Attachment IV
INSTRUCTIONS FOR THE PREPARATION OF THE
ANNUAL
SUMMARY OF CHILD WELFARE SERVICES
General: This form summarizes the State Agency's child welfare services program for the next year by service, by source of funds, and by number of clients to be served. The form is an integral part of the State Child Welfare Services Plan and should be discussed by Children's Bureau and State Agency Representatives. It is also a working document that presents an overview of the State Agency's planned program for the next year.
Specific:
Services/Activities
For each of the services/activities listed, include the type of information specified in the following explanation:
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Preventive/Supportive Services Including Protective Services
Services to strengthen and support intact families and to prevent family disruption and unnecessary removal of children from their homes. These may include casework or counseling, day care and respite care, homemaker services with a parent education component, family planning, legal services, services to unmarried parents, transportation, emergency shelter for families.
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Foster Care Maintenance Payments:
Payments to cover the cost of (and the cost of providing) food, clothing, shelter, daily supervision, school supplies, a child's personal incidentals, liability insurance with respect to a child, and reasonable travel to the child's home for visitation. In the case of institutional care, such terms shall include the reasonable costs of administration and operation of such institution as are necessarily required to provide the items described in the preceding sentence.
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Foster Care Services
Include services to the child, to the natural families and to the foster parents, including case plan development and periodic review of the placement.
Reunification services are those designed to help children, where appropriate, return to their families.
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Adoption
(a) Adoption Assistance Payments are the funds provided to adoptive parents on a recurring and periodic basis to assist in the support of special needs children.
(b) Medical Services for Adoption Assistance are provided to children who are adopted or are in the process of being adopted.
(c) Adoption services include the range of services provided for the purpose of obtaining and maintaining a permanent family for a child who is, or is expected to be, legally free for adoption. -
Administration and Management:
Includes costs of supervisors and staff whose activities support child welfare services and which cannot be allocated under other services/activities.
-
Day Care Related to Employment or Training for Employment:
This refers to day care purchased for the purpose of employment of one or both of the parents.
Estimated Expenditures for Child Welfare Services by
Program:
Federal Funds: Indicate for each service/activity the amount to be
expended from the Federal program indicated. Do not include the
State/local match. If other Federal funds will be used by the State
Agency, specify the other Federal programs in the space at the
bottom of the page.
State, Local
and Donated: List all State, local and donated funds, whether or
not they are used to match Federal funds.
Estimated Number of Clients to be Served
| Estimate as accurately as possible the number of clients to be served during the next year with these funds. Indicate whether clients are individuals or families. |
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Human Development Services
Regional Office Telephone Listing
| Region I | |
|
A. Kenton Williams Richard Stirling JFK Building |
Connecticut Maine Massachusetts New Hampshire Rhode Island Vermont |
| Region II | |
|
Miguel Torrado Dennis Coughlin Federal Building, 41st Floor |
New Jersey New York Puerto Rico Virgin Islands |
| Region III | |
|
Eileen Bradley Alvin Pearis Box 13716, 3535 Market Street, |
Delaware District of Columbia Maryland Pennsylvania Virginia West Virginia |
| Region IV | |
|
L. Bryant Tudor John L. Jordan 101 Marietta Tower, Suite 903, |
Alabama Florida Georgia Kentucky Mississippi North Carolina South Carolina Tennessee |
| Region V | |
|
Carolyn Woodard German White 13th Floor, |
Illinois Indiana Michigan Minnesota Ohio Wisconsin |
| Region VI | |
|
William Acosta Tommy Sullivan 1200 Main Tower Bldg., |
Arkansas Louisiana New Mexico Oklahoma Texas |
| Region VII | |
|
Linda J. Carson Hilton Baines Room 384, |
Iowa Kansas Missouri Nebraska |
| Region VIII | |
|
Lemm Allen David Chapa Federal Office Bldg., |
Colorado Montana North Dakota South Dakota Utah Wyoming |
|
Lucy Ellison Roy Fleischer Federal Office Building |
American Samoa Arizona California Guam Hawaii Nevada Trust Territory |
| Region X | |
|
Edward Singler William Hayden Third & Broad Bldg., M/S 413, |
Alaska Idaho Oregon Washington |
Attachments:
Attachment I - Certification of Eligibility for Additional
Funds Under Section 427 of the Social Security Act
Attachment
II - Annual Budget Request for Title IV-9 Funds
Attachment III
- Annual Summary of Child Welfare Services
