Home > Laws & Policies > Policy/Program Issuances > Information Memoranda > IM-99-01

STATE ____________________________________________________________

The State information provided below will be considered permanent and will remain in effect unless rescinded
by the State, after notification in writing to the Commissioner, ACYF.

Name of Agency Administration the ILP: ________________________________________________

_______________________________________________________________________________

Employer Identification Number (EIN):    _______________________________________________

________________________________________________________________________________

ADMINISTRATION OF STATE

State Administered _________________________ County Administered _______________________^*

^* If county administered, please describe the following:

1.    The precise legal relationship between the State and the counties with regard to the ILP and the expenditure of funds.

    

   
   
   
   
   

2. How does the State enter into agreements with the counties’

    

   
   
   
   
   

3. Does the State delegate responsibility to the counties’

    

   
   
   
   
   

4. Are there written agreements’

    

   
   
   
   
   

5. Are there provisions for such agreements in State law or in the State plan’

   
   
   
   
   
   
   
   
   

STATE MATCHING INFORMATION

1. The State will apply for and match the additional funds over the $45 million basic amount.

   Yes   ________________*      No   __________________

   If yes, All   ______________________ or   ____________________

2. If funds become available through reallotment, the State will apply for and match these funds.

   Yes   _________________*      No   _______________________

   *If yes, All available   _______________________   or   $ ______________________

   ^*If yes to either item, indicate "ALL" or specify the amount of additional and the amount of reallotted funds the State will apply for and match (dollar-for-dollar).

ELIGIBLE POPULATION

1. The State elects to serve non-IV-E eligible youth.

   Yes   _________________*      No   _______________________

2. The State elects to serve former foster care youth.

   Yes   _________________*      No   _______________________

3. The State elects to serve youth up to age 21.

   Yes   _________________*      No   _______________________

   If yes to any of the above, describe how the State will integrate the additional client population into planning for and implementation to the ILP.

TRUST FUNDS

The State elects to establish trust funds for youth leaving foster care.

Yes   _________________*      No   _______________________

If yes, please describe:

1. How will the trust funds be financed’

   
   
   
   
   
   

2. How will the trust funds be integrated into the overall individual independent living plan’

   
   
   
   
   
   

3. What are the rules that will govern the use of and disbursement from such trust funds’

   
   
   
   
   
   

4. What safeguards will be employed to ensure that no Federal ILP funds contributed to the trust fund are later used for the provision of room and board’

   
   
   
   
   
   
   
   
   __________________________   ______________________
            Signature                                                     Title
   
   __________________________   ______________________
   

            Agency/Organization                                   Date

Attachments:

Attachment A:   ACYF-PI-93-16
Attachment B:   FY 1999 Independent Living Program Allotments

Certifications Regarding: (Links below will open up in another browser window)

Lobbying
SF-LLL, Disclosure of Lobbying Activities
Debarment, Suspension and Other Responsibility Matters

Attachment D:   List of ACF Regional Administrators