Executive Summary: The Child Welfare Accountability Act of 2006 (Maryland Family Law, Section 1301-1311 inclusive) specified the development and implementation of a process to measure the efficiency and effectiveness of child welfare services in Maryland that addresses the safety, permanency and well-being of children in the care and custody of the state. A set of performance indicators were established that encompassed and expanded upon extant federal measures in four areas of child welfare practice: 1. Child abuse and neglect, 2. Protecting children in out-of-home care from abuse and neglect, 3. Permanency and stability of children in out-of-home care, and 4. Effectiveness of efforts to address the health, mental health, education, and well-being of children in out-of-home care. This report, the fourth report completed, describes and documents the performance indicators mandated in the Act for the period July 1, 2009 through June 30, 2010 and compares the states progress in relation to outcomes from prior years. A separate companion report entitled "Quality Assurance Processes in Maryland Child Welfare" describes and evaluates Quality Assurance processes in calendar year 2010. Acknowledgements: This rport was prepared by faculty and staff at the University of Maryland, School of Social Work's Ruth H. Young Center for Families & Children (RYC) in partnership with staff at the Department of Human Resources, Social Services Administration (DHR/SSA). Diane DePanfilis, Terry V. Shaw and Haksoon Ahn co-manage the interagency agreement that supports the development of this report. Terry V. Shaw developed the performance indicators found in this report with the assistance of David Ayer from DHR/SSA. Carnitra White, Richard Larson, David Ayer and Linda Carter at DHR/SSA guided the activities of the outcomes measurment and performance indicators process.