Attachment B: State title IV-E prevention program five-year plan pre-print OMB Approval No: 0970-0433
Expiration Date: XX/XX/XXXX
B. STATE PLAN FOR TITLE IV-E OF THE SOCIAL SECURITY ACT: PREVENTION
SERVICES AND PROGRAMS
STATE OF ________________________
U.S. Department of Health and Human Services
Administration for Children and Families
Children’s Bureau
November 2018
SECTION 1. Service description and oversight
SECTION 2. Evaluation strategy and waiver request
SECTION 3. Monitoring child safety
SECTION 4. Consultation and coordination
SECTION 5. Child welfare workforce support
SECTION 6. Child welfare workforce training
SECTION 7. Prevention caseloads
SECTION 8. Assurance on prevention program reporting
SECTION 9. Child and family eligibility for the title IV-E prevention program
ATTACHMENT I: State title IV-E prevention program reporting assurance
ATTACHMENT II: State request for waiver of evaluation requirement for a well-supported practice
ATTACHMENT III: State assurance of trauma-informed service-delivery
ATTACHMENT IV: State annual maintenance of effort (MOE) report
As a condition of the receipt of Prevention Services and Program funds under title IV-E of the Social Security Act (hereinafter, the Act), the
__________________________________________________________________
(Name of State Agency)
submits here a plan to provide, in appropriate cases, Prevention Services and Programs under title IV-E of the Act and hereby agrees to administer the programs in accordance with the provisions of this plan, title IV-E of the Act, and all applicable Federal regulations and other official issuances of the Department. This Pre-print is provided as an option for title IV-E agencies to use over the course of the five years that the Prevention Services and Programs Plan is in effect.
The state agency understands that if and when title IV-E is amended or regulations are revised, a new or amended plan for title IV-E that conforms to the revisions must be submitted.
Federal Regulatory/Statutory References0 |
Requirement |
State Regulatory, Statutory, and Policy References and Citations for Each |
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Section 1. Services Description and Oversight |
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471(e)(1) |
A. SERVICES. The state agency provides the following services or programs for a child and the parents or kin caregivers of the child when the need of the child, such a parent, or such a caregiver for the services or programs are directly related to the safety, permanence, or well-being of the child or to preventing the child from entering foster care:
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471(e)(5)(B)(i) |
B. OUTCOMES. The state agency provides services and programs specified in paragraph 471(e)(1) is expected to improve specific outcomes for children and families. |
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471(e)(5)(B)(iii)(I)(IV) 471(e)(4)(B) |
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Attachment III |
Section 2. Evaluation strategy and waiver request |
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471(e)(5)(B)(iii)(V) |
A. PRACTICES. With respect to the prevention family services and programs specified in subparagraphs (A) and (B) of paragraph 471(e)(1), information on the specific practices state plans to use to provide the services or programs, including a description of how each service or program provided will be evaluated through a well-designed and rigorous process, which may consist of an ongoing, cross-site evaluation approved by the Secretary, unless a waiver is approved for a well-supported practice; and |
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471(e)(5)(C)(ii) |
B. REQUEST FOR WAIVER OF WELL DESIGNED, RIGOROUS EVALUATION OF SERVICES AND PROGRAMS FOR A WELL- SUPPORTED PRACTICE. The state must provide evidence of the effectiveness of the practice to be compelling and the state meets the continuous quality improvement requirements included in subparagraph 471(e)(5)(B)(iii)(II) with regard to the practice. |
Attachment II |
Section 3. Monitoring child safety |
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471(e)(5)(B)(ii) |
The state agency monitors and oversees the safety of children who receive services and programs specified in paragraph 471(e)(1), including through periodic risk assessments throughout the 12-month period in which the services and programs are provided on behalf of a child and reexamination of the prevention plan maintained for the child under paragraph 471(e)(4) for the provision of the services or programs if the state determines the risk of the child entering foster care remains high despite the provision of the services or programs. |
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Section 4. Consultation and coordination |
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471(e)(5)(B)(iv) and (vi) |
A. The state must:
471(e)(2) and their parents or kin caregivers and
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Section 5. Child welfare workforce support |
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471(e)(5)(B)(vii) |
The state agency supports and enhances a competent, skilled, and professional child welfare workforce to deliver trauma-informed and evidence-based services, including— A. ensuring that staff is qualified to provide services or programs that are consistent with the promising, supported, or well supported practice models selected; and B. developing appropriate prevention plans, and conducting the risk assessments required under clause (iii) of section 471(e)(5)(B). |
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Section 6. Child welfare workforce training |
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471(e)(5)(B)(viii) |
The state provides training and support for caseworkers in assessing what children and their families need, connecting to the families served, knowing how to access and deliver the needed trauma informed and evidence-based services, and overseeing and evaluating the continuing appropriateness of the services. |
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Section 7. Prevention caseloads |
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471(e)(5)(B)(ix) |
The state must describe how caseload size and type for prevention caseworkers will be determined, managed, and overseen. |
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Section 8. Assurance on prevention program reporting |
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471(e)(5)(B)(x) |
The state provides an assurance in Attachment I that it will report to the Secretary such information and data as the Secretary may require with respect to the provision of services and programs specified in paragraph 471(e)(1), including information and data necessary to determine the performance measures for the state under paragraph 471(e)(6) and compliance with paragraph 471(e)(7). |
Attachment I |
Section 9. Child and family eligibility for the title IV-E prevention program |
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471(e)(2) |
A. CHILD DESCRIBED.—For purposes of the title IV-E prevention services program, a child is:
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Title IV-E Plan – State of ________________________________
PLAN SUBMISSION CERTIFICATION
Instructions: This Certification must be signed and submitted by the official authorized to submit the title IV-E plan, and each time the state submits an amendment to the title IV-E plan.
I _______________________________ (name) hereby certify that I am authorized to submit the title IV-
E Plan on behalf of ______________________________________________________________
(state). I also certify that the title IV-E plan was submitted to the governor for his or her review and approval in accordance with 45 CFR 1356.20(c)(2) and 45 CFR 204.1.
Date________________________________ ________________________________ (Signature)
________________________________
APPROVAL DATE: EFFECTIVE DATE:
_____________________________ ___________________________
_____________________________________
(Signature, Associate Commissioner, Children's
0 Statutory references refer to the Social Security Act. Regulatory references refer to Title 45 of the Code of Federal Regulations (CFR).
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | B. STATE PLAN FOR TITLE IV-E OF THE SOCIAL SECURITY ACT: PREVENTION |
Author | HHS/CB |
File Modified | 0000-00-00 |
File Created | 2022-05-19 |