ACYF-CB-IM-01-11 - Title IV-E Foster Care Eligibility Review Guide

Chapter 3 On-Site Reviews

Advance Preparation for the On-Site Review

The ACF Central Office Team Leader for Eligibility Monitoring serves as the contact point for questions and concerns before, during, and after the on-site review

ACF Central Office Responsibilities

Develop a national review schedule based on information provided by the ACF Regional Offices with input from States.
Identify the ACF Central Office review team member(s) and ensure that each team member is available for the entire review period.
Provide the ACF Central Office reviewer(s) with training and preparation to participate as reviewers or in a leadership role.
Consult with the ACF Regional Office and the State agency on the sample and issues needing particular attention in the review.
Provide from the AFCARS data a listing of random numbers that will be used to identify the sample of cases to be reviewed on site, and work with the ACF Regional Office to provide the sample to the State agency, no less than 60 calendar days before the on-site review.
Coordinate, in collaboration with the ACF Regional Office, the transportation and lodging of the ACF Central Office team member(s).

ACF Regional Office Responsibilities

Transmit to State agency officials within 120 calendar days before the on-site review a written confirmation of the scheduled primary or secondary review and notify the State agency of material it is required to provide before and during the on-site review. (See "Sample State Notification Letter," Appendix II.)
Assign an overall review team leader and identify other ACF Regional Office staff, including a fiscal specialist, to serve on the review team.
Consult with the ACF Central Office and State agency staff about the review team size and composition, including representatives from other ACF Regional Offices or States, if appropriate.
Coordinate with the ACF Central Office to obtain the random sample of foster care cases from the AFCARS to be reviewed on site.
Arrange for and lead conference calls among the ACF Central and Regional Offices, and the State agency, as needed, to discuss issues that may need clarification before the on-site review, for example, sampling, case payment history, State policy on AFDC and title IV-E eligibility, and electronic files.
Coordinate the orientation and training of review team members.
Consult with State agency staff and the ACF Central Office to discuss how the State Automated Child Welfare Information System (SACWIS) or other electronic files support the State's eligibility process, and the system's role in facilitating the on-site review, if electronic files will be used during the on-site review. It is expected that the ACF Regional Office will become familiar with the State's automated system before the pre-review conference call and on-site review. (See "Electronic Files," Chapter 3.)
Develop the agenda for the review in collaboration with the State agency and lead the entrance and exit conferences.
Request advance copies of information from the State agency at least 120 calendar days before the on-site review, ensure that all Federal team members have copies of materials, and become familiar with materials, for example, policy on eligibility determinations, case record format, criminal background check processes, safety requirements, sample court orders, agreements for placement and care (§472(a)(2) of the Act), and payment and placement histories for the sample cases. The request for advance material from the State agency may be included in the letter that confirms the date of the on-site review. (See "Sample State Notification Letter," Appendix II.) The ACF Regional Office team leader must be familiar with the State's AFDC plan as it was in effect on July 16, 1996, or earlier; the eligibility determination process; and the most recently approved title IV-E plan and amendments.
Designate one or more team members to perform quality control functions during the on-site review in order to ensure consistency, objectivity, and accuracy in reviewing cases.

State Agency Responsibilities

Assign a State coordinator for the review to act as the liaison with the ACF Regional Office in making arrangements for the review.
Ensure that all State reviewers are oriented to the review process and are available for the entire review week.
Consult with the ACF Regional Office staff on logistical arrangements for the review, including the identification of locations for entrance and exit conferences.
Ensure that all sample and oversample case files are available and ready for review.
Provide information requested by the Federal team leader at least 90 calendar days before the on-site review, for example, policy on eligibility determinations, case record format, and safety requirements. Material may be transmitted electronically.
Provide payment and placement histories to the Federal team leader at least 60 calendar days before the on-site review. Material may be transmitted electronically.

Case Selection and Review

Sample of Cases Reviewed

The ACF Central Office statistician selects the sample of foster care cases to be reviewed on site from the most recent AFCARS data and transmits the sample by e-mail to the State agency. The ACF Regional Office may request a stratified sample to ensure the sample proportionally represents the title IV-E foster care population when the State agency has a title IV-E agreement for placement and care with another public agency, such as the juvenile justice agency or a federally recognized tribal agency.

Cases selected for the sample must have a related title IV-E foster care maintenance payment during the 6-month period under review (PUR). Before the on-site review, the State coordinator must record the reason for eliminating any cases from the sample of cases that will be reviewed on site and furnish that information to the ACF Regional Office team leader.

Preparation of Case Records for Review

Case records must be organized and up to date. The tagging, labeling, or segregating of sample case documents to identify specific material pertaining to the PUR or on-site review is not encouraged or recommended. Nor is it recommended that separate case folders be established primarily for the on-site review. The State agency must make sure that all documents needed to substantiate individual child and provider eligibility in each of the sample cases are available to the review team. The review team will not infer or speculate about the eligibility of a child or provider. The determination of case compliance must be supported by the appropriate documentation, even when the State agency placed a child with an out-of-state foster care provider and the placing State agency retained placement and care responsibility of the child. If acceptable documentation is not provided during the on-site review, the case may be assigned a preliminary finding of undetermined. Subsequently, if acceptable documentation is not provided before the issuance of the final report of review findings the case will be determined to be in error.

Sample case records being reviewed must be available at the review site so that the reviewers will have access to pertinent case material. Furthermore, the State agency must provide any records maintained separately, i.e., provider records and/or eligibility records necessary for the review. During the on-site review, the reviewer typically should be able to examine the child's entire case record, family record, and provider licensing file. This allows for a thorough review of the child's placement beginning from entry into foster care and extending throughout the life of the foster care episode. It also affords the review team better insight into how the State implements the foster care maintenance payment program, and provides the State agency an opportunity to receive immediate training and technical assistance on site. The ACF authority for requiring access to sample case records is included in the Federal regulations at 45 CFR Parts 92 and 1356. The following list provides general guidelines concerning pertinent case documentation:

>The child's service records, including all court orders, must be available for review to establish that the judicial requirements of "contrary to the welfare" and "reasonable efforts" are met for initial and ongoing eligibility concerning children who are judicially removed. The voluntary placement agreements and subsequent court orders must be available for review to establish that the initial and ongoing requirements are met for children who are removed pursuant to a voluntary placement agreement.
The foster family home provider's licensure file must contain, at a minimum, the licensing history and a copy of the provider license, certificate, or letter of approval that verifies licensure status and type covering the entire PUR. The license/letter should include the provider name, provider type, starting and ending date of licensure, and some indication of the State agency's endorsement. For those States that have not opted out of the criminal records check requirement, documentation that a criminal records check has been conducted and that the prospective foster parent has not been convicted of any of the felonies enumerated in �471(20)(A)(i) and (ii) of the Act also must be provided. For those States that have opted out of the criminal records check requirement, documentation that verifies that safety considerations with respect to the prospective foster parent have been addressed must be provided.
The childcare institution's licensure file must contain, at a minimum, the licensing history and a copy of the provider license or letter of approval that verifies licensure status and type covering the entire PUR. The license/letter should include the institution name, institution type, starting and ending date of licensure, and an indication of the State agency's endorsement. The licensing record must contain documentation verifying that safety considerations with respect to the staff of the institution have been addressed.
For the initial AFDC determination of the child's financial need and deprivation, the child's case file should contain documentation verifying that the family's financial need is evaluated, including resources, and indicating the reason that the child is deprived of parental support or care. The manner used to substantiate that the school attendance criterion is satisfied for the 18-year-old youth should be included as well. At a minimum, the documentation should include an eligibility worksheet that contains the name of the household for which the child's AFDC eligibility is based, period of eligibility, eligibility decision, basis of eligibility decision, and an indication of the State agency's sanction of the decision, such as a supervisory signature on the worksheet. The eligibility worksheet or summary should provide a clear, evidence-based path to the eligibility decision. The documentation should verify whether the child is AFDC eligible during the month the voluntary placement agreement is signed or the month the removal petition is filed, or removal court order is granted if a petition is not filed.
At annual intervals, there should be documentation that the AFDC-related criteria are re-determined. The documentation, at a minimum, should include an eligibility worksheet that contains the eligibility decision, period of eligibility, basis of decision, and an indication of the State agency sanction of the eligibility decision, such as a supervisory signature on the worksheet. The eligibility worksheet or summary should provide a clear, evidence-based path to the eligibility decision. The documentation should verify whether the child is AFDC eligible during the entire PUR.

For further information on the review procedures pertaining to the title IV-E foster care eligibility requirements, refer to Chapter IV of this review guide.

Use of Electronic Files for Review

The State agency may use electronic files to substantiate title IV-E eligibility. If electronic files are used on site, the State agency should make computers and technical assistance available to the reviewers for viewing the electronic records or obtain hard copies of all the files or portions of the files that contain information relevant to the review. The State agency must provide training to the review team members to acquaint the team with the State's child welfare data system, and provide staff to assist reviewers in obtaining documentation that verifies the child's eligibility. The electronic files may be used to provide evidence of: the child's removal as a result of judicial determinations of "contrary to the welfare" and "reasonable efforts" or via a voluntary placement agreement; responsibility for placement and care vested with State agency; placement in a licensed foster family home or childcare institution; eligibility for AFDC under the State plan as it was in effect on July 16, 1996; and verification of safety requirements for children placed in foster care.

Before the on-site review, the ACF Regional Office should request that the State agency demonstrate how the automated system sustains the functional aspects of the eligibility program, such as provider licensing, AFDC eligibility determination, and court documentation. Perusal of ACF Action Transmittal (AT) ACF-OSS-05 and consultation with the ACF Office of State Systems will assist the ACF Regional Office in assessing the extent to which the State's automated system will support the on-site review and alleviate the State agency's burden to reproduce paper documentation. The AT ACF-OSS-05, issued August 21, 1998, provides guidance to States with State Automated Child Welfare Information Systems concerning the level of automation required for supporting title IV-E eligibility determination, and lists a number of approaches States may take to automate the determination process. This document is located on the Children's Bureau Web site at http://www.acf.hhs.gov/programs/cb/systems/sacwis/at98.htm.

The ACF Regional Office also should become familiar with the State statutes and administrative policies on electronic files, including signature and document authentication. It is expected that the State's automated system will document the data used to establish child and provider eligibility and apply all eligibility factors consistently and accurately in every eligibility determination. The ACF Regional Office's assessment of the automated process should entail a basic exploration of:

source of eligibility data in the system;
how data is input into the system;
how financial eligibility, legal decisions, and provider licensure/approval (including safety considerations) are determined and documented;
how eligibility decisions are sanctioned by the agency;
policy for accepting or certifying electronic signatures;
how the system captures all of the necessary factors considered in calculating eligibility;
how the system ensures that the eligibility rules are applied uniformly in every eligibility determination;
how data accuracy is ensured;
how data is maintained, updated, and secured; and
how agency sanction of eligibility decisions and case actions is documented.

The above information is not intended to be an exhaustive list of all the factors to consider in examining the State's automated system. In general, the State agency should demonstrate to the satisfaction of the ACF Central and Regional Offices that the automated system is a valid representation of the State's business practice and policy pertaining to the eligibility determination process. A comparison of information in actual case records to that contained in the electronic files also will help the ACF Regional Office determine the validity of the State agency's automated system and degree of representation.

On-Site Review Instrument and Instructions

The On-Site Review Instrument and Instructions (checklist) used for the review will be provided to the team by the ACF Regional Office or its designee (at least 100 copies for the primary review). Copies of the On-Site Review Instrument also are available on the Children's Bureau Web site at www.acf.hhs.gov/programs/cb. (See "On-Site Review Instrument and Instructions," Appendix I; see also "Title IV-E Eligibility Criteria for the Foster Care Maintenance Payments Program," Appendix VII; and "Title IV-E Foster Care Eligibility Chart," Appendix XI.)

An On-Site Review Instrument is completed for each sample case in which at least one title IV-E foster care maintenance payment is made during the PUR. If the child exits and subsequently re-enters foster care during the PUR, an On-Site Review Instrument is completed for each foster care entry during the PUR.

On-Site Review Activities

It is preferable to conduct the review in one large room rather than several small rooms to allow for effective interaction among the team members. The room should be accessible to the review team at all times and secure to protect the confidentiality of the case records. Team members are expected to be flexible about their working hours in order to complete the review of all cases in the allotted 5 working days.

The State agency schedules the following activities for the on-site review:

An entrance conference for Federal staff to meet with the review team members to discuss the structure and agenda of the week's activities and provide opportunities to raise and clarify issues pertinent to the review. This usually requires approximately 1 hour. State officials should be invited to attend the entrance conference.
An orientation of the review team members at the start of the review to the On-Site Review Instrument, the orientation questions, the case record format, electronic files, if any, and the functions of the review team. The ACF Regional Office typically conducts the orientation to the On-Site Review Instrument. The State is responsible for providing information in response to the orientation questions. From 1 to 3 hours should be set aside to complete these activities. (See "Recommended Topics for Discussion by the Title IV-E Foster Care Eligibility Review Team During the Pre-Review Conference Call and Before Reviewing Records On-Site," Appendix IV.)
A meeting of the entire review team at the end of the review week to compile a summary of error cases, if any, to discuss the model practices and areas in need of improvement that were revealed during the review, and to prepare for the exit conference. Team members also may raise concerns and offer suggestions that will help to improve the review process, on-site review activities, and the On-Site Review Instrument. About 1 to 2 hours should be allotted for the review team debriefing.
An exit conference for Federal staff to meet with the senior management staff identified by the State agency. During this conference, the ACF staff provide an overview of tentative findings of the review, discuss next steps, and raise and clarify issues related to the review or the findings. It is usually sufficient to allow 1 hour to complete the exit conference. The entire review team should be present for the exit conference.