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Children's Bureau
Title IV-E Foster Care Eligibility Reviews
Fact Sheet

History and Purpose

The 1994 Amendments to the Social Security Act (SSA) authorize the U.S. Department of Health and Human Services (HHS) to review State child and family services programs to ensure compliance with the requirements in titles IV-B and IV-E of the SSA. This includes assessing the title IV-E Foster Care Program, which provides funds to States to assist with the costs of foster care maintenance for eligible children; administrative expenses to manage the program; and training for staff, foster parents, and private agency staff.

In 2000, the HHS published a final rule in the Federal Register to establish a new approach to monitoring State child welfare programs. Under the rule, States are assessed for substantial compliance against certain Federal requirements of title IV-E regarding the following:

• The eligibility of the children on whose behalf the foster care maintenance payments are made, including:
• Judicial determinations regarding reasonable efforts and contrary to the welfare
• Voluntary placement agreements
• Responsibility for placement and care vested with the State agency
• Placement in a licensed foster family home or child care institution
• The child's eligibility for Aid to Families With Dependent Children (AFDC) under the State plan that was in effect on July 16, 1996 (at the child's removal from the home, the AFDC financial need determination is based on the family's income; after 1 year in foster care, AFDC financial need must be redetermined and is based on the child's income).
• Allowable payments made to foster care providers
• The Children's Bureau, Administration for Children and Families (ACF), HHS, administers the IV-E program and the reviews.

Title IV-E Foster Care Eligibility Reviews

The reviews of the IV-E program (FC eligibility reviews), conducted by a team of Federal and State child welfare agency representatives, focus on whether a child meets the statutory eligibility requirements for foster care maintenance payments. Title IV-E foster care funds enable States to provide foster care for children who were or would have been eligible for assistance from AFDC (as of July 16, 1996) but for removal from their home.

The review team examines a sample of cases for Federal eligibility requirements to determine whether:

• A court order has confirmed the need to remove the child from the home


• A court order has confirmed the State agency's reasonable efforts to preserve the family, when it is safe to do so, and to finalize a permanency plan


• Safety requirements for foster parents and child care institutions have been satisfied


• Foster care providers are licensed


• A worksheet has confirmed the child's AFDC eligibility


• State responsibility for placement and care of the child has been confirmed through a court order or voluntary placement agreement

The Review Process

During the onsite review, the review team examines child case records, including placement and payment histories, court orders, and other relevant case material, including provider licensing and provider safety documentation. They complete a Title IV-E Foster Care Eligibility Onsite Review Instrument and Instructions for each case in which at least one IV-E foster care maintenance payment was made during the 6-month period under review. The review is conducted onsite, typically in the State capital where the State child welfare central office is located, during a 5-day period.

States receive a primary review and, when necessary, a secondary review. In the primary reviews, a sample of 80 foster care cases is examined to ensure that children for whom IV-E payments are being made meet the Federal eligibility requirements. If five or more cases in the primary review do not meet the Federal requirements, the State is determined not to be in substantial compliance. Regardless of the compliance determination, a disallowance in Federal financial participation funds is assessed for all cases that do not meet Federal requirements. States determined to be in substantial compliance based on the primary review are reviewed at 3-year intervals. States determined not to be in substantial compliance are required to develop and implement a Program Improvement Plan (PIP) to correct the areas of noncompliance. Within a year after the PIP is completed, the Children's Bureau conducts a secondary review that assesses a sample of 150 cases. After the secondary review, if the State still is not in compliance, a disallowance is assessed on the basis of the State's total foster care population for the 6-month review period. Regardless of the compliance determination, a disallowance in Federal financial participation funds is assessed for all cases that do not meet Federal requirements.