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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

[Notice of Program Announcement No. ACF/ACY/CB-98-05]

New Child Welfare Demonstration Project Proposals Submitted by

States for Waivers Pursuant to Section 1130 of the Social Security Act

(the Act); Titles 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 the guidance contained in Information Memorandum

ACYF-CB-IM-98-01 dated February 13, 1998, public notice of which was

given in the Federal Register of March 4, 1998, Vol. 63, No. 42, page

10637.

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

not provide written responses to comments. We will 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

person 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 2058, Washington, D.C.,

20201. FAX: (202) 260-9345.

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.

The most recent expression of these policies and procedures may be

found in the February 13, 1998 Information Memorandum cited above, a

copy of which may be found at the ACF website at http://

www.acf.dhhs.gov/program/cb/demonstrations or may be obtained from the

National Clearinghouse on Child Abuse and Neglect Information, (800)

394-3366, internet address [email protected]>. We are committed to a

thorough and expeditious review of state proposals to conduct child

welfare 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 17 proposals received by April 30, 1998. 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.

State: Arkansas

Description: The State of Arkansas proposes to use title IV-E funds

to enhance mental health services available for children in foster care

and children at risk of being placed in foster care, and thereby reduce

barriers to permanency for those children. The State intends, in

October, 1998, to implement a system for mental health managed care for

all title XIX eligible children, and all children in DCFS foster care.

Under this demonstration, the State would use title IV-E funds to

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provide supplemental payment to the managed care capitated rate to (1)

allow for previously unallowable services to title IV-E eligible

children (Managed Care component); (2) provide specialized,

collaborative case management services to a group of randomly selected

foster children (some of whom may not be IV-E eligible) and children

who are at risk for being placed in foster care because of their

service needs, to identify and address barriers to permanency (FOCUS

component); and (3) provide training to child welfare staff as well as

others in the community to enhance participation in the project from

agencies and persons outside DCFS.

Arkansas proposes to conduct a process evaluation as well as an

evaluation to produce outcome data, and a cost/benefit analysis. The

evaluation design for the collaborative case management services

portion of the project is proposed as a design based on random

assignment of children or families to treatment or control conditions.

The State requests waivers of title IV-E to allow the State to

conduct a portion of the Demonstration on less than a Statewide basis,

to allow the State to expend title IV-E funds for children and families

who are not normally eligible, to allow the State to make payments for

services that are not normally covered under Part E of title IV of the

Act, and to allow the State to expend title IV-E funds for training of

persons who are not normally eligible. The State also has requested a

title XIX waiver under the authority of section 1915(b) of the Social

Security Act to establish a mental health managed care system to reduce

costs, prevent unnecessary and inappropriate utilization, and ensure

access to quality mental health care for Medicaid recipients.

Contact Person: Lee Frazier, Director, Arkansas Department of Human

Services, 329 Donaghey Plaza South, P.O. Box 1437, Little Rock,

Arkansas 72203-1437, Phone: (501) 682-8650, Fax: (501) 682-6836.

State: Connecticut

Description: Connecticut's proposal has two distinct program

components. The first proposes to use title IV-E funds to implement a

subsidized guardianship program and to change case work practice to

provide increased emphasis and support for guardianship as a viable

permanency option for cases where reunification or adoption of children

living with relative care givers is neither appropriate nor feasible.

The second component proposes to conduct pilot demonstrations of a

service delivery model in which a single lead agency would organize,

manage and provide an array of services to address the specific needs

of children who require placement in residential or group homes.

The goal of the proposed guardianship program is to provide another

means of attaining permanency for children who would otherwise remain

in foster care. The program would be implemented state-wide and would

focus on children residing with relative caregivers. It would provide:

(1) A monthly subsidy on behalf of the child payable to the guardian

equal to the prevailing appropriate foster care rate; (2) a medical

subsidy comparable to the medical subsidy for subsidized adoption (if

the child has no private health insurance); and (3) a lump sum payment

for one-time expenses resulting from the assumption of care for the

child (when other resources are unavailable). Waivers would be required

to allow for Federal IV-E reimbursement for payments to relative

caregivers when a child leaves legal custody of the State agency, and

for program administration and services that are not currently

allowable under IV-E.

The proposed ``single contact/continuum of care'' program's goal is

to test the effectiveness of the service delivery model in which the

State's Child and Family agency (DCF) would contract with a single Lead

Service Agency that would manage subcontracts and create an expanded

network of regular and specialized services for children and youth with

behavioral problems who are referred to residential or group homes.

The State hypothesizes that this demonstration project would

decrease the length of stay in restrictive settings; increase treatment

options for children and families; improve permanency outcomes for

children and provide long-term stability in the community; and

establish a more flexible, incentive-oriented fiscal environment for

service providers. One or two pilot programs would be established to

serve 30 children per pilot over a five year project period. The

program would be targeted to DCF children aged 7 to 15. A 15 month

service period, which includes a minimum of 3 months of aftercare, is

projected for each child. Waivers are requested to allow the

administrative and services costs to be IV-E reimbursable.

Contact Person: Robert Dakers, Department of Children and Families,

505 Hudson Street, Hartford, CT 06106-7107, Phone: (860) 550-6542, Fax:

(860) 566-7947.

State: District of Columbia

Description: The District of Columbia proposes to test the ability

of a partnership between the Child and Family Services Agency (CFSA)

and neighborhood-based community collaboratives to improve service

delivery for children in kinship placements. Teams of CFSA social

workers matched with trained collaborative community workers would

provide family preservation services to the kinship triad: the kinship

caregiver, the parent and the child. CFSA hypothesizes that this

public-private partnership would increase the number of children who

achieve permanency, speed the permanency process, increase stability in

kinship care families, increase outreach and education that promotes

child safety and reduce the incidence of further abuse or neglect for

children and families receiving these services, and reduce time in out-

of-home placements and the number of new foster care placements.

To test its hypotheses, CFSA has requested waivers to permit title

VI-E funds to be expended for services and individuals that are not

eligible under existing law. The requested waiver would allow the

District to be reimbursed for foster care services provided to children

who are not IV-E eligible, including those who are living with kinship

caregivers, and to allow adoption subsidy payments for children who are

not IV-E eligible.

The District's proposed evaluation design would randomly assign

eligible kinship triads to experimental and control groups. The

experimental group would receive the team approach and the control

group would receive traditional services from a social worker. The

evaluation would measure: Changes in Child Safety through the number of

new allegations, allegations after a case is closed, disruptions in

placement, entries or re-entries into non-kinship foster care; Child

Well-Being through the Child and Adolescent Functional Assessment

Scale; and Child Permanency as indicated by adoption, legal custody or

re-unification.

Contact Person: Ernestine Jones, General Receiver, Office of the

General Receiver, Child and Family Services Agency, 900 Second Street,

N.E., Suite 221, Washington, DC 20002, Phone: (202) 842-0888, Fax:

(202) 842-2335.

State: Florida

Description: Florida proposes to demonstrate whether children and

families can achieve better outcomes through: privatization, managed

care, and Medicaid therapeutic service

[[Page 37389]]

integration. In response to a 1996 legislative mandate to private child

welfare services, the Florida Department of Children and Families

allowed community-based providers to operate five pilot projects.

Waivers under a demonstration project would enable these providers to

use State funds and federal title IV-E funds to purchase therapeutic

services for children who do not meet Medicaid ``medical necessity''

restrictions for therapeutic services. In addition, at least one

demonstration site would receive a capitation payment linked to the

number of children living in poverty. Each site would then utilize this

funding flexibility to reconfigure services. The state hypothesizes

that this would expedite all aspects of permanency, improve family

capacity to care for children, increase family involvement and the

range of supports available to families, and increase youths'

preparation for independence.

Florida proposes to compare the performance of selected comparison

counties to the performance of the demonstration counties. The State's

evaluation design would include outcome evaluation, process evaluation,

cost analysis and cost benefit analysis. Outcome measures include

safety and protection, permanency goals, stability and functioning and

customer satisfaction. Process measures would examine policies,

procedures, client flow, staffing expertise and levels, service types,

duration, mix, timing and accessibility, assessment processes, and

court, community and media relationships. A cost analysis would study

all costs associated with the project and comparison counties. The

cost-benefit analysis merges cost data with outcome data to determine

the overall value of the outcomes.

Contact Person: Margaret Taylor, Florida Department of Children and

Families, 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700,

Phone: (850) 922-0149, Email: Taylor __M[email protected].

State: Iowa

Description: Iowa proposes to fund community-based services to

improve outcomes for children and families in the child welfare system

using title IV-E funds. The State plans to build on the existing

Decategorization Project areas and Innovation Zones to increase the

capacity of local organizations to care for children and families and

build service strategies for children and families in the child welfare

system. The State believes this demonstration would efficiently reduce

the amount of time children spend in out-of-home care and move children

into permanent placements more quickly.

The State proposes to implement this demonstration in several

counties or clusters and use a comparison group of counties to evaluate

both the impact and the cost of using title IV-E funds flexibly. Under

the State's plan, counties would present proposals for participating in

the IV-E demonstration that focus on: (1) Diverting children from out-

of-home care, including foster care, group care, residential care, and

mental health or juvenile justice institutions; (2) providing for

permanency for children quickly and effectively; and/or (3) reducing

re-entry into out-of-home care. For each county's or cluster's

proposal, the State is proposing that the eligibility determination for

title IV-E be eliminated under the demonstration. To assess the

demonstration project, the State proposes to compare demonstration

counties or clusters to children in comparison counties or clusters.

The evaluation would produce process, outcome, and cost/benefit

information.

The State is requesting waivers of certain provisions of title IV-E

which would allow Iowa to: (1) Use title IV-E funds to pay for

additional services for children and families; and (2) spend title IV-E

funds on children and families who would not normally be eligible for

title IV-E.

Contact Person: Mary Nelson, Division Administrator for Adult,

Children and Family Services, Iowa Department of Human Services, Hoover

State Office Building, Des Moines, IA 50319-0114, Phone: (515) 281-

5521, Fax: (515) 281-4597.

State: Kansas

Description: Kansas proposes to fund a demonstration project

intended to ``support and enhance'' the new performance-based

administration of the Kansas Child Welfare System. The Kansas

Department of Social and Rehabilitation Services (SRS) intends to

conduct a multi-faceted project consisting of a subsidized guardianship

program, integrated child welfare training, enhanced drug/alcohol

services, and subsidized family reintegration upon return home

(aftercare). In addition, the initiative would compare the new case

rate, performance-based payment system (already in place statewide)

with the traditional fee-for-service payment system in order to

determine which payment method produces better outcomes.

The State hypothesizes that: (1) The subsidized guardianship

project would facilitate the permanency of children when adoption and

reunification with their family is not feasible; (2) an integrated

child welfare training project for private and public social service

professionals aimed at supporting an integrated social service model

with a ``single worker per family'' concept would provide social

service staff with the tools needed to meet the needs of families,

including preventing out-of-home placement; (3) a strengthened approach

to drug and alcohol dependency assessment and treatment planning

directed to IV-E eligible children and families would decrease the

number of disruptions to placement and decrease the length of stay in

out-of-home placement; and (4) a project making resources and services

such as respite care, family support services, parenting education,

family, individual, and group therapy, available to families upon

reintegration of a child would prevent further disruption.

The proposed evaluation design would compare the fee-for-service

delivery system to the case rate performance based delivery system.

Since the SRS has already shifted all of the adoption and foster care

delivery systems into the latter, it would be necessary to randomly

select children to be placed ``outside the case rate.'' The random

selection process would be applied to selected area offices which

collectively represent 40% of the children served, and three of the

five foster care regions. The State would measure outcomes such as

amount of time for children to be placed with adoptive families,

percentage of finalized adoptions within 12 months, disrupted

placements, number of siblings placed together, number of placement

changes, new substantiated claims of abuse or neglect, percentage of

children placed within Regional boundaries, percentage of children

returned to family or achieving permanence, re-entry into foster care,

percentage of children achieving permanency and family satisfaction

with services.

The proposed project would be cost neutral and would run for five

years.

Contact Person: Teresa Markowitz, Commissioner, Kansas Department

of Social and Rehabilitation Services, 915 SW Harrison Street, Topeka,

Kansas 66612, Phone: (785) 368-6448, Fax: (785) 368-8159, Email:

tamasrcfs.wpo.state.ks.us.

State: Maine

Description: Maine proposes a two-phase demonstration project. The

first phase would involve the design and implementation of an adoption

training

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curriculum for mental health professionals and other service providers

who would become expert in working with families in need of post-

adoption services. The second aspect of the demonstration would phase

in the purchase and delivery of post-adoption support services for

families who adopt special needs children. The overall goals of the

project are to increase the number of special needs children who are

adopted and to decrease the number of disrupted adoptions. It is the

State's hypothesis that increasing the array of supportive services

available to families who elect adoption would promote family stability

and reduce disruptions, as well as encourage other community members to

consider adopting children with special needs. The State has proposed a

five-year demonstration period.

The demonstration would be conducted in four test sites, two urban

and two rural, from among the Department of Human Services district

offices. At present, Maine has about 535 IV-E eligible children free

for adoption.

The evaluation design calls for establishing a control and

experimental group in each pair of selected sites, i.e., one urban

control, one urban experimental, one rural control and one rural

experimental. The State expects that a total of 200 children and

families (100 control and 100 experimental) would participate in the

study over the life of the demonstration. The experimental group would

receive the expanded post-adoption services, while the control group

would receive the current service mix.

Outcome measures would include the number of special needs

adoptions, the incidence of disrupted adoptions, the average length of

stay in foster care and the stability of the adoptive families.

Waivers are requested to enable the State to use title IV-E funds

to provide services which are not normally allowed under title IV-E

Adoption Assistance or title IV-E Foster Care.

Contact Person: Dawn Stiles, Department of Human Services, State

House Station #11, Augusta, Maine 04333, Phone: (207) 287-5060, Fax:

(207) 287-5282, TDD: (207) 287-4479.

State: Mississippi

Description: Mississippi proposes to expand the use of title IV-E

funds to non-IV-E eligible children and families and to use title IV-E

funds for any items or activities that would eliminate or reduce harm

to children and families. The demonstration proposes to implement a

Child-Focused Family Centered Practice Methodology, which emphasizes

the safety and best interests of children through the elimination of

harm-causing factors. The proposed project involves using title IV-E

funds to provide services for children and families whether children

are in State custody or not, including children in residential care.

This project would involve the identification of services, the

development of a service delivery system, the development of a business

plan, the building of multi-disciplinary case management teams, and

ongoing evaluation and program modification. It is the State's

hypothesis for the demonstration that the expenditure of funds to

benefit any child, regardless of IV-E eligibility, to reduce or

eliminate factors that cause harm to that child, would demonstrate a

reduction in harm to children. The demonstration would result in safer

children due to the reduction of harm to children who are a part of the

demonstration. The State has proposed a five year demonstration period.

The demonstration would be conducted in eight selected counties, which

are located in two Division of Family and Children's Services' (DFCS)

regions.

The State proposes an evaluation design in which eligible children

and families would be randomly assigned to experimental and control

groups. The experimental group would receive a combination of existing

or modified services along with newly created services. The control

group would be served by the existing services only. The evaluation

would compare results from the experimental group and control group.

Outcome measures include: decrease in the proportion of children who

experience subsequent abuse or neglect; increase in the proportion of

children who remain permanently with their parental family; among those

children placed outside of their parental home, increase in the

proportion who are in placements in the community of their parental

family and who are placed with relatives; decrease in the proportion of

children placed in foster care; decrease in the average number of

placements for children in foster care; decrease in the amount of time

spent in foster care; an increase among children awaiting adoption in

the proportion of children adopted and the speed of the process; where

two or more siblings are placed outside of their parental home,

increase in the proportion of sibling groups where siblings are placed

in the same setting; and increase in the well-being of children.

Waivers are requested to allow the State to use title IV-E funds

for children and families who are not normally eligible under title IV-

E and to use title IV-E funds, including funds which would be

reimbursed as costs of administration, for the provision of services.

Contact Person: Henry Goodman, Department of Human Services, 750

North State Street, Jackson, Mississippi 39202, Phone: (601) 873-6144,

Fax: (601) 359-4477.

State: Montana

Description: Montana's Department of Public Health and Human

Services (DPHHS) is requesting approval of a Child Welfare

Demonstration Project, which would allow title IV-E funds to be used

for a subsidized guardianship program. The demonstration would

authorize a subsidized guardianship program for eligible children;

provide a monthly guardianship subsidy, Medicaid and non-recurring

costs associated with establishing legal guardianship, and provide

federal financial participation in the costs of administration and

training associated with the guardianship program.

Montana postulates that guardianship provides the child and family

a legally recognized relationship, increases the sense of family by

granting the caretakers in the family the right and responsibility to

make important decisions regarding a child in their home, provides a

more stable placement than does long term foster care and is less

costly, due in part to a reduction in the administrative costs

associated with foster care. The demonstration project would be

statewide, for five years, and would include children on the state's

seven reservations. The project would serve children 12 years old or

older and would mirror the adoption assistance program as much as

possible. The project is expected to be cost neutral. Comparison of the

costs associated with the demonstration group and the control group

will be used to determine the fiscal effect of the demonstration.

The Montana DPHHS is also considering joining a consortium of

states in Region VIII, which would seek to demonstrate the impact of

allowing IV-E funds to be provided as a direct pass through of federal

funds to one or more tribes in Montana and in each of the other

consortium States.

The State requests waivers to allow title IV-E funds to be used for

children who are not IV-E eligible and for services which are not

ordinarily reimbursable under title IV-E. The DPHHS intends to use

random assignment of children to either a service or a control group,

and will use an independent contractor to conduct the required

evaluation.

Contact Person: Hank Hudson, Administrator, Child and Family

[[Page 37391]]

Services Division, Department of Public Health and Human Services,

State of Montana, P.O. Box 8005, Helena, Montana 59604-8005, Phone:

(406) 444-5900, Fax: (406) 444-2547.

State: Nebraska

Description: The Nebraska Health and Human Services System proposes

to test local approaches to child welfare system change through a

demonstration project. It is the State's hypothesis that the

combination of flexible use of title IV-E funds and local integrated

networks would: (1) Promote positive social and health outcomes and

prevent negative outcomes for children and families; (2) improve the

well-being of children who are at risk of, or actually require out-of-

home placement; and (3) improve the family functioning and

participation of child welfare involved families. The project would

involve entities across the State, including three which have existing

relationships with the State system, by forming local integrated

networks to facilitate a better use of resources. The State would

provide technical assistance, support and expectations for systems

management. The effort is part of an ongoing Network Development

Strategy that is being implemented Statewide.

The state estimates that a total of 3,240 children would be served

through the demonstration project. Each site would utilize the flexible

funds differently, so the outcome measures for each would be different.

Sites are expected to use the waiver authority for purposes which

include: promoting the wraparound process for each child and adolescent

at high risk of out-of-home placement; focusing on community-based

prevention, intensive community-based services, community re-

integration of out-of-area high-needs children, and child and community

safety and community ownership by developing a Managed Care Child

Welfare system in the third year of the project; sustaining and

enhancing the local service network, increasing parental, family and

civic involvement, co-locating staff and integrated services, expanding

choice and opportunities, and increasing communication and networking.

Nebraska is requesting waivers of title IV-E to permit

reimbursement for expenditures made on behalf of children who are not

IV-E eligible, and for purposes that do not ordinarily qualify for

reimbursement under IV-E.

The State proposes to compare the demonstration sites with

geographical areas that do not have flexible use of funds. The State

would examine child safety, permanence, child and family well-being and

community safety and responsibility outcomes.

Contact Person: John Mader, Program Specialist, Protection and

Safety Division, Nebraska Health and Human Services System, 2345 North

60th Street, Lincoln, NE 68507, Phone: (402) 471-9364, Fax: (402) 471-

9034, Email:[email protected].

State: New Hampshire

Description: New Hampshire proposes to use title IV-E funds to hire

a substance abuse specialist with expertise regarding child protective

services who would conduct substance abuse assessments of parents where

alcohol or other drug abuse is believed to be a factor contributing to

the child's abuse or neglect. For those families in need of ongoing

services, this staff person would also assist them in accessing

intensive, community based substance abuse treatment services. It is

the State's hypothesis that the provision of these immediate, targeted

and intensive services would enable families better to provide a safe,

nurturing environment for their children, resulting in the prevention

of placement or a reduction in the length of time children remain in

out-of-home care. The State has proposed a five year demonstration

period.

The demonstration would be conducted in two District Offices of the

State's child welfare agency: those located in Manchester and Nashua.

December 1997 statistics showed 245 children in foster care in these

districts who were IV-E eligible. Of these, 56% had caretakers in which

substance abuse was a factor in their maltreatment.

The State proposes an evaluation design in which eligible families

would be randomly assigned to experimental and control groups. The

experimental group would receive the services of the substance abuse

specialist while the control group would receive the current services

mix. Outcomes for each group would be tracked. The State would examine

outcomes including placement prevention, more timely reunification,

more timely alternate permanency planning for children unable to return

home, and cost savings as a result of improved permanency planning. The

State expects approximately 120 children in the experimental condition

and 120 in the control condition.

Waivers are requested in order to (a) serve children not otherwise

eligible for IV-E (children at risk of but not in foster care); and (b)

provide services not normally covered by IV-E (substance abuse

assessment, referral and case management services).

Contact Person: Nancy Rollins, Division for Children, Youth and

Families, New Hampshire Department of Health and Human Services, 6

Hazen Drive, Concord, NH 03301-6522, Phone: (603) 271-4451, Fax: (603)

271-4729, Email: [email protected].

State: New Jersey

Description: New Jersey seeks to implement concurrent permanency

planning and the use of the fost-adopt model of foster care. In New

Jersey, the average length of stay for children who are six years old

or less with a goal of adoption is 25 months in their current

placement. The State proposes to use title IV-E funding for services

and activities designed to reduce to 15 months, the time in foster care

preceding the initiation of termination of parental rights/initiation

of permanency, for children whose permanency goal is adoption as

envisioned by the Adoption and Safe Families Act. The state would hire

case managers specifically dedicated to the project to apply the

permanency reform/fost-adopt model for both title IV-E eligible and

non-eligible children. Funds would also be used for enhanced legal

services and substance abuse services.

The proposed demonstration builds upon and further elaborates the

permanency reform project underway in Union, Middlesex and Essex

counties funded by the Children's Bureau under the Adoption

Opportunities program. Now completing its second year of a planned

three years of operation, this program utilizes a variety of methods

including concurrent permanency planning by child protection and

adoption staff, mediation services, recruitment and training of special

fost-adopt homes, and use of post-adoption counseling therapists to

address the issues of the birth and fost-adopt families. By building on

the curriculum development, cross training, outreach to the legal

community, and recruitment and support of fost-adopt homes already

underway, the demonstration project would facilitate acceleration of

the project schedule to Essex county, which contributes the largest

number of children to the State's foster care caseload.

New Jersey hypothesizes that allocating case management staff and

other resources to the dedicated units would reduce foster care costs

and lengths of stay and lead to more adoptive placements and/or more

stable relative placements than would occur in the comparison groups

over the five years of the project. Assignment to comparison groups

will be randomized,

[[Page 37392]]

and the evaluation would produce process and outcome data, as well as

cost/benefit information.

The State requests waivers to permit the use of title IV-E funds

for purposes not ordinarily eligible for federal funding, and for

children or families who are not IV-E eligible.

Counties not involved in the project would serve as the control

group, and after the first year the project would be extended to other

randomly selected counties.

Contact Person: Michele K. Guhl, Deputy Commissioner, Division of

Youth and Family Services, P.O. Box 717, Trenton, New Jersey 08625-

0717, Phone: (609) 292-6920, Fax: (609) 984-0507.

State: New Mexico

Description: The New Mexico project would provide title IV-E

funding as a direct pass through of federal funds to identified Tribes,

simulating direct federal funding of Tribes under title IV-E in order

to test this concept. In addition, the State is proposing the

establishment of a subsidized guardianship program for Tribal children,

which the State says would allow permanency while respecting Tribal

customs. The demonstration project would test both simulated direct

funding and flexible use by Tribes of IV-E funds.

Currently, title IV-E funding is extended by the State to five

Indian Tribes through a Joint Powers Agreement (JPA). The JPA spells

out procedures to be followed in cases of child abuse and neglect,

including how investigations are to be conducted, how and when

jurisdiction is to be transferred, and how and when parties are to be

notified. It also provides that the State would pay Tribes to cover the

foster care maintenance and adoption assistance for IV-E eligible

children in Tribal custody.

The State proposes a comparison design for the evaluation. The five

Tribes currently operating under JPA's would serve as the comparison

sites. Five additional Tribes would be selected as the pilot sites. The

selection of the pilot sites would be purposive, based on the Tribes'

willingness to participate and their capacity in terms of the human and

material resources and infrastructure currently in place to manage the

IV-E Program. A five year project is proposed.

Title IV-E waivers are requested to allow for the provision of non-

recurring expenses and ongoing assistance payments for guardians

assuming responsibility in those instances where Tribal Courts are

reluctant to terminate parental rights, to provide Federal Financial

Participation for individuals and purposes that are not IV-E eligible.

Contact Person: Maryellen Strawniak, Acting Director, Protective

Services Division, PO Drawer 5160, Santa Fe, New Mexico 87502, Phone:

(505) 827-8400, Fax: (505) 827-8480.

State: Oklahoma

Description: Oklahoma proposes a project to provide assisted

guardianship to the permanency continuum for long-term foster care

children for whom adoption or reunification is not an option. The goal

of the project is twofold: to determine if quality, permanency outcomes

can be achieved for these children; and to assess the impact of

providing services, e.g., post-placement services, on achieving these

outcomes.

The State anticipates that assisted guardianships would provide a

permanency plan option for children in long-term foster care; alleviate

the financial barriers for persons who desire to obtain guardianship,

thereby enhancing the prospects of permanency for these children; and

provide stability for children. In addition, the demonstration would

provide an opportunity to test the impact of different levels of

services and supports to children and families served by the project in

achieving quality permanency outcomes for children. The State also

anticipates that the project would reduce the workload for child

welfare staff, allowing them time to do expedited permanency planning

for the remaining children.

The State currently has approximately 1,100 children statewide in

long-term foster care; 15 percent of these children are Native

American. Some of the Native American children are in the legal custody

of the Department while others are in tribal custody. The State

estimates that 550 of these children would be potentially eligible for

this project, with approximately 200 children and families actually

served under the project. The State proposes three different levels or

categories of services and supports to children and families who

participate in the demonstration, with each category having 50-100

children and families assigned to it. The State would test the

permanency outcomes for children in relation to the level or category

of services provided to each family. The State proposes a statewide,

five-year demonstration project.

Oklahoma proposes to randomly assign children to one of the

following: a control group, which would receive the current service

mix; Target Group I, which would receive all identified waiver services

and a full range of on-going post placement services; or Target Group

II which would receive all initial services included in the waiver, but

limited on-going post placement services. To assess the project,

Oklahoma proposes to measure outcomes, processes and cost-benefits.

The State requests waivers of title IV-E provisions regarding use

of title IV-E funds to pay: a monthly subsidy for children in

guardianship arrangements; the cost of legal fees required to obtain

guardianship; and the costs of providing a range of services and

supports to families and children in guardianship situations (similar

to the services received by adoptive families and children).

Contact Person: Mike Moore, Division of Children and Family

Services, P.O. Box 25352, Oklahoma City, OK 73125, Phone: (405) 522-

4487, Fax: (405) 521-4373.

State: Texas

Description: Texas proposes a Child Welfare Demonstration project

with three components over five years. The components affect kinship

care, adoption and Texas' Permanency Achieved through Coordinated

Efforts (PACE) project.

First, Texas proposes to implement a kinship care program as part

of Protective and Regulatory Services (PRS) and requests a waiver of

title IV-E to utilize otherwise restricted funds for foster care

assistance, in conjunction with title IV-B funds, to provide upfront

financial assistance and services for kinship care placements. The

state hypothesizes that if families are provided financial assistance

for the costs of integrating the child into the home during the first

year of care and then supplementing caretaker expenses thereafter to

support the child's care, are trained, and take part in support groups,

more placements would be made and would succeed, to the benefit of the

families and children served by PRS. The length of time in foster care

would decline, freeing up funds devoted both to staff and foster care

maintenance.

Texas proposes to implement the kinship initiative in El Paso and

in Corpus Christi, Laredo and the Lower Rio Grande Valley. To evaluate

this component, the State would implement a matched-group comparison of

three groups: (1) Those that received the Integration Package, which

would consist of startup money, and the Training and Services Package;

(2) those that received only the Training and Services Package; and (3)

those that receive neither package. The state

[[Page 37393]]

would measure: implementation through qualitative means; process

outcomes through the provision and use of incentives, provision and use

of services and parenting skills and knowledge; and outcome through

case flow, duration of time in care, patterns of disruption and rate of

dissolution and/or re-entry. A cost-benefit analysis would asses

whether the costs of the demonstration project are justified by the

benefit produced.

The second proposed component of Texas' demonstration project is to

use title IV-E funds for the assessment of prospective adoptive

children and families and to allow for joint training with Child

Placing Agencies (CPA) of CPA professionals providing adoption and

permanency services. The state's hypotheses are that a more

comprehensive assessment would reduce the disruption and dissolution

rate of PRS adoptions, decrease the average length of time that

children spend in foster care prior to adoptive placement, increase

satisfaction among children and families, decrease the number of

placements before placement in an adoptive home, and increase the

number of children leaving foster care for placements with adoptive

families. These improvements would speed permanency and reduce

expenditure of IV-E funds.

Texas proposes to implement this demonstration project in Harris

County, Houston and the counties surrounding Houston. To evaluate this

project, the state proposes to compare one region which would receive

an Enhanced Training condition and an Enhanced Assessment condition, to

other regions and to statewide historical data. The evaluation would

include implementation measures of a qualitative nature; process

measures including pool of potential families, assessment, quality of

placements and extension of training; and outcome measures such as case

flow, duration of time in care, patterns of disruption and rate of

dissolution and/or reentry into the Child Protective Services System. A

cost benefit analysis would assess whether the costs of the project are

justified by the benefits produced.

The third component of the proposal is to utilize title IV-E funds

flexibly as part of Phase II of the State's PACE project. The state-

funded Phase I of PACE is designed to contract for a network of private

providers to provide a continuum of services designed to improve

substitute care service and enhance PRC permanence initiatives. The

State requests a waiver of title IV-E for Phase II of PACE, to pay for

foster care services and child and family services on a per-child case

rate or capitated rate, to the network of providers established in

Phase I. PRS would test the impact of the case rate on an expansion of

service delivery model that is developed in Phase I.

The state hypothesizes that the new service delivery system would

result in improved child functioning, increased stability of

placements, shortened duration of care, reduced rate of return to

foster care, and maintenance of least restrictive placements. The state

hypothesizes that for Phase II, capitated rates would result in: cost

neutrality, the ability to provide a case rate for daily care and

supervision reimbursement, increased incentives for providers to

provide treatment and services to improve children's level of care

(LOC), increased ability to provide wraparound services for children

for quicker movement to permanency or for placement in the least

restrictive environment and increased incentive to provide preventive

services to lessen the need for high cost treatment/residential

services. Children would be placed by random assignment into an equal

number of PRS and Primary Contractor foster homes.

The state evaluation proposal would compare the outcomes of four

subgroups of LOC children in PACE Phase II, to three types of

comparison groups: randomly assigned control groups, statistically

matched cross-sectional comparison groups, and historical comparison-

sectional comparison. The state would measure: implementation through

qualitative means; process through continuity of care, expanded

services and satisfaction with services; and outcome through change in

LOC, change in level of care domains, change in rated individual goals,

duration of time, patterns of disruption, rate of reentry and rate of

maltreatment recurrence. A cost-benefit analysis would assess whether

the costs of the demonstration project are justified by the benefits

produced.

Contact Persons: Texas Department of Protective and Regulatory

Services, 701 W. 51st Street, P.O. Box 149030, Austin, TX 78714-9030,

Karen Eells (Kinship Care & Adoption), Judy Rouse (PACE), Phone: (512)

438-5712, Fax: (512) 438-3394.

State: Washington

Description: Washington State proposes to adopt a managed care

approach for services such as mental health and family preservation to

children who are IV-E eligible and children who are not. Under the

demonstration project, the State would make monthly payments for the

care of children with complex needs who have been screened into the

project. These funds would be pooled with other resources to contract

with local service providers for oversight of treatment plan

development, implementation, screening and training. The State

postulates that such coordination between the State and various local

service providers might result in a better use of resources, while also

providing individualized and comprehensive wraparound services. The

State hopes that such an approach would enable it to tailor services to

meet the real needs of families and children particularly those

children with special needs and problems.

Washington State would begin the project in Spokane county and

phase in other counties until a maximum of ten counties were included

in the demonstration project. The State would randomly assign children

to either the control or demonstration. The State proposes to evaluate

the project through random assignment comparison, pre/post comparison

and a cost-benefit analysis.

The State requests waivers of certain sections of title IV-E and

related regulations to allow expenditures on behalf of children and

families not normally eligible under title IV-E, and to allow

expenditures for services not normally permitted under title IV-E. The

State is also considering the possibility that it might request a

waiver of title XIX pertaining to Behavioral Rehabilitation Services.

Contact Person: Tammi Erickson, Office Chief, Office of Federal

Funding and Victims' Assistance, State of Washington Department of

Social and Health Services, P.O. Box 45710, Olympia, WA 98504-5710,

Phone: (360) 902-7936, Fax (360) 902-7903.

State: West Virginia

Description: West Virginia proposes a school based services

project, the Cabell County Adopt-A-Middle-School project. The project

would provide a variety of services for children in middle schools

(grades 6, 7, and 8) and their families, whether or not they would

otherwise qualify for the title IV-E. The purpose of the service

provision is to create a seamless social support system that

strengthens the ability of children and families to handle stress

affecting their lives by: facilitating school-based support for child

victims of abuse and neglect who can be kept in the home and community;

providing early identification of youth with delinquent tendencies in

order to link the child and family with services prior to the

initiation of court action; utilizing home

[[Page 37394]]

and community-based services whenever possible; ensuring EPSDT

screening and appropriate treatment for children in foster care; and

assisting the Department in maintaining linkages with schools for out-

of-home placement, facilitate return to school for the child and

family, and assist students who are new to the school district due to

foster or adoptive placements.

To accomplish these services, WV proposes a two-phase

demonstration. Phase one would pair community social services agencies

with middle schools in Cabell County as resources for information,

assessments, and referrals. Phase two proposes the hiring of full-time

prevention coordinators for each school, beginning with two schools and

phasing in additional schools as resources permit. Coordinators would

be school-based during the school year, would serve as initial case

managers and advocates for the child/family, provide direct services,

and provide follow-up with families over the summer months.

The State's hypothesis is that middle school-based prevention and

early intervention programs would result in a reduction of the number

of children in foster care, the average expense and intensity of foster

care, and the average number of days children are in foster care. This

project would be limited to Cabell County, in southwestern WV, which

includes six middle schools. The project is proposed to begin in

September 1998 and would run through August 2003.

The State requests waivers of title IV-E to permit reimbursement

for amounts expended for children and families and for purposes that

are not normally eligible under IV-E.

For evaluation purposes, the state proposes to identify a control-

group county. Outcome measures would include the number of children

entering foster care, the number of placements in community-based or

family settings, and the number of days the children are in foster

care. Process evaluation components include frequency and types of

intervention activities. An outside evaluator would conduct the

evaluation.

Contact Person: Joan E. Ohl, Secretary, Department of Health and

Human Resources, Bureau of Children & Families/Office of Social

Services, Charleston, West Virginia 25305, Phone: (304) 558-0684, Fax:

(304) 558-1130.

Dated: June 25, 1998.

James A. Harrell,

Deputy Commissioner, Administration on Children, Youth and Families.

[FR Doc. 98-18437 Filed 7-9-98; 8:45 am]

BILLING CODE 4184-01-M