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Attachment F
OMB Approval # 0980-0047
Approved Through July 31, 2005
State or IT ___________________________________________ For FFY October, ____ to September 30, ____
blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | (k) Number to be served [ ] Families [ ] Individuals |
(l) Pop. to be Served |
(m) Geog. Area to be Served |
|
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Services/Activities | Title IV-B | (c) CAPTA* |
(d) CFCIP* |
(e) Title IV-E |
(f) Title XX(SSBG) |
(g) Title IV-A |
(h) Title XIX (Medicaid) |
(i) Other Fed Prog |
(j) State Local Donated Funds |
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(a) I-CWS |
(b) II-PSSF |
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1) Prevention
& Support Services (Family Support) |
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of abuse/neglect |
Statewide/ Reservation |
2) Protective Services | blank cell | shaded cell | blank cell | shaded cell | shaded cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell |
3) Crisis
Intervention (Family Preservation) |
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(A) Preplacement Prevention | blank cell | blank cell | blank cell | shaded cell | shaded cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | All children in foster care |
Statewide/ Reservation |
(B) Reunification Services | blank cell | blank cell | blank cell | shaded cell | shaded cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell |
4) Time-Limited Family Reunification Services |
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5.) Adoption Promotion and Support Services |
blank cell | blank cell | shaded cell | shaded cell | shaded cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | All eligible children | Statewide/ Reservation |
6.) Foster Care
Maintenance: (A) Foster Family & Relative Foster Care |
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(B) Group/Inst Care | blank cell | shaded cell | shaded cell | shaded cell | blank cell | shaded cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | Statewide/ Reservation |
7) Adoption Subsidy Pmts. | blank cell | shaded cell | shaded cell | shaded cell | blank cell | shaded cell | shaded cell | shaded cell | shaded cell | blank cell | blank cell | blank cell | blank cell |
8) Independent Living Services | blank cell | blank cell | shaded cell | blank cell | blank cell | shaded cell | shaded cell | shaded cell | shaded cell | blank cell | shaded cell | shaded cell | shaded cell |
9) Admin & Mgmt | blank cell | blank cell | shaded cell | shaded cell | blank cell | shaded cell | shaded cell | shaded cell | shaded cell | blank cell | shaded cell | shaded cell | shaded cell |
10) Staff Training | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | shaded cell | shaded cell | blank cell | blank cell | shaded cell | shaded cell | shaded cell |
11) Training Parent
Recruitment & Training |
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12) Adoptive Parent
Recruitment & Training |
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13) Child Care Related to Employment/Training |
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14) Total | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | blank cell | shaded cell | shaded cell | shaded cell |
* States only, Indian Tribes are not required to include information on these programs.
ACYF-CB-PI-04-02 HTML or PDF (328 KB) | |
Attachment A: | Promoting Safe and
Stable Families (PSFF) Tribal FY 2004 Allocations HTML or PDF (9 KB) Title IV-B, Subpart 1 - Child Welfare Services Tribal Child Population and Federal Share of Funds Fiscal Year (FY) 2004 Allotments HTML or PDF (28 KB) |
Attachment B: | Current Variances in Title IV-B
Provisions of Law and Regulation HTML or PDF (93 KB) |
Attachment C: | CFSP/APSR Program Instruction (PI)
Grid HTML or PDF (81 KB) |
Attachment D: | Preparing for the FY 2005-2009
Tribal Child and Family Services Plan HTML or PDF (14 KB) |
Attachment E: | Title IV-B Child And Family
Services Plan: Assurances HTML or PDF (14 KB) |
Attachment F: | CFS-101, Part I: Annual Budget
Request for Title IV-B, Subparts 1 and 2, CAPTA, Chafee Foster Care
Independence (CFCIP) and Education and Training Voucher (ETV)
Program Instructions HTML or PDF (15 KB) CFS-101, Part II: Annual Summary of Child and Family Services Instructions HTML or PDF (17 KB) CFS-101, Part II: Annual Summary of Child and Family Services Form HTML or PDF (23 KB) |
Attachment G: | Regional Administrators HTML or PDF (67 KB) |