Attachment E
CFS-101, PART II: ANNUAL SUMMARY OF CHILD AND FAMILY SERVICES
OMB APPROVAL # 0980-0047
Approved Through 5/31/2002
State or IT ___________________________________________ For FFY OCTOBER 2, ____ TO SEPTEMBER 30, ____ DUE JUNE 30, ____
|
(k)
NUMBER TO BE SERVED
[ ] Families
[ ]
Individuals |
(l)
POP.
TO BE SERVED
|
(m)
GEOG.
AREA
TO BE
SERVED
|
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|
SERVICES/ACTIVITIES |
TITLE IV-B |
(c) |
(d) |
(e) |
(f) |
(g) |
(h)
Title XIX
(Medicaid) |
(i) |
(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) |
Reports of abuse/neglect |
Statewide/ |
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2) PROTECTIVE SERVICES |
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3) CRISIS INTERVENTION (FAMILY PRESERVATION) |
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|
(A) PREPLACEMENT PREVENTION |
All Children in foster care |
Statewide/ Reservation |
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(B)REUNIFICATION SERVICES |
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4. TIME-LIMITED FAMILY REUNIFICATION |
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5. ADOPTION PROMOTION AND SUPPORT SERVICES |
All egligible children |
Statewide/ Reservation |
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| 6) FOSTER CARE MAINTENANCE: (A) FOSTER FAMILY & RELATIVE FOSTER CARE |
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(B) GROUP/INST CARE |
Statewide/ Reservation |
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7) ADOPTION SUBSIDY PMTS. |
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8) INDEPENDENT LIVING SERVICES |
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9) ADMIN & MGMT |
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10) STAFF TRAINING |
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11) FOSTER 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 |
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* State only, Indian Tribes are not required to include information on these programs.
Attachments
Attachment A: Major ICWA
Requirements
Attachment B: ACYF-CB-PI-01-02, February
13, 2001
Attachment C: Title IV-B and CAPTA FY 2002 Estimated
Allotments
CFS-Instructions
CFS-101, Part I: Annual Budget Request for
Title IV-E, Subparts 1 and 2, CAPTA and Independent Living
Program
Budget Request Form
CFS-101, Part II