IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

OCTOBER 2023 REPORT ON OVERARCHING OUTCOME MEASURES

This Report on Overarching Outcome Measures (“Report”) is submitted jointly by the parties in connection with the Superseding B.H. Implementation Plan (SIP, Dkt. 816), which was adopted to address certain requirements of the B.H. Consent Decree.1 Dkt. 456. The SIP states that the Illinois Department of Children and Family Services (“DCFS” or the “Department”) will file “Overarching Outcome Reports” addressing its performance on the Overarching Outcome measures regarding the safety, permanency, and well-being of the youth in DCFS care. This report, which is in substantially the same form as the Interim Reports on Overarching Outcome

Measures previously filed with this Court, provides data on the following measures:

1. Maltreatment in foster care

2. Permanency in 12 months

3. Permanency in 12-23 months

4. Permanency in 24+ months

5. Placement stability

6. Reentry into foster care

7. Well-being indicators

1 The Report follows the format utilized in the series of Interim Reports on Overarching Outcome Measures previously filed. See, e.g., most recently filed Tenth Interim Report on Overarching Outcome Measures.

Dkt. 800.

B.H., et al., Plaintiffs, v.

MARC D. SMITH, Director, Illinois Department of Children and

Family Services, Defendant.

No. 88 C 5599

Hon. Jorge L. Alonso

Judge Presiding

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I. Adoption of the Illinois Standards

On May 18, 2023, this Court granted the parties Joint Motion for Approval of the Illinois

Standards. Dkt. 817. That motion proposed standards for four of the six overarching outcomes measures. The Illinois Standards for the four measures that have been adopted by the Court are contained on the charts below.

There remain two measures, Permanency in 12 Months for Children Entering Foster Care and Permanency in 12 Months for Children in Care 12 to 23 Months, for which no Illinois

Standards have been determined. The Department has been discussing with the Expert Panel further areas of research to be conducted by the Department’s University Partners to evaluate

Illinois’s performance compared to the national performance levels for each of these measures.2

II. General Format and Data Sources for the Graphs Presented

As in prior reports, the data for the graphs presented below are gathered from the

Department’s Statewide Automated Child Welfare Information System (“SACWIS”) and Child and Youth Centered Information System (“CYCIS”). The Overarching Outcome measures are presented in a uniform rolling 12-month format with a three-month reporting lag to allow for data-entry delays and disposition achievement (i.e., May 1, 2022 to April 30, 2023, is the latest observation period for the current report). The rolling 12-month format is used to account for volatility and fluctuations from month to month and is calculated by using the current month’s

2 National performance levels are how the nation as a whole performed on a given data indicator. They are used as reference points to determine if a state performed statistically better, worse, or no different from the nation after taking into account some of the factors over which states have little control. As noted in the

CFSR Round 4 Statewide Data Indicators Workbook (October 2022), a state’s observed performance should not be compared to national performance. Instead, as advised by the Expert Panel, Illinois should rely on its own observed performance statistics to assess how well it is performing on an overarching outcome indicator compared to itself over time, to a comparable jurisdiction, or to a state-specific standard of improvement. The SIP relies on all three types of comparison to assess DCFS’s progress. Dkt. 816.

Case: 1:88-cv-05599 Document #: 831 Filed: 10/23/23 Page 2 of 14 PageID #:7855 data and averages the rate into the prior 11 months to determine the average for the 12-month period. The calculation for each month advances by one month to reflect the next month and the prior 11 months to determine the new average.

The graphs in this report include data for the latest observation period from May 1, 2022 to April 30, 2023 available as of August 17, 2023.

III. Discussion of Measures 1-7

1. Maltreatment in care (lower is better)

The DCFS maltreatment in foster care rate for the rolling 12-month time period of May 1, 2022 to April 30, 2023 is 15.3 victimizations per 100,000 days in care, which is an increase in the rate reported in the Tenth Interim Report on Overarching Measures. Dkt. 800. The rate for this measure is significantly higher than the Illinois Standard of 9 victimizations per 100,000 days.

Disaggregating the statewide rate by regions for the same time period of May 2022 to April

2023, shows the Cook region rate at 10.7, the Northern region rate at 11.7, the Central region rate

Case: 1:88-cv-05599 Document #: 831 Filed: 10/23/23 Page 3 of 14 PageID #:7856 at 19.3, and the Southern region rate at 17.6. The graph below is a breakout by region of maltreatment in care for the same time period in this report. This graph shows that the rate of maltreatment in care has been declining in the Cook and Northern Regions, remains highest in the

Central Region, and increased sharply in the Southern Region. DCFS is examining these differences, including a targeted case review of a sample of cases to provide insight around the reasons for the variation among the regions as the Department works to improve safety for youth in care.

2. Permanency within 12 months of entering care (higher is better)3

Of children who entered DCFS care between May 1, 2021 and April 2022, 15.4% achieved permanency within 12 months of entering care. Disaggregating the statewide percentage by region shows the Central region at 15.8%, the Cook region at 7.3%, the Northern region at 20.3%, and the Southern region at 16.7%. The national average in performance level is 42.7%

3 There is not an Illinois Standard line to compare performance for this measure. See infra at p. 2.

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According to the Expert Panel, one of the reasons for the sizeable disparity in Illinois’s permanency rates across all regions compared to the nation as a whole is that Illinois removes a much smaller proportion of indicated child maltreatment victims than most other states. States with low removal rates like Illinois confront hurdles when pursuing reunification because families in low removal states tend to present with more challenging problems that take an extended time to ameliorate before reunification is deemed safe to pursue. States with high removal rates reunify children more quickly than Illinois. Some of these rapid reunifications could possibly have been avoided if appropriate supports and preventive services were provided to preserve families instead of removing children and returning them back home quickly. Thus, it can be misleading to characterize high reunification rates among children entering foster care as invariably “better,” especially if more of these children could have been spared the trauma of removal by providing protective services in the context of their own homes. For this reason, the Expert Panel has advised

DCFS to postpone setting state-specific permanency standards for new entrants

DCFS will be observing the permanency rates that emerge in designated Pilot Teams when best practices identified in the SIP and it’s Meta Model are implemented, including providing families and child welfare caseworkers the resources they need in a timely manner to obtain the necessary services before addressing what the Illinois standard should be.

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3. Permanency for children in care for 12 to 23 months (higher is better)

Of children who had been in DCFS care for 12 to 23 months on May 1, 2022, 22.7% achieved permanency within the one-year period. The national performance is 45.9%.

Disaggregating the statewide percentage by region shows the Cook region at 14.3%, the

Northern region at 28.50%, the Central region at 24.9%, and the Southern region at 23.3%. The same observations and recommendations made above also apply to this area of permanency performance. See infra at p. 5.

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4. Permanency for children in care for 24 months or more (higher is better)

Of children who had been in care for 24 months or longer on May 1, 2022, the percentage of children who achieved permanency within the one year period was 24.3%. The number has remained fairly steady and still falls below the Illinois Standard of 31%. Disaggregating the statewide percentage by region shows the Cook region at 15.1%, the Northern region at 27.4%, the Central region at 29.1%, and the Southern region 32.1%.

The parties selected an Illinois-specific standard of 31% for permanency within 12 months for children in care for 24 months or more.4 As illustrated in the Figure above, the best permanency rate achieved over the past several years, was 25.2% for the 12-months ending June 2022. During the most recent period under review, the rolling 12- month rate has stayed approximately constant at around 24%. In order to get on track to reaching the desired goal of 31% within the next 18 months, current performance levels would need to be around 28%.

4 This standard is similar to the national performance level the Administration for Children and Families referenced for Round 3 of the federal Child and Family Services Review (CFSR). See

SWDI_Workbook_May_2022_Final (2).pdf (last visited October 23, 2023).

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Many more children must be discharged to permanency homes in order for DCFS to reach the Illinois Standard. Because of the rise in foster care entries during the pandemic, the number of Illinois youth in long-term foster care for 24 months or longer rose from 7,590 at the start of

FFY 2020 to a projected 10,000 throughout FY 2024. The repercussions from serving a growing fraction of youth in long-term foster care are that the length of stay in care must be decreased by accelerating the discharge of children to permanent homes in order to stay even with past performance levels. For example, whereas the absolute number of permanencies finalized for

Illinois youth in long-term foster care increased by 27% from 1,981 reunifications, guardianships, or adoptions in FY 2021 to 2,523 in FY 2023, performance levels showed no improvement.

Instead, they held steady at 24% when calculated as a percentage of all youth in care for 24 months or longer. In order to progress satisfactorily toward the desired benchmark of discharging 31% of youth in long-term foster care to permanent homes within the next 12 months, the system needs to generate an additional 680 to 740 permanencies annually for the projected 10,000 children in long-term foster care for 24 months or more. Performance targets must be set in reference to projected future needs rather than against past accomplishments. The steps DCFS is taking to accommodate this future need are addressed in the October 2023 Progress Report for the Superseding

Implementation Plan. Dkt. 832 at 23-25.

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5. Placement stability (lower is better)

The rate of placement moves between May 1, 2022 and April 30, 2023 remains at 3.9 moves per 1,000 days in out-of-home care for children who enter foster care in a 12-month period.5

The current placement stability rate, which has been relatively consistent for the last three years, continues to be lower than the Illinois Standard.

Disaggregating the statewide rate by region shows the Cook region rate at 4.22, the

Northern region rate at 4.45, the Central region rate at 3.79, and the Southern region rate at 3.52.

5 The Placement Stability rate is calculated based on the number of children who enter foster care in a 12-month period, the total number of days these children were in foster care as of the end of that 12-month period, and the number of placement moves during that 12-month period. The rate is expressed as a rate per 1,000 days of out-of-home care to make it easier to understand and compare from year to year. The days of out-of-home care of each child who entered care during the 12-month period are added together in the calculation of the rate. U.S. Dept. of Health and Human Services, Admin. for Children and Families, Children’s Bur., CFSR Round 3 Statewide Data Indicator Data Dictionary 2020, https://www.acf.hhs.gov/cb/report/cfsr-round-3-statewide-data-indicator-data-dictionary-2020 (last visited

October 23, 2023).

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6. Reentry into foster care within 12 months of permanency (lower is better)

Of children who entered care between May 1, 2020 and April 30, 2021 and achieved permanency within the next 12 months, 11.5% re-entered out of home placement within 12 months of achieving permanency. The re-entry rate was 13.4% for the prior reporting period ending

November 2019 and was as low as 6.4% for the period ending September 2020. The re-entry rate is a companion measure to balance permanency within 12 months of entry to foster care to promote stable reunifications. This statewide rate remains above the Illinois Standard. Disaggregating the statewide percentage by region shows the Cook region at 23.8%, the Northern region at 16.6%, the Central region at 8.8%, and the Southern region at 6.10%.

As with the maltreatment in care measure, the Department reviewed the data related to re-entry to care in an attempt to identify issues that might be driving the increase in this measure.

While the Cook region has a large percentage increase, the numbers of youth who re-enter care in

Cook are relatively small (approximately 20 youth). The Northern region has a smaller percentage

Case: 1:88-cv-05599 Document #: 831 Filed: 10/23/23 Page 10 of 14 PageID #:7863 increase but has a larger number of youth re-entering care (approximately 59 youth). Since this measure applies to re-entries for youth returned home within the first 12 months, one theory is that the numbers could be driven by petitions that are dismissed at the adjudicatory stage and those youth subsequently return to care. Staff from the Department’s Strategy and Performance

Execution Division will do a review of the cases for youth re-entering foster care to determine if there is a pattern on how DCFS can improve on this measure.

7. Well-Being Indicators

As noted in prior reports (e.g., Dkt. 800 at 18-19), due to lack of existing federal measures on well-being, the Department would explore the development and adoption of its own well-being indicators. To that end, the Child Well-Being Subcommittee of the Child Welfare Advisory

Committee initiated the Child Well-Being Indicators (CWBI) project. The CWBI project identified and recommended a set of developmentally appropriate measures of well-being: (i) cognitive functioning; (ii) physical health and development; (iii) behavioral/emotional functioning; and (iv) social functioning.6

The Department also worked with the Juvenile Protective Association and Northwestern

University to analyze indicators of well-being drawn from the Child and Adolescent Needs and

Strengths (CANS), an assessment tool the Department has used for many years, and other such assessment tools.7 After a review, the Expert Panel agreed that the correlation between CANS data and the other assessment tools was strong enough to warrant use of the CANS as a tool for assessing child well-being. Dkt. 789.

6 These four domains are consistent with domains identified by ACF. See ACYF-CB-IM-12-04 (hhs.gov)

(last visited October 12, 2023).

7 These other assessment tools include Devereux Early Childhood Assessments for Infants and Toddlers, the Devereux Early Childhood Assessments for Preschoolers, and the Strengths and Difficulties

Questionnaire. (See, e.g., Dkt. 800 at 18.)

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Based on the data and reviews conducted as part of the CWBI project, the Department believes it can reliably infer that: (i) about 44% of youth entering care meet the criteria for complex trauma exposure and 56% of youth entering care have non-complex trauma exposure; (ii) youth with complex trauma are much more likely than other youth to have problems in the behavioral/emotional functioning and social functioning well-being domains; (iii) children entering care are two to three times more likely to have higher behavioral/emotional functioning and social functioning needs/problems than children in normative samples; (iv) children who were older age at entry were more likely to have higher behavioral/emotional functioning and social functioning needs/problems; and (v) many youth in care have significant behavioral/emotional functioning needs. Dkt. 796.

The Department will build on the work of the CWBI project to attempt to develop well-being indicators that can be used to compare the well-being of child entry cohorts both at the time of entry into foster care and as it may change during their time in foster care.8 The Department will provide updates on this work in subsequent reports.

Conclusion

The data related to the overarching outcome measures presented in this October 2023

Overarching Outcomes Report continues to help focus the parties’ development and implementation of the strategies needed to improve performance on these measures. The

8 Building on this work, one of the Satisfaction Criterion in the SIP is the improved living arrangement stability for youth experiencing living arrangement instability due to high mental health or behavioral health needs. This subset of youth, which are youth who move to a fourth living arrangements in a twelve-month period when one of those living arrangements includes a psychiatric hospitalization, will be reported on in the Progress Reports as set forth in the SIP. Dkt. 816.

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Department, Plaintiffs’ counsel, and Expert Panel remain committed to improving performance on the overarching outcome measures.

Dated: October 23, 2023 Respectfully submitted, KWAME RAOUL

Barbara L. Greenspan Illinois Attorney General

Assistant Attorney General

100 W. Randolph St., 11-200 By: s/Barbara L. Greenspan

Chicago, Illinois 60601 Barbara L. Greenspan

(312) 814-7087

Barbara.greenspan@illinois.gov

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CERTIFICATE OF SERVICE

The undersigned, an attorney, deposes and states that a copy of the October 2023 Report on Overarching Outcome Measures was served upon counsel of record by electronic filing this

23rd day of October 2023. The Expert Panel listed below, who are not ECF filers, were served by email on October 23, 2023.

s/Barbara L. Greenspan

Attorney

Marci White, MSW mwhitedcr@gmail.com

Mark Testa mtesta@email.unc.edu

Case: 1:88-cv-05599 Document #: 831 Filed: 10/23/23 Page 14 of 14 PageID #:7867 mailto:pv@childwelfaregroup.org