ND Quality Assurance

The goal of the child welfare system is to promote, safeguard, and protect the overall well-being of children, to intervene on behalf of abused and neglected children, and to work with children and families to ensure that every child has a permanent, safe, and nurturing environment in which to achieve their maximum potential. ND Children and Family Services (CFS) utilizes the Quality Assurance (QA) Unit to conduct case reviews as one tool to ensure that child welfare services achieve these outcomes and support the state’s ongoing quality improvement efforts. Although the reviews do generate data on specific cases, the larger focus is to take the information generated through multiple reviews to understand how the child welfare system is functioning overall and to support the state's ongoing quality improvement efforts. 

Round 4 Children & Family Service Reviews (CFSR)

The QA Unit completed our first-ever state-led CFSR Case Review between October 2024 and March 2025, and the state received its R4 CFSR Final Report in August 2025.  While the report noted many areas of growth and strength, the state did not meet any of the federal measures. An initial PIP was submitted to the Children’s Bureau on October 31, 2025.  However, in December, the Children’s Bureau issued Technical Bulletin 14, which provides states a pilot opportunity for Performance Improvement Plans.  North Dakota is gathering information and feedback.  A decision of which option to pursue has not yet been made. North Dakota must complete a Performance Improvement Plan (PIP).  If you or your staff have questions, please contact Leanne Miller at lemiller@nd.gov.

 

The QA Case Reviews use the Round 4 Federal Onsite Case Review Instrument (OSRI). The *newly updated OSRI is available at: www.cfsrportal.acf.hhs.gov/resources/round-4-resources/cfsr-round-4-instruments-tools-and-guides

This page contains information for agencies participating in a QA Case Review to prepare for the review and know what to expect when the case is actually reviewed.

26B QA Case Review Highlights

Case Sampling and Outreach

• A random statewide sample will be utilized. We will then divide the sample according to the proportions found in each CQI Cross Zonal Team, ensuring a sufficient number of cases for the Metro area, much like we did previously. However, each QA Reviewer will be assigned to specific agencies to work within their own list throughout the review event.
• We will complete all case reviews by the end of September 2026. During the first quarter (Apr – Jun), we will conduct thirty-one (31) full reviews. During the second quarter (Jul – Sep), we will conduct at least twenty-eight (28) full reviews. No Item-Only reviews will occur during this measurement period. We aim to have twenty-four (24) in-home and thirty-five (35) foster care cases for a total of fifty-nine (59) cases reviewed.
• Case reviews will be staggered throughout the review period. We anticipate that each reviewer will complete two full case reviews per month. We will review in-home services cases first and then move to the foster care sample.
• The period under review (PUR) for the first quarter is 9/1/25 to the date the case is reviewed or closed (whichever happens first). The period under review (PUR) for the second quarter will start 12/1/25.
• North Dakota will continue to shift to a shorter ‘PUR”. Instead of a 12 – 15 month ‘lookback’ time for which practice is assessed, the state focuses on more recent practice, which will help the state better understand the impact of performance improvement efforts.

Case Files

• Access to case file documents will be needed sooner rather than later in this revised process. QA will utilize any case files located in a Zone’s SharePoint Child Welfare Files library.
• Agencies not utilizing SharePoint for their child welfare files will be given five (5) business days to gather and submit case file documentation. This can be done by uploading the case files to the assigned TEAMS channel or emailing the files to the QA Reviewer. 

Case Related Interviews

• QA Reviewers will contact agencies to initiate the case outreach process as cases appear in the sample.
• The QA Reviewer will also contact relevant key case participants to determine if they are interested in participating in the review or if someone else can speak to their perspective. We may seek the assistance of the agency to reach a case participant. Once non-agency case participants have agreed to participate, the case will be secured for review. The QA Reviewer will coordinate interviews with the agency worker on a case-by-case basis.
• Interviews must be held within seven (7) business days of the case being secured.

Case Review Findings

• Once a case has been reviewed and has reached the approved and final status, agency personnel will receive a copy of the final report.
• After reviewing the final report, agencies can contact Leanne Miller, QA Manager, if there are questions about the case review results.

Reference Documents

Case Preparation Documents 

• Adoption Summary-SFN 992  **Required for Applicable Cases** 

 

Any Quality Assurance questions should be directed to the North Dakota Children and Family Services Quality Assurance Unit by email to: dhscfsqateam@nd.gov