3. Youth Outcome Survey

3.1. In the original 17-year-old sample, how much can we screen youth for cognitive difficulties that would prevent them from completing the survey?

A State has the discretion to choose the methods, if any, by which it determines that a youth in the baseline population is unable to participate in the outcomes data collection due to an incapacitating permanent or temporary mental condition (45 CFR 1356.82(a)(2) and 1356.83(g)(34)(iv)). The extent to which a State reports youth as not participated in the outcomes data collection, due to incapacitation or other reasons, is an area that the Administration for Children and Families (ACF) plans to monitor to provide any additional technical guidance, as needed.

From: NYTD Webinar Briefing - April 10, 2008

3.2. If youth in foster care on runaway status are to be included in the baseline population, how does a State survey runaway youth?

Youth who have run away in foster care are considered to be part of the baseline population if they are still under the placement and care responsibility of the State title IV-B/IV-E agency. If the youth is on runaway status at the time(s) that the State attempts outcomes data collection, the State will report the youth as having run away in the outcomes reporting status element (45 CFR 1356.83(g)(34)) to explain why that youth's information was not collected.

From: NYTD Webinar Briefing - April 10, 2008

3.3. How do States survey youth in the baseline population?

A State has the discretion to choose the method(s) it will use to administer the outcomes survey to youth (e.g., in person, via the Internet or over the phone) provided that the survey is administered to youth directly. We anticipate providing technical assistance to States in devising effective methods of administering the youth outcomes survey.

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.4. Can we alter the survey verbiage in Appendix B to make the survey more "youth friendly" or must we use the language listed in the regulation?

No. We choose to regulate the survey questions to ensure that each youth is provided with standard questions and response options so we can allow for consistency of the data collection nationwide. States must collect information on the youth outcome survey data elements using the survey questions in Appendix B of the National Youth in Transition Database (NYTD) regulation and may not alter these questions in any way. It is allowable, however, for a State to use "youth friendly" language in explaining the survey questions if the youth indicates they are unclear. We anticipate providing technical assistance and further guidance on how States may best administer the survey to youth to minimize non-response bias and measurement error.

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.5. If a youth that is eligible for Chafee receives services through either Temporary Assistance for Needy Families (TANF) or Title XX for teen parent services or homelessness, would those services be counted in the survey data?

It is not clear whether the question refers to youth that are in the served population or the baseline and follow-up populations. For the served population, we are requiring States to collect and report information on youth who receive an independent living service due to the State agency's direct or indirect commitment of funds or resources to provide the service. Services provided due to another State program's commitment of funds or resources do not count as a service provided by the Chafee Foster Care Independence Program (CFCIP) agency. For the outcomes data collection, the State will report the youth's response to the survey questions. It is possible that a youth may report receiving services funded by TANF or Title XX in response to some of the outcome survey questions.

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.6. If a youth in the baseline or follow-up populations indicates in the outcomes survey that he/she is not receiving a particular service or benefit (data elements 37-58), can the State consult other administrative data systems to confirm whether the youth is in fact receiving a benefit or service (i.e., food stamps, Medicaid, etc.)?

No, not for the purposes of NYTD. States must administer the survey to youth directly and may not provide information on outcomes data elements from any other source including administrative databases, such as TANF, Social Security, or employment records (73 FR 10350).

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.7. If a SACWIS State has an interface with the Medicaid database, should data element 54 (Medicaid) be reported from the information received through the Medicaid database or through the youth's self-report?

No. The outcomes data for this element must be based on the youth's self-report. Again, States must administer the survey to youth directly and may not provide information on outcomes data elements from any other source including the State's Medicaid data system (73 FR 10350). We also added a response option of "don't know" to data elements 54-58 to permit the youth to identify the types of health insurance that he/she knows and does not know about.

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.8. If the youth indicates in the outcomes survey that he is still in foster care, is under age 19, and does not have Medicaid but the State knows he does have Medicaid, should the answer to survey question be "yes" or "no"?

States must administer the survey to youth directly and may not provide information on outcomes data elements from any other source including the State's Medicaid data system (73 FR 10350). A State must report the answer provided by the youth. Also, a State is responsible for determining and reporting whether a youth in the baseline or follow-up population is in foster care. Please note that while there is a foster care status data element for the baseline and follow-up populations, there is not a survey question related to foster care status.

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.9. What about verification of youth responses for youths who are not truthful?

The goal of the youth outcome survey is to collect information that represents the youth's understanding of his/her circumstances and experiences as a whole. To achieve this goal, and to preserve the integrity of the survey and data, States must administer the survey to youth directly and may not provide information on outcomes data elements from any other source including administrative databases, such as TANF, Social Security or employment records (73 FR 10350). Also, States may not correct a youth's response if they have alternative knowledge about a youth's outcomes. It is, however, allowable for a State to develop a system of prompts to help the State verify whether a youth meant to provide a particular answer (73 FR 10350).

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.10. What about youth who may need assistance in responding to the youth outcomes survey due to a disability?

A State may select the method for administering the youth outcomes survey, including providing assistance in recording youth responses (i.e., filling out a survey for a youth with a disability as the youth provides responses to the survey questions). A State, however, may not consult any source other than the youth when administering the youth outcomes survey. A State also has the discretion to choose the methods, if any, by which it determines that a youth is unable to participate in the outcomes data collection due to an incapacitating permanent or temporary mental condition (45 CFR 1356.82(a)(2) and 1356.83(g)(34)(iv)).

From: 2008 NYTD Technical Assistance Meeting - July 23-25, 2008

3.11. Would it be allowable for a State to use an online chat session to administer the NYTD youth outcome survey?

Yes. A State has the discretion to choose the method(s) it will use to administer the outcomes survey to youth (e.g., in person, via the Internet or over the phone) provided that the survey is administered to youth directly. Each State will determine the most appropriate approach to meet its needs and the particular characteristics of the State's population of youth and young adults. We anticipate providing technical assistance to States in devising effective methods of administering the youth outcomes survey. (See: 73 FR 10343)

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.12. How can States verify the identity of youth taking the outcome survey if a State is not administering the survey in person (using a web-based application or a survey mailed out to the youth)?

Developing a protocol to verify the identify of a youth responding to the NYTD Youth Outcome Survey questions via the web or by mail is up to the State to determine and should be based on the method of survey administration selected by the State. (See 73 FR 10343)

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.13. Does a youth's non-response to any particular outcome survey question mean that a State should report "declined" for that item?

Yes. (See 45 CFR 1356.83(g))

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.14. If a youth responds "yes" to the youth outcome survey question regarding full-time employment, does the State have to ask if the youth is employed part-time?

Yes. While the regulation specifies the definition of "full-time" and "part-time" employment in terms of number of total hours worked, these two data elements are not mutually-exclusive. A youth may report having both full-time employment (working in one job for 35 hours a week, for example) and part-time job concurrently (working a different job for 10 hours a week, for example). (See 45 CFR 1356.83(g)(37) and (38))

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.15. In the event that a youth in the baseline population exits foster care before the State attempts to collect outcomes information via the youth outcome survey within 45 days of the youth's 17th birthday, should the State still attempt to collect these data and report them in the State's NYTD data file?

No. The State must attempt to collect the required data described in 45 CFR 1356.83(d) during the time the youth is in foster care. The State does not report outcomes data on a youth in the baseline population that exits foster care before the State attempts to administer the youth outcome survey. However, in the event that a youth in the baseline population exits foster care before the State is able to collect outcomes data, the State would still report information on data element 34 (outcomes reporting status). "Unable to locate/invite" would be the appropriate response option for data element 34 in this case. (See 45 CFR 1356.82(a)(2))

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.16. If the State attempts to collect outcomes data for NYTD for a youth in the baseline population within 45 days of the youth's 17th birthday, but is not able to do so before the youth exits foster care, then should the State exclude the youth's record from the data file completely? If not, what, if any, other information should be provided on that youth for NYTD data reporting purposes?

Regarding the first question, no, the State must not exclude the record of the youth described in the scenario above. Regarding the second question, the State must still report information on data element 34 (outcomes reporting status), and on all other data elements relevant to the youth as described in the regulation, including information on basic demographics of the youth (data elements 1-13) and, if applicable, any information on independent living services the State paid for or provided to the youth. (See: 45 CFR 1356.82(a)(2) and 45 CFR 1356.83(b) and (d))

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.17. Is NYTD outcomes data collection exempt from the human subjects protection requirements specified in 45 CFR 46?

The data collection required by NYTD is not a research activity that is subject to the Federal regulations for the protection of human subjects. (See 45 CFR 46)

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.18. Does the Children's Bureau have any regulations regarding consent to participate in NYTD outcomes survey, particularly for 17-year-olds? Is parental consent required because they are minors?

Because NYTD data collection is not subject to the Federal regulations for the protection of human subjects, there is no specific Federal requirement or procedure to seek informed consent of a youth, or parental consent on a youth's behalf, to participate in the NYTD Youth Outcome Survey. However, States are encouraged to develop their own procedures to ensure that youth understand the purpose and use of the survey, including the voluntariness of the survey. States may wish to review the guidance from the Federal Office of Human Research Protections (OHRP) regarding the protections of human subjects including proper procedures for obtaining informed consent from Youth Outcome Survey participants (www.hhs.gov/ohrp/). The basic elements of informed consent can be found in the HHS regulations at 45 CFR 46.116(a). OHRP also has a tips sheet for informed consent available at http://www.hhs.gov/ohrp/humansubjects/guidance/ictips.htm. We anticipate providing further technical assistance to States on informed consent practices. (See 45 CFR 46)

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.19. If upon leaving foster care, a youth that had been in the baseline population asks the State not to contact them in the future should the State persist in attempting to engage that youth in the outcome survey at ages 19 and 21?

This is at a State's discretion. Though the NYTD regulation outlines the standards States must meet for collecting and reporting outcomes data, including required participation rates, States are reminded that a youth's participation in the youth outcome survey is voluntary and refusal to participate should involve no penalty to the youth. States are strongly encouraged to develop procedures to seek and obtain informed consent from a youth, including an easily understood explanation of the purposes of the survey, the expected duration of the youth's participation, a description of the procedures to be followed, and the voluntariness of participation. (See 73 FR 10344)

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.20. Will there be a national website for youth to visit in order to take the NYTD youth outcome survey? Is it possible for multiple States to develop regional web portals/sites for collecting survey data from youth?

Regarding the first question, ACF will not be creating a website for the purpose of collecting survey information. The statute that mandated NYTD requires that we develop data collection requirements and impose penalties on States that do not comply with those requirements. As such, the statute creates an obligation for States to meet the data collection requirements for NYTD. Regarding the second question, it may be possible for a State or group of States to develop web-based applications for the purposes of collecting survey data from youth, but States with a SACWIS should submit their plans and business case to the Children's Bureau/Division of State Systems (CB/DSS) in an As Needed Advance Planning Document (APD). State project teams may also discuss alternatives with the CB/DSS analyst responsible for their State. (See Sections 477(e)(2) and (f) of title IV-E of the Social Security Act)

From: 2009 NYTD Technical Assistance Meeting - June 25-26, 2009

3.21. In Appendix B of the NYTD regulation, the youth outcome survey questions related to data elements 49 through 52 each contain two different questions—one asking about a youth's lifetime experiences and one asking about a youth's experiences in the past two years. Are States supposed to ask both questions of youth in the baseline and follow-up populations?

No. As described in the regulation at 45 CFR 1356.83(g)(49) through (52), these data elements relate to a baseline youth's lifetime experiences and to a follow up youth's experience in the past two years. Consequently, States are only to ask the question that relates to the youth's appropriate reporting population.

From: 2010 NYTD Technical Assistance Meeting - July 21-23, 2010

3.22. For the youth outcome survey questions that correspond to data elements 42-44, 53, and 56-58 "not applicable" is listed as a valid response option in the regulation at 45 CFR 1356.83(g) but is not listed as a valid option in Appendix B of the regulation. Is it allowable to offer youth "not applicable" as response option during survey administration for the questions that relate to these data elements?

"Not applicable" is a valid response option for a State to report for data elements 42-44, 53, and 56-58 (73 FR 10369-10370). However, States are encouraged to use the required NYTD survey questions, listed in Appendix B of the NYTD regulation, to develop a survey instrument that directs the youth to answer only the survey questions that are applicable to them. Appendix B does not list "not applicable" as a response option because it is our intent that youth will be only asked questions that are applicable to them (73 FR 10375). The technical assistance document Planning for the Mode of Administration for the Youth Outcome Survey, available at http://www.nrccwdt.org , contains helpful tips on how to develop a survey instrument and present the questions in a logical manner using a variety of possible administration modes.

From: 2010 NYTD Technical Assistance Meeting - July 21-23, 2010

3.23. Is it allowable for State staff, such as caseworkers, to see the results of a survey taken by a youth?

Neither the regulations nor the statute that mandates NYTD prohibit State staff from seeing a youth's responses to the NYTD survey (45 CFR 1355.30). We are aware that some States plan on administering the NYTD survey to youth in person or by phone through a caseworker employed by the State agency.

States are encouraged to be mindful of the sensitivities of youth and to develop informed consent procedures to assist youth in understanding the purpose of the survey and the State's plans for using the youth's survey information prior to deciding whether to participate in the outcomes survey. Part of this recommended informed consent process should also include explaining the State's plans for protecting the confidentiality of the youth's responses.

From: 2010 NYTD Technical Assistance Meeting - July 21-23, 2010

3.24. If a State successfully locates a youth and invites him/her to participate in the NYTD survey, but the youth does not respond to the State's invitation and ultimately does not participate in the survey, then should the State report that the youth "declined" to participate or that the State was "unable to locate/invite" the youth for data element 34 (outcomes reporting status)? At what point do we consider a youth's non-response, after a formal invitation and appropriate follow-up contact (e.g., reminders, etc.), as "declined"?

We believe that States are too different to offer a single approach to data collection, and chose not to prescribe a single way for States develop and administer the NYTD youth outcomes survey in our regulation (73 FR 10343). Further, we have acknowledged in previous guidance that the exact reason for the youth's participation may be difficult to pinpoint (71 FR 40359). It is our expectation that a State will use all appropriate methods to encourage a youth to complete the survey in order to collect outcomes data or to indicate accurately in data element 34 (outcomes reporting status) whether the youth did not participate in the outcomes survey because they declined ("youth declined") or whether the youth was unable to be located or invited by the State ("unable to locate/invite") (Q&A #2.50).

From: Questions & Answers Released on January 13, 2011

3.25. Is it acceptable for States to "correct" or "clean up" a youth's survey responses before reporting NYTD data to ACF in order to avoid logical inconsistencies in the data file? For example, if a youth answers "no" for element 52 (children) and "no" for element 53 (marriage at child's birth), then can the State report "not applicable" instead for element 53 in the data file? Similarly, if a youth answers "no" for element 55 (other health insurance coverage), "not applicable" for elements 56 (health insurance type—medical) and 58 (health insurance type—prescription drugs), but "yes" for element 57 (health insurance type—mental health), then can the State report "not applicable" for element 57 in the data file?

No.  The goal of the youth outcome survey is to collect information that represents the youth's understanding of his/her circumstances and experiences as a whole (NYTD Q&A #3.9). To achieve this goal and to preserve the integrity of NYTD survey data, States may not alter the youth's responses and presume that the youth's response to one question is "correct" and the youth's response to a proceeding question is "incorrect". Consequently, States may not alter a youth's survey responses without consulting the youth.

We have previously encouraged States to carefully evaluate their survey administration methods for the potential for such response errors as a result of using a particular methodology (i.e., paper survey format) (see NYTD Q&A #5.7). In addition, States are encouraged to use the required NYTD survey questions, listed in Appendix B of the NYTD regulation, to develop a survey instrument that directs the youth to answer only the survey questions that are applicable to them, thereby reducing the likelihood of internally inconsistent errors (NYTD Q&A #3.22).

From: Questions & Answers released on April 7, 2011

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