[Federal Register Volume 60, Number 173 (Thursday, September 7, 1995)]
[Notices]
[Pages 46616-46620]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-22230]



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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