
0- 21
21- 61
62- 182
182 and above
A s Table 4 i n d i c a t e s , 78 percent of the f o s t e r c h i l d r e n were i n emergency
receiving c a r e l o n g e r t h a n the maximum 21- day period. I n a d d i t i o n , t h r e e
c h i l d r e n were i n emergency receiving c a r e more than s i x months, one f o r
268 days.
We c a l c u l a t e d the increased c o s t s t o t h e S t a t e , because these c h i l d r e n had
been i n emergency receiving c a r e more than 21 days, t o be $ 75,000.
However, annual c o s t s o f o v e r s t a y s i n receiving c a r e may be as high a s
$ 400,000 i f a l l the c h i l d r e n i n emergency receiving c a r e f o r a whole year
a r e taken i n t o account.
DES NEEDS TO DO ADDITIONAL WORK I N ORDER
TO INCREASE THE NUMBER OF FOSTER HOMES
DES needs t o concentrate on two o b j e c t i v e s i n order t o ease the shortage
of f o s t e r homles. One is t o reduce the turnover r a t e among e x i s t i n g f o s t e r
homes; t h e o t h e r is t o s t e p up recruitment e f f o r t s .
Reducing Turnover
Arizona is l o s i n g f o s t e r homes f a s t e r through turnover than it is a b l e t o
r e c r u i t replacement homes. Thus, the s h o r t a g e o f f o s t e r homes appears t o
be g e t t i n g worse. An important s t e p i n combatting the shortage is
reducing f o s t er- home turnover.
The turnover r a t e i n 1977 was 23 p e r c e n t ; i n 1978 it was 41 p e r c e n t ; and
i n 1979 it was 42 percent. A t l e a s t two major f a c t o r s appear t o be
responsible f o r the turnover r a t e , including:
1. F o s t e r p a r e n t s 1 sense of i s o l a t i o n from, and u n s a t i s f a c t o r y
involvement with, DES.
2. Inadequate d a t a c o l l e c t i o n and a n a l y s i s of f o s t e r home turnover
by DES.
D i s s a t i s f a c t i o n and a Sense of I s o l a t i o n - Current and former f o s t e r
parents surveyed by t h e a u d i t s t a f f expressed strong f e e l i n g s of
d i s s a t i s f a c t i o n with DES. Table 5, which summarizes former f o s t e r parent
responses t o an Auditor General survey, mirrors t h i s d i s s a t i s f a c t i o n .
TABLE 5
SUMMARY OF FORMER FOSTER PARENTS1
REASONS FOR TERMINATING THEIR LICENSES
Number of Former
Reason f o r Terminating F o s t e r P a r e n t s
D i s s a t i s f a c t i o n with program
R e s t r i c t e d home
I n s u f f i c i e n t monetary support
Family h e a l t h problems
Agency terminated l i c e n s e
Moved
Unable t o cope with f o s t e r c h i l d
Adopted f o s t e r c h i l d
Other
* There were 112 responses t o the survey. Some respondents l i s t e d
multiple reasons f o r termination.
The following comments made by former f o s t e r p a r e n t s f u r t h e r exemplify
t h e i r d i s s a t i s f a c t i o n with DES:
- " I was d i s s a t i s f i e d t o t a l l y with t h e program -- and disappointed
too.!'
- " I w i l l not recommend anyone t o be a f o s t e r parent i n the S t a t e
of Arizona."
- " Impossible t o work with last caseworker. She talked behind our
back; breaking down our r e l a t i o n s h i p with t h e c h i l d we had i n our
care.
- " T a ~ i n g c a r e and working with t h e c h i l d r e n was one of the most
rewarding experiences of our l i v e s . Working with DES was not!"
- " 1 would never consider being a f o s t e r parent again because of
g r o s s d i s s a t i s f a c t i o n with t h e e n t i r e program. What can I say,
other than, it's a mess!"
- " Not enough help from caseworkers. It was poor s e r v i c e from t h i s
program. They d i d n ' t do t h e i r part."
- " This program is a t r a g i c joke.. . The whole department seems t o be
i n a constant s t a t e o f d i s o r g a n i z a t i o n , switching p r i o r i t i e s , and
making d e c i s i o n s contrary t o t h e proof."
- " We g o t t i r e d of a l l t h e h a s s l e s with the state... The c h i l d ' s
best i n t e r e s t s were not considered very well."
- " To sum it up, we f e l t used and mistreated a s f o s t e r parents."
Although DES r e g u l a t i o n s r e q u i r e f o s t e r - c a r e caseworkers t o consult with
the f o s t e r parents a t l e a s t q u a r t e r l y regarding t h e c h i l d ' s placement
plan, f o s t e r parents r a r e l y a r e asked f o r t h e i r i n p u t . A survey of f o s t e r
parents conducted by t h e a u d i t s t a f f found 62 percent of t h e f o s t e r
p a r e n t s r e p o r t i n g they never have had any input i n t o any c h i l d ' s plan.
F u r t h e r , one f o s t e r parent commented t h a t attempts t o make suggestions may
r e s u l t i n being considered ' Itrouble makers" and/ or t h e c h i l d being moved
t o a d i f f e r e n t f o s t e r home.
A recent DES survey of former and c u r r e n t f o s t e r parents a l s o revealed
t h a t the major change advocated by f o s t e r p a r e n t s was t o include them i n
planning f o r t h e f o s t e r c h i l d .
Another f a c t o r c o n t r i b u t i n g t o f o s t e r parents1 f e e l i n g of i s o l a t i o n from
DES a r e t h e i n f r e q u e n t c o n t a c t s with, and i n a c c e s s i b i l i t y o f , caseworkers.
A t a minimum, f o s t e r p a r e n t s should receive q u a r t e r l y home v i s i t s both
from t h e l i c e n s i n g caseworker f o r the home and from t h e c h i l d ' s
caseworker. A review of a sample of l i c e n s i n g records found evidence of
only 33 percent of the required l i c e n s i n g caseworker v i s i t s , and a review
of a sample of f o s t e r c h i l d case records showed evidence of only 30
percent of the required c h i l d caseworker v i s i t s . I n f a c t , the sample of
f o s t e r c h i l d c a s e records showed no evidence of any v i s i t s made t o 33
percent o f t h e f o s t e r parents during the year 1979.
An Auditor General survey of p r a c t i c i n g f o s t e r p a r e n t s a l s o documented t h e
infrequency of caseworker v i s i t s . S i x t y - f o u r p e r c e n t of t h e f o s t e r
parents responding reported receiving v i s i t s from l i c e n s i n g workers only
once every s i x months o r l e s s , and 30 percent reported i r r e g u l a r
face- to- face c o n t a c t with f o s t e r c h i l d r e n ' s caseworkers.
Perhaps a s a r e s u l t of i n f r e q u e n t c o n t a c t , f o s t e r parents a l s o expressed a
f e e l i n g of having no resource t o t u r n t o when they needed answers t o
questions or advice on f o s t e r - p a r e n t i n g . Twenty- four f o s t e r parents
independently and spontaneously commented t h a t more and c l o s e r c o n t a c t
with caseworkers was needed. Some f o s t e r parents suggested t h a t a
telephone h o t l i n e be e s t a b l i s h e d , even though f o s t e r p a r e n t s
( t h e o r e t i c a l l y ) can c a l l e i t h e r the l i c e n s i n g worker o r t h e c h i l d ' s
caseworker f o r such a s s i s t a n c e .
DES Lacks Data t o Evaluate
Foster Home Turnover
DES l a c k s d a t a on f o s t e r home t u r n o v e r , i n c l u d i n g the reasons f o s t e r
parents leave t h e program. Without t h e information DES n o t o n l y d o e s not
know t h e e x t e n t of f o s t e r home t u r n o v e r , b u t is hampered i n attempts t o
formulate a plan t o d e a l with t h e problem.
DES has d a t a s t o r e d i n its computerized f o s t e r c a r e t r a c k i n g system t h a t
could be used t o c a l c u l a t e t h e r a t e of foster- home turnover. Even though
the d a t a is r e t r i e v a b l e , DES had not compiled a S t a t e w i d e a n n u a l f o s t e r
home turnover r a t e by d i s t r i c t u n t i l it was requested t o do so by t h e
Auditor General. Based on f o s t e r c a r e t r a c k i n g system d a t a , turnover r a t e
f o r 1979 Mas c a l c u l a t e d a t 42 percent. It should be noted t h a t
a d m i n i s t r a t o r s had assumed t h e 1979 r a t e was 25 percent.
The t r a c k i n g system a l s o s t o r e s d a t a on reasons f o r f o s t e r home
turnovers. However, it is o f t e n reported i n a manner not u s e f u l t o
program managers. For example, i n one Statewide r e p o r t o f t h e number of
f o s t e r home c l o s u r e s and t h e reasons f o r them, 50 percent of t h e reasons
f o r c l o s u r e were coded a s " other." Such a high r a t e of t h e use of t h e
" other" category d e p r i v e s DES a d m i n i s t r a t o r s of u s e f u l information on t h e
r e a l reasons f o r f o s t e r home turnover. One DES d i s t r i c t records
information manually on reasons f o r f o s t e r home c l o s u r e s , because t h e
caseworkers i n t h a t d i s t r i c t b e l i e v e t h e g e n e r a l i z e d computerized
information d o e s n o t meet t h e i r needs. Without a c c u r a t e , r e l i a b l e and
complete d a t a on f o s t e r home t u r n o v e r , and t h e reasons f o r such t u r n o v e r ,
DES a d m i n i s t r a t o r s cannot e v a l u a t e t h e program adequately nor can they
develop a p p r o p r i a t e plans t o reduce f o s t e r home turnover.
Increasing Foster Home Recruitment E f f o r t s
In a d d i t i o n t o reducing f o s t e r home t u r n o v e r , more must be done t o r e c r u i t
new f o s t e r homes. In reviewing f o s t e r home recruitment we found progress
has been made i n developing a formal recruitment program; however,
a d d i t i o n a l work needs t o be done: b e t t e r d a t a must be c o l l e c t e d and
followups must be made i n order f o r t h e p r o j e c t t o achieve ' e f f e c t i v e n e s s .
Developing a Formal Program
P r i o r t o 1978, DES had no formal Statewide program t o r e c r u i t f o s t e r
homes. I n s t e a d , recruitment was a r e s p o n s i b i l i t y of the l i c e n s i n g workers
and was handled i n conjunction with t h e i r o t h e r d u t i e s . I n f i s c a l year
1978- 79, a demonstration f o s t e r home recruitment p r o j e c t was conducted i n
Maricopa County. Since t h a t p r o j e c t DES has contracted f o r a Statewide
market a n a l y s i s of t h e pool of p o t e n t i a l f o s t e r parents and t h e most
e f f e c t i v e methods o f r e c r u i t i n g them. DES is h i r i n g persons and
e s t a b l i s h i n g formal recruitment programs i n each of t h e d i s t r i c t s .
Although it is t o o e a r l y t o evaluate the o v e r a l l e f f e c t i v e n e s s of t h e new
f o s t e r home recruitment program, we noted t h a t information is not
c o l l e c t e d a s t o why p o t e n t i a l f o s t e r parents contacted by t h e r e c r u i t i n g
program do not become f o s t e r parents.
For example, the demonstration recruitment p r o j e c t i n f i s c a l year 1978- 79
showed t h a t only e l e v e n p e r c e n t of c o n t a c t e d p r o s p e c t s a c t u a l l y became
f o s t e r parents. However, d a t a was n o t g a t h e r e d on t h e reasons f o r
choosing not t o become f o s t e r parents. The lack of such d a t a precludes a
determination t h a t t h e r e c r u i t i n g e f f o r t was aimed a t t h e r i g h t population
o r t h a t other f a c t o r s , such a s l i c e n s i n g procedures, caused persons t o
r e j e c t f o s t e r parenthood. The absence of such information severely
r e s t r i c t s DES a b i l i t y t o determine how t o i n c r e a s e t h e percentage success
of recruitment c o n t a c t s .
Information is not c o l l e c t e d and stored i n a manner t o allow f o r followup
c o n t a c t s w i t h p r o s p e c t s who may be i n t e r e s t e d i n f o s t e r parenting a t a
l a t e r d a t e . Randomly we s e l e c t e d 50 persons who i n q u i r e d a b o u t , but did
not become, f o s t e r parents. We interviewed them t o determine why they
dropped out. During t h e course of our i n t e r v i e w s , we i d e n t i f i e d nine
persons who still were i n t e r e s t e d i n becoming f o s t e r parents at a l a t e r
date. S i m i l a r l y , i n reviewing l i c e n s i n g u n i t s r e c o r d s , we i d e n t i f i e d
s e v e r a l f o s t e r parents who had dropped out but still were i n t e r e s t e d i n
becoming f o s t e r parents a t a l a t e r d a t e . A s of August 1980, the f o s t e r
home recruitment program had n o t c o l l e c t e d d a t a nor e s t a b l i s h e d a system
t o allow f o r followups with p o t e n t i a l f o s t e r parents.
Funding f o r a r e c r u i t m e n t program is developing slowly. P r i o r t o f i s c a l
year 1980- 81, DES had no s p e c i f i c budget f o r recruitment of f o s t e r homes,
and DES a d m i n i s t r a t o r s funded recruitment e f f o r t s from the g e n e r a l f o s t e r
care budget. I n f i s c a l year 1980- 81, $ 200,000 was budgeted s p e c i f i c a l l y
f o r t h e development of a Statewide f o s t e r home r e c r u i t i n g program.
However, because of a change i n DES p r i o r i t i e s , not a l l of t h e budgeted
$ 200,000 w i l l be spent on f o s t e r home r e c r u i t m e n t , although DES
a d m i n i s t r a t o r s a g r e e t h e f u l l $ 200,000 still is needed t o implement
properly a Statewide recruitment program.
CONCLUSIONS
1. There is an apparent s h o r t a g e o f f o s t e r homes i n Arizona. Such a
s i t u a t i o n is p o t e n t i a l l y dangerous f o r some f o s t e r c h i l d r e n .
2. The shortage of f o s t e r homes c o s t s t h e S t a t e up t o $ 400,000 a
year i n increased emergency receiving c a r e c o s t s f o r c h i l d r e n who
cannot be placed i n f o s t e r homes.
3. DES needs t o s t r i v e harder t o reduce the foster- home turnover
r a t e . F o s t e r p a r e n t s need more frequent c o n t a c t s with, and
e a s i e r access t o , caseworkers, and they need g r e a t e r involvement
i n developing plans f o r f o s t e r c h i l d r e n . The Foster Care Program
needs t o monitor and analyze f o s t e r home turnover.
RECOMMENDATIONS
It is recommended t h a t DES take t h e following s t e p s t o help reduce f o s t e r
parent turnover :
1. D i r e c t a d m i n i s t r a t o r s t o implement management a c t i o n s , including
spot- checks of case f i l e s , t o ensure t h a t scheduled worker
c o n t a c t s a r e made with f o s t e r p a r e n t s and t h a t f o s t e r p a r e n t s a r e
consulted i n planning f o r f o s t e r c h i l d r e n .
2. Review t h e need f o r , and f e a s i b i l i t y o f , a telephone h o t l i n e f o r
f o s t e r parents.
3. Monitor and analyze f o s t e r home turnover d a t a p e r i o d i c a l l y .
It is f u r t h e r recommended t h a t DES e s t a b l i s h and implement t h e following
procedures f o r r e c r u i t i n g f o s t e r parents.
4. A s a p a r t of t h e recruitment program, c o l l e c t d a t a as t o why
persons who i n q u i r e about f o s t e r p a r e n t i n g d r o p out a f t e r
inquiry. Also, c o l l e c t d a t a as t o whether persons who d r o p o u t
would be i n t e r e s t e d i n f o s t e r parenting at a l a t e r d a t e and
e s t a b l i s h a system f o r contacting these persons a g a i n .
FINDING I11
IF DES WERE AS EFFECTIVE AS OTHER STATES I N COLLECTING AFDC- FC AND
NATURAL- PARENT CHILD- SUPPORT PAYMENTS, STATE REVENUES COULD INCREASE BY AN
ESTIMATED $ 1.3 MILLION A YEAR.
DES does not use e f f e c t i v e l y a l t e r n a t e funding sources t o help support the
f o s t e r c a r e program. Two a r e a s i n which DES does not t a k e f u l l advantage
of funds a v a i l a b l e a r e Federal Aid t o F a m i l i e s w i t h Dependent Children -
Foster Care ( AFDC- FC) matching funds and natural- parent c h i l d support f o r
f o s t e r c h i l d r e n . However, during t h e past year DES h a s i n c r e a s e d its
c o l l e c t i o n s from S o c i a l S e c u r i t y , Supplemental S e c u r i t y Income and
Veteran's Administration b e n e f i t s a v a i l a b l e f o r f o s t e r c h i l d r e n . I f DES
were a s e f f e c t i v e a s o t h e r s t a t e s i n c o l l e c t i n g AFDC- FC and natural- parent
child- support payments, S t a t e revenues could i n c r e a s e by an estimated $ 1.3
m i l l i o n a year.
AFDC- FC
AFDC- FC is a F e d e r a l program t h a t provides s t a t e s with matching funds up
t o $ 61.30 a month per c h i l d f o r f o s t e r c h i l d r e n who meet t h e e l i g i b i l i t y
requirements of the AFDC program. We found t h a t Arizona may be l o s i n g a s
much a s $ 670,000 of these funds each year because AFDC- FC g r a n t monies a r e
not claimed c o r r e c t l y . This l o s s occurs because:
- DES does not i d e n t i f y approximately 90 percent of t h e c h i l d r e n
who should be r e f e r r e d f o r AFDC- FC,
- ~ r o c e d u r e s f o r determining e l i g i b i l i t y and claiming AFDC- FC a r e
not followed, and
- The Family Assistance Administration within DES has not defined
the d a t e of a p p l i c a t i o n i n such a manner a s t o permit DES t o
claim the maximum amount of AFDC- FC a v a i l a b l e .
DES Does Not I d e n t i f y A l l Children
P o t e n t i a l l y E l i g i b l e f o r AFDC- FC
Arizona has i d e n t i f i e d t h e lowest percentage of c h i l d r e n p o t e n t i a l l y
e l i g i b l e f o r AFDC- FC among t h e eleven western s t a t e s we surveyed. A s
shown i n Table 6, t e n other western s t a t e s have i d e n t i f i e d from two t o
more than 15 times a s many e l i g i b l e c h i l d r e n on a percentage b a s i s a s
Arizona . a
TABLE 6
COMPARISON OF ARIZONA AFDC- FC ELIGIBILITY RATES
WITH TEN OTHER WESTERN STATES
DECEMBER 1979
Total Number o f F o s t e r Percentage of Foster
Foster Children E l i g i b l e Care Population
Care f o r AFDC- FC E l i g i b l e
Population Federal Match f o r AFDC- FC
NEW MEXICO 1,200 70 6 %
WYOMING 385 4 6 12
COLORADO 4,600 800 17
UTAH 1,000 168 17
WASHINGTON 5,400 1,260 2 3
IDAHO 800 250 31
MONTANA 790 2 80 35
OREGON 4,000
NEVADA 580
CALIFORNIA 27,000 12,452
TOTAL zdzi 17,083
ARIZONA 2.200 * 2
* Exclusive of c h i l d r e n adjudicated i n c o r r i g i b l e o r d e l i n q u e n t , since
they a r e not e l i g i b l e f o r AFDGFC. a
I f DES i d e n t i f i e d and claimed AFDC- FC e l i g i b l e c h i l d r e n a t the same r a t e
a s C a l i f o r n i a , Arizona would r e c e i v e an a d d i t i o n a l $ 670,000 a year i n
ADFC- FC payments. I f DES were to i d e n t i f y and claim AFDC- FC e l i g i b l e
c h i l d r e n a t tne average r a t e f o r the o t n e r t e n western s t a t e s , Arizona
still would receive an a d d i t i o n a l $ 360,000 a y e a r i n AFDC- FC payments.
The DES operating manual s t a t e s t h a t it is t h e s o c i a l s e r v i c e s worker's
r e s p o n s i b i l i t y t o " Evaluate each f o s t e r c h i l d ' s case t o determine
p o t e n t i a l AFDC- FC e l i g i b i l i t y . . . and t o " Refer the apparently e l i g i b l e
AFDC- FC case t o the l o c a l Assistance Payments u n i t . . . " . S o c i a l s e r v i c e
workers do not appear t o perform t h i s procedure adequately. For example,
the a s s i s t a n c e payments u n i t i n Maricopa County, which contains
approximately 1,100 f o s t e r c h i l d r e n , received only f i v e r e f e r r a l s f o r
AFDC- FC from November 1979 through January 1980.
In January 1980, during t h e course of our a u d i t , the Administration f o r
Children, Youth and Families ( ACYF) issued a d i r e c t i v e t o s u p e r v i s o r s t o
check a l l f o s t e r c h i l d cases f o r possible AFDC- FC e l i g i b i l i t y . The
response t o t h e d i r e c t i v e was minimal and r e s u l t e d i n a memo from t h e
Manager of t h e Service Delivery Unit t o t h e Program Administrator of ACYF
i n March 1980, which s t a t e d :
" It is my opinion t h a t u n l e s s t h e r e a r e some s a n c t i o n s
t o Program Managers and Supervisors i n t h i s a r e a , it
w i l l n o t r e c e i v e p r i o r i t y a t t e n t i o n . "
Even with limited response t o t h e d i r e c t i v e , on March 21, 1980, 178
children were i d e n t i f i e d as possibly e l i g i b l e f o r AFDC- FC. Although t h i s
is a p o s i t i v e s t e p , i f a l l 178 were determined t o be e l i g i b l e , Arizona
would s t i l l have l e s s than t e n percent o f t h e f o s t e r c a r e population
e l i g i b l e f o r AFDC- FC matching funds. This is still well below the
e l i g i b i l i t y r a t e of the t e n other western s t a t e s surveyed.
DES P o l i c i e s and Procedures
f o r Determining AFDC- FC
E l i g i b i l i t y Are Not Followed
The procedures f o r determining AFDC- FC e l i g i b i l i t y are outlined i n the
s o c i a l s e r v i c e s manual and i n an AFDC- FC t r a i n i n g package, y e t these
procedures a r e not followed c o n s i s t e n t l y .
Procedures for Determining
AFDC- FC E l i g i b i l i t y
According t o c u r r e n t DES p o l i c y , procedures t o be followed i n determining
e l i g i b i l i t y f o r AFDC- FC a r e :
1. The ACYF caseworker r e f e r s c a s e s i n which a c h i l d may be e l i g i b l e
f o r AFDC- FC t o a n A s s i s t a n c e Payments ( AP) worker f o r
determination of e l i g i b i l i t y .
2. The AP worker makes an e l i g i b i l i t y study of each c a s e , determines
e l i g i b i l i t y and n o t i f i e s the ACYF caseworker. The AP worker a l s o
e n t e r s t h e determination of e l i g i b i l i t y or i n e l i g i b i l i t y i n t o the
Assistance Payments Information System ( APIS) , which provides a
monthly p r i n t o u t of c h i l d r e n who have been r e f e r r e d f o r AFDC- FC
s t u d i e s and the r e s u l t s o f t h o s e s t u d i e s .
3. I f AFDC- FC e l i g i b i l i t y is determined, t h e ACYF caseworker e n t e r s
t h e necessary changes i n t o the f o s t e r c a r e tracking system
( FCTS). The record of the determination of e l i g i b i l i t y is placed
i n the permanent case f i l e .
4. A monthly l i s t i n g is generated from FCTS of a l l AFDC- FC e l i g i b l e
c h i l d r e n . The FCTS p r i n t o u t is compared with t h e APIS p r i n t o u t ,
and d i s c r e p a n c i e s a r e followed up. The FCTS p r i n t o u t becomes the
source document used i n preparing t h e AFDC- FC claim t o the
Federal government.
Noncompliance with Procedures
Our a u d i t disclosed t h a t none of t h e procedures a r e performed adequately.
We i d e n t i f i e d t h e following problems with each procedure:
Procedure 1 - Many ACYF caseworkers do n o t f o l l o w procedures f o r
f i l i n g AFDC- FC r e f e r r a l s with Assistance Payments. They a r e not aware
of e l i g i b i l i t y requirements, o f the t y p e o f information t h a t should be
included i n a r e f e r r a l , and i n some cases t h a t the AFDC- FC program
e x i s t s . Reasons f o r t h i s include: 1) a lack of proper t r a i n i n g
regarding the AFDC- FC program, and 2) a d i s p u t e between ACYF
caseworkers and AP e l i g i b i l i t y workers over which should be
r e s p o n s i b l e f o r gathering information.
Procedure 2 - A l l AP e l i g i b i l i t y workers a r e not aware of the
procedures f o r determining e l i g i b i l i t y . One AP u n i t was holding cases
i n which the p a r e n t h e l a t i v e could not be l o c a t e d , d e s p i t e procedures
i n t h e AFDC- FC t r a i n i n g packet s p e c i f i c a l l y designed t o expedite such
cases. Also, ACYF caseworkers do not always n o t i f y AP e l i g i b i l i t y
workers of case s t a t u s changes which may a f f e c t e l i g i b i l i t y . On the
December 1979 APIS p r i n t o u t of AFDC- FC e l i g i b l e c h i l d r e n ,
approximately 15 percent were no longer i n f o s t e r care.
Procedure 3 - Many ACYF caseworkers do not c o r r e c t l y recode FCTS when
an approved e l i g i b i l i t y determination is returned by Assistance
Payments. Approximately 25 percent of t h e names on t h e December 1979
APIS l i s t i n g of AFDC- FC e l i g i b l e c h i l d r e n were not included on FCTS
because of coding e r r o r s . Coding e r r o r s occur f o r two reasons:
1 ) ACYF caseworkers a r e not aware o f t h e c o r r e c t codes t o i n d i c a t e an
a c t i v e AFDC- FC case, and 2) the codes and t h e i r meanings f o r AFDC- FC
a r e not uniform among ACYF forms.
Procedure 4 - Controls a r e i n s u f f i c i e n t t o ensure t h a t claims for
AFDC- FC matching funds include a l l e l i g i b l e f o s t e r c h i l d r e n . For
example, i n April 1980, DES submitted an AFDC- FC claim f o r t h e period
October 1978 through June 1979. The claim included 106 names, of
which 33 were from Maricopa County. By simply comparing the APIS and
FCTS p r i n t o u t s , we i d e n t i f i e d 25 a d d i t i o n a l c h i l d r e n from Maricopa
County who might be e l i g i b l e f o r AFDC- FC. Although Assistance
Payments had changed its e l i g i b i l i t y c r i t e r i a between the time the
AFDC- FC claim was prepared i n April 1980 and the t i m e of our study, we
found s i x c h i l d r e n who still were e l i g i b l e under t h e new c r i t e r i a , and
15 c h i l d r e n who would have been e l i g i b l e using t h e c r i t e r i a i n e f f e c t
when the claim was prepared. Thus, DES did not include nearly a t h i r d
of t h e c h i l d r e n from Maricopa County possibly e l i g i b l e f o r AFDC- FC on
the claim. These c h i l d r e n could have been i d e n t i f i e d simply by
comparing the APIS p r i n t o u t with the FCTS p r i n t o u t .
Defining the Date of Application
Under the r u l e s of the AFDC- FC program i f a c h i l d is determined t o be
e l i g i b l e , a claim can be submitted f o r the period from t h e d a t e of
a p p l i c a t i o n . However, Assistance Payments has f a i l e d t o d e f i n e t h e d a t e
of a p p l i c a t i o n i n a manner t h a t would permit claims t o be made f o r the
maximum allowable period.
We learned from Federal a u t h o r i t i e s t h a t Assistance Payments can d e f i n e
t h e d a t e of a p p l i c a t i o n as e i t h e r : 1 ) the d a t e an ACYF worker r e f e r s a
case t o Assistance Payments f o r e l i g i b i l i t y determination, or 2) t h e d a t e
Assistance Payments completes its e l i g i b i l i t y d e t e r m i n a t i o n . C u r r e n t l y ,
Assistance Payments d e f i n e s t h e d a t e of a p p l i c a t i o n as the d a t e it
completes e l i g i b i l i t y determination. However, from two t o s i x months
o f t e n e l a p s e s from the time a case is r e f e r r e d t o Assistance Payments
u n t i l e l i g i b i l i t y determination is reached. Thus, because of t h e c u r r e n t
d e f i n i t i o n of d a t e of a p p l i c a t i o n , DES does not claim AFDC- FC f o r t h i s two
t o six- month period -- a period f o r which claims would be allowable i f the
d a t e of a p p l i c a t i o n were defined a s t h e d a t e of r e f e r r a l .
NATURAL- PARENT CHILD SUPPORT
Child support payments from n a t u r a l parents is another funding source
which DES has not used f u l l y . DES policy s t i p u l a t e s t h a t n a t u r a l p a r e n t s
or guardians have a f i n a n c i a l o b l i g a t i o n t o support t h e i r c h i l d r e n i n
f o s t e r care. Such support is based on the parents' a b i l i t y t o pay.
Parents earning more than $ 7,000 a year may pay from 2.5 percent t o t e n
percent o f t h e i r monthly g r o s s income -- up t o t h e c o s t o f t h e i r
c h i l d r e n 1 s c a r e . However, DES does not i n i t i a t e c o l l e c t i o n procedures
a g a i n s t many parents who should be required t o pay c h i l d support, and DES
has inadequate c o l l e c t i o n procedures f o r accounts t h a t become delinquent.
A s a r e s u l t , Arizona may be l o s i n g approximately $ 675,000 a year i n
natural- parent child- support payments.
F a i l u r e t o Assess Natural Parents
The procedures f o r i n i t i a t i n g p a r e n t a l assessment a r e outlined i n t h e
s o c i a l s e r v i c e s manual, which s t a t e s it is t h e caseworker's r e s p o n s i b i l i t y
t o :
- Explain t o parents t h e i r r e s p o n s i b i l i t y t o provide c h i l d support
i f t h e i r c h i l d is placed i n f o s t e r care.
- Require t h a t p a r e n t s complete an income worksheet used t o
determine p a r e n t a l assessment.
- Include i n t h e court r e p o r t a recommendation f o r p a r e n t a l
assessment.
Our case a n a l y s i s i n d i c a t e s t h a t income worksheets a r e not prepared and
t h a t court r e p o r t s o f t e n d o n o t i n c l u d e recommendations f o r p a r e n t a l
assessment. A s a r e s u l t , Arizona is assessing fewer n a t u r a l parents and
c o l l e c t i n g s i g n i f i c a n t l y fewer d o l l a r s than neighboring Utah, which has a
more aggressive program f o r natural- parent support.
It should be noted t h a t Utah has assessment c r i t e r i a s i m i l a r t o Arizona's;
however, a s shown i n Table 7, on a proportional b a s i s Utah a s s e s s e s f i v e
times as many parents a s Arizona does and c o l l e c t s an average of inore than
four times a s many d o l l a r s f o r each f o s t e r c h i l d as Arizona does.
TABLE 7
A COMPARISON OF ARIZONA'S AND UTAH'S ASSESSMENTS
AND COLLECTIONS FOR NATURAL- PARENT SUPPORT
DURING FISCAL YEAR 1978- 79
Foster c a r e population
Number o f n a t u r a l parents assessed
c h i l d support
Percentage o f n a t u r a l parents assessed
c h i l d support
ARIZONA UTAH
2,500 1,000
C o l l e c t i o n s from n a t u r a l parents $ 201,857 $ 350,000
Average c o l l e c t i o n f o r each f o s t e r c h i l d $ 8 1 $ 350
A s Table 7 i n d i c a t e s , Utah's c o l l e c t i o n r a t e f o r each f o s t e r c h i l d is more
t h a n f o u r times g r e a t e r than Arizona's. If Arizona were assessing and
c o l l e c t i n g natural- parent c h i l d support a t the same r a t e as Utah,
c o l l e c t i o n s could be increased by nearly $ 675,000 a year.
In January 1980, during the course o f o u r a u d i t , ACYF issued a program
d i r e c t i v e r e q u i r i n g p a r e n t a l assessment f o r new dependency c a s e s , a l l
voluntary placements and c a s e s t h a t had not been assessed previously. A s
with the d i r e c t i v e on AFDC- FC ( page 5 3 ) , response t o t h i s d i r e c t i v e has
been minimal.
Collection Procedures f o r Delinquent
Accounts Are Inadequate
Even when n a t u r a l parents a r e assessed f o r f o s t e r c a r e , DES l a c k s adequate
procedures t o c o l l e c t i f t h e parents become delinquent i n t h e i r payments.
Currently, n a t u r a l parents owe more than $ 200,000 i n delinquent payments
on t h e i r assessments.
DES w e l f a r e a c c o u n t i n g ' s s p e c i a l funds u n i t is r e s p o n s i b l e f o r b i l l i n g and
accounting f o r f o s t e r care p a r e n t a l assessments. When accounts become
delinquent the u n i t ' s only recourse is through the Attorney General's
o f f i c e and the c o u r t s . However, the matter is low p r i o r i t y f o r the
Attorney General's o f f i c e , so only a small number of delinquent accounts
a r e taken t o c o u r t . From April 1979 t o March 1980, no cases were taken t o
court f o r delinquent payments. In March 1980, 15 c a s e s were taken t o
c o u r t ; y e t t h e s e c a s e s represented only s i x percent of the t o t a l accounts
t h a t were delinquent and only 20 percent of the delinquent accounts t h a t
were more than $ 500. A t t h a t time, t h e A s s i s t a n t Attorney General who
handled such cases s t a t e d t h a t the o f f i c e could accept no more cases
because o f a manpower shortage.
In order t o i n c r e a s e t h e c o l l e c t i o n of d e l i n q u e n t a c c o u n t s , ACYF h a s t a k e n
s t e p s t o involve the Child Support Enforcement Administration, which has
the f u l l - t i m e s e r v i c e s of an A s s i s t a n t Attorney General f o r t h e f i l i n g of
c o u r t o r d e r s , contempt d e c r e e s and other l e g a l remedies.
We found t h a t Utah, with its more s u c c e s s f u l n a t u r a l - p a r e n t s u p p o r t
program, uses its Child Support Enforcement agency t o c o l l e c t delinquent
payments.
SOCIAL SECURITY, SSI AND VA BENEFITS
DES c o l l e c t e d $ 500,000 more i n S o c i a l S e c u r i t y , Supplemental S e c u r i t y
Income ( SSI) and Veteran's Administration ( VA) b e n e f i t s i n f i s c a l year
1979- 80 than it c o l l e c t e d i n f i s c a l year 1978- 79. SSI b e n e f i t s made up
the biggest p a r t o f t h e i n c r e a s e by almost quadrupling from $ 150,000 i n
f i s c a l year 1978- 79 t o more than $ 550,000 i n f i s c a l year 1979- 80. The
i n c r e a s e was due p r i m a r i l y t o the e f f o r t s of one ACYF c e n t r a l o f f i c e s t a f f
person, who prepared a list of names o f p o t e n t i a l l y e l i g i b l e disabled
c h i l d r e n . Caseworkers were then requested t o prepare SSI claims f o r t h e
c h i l d r e n whose names were on t h e list. The i n c i d e n t demonstrates what can
r e s u l t from increased e f f o r t t o c o l l e c t from a l t e r n a t e funding sources.
Despite t h e i n c r e a s e i n c o l l e c t i o n s from S o c i a l S e c u r i t y , SSI and VA, it
appears the funding sources a r e not used f u l l y . A program d i r e c t i v e
issued i n January 1980 requested s u p e r v i s o r s o f f o s t e r c a r e u n i t s t o
review t h e i r c a s e s f o r possible S o c i a l S e c u r i t y , SSI o r VA e l i g i b i l i t y .
The review, conducted i n January and February 1980, i d e n t i f i e d an
a d d i t i o n a l 122 c h i l d r e n p o t e n t i a l l y e l i g i b l e f o r S o c i a l S e c u r i t y , SSI o r
VA b e n e f i t s , even though response from four o f t h e s i x d i s t r i c t s was slow
o r nonexistent. Completion of t h e review should be mandatory i n order t o
ensure t h a t DES r e c e i v e s a l l funds t h a t a r e a v a i l a b l e .
CONCLUSIONS
1. I f DES were a s e f f e c t i v e a s other s t a t e s i n c o l l e c t i o n AFDC- FC
and natural- parent child- support payments, S t a t e revenues could
i n c r e a s e by an estimated $ 1.3 m i l l i o n a year.
2. DES did i n c r e a s e t h e c o l l e c t i o n of S o c i a l S e c u r i t y , SSI and VA
b e n e f i t s i n f i s c a l year 1979- 80 by $ 500,000 over f i s c a l year
1978- 79. However, a DES review of cases i n January and February
1980 i n d i c a t e d t h a t t h i s funding source still is not f u l l y used.
It is recommended t h a t :
1. ACYF s u p e r v i s o r s r e c e i v e a d d i t i o n a l t r a i n i n g on the proper
procedures f o r i d e n t i f y i n g and r e f e r r i n g AFDC- FC c a s e s , preparing
p a r e n t a l assessments and completing claims f o r S o c i a l S e c u r i t y ,
SSI and VA b e n e f i t s , and the s u p e r v i s o r s then r e t r a i n t h e i r
caseworkers i n these procedures and review each case i n t h e i r
u n i t s every s i x months t o ensure the procedures a r e followed
c o r r e c t l y .
2. AP workers receive t r a i n i n g on the proper procedures for
determining AFDC- FC e l i g i b i l i t y and t h a t Assistance Payments
d e f i n e the d a t e of a p p l i c a t i o n f o r AFDC- FC a s the d a t e of
r e f e r r a l f o r e l i g i b i l i t y determination so DES c a n c l a i m the
maximum amount of AFDC- FC a v a i l a b l e .
3. D e l i n q u e n t f o s t e r care p a r e n t a l a s s e s s m e n t s be c o l l e c t e d by t h e
Child Support Enforcement A d m i n i s t r a t i o n .
4. F o s t e r care cases be reviewed f o r p o s s i b l e e l i g i b i l i t y f o r S o c i a l
S e c u r i t y , SSI and VA b e n e f i t s .
FINDING I V
A LACK OF CONTROL OVER THE FOSTER CARE PAYMENT SYSTEM HAS RESULTED I N
DUPLICATE PAYMENTS, PAYMENTS I N WRONG AMOUNTS, UNCOLLECTED OVERPAYMENTS
AND INADEQUATE MONITORING OF CONTRACTS.
DES d i s t r i b u t e s approximately $ 18 m i l l i o n of S t a t e funds annually f o r
f o s t e r c a r e and r e l a t e d s e r v i c e s . D i s t r i b u t i o n s a r e made primarily by one
of t h r e e methods. Most payments a r e made by the computerized F o s t e r Care
Tracking Statewide System; however, some paynents a r e made on claims
submitted by providers and some a r e made f o r block purchases o f c a r e
negotiated under s p e c i a l c o n t r a c t s . Our review of the DZS methods
revealed a pervasive absence of adequate c o n t r o l s over f o s t e r c a r e
payments. We i d e n t i f i e d : 1) numerous i n s t a n c e s of d u p l i c a t e payments and
payments i n wrong amounts which DES did not d e t e c t , 2 ) c o l l e c t i o n
procedures t n a t were inadequate, r e s u l t i n g i n many overpayments never
c o l l e c t e d , and 3) inadequate monitoring and a d m i n i s t r a t i o n of
block- purchase c o n t r a c t s , r e s u l t i n g i n unnecessary expenditures of
approximately $ 120,000 during f i s c a l year 1979- 80 due t o u n d e r u t i l i z a t i o n
of contracted bed spaces."
DUPLICATE PAYMENTS
The DES f o s t e r c a r e payment system does not include adequate c o n t r o l s t o
h e l p p r e v e n t d u p l i c a t e payment. Our a u d i t disclosed t h a t i n some
i n s t a n c e s payments were made through t h e Statewide Tracking System and
a l s o paid by claim. In o t h e r i n s t a n c e s , two claims were paid f o r t h e same
care. The d u p l i c a t e payments were i d e n t i f i e d during: 1) a review o f
payments made during the period September 1979 through Decernber 1979 t o
f o u r o f the 40 i n s t i t u t i o n s providing r e s i d e n t i a l t r e a t m e n t , and 2) a
review of payments made f o r a l l Emergency Receiving Home Care during
January 1980.
* Some of these conditions were previously i d e n t i f i e d i n an August 1979
s p e c i a l a u d i t by the Office of the Auditor General of Visionquest, a
DES provider.
Duplication Between Tracking System
Payments and Claims
We found $ 16,337 i n d u p l i c a t e payments were made t o two of four
r e s i d e n t i a l treatment i n s t i t u t i o n s during the four- month period we
examined. DES was aware of l e s s than a t h i r d of t h e s e d u p l i c a t e payments
a t t h e time we made our review. DES had paid t h e i n s t i t u t i o n s by claim
and a l s o paid f o r t h e same c a r e through t h e Statewide Tracking System. I n
d i s c u s s i o n with DES personnel we determined t h a t t h e r e a r e no c o n t r o l s t o
prevent d u p l i c a t e payments f o r the same s e r v i c e being made by claim and
t h e tracking system.
Payments Made f o r Duplicate Claims
We found two i n s t a n c e s of d u p l i c a t e payments made t o emergency receiving
homes during January 1980. The two double payments, t o t a l i n g $ 545,
r e s u l t e d from the processing of d u p l i c a t e claims. There a r e no apparent
c o n t r o l s t o prevent d u p l i c a t e claims f o r t h e same c a r e being processed by
Welfare Accounting.
Although t h e d u p l i c a t e payments shown above a r e somewhat i n s i g n i f i c a n t ,
t h e p o t e n t i a l does e x i s t f o r s i g n i f i c a n t l o s s e s t o t h e S t a t e i n t h a t :
1) our review was l i m i t e d , 2 ) t h e r e is a pervasive absence of adequate
c o n t r o l s over f o s t e r c a r e payments, and 3) DES pays more than $ 18 m i l l i o n
a year f o r f o s t e r care.
PAYMENTS FOR INCORRECT AMOUNTS
Our a u d i t disclosed numerous i n s t a n c e s of payments made f o r i n c o r r e c t
amounts, another i n d i c a t i o n t h a t the Foster Care Program payment system
has inadequate c o n t r o l s . We determined t h a t t h r e e o f four i n s t i t u t i o n s
whose records we reviewed had received overpayments or underpayments
during the period from September 1979 through December 1979. I n a d d i t i o n ,
we found two emergency receiving homes were paid r e t a i n e r f e e s i n January
1980 f o r more c h i l d r e n than t h e homes were licensed t o f o s t e r . Such
d i s c r e p a n c i e s should n o t occur i n a payment system with proper checks and
balances.
Our review of DES payments t o four i n s t i t u t i o n s revealed t h a t overpayments
and underpayments a r e a common occurrence. We found the following
d i s c r e p a n c i e s during t h e review:
- Payments t o one o f t h e i n s t i t u t i o n s became so disordered t h a t DES
had t o perform manual r e c o n c i l i a t i o n s on each c h i l d ' s account i n
t h a t f a c i l i t y . F i f t e e n percent of the payments t o t h e f a c i l i t y
during the period from September 1979 through December 1979 were
i n c o r r e c t . F u r t h e r , we found t h e DES r e c o n c i l i a t i o n s s t i l l did
not account f o r more than $ 2,500 i n overpayments.
- An i n s t i t u t i o n f o s t e r e d 28 c h i l d r e n i n one of its f a c i l i t i e s
during the review period. A comparison of the f a c i l i t i e s 1
records with DES r e c o r d s i n d i c a t e d t h a t overpayments or
underpayments were made f o r t h e c a r e of 14 of t h e 28 c h i l d r e n .
- A t h i r d i n s t i t u t i o n received s i x overpayments and one
underpayment during the review period. DES was unaware of any of
t h e i n c o r r e c t payments.
During our review we a l s o found t h a t one of the i n s t i t u t i o n s no longer
t r i e d t o r e c o n c i l e DES payments on a case- by- case b a s i s .
A t l e a s t one i n s t i t u t i o n ' s d i r e c t o r claims the f a c t t h a t DES does not use
b i l l i n g s from providers t o determine payments is causing t h e overpayment
problem. He s t a t e d t h a t t h e major cause of the problems is t h a t the
present system does not i n v o l v e p r o v i d e r input u n t i l a f t e r the payment has
been generated. Therefore, many mistakes t h a t could be avoided through
communication, with t h e providers end up taking months t o s t r a i g h t e n out.
He a l s o noted h i s i n s t i t u t i o n f o s t e r s c h i l d r e n f o r t h r e e o t h e r s t a t e s , a l l
of which base payments on b i l l i n g s from the i n s t i t u t i o n .
INADEQUATE COLLECTION OF OVERPAYMENTS
DES is i n e f f e c t i v e i n c o l l e c t i n g overpayments made t o f o s t e r homes and
i n s t i t u t i o n s . A s s t a t e d e a r l i e r , DES is unaware of many of the
overpayments. However, f o r many overpayments t h a t DES is aware of,
c o l l e c t i o n procedures a r e never i n i t i a t e d . When DES does i n i t i a t e
c o l l e c t i o n procedures, t h e r a t e of recovery of overpayments is 20 percent
of t o t a l i d e n t i f i e d overpayments.
Collection Procedures Are Not I n i t i a t e d
The procedure f o r i n i t i a t i n g c o l l e c t i o n s of overpayments is a s follows:
1. The Foster Care Statewide Tracking System generates a monthly
p r i n t o u t of i n v a l i d f o s t e r c a r e payments, which is reviewed by
c l e r k s i n t h e processing u n i t .
2. I f a n i n v a l i d payment is the r e s u l t of an e r r o r by t h e processing
u n i t ( such a s a keypunch e r r o r ) , the processing u n i t prepares an
overpayment r e p o r t .
3. I f an i n v a l i d payment is t h e r e s u l t of a caseworker e r r o r , the
u n i t n o t i f i e s the caseworker, who becomes r e s p o n s i b l e f o r
preparing an overpayment r e p o r t .
4. Copies of overpayment r e p o r t s a r e f i l e d with Welfare Accounting,
which attempts t o c o l l e c t the overpayments.
We found, however, t h e r e a r e no c o n t r o l s t o ensure t h a t overpayment
r e p o r t s a r e prepared and f i l e d with Welfare Accounting. In reviewing the
monthly p r i n t o u t s of i n v a l i<
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| Rating | |
| TITLE | A performance audit of the Department of Economic Security Foster Care Program |
| CREATOR | Arizona. Office of the Auditor General. |
| SUBJECT | Arizona--Dept. of Economic Security--Foster Care Program; Foster home care--Arizona; |
| Browse Topic |
Government and politics |
| DESCRIPTION | 129 pages (PDF version). File size: 3631.264 KB. A Report to the Arizona State Legislature October 1980, Report No. 80-5. |
| Language | English |
| Publisher | Arizona. Office of the Auditor General. |
| TYPE | Text |
| Material Collection |
State Documents House Received Reports |
| Acquisition Note | Publication or link to publication sent to reports@lib.az.us |
| RIGHTS MANAGEMENT | Copyright to this resource is held by the creating agency and is provided here for educational purposes only. It may not be downloaded, reproduced or distributed in any format without written permission of the creating agency. Any attempt to circumvent the access controls placed on this file is a violation of United States and international copyright laws, and is subject to criminal prosecution. |
| DATE ORIGINAL | 1980-10 |
| Time Period |
1980s (1980-1989) |
| ORIGINAL FORMAT | Paper |
| Source Identifier | LG 6.2:R 36 |
| Location | 08331814 |
| DIGITAL IDENTIFIER | 80-5.pdf |
| DIGITAL FORMAT | PDF (Portable Document Format) |
| DIGITIZATION SPECIFICATIONS | Digitized into PDF form through scanning at the Records Management Division, Arizona State Library. |
| REPOSITORY | Arizona State Library. Archives and Public Records--Law and Research Library. |
| File Size | 3631.264 KB |
| Full Text | STATE OF ARIZONA OFFICE OF THE AUDITOR GENERAL A PERFORMANCE AUDIT OF THE DEPARTMENT OF ECONOMIC SECURITY FOSTER CARE PROGRAM OCTOBER 1980 A REPORTTO THE ARIZONA STATE LEGISLATURE RE PORT 80- 5 DOUGLAS R. NORTON. CPA AUDITOR GENERAL STATE OF ARIZONA OFFICE OF THE AUDITOR GENERAL October 2, 1980 Members of the Arizona L e g i s l a t u r e The Honorable Bruce B a b b i t t , Governor Transmitted herewith is a r e p o r t o f t h e Auditor General, A Performance Audit of t h e Department of Economic Security - F o s t e r Care Program. This r e p o r t is i n response t o t h e June 19, 1979, r e s o l u t i o n of t h e J o i n t L e g i s l a t i v e Budget Committee. The blue pages present a summary of t h e r e p o r t ; a response from the Department of Economic Security is found on t h e yellow pages preceding the appendices. My s t a f f and I w i l l be pleased t o d i s c u s s o r c l a r i f y items i n t h e r e p o r t . Respectfully submitted, Douglas R. Norton Auditor General S t a f f : Gerald A. S i l v a William Thomson Steve Wallace Martha B. R a w l s Marsha Wallace Sylvia Forte Enclosure LEGISLATIVE SERVICES WING 0 SUITE 200 STATE CAPITOL PHOENIX. ARIZONA 85007 255- 4385 O F F I C E OF THE AUDITOR GENERAL A PERFORMANCE AUDIT OF THE DEPARTMENT OF ECONOMIC SECURITY FOSTER CARE PROGRAM A REPORT TO THE ARIZONA STATE LEGISLATURE REPORT 80- 5 TABLE OF CONTENTS SUMMARY INTRODUCTION AND BACKGROUND FINDINGS FINDING I Foster c a r e caseworkers do not comply with Department of Economic S e c u r i t y ( DES) p o l i c i e s and procedures regarding prompt and proper placement and monitoring of f o s t e r c h i l d r e n . A s a r e s u l t , many c h i l d r e n simply g e t l o s t i n t h e f o s t e r c a r e system. CONCLUSION RECOMMENDATION FINDING I1 An apparent shortage of f o s t e r homes is r e s u l t i n g i n p o t e n t i a l l y dangerous s i t u a t i o n s f o r some f o s t e r c h i l d r e n and increased c o s t s t o t h e S t a t e f o r emergency r e c e i v i n g c a r e . CONCLUSIONS RECOMMENDATIONS FINDING I11 I f DES were as e f f e c t i v e a s o t h e r s t a t e s i n c o l l e c t i n g AFDC- FC and natural- parent child- support payments, S t a t e revenues could i n c r e a s e by a n e s t i m a t e d $ 1.3 m i l l i o n a year. CONCLUSIONS RECOMMENDATIONS FINDING I V A lack of c o n t r o l over the f o s t e r c a r e payment system has r e s u l t e d i n d u p l i c a t e payments, payments i n wrong amounts, uncollected overpayments and inadequate monitoring of c o n t r a c t s . Page 1 7 CONCLUSIONS RECOMMENDATIONS FINDING V Page 7 3 Improvements a r e needed i n t h e f o s t e r care management information system. CONCLUSION RECOMMENDATIONS OTHER PERTINENT INFORMATION Average Stay i n Foster Care f o r Analyzed Cases was 4.5 Years. DES Has L i t t l e Control over Many Foster Care Expenditures. A Review of Arizona's R e s i d e n t i a l Treatment Centers. Organizational Changes within ACYF Have Been Extensive. Survey of ACYF Caseworkers, Supervisors and Current and Former F o s t e r Parents WRITTEN RESPONSE TO THE AUDITOR GENERAL'S REPORT 8 3 APPENDICES APPENDIX I - Statewide Survey of Licensed Arizona Foster Parents APPENDIX I1 - Statewide Survey of Formerly Licensed Arizona F o s t e r P a r e n t s APPENDIX I11 - Statewide Survey of ACYF P r o f e s s i o n a l s APPENDIX I V - Statewide Survey of ACYF D i r e c t Service Supervisors APPENDIX V - Case L i s t i n g of Missing, Incomplete o r Conflicting Information LIST OF TABLES TABLE 1 - S t a t e Expenditures f o r Programs Administered by ACYF f o r F i s c a l Years 1975- 76 Through 1979- 80 TABLE 2 - Reasons f o r Foster Care Placement Changes between 1975 and 1980 TABLE 3 - Ratio o f F o s t e r Homes t o Foster Children f o r Arizona and Nine otner Western S t a t e s , July 1980 TABLE 4 - Number of Days Foster Children Remain i n Emergency Receiving Care TABLE 5 - Summary of Former F o s t e r P a r e n t s 1 Reasons f o r Terminating T h e i r L i c e n s e s TABLE 6 - A Comparison of Arizona AFDC- FC E l i g i b i l i t y Rules With Ten other Western S t a t e s , December 1979 TABLE 7 - A Comparison of Arizona's and Utah's Assessment and C o l l e c t i o n s f o r Natural- Parent Support during F i s c a l Year 1978- 79 TABLE 8 - Comparison of Federal Standards f o r a Foster Care Information System t o the C a p a b i l i t i e s of t h e Statewide Tracking System a s of August 1980 TABLE 9 - Length of Time i n the Foster Care System f o r t h e 206 C h i l d r e n ' s Cases Analyzed TABLE 10 - County Juvenile Court Foster Care Allocations and Expenditures f o r F i s c a l Year 1979- 80 Page 8 2 2 3 4 4 2 4 3 52 SUMMARY The O f f i c e o f t h e Auditor General has conducted a performance a u d i t of the Department of Economic S e c u r i t y - Foster Care Program i n response t o a June 19, 1979, r e s o l u t i o n of the J o i n t L e g i s l a t i v e Budget Committee. The performance a u d i t r e p o r t presented h e r e i n was prepared under t h e a u t h o r i t y vested i n the Auditor General by Arizona Revised S t a t u t e s ( A. R. S.) $ 41- 1279 e t seq. Foster care has been defined a s " . . . s u b s t i t u t e parenting and nurturance, which is provided on a f e e f o r s e r v i c e b a s i s , t o c h i l d r e n who cannot o r should not l i v e with t h e i r n a t u r a l f a m i l i e s f o r a period of time.. ." I n t h e s t r i c t e s t sense, f o s t e r c a r e s e r v i c e s include placement and casework s e r v i c e s , and l i c e n s i n g and monitoring of such f o s t e r c a r e f a c i l i t i e s a s family f o s t e r homes, group f o s t e r homes and r e s i d e n t i a l treatment c e n t e r s . However, s i n c e f o s t e r care is viewed as one p a r t o f a continuum of s e r v i c e s t o c h i l d r e n , s e v e r a l o t h e r functions r e l a t e importantly t o f o s t e r c a r e , including c h i l d p r o t e c t i v e s e r v i c e s and adoption s e r v i c e s . The f o s t e r c a r e program is administered by the Administration f o r Children, Youth and Families ( ACYF), a bureau i n t h e D i v i s i o n o f Aging, Family and Children S e r v i c e s w i t h i n t h e Department of Economic S e c u r i t y ( DES). Approximately 1,900 c h i l d r e n c u r r e n t l y receive f o s t e r c a r e s e r v i c e s through ACYF and 700 more receive s e r v i c e s from o t h e r agencies and a r e paid through ACYF. I n f i s c a l year 1979- 80, S t a t e payments f o r c a r e of t h e s e c h i l d r e n t o t a l e d more than 18 m i l l i o n d o l l a r s . In reviewing the Foster Care Program we found t h a t ACYF g e n e r a l l y has e s t a b l i s h e d a good system o f p o l i c i e s t o govern t h e program's operations. Nevertheless, we found t h a t some s i g n i f i c a n t problems e x i s t within the program and t h a t these problems primarily a r i s e because: a ) e x i s t i n g p o l i c i e s a r e not followed, and/ or b) the f o s t e r c a r e d a t a system c o n t a i n s i n a c c u r a t e and incomplete d a t a . The problems we i d e n t i f i e d a r e addressed - i n f i v e major f i n d i n g s : 1. Foster c a r e caseworkers do not comply with DES p o l i c i e s and procedures regarding prompt and proper placement and monitoring 4 of f o s t e r c a r e c h i l d r e n . A s a r e s u l t , many c h i l d r e n simply g e t l o s t i n the f o s t e r c a r e system. ( page 11) 2. An apparent shortage of f o s t e r homes is r e s u l t i n g i n p o t e n t i a l l y dangerous s i t u a t i o n s f o r some f o s t e r c h i l d r e n and increased c o s t s t o the S t a t e f o r emergency r e c e i v i n g c a r e . ( page 33) 3. I f DES were a s e f f e c t i v e a s other s t a t e s i n c o l l e c t i n g AFDC- FC and natural- parent child- support payments, S t a t e revenues could i n c r e a s e by a n e s t i m a t e d $ 1.3 m i l l i o n a year. ( page 51) 4. A lack of c o n t r o l over the f o s t e r c a r e payment system has r e s u l t e d i n d u p l i c a t e payments, payments i n wrong amounts, uncollected overpayments and inadequate monitoring of c o n t r a c t s . ( page 63) 5. Improvements a r e needed i n the f o s t e r c a r e management information system. ( page 73) The r e p o r t c o n t a i n s i n f o r m a t i o n r e g a r d i n g l e n g t h of s t a y i n f o s t e r c a r e , DES c o n t r o l over f o s t e r c a r e expenditures, a review of Arizona's r e s i d e n t i a l treatment c e n t e r s , DES r e o r g a n i z a t i o n and Auditor General surveys of ACYF caseworkers, s u p e r v i s o r s and c u r r e n t and former f o s t e r parents. It is recommended t h a t : - Supervisors review cases every t h r e e months t o determine i f : 1) placement plans a r e developed i n a timely manner and implemented properly, 2) home v i s i t s a r e made as o f t e n a s r e q u i r e d , 3) case records a r e maintained properly, and 4) c h i l d r e n change placements only when necessary and a r e prepared adequately f o r t h e change. When these procedures a r e not followed, a p p r o p r i a t e ' d i s c i p l i n a r y a c t i o n should be a administered. ( page 30) - D i s t r i c t Program Managers review cases on a random b a s i s t o ensure t h a t s u p e r v i s o r s monitor t h e i r cases properly. When Program Managers determine t h a t s u p e r v i s o r s a r e not properly reviewing t h e i r c a s e s , a p p r o p r i a t e d i s c i p l i n a r y a c t i o n should be administered. ( page 31) - A manpower study be commissioned t o determine i f DZS caseworkers have adequate time t o follow a l l procedures required of them. In a d d i t i o n , t h e study should determine i f DES uses case a i d s , c l e r i c a l s t a f f and o u t s i d e p r o f e s s i o n a l s t o f u l l advantage. ( page 31) - DES take the following s t e p s t o help reduce f o s t e r parent turnover and improve recruitment of f o s t e r p a r e n t s : ( page 49) 1. D i r e c t a d m i n i s t r a t o r s t o implement management a c t i o n s , including spot- checks of case f i l e s t o ensure t h a t scheduled worker c o n t a c t s a r e made with f o s t e r parents and t h a t f o s t e r parents a r e consulted i n planning f o r f o s t e r c h i l d r e n . 2. Review t h e need f o r , and f e a s i b i l i t y o f , a telephone h o t l i n e f o r f o s t e r parents. 3. Monitor and analyze f o s t e r home turnover d a t a p e r i o d i c a l l y . 4. A s a p a r t of t h e recruitment program, c o l l e c t d a t a as t o why persons who i n q u i r e about f o s t e r p a r e n t i n g d r o p out a f t e r i n q u i r y . Also, c o l l e c t d a t a as t o whether persons who drop out would be i n t e r e s t e d i n f o s t e r parenting a t a l a t e r d a t e and e s t a b l i s h a system f o r contacting these persons again. - ACYF s u p e r v i s o r s r e c e i v e a d d i t i o n a l t r a i n i n g on t h e proper procedures f o r i d e n t i f y i n g and r e f e r r i n g AFDC- FC c a s e s , preparing p a r e n t a l assessments and completing claims f o r S o c i a l S e c u r i t y , Supplemental Security Income ( SSI) and Veterans1 Administration ( VA) b e n e f i t s , and the s u p e r v i s o r s t h e n r e t r a i n t h e i r caseworkers i n these procedures and review each case i n t h e i r u n i t s every s i x months t o ensure t h e procedures a r e followed c o r r e c t l y . ( page 60) - - Assistance Payments workers receive t r a i n i n g on t h e proper procedures f o r determining AFDC- FC e l i g i b i l i t y and t h a t Assistance Payments d e f i n e the d a t e of a p p l i c a t i o n f o r AFDC- FC a s the d a t e of r e f e r r a l f o r e l i g i b i l i t y determination so DES can claim the maximum amount of AFDC- FC a v a i l a b l e . ( page 60) - Delinquent f o s t e r c a r e p a r e n t a l assessments be c o l l e c t e d by t h e Child Support Enforcement Administration. ( page 61) - Foster c a r e cases be reviewed f o r possible e l i g i b i l i t y f o r S o c i a l S e c u r i t y , SSI and VA b e n e f i t s . ( page 61) - DES i n c o r p o r a t e t h e following c o n t r o l s i n t o its payment system: ( page 72) 1. Require itemized b i l l i n g s from agency providers of r e s i d e n t i a l treatment, s h e l t e r c a r e and emergency receiving care. Such b i l l i n g s e i t h e r could be incorporated as t h e input documents t o g e n e r a t e payments through t h e Statewide Tracking System or reconciled a g a i n s t d a t a c u r r e n t l y entered i n t o the tracking system. 2. Make payments through the tracking system whenever possible. I f payment is made by claim, cross- check such payment a g a i n s t the tracking system and o t h e r claims paid the same provider. 3. Recover overpayments owed t h e S t a t e by withholding the amount of overpayment from subsequent payments t o the same provider. 4. Monitor the bed- space u t i l i z a t i o n r a t e on block- purchase c o n t r a c t s monthly and take a p p r o p r i a t e a c t i o n t o i n v e s t i g a t e and, i f necessary, seek t o r e n e g o t i a t e c o n t r a c t s on which u t i l i z a t i o n is low. - By July 1, 1981, DES submit a r e p o r t t o t h e J o i n t L e g i s l a t i v e Budget Committee ( JLBC) d e t a i l i n g improvements made t o the information- generating c a p a b i l i t i e s of t h e Statewide Tracking System. Upon r e c e i p t of the DES r e p o r t s , the JLBC consider d i r e c t i n g t h e O f f i c e o f the Auditor General t o r e e v a l u a t e the Statewide Tracking System and submit a r e p o r t t o the JLBC by January 1, 1982. ( page 78) - DES conduct a thorough examination of information i n the Statewide Tracking System and make a p p r o p r i a t e c o r r e c t i o n s . ( page 78) - The Director of DES i s s u e a memorandum t o f o s t e r c a r e s u p e r v i s o r s , caseworkers and d i s t r i c t employees s t r e s s i n g the importance o f t h e Statewide Tracking System and d i r e c t i n g them t o e x e r c i s e t h e utmost d i l i g e n c e i n preparing and submitting information t o the system. ( page 78) INTRODUCTION AND BACKGROUND The Office of the Auditor General has conducted a performance a u d i t of t h e Department of Economic S e c u r i t y - Foster Care Program i n response t o a June 19, 1979, r e s o l u t i o n of t h e J o i n t L e g i s l a t i v e Budget Committee. The performance a u d i t r e p o r t presented herein w a s prepared under t h e a u t h o r i t y vested i n the Auditor General by Arizona Revised S t a t u t e s ( A. R. S.) $ 41- 1279 e t seq. Foster c a r e has been defined as ' I . . . s u b s t i t u t e parenting and nurturance, which is provided on a f e e f o r s e r v i c e b a s i s , t o c h i l d r e n who cannot o r should not l i v e with t h e i r n a t u r a l f a m i l i e s f o r a period of time.. ." I n the s t r i c t e s t sense, f o s t e r c a r e s e r v i c e s include placement and casework s e r v i c e s , and l i c e n s i n g and monitoring of such f o s t e r c a r e f a c i l i t i e s a s family f o s t e r homes, group f o s t e r homes and r e s i d e n t i a l treatment c e n t e r s . However, s i n c e f o s t e r c a r e is viewed a s one p a r t o f a continuum of s e r v i c e s t o c h i l d r e n , s e v e r a l other functions r e l a t e importantly t o f o s t e r c a r e , including c h i l d p r o t e c t i v e s e r v i c e s and adoption s e r v i c e s . The f o s t e r c a r e program is administered by t h e Administration f o r Children, Youth and Families ( ACYF), a bureau i n t h e Division of Aging, Family and Children Services within the Department of Economic S e c u r i t y ( DES). Approximately 1,900 c h i l d r e n c u r r e n t l y r e c e i v e f o s t e r c a r e s e r v i c e s through ACYF and 700 more receive f o s t e r c a r e s e r v i c e s from o t h e r agencies and a r e paid through ACYF. Table 1 shows Arizona's expenditures f o r programs administered by ACYF f o r t h e past f i v e years. The l i n e item e n t i t l e d F o s t e r Care Program c o n s i s t s of the a c t u a l payments t o such f o s t e r c a r e f a c i l i t i e s a s family f o s t e r homes, group homes, i n s t i t u t i o n s and r e l a t e d s e r v i c e s . TABLE 1 STATE EXPENDITURES FOR PROGRAMS ADMINISTERED BY ACYF FOR FISCAL YEARS 1975- 76 THROUGH 1979- 80 1975- 76 Actual FTE* p o s i t i o n s 492.5 Operating Budget Personal s e r v i c e s $ 4,472,300 Employee- related expenditures 614,200 Professional & o u t s i d e s e r v i c e s 162,700 Travel: In- State 222,100 Out- of- State 10,200 Other operating expenditures 401,300 Equipment 73,500 Operating s u b t o t a l 5,956,300 CMDP* * * 2,436,900 FOSTER CARE PROGRAM 8,661,200 Informational & r e f e r r a l s e r v i c e s 48,600 Child s h e l t e r c a r e 311,500 Family planning 52,300 Day c a r e 1,029,700 Manpower s e r v i c e s 236,200 Adoption subsidy - 0 - Child p r o t e c t i v e s e r v i c e - 0- 1976- 77 1977- 78 1978- 79 1979- 80 Actual Actual Actual Estimatedn*** * Full- time equivalent. ** These l i n e items now a r e funded from t h e DES D i r e c t o r ' s Office. *** Comprehensive Medical and Dental Program. **** The f i s c a l year 1979- 80 estimates r e f l e c t a t r a n s f e r of State- funded FTE postions t o Federal funding. In reviewing the Foster Care Program we found t h a t ACYF generally has e s t a b l i s h e d a good system of p o l i c i e s t o govern the program's operations. Nevertheless, we found t h a t some s i g n i f i c a n t problems e x i s t within the program and t h a t these problems primarily a r i s e because: a) e x i s t i n g p o l i c i e s a r e not followed, and/ or b) the f o s t e r c a r e d a t a system c o n t a i n s i n a c c u r a t e and incomplete d a t a . The problems we i d e n t i f i e d a r e addressed i n f i v e major f i n d i n g s : 1. Foster care caseworkers d o n o t comply with DES p o l i c i e s and procedures regarding prompt and proper placement and monitoring of f o s t e r c a r e c h i l d r e n . A s a r e s u l t , many c h i l d r e n simply g e t l o s t i n the f o s t e r c a r e system. 2. An apparent shortage of f o s t e r homes is r e s u l t i n g i n p o t e n t i a l l y dangerous s i t u a t i o n s f o r some f o s t e r c h i l d r e n and increased c o s t s t o the S t a t e f o r emergency receiving care. 3. I f DES were as e f f e c t i v e a s o t h e r s t a t e s i n c o l l e c t i n g AFDC- FC and natural- parent child- support payments, S t a t e revenues could i n c r e a s e by a n e s t i m a t e d $ 1.3 m i l l i o n a year. 4. A lack of c o n t r o l over the f o s t e r c a r e payment system has r e s u l t e d i n d u p l i c a t e payments, payments i n wrong amounts, uncollected overpayments and inadequate monitoring of c o n t r a c t s . 5. Improvements a r e needed i n the f o s t e r c a r e management information system. The Office of the Auditor General expresses its g r a t i t u d e t o the D i r e c t o r of the Department of Economic Security and h i s s t a f f f o r t h e i r cooperation, a s s i s t a n c e and c o n s i d e r a t i o n d u r i n g t h i s a u d i t . FINDING I FOSTER CARE CASEWORKERS DO NOT COMPLY WITH DEPARTMENT OF ECONOMIC SECURITY ( DES) POLICIES AND PROCEDURES REGARDING PROMPT AND PROPER PLACEMEN'I AND MONITORING OF FOSTER CARE CHILDREN. AS A RESULT MANY CHILDREN SIMPLY GET LOST I N THE FOSTER CARE SYSTEM. The main g o a l s of the f o s t e r care system, a s summarized from t h e DES s o c i a l s e r v i c e s manual, a r e t o : - Prevent, reduce o r eliminate dependency, * - Prevent or remedy n e g l e c t , abuse o r e x p l o i t a t i o n of c h i l d r e n , - Preserve, r e h a b i l i t a t e o r r e u n i t e f a m i l i e s , and - Prevent o r reduce i n a p p r o p r i a t e i n s t i t u t i o n a l c a r e by providirg other forms of l e s s - i n t e n s i v e c a r e . To achieve these g o a l s t h e following o b j e c t i v e s should be met. 1. Enable c h i l d r e n who cannot remain i n t h e i r own homes t o receive c a r e , p r o t e c t i o n and t r a i n i n g i n a s u b s t i t u t e l i v i n g arrangement. 2. Develop a permanent plan f o r the c h i l d r e n . Although DES s t r e s s e s proper c a r e and permanency f o r f o s t e r c h i l r e n , our a u d i t of the Foster Care Program disclosed t h a t these g o a l s and o b j e c t i v e s a r e not being achieved. * According t o A. R. S. $ 8- 201.10 a dependent c h i l d is one who is adjudicated by t h e j u v e n i l e court t o be i n need of proper and e f f e c t i v e p a r e n t a l c a r e and c o n t r o l . Our o f f i c e reviewed 82 f o s t e r care* cases involving 206 c h i l d r e n . This review revealed t h a t : 1. Permanent placement plans a r e not developed i n a timely manner and a r e not implemented properly. 2. Children within the f o s t e r c a r e system a r e denied a s e n s e of permanency because they change placements so often. 3. Foster c a r e caseworkers d o n o t make home v i s i t s as o f t e n a s required nor do they document v i s i t s . 4. Case records i n d i c a t e s e r i o u s information gaps, c o n f l i c t i n g information and i n c o n s i s t e n t organization. These f a i l u r e s have r e s u l t e d i n numerous i n s t a n c e s of c h i l d r e n s i a p l y g e t t i n g l o s t i n the f o s t e r c a r e system, with l i t t l e e f f o r t made by f o s t e r care caseworkers t o c o r r e c t t h e s i t u a t i o n . PERMANENT PLACEMENT PLANS ARE NOT DEVELOPED OR IMPLEMENTED PROPERLY The DES S o c i a l Services Manual s t a t e s t h a t it is the caseworker's r e s p o n s i b i l i t y t o : ItDevelop( s) placement plan f o r c h i l d within first t h r e e months of i n i t i a l placement d i r e c t e d t o one of the following g o a l s : " 1. Return t o n a t u r a l p a r e n t s / l e g a l guardians, " 2. Placement with other s u i t a b l e r e l a t i v e s , " 3. Adoption, o r " 4. Permanent f o s t e r care. " * For our a u d i t purposes, f o s t e r c a r e includes placement with f o s t e r - a p a r e n t s , i n s t i t u t i o n s , r e l a t i v e s and emergency receiving homes, a s well a s unsuccessr'ul attempts t o r e u n i t e c h i l d r e n with t h e i r n a t u r a l parents. Adequate permanent placement plans a r e important because they c l e a r l y enumerate t h e s t e p s necessary t o reach the c h i l d ' s u l t i m a t e placement goal and e s t a b l i s h time parameters f o r achieving both s t e p s and goals. In a d d i t i o n , a good permanent placement plan properly monitors a f o s t e r c a r e case i n t h a t i t provides s p e c i f i c progress benchmarks a g a i n s t which a c t u a l c a s e p r o g r e s s can be measured. Our a n a l y s i s of f o s t e r c a r e case f i l e s revealed t h a t proper permanent placement plans a r e n e i t h e r developed nor implemented a s required. For example, the following noncompliances with the DES s o c i a l s e r v i c e s manual were i d e n t i f i e d . 1. I n more than two- thirds of the cases reviewed, placement plans were not e s t a b l i s h e d within t h r e e months of i n i t i a l placement, 2. F o s t e r p a r e n t s o f t e n a r e not involved i n the development of placement plans, and 3. Placement plans have not been properly monitored and/ or e f f o r t s t o achieve t h e plans have not been documented. These noncompliances, combined with frequent caseworker assignment changes" have r e s u l t e d i n c h i l d r e n remaining i n f o s t e r c a r e f o r long periods of time with no a p p a r e n t p r o g r e s s made toward implementing t h e i r placement goals. - * Caseworker assignment changes i n c l u d e t h o s e caused by caseworker turnover as well a s a d m i n i s t r a t i v e caseworker charges. Permanent Placement Plans Are Not Developed i n a Timely Manner Our review i n d i c a t e d t h a t permanent placement plans were not developed i n t h e first t h r e e months of placement i n more than two- thirds of t h e cases for which we could determine t h e f i r s t placement d a t e and the d a t e of the i n i t i a l placement plan." Hhile t h e r e has been some improvement i n t h i s a r e a during f i s c a l years 1978- 79 and 1979- 80, permanent plans still were not developed within t h e f i r s t t h r e e months of placement f o r h a l f the cases opened during t h a t period. The following two cases demonstrate t n e adverse e f f e c t s of permanent placement plans not being developed i n a timely manner. CASE I A one- and- a- half- year- old c h i l d was taken from her p a r e n t s i n May 1977 because o f n e g l e c t . The placement goal was t o r e t u r n t h e c h i l d t o the p a r e n t s , but no placement plan was developed t o accomplish t h a t goal f o r more than two years. When a placement plan f i n a l l y was developed i n June 1979, the Foster Care Review Board** disagreed with the plan and recommended adoption as an a l t e r n a t i v e placement goal. Subsequently, the c h i l d ' s year- old s i s t e r a l s o was removed from the p a r e n t s i n October 1979, because o f s e v e r e n e g l e c t . A s of January 17, 1980, the Foster Care Program had not i n i t i a t e d a severance process** x or developed a plan f o r adoption of t h e two c h i l d r e n d e s p i t e t h e parents1 demonstrated unwillingness and i n a b i l i t y t o c a r e f o r them. * Such d e t e r m i n a t i o n s could not be made i n many c a s e s because of a pervasive absence of adequate case documentation. 111 ** The Foster Care Review Board was e s t a b l i s h e d by the L e g i s l a t u r e i n 1979 t o review o b j e c t i v e l y f o s t e r c a r e cases i n which c h i l d r e n a r e i n c a r e f o r l o n g e r t h a n s i x months and t o present t h e i r f i n d i n g s t o the j u v e n i l e c o u r t . *** A severance process is a means t o determine i f the parent- child r e l a t i o n s h i p should be permanently terminated and t h e c h i l d made a v a i l a b l e f o r adoption. CASE 2 A brother and s i s t e r were v o l u n t a r i l y placed i n t o f o s t e r c a r e by t h e i r mother i n July 1976 because they were severely handicapped emotionally. A dependency p e t i t i o n * was f i l e d so they could remain i n f o s t e r c a r e . The placement goal f o r the c h i l d r e n was t o r e t u r n them t o t h e i r p a r e n t , but a f o s t e r c a r e caseworker did n o t develop a placement plan u n t i l April 1979, nearly t h r e e years l a t e r . The Foster Care Program did l i t t l e t o help r e u n i t e t h e c h i l d r e n with t h e i r mother u n t i l t h e placement plan was developed . However, once t h e placement plan was developed, the mother received counseling and was allowed t o v i s i t the c h i l d r e n r e g u l a r l y . It should be noted t h a t most of t h e f o s t e r c a r e c h i l d r e n who r e t u r n t o t h e i r p a r e n t s do so within t h e first y e a r o f placement i n f o s t e r c a r e . Thus, f a i l u r e t o plan promptly f o r t h e r e u n i t i n g of parent and c h i l d , ' o r an a l t e r n a t i v e such a s adoption, simply i n c r e a s e s t h e l i k e l i h o o d of a c h i l d ' s remaining i n the f o s t e r c a r e system. Caseworkers Do Not Involve Foster Parents i n Developing Placement Plans According t o t h e DES S o c i a l Services Manual, f o s t e r c a r e caseworkers a r e required t o : " Confer( s) with n a t u r a l p a r e n t s , f o s t e r c a r e p r o v i d e r s , c h i l d when a p p r o p r i a t e and other involved p r o f e s s i o n a l s t o develop placement plan.!! An Auditor General survey o f f o s t e r p a r e n t s and a review of t h e case f i l e s i n d i c a t e t h a t the policy is not adhered t o properly. Less than 40 percent of t h e f o s t e r p a r e n t s responding t o t h e survey s t a t e d t h a t a f o s t e r c a r e caseworker had involved them i n a placement plan. The same survey revealed t h a t more than 95 percent o f t h e f o s t e r p a r e n t s f e l t t h a t t h e i r caseworker should c o n s u l t with them i n e s t a b l i s h i n g t h e placement plan- Comments from the surveyed f o s t e r - c a r e p a r e n t s included: * A dependency p e t i t i o n is f i l e d with t h e j u v e n i l e court t o l e g a l l y remove the c h i l d ' s dependency on t h e parents and place t h e c h i l d i n the c a r e of the S t a t e . - " How can a f o s t e r parent work with t h e c h i l d not knowing o r having input t o t h e case plan?" - " When a case plan is e s t a b l i s h e d f o r a c h i l d i n our c a r e how does anyone expect the plan t o be s u c c e s s f u l ? I cannot a s s i s t i n the unknown." - " I ' v e given my input and i n t h e end, t h i n g s have worked out well f o r the c h i l d but i n i t i a l l y , I f e l t I was disregarded and ignored. My opinion was not asked for." - We a r e considered troublemakers i f making suggestions, and when asked t o assist with a problem the s o c i a l worker instead w i l l remove t h e c h i l d t o a d i f f e r e n t f o s t e r home." - " I f e l t I was t r y i n g t o assist f o r t h e good of t h e c h i l d but t h e caseworker told me t o ' b u t t o u t ' . " The review of f o s t e r c a r e case f i l e s s i m i l a r l y i n d i c a t e d t h a t f o s t e r parents a r e n o t c o n f e r r e d with when placement plans a r e developed. The following cases i l l u s t r a t e what can and does happen when f o s t e r parents a r e not involved i n developing a placement plan. CASE I In October 1974, a f o s t e r c a r e c h i l d gave b i r t h . The baby remained with the child- mother u n t i l May 1975, at which time he was moved t o a separate f o s t e r home, where he remained f o r almost two- and- a- half years. In October 1977, t h e c h i l d was reunited with h i s mother; however, s i x months l a t e r t h e c h i l d again was removed from h i s mother because of n e g l e c t . He was placed back i n t h e f o s t e r home i n which he had stayed from May 1975 through October 1977. A t t h a t time t h e f o s t e r parents were t o l d t h a t the goal was t o prepare t h e c h i l d f o r adoption. Approximately eleven months l a t e r , the f o s t e r parents q u i t the F o s t e r Care Program when they discovered t h a t t h e c h i l d ' s placement plan still was t o r e t u r n the c h i l d t o h i s mother. Had the f o s t e r p a r e n t s been involved i n developing the c h i l d ' s placement plan, the s i t u a t i o n could have been avo id ed . CASE I1 The two- month- old c h i l d of a heroin a d d i c t was placed i n a f o s t e r home i n June 1976. The c h i l d changed f o s t e r homes i n April 1978 and remained i n the second f o s t e r home, an emergency receiving home, u n t i l November 1979, a t which time the f o s t e r parents refused t o help t h e c h i l d any longer. According t o the f o s t e r p a r e n t s , they were told repeatedly by t h e f o s t e r c a r e caseworker t h a t t h i s would be a temporary placement, and they were concerned t h a t i f t h e y k e p t t h e c h i l d any longer, he would become too attached t o the f o s t e r family. The f o s t e r parents were so upset about the caseworker's f a i l u r e t o involve them i n t h e placement plan t h a t they logged a complaint with the Governor's Office. Placement Plans Are Not Properly Monitored The g u i d e l i n e s f o r monitoring placement plans and g o a l s a r e c l e a r l y s t a t e d i n t h e S o c i a l Services Manual. The f o s t e r c a r e caseworker should: " 1. Do( es) a complete review of progress toward t h e planned goal every s i x months, including i n the n a r r a t i v e d i c t a t i o n the following information: " a. Present goal f o r t h e c h i l d ; " b. Whether t h e g o a l has been reached; " c. I f the goal has not been reached i n d i c a t e : - Main f a c t o r s t h a t have hindered o r blocked progress, - Workers' a c t i v i t i e s of t h e past s i x months, and - Workers' plans f o r t h e next s i x months; " d. I f t h e goal has been reached i n d i c a t e what, i f any, necessary supportive s e r v i c e s a r e being provided t o support the c u r r e n t case s t a t u s ; and " e. Whether t h e r e is a need t o change the planned g o a l , and why. " 2 . Submit( s) case f o r review every s i x months beginning 18 months a f t e r d a t e of i n i t i a l placement, i f t h e planned goal has not been reached, t o one of t h e following: " a. Local o f f i c e s o c i a l s e r v i c e s manager; " b. D i s t r i c t s o c i a l s e r v i c e s program manager; and " c. Local o f f i c e s t a f f i n g , t o include: - Supervisor, - Permanent placement worker, - Foster c a r e s p e c i a l i s t , - Nonagency p r o f e s s i o n a l s involved i n t h e c a s e , and - Others who may o f f e r input t o t n e placement plan." The caseworker's supervisor should: " Review( s) progress toward t h e goal with worker not l e s s than once every t h r e e months and document t h i s review i n t h e case record by i n i t i a l s o r w r i t t e n statement." Our a n a l y s i s disclosed t h a t none of these functions were performed o r documented properly f o r a l l of t h e case f i l e s analyzed. This f a i l u r e is manifested i n t h e l e n g t h of time t h a t c h i l d r e n with a placement goal of adoption remain i n f o s t e r c a r e with no apparent e f f o r t made t o achieve t h a t goal. For example, 69 of the 206 c h i l d r e n i n our case a n a l y s i s had a n a d o p t i o n goal during the period 1975 through 1979. O f these 69 c h i l d r e n , only t h r e e , l e s s than f i v e percent, had been adopted as of December 1979; 14 had t h e i r placement goal of adoption cnanged; and 52 still had adoption as a placement goal. These 52 c h i l d r e n had r e t a i n e d a goal of adoption f o r an average o f almost 500 days. F u r t h e r , only s i x of the 52 c h i l d r e n had a severance hearing scheduled as of December 1979. The following two c a s e s a r e i l l u s t r a t i v e of the s i t u a t i o n . CASE I Between February 1972 and April 1974, s i x b r o t h e r s and s i s t e r s were placed i n f o s t e r c a r e because they were neglected by t h e i r mother. Adoption was first mentioned i n the case record a s a placement goal i n 1976, and became t h e o f f i c i a l goal f o r t h r e e o f t h e c h i l d r e n i n July 1977 only a f t e r it became apparent t h a t t h e mother was not a b l e t o c a r e f o r them. A f o u r t h c h i l d ' s placement goal was changed t o adoption i n February 1979. However, a s of December 1979, no documented e f f o r t had been made by t h e caseworker t o e f f e c t adoption. A s of December 1979, the F o s t e r Care Program hall not even f i l e d a severance p e t i t i o n , t h e first of many s t e p s toward an adoption. CASE I1 Two s i s t e r s and a brother entered t h e Foster Care Program i n July 1977 and were placed immediately with an adoptive family. The prospective adopting p a r e n t s s e p a r a t e d , and the c h i l d r e n were removed i n December 1977. In June 1978, t h e c h i l d r e n ' s mother relinquished her r i g h t s t o t h e c h i l d r e n ; however, a s of January 1980, no e f f o r t had been made by f o s t e r c a r e t o e f f e c t an adoption. For example, between June 1978 and January 1980, the two c h i l d r e n had changed f o s t e r c a r e placements twice b u t t h e y had not been placed with a n o t h e r p r o s p e c t i v e a d o p t i v e family. These c a s e s demonstrate c l e a r l y t h a t the Foster Care Program must place a d d i t i o n a l emphasis on monitoring placement plans t o ensure they a r e c a r r i e d o u t e x p e d i t i o u s l y and t o determine why they a r e not i f they a r e not. Caseworker Reassignments Slow Placement A primary cause f o r placement p l a n s n o t being implemented promptly is t h e high frequency o f f o s t e r - c a r e caseworker reassignment. Because of numerous assignment changes, placement goals a r e f r e q u e n t l y changed by new caseworkers thus causing the whole process t o start over. Foster c h i l d r e n do not r e c e i v e a c o n t i n u i t y of care. The following examples a r e r e p r e s e n t a t i v e . CASE I In May 1972, two s i s t e r s and a brother entered f o s t e r c a r e because t h e i r mother neglected them. A placement goal of adoption was e s t a b l i s h e d i n January 1973, and a severance p e t i t i o n was d r a f t e d i n p a r t . Adoption remained t h e placement goal f o r the c h i l d r e n f o r s i x years. The Foster Care Program made no documented attempts t o o b t a i n a severance. I n August 1979, a seventh caseworker was assigned t o the c h i l d r e n . The placement goal was abruptly changed t o a r e t u r n of t h e c h i l d r e n t o t h e i r mother, d e s p i t e t h e f a c t t h a t she had made i n f r e q u e n t c o n t a c t with t h e c h i l d r e n from 1972 through 1979. CASE I1 In February 1979, t h r e e s i s t e r s entered the Program a f t e r t h e i r mother had abandoned them and t h e i r f a t h e r had admitted i n c e s t . A placement goal was e s t a b l i s h e d t o r e t u r n t h e c h i l d r e n t o t h e i r p a r e n t s , b u t as of December 1979 an adequate placement plan had not been developed t o accomplish t h a t goal. Between February 1979 and July 1979, f i v e d i f f e r e n t caseworkers were assigned t o these c h i l d r e n . An August 1979 F o s t e r Care Review Board r e p o r t s t a t e d t h a t caseworker turnover impeded progress of t h e case. CHILDREN SUFFER LACK OF PERMANENCY BECAUSE THEIR PLACEMENT IS CHANGED SO OFTEN Because a p p r o p r i a t e f o s t e r homes simply a r e not a v a i l a b l e , " f o s t e r c h i l d r e n i n Arizona o f t e n a r e moved from one i n a p p r o p r i a t e placement t o another with no regard f o r permanency o r s t a b i l i t y . According t o child- psychology s p e c i a l i s t s , a s well as the Child Welfare League of America ( CWLA), a lack of permanency can be harmful t o c h i l d r e n . Standards f o r Placement Child- psychology s p e c i a l i s t s agree with the widely accepted p r i n c i p l e of c o n t i n u i t y of c a r e . A s described by Goldstein e t a l , * * f o s t e r c a r e placement d e c i s i o n s "... should safeguard the c h i l d ' s need f o r c o n t i n u i t y of relationship^.'^ The a u t h o r s conclude t h a t "... each c h i l d placement be f i n a l and unconditional and t h a t pending f i n a l placement a c h i l d must not be s h i f t e d t o accord with each t e n t a t i v e d e c i s i o n . This means t h a t a l l child placements, except when s p e c i f i c a l l y designed f o r b r i e f temporary c a r e , s h a l l be a s permanent as the placement of a newborn with its b i o l o g i c a l parents. '' Placement Changes a r e Numerous An a n a l y s i s of c h i l d r e n i n t h e f o s t e r c a r e system during 1975, who l e f t the system p r i o r t o 1980, revealed t h a t on the average, f o s t e r c h i l d r e n have a t l e a s t four placements while they a r e i n Arizona's Foster Care System. The following f i g u r e summarizes o u r a n a l y s i s . * See page 33 for a f u r t h e r d i s c u s s i o n of placement a v a i l a b i l i t y . - ** Goldstein, Freud and S o l n i t , Beyond the Best I n t e r e s t s of t h e Child ( New York: Free Press, 1973). 20 FIGURE 1 Number of Placements* P e r Child i n F o s t e r Care From 1975 t o 1980 / I 1 Placement \ 1 4 O r More 3 Placements P Figure 1 shows t h a t 42 p e r c e n t of t h e c h i l d r e n were i n f o u r o r more placements s i n c e 1975. I n a d d i t i o n , n i n e p e r c e n t were i n ten o r more placements. Seventy p e r c e n t o f t h e s e c h i l d r e n still were i n f o s t e r c a r e at t h e time of our review and may change placements a g a i n . Reasons f o r Changes I n d i c a t e I n a p p r o p r i a t e Placement The high number of f o s t e r c a r e placement changes m a n i f e s t s t h a t c h i l d r e n o f t e n a r e put i n t o placements n o t a p p r o p r i a t e t o t h e i r needs. A review of t h e reasons f o r f o s t e r c a r e placement changes from 1975 t o 1980 i n d i c a t e s t h a t many f o s t e r c a r e placements do not meet t h e needs of t h e c h i l d r e n . Table 2 shows t h e most f r e q u e n t c a u s e s of f o s t e r placement changes from 1975 t o 1980. * I n i t i a l s h e l t e r - c a r e placements a r e excluded. TABLE 2 REASONS FOR FOSTER CARE PLACEMENT CHANGES BETWEEN 1975 AND 1980 Reason f o r Change Number Percentage Foster home unable t o meet c h i l d ' s needs 8 8 20 % Returned t o parent 7 3 17 Temporary placement 5 7 13 Runaway Foster home closed - l i c e n s e changed Placed with r e l a t i v e s A l l o t h e r reasons Total Note t h a t t h e reason most o f t e n given f o r a placement change was t h a t the f o s t e r parents were unable t o meet the needs of t h e c h i l d r e n ( 20 percent). The second most common reason was t h a t t h e c h i l d r e n were returned t o t h e i r n a t u r a l parents ( 17 percent). While t h e l a t t e r appears t o be an a p p r o p r i a t e placement change, it should be noted t h a t 70 percent of the c h i l d r e n who a r e returned t o t h e i r n a t u r a l parents subsequently re- enter t h e f o s t e r c a r e system. F u r t h e r , the Acting Program Administrator of ACYF within DES s t a t e d t h a t : - Caseworkers do not have the time t o do as much work a s should be done t o prepare t h e c h i l d and t h e n a t u r a l family f o r t h e r e t u r n home, and - A t p r e s e n t , i f t h e c h i l d ' s ( f o s t e r c a r e ) dependency is terminated, t h e r e is no planned followup t o ensure t h a t the replacement ( with t h e p a r e n t s ) is working out because DES has no l e g a l s t a t u s t o continue t o intervene. The t h i r d most o f t e n c i t e d reason f o r a placement change was t h a t a f o s t e r home became a v a i l a b l e . T h i s o c c u r s when a c h i l d o r i g i n a l l y is placed i n a nonfoster home s e t t i n g ( such a s an emergency receiving home), s h e l t e r c a r e or i n s t i t u t i o n , and subsequently is placed i n a f o s t e r home when one becomes available." CASEWORKERS DO NOT MAKE HOME VISITS AS OFTEN AS REQUIRED AND DO NOT DOCUMENT VISITS DES caseworkers do not make the minimum number of required v i s i t s t o f o s t e r homes nor do they document v i s i t s when they a r e made. The DES S o c i a l Services Manual s t a t e s t h a t , a t a minimum, f o s t e r homes should be v i s i t e d every t h r e e months. Our case a n a l y s i s and a survey of f o s t e r parents i n d i c a t e t h a t t h e s e requirements a r e not met. When caseworkers do not make the required home v i s i t s t o see f o s t e r c h i l d r e n , abuse o r neglect t h a t may be i n f l i c t e d on t h e f o s t e r c h i l d r e n e i t h e r w i l l not be detected or w i l l go undetected f o r long periods. During 1979 and 1980, f o s t e r c a r e caseworkers documented v i s i t s t o only 40 percent of t h e i r f o s t e r c h i l d r e n every t h r e e months, a s required. I n a d d i t i o n , f o s t e r p a r e n t r e s p o n s e s t o an Auditor General survey i n d i c a t e t h a t caseworkers did not make the minimum required number of v i s i t s t o 30 percent of t h e f o s t e r c h i l d r e n . MISSING OR CONFLICTING INFORMATION AND INCONSISTENT ORGANIZATION Foster c a r e case records d o n o t meet the requirements of t h e ACYF operating manual or t h e s t a n d a r d s e s t a b l i s h e d by the Child Welfare League of America ( CWLA). Many r e c o r d s c o n t a i n incomplete information o r exclude information t h a t should be i n t h e case f i l e . I n a d d i t i o n , t h e r e a r e i n s t a n c e s o f c o n f l i c t i n g information from two o r more sources within the same case f i l e , and i n s t a n c e s of case f i l e s t h a t a r e improperly organized, o f t e n r e s u l t i n g i n d u p l i c a t e paperwork. * See page 39 f o r a f u r t h e r discussion of t h i s s i t u a t i o n . F i n a l l y , f o s t e r home case records and Child P r o t e c t i v e S e r v i c e s ( CPS) f i l e s , which contain information r e g a r d i n g a b u s i v e o r n e g l e c t i v e p r a c t i c e s by f o s t e r p a r e n t s , a r e inadequate, precluding d e f i n i t e determination t h a t : 1) f o s t e r c h i l d r e n a r e not abused or m a l t r e a t e d , and 2) i n s t a n c e s of abuse a r e properly i n v e s t i g a t e d and resolved. DES S o c i a l Services Manual Requirements and Child Welfare League of America Standards According t o the CWLA, f o s t e r c a r e case f i l e s have t h r e e main purposes: 1. To i n d i c a t e t h e goal s e t f o r t h e c h i l d , t h e s e r v i c e s t o be provided and t h e e f f e c t i v e n e s s of those s e r v i c e s , 2. To make it possible t o maintain a c o n t i n u i t y of s e r v i c e , and 3. To preserve e s s e n t i a l information. The DES S o c i a l S e r v i c e s Manual p a r a l l e l s the CWLA standards. However, f o s t e r c a r e case f i l e s a r e not maintained i n compliance with DES p o l i c i e s . The S o c i a l Services Manual o u t l i n e s the c o n t e n t s and t h e manner i n which f o s t e r c a r e case f i l e s should be organized. The manual s p e c i f i e s t h a t s i x s e c t i o n s should be maintained within t h e case record, with m a t e r i a l s i n each s e c t i o n f i l e d by d a t e . The s i x s e c t i o n s a r e : 1. SSISf forms ( caseworker c o n t a c t s ) , 2. Narrative summaries, 3. Court- related m a t e r i a l s , 4. Medical/ professional m a t e r i a l s , 5. Foster/ adoptive home s t u d i e s , and 6. Correspondence and a l l o t h e r forms. * S o c i a l Services Information System. The manual f u r t h e r r e q u i r e s t h a t progress e v a l u a t i o n s be completed p e r i o d i c a l l y and f i l e d . A progress evaluation is defined a s : ' I . . . a formal review of a primary c l i e n t ' s s e r v i c e plan. It is used t o determine i f progress was made toward the a t t a i n m e n t o f an e a r l i e r s t a t e d o b j e c t i v e and its r e l a t e d f e d e r a l goal. This a c t i o n e v a l u a t e s t h e e f f e c t i v e n e s s of a case' s previous needs assessment ( a plan t o solve problems s y s t e m a t i c a l l y ) . In a d d i t i o n , a Progress Evaluation may d e s c r i b e new a r e a s t h a t r e q u i r e s e r v i c e a t t e n t i o n , o r show a need t o continue, change o r c l o s e t h e primary c l i e n t ' s s e r v i c e plan. ' I Progress e v a l u a t i o n s a r e required a t l e a s t every s i x months f o r each primary c l i e n t ' s s e r v i c e plan. Incomplete or Missing Information Our review disclosed t h a t approximately 70 percent o f f o s t e r - c a r e case f i l e s contained incomplete information o r excluded information i n the following a r e a s : placement d a t a , caseworker c o n t a c t s and development of case g o a l s and plans.* Often, the forms and documents t h a t a r e included i n the f i l e s a r e not signed or d a t e d , t h u s precluding development of a complete f o s t e r c h i l d p r o f i l e and h i s t o r y . I n a d d i t i o n , a n automated tracking system which the Foster Care Program developed t o monitor movement of c h i l d r e n through t h e program f r e q u e n t l y c o n t a i n s d a t a t h a t c o n f l i c t s w i t h i n f o r m a t i o n i n f o s t e r c a r e case f i l e s . * * The following cases i l l u s t r a t e t h e lack of adequate documentation within f o s t e r c a r e case f i l e s and c o n f l i c t i n g information i n the Statewide Tracking System and f o s t e r c a r e case f i l e s . * Appendix V is a d e t a i l e d l i s t i n g o f t y p e s o f information t h a t was - missing i n the f i l e s f o r t h e 206 f o s t e r c h i l d r e n we analyzed. ** See page 73 f o r a complete d i s c u s s i o n o f t h i s t o p i c . CASE I On March 5, 1973, a brother and s i s t e r were placed i n f o s t e r care. A s of December 1979, they have been returned t o t h e i r mother f i v e times and placed i n a t l e a s t e i g h t d i f f e r e n t f o s t e r c a r e s e t t i n g s . The f o s t e r care tracking system, however, showed the i n i t i a l f o s t e r c a r e placement d a t a f o r t h e s e c h i l d r e n a s November 9, 1977, and t h e r e a r e no tracking system forms f o r t h r e e o f s i x placements made between November 1978 and December I n a d d i t i o n , t h e r e is no documentation i n t h e c h i l d r e n ' s case f i l e t o i n d i c a t e why they were removed from t h e i r mother on two occasions. F i n a l l y , many of t h e SSIS c o n t a c t s h e e t s i n t h e c h i l d r e n ' s case f i l e do not c o n t a i n r e q u i r e d i n f o r m a t i o n such a s who was contacted o r what t r a n s p i r e d during t h e c o n t a c t . CASE I1 On March 22, 1978, seven s i b l i n g s entered f o s t e r care. Each c h i l d had a s e p a r a t e c a s e f i l e and t h e n a r r a t i v e s e c t i o n s of each case f i l e were incomplete. Between September 1979 and January 1980, only one document was entered i n each o f t h e case f i l e s . That document was a court report which i n d i c a t e d t h a t t h e placement goal f o r the c h i l d r e n had been changed from r e t u r n t o parent t o adoption. However, t h e caseworker had not developed a placement plan t o achieve t h e new goal. CASE I11 Two s i s t e r s and a brother were placed i n f o s t e r c a r e i n i t i a l l y i n 1973; however, the tracking system showed the i n i t i a l d a t e of placement as June 1978. Placement information i n the boy's case f i l e f o r t h e period February 1979 through October 1979 was confused because d a t a i n t h e case f i l e n a r r a t i v e , the f o s t e r c a r e tracking system and various correspondence did n o t a g r e e . I n a d d i t i o n , r e p o r t s t o and from t h e Foster Care Review Board ( FCRB) were not included i n t h e case f i l e . The FCRB had t o request a d d i t i o n a l information when a r e p o r t d i d not c o n t a i n s u f f i c i e n t information t o allow the Board t o evaluate the case. Required information f r e q u e n t l y is missing from f o s t e r c a r e case records. A primary cause of noncompliance appears t o be t h a t caseworkers a r e not f a m i l i a r with the DES S o c i a l Services Manual. An Auditor General survey of ACYF caseworkers showed t h a t more than 45 percent of t h e caseworkers do not use t h e manual r e g u l a r l y . The lack of information i n t h e f o s t e r c a r e c a s e r e c o r d s is s i g n i f i c a n t p a r t i c u l a r l y i n view of the high frequency of f o s t e r c a r e caseworker reassignment. It seems u n l i k e l y t h a t a new caseworker can serve a f o s t e r c h i l d adequately i f important information about t h a t c h i l d is missing from h i s case f i l e . Information is Incomplete Concerning Complaints Against F o s t e r P a r e n t s We reviewed f o s t e r l i c e n s i n g worker records from D i s t r i c t I* and Child P r o t e c t i v e S e r v i c e ( CPS) records t h a t a l l e g e d l y involved complaints against f o s t e r parents. We i d e n t i f i e d : - Sixteen apparent i n s t a n c e s of f o s t e r c h i l d r e n abuse o r neglect B t h a t were reported t o CPS not r e f l e c t e d i n f o s t e r l i c e n s i n g worker case f i l e s a s required. - Eight apparent i n s t a n c e s of f o s t e r c h i l d r e n abuse o r neglect t h a t were r e f l e c t e d i n f o s t e r l i c e n s i n g worker f i l e s but f o r which no apparent CPS r e f e r r a l was made. I n a d d i t i o n , a review of f o s t e r c a r e case f i l e s , l i c e n s i n g worker and CPS records revealed s e v e r a l i n s t a n c e s of f o s t e r c a r e caseworker o r CPS i n v e s t i g a t i o n s not r e s u l t i n g i n a p p r o p r i a t e a c t i o n when alleged abuse or neglect was reported. * Maricopa County. The following cases a r e r e p r e s e n t a t i v e . CASE I On November 5, 1979, a c h i l d t o l d her caseworker t h a t her f o s t e r mother h i t t h e o t h e r f o s t e r c h i l d r e n i n the home with a b e l t and t h a t she was a f r a i d it would happen t o her. The home was not v i s i t e d u n t i l t h r e e weeks l a t e r , on November 26, 1979, a t which time the f o s t e r mother admitted spanking t h e c h i l d r e n . The worker arranged f o r t h e f o s t e r p a r e n t s t o a t t e n d a workshop on a l t e r n a t i v e s t o physical punishment, which they did - not a t t e n d ; y e t no f u r t h e r a c t i o n was taken. On January 4, 1980, the same c h i l d who i n i t i a t e d t h e previous complaint now alleged sexual abuse. An i n v e s t i g a t i o n on the same day s u b s t a n t i a t e d t h e a l l e g a t i o n and a l l f o s t e r c h i l d r e n were removed. The f o s t e r f a m i l y ' s l i c e n s e was revoked i n July 1980. CASE I1 On December 4, 1979, a n a t u r a l f a t h e r contacted a CPS caseworker and s t a t e d t h a t h i s son was bruised as a r e s u l t o f a spanking administered by the f o s t e r parents. The CPS worker t o l d t h e n a t u r a l f a t h e r t o take photographs and t o w r i t e a l e t t e r explaining the circumstances. A p r i v a t e agency f o s t e r c a r e caseworker, who did not l e a r n of t h e CPS r e f e r r a l u n t i l January 2 , 1980, requested CPS t o conduct a n i n v e s t i g a t i o n . CPS contacted the f o s t e r parents on January 12, 1980. In an attempt t o e x p l a i n why CPS did not conduct an immediate i n v e s t i g a t i o n , t h e CPS caseworker assigned t o t h e c a s e s t a t e d t h a t t h e n a t u r a l f a t h e r had a " . . . p r o c l i v i t y towards f a l s e a l l e g a t i o n s and anger regarding CPS involvement." CASE I11 On June 6, 1979, a CPS worker was told by a c h i l d t h a t her f o s t e r mother was h i t t i n g t h e f o s t e r c h i l d r e n w i t h a s t i c k . A CPS i n v e s t i g a t i o n was i n i t i a t e d the following day and t h e a l l e g a t i o n s were confirmed by t h e f o s t e r mother, who a l s o admitted punishing the c h i l d r e n with an extension cord. Only one o f t h e four c h i l d r e n i n the f o s t e r home was removed. On June 15, 1979, the Foster Care Program recommended t h a t the home be r e s t r i c t e d t o the f o s t e r c h i l d r e n a l r e a d y t h e r e . On September 20, 1979, t h e f o s t e r f a t h e r was accused of abusing a f o s t e r c h i l d sexually. Six days l a t e r an i n v e s t i g a t i o n was made but it proved t o be inconclusive. On October 10, 1979, the F o s t e r Care Program recommended t h a t t h e f o s t e r parents undergo p s y c h o l o g i c a l e v a l u a t i o n . The e v a l u a t i o n i n d i c a t e d t h a t t h e f o s t e r f a t h e r was capable of abusing c h i l d r e n sexually and recommended the home not be licensed a s a f o s t e r home. The f o s t e r p a r e n t s v o l u n t a r i l y relinquished t h e i r l i c e n s e on December 13, 1979, and the remaining f o s t e r c h i l d r e n were removed. Reasons DES P o l i c i e s Are Not Followed Our a n a l y s i s of f o s t e r c a r e cases and a survey of f o s t e r c a r e caseworkers revealed t h a t a lack of proper supervision over f o s t e r c a r e caseworkers and heavy workloads f o r those caseworkers a r e primary c a u s e s o f DES p o l i c i e s and procedures not being followed. For example, a n a l y s i s of f o s t e r c a r e c a s e s disclosed numerous i n s t a n c e s of lack of progress toward the case goal. This is a c l e a r i n d i c a t i o n of inadequate supervision i n t h a t t h e supervisor is u l t i m a t e l y r e s p o n s i b l e f o r the attainment o f t h e s e goals. DES procedures r e q u i r e s u p e r v i s o r s t o review cases a t l e a s t every t h r e e months and t o determine i f progress toward t h e case goal is being made. We i d e n t i f i e d numerous i n s t a n c e s of these supervisory reviews a p p a r e n t l y n o t made. The absence of adequate s u p e r v i s i o n was a l s o c i t e d by f o s t e r c a r e caseworkers i n an Auditor General survey a s a primary o b s t a c l e t o d e l i v e r y of s e r v i c e . I n t h a t same survey, caseworkers a l s o noted t h e following o b s t a c l e s t o d e l i v e r y of s e r v i c e . - lack of time t o do casework properly, - too many paperwork r e s p o n s i b i l i t i e s f o r caseworkers, - t r a n s p o r t a t i o n problems, - l a c k o f adequate placements, and - caseworker turnover. CONCLUSION DES p o l i c i e s and procedures are not followed i n t h a t : - Permanent placement plans a r e not developed i n a timely manner or implemented p r o p e r l y , - Home v i s i t s a r e not made a s o f t e n as r e q u i r e d , and - Case records e x c l u d e i n f o r m a t i o n , c o n t a i n c o n f l i c t i n g i n f ormation or a r e improperly organized. These problems combined with frequent placement changes are, at l e a s t i n p a r t , t h e r e s u l t of i n a d e q u a t e s u p e r v i s i o n . Another p o s s i b l e cause is t h a t caseworkers lack t h e time t o follow a l l procedures required of them. RECOMMENDATIONS It is recommended t h a t : - Supervisors review c a s e s every t h r e e months t o determine i f : 1) permanent placement plans a r e developed i n a timely manner and implemented p r o p e r l y , 2) home v i s i t s a r e made a s o f t e n a s r e q u i r e d , 3) c a s e records a r e maintained p r o p e r l y , and 4) c h i l d r e n change placements only when necessary and a r e prepared adequately f o r t h e change. When t h e s e procedures a r e not followed, a p p r o p r i a t e d i s c i p l i n a r y a c t i o n should be administered. - D i s t r i c t Program Managers review cases on a random b a s i s t o ensure t h a t s u p e r v i s o r s monitor t h e i r c a s e s properly. When Program Managers determine t h a t s u p e r v i s o r s a r e n o t p r o p e r l y reviewing t h e i r c a s e s , a p p r o p r i a t e d i s c i p l i n a r y a c t i o n should be administered. - A manpower study be commissioned t o determine i f DES caseworkers have adequate time t o follow a l l procedures required of them. In a d d i t i o n , t h e study should determine i f DES u s e s c a s e a i d s , c l e r i c a l s t a f f and o u t s i d e p r o f e s s i o n a l s t o f u l l advantage. FINDING I1 AN APPARENT SHORTAGE OF FOSTER HOMES IS RESULTING I N POTENTIALLY DANGEROUS SITUATIONS FOR SOME FOSTER CHILDREN AND INCREASED COSTS TO THE STATE FOR EMERGENCY RECEIVING CARE. Arizona may be approaching a c r i s i s l e v e l i n a t l e a s t one d i s t r i c t with regard t o the a v a i l a b i l i t y of f o s t e r homes. Our review of the a v a i l a b i l i t y of f o s t e r homes revealed t h a t : - There is an apparent shortage of f o s t e r homes Statewide, - The shortage of f o s t e r homes is leading t o p o t e n t i a l l y dangerous s i t u a t i o n s f o r some f o s t e r c h i l d r e n , - The shortage of f o s t e r homes c a u s e s i n c r e a s e d c o s t s t o t h e S t a t e because of overuse of more expensive emergency receiving c a r e f a c i l i t i e s , and - The Foster Care Program needs t o do a d d i t i o n a l work i n order t o i n c r e a s e the number o f a v a i l a b l e f o s t e r homes. Shortage o f F o s t e r Homes Arizona's shortage of f o s t e r homes is evident i n t h a t : 1) t h e r a t i o of f o s t e r homes t o f o s t e r c h i l d r e n i n Arizona is lower than the average of nine western s t a t e s , 2 ) a s u b s t a n t i a l number of r e q u e s t s f o r f o s t e r home placements cannot be s a t i s f i e d , 3) homes of marginal q u a l i t y a r e not eliminated a s f o s t e r homes by DES, and 4) f o s t e r homes t h a t a r e a v a i l a b l e a r e o v e r u t i l i z e d . Ratio o f F o s t e r Homes t o Foster Children Arizona's r a t i o of f o s t e r homes t o f o s t e r c h i l d r e n is low i n comparison t o nine o t h e r western s t a t e s . Table 3 shows t h a t only one o t h e r s t a t e ( Colorado) has a lower r a t i o of f o s t e r homes t o f o s t e r c h i l d r e n than Arizona a s of July 1980. TABLE 3 State*" Colorado ABIZONA*** C a l i f o r n i a Washington Wyoming Oregon Idaho Montana Nevada Utah RATIO OF FOSTER HOMES TO FOSTER CHILDREN FOR ARIZONA AND NINE* OTHER WESTERN STATES JULY 1980 Total Foster Care Population Total Foster Homes Available Ratio of Foster Homes t o F o s t e r Children A S u b s t a n t i a l Number of Requests f o r Foster Home Placement Cannot Be S a t i s f i e d Eighty percent of DES caseworkers and 70 percent of DES s u p e r v i s o r s responding t o an a u d i t survey s t a t e d t h a t t h e r e a r e not enough f o s t e r homes a v a i l a b l e f o r t h e c h i l d r e n i n t h e i r caseloads. I n a d d i t i o n , a v a i l a b l e d a t a i n d i c a t e s t h a t f o s t e r - c a r e caseworker r e q u e s t s for placements could not be s a t i s f i e d 61 percent of t h e time i n Maricopa County during 1979 and 48 percent o f t h e time i n Pima County between June 1979 and February 1980.**** The shortage of f o s t e r homes is aggravated by the f a c t t h a t not a l l e x i s t i n g fost- er homes a r e a v a i l a b l e t o t h e general f o s t e r - c h i l d population. * New Mexico was not included because of a lack of d a t a on t h e number of f o s t e r homes a v a i l a b l e . ** Listed i n order from the lowest t o t h e highest r a t i o of f o s t e r homes t o f o s t e r c h i l d r e n . *** A s of April 1980. **** Includes some i n s t a n c e s o f m u l t i p l e r e q u e s t s f o r f o s t e r c a r e - a placements. F o s t e r p a r e n t s a r e licensed according t o t h e c h i l d r e n they w i l l accept i n regard t o such d e s c r i p t i o n s a s a g e , s e x or race. In a d d i t i o n , approximately 28 percent of f o s t e r homes a r e l i c e n s e d w i t h the i n t e n t of caring only f o r a s p e c i f i c c h i l d , such a s a r e l a t i v e . Therefore, t h e f a c t t h a t a home is licensed a s a f o s t e r home does not mean it is n e c e s s a r i l y a v a i l a b l e f o r use by t h e g e n e r a l f o s t e r - c h i l d population. F i n a l l y , today's f o s t e r - c h i l d population i n c l u d e s o l d e r ( h a l f a r e a t l e a s t 13 years old) and more d i f f i c u l t t o manage* ( 18 percent) c h i l d r e n than i n past years. Many f o s t e r parents a r e not w i l l i n g t o accept c h i l d r e n who f a l l i n t o e i t h e r of these c a t e g o r i e s . Homes of Marginal Q u a l i t y Are Not Eliminated as Foster Homes by DES One adverse consequence of t h e f o s t e r home shortage is t h a t DES is r e l u c t a n t t o eliminate homes already i n t h e program, even homes of marginal q u a l i t y o r bad hones. The s i t u a t i o n is dangerous f o r f o s t e r c h i l d r e n . In an Auditor General survey o f f o s t e r - c a r e caseworkers and s u p e r v i s o r s , 79 percent rated e x i s t i n g f o s t e r homes a s adequate o r b e t t e r . However, the responses were o f t e n q u a l i f i e d t o note t h a t homes of marginal q u a l i t y do e x i s t . A s one caseworker responded: " We have a few e x c e l l e n t homes, many mediocre ones and a few r e a l l y bad ones ( which workers f e e l they sometimes have t o use.) If The survey responses were s u b s t a n t i a t e d by a review of the l i c e n s i n g records f o r 51 f o s t e r homes. Nine of the 51 contained information concerning repeated complaints a g a i n s t t h e f o s t e r homes. The following case examples were taken from foster- home l i c e n s i n g records t o demonstrate t h e t y p e s o f complaints. * See footnote regarding Special I1 c h i l d r e n on page 37. CASE I In A p r i l 1974, the Foster Care Program recommended t h a t a f o s t e r home be closed a f t e r a c h i l d was removed because of an abuse complaint. The police department a l s o recommended c l o s u r e due t o unsanitary conditions and the i n a b i l i t y of the f o s t e r parent t o manage t h e c h i l d r e n . In December 1974, the l i c e n s i n g worker reported t h a t t h e care given t o two previously placed f o s t e r c h i l d r e n was inadequate and t h a t housekeeping standards were poor, and recommended t h a t under no circumstances should a d d i t i o n a l f o s t e r c h i l d r e n be placed i n t h e home. I n September 1976, the l i c e n s i n g caseworker found t h e house f i l t h y and u n h e a l t h f u l , and recommended c l o s u r e i f the home were found i n t h e same c o n d i t i o n again. In January and April 1977, the f o s t e r home f a i l e d Department of Health Services h e a l t h and s a f e t y i n s p e c t i o n s . In a 1978 r e l i c e n s i n g s t u d y , t h e DES l i c e n s i n g worker reported t h a t t h e f o s t e r home has had obvious problems i n t h e past and w i l l continue t o have problems. The home is c u r r e n t l y l i c e n s e d . CASE I1 A f o s t e r home was licensed i n i t i a l l y on October 31, 1977, although s e v e r a l foster- home l i c e n s i n g s t u d i e s reported such problems a s emotional abuse and not enough food i n the home. A March 29, 1978, entry by a f o s t e r - c a r e caseworker s t a t e d t h a t If.. . t h e family does not l i v e within t h e standards a s s e t by t h i s agency and should be c l o s e l y watched." The same caseworker, however, recommended r e l i c e n s i n g on September 18, 1978. The home is c u r r e n t l y l i c e n s e d . O v e r u t i l i z a t i o n o f F o s t e r Homes Licensing s u p e r v i s o r s interviewed claimed t h a t foster- home shortages have r e s u l t e d i n tremendous pressure on l i c e n s i n g caseworkers n o t o n l y t o keep marginal f o s t e r homes open, but t o o v e r u t i l i z e f o s t e r homes a s well. A recent DES r e p o r t s t a t e d , " The l o s s of c o n t r o l due t o heavy and continuous c h i l d case r e s p o n s i b i l i t i e s may be r e f l e c t i v e of t h e number of c h i l d r e n t h a t a home is licensed f o r or may be i n d i c a t i v e o f t h e common p r a c t i c e s of keeping a f o s t e r family c o n s t a n t l y a c t i v e with l i t t l e or no r e s p i t e . " * Currently t h e r e is a DES r e s p i t e policy; however, i n r e a l i t y , t h e f a m i l i e s a r e never a b l e t o t a k e a r e s p i t e . The o v e r u t i l i z a t i o n of f o s t e r homes is not infrequent. A recent DES study of the reasons f o r foster- home turnover revealed t h a t s i x of e i g h t closed f o s t e r homes had l i c e n s e l i m i t a t i o n s extended because of agency request o r p r e s s u r e . Recently, t h e c r i s i s s h o r t a g e o f f o s t e r homes i n Maricopa County has r e s u l t e d i n l i c e n s i n g workers asking r e s t r i c t e d f o s t e r homes t o r e v i s e t h e i r l i c e n s e s t o permit t h e c a r e of more c h i l d r e n . The following case example is t y p i c a l o f t h e problem of o v e r u t i l i z a t i o n of f o s t e r homes. EXAMPLE CASE In 1979, a f o s t e r p a r e n t r e p o r t e d t o DES Child P r o t e c t i v e S e r v i c e s personally, s t a t i n g t h a t he had h i t t h e f o s t e r c h i l d r e n . He requested a r e s p i t e from having f o s t e r c h i l d r e n i n h i s home. Information contained i n the l i c e n s i n g record noted t h a t i n 1974 t h e r e had been too many c h i l d r e n i n the home f o r adequate care. The r e l i c e n s i n g study f o r 1974 s t a t e d t h a t the f o s t e r home should harbor no more than f o u r c h i l d r e n ; however, i n 1975 the f o s t e r home was r e l i c e n s e d f o r f i v e c h i l d r e n . In 1977, approval was obtained t o overload the home with s i x f o s t e r c h i l d r e n . I n a 1979 r e l i c e n s i n g study, t h e l i c e n s i n g worker assessed t h a t t h e family was not a b l e t o handle more than two S p e c i a l I1 children#* a t one time, but recommended t h a t the home be licensed f o r f i v e such c h i l d r e n . * R e s p i t e i n v o l v e s n o t r e p l a c i n g c h i l d r e n i n a home f o r a period of time t o g i v e t h e f o s t e r family a h i a t u s . / ** S p e c i a l I1 c h i l d r e n a r e harder- to- handle c h i l d r e n , u s u a l l y having emotional or physical problems. POTENTIALLY HARMFUL SITUATIONS FOR SOME CHILDREN The foster- home s h o r t a g e h a s r e s u l t e d i n some c h i l d r e n ' s placement i n s i t u a t i o n s t h a t a r e p o t e n t i a l l y harmful, both p h y s i c a l l y and emotionally. Remaining i n Physically Dangerous Environments The shortage of f o s t e r homes c o n t r i b u t e s t o s h o r t a g e s o f o t h e r types of placements f o r some f o s t e r c h i l d r e n . Nhen no f o s t e r homes a r e a v a i l a b l e , s h e l t e r c a r e f a c i l i t i e s a r e used t o house f o s t e r c h i l d r e n . T h i s , i n t u r n , l i m i t s the number of s h e l t e r c a r e placements a v a i l a b l e f o r children needing immediate, temporary s h e l t e r . According t o A. R. S. $ 8- 546.01. C. 4: " A p r o t e c t i v e s e r v i c e s worker s h a l l : . . . t a k e a c h i l d i n t o temporary custody i f t h e r e a r e reasonable grounds t o believe t h a t t h e c h i l d is s u f f e r i n g from i l l n e s s or i n j u r y or is i n immediate danger from h i s surroundings and t h a t h i s removal is necessary. If Currently, however, some c h i l d r e n are l e f t i n p o t e n t i a l l y abusive and n e g l e c t f u l home environments because t h e r e a r e few placements f o r them. A p r o t e c t i v e s e r v i c e s supervisor interviewed reported t h a t one day i n April t h e r e were seven c h i l d r e n needing immediate emergency placements f o r whom no placements were a v a i l a b l e . A l l t h e s e c h i l d r e n remained where they were u n t i l placements were a v a i l a b l e which, f o r one c h i l d , was ten days l a t e r . Surveyed caseworkers a l s o reported t h a t c h i l d r e n sometimes a r e l e f t i n p o t e n t i a l l y dangerous environments. One caseworker reported: " We f r e q u e n t l y l e a v e c h i l d r e n i n i n a p p r o p r i a t e and dangerous s e t t i n g s due t o a lack of placements." Cited below a r e two recent examples of c h i l d r e n l e f t " a t r i s k u * a t home, although removal was v i t a l f o r t h e i r protection. * A t r i s k o f n e g l e c t or abuse. CASE I Four c h i l d r e n , t h r e e t o nine years o l d , were l e f t alone with an eleven- year- old b a b y s i t t e r . A Child P r o t e c t i v e Services ( CPS) worker i d e n t i f i e d t h a t : 1) t h e c h i l d r e n had a communicable d i s e a s e , 2) one c h i l d had a n u n t r e a t e d scalp wound, 3) no food was i n t h e home, 4) the c h i l d r e n reported they had n o t e a t e n t h a t day, and 5) the house was f i l t h y and had c a t and dog feces on the f l o o r . The CPS worker, because of the lack of s h e l t e r c a r e placements, was forced t o leave t h e c h i l d r e n t h e r e with the eleven- year- old s i t t e r . CASE I1 In April 1980, a f a t h e r requested immediate emergency help from DES Child P r o t e c t i v e Services t o remove h i s c h i l d r e n because he was f e a r f u l t h a t he was going t o h u r t them. The f a t h e r had a h i s t o r y o f abusing h i s c h i l d r e n . However, because t h e r e were no f o s t e r home placements a v a i l a b l e , CPS t o l d t h e f a t h e r t h a t t h e c h i l d r e n would have t o remain i n t h e home u n t i l placements were a v a i l a b l e . The f i r s t a v a i l a b l e placement was l o c a t e d n i n e day l a t e r . Not only a r e placement o p p o r t u n i t i e s l i m i t e d , but DES has n e i t h e r g u i d e l i n e s nor options f o r workers faced with t h e c r i s i s s i t u a t i o n s of c h i l d r e n a t r i s k , needing emergency removal from t h e home, when no placements a r e a v a i l a b l e . DES caseworkers and s u p e r v i s o r s have, however, developed t h e i r own informal p r i o r i t y g u i d e l i n e s t o determine which c h i l d r e n a t r i s k a r e placed f i r s t . CPS s u p e r v i s o r s and caseworkers we interviewed declared t h a t p r i o r i t i e s hinge on placement a v a i l a b i l i t y , urgency of the home s i t u a t i o n and age of t h e c h i l d . For example, o l d e r c h i l d r e n who need t o be removed frequently a r e advised by CPS t o seek refuge i n a runaway halfway house or a neighbor's o r r e l a t i v e 1 s home. Younger c h i l d r e n i n similar s i t u a t i o n s more l i k e l y would be placed. Interviewed s u p e r v i s o r s a l s o reported t h a t c h i l d r e n who a r e abused physically a r e removed sooner than c h i l d r e n who a r e abused sexually. The theory advanced is t h a t sexual abuse is more d i f f i c u l t t o s u b s t a n t i a t e than physical a b u s e , . and t h a t sexual abuse is l e s s l i k e l y t o r e s u l t i n severe physical i n j u r y t o t h e c h i l d t h a n p h y s i c a l abuse. P o t e n t i a l Emotionally Harmful S i t u a t i o n s Another r e s u l t of the shortage of f o s t e r homes is t h a t c h i l d r e n a r e placed i n s e t t i n g s t h a t may not be a p p r o p r i a t e t o t h e i r needs. Such placements may lead u l t i m a t e l y t o s e r i o u s emotional damage t o a c h i l d . The Child Welfare League of America ( CWLA), i n its Standards For Foster Family Service, s t a t e s : " It is never j u s t i f i a b l e t o place a c h i l d i n a home deemed u n s u i t a b l e f o r h i s continuing c a r e , except when a s i n g l e placement f o r a limited period of emergency o r i n t e r i m c a r e is required. The p r a c t i c e of moving a c h i l d from one f o s t e r home t o another i n the hope of improving t h e s i t u a t i o n should be avoided, s i n c e each a d d i t i o n a l placement r e p e a t s f o r a c h i l d t h e p a i n f u l experience of s e p a r a t i o n ...." D r . Ner L i t t n e r , a n a t i o n a l l y known c o n s u l t a n t p s y c h i a t r i s t , has noted t h a t each move or replacement: "... merely pyramids the traumatic e f f e c t s , i n c r e a s e s t h e problems t h e c h i l d must master, i n t e n s i f i e s the c h i l d ' s f e a r of and need t o fend o f f c l o s e r e l a t i o n s h i p s , and adds t o the d i f f i c u l t i e s i n adjustment i n the next home. A s you know, t h e end r e s u l t of frequent replacements is t h e t y p i c a l , agency- created psychopath whose f e a r of closeness is so g r e a t t h a t he can t o l e r a t e only shallow and s u p e r f i c i a l r e l a t i o n s h i p s . " The shortage of f o s t e r homes apparently l e a d s t o placements of c h i l d r e n i n t o homes unable t o meet t h e i r needs and then t o subsequent replacements. More than half t h e f o s t e r - c a r e s u p e r v i s o r s and caseworkers surveyed f e l t t h a t , o v e r a l l , t h e needs of f o s t e r c h i l d r e n were not met adequately by f o s t e r p a r e n t s . T h e i r b e l i e f is supported by s t a t i s t i c s from Pima County, i n d i c a t i n g t h a t from June 1979 t o February 1980, 155 f o s t e r homes i n Pima County alone were unable t o c a r e f o r t h e c h i l d r e n placed with them. F u r t h e r , an Auditor General review of the case records of 206 f o s t e r c h i l d r e n revealed 88 i n s t a n c e s of f o s t e r c h i l d r e n moved - a from one home t o another because the homes were unable t o meet t h e i r needs. A s one caseworker surveyed explained: ttInappropriate f o s t e r homes a r e the b i g g e s t r e a s o n s kids move around so much. Another worker commented: ttYou place c h i l d r e n i n inadequate homes and j u s t count t h e days u n t i l placement d i s r u p t s . " INCREASED COSTS OF CARE The s h o r t a g e o f f o s t e r homes is t r a n s l a t e d i n t o increased c o s t s t o the S t a t e f o r c h i l d c a r e , because f o s t e r c h i l d r e n must be placed i n more expensive forms of c a r e , such as emergency receiving c a r e f a c i l i t i a s and i n s t i t u t i o n s . Foster c a r e c o s t s an average of $ 7 a day f o r each c h i l d . Emergency receiving c a r e c o s t s average $ 25 a day f o r each c h i l d and i n s t i t u t i o n a l care ranges from $ 27 t o $ 80 a day f o r each c h i l d . Cases of c h i l d r e n l e f t i n emergency receiving c a r e because f o s t e r homes were not a v a i l a b l e revealed t h a t the foster- home shortage may have c o s t t h e S t a t e a s much a s $ 400,000 i n 1979. Emergency receiving c a r e is meant t o be short- term emergency c h i l d c a r e i n a s a f e environment u n t i l DES c a n a r r a n g e a l t e r n a t i v e placement. Because of the intended use, DES r e g u l a t i o n s s t i p u l a t e t h a t a c h i l d may remain i n receiving c a r e a maximum of 21 days.* We found, however, t h a t because of the s h o r t a g e o f f o s t e r homes, c h i l d r e n remain i n emergency receiving c a r e much longer. We examined computerized emergency receiving c a r e payment records f o r 53 of 159 c h i l d r e n i n receiving c a r e on December 1, 1979. We tracked the c h i l d r e n from the d a t e they f i r s t e n t e r e d a n emergency receiving c a r e f a c i l i t y u n t i l December 31, 1979. Table 4 shows t h e l e n g t h s of time these c h i l d r e n remained i n emergency r e c e i v i n g c a r e . * The j u v e n i l e court must i s s u e a court order t o extend an emergency receiving home placement beyond 21 days and must review t h e court order weekly u n t i l t h e c h i l d is removed from the receiving home. TABLE 4 NUMBER OF DAYS FOSTER CHILDREN REMAIN I N EMERGENCY RECEIVING CARE Number of Number of Percentage of Days Children Total 0- 21 21- 61 62- 182 182 and above A s Table 4 i n d i c a t e s , 78 percent of the f o s t e r c h i l d r e n were i n emergency receiving c a r e l o n g e r t h a n the maximum 21- day period. I n a d d i t i o n , t h r e e c h i l d r e n were i n emergency receiving c a r e more than s i x months, one f o r 268 days. We c a l c u l a t e d the increased c o s t s t o t h e S t a t e , because these c h i l d r e n had been i n emergency receiving c a r e more than 21 days, t o be $ 75,000. However, annual c o s t s o f o v e r s t a y s i n receiving c a r e may be as high a s $ 400,000 i f a l l the c h i l d r e n i n emergency receiving c a r e f o r a whole year a r e taken i n t o account. DES NEEDS TO DO ADDITIONAL WORK I N ORDER TO INCREASE THE NUMBER OF FOSTER HOMES DES needs t o concentrate on two o b j e c t i v e s i n order t o ease the shortage of f o s t e r homles. One is t o reduce the turnover r a t e among e x i s t i n g f o s t e r homes; t h e o t h e r is t o s t e p up recruitment e f f o r t s . Reducing Turnover Arizona is l o s i n g f o s t e r homes f a s t e r through turnover than it is a b l e t o r e c r u i t replacement homes. Thus, the s h o r t a g e o f f o s t e r homes appears t o be g e t t i n g worse. An important s t e p i n combatting the shortage is reducing f o s t er- home turnover. The turnover r a t e i n 1977 was 23 p e r c e n t ; i n 1978 it was 41 p e r c e n t ; and i n 1979 it was 42 percent. A t l e a s t two major f a c t o r s appear t o be responsible f o r the turnover r a t e , including: 1. F o s t e r p a r e n t s 1 sense of i s o l a t i o n from, and u n s a t i s f a c t o r y involvement with, DES. 2. Inadequate d a t a c o l l e c t i o n and a n a l y s i s of f o s t e r home turnover by DES. D i s s a t i s f a c t i o n and a Sense of I s o l a t i o n - Current and former f o s t e r parents surveyed by t h e a u d i t s t a f f expressed strong f e e l i n g s of d i s s a t i s f a c t i o n with DES. Table 5, which summarizes former f o s t e r parent responses t o an Auditor General survey, mirrors t h i s d i s s a t i s f a c t i o n . TABLE 5 SUMMARY OF FORMER FOSTER PARENTS1 REASONS FOR TERMINATING THEIR LICENSES Number of Former Reason f o r Terminating F o s t e r P a r e n t s D i s s a t i s f a c t i o n with program R e s t r i c t e d home I n s u f f i c i e n t monetary support Family h e a l t h problems Agency terminated l i c e n s e Moved Unable t o cope with f o s t e r c h i l d Adopted f o s t e r c h i l d Other * There were 112 responses t o the survey. Some respondents l i s t e d multiple reasons f o r termination. The following comments made by former f o s t e r p a r e n t s f u r t h e r exemplify t h e i r d i s s a t i s f a c t i o n with DES: - " I was d i s s a t i s f i e d t o t a l l y with t h e program -- and disappointed too.!' - " I w i l l not recommend anyone t o be a f o s t e r parent i n the S t a t e of Arizona." - " Impossible t o work with last caseworker. She talked behind our back; breaking down our r e l a t i o n s h i p with t h e c h i l d we had i n our care. - " T a ~ i n g c a r e and working with t h e c h i l d r e n was one of the most rewarding experiences of our l i v e s . Working with DES was not!" - " 1 would never consider being a f o s t e r parent again because of g r o s s d i s s a t i s f a c t i o n with t h e e n t i r e program. What can I say, other than, it's a mess!" - " Not enough help from caseworkers. It was poor s e r v i c e from t h i s program. They d i d n ' t do t h e i r part." - " This program is a t r a g i c joke.. . The whole department seems t o be i n a constant s t a t e o f d i s o r g a n i z a t i o n , switching p r i o r i t i e s , and making d e c i s i o n s contrary t o t h e proof." - " We g o t t i r e d of a l l t h e h a s s l e s with the state... The c h i l d ' s best i n t e r e s t s were not considered very well." - " To sum it up, we f e l t used and mistreated a s f o s t e r parents." Although DES r e g u l a t i o n s r e q u i r e f o s t e r - c a r e caseworkers t o consult with the f o s t e r parents a t l e a s t q u a r t e r l y regarding t h e c h i l d ' s placement plan, f o s t e r parents r a r e l y a r e asked f o r t h e i r i n p u t . A survey of f o s t e r parents conducted by t h e a u d i t s t a f f found 62 percent of t h e f o s t e r p a r e n t s r e p o r t i n g they never have had any input i n t o any c h i l d ' s plan. F u r t h e r , one f o s t e r parent commented t h a t attempts t o make suggestions may r e s u l t i n being considered ' Itrouble makers" and/ or t h e c h i l d being moved t o a d i f f e r e n t f o s t e r home. A recent DES survey of former and c u r r e n t f o s t e r parents a l s o revealed t h a t the major change advocated by f o s t e r p a r e n t s was t o include them i n planning f o r t h e f o s t e r c h i l d . Another f a c t o r c o n t r i b u t i n g t o f o s t e r parents1 f e e l i n g of i s o l a t i o n from DES a r e t h e i n f r e q u e n t c o n t a c t s with, and i n a c c e s s i b i l i t y o f , caseworkers. A t a minimum, f o s t e r p a r e n t s should receive q u a r t e r l y home v i s i t s both from t h e l i c e n s i n g caseworker f o r the home and from t h e c h i l d ' s caseworker. A review of a sample of l i c e n s i n g records found evidence of only 33 percent of the required l i c e n s i n g caseworker v i s i t s , and a review of a sample of f o s t e r c h i l d case records showed evidence of only 30 percent of the required c h i l d caseworker v i s i t s . I n f a c t , the sample of f o s t e r c h i l d c a s e records showed no evidence of any v i s i t s made t o 33 percent o f t h e f o s t e r parents during the year 1979. An Auditor General survey of p r a c t i c i n g f o s t e r p a r e n t s a l s o documented t h e infrequency of caseworker v i s i t s . S i x t y - f o u r p e r c e n t of t h e f o s t e r parents responding reported receiving v i s i t s from l i c e n s i n g workers only once every s i x months o r l e s s , and 30 percent reported i r r e g u l a r face- to- face c o n t a c t with f o s t e r c h i l d r e n ' s caseworkers. Perhaps a s a r e s u l t of i n f r e q u e n t c o n t a c t , f o s t e r parents a l s o expressed a f e e l i n g of having no resource t o t u r n t o when they needed answers t o questions or advice on f o s t e r - p a r e n t i n g . Twenty- four f o s t e r parents independently and spontaneously commented t h a t more and c l o s e r c o n t a c t with caseworkers was needed. Some f o s t e r parents suggested t h a t a telephone h o t l i n e be e s t a b l i s h e d , even though f o s t e r p a r e n t s ( t h e o r e t i c a l l y ) can c a l l e i t h e r the l i c e n s i n g worker o r t h e c h i l d ' s caseworker f o r such a s s i s t a n c e . DES Lacks Data t o Evaluate Foster Home Turnover DES l a c k s d a t a on f o s t e r home t u r n o v e r , i n c l u d i n g the reasons f o s t e r parents leave t h e program. Without t h e information DES n o t o n l y d o e s not know t h e e x t e n t of f o s t e r home t u r n o v e r , b u t is hampered i n attempts t o formulate a plan t o d e a l with t h e problem. DES has d a t a s t o r e d i n its computerized f o s t e r c a r e t r a c k i n g system t h a t could be used t o c a l c u l a t e t h e r a t e of foster- home turnover. Even though the d a t a is r e t r i e v a b l e , DES had not compiled a S t a t e w i d e a n n u a l f o s t e r home turnover r a t e by d i s t r i c t u n t i l it was requested t o do so by t h e Auditor General. Based on f o s t e r c a r e t r a c k i n g system d a t a , turnover r a t e f o r 1979 Mas c a l c u l a t e d a t 42 percent. It should be noted t h a t a d m i n i s t r a t o r s had assumed t h e 1979 r a t e was 25 percent. The t r a c k i n g system a l s o s t o r e s d a t a on reasons f o r f o s t e r home turnovers. However, it is o f t e n reported i n a manner not u s e f u l t o program managers. For example, i n one Statewide r e p o r t o f t h e number of f o s t e r home c l o s u r e s and t h e reasons f o r them, 50 percent of t h e reasons f o r c l o s u r e were coded a s " other." Such a high r a t e of t h e use of t h e " other" category d e p r i v e s DES a d m i n i s t r a t o r s of u s e f u l information on t h e r e a l reasons f o r f o s t e r home turnover. One DES d i s t r i c t records information manually on reasons f o r f o s t e r home c l o s u r e s , because t h e caseworkers i n t h a t d i s t r i c t b e l i e v e t h e g e n e r a l i z e d computerized information d o e s n o t meet t h e i r needs. Without a c c u r a t e , r e l i a b l e and complete d a t a on f o s t e r home t u r n o v e r , and t h e reasons f o r such t u r n o v e r , DES a d m i n i s t r a t o r s cannot e v a l u a t e t h e program adequately nor can they develop a p p r o p r i a t e plans t o reduce f o s t e r home turnover. Increasing Foster Home Recruitment E f f o r t s In a d d i t i o n t o reducing f o s t e r home t u r n o v e r , more must be done t o r e c r u i t new f o s t e r homes. In reviewing f o s t e r home recruitment we found progress has been made i n developing a formal recruitment program; however, a d d i t i o n a l work needs t o be done: b e t t e r d a t a must be c o l l e c t e d and followups must be made i n order f o r t h e p r o j e c t t o achieve ' e f f e c t i v e n e s s . Developing a Formal Program P r i o r t o 1978, DES had no formal Statewide program t o r e c r u i t f o s t e r homes. I n s t e a d , recruitment was a r e s p o n s i b i l i t y of the l i c e n s i n g workers and was handled i n conjunction with t h e i r o t h e r d u t i e s . I n f i s c a l year 1978- 79, a demonstration f o s t e r home recruitment p r o j e c t was conducted i n Maricopa County. Since t h a t p r o j e c t DES has contracted f o r a Statewide market a n a l y s i s of t h e pool of p o t e n t i a l f o s t e r parents and t h e most e f f e c t i v e methods o f r e c r u i t i n g them. DES is h i r i n g persons and e s t a b l i s h i n g formal recruitment programs i n each of t h e d i s t r i c t s . Although it is t o o e a r l y t o evaluate the o v e r a l l e f f e c t i v e n e s s of t h e new f o s t e r home recruitment program, we noted t h a t information is not c o l l e c t e d a s t o why p o t e n t i a l f o s t e r parents contacted by t h e r e c r u i t i n g program do not become f o s t e r parents. For example, the demonstration recruitment p r o j e c t i n f i s c a l year 1978- 79 showed t h a t only e l e v e n p e r c e n t of c o n t a c t e d p r o s p e c t s a c t u a l l y became f o s t e r parents. However, d a t a was n o t g a t h e r e d on t h e reasons f o r choosing not t o become f o s t e r parents. The lack of such d a t a precludes a determination t h a t t h e r e c r u i t i n g e f f o r t was aimed a t t h e r i g h t population o r t h a t other f a c t o r s , such a s l i c e n s i n g procedures, caused persons t o r e j e c t f o s t e r parenthood. The absence of such information severely r e s t r i c t s DES a b i l i t y t o determine how t o i n c r e a s e t h e percentage success of recruitment c o n t a c t s . Information is not c o l l e c t e d and stored i n a manner t o allow f o r followup c o n t a c t s w i t h p r o s p e c t s who may be i n t e r e s t e d i n f o s t e r parenting a t a l a t e r d a t e . Randomly we s e l e c t e d 50 persons who i n q u i r e d a b o u t , but did not become, f o s t e r parents. We interviewed them t o determine why they dropped out. During t h e course of our i n t e r v i e w s , we i d e n t i f i e d nine persons who still were i n t e r e s t e d i n becoming f o s t e r parents at a l a t e r date. S i m i l a r l y , i n reviewing l i c e n s i n g u n i t s r e c o r d s , we i d e n t i f i e d s e v e r a l f o s t e r parents who had dropped out but still were i n t e r e s t e d i n becoming f o s t e r parents a t a l a t e r d a t e . A s of August 1980, the f o s t e r home recruitment program had n o t c o l l e c t e d d a t a nor e s t a b l i s h e d a system t o allow f o r followups with p o t e n t i a l f o s t e r parents. Funding f o r a r e c r u i t m e n t program is developing slowly. P r i o r t o f i s c a l year 1980- 81, DES had no s p e c i f i c budget f o r recruitment of f o s t e r homes, and DES a d m i n i s t r a t o r s funded recruitment e f f o r t s from the g e n e r a l f o s t e r care budget. I n f i s c a l year 1980- 81, $ 200,000 was budgeted s p e c i f i c a l l y f o r t h e development of a Statewide f o s t e r home r e c r u i t i n g program. However, because of a change i n DES p r i o r i t i e s , not a l l of t h e budgeted $ 200,000 w i l l be spent on f o s t e r home r e c r u i t m e n t , although DES a d m i n i s t r a t o r s a g r e e t h e f u l l $ 200,000 still is needed t o implement properly a Statewide recruitment program. CONCLUSIONS 1. There is an apparent s h o r t a g e o f f o s t e r homes i n Arizona. Such a s i t u a t i o n is p o t e n t i a l l y dangerous f o r some f o s t e r c h i l d r e n . 2. The shortage of f o s t e r homes c o s t s t h e S t a t e up t o $ 400,000 a year i n increased emergency receiving c a r e c o s t s f o r c h i l d r e n who cannot be placed i n f o s t e r homes. 3. DES needs t o s t r i v e harder t o reduce the foster- home turnover r a t e . F o s t e r p a r e n t s need more frequent c o n t a c t s with, and e a s i e r access t o , caseworkers, and they need g r e a t e r involvement i n developing plans f o r f o s t e r c h i l d r e n . The Foster Care Program needs t o monitor and analyze f o s t e r home turnover. RECOMMENDATIONS It is recommended t h a t DES take t h e following s t e p s t o help reduce f o s t e r parent turnover : 1. D i r e c t a d m i n i s t r a t o r s t o implement management a c t i o n s , including spot- checks of case f i l e s , t o ensure t h a t scheduled worker c o n t a c t s a r e made with f o s t e r p a r e n t s and t h a t f o s t e r p a r e n t s a r e consulted i n planning f o r f o s t e r c h i l d r e n . 2. Review t h e need f o r , and f e a s i b i l i t y o f , a telephone h o t l i n e f o r f o s t e r parents. 3. Monitor and analyze f o s t e r home turnover d a t a p e r i o d i c a l l y . It is f u r t h e r recommended t h a t DES e s t a b l i s h and implement t h e following procedures f o r r e c r u i t i n g f o s t e r parents. 4. A s a p a r t of t h e recruitment program, c o l l e c t d a t a as t o why persons who i n q u i r e about f o s t e r p a r e n t i n g d r o p out a f t e r inquiry. Also, c o l l e c t d a t a as t o whether persons who d r o p o u t would be i n t e r e s t e d i n f o s t e r parenting at a l a t e r d a t e and e s t a b l i s h a system f o r contacting these persons a g a i n . FINDING I11 IF DES WERE AS EFFECTIVE AS OTHER STATES I N COLLECTING AFDC- FC AND NATURAL- PARENT CHILD- SUPPORT PAYMENTS, STATE REVENUES COULD INCREASE BY AN ESTIMATED $ 1.3 MILLION A YEAR. DES does not use e f f e c t i v e l y a l t e r n a t e funding sources t o help support the f o s t e r c a r e program. Two a r e a s i n which DES does not t a k e f u l l advantage of funds a v a i l a b l e a r e Federal Aid t o F a m i l i e s w i t h Dependent Children - Foster Care ( AFDC- FC) matching funds and natural- parent c h i l d support f o r f o s t e r c h i l d r e n . However, during t h e past year DES h a s i n c r e a s e d its c o l l e c t i o n s from S o c i a l S e c u r i t y , Supplemental S e c u r i t y Income and Veteran's Administration b e n e f i t s a v a i l a b l e f o r f o s t e r c h i l d r e n . I f DES were a s e f f e c t i v e a s o t h e r s t a t e s i n c o l l e c t i n g AFDC- FC and natural- parent child- support payments, S t a t e revenues could i n c r e a s e by an estimated $ 1.3 m i l l i o n a year. AFDC- FC AFDC- FC is a F e d e r a l program t h a t provides s t a t e s with matching funds up t o $ 61.30 a month per c h i l d f o r f o s t e r c h i l d r e n who meet t h e e l i g i b i l i t y requirements of the AFDC program. We found t h a t Arizona may be l o s i n g a s much a s $ 670,000 of these funds each year because AFDC- FC g r a n t monies a r e not claimed c o r r e c t l y . This l o s s occurs because: - DES does not i d e n t i f y approximately 90 percent of t h e c h i l d r e n who should be r e f e r r e d f o r AFDC- FC, - ~ r o c e d u r e s f o r determining e l i g i b i l i t y and claiming AFDC- FC a r e not followed, and - The Family Assistance Administration within DES has not defined the d a t e of a p p l i c a t i o n i n such a manner a s t o permit DES t o claim the maximum amount of AFDC- FC a v a i l a b l e . DES Does Not I d e n t i f y A l l Children P o t e n t i a l l y E l i g i b l e f o r AFDC- FC Arizona has i d e n t i f i e d t h e lowest percentage of c h i l d r e n p o t e n t i a l l y e l i g i b l e f o r AFDC- FC among t h e eleven western s t a t e s we surveyed. A s shown i n Table 6, t e n other western s t a t e s have i d e n t i f i e d from two t o more than 15 times a s many e l i g i b l e c h i l d r e n on a percentage b a s i s a s Arizona . a TABLE 6 COMPARISON OF ARIZONA AFDC- FC ELIGIBILITY RATES WITH TEN OTHER WESTERN STATES DECEMBER 1979 Total Number o f F o s t e r Percentage of Foster Foster Children E l i g i b l e Care Population Care f o r AFDC- FC E l i g i b l e Population Federal Match f o r AFDC- FC NEW MEXICO 1,200 70 6 % WYOMING 385 4 6 12 COLORADO 4,600 800 17 UTAH 1,000 168 17 WASHINGTON 5,400 1,260 2 3 IDAHO 800 250 31 MONTANA 790 2 80 35 OREGON 4,000 NEVADA 580 CALIFORNIA 27,000 12,452 TOTAL zdzi 17,083 ARIZONA 2.200 * 2 * Exclusive of c h i l d r e n adjudicated i n c o r r i g i b l e o r d e l i n q u e n t , since they a r e not e l i g i b l e f o r AFDGFC. a I f DES i d e n t i f i e d and claimed AFDC- FC e l i g i b l e c h i l d r e n a t the same r a t e a s C a l i f o r n i a , Arizona would r e c e i v e an a d d i t i o n a l $ 670,000 a year i n ADFC- FC payments. I f DES were to i d e n t i f y and claim AFDC- FC e l i g i b l e c h i l d r e n a t tne average r a t e f o r the o t n e r t e n western s t a t e s , Arizona still would receive an a d d i t i o n a l $ 360,000 a y e a r i n AFDC- FC payments. The DES operating manual s t a t e s t h a t it is t h e s o c i a l s e r v i c e s worker's r e s p o n s i b i l i t y t o " Evaluate each f o s t e r c h i l d ' s case t o determine p o t e n t i a l AFDC- FC e l i g i b i l i t y . . . and t o " Refer the apparently e l i g i b l e AFDC- FC case t o the l o c a l Assistance Payments u n i t . . . " . S o c i a l s e r v i c e workers do not appear t o perform t h i s procedure adequately. For example, the a s s i s t a n c e payments u n i t i n Maricopa County, which contains approximately 1,100 f o s t e r c h i l d r e n , received only f i v e r e f e r r a l s f o r AFDC- FC from November 1979 through January 1980. In January 1980, during t h e course of our a u d i t , the Administration f o r Children, Youth and Families ( ACYF) issued a d i r e c t i v e t o s u p e r v i s o r s t o check a l l f o s t e r c h i l d cases f o r possible AFDC- FC e l i g i b i l i t y . The response t o t h e d i r e c t i v e was minimal and r e s u l t e d i n a memo from t h e Manager of t h e Service Delivery Unit t o t h e Program Administrator of ACYF i n March 1980, which s t a t e d : " It is my opinion t h a t u n l e s s t h e r e a r e some s a n c t i o n s t o Program Managers and Supervisors i n t h i s a r e a , it w i l l n o t r e c e i v e p r i o r i t y a t t e n t i o n . " Even with limited response t o t h e d i r e c t i v e , on March 21, 1980, 178 children were i d e n t i f i e d as possibly e l i g i b l e f o r AFDC- FC. Although t h i s is a p o s i t i v e s t e p , i f a l l 178 were determined t o be e l i g i b l e , Arizona would s t i l l have l e s s than t e n percent o f t h e f o s t e r c a r e population e l i g i b l e f o r AFDC- FC matching funds. This is still well below the e l i g i b i l i t y r a t e of the t e n other western s t a t e s surveyed. DES P o l i c i e s and Procedures f o r Determining AFDC- FC E l i g i b i l i t y Are Not Followed The procedures f o r determining AFDC- FC e l i g i b i l i t y are outlined i n the s o c i a l s e r v i c e s manual and i n an AFDC- FC t r a i n i n g package, y e t these procedures a r e not followed c o n s i s t e n t l y . Procedures for Determining AFDC- FC E l i g i b i l i t y According t o c u r r e n t DES p o l i c y , procedures t o be followed i n determining e l i g i b i l i t y f o r AFDC- FC a r e : 1. The ACYF caseworker r e f e r s c a s e s i n which a c h i l d may be e l i g i b l e f o r AFDC- FC t o a n A s s i s t a n c e Payments ( AP) worker f o r determination of e l i g i b i l i t y . 2. The AP worker makes an e l i g i b i l i t y study of each c a s e , determines e l i g i b i l i t y and n o t i f i e s the ACYF caseworker. The AP worker a l s o e n t e r s t h e determination of e l i g i b i l i t y or i n e l i g i b i l i t y i n t o the Assistance Payments Information System ( APIS) , which provides a monthly p r i n t o u t of c h i l d r e n who have been r e f e r r e d f o r AFDC- FC s t u d i e s and the r e s u l t s o f t h o s e s t u d i e s . 3. I f AFDC- FC e l i g i b i l i t y is determined, t h e ACYF caseworker e n t e r s t h e necessary changes i n t o the f o s t e r c a r e tracking system ( FCTS). The record of the determination of e l i g i b i l i t y is placed i n the permanent case f i l e . 4. A monthly l i s t i n g is generated from FCTS of a l l AFDC- FC e l i g i b l e c h i l d r e n . The FCTS p r i n t o u t is compared with t h e APIS p r i n t o u t , and d i s c r e p a n c i e s a r e followed up. The FCTS p r i n t o u t becomes the source document used i n preparing t h e AFDC- FC claim t o the Federal government. Noncompliance with Procedures Our a u d i t disclosed t h a t none of t h e procedures a r e performed adequately. We i d e n t i f i e d t h e following problems with each procedure: Procedure 1 - Many ACYF caseworkers do n o t f o l l o w procedures f o r f i l i n g AFDC- FC r e f e r r a l s with Assistance Payments. They a r e not aware of e l i g i b i l i t y requirements, o f the t y p e o f information t h a t should be included i n a r e f e r r a l , and i n some cases t h a t the AFDC- FC program e x i s t s . Reasons f o r t h i s include: 1) a lack of proper t r a i n i n g regarding the AFDC- FC program, and 2) a d i s p u t e between ACYF caseworkers and AP e l i g i b i l i t y workers over which should be r e s p o n s i b l e f o r gathering information. Procedure 2 - A l l AP e l i g i b i l i t y workers a r e not aware of the procedures f o r determining e l i g i b i l i t y . One AP u n i t was holding cases i n which the p a r e n t h e l a t i v e could not be l o c a t e d , d e s p i t e procedures i n t h e AFDC- FC t r a i n i n g packet s p e c i f i c a l l y designed t o expedite such cases. Also, ACYF caseworkers do not always n o t i f y AP e l i g i b i l i t y workers of case s t a t u s changes which may a f f e c t e l i g i b i l i t y . On the December 1979 APIS p r i n t o u t of AFDC- FC e l i g i b l e c h i l d r e n , approximately 15 percent were no longer i n f o s t e r care. Procedure 3 - Many ACYF caseworkers do not c o r r e c t l y recode FCTS when an approved e l i g i b i l i t y determination is returned by Assistance Payments. Approximately 25 percent of t h e names on t h e December 1979 APIS l i s t i n g of AFDC- FC e l i g i b l e c h i l d r e n were not included on FCTS because of coding e r r o r s . Coding e r r o r s occur f o r two reasons: 1 ) ACYF caseworkers a r e not aware o f t h e c o r r e c t codes t o i n d i c a t e an a c t i v e AFDC- FC case, and 2) the codes and t h e i r meanings f o r AFDC- FC a r e not uniform among ACYF forms. Procedure 4 - Controls a r e i n s u f f i c i e n t t o ensure t h a t claims for AFDC- FC matching funds include a l l e l i g i b l e f o s t e r c h i l d r e n . For example, i n April 1980, DES submitted an AFDC- FC claim f o r t h e period October 1978 through June 1979. The claim included 106 names, of which 33 were from Maricopa County. By simply comparing the APIS and FCTS p r i n t o u t s , we i d e n t i f i e d 25 a d d i t i o n a l c h i l d r e n from Maricopa County who might be e l i g i b l e f o r AFDC- FC. Although Assistance Payments had changed its e l i g i b i l i t y c r i t e r i a between the time the AFDC- FC claim was prepared i n April 1980 and the t i m e of our study, we found s i x c h i l d r e n who still were e l i g i b l e under t h e new c r i t e r i a , and 15 c h i l d r e n who would have been e l i g i b l e using t h e c r i t e r i a i n e f f e c t when the claim was prepared. Thus, DES did not include nearly a t h i r d of t h e c h i l d r e n from Maricopa County possibly e l i g i b l e f o r AFDC- FC on the claim. These c h i l d r e n could have been i d e n t i f i e d simply by comparing the APIS p r i n t o u t with the FCTS p r i n t o u t . Defining the Date of Application Under the r u l e s of the AFDC- FC program i f a c h i l d is determined t o be e l i g i b l e , a claim can be submitted f o r the period from t h e d a t e of a p p l i c a t i o n . However, Assistance Payments has f a i l e d t o d e f i n e t h e d a t e of a p p l i c a t i o n i n a manner t h a t would permit claims t o be made f o r the maximum allowable period. We learned from Federal a u t h o r i t i e s t h a t Assistance Payments can d e f i n e t h e d a t e of a p p l i c a t i o n as e i t h e r : 1 ) the d a t e an ACYF worker r e f e r s a case t o Assistance Payments f o r e l i g i b i l i t y determination, or 2) t h e d a t e Assistance Payments completes its e l i g i b i l i t y d e t e r m i n a t i o n . C u r r e n t l y , Assistance Payments d e f i n e s t h e d a t e of a p p l i c a t i o n as the d a t e it completes e l i g i b i l i t y determination. However, from two t o s i x months o f t e n e l a p s e s from the time a case is r e f e r r e d t o Assistance Payments u n t i l e l i g i b i l i t y determination is reached. Thus, because of t h e c u r r e n t d e f i n i t i o n of d a t e of a p p l i c a t i o n , DES does not claim AFDC- FC f o r t h i s two t o six- month period -- a period f o r which claims would be allowable i f the d a t e of a p p l i c a t i o n were defined a s t h e d a t e of r e f e r r a l . NATURAL- PARENT CHILD SUPPORT Child support payments from n a t u r a l parents is another funding source which DES has not used f u l l y . DES policy s t i p u l a t e s t h a t n a t u r a l p a r e n t s or guardians have a f i n a n c i a l o b l i g a t i o n t o support t h e i r c h i l d r e n i n f o s t e r care. Such support is based on the parents' a b i l i t y t o pay. Parents earning more than $ 7,000 a year may pay from 2.5 percent t o t e n percent o f t h e i r monthly g r o s s income -- up t o t h e c o s t o f t h e i r c h i l d r e n 1 s c a r e . However, DES does not i n i t i a t e c o l l e c t i o n procedures a g a i n s t many parents who should be required t o pay c h i l d support, and DES has inadequate c o l l e c t i o n procedures f o r accounts t h a t become delinquent. A s a r e s u l t , Arizona may be l o s i n g approximately $ 675,000 a year i n natural- parent child- support payments. F a i l u r e t o Assess Natural Parents The procedures f o r i n i t i a t i n g p a r e n t a l assessment a r e outlined i n t h e s o c i a l s e r v i c e s manual, which s t a t e s it is t h e caseworker's r e s p o n s i b i l i t y t o : - Explain t o parents t h e i r r e s p o n s i b i l i t y t o provide c h i l d support i f t h e i r c h i l d is placed i n f o s t e r care. - Require t h a t p a r e n t s complete an income worksheet used t o determine p a r e n t a l assessment. - Include i n t h e court r e p o r t a recommendation f o r p a r e n t a l assessment. Our case a n a l y s i s i n d i c a t e s t h a t income worksheets a r e not prepared and t h a t court r e p o r t s o f t e n d o n o t i n c l u d e recommendations f o r p a r e n t a l assessment. A s a r e s u l t , Arizona is assessing fewer n a t u r a l parents and c o l l e c t i n g s i g n i f i c a n t l y fewer d o l l a r s than neighboring Utah, which has a more aggressive program f o r natural- parent support. It should be noted t h a t Utah has assessment c r i t e r i a s i m i l a r t o Arizona's; however, a s shown i n Table 7, on a proportional b a s i s Utah a s s e s s e s f i v e times as many parents a s Arizona does and c o l l e c t s an average of inore than four times a s many d o l l a r s f o r each f o s t e r c h i l d as Arizona does. TABLE 7 A COMPARISON OF ARIZONA'S AND UTAH'S ASSESSMENTS AND COLLECTIONS FOR NATURAL- PARENT SUPPORT DURING FISCAL YEAR 1978- 79 Foster c a r e population Number o f n a t u r a l parents assessed c h i l d support Percentage o f n a t u r a l parents assessed c h i l d support ARIZONA UTAH 2,500 1,000 C o l l e c t i o n s from n a t u r a l parents $ 201,857 $ 350,000 Average c o l l e c t i o n f o r each f o s t e r c h i l d $ 8 1 $ 350 A s Table 7 i n d i c a t e s , Utah's c o l l e c t i o n r a t e f o r each f o s t e r c h i l d is more t h a n f o u r times g r e a t e r than Arizona's. If Arizona were assessing and c o l l e c t i n g natural- parent c h i l d support a t the same r a t e as Utah, c o l l e c t i o n s could be increased by nearly $ 675,000 a year. In January 1980, during the course o f o u r a u d i t , ACYF issued a program d i r e c t i v e r e q u i r i n g p a r e n t a l assessment f o r new dependency c a s e s , a l l voluntary placements and c a s e s t h a t had not been assessed previously. A s with the d i r e c t i v e on AFDC- FC ( page 5 3 ) , response t o t h i s d i r e c t i v e has been minimal. Collection Procedures f o r Delinquent Accounts Are Inadequate Even when n a t u r a l parents a r e assessed f o r f o s t e r c a r e , DES l a c k s adequate procedures t o c o l l e c t i f t h e parents become delinquent i n t h e i r payments. Currently, n a t u r a l parents owe more than $ 200,000 i n delinquent payments on t h e i r assessments. DES w e l f a r e a c c o u n t i n g ' s s p e c i a l funds u n i t is r e s p o n s i b l e f o r b i l l i n g and accounting f o r f o s t e r care p a r e n t a l assessments. When accounts become delinquent the u n i t ' s only recourse is through the Attorney General's o f f i c e and the c o u r t s . However, the matter is low p r i o r i t y f o r the Attorney General's o f f i c e , so only a small number of delinquent accounts a r e taken t o c o u r t . From April 1979 t o March 1980, no cases were taken t o court f o r delinquent payments. In March 1980, 15 c a s e s were taken t o c o u r t ; y e t t h e s e c a s e s represented only s i x percent of the t o t a l accounts t h a t were delinquent and only 20 percent of the delinquent accounts t h a t were more than $ 500. A t t h a t time, t h e A s s i s t a n t Attorney General who handled such cases s t a t e d t h a t the o f f i c e could accept no more cases because o f a manpower shortage. In order t o i n c r e a s e t h e c o l l e c t i o n of d e l i n q u e n t a c c o u n t s , ACYF h a s t a k e n s t e p s t o involve the Child Support Enforcement Administration, which has the f u l l - t i m e s e r v i c e s of an A s s i s t a n t Attorney General f o r t h e f i l i n g of c o u r t o r d e r s , contempt d e c r e e s and other l e g a l remedies. We found t h a t Utah, with its more s u c c e s s f u l n a t u r a l - p a r e n t s u p p o r t program, uses its Child Support Enforcement agency t o c o l l e c t delinquent payments. SOCIAL SECURITY, SSI AND VA BENEFITS DES c o l l e c t e d $ 500,000 more i n S o c i a l S e c u r i t y , Supplemental S e c u r i t y Income ( SSI) and Veteran's Administration ( VA) b e n e f i t s i n f i s c a l year 1979- 80 than it c o l l e c t e d i n f i s c a l year 1978- 79. SSI b e n e f i t s made up the biggest p a r t o f t h e i n c r e a s e by almost quadrupling from $ 150,000 i n f i s c a l year 1978- 79 t o more than $ 550,000 i n f i s c a l year 1979- 80. The i n c r e a s e was due p r i m a r i l y t o the e f f o r t s of one ACYF c e n t r a l o f f i c e s t a f f person, who prepared a list of names o f p o t e n t i a l l y e l i g i b l e disabled c h i l d r e n . Caseworkers were then requested t o prepare SSI claims f o r t h e c h i l d r e n whose names were on t h e list. The i n c i d e n t demonstrates what can r e s u l t from increased e f f o r t t o c o l l e c t from a l t e r n a t e funding sources. Despite t h e i n c r e a s e i n c o l l e c t i o n s from S o c i a l S e c u r i t y , SSI and VA, it appears the funding sources a r e not used f u l l y . A program d i r e c t i v e issued i n January 1980 requested s u p e r v i s o r s o f f o s t e r c a r e u n i t s t o review t h e i r c a s e s f o r possible S o c i a l S e c u r i t y , SSI o r VA e l i g i b i l i t y . The review, conducted i n January and February 1980, i d e n t i f i e d an a d d i t i o n a l 122 c h i l d r e n p o t e n t i a l l y e l i g i b l e f o r S o c i a l S e c u r i t y , SSI o r VA b e n e f i t s , even though response from four o f t h e s i x d i s t r i c t s was slow o r nonexistent. Completion of t h e review should be mandatory i n order t o ensure t h a t DES r e c e i v e s a l l funds t h a t a r e a v a i l a b l e . CONCLUSIONS 1. I f DES were a s e f f e c t i v e a s other s t a t e s i n c o l l e c t i o n AFDC- FC and natural- parent child- support payments, S t a t e revenues could i n c r e a s e by an estimated $ 1.3 m i l l i o n a year. 2. DES did i n c r e a s e t h e c o l l e c t i o n of S o c i a l S e c u r i t y , SSI and VA b e n e f i t s i n f i s c a l year 1979- 80 by $ 500,000 over f i s c a l year 1978- 79. However, a DES review of cases i n January and February 1980 i n d i c a t e d t h a t t h i s funding source still is not f u l l y used. It is recommended t h a t : 1. ACYF s u p e r v i s o r s r e c e i v e a d d i t i o n a l t r a i n i n g on the proper procedures f o r i d e n t i f y i n g and r e f e r r i n g AFDC- FC c a s e s , preparing p a r e n t a l assessments and completing claims f o r S o c i a l S e c u r i t y , SSI and VA b e n e f i t s , and the s u p e r v i s o r s then r e t r a i n t h e i r caseworkers i n these procedures and review each case i n t h e i r u n i t s every s i x months t o ensure the procedures a r e followed c o r r e c t l y . 2. AP workers receive t r a i n i n g on the proper procedures for determining AFDC- FC e l i g i b i l i t y and t h a t Assistance Payments d e f i n e the d a t e of a p p l i c a t i o n f o r AFDC- FC a s the d a t e of r e f e r r a l f o r e l i g i b i l i t y determination so DES c a n c l a i m the maximum amount of AFDC- FC a v a i l a b l e . 3. D e l i n q u e n t f o s t e r care p a r e n t a l a s s e s s m e n t s be c o l l e c t e d by t h e Child Support Enforcement A d m i n i s t r a t i o n . 4. F o s t e r care cases be reviewed f o r p o s s i b l e e l i g i b i l i t y f o r S o c i a l S e c u r i t y , SSI and VA b e n e f i t s . FINDING I V A LACK OF CONTROL OVER THE FOSTER CARE PAYMENT SYSTEM HAS RESULTED I N DUPLICATE PAYMENTS, PAYMENTS I N WRONG AMOUNTS, UNCOLLECTED OVERPAYMENTS AND INADEQUATE MONITORING OF CONTRACTS. DES d i s t r i b u t e s approximately $ 18 m i l l i o n of S t a t e funds annually f o r f o s t e r c a r e and r e l a t e d s e r v i c e s . D i s t r i b u t i o n s a r e made primarily by one of t h r e e methods. Most payments a r e made by the computerized F o s t e r Care Tracking Statewide System; however, some paynents a r e made on claims submitted by providers and some a r e made f o r block purchases o f c a r e negotiated under s p e c i a l c o n t r a c t s . Our review of the DZS methods revealed a pervasive absence of adequate c o n t r o l s over f o s t e r c a r e payments. We i d e n t i f i e d : 1) numerous i n s t a n c e s of d u p l i c a t e payments and payments i n wrong amounts which DES did not d e t e c t , 2 ) c o l l e c t i o n procedures t n a t were inadequate, r e s u l t i n g i n many overpayments never c o l l e c t e d , and 3) inadequate monitoring and a d m i n i s t r a t i o n of block- purchase c o n t r a c t s , r e s u l t i n g i n unnecessary expenditures of approximately $ 120,000 during f i s c a l year 1979- 80 due t o u n d e r u t i l i z a t i o n of contracted bed spaces." DUPLICATE PAYMENTS The DES f o s t e r c a r e payment system does not include adequate c o n t r o l s t o h e l p p r e v e n t d u p l i c a t e payment. Our a u d i t disclosed t h a t i n some i n s t a n c e s payments were made through t h e Statewide Tracking System and a l s o paid by claim. In o t h e r i n s t a n c e s , two claims were paid f o r t h e same care. The d u p l i c a t e payments were i d e n t i f i e d during: 1) a review o f payments made during the period September 1979 through Decernber 1979 t o f o u r o f the 40 i n s t i t u t i o n s providing r e s i d e n t i a l t r e a t m e n t , and 2) a review of payments made f o r a l l Emergency Receiving Home Care during January 1980. * Some of these conditions were previously i d e n t i f i e d i n an August 1979 s p e c i a l a u d i t by the Office of the Auditor General of Visionquest, a DES provider. Duplication Between Tracking System Payments and Claims We found $ 16,337 i n d u p l i c a t e payments were made t o two of four r e s i d e n t i a l treatment i n s t i t u t i o n s during the four- month period we examined. DES was aware of l e s s than a t h i r d of t h e s e d u p l i c a t e payments a t t h e time we made our review. DES had paid t h e i n s t i t u t i o n s by claim and a l s o paid f o r t h e same c a r e through t h e Statewide Tracking System. I n d i s c u s s i o n with DES personnel we determined t h a t t h e r e a r e no c o n t r o l s t o prevent d u p l i c a t e payments f o r the same s e r v i c e being made by claim and t h e tracking system. Payments Made f o r Duplicate Claims We found two i n s t a n c e s of d u p l i c a t e payments made t o emergency receiving homes during January 1980. The two double payments, t o t a l i n g $ 545, r e s u l t e d from the processing of d u p l i c a t e claims. There a r e no apparent c o n t r o l s t o prevent d u p l i c a t e claims f o r t h e same c a r e being processed by Welfare Accounting. Although t h e d u p l i c a t e payments shown above a r e somewhat i n s i g n i f i c a n t , t h e p o t e n t i a l does e x i s t f o r s i g n i f i c a n t l o s s e s t o t h e S t a t e i n t h a t : 1) our review was l i m i t e d , 2 ) t h e r e is a pervasive absence of adequate c o n t r o l s over f o s t e r c a r e payments, and 3) DES pays more than $ 18 m i l l i o n a year f o r f o s t e r care. PAYMENTS FOR INCORRECT AMOUNTS Our a u d i t disclosed numerous i n s t a n c e s of payments made f o r i n c o r r e c t amounts, another i n d i c a t i o n t h a t the Foster Care Program payment system has inadequate c o n t r o l s . We determined t h a t t h r e e o f four i n s t i t u t i o n s whose records we reviewed had received overpayments or underpayments during the period from September 1979 through December 1979. I n a d d i t i o n , we found two emergency receiving homes were paid r e t a i n e r f e e s i n January 1980 f o r more c h i l d r e n than t h e homes were licensed t o f o s t e r . Such d i s c r e p a n c i e s should n o t occur i n a payment system with proper checks and balances. Our review of DES payments t o four i n s t i t u t i o n s revealed t h a t overpayments and underpayments a r e a common occurrence. We found the following d i s c r e p a n c i e s during t h e review: - Payments t o one o f t h e i n s t i t u t i o n s became so disordered t h a t DES had t o perform manual r e c o n c i l i a t i o n s on each c h i l d ' s account i n t h a t f a c i l i t y . F i f t e e n percent of the payments t o t h e f a c i l i t y during the period from September 1979 through December 1979 were i n c o r r e c t . F u r t h e r , we found t h e DES r e c o n c i l i a t i o n s s t i l l did not account f o r more than $ 2,500 i n overpayments. - An i n s t i t u t i o n f o s t e r e d 28 c h i l d r e n i n one of its f a c i l i t i e s during the review period. A comparison of the f a c i l i t i e s 1 records with DES r e c o r d s i n d i c a t e d t h a t overpayments or underpayments were made f o r t h e c a r e of 14 of t h e 28 c h i l d r e n . - A t h i r d i n s t i t u t i o n received s i x overpayments and one underpayment during the review period. DES was unaware of any of t h e i n c o r r e c t payments. During our review we a l s o found t h a t one of the i n s t i t u t i o n s no longer t r i e d t o r e c o n c i l e DES payments on a case- by- case b a s i s . A t l e a s t one i n s t i t u t i o n ' s d i r e c t o r claims the f a c t t h a t DES does not use b i l l i n g s from providers t o determine payments is causing t h e overpayment problem. He s t a t e d t h a t t h e major cause of the problems is t h a t the present system does not i n v o l v e p r o v i d e r input u n t i l a f t e r the payment has been generated. Therefore, many mistakes t h a t could be avoided through communication, with t h e providers end up taking months t o s t r a i g h t e n out. He a l s o noted h i s i n s t i t u t i o n f o s t e r s c h i l d r e n f o r t h r e e o t h e r s t a t e s , a l l of which base payments on b i l l i n g s from the i n s t i t u t i o n . INADEQUATE COLLECTION OF OVERPAYMENTS DES is i n e f f e c t i v e i n c o l l e c t i n g overpayments made t o f o s t e r homes and i n s t i t u t i o n s . A s s t a t e d e a r l i e r , DES is unaware of many of the overpayments. However, f o r many overpayments t h a t DES is aware of, c o l l e c t i o n procedures a r e never i n i t i a t e d . When DES does i n i t i a t e c o l l e c t i o n procedures, t h e r a t e of recovery of overpayments is 20 percent of t o t a l i d e n t i f i e d overpayments. Collection Procedures Are Not I n i t i a t e d The procedure f o r i n i t i a t i n g c o l l e c t i o n s of overpayments is a s follows: 1. The Foster Care Statewide Tracking System generates a monthly p r i n t o u t of i n v a l i d f o s t e r c a r e payments, which is reviewed by c l e r k s i n t h e processing u n i t . 2. I f a n i n v a l i d payment is the r e s u l t of an e r r o r by t h e processing u n i t ( such a s a keypunch e r r o r ) , the processing u n i t prepares an overpayment r e p o r t . 3. I f an i n v a l i d payment is t h e r e s u l t of a caseworker e r r o r , the u n i t n o t i f i e s the caseworker, who becomes r e s p o n s i b l e f o r preparing an overpayment r e p o r t . 4. Copies of overpayment r e p o r t s a r e f i l e d with Welfare Accounting, which attempts t o c o l l e c t the overpayments. We found, however, t h e r e a r e no c o n t r o l s t o ensure t h a t overpayment r e p o r t s a r e prepared and f i l e d with Welfare Accounting. In reviewing the monthly p r i n t o u t s of i n v a l i< |
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