The Uptake and Landscape of Council on Accreditation (COA) in Public Child Welfare

Background and Purpose

Our child welfare system struggles to protect children from abuse and neglect while supporting vulnerable families. This study focuses on the Council on Accreditation (COA), an organizational intervention to improve the quality of care. Little is known about the accreditation phenomenon and the uptake of COA accreditation among public child welfare agencies. This study aims to:

1) describe the COA accreditation rate of local public child welfare agencies,

2) examine the association between COA accreditation status and state requirements for accreditation among public child welfare agencies, and

3) map the locations of COA accredited public child welfare agencies according to how they are administered (state, county, or both).

This study provides fundamental information about the landscape of COA accreditation in public child welfare.

Methods

Using data from the National Survey of Child and Adolescent Well-Being (NSCAW) II, descriptive statistics showed the proportion of public child welfare agencies accredited by COA. Chi-square analysis were conducted to reveal if state requirements for accreditation are associated with the COA accreditation status of public child welfare agencies. Since the NSCAW II data do not include agencies’ locations, additional information was gathered from COA to  map the location of COA-accredited agencies and how those child welfare systems are administered using geographic information systems (GIS) methods.

 

Results

According to data from NSCAW II, 25% (n=1,472), of the agencies (N=5,888) reported being accredited by COA. There was a statistically significant association between accreditation status and states requiring public child welfare agencies to become accredited (X²= 818.46, df=1, p< 0.0001). Although this association may not be surprising, 671 (45.6%) of COA-accredited agencies reported that their state did not require accreditation. According to data from COA, four state administered child welfare systems (IL, KY, MO, and TN), one hybrid system (MD with 8 counties), 15 county administered systems (one county in CA, one county in NY, and 13 counties in OH), two counties in state administered systems (one in FL and another in TX) were COA-accredited as of April 2017. While most agencies were not COA-accredited, there was a converging of the COA-accredited state administered agencies in the Midwest/Southern area where MO, IL, KY, and TN partially share state borders.

 

Conclusion and Implications

This study has implications for understandingaccreditation trends in public child welfare, including reasons for differing accreditation rates across the country, such as possible regional effects. This study’s findings can also help inform future policies regarding accreditationsince, in addition to accreditation mandates, there may be other factors influencing accreditation rates. Future research could examine public child welfare agencies’ reasons for pursuing or not pursuing COA accreditation and changes in accreditation trends over time. Other national accreditors—the Commission on Accreditation of Rehabilitation Facilities and the Joint Commission—could also be included in future research, as they have moved from healthcare into the social service arena. This study is a step towards building a much needed evidence-base regarding accreditation as a potential leverage point for improving the quality of our child welfare system.