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December 31, 2004

Administration for Children and Families
Office of Family Assistance
Aerospace Building, 5th Floor
370 L'Enfant Promenade, S.W.
Washington, D.C. 20447.

Attached is Indiana’s completed Annual Report on TANF Programs (Attachment A) and State Maintenance-of-Effort (MOE) Programs (Form ACF-204) (Attachment B). If you have any questions or need additional information please contact:

Jim Dunn, TANF IMPACT Program Manager
Division of Family & Children
402 W. Washington Street, Rm W363, MS 09
Indianapolis, IN 46204
317-232-4908
E-mail jdunn@fssa.state.in.us

Sincerely,

Stephen E. DeMougin, Director
Division of Family and Children
State of Indiana
Family and Social Services Administration

2004 Annual Report of TANF Programs Under 45 CFR 265.9(b)

1) The State’s definition of each work activity:

Families receiving cash assistance employment services through the Indiana Manpower Placement and Comprehensive Training (IMPACT) Program. The activities offered under this program include:

a) Unsubsidized employment:

This activity includes all work efforts or services provided which are compensated directly by an employer or through self-employment. The compensation for the work does not include state or federal funds.

b) Subsidized private sector employment:

This activity includes all work efforts or services provided which are compensated directly by an employer. The monetary compensation for work performed includes TANF funds or funds from other state or federal programs.

c) Subsidized public sector employment:

N/A

d) Work experience (including work associated with the refurbishing of publicly assisted housing) if sufficient private sector employment is not available:

Work Experience Training: Work Experience Training is paid work experience at a profit or non-profit business. This activity is designed to help participants develop work skills by providing actual experience in a work environment.

Community Work Experience Training: The Community Work Experience Training activity is offered to allow a participant who has not been able to obtain unsubsidized employment to begin to get work experience in an unpaid position. The participant is scheduled to work no more than the number of hours per month that is determined by dividing the TANF grant received by the participant’s family the federal minimum wage.

e) On-the-Job Training:

On-the-Job Training is an activity available only to an IMPACT participant who is working full-time in a permanent job in the private or public employment. The activity provides training to enable the participant to acquire the knowledge or skills necessary to keep the job or meet the requirements of an advanced position with the employer.

f) Job Search and Job Readiness assistance:

Job Search is the process that provides an individual assistance to find work. It includes activities such as job counseling, job seeking skills training, support in completing applications and resume development, and follow-up with potential employers.

Job Readiness in an activity that helps prepare an individual to enter the workforce through training on workforce expectations, conflict resolution, coping with job stress and employment retention. A participant in Job Readiness activities is also provided counseling to manage the changes in the family and household resulting from employment.
g) Community Service Programs:

N/A

h) Vocational Educational training (not to exceed 12 months with respect to any individual):

Vocational education is a short-term training activity that leads to the acquisition of competencies directly related to specific trade, occupation or vocation.

i) Job Skills Training directly related to employment:

Job Skills training is a short-term activity that leads to the acquisition of competencies directly related to specific trade, occupation or vocation.

j) Education Directly Related to employment, in the case of a recipient who has not received a high school diploma or a certificate of high school equivalency:

Educational activities include preparation for the General Education Development (GED) certificate. High School classes, Adult Basic Education classes, and English as a Second Language classes.

k) Satisfactory attendance at secondary schools or in a course of study leading to a certificate of general equivalence, in the case of a recipient who has not completed secondary school or received such a certificate:

Educational activates include preparation for the General Education Development (GED) certificate. High School classes, Adult Basic Education classes, and English as a Second Language classes.

l) Provision of child care services to an individual who is participating in a community service program:

N/A

2) The description of the transitional services provided to families no longer receiving assistance due to employment.

Upon becoming financially ineligible for TANF cash assistance a family can receive up to twelve months of child care services and Medicaid coverage. TANF families participating in IMPACT at the time of leaving TANF may also receive case management services for a period of at least 90 days.

3) The description of how a State will reduce the amount of assistance payable to family when an individual refuses to engage in work without good cause pursuant to 45 CFR 261.14

The needs of the parent or caretaker who refuses to engage in work without good cause are not included in the eligibility determination or in determining the amount of the TANF benefits provided to the family. The individual also loses his eligibility for Medicaid for Low Income Families for the duration of the sanction. If the sanction continues for two consecutive months, the family’s TANF benefit is terminated.

4) The average monthly number of payments for child care services made by the State through the use of disregards, by the following types of child care providers:

i. Licensed/regulated in-home child care;

N/A

ii. Licensed/regulated family child care;

N/A

iii. Licensed/regulated group home child care;

N/A

iv. Licensed/regulated center-based child care;

N/A

v. Legally operated (i.e., no license category available in State or locality) in-home child care provided by a non-relative;

N/A

vi. Legally operated (i.e., no license category available in State or locality) in-home child care provided by relative;

N/A

vii. Legally operated (i.e., no license category available in State or locality) family child care provided by a non-relative;

N/A

viii. Legally operated (i.e., no license category available in State or locality) family child care provided by a relative;

N/A

ix. Legally operated (i.e., no license category available in State or locality) group child care provided by a non-relative;

N/A

x. Legally operated (i.e., no license category available in State or locality) group child care provided by a relative; and

N/A

xi. Legally operated (i.e., no license category available in State or locality) center-based child care.

N/A

5) If the state has adopted the Family Violence Option and wants federal recognition of its good cause domestic violence waivers under 45 CFR 260.50-58, then provide (a) a description of the strategies and procedures in place to ensure that victims of domestic violence receive appropriate alterative services and (b) an aggregate figure for the number of good cause domestic waivers granted.

Indiana continues to develop a statewide domestic violence service network and has not fully implemented the Family Violence Option. TANF policies currently allow for exemptions to eligibility requirements and time limit extensions for victims of domestic violence. However, the domestic violence service infrastructure is believed to be insufficient to meet the service needs that would result from a full assessment of all cash assistance applicants and recipients.

6) A description of any non-recurrent, short-term benefits provided, including:
(i) The eligibility criteria associated with such benefits, including any restrictions on the amount, duration, or frequency;
(ii) Any policies that limit such payments to families that are eligible for TANF assistance or that have the effect of delaying or suspending a family’s eligibility for assistance; and
(iii) Any procedures or activities developed under the TANF program to ensure that individuals diverted from assistance receive information about, referrals to, or access to other program benefits (such as Medicaid and food stamps) that might help them make the transition from welfare to work.

Indiana administers the Emergency Assistance Program, but that program does not divert families from receiving assistance.

Indiana provides families the opportunity to apply for TANF, Food Stamps and Medicaid through an integrated application process at the point of contact with the agency.

Both the local and central offices of the Division of Family and Children perform outreach activities for Food Stamp and Medicaid programs. These activities include the provision of information and applications by agency staffs who serve potentially eligible families through other programs such as Healthy Families, First Steps, and Women, Infants, and Children (WIC) Program.

Emergency Assistance

Emergency Assistance is provided to families with income up to 250% of the Federal Poverty Guidelines. Eligibility for this program is based upon the existence of a substantiated complaint of child abuse or neglect or a court adjudication of Child in Need of Services. The goal of the program is to provide services in order to maintain children in the home of a relative or to provide safe, temporary living arrangements while the family is working towards re-unification.

The benefits provided under the program include shelter (including out-of-home placement), non-medical counseling, clothing and homemaker services. Services are authorized within 30 days of the identification of eligibility and need and can be authorized for a period not to exceed 120 days.

7) A description of the procedures the State has established and is maintaining to resolve displacement complaints, pursuant to section 407(f)(3) of the Social Security Act. This description must include the name of the State agency with the lead responsibility for administering this provision and explanations of how the State has notified the public about these procedures and how an individual can register a complaint.

The agency has worked closely with labor organizations to develop procedures that prevent the occurrence of displacement let alone complaints regarding it. Efforts are also made at the time of job placement to ensure that the vacant position into which a TANF participant is placed was not created due to layoff or involuntary reduction of staff. The work between the agency’s placement staff and employer prior to placement is critical in ensuring the success of placement and prevention of complaints. Labor organizations are also made aware of our involvement at the time of placement and informed to notify the Division of Family and Children in the event of any complaint regarding displacement resulting from the agency’s placement efforts.

Communication with the agency continues to be initiated between the employer and any TANF participant placed in the position. Both are reminded and encouraged to ask questions of and express concerns to the agency’s staff contact. The employer is further encouraged to discuss any other staff issues affected by this placement including complaints of displacement.

The worker or other office staff of the Division may also receive complaints regarding displacement. The worker or supervisor has the primary responsibility to resolve the complaint. If unable to resolve the situation locally, the complainant is encouraged to file for a fair hearing. If the complainant wished to request a fair hearing, the request is submitted to the Central Office and processed in accordance with the agency’s fair hearing process which conforms to the TANF, Food Stamp and Medicaid hearing procedures and timeliness.

8) A summary of State programs and activities directed at the third and fourth statutory purposes of TANF (as specified at 45 CFR 260.20 (c) and (d).

Indiana uses TANF funds to address pregnancy prevention services for unmarried women at or below 100% of the Federal Poverty Guidelines. Additionally, TANF funds are used to support a program for young males, which encourages the development of healthy relationships and sexual responsibility.

The Fatherhood Initiative uses TANF funds to support community based efforts that promote and restore fatherhood. TANF funds are use for projects that establish or expand effective fatherhood involvement strategies. The strategies are broad based and serve to promote fathers’ emotional and financial involvement in their children’s lives. Services include child development and responsible parenting classes, supervised visitation, employment placement and pregnancy prevention services.

9) An estimate of the total number of individuals who have participated in subsidized employment under 45 CFR 261.30 (b) or (c).

Indiana did not place anyone in subsidized employment during FFY 2004.

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: TANF Welfare Reform Demonstration (For all families except 2 parent)

2. Description of the Major Program Benefits, Services and Activities:

See TANF Plan.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

__X_ This Program is operated under the TANF Program

____ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $112,071,533

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $5,446,113

8. Total Number of Families served under the Program with MOE funds: $3,922

This last figure represents (check one):

__X_ The average monthly total for the fiscal year

____ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes_X_ No ____

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: TANF Welfare Reform Demonstration --- Two-Parent Program

2. Description of the Major Program Benefits, Services and Activities:

See TANF Plan.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

___ This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

See TANF Plan.

6. Total State Expenditures for the Program for the Fiscal Year: $7,895,984

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $7,895,984

8. Total Number of Families served under the Program with MOE funds: 3,331

This last figure represents (check one):

_X_ The average monthly total for the fiscal year

___ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Transportation and other assistance (for all families except two-parent)

2. Description of the Major Program Benefits, Services and Activities:

Provide bus passes, gas coupons, mileage reimbursement and vehicle repair payments that are short term or one time payments to employed individuals transitioning off of TANF assistance.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families in the form of transportation assistance.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $4,267,972

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $1,928,368

8. Total Number of Families served under the Program with MOE funds: 7,537

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana     Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Transportation and other assistance (Two-Parent Program)

2. Description of the Major Program Benefits, Services and Activities:

Provide bus passes, gas coupons, mileage reimbursement and vehicle repair payments that are short term or one time payments to employed individuals transitioning off of the
Two-Parent Program (SSP).

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families in the form of transportation assistance.

4. Program Type. (Check one)

___ This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $15,497,739

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $519,981

8. Total Number of Families served under the Program with MOE funds: 1,253

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Work Activities (for all families except 2-parent)

2. Description of the Major Program Benefits, Services and Activities:

Employment and training services including work activities (job readiness training, job search, etc.) and supportive services (transportation assistance, vehicle repair, clothing)

3. Purpose(s) of Benefit or Service Program:

Provide work related services to help TANF assistance families attain self-sufficiency.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year $5,677,065

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $2,567,789

8. Total Number of Families served under the Program with MOE funds: 6,930

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Work Activities for Families (Two-Parent Program)

2. Description of the Major Program Benefits, Services and Activities:

Employment and training services including work activities (job readiness training, job search, etc.) and supportive services (transportation assistance, vehicle repair, clothing)

3. Purpose(s) of Benefit or Service Program:

Provide work related services to help families in the Two-Parent Program attain self-sufficiency.

4. Program Type. (Check one)

____ This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $15,497,739

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $810,825

8. Total Number of Families served under the Program with MOE funds: 1,310

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Part Time Student Grant Program

2. Description of the Major Program Benefits, Services and Activities:

This is a financial assistance program designed to provide support for students taking at least six (6) but no more than twelve (12) hours of college classes per semester.

3. Purpose(s) of Benefit or Service Program:

End the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

____ This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

N/A as this is a non-assistance program.

6. Total State Expenditures for the Program for the Fiscal Year: $4,572,740

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $4,022,219

8. Total Number of Families served under the Program with MOE funds: 5,662

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

This program will provide financial assistance to students whose family’s income is less than 250% of the federal poverty level. Eligible students must be either:

a) a parent with a dependent child; or

b) a dependent student less than twenty-four (24) years of age who has a custodial parent or caretaker (even if the student lives apart from the parent or caretaker).

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Child Care Assistance

2. Description of the Major Program Benefits, Services and Activities:

Subsidized child care for low-income families.

3. Purpose(s) of Benefit or Service Program:

The program’s purpose is to help the parent and related caretakers of children under the age of 13 participate in employment or employment related activities.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

There are no work activities as this is not an assistance program.

6. Total State Expenditures for the Program for the Fiscal Year: $124,796,952

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $15,356,947

8. Total Number of Families served under the Program with MOE funds: 24,578
This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

TANF and CCDF funds are combined and administered as one program. Eligibility is consistent with the CCDF eligibility policies. Financial eligibility is base upon 141% of the Federal Poverty Guidelines. However once qualified a family can continue to receive assistance until the family’s income exceeds 180% of the Federal Poverty Guidelines.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditure in FY 1995.
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Individual Development Accounts

2. Description of the Major Program Benefits, Services and Activities:

Qualified individuals receive state funds which match their contributions to Individual Development Accounts (IDA). The State match is three times the amount deposited by the individual up to $900 per year.

3. Purpose(s) of Benefit or Service Program:

End the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

____ This Program is operated under the TANF Program

__X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program): N/A as this is a non-assistance program.

6. Total State Expenditures for the Program for the Fiscal Year: $779,992

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $616,147

8. Total Number of Families served under the Program with MOE funds: 692

This last figure represents (check one):

____ The average monthly total for the fiscal year

__X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Contributions to the IDA are provided for families with dependent children who receive public assistance or have incomes less than 150% of the federal poverty level.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Earned Income Tax Credit

2. Description of the Major Program Benefits, Services and Activities:

The benefit under his program is a refundable tax credit. The credit is equal to three and four-tenths percent (3.4%) of $12,000 minus the amount of the individual’s Indiana total income. If the credit amount exceeds the taxpayer’s adjusted gross income tax liability for the taxable year, the excess will be refunded to the taxpayer. The refunded amount is considered towards the State’s TANF maintenance of effort requirements.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

___ This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program): N/A as this is a non-assistance program.

6. Total State Expenditures for the Program for the Fiscal Year: $37,894,893

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year:
$34,998,880

8. Total Number of Families served under the Program with MOE funds: 315,568

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

This tax credit is available to an individual who, in a year, has at least one qualified child and total annual income less than $12,000 of which 80% or more is derived from earnings.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Two-Parent Family Administration

2. Description of the Major Program Benefits, Services and Activities:

Payment of expenses incurred in administration of the TANF program.

3. Purpose(s) of Benefit or Service Program:

Administration of the TANF program.

4. Program Type. (Check one)

____ This Program is operated under the TANF Program

__X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $253,541

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $253,541

8. Total Number of Families served under the Program with MOE funds: NA

This last figure represents (check one):

The average monthly total for the fiscal year

The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: TANF Administration

2. Description of the Major Program Benefits, Services and Activities:

Payment of expenses incurred in administration of the TANF program.

3. Purpose(s) of Benefit or Service Program:

Administration of the TANF program.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $26,440,964

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $12,158,236

8. Total Number of Families served under the Program with MOE funds: NA

This last figure represents (check one):

The average monthly total for the fiscal year

The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: TANF Welfare Automation

2. Description of the Major Program Benefits, Services and Activities:

State expenditures for the three primary computer systems used by Indiana in administering its TANF program: the TANF Welfare Reform Information Database, the Indiana Client Eligibility System (ICES), and the Indiana Child Welfare Information System (ICWIS).

3. Purpose(s) of Benefit or Service Program:

Provide computer systems for determining eligibility and benefits for TANF assistance and Emergency Assistance and generation of state and federal reports.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $2,836,986

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $1,034,548

8. Total Number of Families served under the Program with MOE funds: NA

This last figure represents (check one):

___ The average monthly total for the fiscal year

___ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: First Steps – Early Intervention (Medical)

2. Description of the Major Program Benefits, Services and Activities:

First Steps provides non-medical services with federal TANF dollars and provides medical services with state TANF MOE dollars.

First Steps - Early Intervention (Non-Medical)

Included under the non-medical category with federal funds are direct intervention for the following service categories: Developmental Therapy (special instruction), Service Coordination (case management), and Nutrition Services.

First Steps - Early Intervention (Medical)

Included under the medical category with state dollars are Evaluation/Assessment activities in the following service areas: Audiology, Health Services, Medical, Nursing, Occupational Therapy, Physical Therapy, Psychology, Speech Therapy, and Vision.

Included under the medical category are Direct Child Treatment in the following service areas: Audiology, Health, Occupational Therapy, Physical Therapy, Psychology, Speech
Therapy, Transportation and Vision.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program): N/A as this is a non-assistance program.

6. Total State Expenditures for the Program for the Fiscal Year: $58,982,850

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $12,696,670

8. Total Number of Families served under the Program with MOE funds: 1,795

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Medical services will be provided to children under age 3 who are living with a parent or eligible relative with family income under 250% of the Federal Poverty Guidelines. First Steps eligibility is established without regard to the child’s Medicaid eligibility.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Healthy Families

2. Description of the Major Program Benefits, Services and Activities:

Services under the Healthy Families Program include child development, parent education, and family incentives to encourage participation and improved child health outcomes.

3. Purpose(s) of Benefit or Service Program:

The Healthy Families Program is a voluntary, multifaceted home visitation program designed to promote healthy families and healthy children. Services can begin for eligible families either prior to or at the time of birth and can continue until the child is five years of age.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

N/A.

6. Total State Expenditures for the Program for the Fiscal Year: $36,529,049

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $4,849,638

8. Total Number of Families served under the Program with MOE funds: 12,124

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

This program is open to all Hoosier families with children age 0 to five years regardless of income. TANF State and federal funds are used solely for families with incomes below 250% of the federal poverty level.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana     Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Oil Overcharge Settlement Fund

2. Description of the Major Program Benefits, Services and Activities:

State expenditures from the state oil overcharge settlement fund provide utility assistance payments to maintain utility service for low-income households.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program): N/A as this is not an on-going assistance program.

6. Total State Expenditures for the Program for the Fiscal Year: $4,560,501

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $2,000,000

8. Total Number of Families served under the Program with MOE funds: 8,620

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

The family must meet TANF non-financial requirements and have income below 125% of the federal poverty level.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Children's Choice

2. Description of the Major Program Benefits, Services and Activities:

Services under the Children's Choice Program include:

•1. Information & Assistance: The goal of these services is to insure access, linkage, and follow-up procedures to available Children’s CHOICE benefits and services.
•2. Outreach: The goal of this service is to identify individuals eligible for Children’s CHOICE assistance and informs them of available assistance.
•3. Family and Caregiver Education: Provides training and/or education to a parent or primary caregiver of a child receiving CHOICE services.
•4. Specialized Child Care: This service provides assistance in paying for specialized childcare services to working parents/caregivers of a child receiving CHOICE services. Specialized Child Care may be used to pay for a formal child care worker if needed.

The Community and Home Options to Institutional Care for the Elderly and the Disabled (CHOICE) Program provides the following services to children age 18 and under who are living with their parent or eligible adult relative. To be eligible for TANF funded services the family's income must be under 250% of the Federal Poverty Guidelines.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

N/A.

6. Total State Expenditures for the Program for the Fiscal Year: $1,740,906.81

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $1,672,539

8. Total Number of Families served under the Program with MOE funds: 953

This last figure represents (check one):

____ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Program provides services to children age 18 and under who are living with their parent or eligible adult relative. To be eligible for TANF funded services the family's income must be under 250% of the Federal Poverty Guidelines.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ____ No __X_

11. Total Program Expenditure in FY 1995. $0

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Gambling Addictions

2. Description of the Major Program Benefits, Services and Activities:

The State of Indiana provides addiction treatment for TANF eligible family members.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

____ This Program is operated under the TANF Program

_X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $480,472

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $48,488

8. Total Number of Families served under the Program with MOE funds: 22

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

This program is for TANF eligible children of families whose income is less than 250% of the federal poverty guidelines.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $0
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Textbook Reimbursement Program

2. Description of the Major Program Benefits, Services and Activities:

The State of Indiana provides payment for the elementary and secondary school textbook rental fee of low-income families.

3. Purpose(s) of Benefit or Service Program:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

____ This Program is operated under the TANF Program

__X_ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $25,019,884

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $11,761,858

8. Total Number of Families served under the Program with MOE funds: 164,396

This last figure represents (check one):

____ The average monthly total for the fiscal year

__X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

This program is for TANF eligible children of families whose income is less than 185% of the federal poverty level.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditure in FY 1995. $7,526,815
(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: Indiana      Fiscal Year: 2004

Date Submitted: December 31, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: TANF Case Management

2. Description of the Major Program Benefits, Services and Activities:

Case management services such as applicant job search, application processing and other case related activities preformed by casework staff.

3. Purpose(s) of Benefit or Service Program:

Provide timely application processing and other services to needy families prior to the receipt of TANF assistance.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF Program

___ This Program is a separate state program.

5. Description of Work Activities in the SSP-MOE program (i.e., Complete only if this is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $1,256,501

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $454,539

8. Total Number of Families served under the Program with MOE funds: 31,348

This last figure represents (check one):

___ The average monthly total for the fiscal year

_X_ The total served over the fiscal year

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

See detailed explanation of the program in the TANF State Plan.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at § 260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditure in FY 1995. N/A

(NOTE: provide only of the response to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families”.

SIGNATURE:

NAME: Stephen E. DeMougin

Approved OMB No. 0970-0199 Form ACF-204, expires 6/30/2002

ACF-204

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