STATE LEGISLATURES MAGAZINE | april 2015
States are finding better ways to ensure foster children’s personal information follows them through the system, and is updated and comprehensive.
By Meghan McCann
Why can we track a package around the world, but we can’t keep track of our kids in foster care?
“Since I moved around from school district to school district so often, tracking down all of the paperwork was a huge problem. No one knew if I had enough credits to graduate. If I had known, I could have applied to college,” says one former foster youth.
In the information age we live in—where personal data and records are needed to do just about anything—children in foster care without school and medical records can be at a real disadvantage.
States use a variety of data collection and sharing systems to track numbers—how many children are entering and exiting foster care, for example. But there are roadblocks along the way that can make it quite difficult to obtain and maintain complete, consistent and specific information about each child.
Child welfare caseworkers typically, but not always, collect health histories, immunization records and school records. In many instances, however, the information is never entered into an electronic database, often because of a chronic lack of time and resources.
Children in foster care move frequently—often for their own safety—but too often, their information doesn’t keep up with them. State and federal laws that require confidentiality of foster children’s records present other special challenges, as does the inconsistency in the kinds of data reported, recorded and managed by all the different agencies involved in a foster child’s life.
Ensuring health records follow children in foster care as they move through the system is critical to their well-being. Because they often have complex behavioral and mental health care needs, the lack of records can have serious consequences, like an over-prescription of psychotropic medications or duplicate immunizations, for example.
This lack of consistent, complete information can lead to misunderstandings and can potentially harm children in foster care in the long term.
The system currently used by most states is the Statewide Automated Child Welfare Information System, which is used to collect statewide information on children in foster care. (The rest of the states use a similar system.) This information is reported to the federal Adoption and Foster Care Analysis and Reporting System, which then provides the national picture on children entering and exiting foster care.
The Statewide Automated Child Welfare Information System was designed to provide comprehensive statewide information required by the federal government. It provides information on entries and exits into and out of foster care and the number of placements per child. But it doesn’t include information about children’s education, health care and other day-to-day information used by caseworkers, teachers, doctors or foster parents in making decisions regarding the child.
Although these systems work well providing the big picture, they are not designed to provide individualized data to those making important decisions on the fates of specific children in foster care.
Alternative Data Systems
Although alternative systems to the Statewide Automated Child Welfare Information System are rare, Indiana recently adapted a new Internet-based case management tool called Casebook. It was developed by CaseCommons and the Annie E. Casey Foundation and funded through a federal waiver to use federal foster care funds to test modern child welfare technology.
The state hopes the new system, by providing real-time, specific data, will help child welfare caseworkers and other decision makers make better informed decisions on behalf of foster children.
And good decisions are exactly what many of these children are seeking. Good decisions and a chance to start afresh.
Backpacks and Passports
To ensure children don’t lose their vital personal information while in the foster care system, a couple of states are looking at electronic backpacks or passports. This innovative idea was developed recently at the county level as a way to use current technology to be sure the information collected on children travels with them throughout their journey through foster care.
The information collected and kept in the “ebackpacks” is not to be reported as part of federal requirements. Its sole purpose is to provide the most current information on the child to caseworkers and decision makers.
In Ventura County, Calif., an electronic backpack program begins this year with medical records and will phase in other child-specific information gradually. The backpack will be available for children to take with them as they leave foster care to help with college and job applications.
Kansas, Tennessee and Texas are using electronic health passports in a similar way. They provide a Web-based program that contains health information from several sources to prevent duplicate immunizations and over-prescriptions. These passports can include other information as well, such as education records.
In Search of a Better Way
State legislators are discussing the best way to improve the data collection system.
Vermont lawmakers, for example, created the Joint Legislative Committee on Child Protection in 2014 in order to “investigate and evaluate Vermont’s current system of child protection for the purpose of protecting children from abuse and neglect.” One area that was addressed was sharing information on children and families in the child welfare system.
Senator Claire Ayer (D) who chairs the Vermont Committee on Child Protection, says the committee learned that the various confidentiality requirements were keeping important information from reaching those who needed it. “The committee’s ultimate question,” she says, became, “Are these confidentiality rules actually protecting the child?”
Committee members learned that foster parents, teachers, caregivers, guardians and other people who knew the child felt no one was listening to them about the child’s issues.
And finally, the committee discovered that “mandatory reporters were concerned about what was happening to children that they were reporting. But they were never told what happened to those children,” says Ayer.
From this committee came Senate Bill 9, which among other things, seeks to foster better communication among all participants in the child protection system by giving health care providers, educators, foster parents and others access to a child’s records.
What Is the Role of the Legislature?
State legislators already study child welfare data to make policy decisions. But they can also play an important role in promoting more consistent collection and sharing of child welfare information, defining what type of information is collected and deciding who will have access to the data.
Last year, for example, Delaware lawmakers created a Child Welfare Data Sharing Task Force to make recommendations for data-sharing among the Family Court, the Department of Education, and the Department of Services for Children, Youth and Their Families.
To do this, the task force will:
- Define what specific data are to be shared among the agencies and Family Court.
- Identify any potential legal obstacles.
- Develop regulatory requirements and security parameters.
- Calculate the potential costs.
- Determine the feasibility and cost of developing a student ID for every child born in the state.
State lawmakers can consider providing specific health and education information for each child. They may also facilitate the coordination of physical, dental and mental health services and care provided to children in custody.
The Confidentiality Conundrum
As children move from placement to placement in foster care, it is often difficult to gather data in time to move with them. State and federal confidentiality laws limit who can see the data and whom it can be shared with, making it difficult for those trying to keep foster kids’ information comprehensive, complete and current.
Two federal laws present the greatest challenges: the Child Abuse Prevention and Treatment Act (CAPTA) and the Health Insurance Portability and Accountability Act. The first requires confidentiality of child abuse and neglect records, while the second requires health records to be kept strictly confidential, especially patients’ personal identifying information.
CAPTA requires that states must preserve the confidentiality of all child abuse and neglect reports and records to protect the privacy rights of the child and of the child’s parents or guardians. Most states statutorily permit certain persons access to the information, such as those with a direct interest in the case, in the child’s welfare or in providing child protection or treatment services.
Foster Children By The Numbers
Children in foster care
254,904 and 238,280
Children who entered and exited foster care in 2013
Average age of a child in foster care
The average number of months children stay in foster care
Portion of foster children with two or fewer placements who were in care between 12 and 24 months (37% had three or more placements)
Source: Adoption and Foster Care Analysis and Reporting System, 2012–2013
Meghan McCann is an NCSL policy specialist who focuses on foster care issues.