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Home > Laws & Policies > Policy/Program Issuances > Program Instructions > PI-08-03 > Attachment D: Assurances and Certificates

Attachment D

Assurances and Certificates

The State/Tribe assures that not more than 10 percent of each fiscal year's title IV-B, subpart 1 funds (including FY 2007) will be spent on administrative costs beginning October 1, 2007.

 

__________________________________________________________
State Director of State Agency
that administers titles IV-E and
IV-B of the Social Security Act.

 

_______________________
Date

 

OR

 

__________________________________________________________
Tribal Leader

 

_______________________
Date

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Title IV-B Child and Family Services Plan: Assurances

The assurances listed below are in 45 CFR 1357.15(c) and title IV-B sections 422(b)(10), 422(b)(12), section 422 (b) (14), section 432(a)(4), 432 (a)(7) and 432(a)(9). These assurances will remain in effect during the period of the current five-year CFSP.

  1. The State assures that it will participate in any evaluations the Secretary of HHS may require.
  2. The State assures that it will administer the CFSP in accordance with methods determined by the Secretary to be proper and efficient.
  3. The State assures that it has a plan for the training and use of paid paraprofessional staff, with particular emphasis on the full-time or part-time employment of low-income persons, as community service aides; and a plan for the use of non-paid or partially paid volunteers in providing services and in assisting any advisory committees established by the State.
  4. The State assures that standards and requirements imposed with respect to child care under title XX shall apply with respect to day care services, if provided under the CFSP, except insofar as eligibility for such services is involved.
  5. The State assures that it is operating, to the satisfaction of the Secretary:
    • a statewide information system from which can be readily determined the status, demographic characteristics, location, and goals for the placement of every child who is (or, within the immediately preceding 12 months, has been) in foster care;
    • a case review system (as defined in section 475(5) for each child receiving foster care under the supervision of the State;
    • a service program designed to help children-where safe and appropriate, return to families from which they have been removed; or be placed for adoption, with a legal guardian, or, if adoption or legal guardianship is determined not to be appropriate for a child, in some other planned, permanent living arrangement; and
    • a preplacement preventive services program designed to help children at risk of foster care placement remain safely with their families; and
    • The State assures that it has implemented policies and administrative and judicial procedures for children abandoned at or shortly after birth that are necessary to enable permanent decisions to be made expeditiously with respect to the placement of such children.
  6. The State assures that plans will be developed for the effective use of cross-jurisdictional resources to facilitate timely adoptive or permanent placements for waiting children.
  7. The State assures that it will collect and report information on children who are adopted from other countries and who enter State custody as a result of the disruption of an adoptive placement, or the dissolution of an adoption. Such information will include the reasons for disruption or dissolution, the agencies who handled the placement or adoption, the plans for the child, and the number of children to whom this pertains.
  8. The State assures that no more that 10 percent of expenditures under the plan for any fiscal year with respect to which the State is eligible for payment under section 434 of the Act for the fiscal year shall be for administrative costs and that the remaining expenditures shall be for programs of family preservation services, community-based family support services, time-limited reunification services and adoption promotion and support services, with significant portions of such expenditures for each such program.
  9. The State assures that Federal funds provided to the State for title IV-B, Subpart 2 programs will not be used to supplant Federal or non-Federal funds for existing services and activities.
  10. The State assures that, in administering and conducting service programs under this plan, the safety of the children to be served shall be of paramount concern.

Effective Date and State Officials Signature

I hereby certify that the State complies with the requirements of the above assurances.

Certified by: ________________________________________________

Title:______________________________________________________

Agency:____________________________________________________

Dated:_____________________________________________________

Reviewed by:_______________________________________________

        (ACF Regional Representative)

Dated:_____________________________________________________

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State Chief Executive Officer's Certifications for the
Chafee Foster Care Independence Program

As Chief Executive Officer of the State of _______________________, I certify that the State has in effect and is operating a Statewide program relating to Foster Care Independent Living and that the following provisions to effectively implement the Chafee Foster Care Independence Program are in place:

  1. The State will provide assistance and services to youth who have left foster care because they have attained 18 years of age, and have not attained 21 years of age [Section 477(b)(3)(A)];
  2. Not more than 30 percent of the amounts paid to the State from its allotment for a fiscal year will be expended for room and board for youth who have left foster care because they have attained 18 years of age, and have not attained 21 years of age [Section 477(b)(3)(B)];
  3. None of the amounts paid to the State from its allotment will be expended for room or board for any child who has not attained 18 years of age [Section 477(b)(3)(C)];
  4. The State will use training funds provided under the program of Federal payments for foster care and adoption assistance to provide training to help foster parents, adoptive parents, workers in group homes, and case managers understand and address the issues confronting adolescents preparing for independent living, and will, to the extent possible, coordinate such training with the independent living program conducted for adolescents [Section 477(b)(3)(D)];
  5. The State will adequately prepare prospective foster parents with the appropriate knowledge and skills to provide for the needs of the child before a child, under the supervision of the State, is placed with prospective foster parents and that such preparation will be continued, as necessary, after the placement of the child. [Section 471(a), as amended];
  6. The State has consulted widely with public and private organizations in developing the plan and has given all interested members of the public at least 30 days to submit comments on the plan [Section 477(b)(3)(E)];
  7. The State will make every effort to coordinate the State programs receiving funds provided from an allotment made to the State under subsection (c) with other Federal and State programs for youth (especially transitional living youth projects funded under part B of title III of the Juvenile Justice and Delinquency Prevention Act of 1974); abstinence education programs, local housing programs, programs for disabled youth (especially sheltered workshops), and school-to-work programs offered by high schools or local workforce agencies [Section 477(b)(3)(F)];
  8. Each Indian tribe in the State has been consulted about the programs to be carried out under the plan; there have been efforts to coordinate the programs with such tribes; and benefits and services under the programs will be made available to Indian youth in the State on the same basis as to other youth in the State [Section 477(b)(3)(G)];
  9. Adolescents participating in the program under this section will participate directly in designing their own program activities that prepare them for independent living and the adolescents will be required to accept personal responsibility for living up to their part of the program [Section 477(b)(3)(H)]; and
  10. The State has established and will enforce standards and procedures to prevent fraud and abuse in the programs carried out under the plan [Section 477(b)(3)(I)].

_______________________________________________
Signature of Chief Executive Officer

___________________________________________
Date

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State Chief Executive Officer's Certification
for the
Education and Training Voucher Program
Chafee Foster Care Independence Program

As Chief Executive Officer of the State of _______________________, I certify that the State has in effect and is operating a Statewide program relating to Foster Care Independent Living and that the following provisions will be implemented as of September 30, 2003:

  1. The State will comply with the conditions specified in subsection 477(i).
  2. The State has described methods it will use to:
    • ensure that the total amount of educational assistance to a youth under this and any other Federal assistance program does not exceed the total cost of attendance; and
    • avoid duplication of benefits under this and any other Federal assistance program, as defined in section 477(3)(b)(J).

_________________________________________
Signature of Chief Executive Officer

___________________________________________
Date

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State Chief Executive Officer's Assurance Statement for
The Child Abuse and Neglect State Plan

As Chief Executive Officer of the State of __________________________________, I certify that the State has in effect and is enforcing a State law, or has in effect and is operating a Statewide program, relating to child abuse and neglect which includes:

  1. provisions or procedures for reporting known or suspected instances of child abuse and neglect (section 106(b)(2)(A)(i));
  2. policies and procedures (including appropriate referrals to child protection service systems and for other appropriate services) to address the needs of infants born and identified as affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure, including a requirement that health care providers involved in the delivery or care of such infants notify the child protective services system of the occurrence of such condition in such infants (section 106(b)(2)(A)(ii));
  3. the development of a plan of safe care for the infant born and identified as being affected by illegal substance abuse or withdrawal symptoms (section 106(b)(2)(A)(iii));
  4. procedures for the immediate screening, risk and safety assessment, and prompt investigation of such reports (section 106(b)(2)(A)(iv));
  5. triage procedures for the appropriate referral of a child not at risk of imminent harm to a community organization or voluntary preventive service (section 106(b)(2)(A)(v));
  6. procedures for immediate steps to be taken to ensure and protect the safety of the abused or neglected child, and of any other child under the same care who may also be in danger of abuse or neglect; and ensuring their placement in a safe environment (section 106(b)(2)(A)(vi));
  7. provisions for immunity from prosecution under State and local laws and regulations for individuals making good faith reports of suspected or known instances of child abuse or neglect (section 106(b)(2)(A)(vii));
  8. methods to preserve the confidentiality of all records in order to protect the rights of the child and of the child's parents or guardians, including requirements ensuring that reports and records made and maintained pursuant to the purposes of CAPTA shall only be made available to—
    1. individuals who are the subject of the report;
    2. Federal, State, or local government entities, or any agent of such entities, as described in number 9 below;
    3. child abuse citizen review panels;
    4. child fatality review panels;
    5. a grand jury or court, upon a finding that information in the record is necessary for the determination of an issue before the court or grand jury; and
    6. other entities or classes of individuals statutorily authorized by the State to receive such information pursuant to a legitimate State purpose (section 106(b)(2)(A)(viii);
  9. provisions to require a State to disclose confidential information to any Federal, State, or local government entity, or any agent of such entity, that has a need for such information in order to carry out its responsibility under law to protect children from abuse and neglect (section 106(b)(2)(A)(ix));
  10. provisions which allow for public disclosure of the findings or information about the case of child abuse or neglect which has resulted in a child fatality or near fatality (section 106(b)(2)(A)(x));
  11. the cooperation of State law enforcement officials, court of competent jurisdiction, and appropriate State agencies providing human services in the investigation, assessment, prosecution, and treatment of child abuse or neglect (section 106(b)(2)(A)(xi));
  12. provisions requiring, and procedures in place that facilitate the prompt expungement of any records that are accessible to the general public or are used for purposes of employment or other background checks in cases determined to be unsubstantiated or false, except that nothing in this section shall prevent State child protective services agencies from keeping information on unsubstantiated reports in their casework files to assist in future risk and safety assessment (section 106(b)(2)(A)(xii));
  13. provisions and procedures requiring that in every case involving an abused or neglected child which results in a judicial proceeding, a guardian ad litem, who has received training appropriate to the role, and who may be an attorney or a court appointed special advocate who has received training appropriate to that role (or both), shall be appointed to represent the child in such proceedings—
    1. to obtain firsthand, a clear understanding of the situation and needs of the child; and
    2. to make recommendations to the court concerning the best interests of the child (section 106(b)(2)(A)(xiii));
  14. the establishment of citizen review panels in accordance with subsection 106(c) (section 106(b)(2)(A)(xiv));
  15. provisions, procedures, and mechanisms—
    1. for the expedited termination of parental rights in the case of any infant determined to be abandoned under State law; and
    2. by which individuals who disagree with an official finding of abuse or neglect can appeal such finding (section 106(b)(2)(A)(xv));
  16. provisions, procedures, and mechanisms that assure that the State does not require reunification of a surviving child with a parent who has been found by a court of competent jurisdiction—
    1. to have committed a murder (which would have been an offense under section 1111(a) of title 18, United States Code, if the offense had occurred in the special maritime or territorial jurisdiction of the United States) of another child or such parent;
    2. to have committed voluntary manslaughter (which would have been an offense under section 1112(a) of title 18, United States Code, if the offense had occurred in the special maritime or territorial jurisdiction of the Unites States) or another child or such parent;
    3. to have aided or abetted, attempted, conspired, or solicited to commit such murder or voluntary manslaughter; or
    4. to have committed a felony assault that results in the serious bodily injury to the surviving child or another child of such parent (section 106(b)(2)(A)(xvi));
  17. provisions that assure that, upon the implementation by the State of the provisions, procedures, and mechanisms under number 16 above, conviction of any one of the felonies listed in number 16 above constitute grounds under State law for the termination of parental rights of the convicted parent as to the surviving children (section 106(b)(2)(A)(xvii));
  18. provisions and procedures to require that a representative of the child protective services agency shall, at the initial time of contact with the individual subject to a child abuse and neglect investigation, advise the individual of the complaints or allegations made against the individual, in a manner that is consistent with laws protecting the rights of the reporter (section 106(b)(2)(A)(xviii));
  19. provisions addressing the training of representatives of the child protective services system regarding the legal duties of the representatives, which may consist of various methods of informing such representatives of such duties, in order to protect the legal rights and safety of children and families from the initial time of contact during investigation through treatment (section 106(b)(2)(A)(xix));
  20. provisions and procedures for improving the training, retention and supervision of caseworkers (section 106(b)(2)(A)(xx));
  21. provisions and procedures for referral of a child under the age of 3 who is involved in a substantiated case of child abuse or neglect to early intervention services funded under part C of the Individuals with Disabilities Education Act (section 106(b)(2)(A))(xxi));
  22. not later than June 25, 2005 (2 years after the enactment of Public Law 108-36), provisions and procedures for requiring criminal background checks for prospective foster and adoptive parents and other adult relatives and non-relatives residing in the household (section 106(b)(2)(A)(xxii));
  23. procedures for responding to the reporting of medical neglect (including instances of withholding of medically indicated treatment from disabled infants with life-threatening conditions), procedures or programs, or both (within the State child protective services system), to provide for—
    1. coordination and consultation with individuals designated by and within appropriate health care facilities;
    2. prompt notification by individuals designated by and within appropriate health-care facilities of cases of suspected medical neglect (including instances of withholding of medically indicated treatment from disabled infants with life-threatening conditions); and
    3. authority, under State law, for the State child protective services system to pursue any legal remedies, including the authority to initiate legal proceedings in a court of competent jurisdiction, as may be necessary to prevent the withholding of medically indicated treatment from disabled infants with life-threatening conditions (section 106(b)(2)(B)); and
  24. authority under State law to permit the child protective services system of the State to pursue any legal remedies, including the authority to initiate legal proceedings in a court of competent jurisdiction, to provide medical care or treatment for a child when such care or treatment is necessary to prevent or remedy serious harm to the child, or to prevent the withholding of medically indicated treatments from disabled infants with life-threatening conditions (section 113).

Signature of Chief Executive Officer: ______________________________________

Date: ___________________________

Reviewed by:_______________________________________________
       (ACF Regional Representative)

Dated:_____________________________________________________

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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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