< Back to Search

Title IV-E Foster Care Eligibility Reviews Fact Sheet

Published: July 6, 2012
Title IV-E
Title IV-E Reviews Instruments, Tools, and Guides for Title IV-E Reviews

History and Purpose

The 1994 Amendments to the Social Security Act (SSA) authorize the Children's Bureau to review State child and family services programs to ensure compliance with the requirements in titles IV-B and IV-E of the SSA. This includes assessing the title IV-E Foster Care Program, which provides funds to title IV-E Agencies to assist with the costs of foster care maintenance for eligible children; administrative expenses to manage the program; and training for staff, foster parents, and private agency staff. In 2000, the HHS published a final rule in the Federal Register to establish a new approach to monitoring State child welfare programs.

Title IV-E Foster Care Eligibility Reviews

Title IV-E agencies are assessed for substantial compliance against certain Federal requirements of title IV-E regarding the following:

  • Judicial determinations regarding reasonable efforts and contrary to the welfare
  • Voluntary placement agreements
  • Responsibility for placement and care vested with the State agency
  • Placement in a licensed foster family home or child care institution
  • The child's eligibility for Aid to Families With Dependent Children (AFDC) under the State plan that was in effect on July 16, 1996
  • Safety requirements are met by the child's foster care provider

The Foster Care eligibility reviews are conducted by a team of Federal and State child welfare agency representatives. The review team examines a sample of cases for Federal eligibility requirements to determine whether the title IV-E Agency program is in compliance with the eligibility requirements as outlined at section 472 of the Social Security Act and 45 CFR §1356.71 and to validate the basis of the agency's financial claims to ensure that appropriate payments were made on behalf of eligible children.

The Review Process

During the onsite review, the review team examines child case records, including placement and payment histories, court orders, provider licensing and safety documentation, and other relevant case material The review team completes a Title IV-E Foster Care Eligibility Onsite Review Instrument and Instructions for each case in the review sample in which at least one IV-E foster care maintenance payment was made during the 6-month period under review. The review is conducted onsite during a 5-day period, typically in the State capital where the State child welfare central office is located.

States receive a primary review and, when necessary, a secondary review. In the primary reviews, a sample of 80 foster care cases is examined to ensure that children for whom IV-E payments are being made meet the Federal eligibility requirements. If five or more cases in the primary review do not meet the Federal requirements, the State is determined not in substantial compliance. Regardless of the compliance determination, a disallowance in Federal financial participation funds is assessed for all cases that do not meet Federal requirements. States determined in substantial compliance based on the primary review are reviewed at 3-year intervals. States determined not in substantial compliance are required to develop and implement a Program Improvement Plan (PIP) to correct the areas of noncompliance. Following the PIP implementation period, the Children's Bureau conducts a secondary review that assesses a sample of 150 cases. After the secondary review, if the State is not in compliance, an additional disallowance is assessed on the basis of the State's total foster care population for the 6-month review period. Regardless of the compliance determination, a disallowance in Federal financial participation funds is assessed for all cases that do not meet Federal requirements.