Contract Oversight Desk Review - University Of South Florida

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CONTRACT OVERSIGHT DESK REVIEWChildren’s Network of Southwest Florida, HJ300As required by section 402.7305 F.S., The Department of Children and Families performed a DeskReview for Children’s Network of Southwest Florida.Children’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

NTSExecutive Summary. 1National Snapshot . 1Section 1: Service Area Description . 3Child Fatalities . 3Section 2: Agency Summary. 4Number of Investigations, Removals and Children Served. 4Financial Viability Report Analysis . 5Section 3: Performance Measures and Quality Assurance Data . 5Contract and CBC SCorecard Measures . 6Performance Indicators and Quality Assurance Data . 7Child Safety . 8Permanency . 12Well-Being . 17Section 5: Practice Model Implementation . 20Section 6: Placement Services and Group Care . 22Section 7: Regional Feedback . 24Section 8: Corrective Action Plan . 25Section 9: Desk Review Findings . 25Areas In Need Of Action. 26Opportunities for Improvement . 26EXECUTIVE SUMMARYThe Department’s Community Based Care Monitoring Team performed a Desk Review for Children’s Network ofSouthwest Florida (CNSWF), Contract HJ300. CNSWF provides child welfare services for Circuit 20, whichencompass Charlotte, Collier, Glades, Hendry and Lee Counties in the Suncoast Region of Florida, since 2012.NATIONAL SNAPSHOTThe charts and graphs on the following page are provided by Casey Family Programs. Casey Family Programs worksin all 50 states, the District of Columbia and two territories and with more than a dozen tribal nations. Theyactively work with Florida child welfare professionals to improve practice through use of evidence based programsand data analytics. Data on the following page provides information related to safety, permanency, length of timein care, placement and entries and exits. In 2012, CNSWF had a lower rate of children in care per 1,000 than the1 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

state and national averages. CNSWF’s rate has steadily increased since 2012 and in 2017, it is now higher thanboth the state and national rates.2 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

SECTION 1: SERVICE AREA DESCRIPTIONThis section provides a snapshot of the community CNSWF serves, including demographic information, a descriptionof the child welfare partners and information about all child fatalities, including those investigated by theDepartment. CNSWF operates in the 20th circuit in the Suncoast Region serving Charlotte, Collier, Glades, Hendry& Lee counties. The median household income in Collier and Lee Counties is higher than the statewide averagewhile it is lower in Charlotte, Glades and Hendry Counties (see Table 1). The largest fresh water lake in Florida, LakeOkeechobee, rests in the northeastern tip of Circuit 20, adjacent to Glades County.US Census FactsCharlotteCollierGladesHendryLeeFlorida 44,244 57,452 34,877 36,771 48,537 47,50712.4%13.6%22.1%25.8%15.9%15.7%Percent of population over 25 yearsold with high school diploma89.3%86.0%76.9%63.0%87.0%86.9%Percent of population over 25 yearsold with a college degree20.8%33.2%8.4%9.8%26.0%27.3%Median Household IncomePercent of population living inpovertyhttps://www.census.gov/quickfacts/Table 1CHI LD FATALIT IESB IRT H R AT E AN D IN F AN T M ORT A LI T Y R A T ESThe birth rate, in four of the five counties, is lower than the statewide rate (11.3). In Hendry county, more babiesare born than in any other county in Circuit 20 and the rate is 3.6 higher than the statewide average (see Table 2).In 2016, the infant mortality ratewas lower than the statewideaverage in two counties in Circuit 20(Collier and Hendry). In Charlotteand Lee Counties, the infantmortality rate per 1,000 live births isslightly above the statewideaverage but in Glades County, therate was nearly five times thestatewide average in 2016. Withthe exception of 2015, GladesCounty had a significantly higherinfant mortality rate, than the othercounties in Circuit 20, for the pastfive years. According to the HealthPlanning Council of SouthwestFlorida, Glades County has ashortage of medical, dental andmental health providers and is amuch less densly populated areathan surrounding counties inFlorida. For additional information,see the Glade County HealthPlanning Council 2017 Report.Birth Rate per 1,000 populationStatewide Rate: .aspxTable 2Infant Mortality Rate per 1,000 live birthsStatewide Rate: 171.83.23.5Lee6.15.95.26.16.4Source: http://www.fl hea l thcha rts .com/FLQUERY/Infa ntMorta l i ty/Infa ntMorta l i tyRa teRpt.a s pxTa bl e 33 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

CH IL D F A TA L IT Y I NV E S TI GA T I ON SFrom 2009 through 2017, there were 233 child fatalities in Circuit 20, twenty-three of which had prior or currentcase management services. In 2017, twenty-one child fatalities occurred in Circuit 20, three of which involved averified prior with the family within the previous twelve months. All three deaths with prior verified abuse or neglectoccurred in Lee county and had received case management services. Two of these three received case managementservices from CNSWF. The third received case management services from Sarasota Family YMCA, Inc., another thecommunity based care agency in the Suncoast Region. The Critical Incident Rapid Response Team (CIRRT) wasdeployed to review the circumstances surrounding these three deaths. The findings are as follows: A 4-month old Lee County infant was found unresponsive after sleeping next to his mother who testedpositive for morphine and cocaine and who had a history of substance use. Voluntary services werepreviously provided to the family however; the family was uncooperative with service referrals. The CIRRTreview found that although information collection was sufficient, it was not critically used to assessprotective capacities, child safety and treatment/service needs. Additionally, a clear process for movingcases from voluntary, non-judicial services to judicial was not found. High caseloads and turnover were alsocited as impacting the ability for staff to adequately complete casework.A 1-year old Lee County child was found unresponsive in the home of a relative caregiver. Services werepreviously provided by Sarasota YMCA. Due to prior agency involvement, the CIRRT was deployed, howeverthe report is not yet available as the investigation is pending.A 1-month old Lee County infant was found unresponsive after sleeping in bed with a relative caregiver.CNSWF had provided case management services. Due to prior agency involvement, the CIRRT wasdeployed, however the report is not yet available as the investigation is pending.Child Fatality InvestigationsCharlotte, Collier, Glades, Hendry and Lee CountiesCalendar Year 2009-2017Number of Child Fatalities Investigated: 2201302014234201520162017Number of Child Fatalites InvestigatedNumber of child fatalities with previous or current case management servicesSource: DCF Chi l d Fa ta l i ty Preventi on Offi ceNote: 2017 Child Fatality Data is as of 10/7/2017Fi g. 1SECTION 2: AGENCY SUMMARYNUMB ER OF INVESTI GAT IONS, REMO VALS AND C HI LDREN SER VEDThe number of reports accepted for investigation in Circuit 20 has increased steadily from FY14/15 to FY16/17 ashas the number of children removed. The number of children receiving in and out of home services has alsoincreased while the number of children receiving family support services has decreased during the same period4 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

(see Table 4). In 2017, a Circuit 20 Roadmap to Success was developed which itemized tasks to improve theoverall performance in the Circuit. One of the goals of the Roadmap to Success was to develop an effective servicearray which allows children to be served safely in their homes and reduce re-abuse.Child Protective Investigations and ChildRemovals (Charlotte, Collier, Glades, Hendryand Lee Counties)FY 2014/2015FY 2015/2016FY 2016/201710,36410,88711,70988310051,237FY 2014/2015FY 2015/2016FY 2016/2017Children Receiving In-Home Services1,5711,6972,009Children Receiving Out of Home Care1,9372,1982,513Young Adults Receiving Services189189181Children Receiving Family Support Services9481,047817Reports accepted for Investigation by DCF(Initial & Additional Reports) 1Children Removed by DCF within the CBCService Area2Children Served by Children's Network ofSouthwest Florida3Da ta Sources :Ta bl e 4il2Chi l d Wel fa re Da s hboa rd: Chi l dren Enteri ng Out-of-Home Ca re/Di s ti nct Remova l s (run da te 10/9/2017)FSFN OCWDRU Report 1006 Chi l dren & Young Adul ts Recei vi ng Servi ces by CBC Agency (run da te 8/14/2017)3FI NANCI AL VIAB ILITY REPORT ANALYS ISThe Office of CBC/ME Financial Accountability performed financial monitoring procedures, based on the DCF 201617 CBC-ME Financial Monitoring Tool for Desk Reviews, of Children’s Network of Southwest Florida and foundthree areas of noncompliance. The desk review period was from January 1, 2017 through March 31, 2017. Theareas of non-compliance were:1.2.3.CNSWF did not comply with the federal requirement regarding receiving prior written approval prior topurchasing capitalized equipment totaling 77,882.66.CNSWF recorded an expense for the purchase of orthodontic treatment for an adoption client in anincorrect OCA. The entry was reclassified to the correct OCA in the May expense report.CNSWF recorded expenses for life skills and normalcy services to youth over age 13 and over age 18 to anincorrect OCA.See the full report for additional details - CNSWF Financial Accountability Desk Review Report July 2017.SECTION 3: PERFORMANCE MEASURES AND QUALITY ASSURANCE DATAThis area assesses whether CNSWF is meeting contract measures and evaluates their functioning related toperformance and quality measures. CNSWF is performing at or above the contract target in several measures andin others, performance improvement is needed.5 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

CONTR ACT AND CB C SCO REC ARD MEASURESCNSWF has consistently performed well in some contract measures. During FY16/17, CNSWF exceeded theirestablished targets or federal standards for five (5) of the thirteen (13) contract measures. However, there areseven (7) contract measures in which CNSWF did not meet the contract targets for the last FY16/17, they are asfollows:1) Rate of abuse or neglect per day while in foster care. Performance on this contract target was not met inthe past six quarters.2) Percent of children who are not neglected or abused after receiving services.3) Percent of children who do not re-enter foster care within twelve (12) months of moving to a permanenthome.4) Children’s placement moves per 1,000 days in foster care. Performance on this contract target was notmet in the past six quarters.5) Percentage of children in out-of-home care who received a medical service in the last twelve months.6) Percentage of children in out-of-home care who received dental services within the last seven (7) months.7) Percent of sibling groups where all siblings are placed together. Performance on this contract target wasnot met in the past six quarters.6 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

e of abuse or neglect per daywhile in foster care(Source: CBC Scorecard)Percent of children who are notneglected or abused during in-homeservices (Scorecard)Percent of children who are notneglected or abused after receivingservices (Scorecard)Percentage of children undersupervision who are seen everythirty (30) days (CBC Scorecard)Percent of children exiting fostercare to a permanent home withintwelve (12) months of entering care(Scorecard)Percent of children exiting to apermanent home within 12 monthsfor those in care 12 to 23 months(Scorecard)Percent of children who do not reenter foster care within twelve (12)months of moving to a permanenthome (Scorecard)Children's placement moves per1,000 days in foster care(Scorecard)Percentage of children in out-ofhome care who received medicalservice in the last twelve (12)months. (Scorecard)Percentage of children in out-ofhome care who received dentalservices within the last seven (7)months. (Scorecard)Percentage of young adults in fostercare at age 18 that have completedor are enrolled in secondaryeducation (Scorecard)Percent of sibling groups where allsiblings are placed together(Scorecard)Number of children with finalizedadoptions (DCF Dashboard run date10/17/18)FederalNationalStandard(Performanceof Other1CBC ContractMeasureTargetsSC #Children's Network of SW FLPerformance MeasuresContract # HJ300 8.5 8.510.56Children's Network SW FloridaFY 2015-2016FY 2016-2017July 1, 2015-June 30,2016July 1, 2016-June 30, 201710.0918.53 95%97.20%97.50%97.40% 95%95.60%96.40%94.00% 99.5%99.80%99.70%99.80% 40.5% 40.5%(16%-61%)41.60%39.60%44.50% 44% 43.6%(21%-50%)53.70%44.80%49.60% 91.7% 91.7%(83%-98%)89%93.80%88.30% 4.12 4.12(2.6%-8.7%)4.335.276.26 95%97.14%95.60%94.20% 95%92.70%88.30%90.50% 80%87.60%92.60%88.90% 65%63.90%62.50%60.90%Source: CBC Scoreca rd-Al l Mea s ures -Run 8/4/2017179196Ta bl e 5PERFORMANCE INDI CATO RS AND QUALIT Y ASSUR ANCE DATAThis section provides a picture of CNSWF’s performance as indicated by data indicators that are used to assess howwell CNSWF is performing on contract measures and within the larger program areas of safety, permanency andwell-being.7 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

The information in the following graphs and tables represent performance as measured through informationentered into the Florida Safe Families Network (FSFN) and performance ratings based on the Department’s CQI casereviews.The performance measures outlined in this report are accessible through the Child Welfare Dashboard and includeboth federal and state measures used to evaluate the lead agencies on 12 key measures to determine how well theyare meeting the most critical needs of at-risk children and families.Federal regulations require title IV-E agencies to monitor and conduct periodic evaluations of activities conductedunder the title IV-E program to ensure that children in foster care are provided quality services that protect thesafety and health of such children (sections 471(a)(7) and 471(a) (22) of the Act (Social Security Act),respectively. The Department of Children and Families has developed additional methods to evaluate the quality ofthe services provided by the lead agency, Rapid Safety Feedback (RSF) reviews and Continuous Quality Improvement(CQI). Rapid Safety Feedback (RSF) assesses open in-home service cases. The RSF Tool focuses on safety and isused to review active cases that have specified high risk factors.CQI reviews are conducted on a random sample of cases that are both in home and out of home. Thereviews are conducted by CBC staff and utilize the same review instrument as the Child and Family ServicesReview (CFSR) tool.In addition to the state developed quality assurance reviews, section 1123A of the Social Security Act requires thefederal Department of Health and Human Services to periodically review state child and family services programs toensure substantial conformity with the state plan requirements in titles IV-B and IV-E of the Act. This review is knownas the CFSR. After receiving the results of the CFSR review, States must enter a Program Improvement Plan (PIP) toaddress areas that the Children’s Bureau determines require improvement (45 CFR 1355.34 and 1355.35). CFSR reviews consist of completing a case file review, interviewing case participants, completing the online review instrument. In addition, these cases receive 2nd level reviews by the Office of Child Welfare andat times, 3rd level reviews by the Administration for Children and Families to ensure each case wasaccurately rated.The results of the CFSR are considered baseline performance and the PIP goal is the level of improvement neededto avoid financial penalties. Therefore, the PIP goal may be lower than the overall federal and state expectation of95%. The Department expects CBC agencies to strive toward 95% performance expectation on all CQI measureswith focused activity around the federal PIP goals.The quality ratings used throughout this report are based on the Department’s CQI case reviews, including CQI/CFSRreviews and Rapid Safety Feedback reviews. The CFSR On Site Review Instrument and Instructions and the RapidSafety Feedback Case Review Instrument are both available on the Center for Child Welfare website and providedetails on how ratings are determined.Several measures represent areas where opportunities for improvement exist. They are described in greater detailbelow.CHI LD SAFETYEnsuring children are not exposed to maltreatment is of utmost importance. CNSWF is currently performingat/above target or trending positively in many child safety measures. However, RSF (Rapid Safety Feedback) andCQI (Continuous Quality Improvement) reviews highlight areas were continued efforts to improve performance are8 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

warranted. Additionally, CNSWF’s performance on the rate of abuse per 100,000 days in foster care is exceptionallyhigh at more than double the statewide target and performance on this measure has trended negatively in four ofthe past six quarters. CNSWF continues to struggle to increase the percentage of children who achieve permanencywithin 12 months and do not re-enter care within twelve months. With the exception of FY16/17 Q1, performancein this area has not met the target in the past five quarters. The graphs and tables on the following pages depictCNSWF’s performance related to child safety in the following areas:1.2.3.4.5.6.Rate of Abuse in Foster CareNo maltreatment after Family Support ServicesNo maltreatment during in-home servicesNo maltreatment after receiving servicesChildren seen every 30 daysCQI qualitative case review resultsRA T E OF AB U S E I N F O S T ER C AR ERate of abuse or neglect per day while in foster care (Scorecard Measure M01): Fig. 2 below depicts the rate atwhich children are the victims of abuseor neglect while in foster care (per100,000 bed days) during the reportperiod. This is a national data indicatorthat measures whether the state childwelfare agency ensures that childrendo not experience abuse or neglectwhile in the states foster care system.The purpose is to hold statesaccountable for keeping children safefrom harm while under theresponsibility of the state.CNSWF has consistently failed to meetthe performance target on thismeasure for at least the past sixquarters and showed decliningperformance in four of the past sixquarters.9 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

NO M A LT R EA TM EN T A F T E R FA M I LY S U PP OR T S ER VI C E SPercent of children not abused or neglected within six months of termination of family support services.Fig. 3 depicts the percentage of children who did not have a verified maltreatment during the report period. Thisis a Florida indicator that measures thePercent of Children Not Maltreated within Six Months of Termination GCBC’s success in keeping children safeoof Family Support Serviceso98dafter family support services have ended.96.997If appropriate services were provided to95.696increase protective factors, repeat9595maltreatment should be diminished.9594.793.994CNSWF’s current performance is below94.293.893the statewide average performance andin need of improvement.92.792.4929190FY 15/16 Q2FY 15/16 Q3State AverageFY 15/16 Q4FY 16/17 Q1FY 16/17 Q2Children's Network of Southwest FloridaSource: FSFN-Chi l dren wi th no veri fi ed ma l trea tment wi thi n s i x months ofTermi na tion of Fa mi l y Support Servi ces (Run da te 11/8/2017)NO M A LT R EA TM EN T D U RI NG IN - H OM E S ER VI C E SPercent of children not abused or neglected while receiving in-home services (Scorecard Measure M02):Fig. 4 shows the percentage of in-home service episodes during the report period where the child did not have averified maltreatment while receivingservices. This indicator measureswhether the CBC was successful inpreventing subsequent maltreatment ofa child while the case is open and theCBC is providing in-home services to thefamily. CNSWF’s performance on thismeasure has been inconsistent, howeverit has been above the target (95%) in thepast six quarters. Although improvedperformance was seen in FY16/17 Q2, ithas been steadily declining since and fellbelow the statewide average in FY17/18Q1.10 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018Fig. 3

NO M A LT R EA TM EN T A F T E R R E C EI VI NG S ER VI C E SPercent of children with no verified maltreatment within six (6) months of termination of supervision(Scorecard Measure M03): Fig. 5 depicts the percent of children who were not the victims of abuse or neglectin the six months immediatelyfollowing termination of supervision.CNSWF’s recent performance in FY17/18Q1 exceeded the target and statewideaverage performance which reversed thedownward trend that was seen in theprevious two quarters. Continuedmonitoring is warranted to ensure theupward trend in performance continues.CH IL D R EN S E EN E V ER Y 3 0 DA Y SChildren under supervision who are seen every thirty (30) days (Scorecard Measure M04): Fig. 6 shows the rateat which children are seen every thirty (30) days while in foster care or receiving in-home services during thereport period. CNSWF consistentlyperforms well in this measure byensuring children under supervision areseen regularly. CNSWF’s performancehas exceeded the target in the past fivequarters and met or exceeded thestatewide average in four out of the pastfive quarters.QA C A S E R E VI E W D AT AThe table below provides CNSWF’s performance based on CQI case reviews. Based on reviews completed, CNSWF’sperformance exceeds the statewide average performance in each of the review areas listed in Table 6 belowindicating that sufficient family assessments and safety plans are being created and visits between the case manager11 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

and child(ren) are of sufficient quality to address issues pertaining to child safety and progress towards case planoutcomes. Additionally, reviews indicate that CNSWF is making concerted efforts to provide services and addressrisk and safety concerns to prevent removal or re-entry into care.Quality Assurance - Rapid Safety FeedbackItemAssessement Based on Case Reviews by ChildWelfare ProfessionalsRSF 1.1: Is the most recent family assessmentsufficient?RSF 2.1: Is the quality of visits between thecase manager and the child (ren) sufficient toaddress issues pertaining to safety andevaluate progress towards case planoutcomes?RSF 4.1: Is a sufficient Safety Plan in place tocontrol danger threats to protect the child?Children's Network ofSW FloridaRapid SafetyFeedbackn 45Statewide RSFPerformance 1n 851July 1, 2016-June 30, 201768.9%50.6%84.4%62.7%68.9%60.7%Green dot denotes performa nce i s a bove s ta tewi de RSF a vera ge; red dot denotes performa nce i s bel ows ta tewi de RSF a vera geQuality Assurance - Florida CQI ItemChildren's Network of Children's Network ofSW FloridaSW FloridaPerformancen 1,29012016 StatewideFederal Child &Federal ProgramFamily ServiceImprovement2ReviewPlan (PIP) Goal34/1/16-9/30/16n 80Federal andStateExpectation4Assessement Based on Case Reviews by ChildWelfare ProfessionalsFY 2015/2016n 70CQI Item 2: Did the agency make concertedefforts to provide services to the family toprevent children’s entry into foster care or reentry after %78%17.0%77%71.3%77.7%95.0%CQI Item 3: Did the agency make concertedefforts to assess and address the risk andsafety concerns relating to the child (ren) intheir own homes or while in foster care?FY 2016/2017n 78PercentImprovementStatewideCQI/QASource: QA Ra pi d Sa fety Feedba ck; Federa l Onl i ne Moni tori ng Sys temTa bl e 61Thi s da te provi des the s ta tewi de ra ti ng i n ea ch ca s e revi ew i tem for a l l CBCs2Thi s provi des the performa nce ra ti ng for the s ta te i n ea ch of the i tems a s a pproved by the Admi ni s tra ti on for Chi l dren a nd Fa mi l i es .3The PIP Goa l i s s et by the Chi l dren's Burea u a nd i s the expected l evel of i mprovement needed to a voi d fi na nci a l pena l i ti es .4Thi s i s the overa l l federa l a nd s ta te expecta ti on for performa nce.Green dot denotes performa nce i s a bove the federa l PIP Goa l ; red dot denotes performa nce i s bel ow the federa l PIP Goa l .PERMANENC YWhen children are placed in out-of-home care it is imperative that child welfare agencies find safe, permanenthomes for them as quickly as possible. Helping children achieve permanency in a safe and timely manner is one ofthe most important tasks for a CBC. CNSWF is performing below target or trending negatively in some permanencymeasures including securing permanency within 12 months, placement stability and siblings placed together.Additionally, RSF (Rapid Safety Feedback) and CQI (Continuous Quality Improvement) reviews highlight areas werecontinued efforts to improve performance are warranted (see Table 7).The graphs and tables on the follow pages depict CNSWF’s performance related to permanency in the followingareas:1.2.3.4.5.Permanency in 12 monthsPermanency in 12-23 monthsPermanency after 24 monthsPlacement stabilityPercent not re-entering care12 P a g eChildren’s Network of Southwest Florida, HJ300 FY17/18 Desk ReviewFebruary, 2018

6.7.Siblings placed togetherQualitative Case Review resultsP ERM AN EN CY IN 1 2 M O N T HSPercent of children exiting foster care to a permanent home within twelve (12) months of entering care(Scorecard Measure M05): Fig. 7depicts the percentage of children whoentered foster care during the reportperiod where the child achievedpermanency within twelve (12) monthsof entering foster care. For the past fourquarters, CNSWF’s performance hassteadily declined in this measure and inthe most recent quarter (FY17/18 Q1),performance fell below the target.P ERM AN EN CY IN 1 2 – 2 3 M ONT H SPercent of children exiting foster care to a permanent home in twelve (12) months for children in foster caretwelve (12) to twenty-three (23) months(Scorecard Measure M06): Fig. 8provides the percentage of children infoster care, as of the beginning of thereporting period, whose length of stay isbetween twelve (12) and twenty-three(23) months and who achievedpermanency within twelve (12) months.CNSWF has consistently performedabove the statewide target in the pastsix quarters and performance has beentrending up in the past three quarters.P ERM AN EN CY A F T ER 24 M ON T HSPercent of children in care 24 months who achieved permanency within an additional 12 months: The graphbelow provides the percentage of children in foster care whose length of stay is twenty-four (24) months or13 P a g eChildren’s Network of Southwest Florida, H

17 CBC-ME Financial Monitoring Tool for Desk Reviews, of hildren's Network of Southwest Florida and found three areas of noncompliance. The desk review period was from January 1, 2017 through March 31, 2017. The areas of non-compliance were: 1. CNSWF did not comply with the federal requirement regarding receiving prior written approval prior .

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