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Attachment

Revised 8/84

STATE CERTIFICATION OF ELIGIBILITY FOR ADDITIONAL FUNDS
UNDER SECTION 427 OF THE SOCIAL SECURITY ACT
(AS ENACTED BY P.L. 96-272, THE ADOPTION ASSISTANCE
AND CHILD WELFARE ACT OF 1980)

State of

I certify that             (name of designated agency) meets the requirements of section 427(a) specified below:

A. Has Completed An Inventory

427(a)(1)

An inventory of all children who have been in foster care under the responsibility of the State for a period of six months preceding the inventory, and

  1. determine the appropriateness of, and necessity for, the current foster care placement, whether the child can or should be returned to his or her parents or should be freed for adoption; and

  2. determined the services necessary to facilitate either the return of the child or the placement of the child for adoption or legal guardianship.


B. Has Implemented and is Operating a Statewide Information System

427(a)(2)(A)

A statewide information system from which the following data can readily be determined for every child currently in foster care and all children who have been in foster care within the preceding 12 months:

  1. demographic characteristic:

  2. legal custody status

  3. location; and

  4. placement goals.


C. Has Implemented and is Operating a Case Review System

(The language in this section varies somewhat from that used in Section 475 in the State Plan for title IV-E, in which the provisions are slightly more abbreviated. There is no variation in the substance of the provisions.)

(1) Case Plan

471(a)(16) 1. For each child receiving foster care maintenance payments, there is a written case plan (as defined in section 475 of the Act) which is a discrete part of the case record and available to the parent(s) or guardian of the foster child.
475(1)
45 CFR 1356.21(d)

2. The written case plan is developed within a reasonable period, but no later than 60 days from the time the State agency assumes responsibility for providing services, including placing the child.

3. The written case plan includes at a minimum the following:

  1. a description of the services offered and the services provided to prevent removal of the child from the home and to reunify the family;

  2. a description of the type of home or institution in which the child is to be placed;

  3. a discussion of the appropriateness of the placement and how the responsible agency plans to carry out the judicial determination made with respect to the child in accordance with section 472(a)(1);*

  4. a plan for assuring that the child receive proper care and that services are provided to the parents in order to improve the conditions in the parents' home to facilitate the child's return to his or her own home or the permanent placement of the child;

  5. a plan for assuring that services are provided to the child and foster parents in order to address the needs of the child while in foster care; and

  6. a discussion of the appropriateness of the services that have been provided to the child under the plan.



475(5)(A)
45 CFR 1356.21(d)
  1. the case plan for each child is designed to achieve placement in the least restrictive (most family like) setting available and in close proximity to the parent's home consistent with the best interest and special needs of the child.

*Section 472(a)(1) - "The removal from the home was the result of a judicial determination to the effect that continuation therein would be contrary to the welfare of such child and (effective October 1, 1983) that reasonable efforts of the type described in Section 471(a)(15) have been made."

 
  1. Case Review

    The State Agency has a case review system which meets the requirements of section 475(5) of the Act and assures that

475(5)(B)
  1. A review of each child's status is made no less frequently than once every six months either by a court or by an administrative review to:
    1. determine the continuing need for and appropriateness of the placement,

    2. determine the extent of compliance with the case plan,

    3. determine the extent of progress made toward alleviating or mitigating the cause necessitating the placement in foster care, and

    4. project a likely date by which the child may be returned home or placed for adoption or legal guardianship.


475(6)
  1. If an administrative review is made, the following requirements specified in section 475(6) are met:

    1. the review is open to the participation of the parent(s) of the child and

    2. the review is conducted by a panel of appropriate persons at least one of whom is not responsible for the case management of, or the delivery of services to either the child or the parent(s) who are the subject of the review.


475(5)(C)
  1. The State agency applies procedural safeguards with respect to each child in foster care under supervision of the State which include:

    1. a disposition hearing held in a family or juvenile court or another court (including a tribal court of competent jurisdiction) or by an administrative body appointed or approved by the court, no later than 18 months after the original placement (and periodically thereafter during the continuation of foster care) to determine the future status of the child (including whether the child should be returned to the parent(s), should be continued in foster care for a specific period, should be placed for adoption, or should (because of the child's special needs or circumstances) be continued in foster care on a permanent or long term basis, and

    2. procedural safeguards with respect to parental rights pertaining to the removal of the child from his or her parent's (s') home, to a change in the child's placement and to any determination affecting visitation privileges of the parent(s).


D. Has Implemented and is Operating a System of Reunification and Other Permanent Placement Services

427(a)(2)(C) A services program designed to help children, where appropriate, return to families from which they have been removed or be placed for adoption or legal guardianship.

The State Agency further certifies that in addition to the above requirement it

/ / has implemented

/ / has not implemented

the requirements of section 427(b)(3) for a preplacement preventative service program designed to help children remain with their families. Section 427(b) permits a State to transfer funds from title IV-E to title IV-B where the conditions in section 474(c)(4)(C) apply; claim FFP for a program of voluntary foster care placements under title IV-E; and avoid a reduction in funds to its Fiscal Year 1979 level for any fiscal year after any two consecutive fiscal years in which $266 million is appropriated for title IV-B.

Date Commissioner of Single State Agency
Date Director of Single Organizational Unit

TRIENNIAL REVIEW DECISION TABLE III

Review Supervisor

Telephone Number

State

Dates

1 2 3 4 5 6 7
Case Record
I.D.
Number Records
Reviewed
Acceptance
Number
Unacceptable*
Actual Cumulative
Rejection
Number
Reviewer's
Initial
Supervisor's
Initial
  1 -   -    
  2 -   -    
  3 -   -    
  4 -   -    
  5 -   -    
  6 -   -    
  7 -   -    
  8 -   -    
  9 -   -    
  10 -   10    
  11 -   11    
  12 -   11    
  13 -   11    
  14 -   11    
  15 -   11    
  16 -   11    
  17 -   11    
  18 -   12    
  19 -   12    
  20 -   12    
  21 -   12    
  22 -   12    
  23 -   12    
  24 -   12    
  25 -   13    
  26 -   13    
  27 -   13    
  28 -   13    
  29 -   13    
  30 -   13    
  31 -   14    
  32 -   14    
  33 -   14    
  34 -   14    
  35 -   14    
  36 -   14    
  37 -   14    
  38 -   15    
  39 -   15    
  40 -   15    
  41 -   15    
  42 -   15    
  43 -   15    
  44 -   15    
  45 0   16    
  46 0   16    
  47 0   16    
  48 0   16    
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  51 0   16    
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TRIENNIAL REVIEW DECISION TABLE IV

Review Supervisor

Telephone Number

State

Dates

1 2 3 4 5 6 7
Case Record
I.D.
Number Records
Reviewed
Acceptance
Number
Unacceptable*
Actual Cumulative
Rejection
Number
Reviewer's
Initial
Supervisor's
Initial
  1 -   -    
  2 -   -    
  3 -   -    
  4 -   -    
  5 -   -    
  6 -   -    
  7 -   7    
  8 -   7    
  9 -   7    
  10 -   8    
  11 -   8    
  12 -   8    
  13 -   8    
  14 -   8    
  15 -   8    
  16 -   8    
  17 -   9    
  18 -   9    
  19 -   9    
  20 -   9    
  21 -   9    
  22 -   9    
  23 -   9    
  24 -   10    
  25 -   10    
  26 0   10    
  27 0   10    
  28 0   10    
  29 0   10    
  30 0   10    
  31 0   11    
  32 0   11    
  33 1   11    
  34 1   11    
  35 1   11    
  36 1   11    
  37 1   11    
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Date

Review Supervisor (Signature)

*Accept = 0
Reject = 1