3-85 3.8.3 Most Common Strategies States Want to Implement to

3.8.3 Most Common Strategies States Want to Implement to

Improve Tracking and Reporting

For strategies not currently used, each State was asked to indicate whether they needed assistance to implement the strategy, they were currently investigating the feasibility of the strategy, or they had no plans to use the strategy. This section focuses on the strategies where at least one-third of reporting States indicated they were interested in trying the strategy (currently investigating or need assistance). As shown by the right box in Figure 3-15, the following two strategies were of interest to the most States:

ƒ Use an electronic-based information system for

simultaneous transmission of information across State lines (62 percent).

ƒ Include data specific to interjurisdictional cases in a SACWIS system (45 percent).

As noted in the previous section, only one State is using an electronic-based information system for simultaneous

transmission of information across State lines. However, a

significant number of States are interested in and need

assistance to implement this strategy (25 States), and five are investigating it on their own.

Also mentioned previously, 19 States include data specific to

interjurisdictional cases in their SACWIS. All 15 States that

ranked the strategy think it is very or somewhat effective (four States reported “Don’t know”), and 21 States (75 percent of States that do not use this strategy) are interested in

implementing this strategy. One State explained the benefit of such a system:

The Division included ICPC in its SACWIS system in the mid-1990s. This has helped create an alert system for workers, helped make information about incoming cases more accessible to workers, and eliminated the duplicate entry of ICPC data onto a separate database.

Another State described their SACWIS as “excellent” and added that it is used by all caseworkers and administrators in their department and includes regular case reviews.

Several States noted that they are currently in the process of developing a SACWIS and/or including ICPC cases in their SACWIS. Two States that currently use the ICPC database

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referred to their plans to improve their data tracking

capabilities with the implementation of a SACWIS or integration of interjurisdictional data into a current SACWIS in the future. The first one said:

For the past 4 years, we have been using the National ICPC ACCESS data entry and tracking system that has served us well. It is hoped with the eventual full

implementation of SACWIS that communication with the field can be integrated with the ICPC office and Central Office operations.

The second State explained:

[Our State] utilized a database provided by APSHA specializing in ICPC-related cases. This has been

effective for the Deputy ICPC Administrator. [Our State] is currently transferring data from this system into our SACWIS, which will allow for concurrent use and tracking by field supervisors.

One State was optimistic that future improvements would be made:

The ICPC data base and use of e-mail and other

communication systems provide the bulk of our tracking and reporting systems. However, with the recent

implementation of SACWIS and eventual incorporation with ICPC, it is hoped that further improvements will be made to the current system.

Nearly two-thirds of the States report they have the ability to track steps in the interstate placement process and most of the ones that already do this find it very effective. The remaining one-third of States (28 percent) reported interest in developing this ability and the one State that doesn’t track steps does not plan to do so.

3.8.4 Assessment of Potential Supports to Improve Tracking and Reporting

States were provided with a list of potential actions that could be implemented at the national or Federal level to support State efforts in tracking and reporting their interjurisdictional placements. States were asked to rate these supports on a scale of one to five, with one meaning not effective and five meaning very effective. States also could describe other supports that they thought would be effective.

Of the 34 States that track steps in the placement process, 33 agree it is effective, and 13 of 14 who do not track steps want to.

Section 3 — Survey Findings

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Figure 3-16 shows that 71 percent of reporting States indicated that providing legal clarification on the scope of HIPAA within the child welfare realm would be most effective. HIPAA, the Federal Health Insurance Portability and Accountability Act of 1996, requires that DHHS establish national standards for electronic health care transactions. Regulations were presented in parts 160, 162 and 164 of Subchapter C of Title 45 of the

Code of Federal Regulations and are quite extensive. HIPAA

also addresses the security and privacy of patient health data, which raises some important questions about information sharing practices in child welfare cases.

Figure 3-16. Effectiveness of Potential Supports to Improve Tracking and Reporting

10 15 21 46 13 19 23 25 23 34 44 71 0 10 20 30 40 50 60 70 80 90 100 % Very Effective % Somewhat Effective Require more information be reported in AFCARS related to

timelines and jurisdictions involved in interstate placements Utilize a system that would extract data from incompatible data

systems (an XML system) and thus enable collection of data from existing data systems Identify the elements needed to track interjurisdictional cases with the goal of introducing Federal legislation to support and fund a national tracking/reporting/case management system

Provide legal clarification of the scope of HIPAA within the child welfare realm from intake to adoption

States were also asked to identify the one support that they thought would facilitate the most positive change in tracking and reporting. Two supports were almost equally important—16 States chose identify elements for inclusion in a national

tracking, reporting, and case management system, and

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HIPAA in regards to child welfare. (See Appendix E.) Federally-

funded SACWIS systems partially address the first support. However, these systems do not necessarily communicate case level information from State to State. States frequently use hard copy forms or e-mail to send information across States. One State added that they thought additional funding for States to link data that is currently in separate systems would be very effective in improving their capabilities.

3.8.5 Summary

The majority of reporting States use between one and four strategies related to tracking and reporting interjurisdictional placements. The greatest number of States have the ability to track steps in the interstate placement process, and all that use it rate it as effective. States use different automated database systems, including the ICPC database; an automated database not linked to a SACWIS; and less commonly, a SACWIS that includes data on interstate cases. States discussed the ways in which these databases are used, their effectiveness, and their limitations. The need for staff and financial resources to

improve the utility of data systems was noted by a few States. Tracking steps in the interstate placement process and

providing judges with electronic reports were all strategies States rated as highly effective. Simultaneous transmission of information across State lines, although used by only one State, was rated as “very effective” by this State. There is a lot of interest in this strategy among States that are not using simultaneous transmission. Also, many States are interested in the ability to track steps and to include data on

interjurisdictional cases in a SACWIS system.

States consider that providing legal clarification on the scope of HIPAA within the child welfare realm and support and funding for the development of a national tracking, reporting, and case management system would promote the most positive change.

3.9 OVERALL ASSESSMENT OF