New Child Welfare Waiver Demonstration Project Proposals Submitted Pursuant to Section 1130 of the Social Security Act (the Act); Title IV-E and IV-B of the Act; Public Law 103-432

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

New Child Welfare Waiver Demonstration Project Proposals

Submitted Pursuant to Section 1130 of the Social Security Act (the

Act); Title IV-E and IV-B of the Act; Public Law 103-432

AGENCY: Administration for Children and Families, HHS.

ACTION: Notice.

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SUMMARY: This notice lists new proposals for child welfare waiver

demonstration projects submitted to the Department of Health and Human

Services pursuant to Federal Register, Volume 60, No. 115, published

Thursday, June 15, 1995. Federal approval for the proposals has been

requested pursuant to section 1130 of the Social Security Act.

COMMENTS: We will accept written comments on these proposals. We will,

if feasible, acknowledge receipt of all comments, but we will not

provide written responses to comments. We will, however, neither

approve nor disapprove any new proposal for at least 30 days after the

date of this notice to allow time to receive and consider comments.

Direct comments as indicated below.

ADDRESSES: For specific information or questions on the content of a

project or requests for copies of a proposal, contact the State contact

listed for that project.

Comments on a proposal should be addressed to:

Michael W. Ambrose, Administration on Children, Youth and Families,

Children's Bureau, 330 C Street, SW.

Mary E. Switzer Building, Room 2068, Washington, D.C. 20201, FAX: (202)

205-9345

SUPPLEMENTARY INFORMATION:

I. Background

Under Section 1130 of the Social Security Act (the Act), the

Secretary of Health and Human Services (HHS) may approve child welfare

waiver demonstration project proposals with a broad range of policy

objectives.

In exercising her discretionary authority, the Secretary has

developed a number of policies and procedures for reviewing proposals.

On June 15, 1995, we published a notice in the Federal Register (Volume

60, No 115, page 31478) that specified (1) the principles that we

ordinarily will consider when approving or disapproving demonstration

projects under the authority in section 1130 of the Act; (2) the

procedures we expect States to use in involving the public in the

development of proposed demonstration projects under section 1130; and

(3) the procedures we ordinarily will follow in reviewing demonstration

proposals. We are committed to a thorough and expeditious review of

State requests to conduct such demonstrations.

II. Listing of New Proposals

As part of our procedures, we are publishing a notice in the

Federal Register of all new proposals. This notice contains summaries

of 14 proposals received by July 31, 1995, the date established for the

first round of proposals. Each of the proposals contains an assurance

that the proposed demonstration effort will be cost neutral to the

federal government over the life of the proposed effort; and each

proposal contains an evaluation component designed to assess the

effectiveness of the project.

The June 15, 1995 Federal Register Announcement indicated the

Department would give priority consideration to proposals received by

July 31, 1995. Further, if ten states had not been approved, additional

proposals would be accepted by September 30, 1995 and at the end of

each calendar quarter thereafter until ten waiver demonstration

projects have been approved. The next date for acceptance of any child

welfare waiver demonstration proposals is changed to December 31, 1995.

STATE: CALIFORNIA.

DESCRIPTION: California proposes to extend, and broaden to include the

use of federal funds, a planned State Partnership Demonstration Project

that will provide direct funding to counties for the implementation of

child welfare services. Participating counties would receive from the

State a single allocation of funds for family and children's services,

rather than using categorical funding streams.

The project would enhance the counties' abilities: to meet

families' needs more comprehensively; to increase the focus on

outcomes; to provide additional in-home services which will result in

less need for out of home care; and to contain costs.

The State anticipates that enhanced flexibility in the use of

federal funds, reduced administrative requirements and a new ``outcome-

oriented oversight role'' will improve outcomes for children and

families, including more effective prevention services that will reduce

the need for out of home care. The State is particularly interested in

promoting a whole family foster care program and long term options for

children in kinship care.

The State proposes, potentially, to waive a large number of

statutory (and regulatory) provisions, which would be based on

negotiations among federal, State and local child welfare services

officials regarding specific local waiver proposals. For each of many

statutory provisions, the state proposes conditionally to ``request

waiver of this section to the extent necessary to implement the

proposed demonstration project.'' Statutory items include certain title

IV-E State plan requirements, title IV-E income eligibility

requirements, statutory definitions (including definitions of eligible

facilities), requirements regarding adoption assistance payments,

required statistical reports, and Independent Living Program

eligibility requirements. Regulatory items proposed for waiver include

limitation on the sources of state match, cost allocation plan

[[Page 46617]]

requirements, general grant administration requirements, fiscal

regulations, the State allotment determination formula, payment review

and facility licensing standards, and regulations regarding the

withholding of federal funds.

CONTACT PERSON: Marjorie Kelly, Deputy Director, Children and Families

Services Division, California Department of Social Services, 744 P

Street M.S. 19073, Sacramento, CA 95814, (916) 657-2614, (916) 653-1695

(FAX).

STATE: DELAWARE.

DESCRIPTION: Delaware proposes a wavier project which has two

components. In the first, the State would use multi-disciplinary teams

composed of social workers and substance abuse counselors to address

the problem of parental substance abuse that creates risks for children

and families. This aspect of the project is designed to reduce the

number of children coming into out of home care; to delay entry into

care; or to reduce the amount of time spent in foster care. The second

component involves adding assisted guardianship to the permanency

continuum when adoption is not possible and a family has made a long-

term commitment to the child. This option is proposed as a cost saving

alternative to placing children in foster care.

In establishing a multi-disciplinary team to address parental

substance abuse issues, the State anticipates that the services will

prevent placement or significantly reduce the duration of placement for

50% of the children in the demonstration units that would come into

care because of parental substance abuse. In adding guardianship as a

continuum of care option, the State projects that 10 children/youth per

year who are currently maintained in long-term foster care will be

moved to the guardianship program.

The State proposes to contract with local substance abuse treatment

agencies to provide counselors to be co-located with child protective

services staff. This effort would provide multi-disciplinary assessment

and treatment services for approximately 180 families a year for a

period of three years.

The second component of the proposal would make guardianship an

available alternative to the caretaking families, thus enabling a

child's case to be closed while still making financial and other

services available to the family as needed. This option would be

considered when adoption is not possible and a family has made a long-

term commitment to the child/youth.

For the use of a multi-disciplinary team to provide assessment and

treatment services, the State is proposing to waive the prohibition on

the expenditure of title IV-E funds for services. For the guardianship

component, the State seeks to waive provisions governing eligibility

for title IV-E foster care maintenance payments, so that caretaking

guardians of children formerly in placement might receive payments

comparable to title IV-E foster care maintenance payments.

CONTACT PERSON: Kathryn J. Way, Director, Division of Family Services,

Delaware Department of Services for Children and Their Families, 1825

Faukland Road, Wilmington, DE 19805, (302) 633-2650, (302) 995-8290

(FAX).

STATE: DISTRICT OF COLUMBIA.

DESCRIPTION: The District of Columbia proposes to develop a community-

based therapeutic model of services to serve as an alternative to

placing children in more restrictive institutional settings, as well as

providing a transitional bridge for those children returning to the

community upon discharge from institutional care.

The flexible use of title IV-E and IV-B funds would allow for the

development and provision of a community-based model of therapeutic

services to prevent foster home and institutional placement and would

increase inter/intra agency and multi-system coordination of services.

The demonstration project would include the use of a ``managed

care'' approach through the use of rate setting procedures to include

articulated caps, and a system to provide comprehensive multi-system

social and support services. The community-based therapeutic approach

would include specialized emergency foster care homes; shared family

care; in-home treatment; use of professional surrogate parents; and

substance abuse treatment services.

The District of Columbia proposes title IV-E waivers to allow

payment for services, and to permit the support of alternatives to

foster home and institutional placement through use of a rate-setting

process to be established under the demonstration project.

CONTACT PERSON: Ricardo Lyles, Acting Administrator, Family Services

Administration, District of Columbia Department of Human Services, 609

H Street, NE, Washington, DC 20002, (202) 724-8756, (202) 727-9460

(FAX).

STATE: GEORGIA.

DESCRIPTION: Georgia proposes to use title IV-E funds to fund

preventive and supportive services for children and families at risk,

to eliminate the need for placement or reduce the time a child spends

in out of home care. Additionally, Georgia seeks to place children in

neighborhood settings; provide specialized living arrangements for

adolescents, and obtain special adoption assistance to expedite the

placement of children into adoptive homes.

The benefits for this demonstration project include removing

systems barriers, decreasing or avoiding the amount of time a child

spends in out of home care, providing more stable placements, expanding

preventive and family support service systems and increasing adoptive

placements by making resources available to adoptive families that

otherwise would not qualify.

The services to be provided under the demonstration project include

family support and prevention services, expansion of kinship care, and

community placement services.

Georgia proposes to expand title IV-E coverage to include placement

prevention and reunification services. The State also wishes to waive

some provisions of title IV-E eligibility determination when a child

comes into custody, provide a special waiver to provide adoption

assistance to pay for the purchase of services to expedite adoptive

placement, and provide funds for adoptive parents for one-time expenses

related to the placement of a specific child in the home. Georgia also

seeks a waiver to permit title IV-E funds to support a kinship care

assistance subsidy, and a waiver of some provisions of title IV-A to

allow families whose children are in foster care to continue receiving

food stamps, when reunification is expected to occur within 180 days.

CONTACT PERSON: Doris Walker, Foster Care Unit Chief, Georgia

Department of Human Resources, Division of Family and Children

Services, Two Peachtree Street, NW., Suite 12-300, Atlanta, GA 30303-

3180, (404) 657-3458, (404) 657-3415 (FAX)

STATE: ILLINOIS.

DESCRIPTION: Illinois is proposing a subsidized private guardianship as

a permanency planning option which would meet the needs of the long-

term kinship care population, in order to reduce the number of children

in long-term foster care and to reduce the number of disrupted

placements.

Illinois seeks to improve permanency outcomes for children in

healthy kinship care arrangements in cases where reunification and

adoption are not possible. The demonstration project

[[Page 46618]]

would reduce government intrusion in family life while creating support

and clinical management systems which minimize risk through annual

reviews of subsidized private guardianship and continuous promotion of

adoption options.

Illinois would provide a subsidized private guardianship program

(which parallels the adoption subsidy program) for a random group of

eligible caregivers.

The State proposes a waiver of title IV-E to permit withholding

subsidized guardianship from a randomly selected control group; a

waiver of certain provisions of the Adoption Assistance Program to

authorize subsidized guardianship for children who meet the eligibility

requirements of Section 673 and additional requirements set by the

State, in order to authorize payment of nonrecurring guardianship

expenses, and for guardianship assistance payments for children; a

waiver of eligibility requirements to limit assistance to special needs

children; a waiver that would permit federal financial participation in

amounts expended as guardianship support payments pursuant to

guardianship assistance agreements; and a waiver to authorize federal

financial participation in amounts expended on training and

administration for the subsidized guardianship program and a waiver of

the provision defining ``adoption agreement'' to allow that term to

include ``guardianship assistance agreement.''

CONTACT PERSON: Joe Loftus, Executive Deputy Director, Illinois

Department of Children and and Family Services, 100 West Randolph, 6th

Floor, Chicago, IL 60601, (312) 814-8741, (312) 814-6859 (FAX).

STATE: INDIANA.

DESCRIPTION: Indiana proposes to divert per diem funds from restrictive

(primarily institutional) placements to more community-based services

in order to create more home-based in-state placements for children,

placements which would be more supportive of family unity.

The effort would result in fewer high cost, out of state child

placements; fewer removals from home, and earlier reunification;

improved family functioning; expeditious adoptions; timely transitions

to independent living; and improved outcomes for children.

Indiana would modify existing interagency agreements between the

Division of Family and Children Services and juvenile court judges to

include community partners such as mental health, education and the

Step Ahead Council. The local office of Family and Children Services,

the county probation office, community mental health center or the

school corporation seeking placement of a child would convene a meeting

of partners to develop alternatives to restrictive placement.

Indiana proposes to waive title IV-E to permit payment of proposed

services: even when a child has not been judicially removed from the

home; in order to prevent the placement of a child in out of home care;

and for the child in substitute care who is not categorically eligible

for title IV-E foster care.

CONTACT PERSON: James Hmurovich, Director, Division of Family and

Children, Family and Services Administration, Room W392, Government

Center south, 402 West Randolph Street, Indianapolis, IN 46204, (317)

232-4705, (317) 232-4490 (FAX).

STATE: MARYLAND.

DESCRIPTION: Maryland proposes to add federal guardianship assistance

as a permanency planning option which would more closely meet the needs

of the kinship care population.

This effort would result in reduced average length of stay in out

of home placement for children; increased stability for children, and

empowerment/support for the caretaking family.

Under this demonstration project in order to be eligible a child

would have to be committed to the local department of social services

as a child in need of assistance and to have been in a successful out

of home placement with the prospective guardian for a minimum of six

months. Reunification and adoption would have to be appropriately ruled

out as permanency planning options. Resources for the child (SSI,

Social Security Survivor's Benefits, etc.) would be transferred to the

guardian and deducted from the subsidy. Prospective guardians would be

required to sign a guardianship agreement which would require annual

renewal.

CONTACT PERSON: Fern Blake, Maryland Department of Human Resources, 311

West Saratoga Street, Baltimore, MD 21201-3521, (410) 767-7269, (410)

333-0099 (FAX).

STATE: MICHIGAN.

DESCRIPTION: Michigan proposes to increase its emphasis on family

preservation and family support services and decrease the need for and

reliance on out of home care by using title IV-E funds to provide

services.

The effort would result in controlled growth of title IV-E

maintenance expenditures; greater collaboration among federally-funded

programs; increased ability to provide services for families; and

decreased reliance on out of home care.

Michigan is proposing to treat title IV-E maintenance payments

(other than those for adoption subsidy) as a capped entitlement. The

State is proposing to use the funds for service provision, in some

cases augmenting funds now being expended under title IV-B Subpart 1

(Child Welfare Services) and Subpart 2 (Family Preservation and

Support). The funds would be used to expand grants to local communities

and to implement family preservation and support services more quickly.

Michigan is proposing to waive those provisions of title IV-E which

restrict States from expending these funds for the provision of

services. Michigan excludes title IV-E adoption assistance from its

waiver proposal.

CONTACT PERSON: David Berns, Director, Office of Children's Services,

Michigan Department of Social Services, 235 South Grand Avenue, P. O.

Box 30037, Lansing, MI 48909, (517) 335-6159, (517) 241-7047 (FAX).

STATE: MINNESOTA.

DESCRIPTION: Minnesota proposes to establish relative-based living

arrangements as an alternative to out of home care.

The results of this project would be enhanced permanency for

children including maintaining a continuity of relationships and a

sense of belonging; protection for children who are at risk; lessened

government intrusion into families; a greater connection for children

with their families and communities; support for kinship placements;

lessened time in substitute care; multiple placements will be reduced;

and expenditures for out of home placement will be contained.

The proposed demonstration project focuses on placement with family

members and would provide support for temporary relative guardianship;

permanent relative guardianship; voluntary relative foster care; and

court-ordered relative foster care.

Minnesota proposes waivers of provisions under title IV-E in order

to exclude grandparents from the foster care licensing requirements;

and approval of a financial support structure that allows differential

payments based on need. Specific services under this waiver project

would include guardianship subsidies, differential foster care support,

and specialized training for relative caregivers.

The State also proposes waivers of certain provisions of title IV-A

in order

[[Page 46619]]

to apply the special child standard of assistance in situations where

the child is living in one of a range of relative care arrangements;

and flexibility to use emergency assistance funds to help relative

caregivers meet minimum health and safety standards. Specific services

under this waiver would include guardianship, subsidies and alternative

care grants.

CONTACT PERSON: Robert DeNardo, Supervisor, Family and Children's

Service Division, Minnesota Department of Human Services, 444 Lafayette

Road North, St. Paul, MN 55112-3831, (612) 296-5288, (612) 297-1949

(FAX).

STATE: NEW YORK.

DESCRIPTION: New York proposes to use a managed care approach to child

welfare services to recapture revenue for reinvestment in preventive

and aftercare services in local communities.

The benefits of this effort would be an accelerated decline in the

foster care population; an increase in the level of services; and a

reduction in the length of stay in foster care.

New York proposes to apply the principles of managed care to its

foster care and adoption assistance programs by identifying preset

payments for a range of services for a specified population over a

predetermined period of time (capitated payments) and adjusting

treatment regimens in light of outcomes so that the client receives the

necessary services to continue to make progress toward the stated goals

of intervention (care management). The State also proposes to increase

the availability of child welfare services so that pre-placement

preventive and aftercare services can be intensified.

New York proposes to waive: title IV-E requirements regarding the

eligibility of children and of foster care facilities; the definition

of ``special needs'' for which title IV-E funds may be used; the

circumstances under which these funds may be claimed; and certain

requirements concerning title IV-E administration and training.

CONTACT PERSON: Fred Wulczyn, Office of Family and Children Services,

Division of Services and Community Development, New York State

Department of Social Services, 40 North Pearl Street, Albany, NY 12243-

0001, (518) 486-3431, (518) 474-9004 (FAX).

STATE: NORTH CAROLINA.

DESCRIPTION: North Carolina proposes outcome-based management of foster

care, in which foster care funding is tied to specific outcomes related

to diverting children from foster care whenever possible and moving

quickly to achieve permanence for children.

The benefits from this demonstration effort would: link funding and

outcomes and measure the effect on service delivery system performance;

demonstrate and evaluate the effectiveness of a comprehensive outcome-

based approach; decrease the amount of time children spend in foster

care, reduce the number of new entries into foster care, and promote

collaborative planning and coordination of services with several other

initiatives currently underway in the State.

The proposed demonstration effort has two parts. Part I is designed

to encourage the development of effective community-based

reunification, adoption and aftercare services. Part II is designed to

achieve a paradigm shift that allows local programs to move resources

from treatment to prevention.

The waiver requests the use of title IV-E foster care funds on

behalf of children not presently eligible: to allow local social

service agencies to use a capitated rate structure with incentives for

achieving specified outcomes; to allow local social service agencies to

contract with public, private non-profit and private for profit

entities as needed to develop an effective community network of

services; and to allow participating agencies to reinvest savings

realized from performance excellence in child welfare services.

CONTACT PERSON: Chuck Harris, North Carolina Department of Human

Resources, Division of Social Services, 325 Salisbury Street, Raleigh,

NC 27603, (919) 733-9467, (919) 715-0024 (FAX).

STATE: OHIO.

DESCRIPTION: Ohio proposes to reduce child removals and/or time of

children in placement and associated costs through the use of managed

care technology to provide a broader array of services to children and

their families.

The benefits of this effort would include decreasing placement

costs, increasing the level and quality of services; strengthening

local partnerships; and expediting the permanency planning process.

The proposed demonstration effort represents a partnership between

public children's service agencies (PCSAs), the Ohio Department of

Human Services (ODHS), and managed care entities (MCE). Decision making

and risk will be shared among the PCSAs, ODHS and the MCE. ODHS's role

is that of coordinator, facilitator and provider of training and

technical assistance. The PCSAs' role is primarily as purchasers of

services, and they may or may not provide all the direct service

functions themselves. The MCE will be responsible for administrative

and management functions, medical/clinical reviews, utilization

management and service authorization, developing and operating a

management information system, developing contracts with providers and

payers, and consumer satisfaction-related duties.

The current system of services will continue but with managed care

options being considered at decision making points. A policy consortium

will be created to develop and implement policy and practices that

support permanency planning and provide guidance to the local PCSAs.

The terms and conditions developed by the Consortium will bind the

provider agencies to uniformly implement the agreed upon practice

criteria and to ensure consistency for evaluation purposes across the

waiver sites.

Ohio proposes to waive a number of title IV-E provisions that

relate to restrictions on child eligibility, and prohibitions on the

use of title IV-E funds for the provision of services.

CONTACT PERSON: Isaac Palmer, Deputy Director, Office of Child Care and

Family Services, Ohio Department of Human Services, 30 East Broad

Street, Columbus, OH 43266-0423, (614) 466-1213, (614) 466-9247 (FAX).

STATE: OREGON.

DESCRIPTION: Oregon proposes to use title IV-E funds for services

including but not limited to prevention and support services,

protective services, crisis intervention and reunification services.

The State also proposes to develop a kinship foster care rate that

would be individually determined based on the needs of the child.

The demonstration project would provide flexible funding for abused

and neglected children and their families and/or caregivers to receive

individual services, regardless of where the chid is placed. Specific

outcomes expected would include decreasing the length of foster care

placement, increasing the number of children remaining safely in their

homes, increasing the use of relative caretakers for children who must

be placed out of the home, having more appropriate foster care

resources and better utilization of community resources.

The proposed demonstration project would provide support to

biological, foster and kinship caretakers through a myriad of services.

The State proposes to shift toward a statewide system of in-home care

services delivery, insure a match between the child's needs and the

skill of the caretakers, establish mechanisms that will refocus the out

of home care systems and move closer to implementation of a ``first

placement/

[[Page 46620]]

only placement'' objective for children who are unable to remain with

their parent(s).

Oregon proposes to waive those provisions of title IV-E: that

require a State to make foster care maintenance payments; that require

that foster care maintenance payments be made only on behalf of a child

who resides in a foster family home or a child care institution; and

that concern the conditions for federal reimbursement for voluntary

placements.

CONTACT PERSON: Richard Schoonover, State Office of Services for

Children and Families, Oregon Department of Human Resources, 500 Summer

Street, NE, Salem, OR 98310-1017, (503) 945-6882, (503) 328-3800 (FAX).

STATE: WEST VIRGINIA.

DESCRIPTION: West Virginia will create a comprehensive, decentralized,

specialized system to determine a child's potential eligibility for all

funding resources for child welfare programs.

The proposed system would maximize the State's child welfare funds

by identifying and accessing additional financial resources available

to children in care. The new system would emphasize parental obligation

and encourage parental participation.

A resource development unit will be created to identify, pursue and

produce accurate claims for all sources of funds to which a child in

care may be entitled, e.g., child support, SSI, Black Lung, Railroad

Retirement, third party medical, SSA, Veterans's Benefits and titles

IV-A, IV-B and IV-E.

West Virginia is requesting a waiver of the title IV-E limit of

fifty percent for Federal Financial Participation in a State's

administrative costs.

CONTACT PERSON: Mary Jarrett, West Virginia Department of Health and

Human Resources, Office of Social Services, Bldg. 6, Room B-850, State

Capitol Complex, Charleston, WV 25305, (304) 558-7980, (304) 558-8800

(FAX).

III. Requests for Copies of a Proposal

Requests for copies of a Child Welfare Waiver Demonstration Project

proposal should be directed to the appropriate State at the telephone

number given above. Questions concerning the content of a proposal

should be directed to the State contact listed for the proposal.

(Catalog of Federal Domestic Assistance Program, No. 93.645, Child

Services--State Grants; 93.658, Foster Care Maintenance; 93.659,

Adoption Assistance)

Dated: August 31, 1995.

Joseph A. Mottola,

Acting Commissioner, Administration on Children, Youth and Families.

[FR Doc. 95-22230 Filed 9-6-95; 8:45 am]

BILLING CODE 4184-01-P