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Attachment B

U.S. Department of Health and Human Services
Administration for Children and Families
OMB Approval #0980-0047
Approved through October 31, 2008

CFS-101, PART II: Annual Summary of Child and Family Services Instructions

This form summarizes the State Agency's and eligible Indian Tribal Organization's (ITO) estimated expenditures on Child and Family Services programs, including the Child Abuse Treatment and Prevention Act (CAPTA) programs and the Chafee Foster Care Independence Program (CFCIP) including Education and Training Vouchers (ETV) for the next year. This information is an integral part of the State Child and Family Services Plan and should be discussed by the ACF Regional Office and State Agency Representatives. States should list estimated expenditures and other information in the category that best fits their programs.

For each of the services/activities listed, indicate in the appropriate columns the estimated expenditures by program, the estimated number of clients to be served, the population to be served and the geographic area to be served.

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Services/Activities

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Estimated Expenditures

  1. Federal Funds (columns a - f): Indicate for each service/activity the amount to be expended from the Federal program indicated in columns (a) through (f).
  2. State, Local and Donated Funds (column g): Indicate the estimated amount of State, local, and donated funds to be expended, even if they are not used to match Federal funds.
  3. Estimated Number to be Served (column h): Estimate, as accurately as possible, the number of individuals and families to be served by service/activity with the total estimated funding indicated.
  4. Population to be Served (column i): Indicate the population that has been targeted for the designated services. Targeting may include a range of vulnerable populations such as:
    1. Children at imminent risk of placement;
    2. All children in foster care;
    3. Families with children returning home following placement;
    4. All eligible children, eligible children under 21 years, or eligible children requiring treatment;
    5. Families with a child abuse or neglect investigation;
    6. Children in contracted care; or
    7. Families in crisis
  5. Geographic Area to be Served (column j): Indicate both the number and type of areas identified within the State where services are to be provided for each program. Areas may include specific regions, counties, cities, reservations, communities, census tracts, or neighborhoods. For example, if the State is operating family preservation programs in six counties, indicate by noting "6 counties"; if the State is operating 12 community-based family support programs, indicate by noting "12 communities".

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Attachments

PI 08-03
HTML or PDF (141 KB)

Attachment A: FFY 2008 Allocation Tables:

(FFY 2009 Estimated Allotments for Monthly Caseworker Visits funds are pending and will be released shortly.)

Attachment B: CFS-101

Attachment C: Children's Bureau Sampling Strategy for Caseworker Visits Data
HTML or PDF (13 KB)

Attachment D: Assurances and Certificates
HTML or PDF (61 KB)

Attachment E: Children's Bureau Regional Program Managers
HTML or PDF (16 KB)

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